Welcome to the Autoimmunity 2021 Congress Calendar

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Displaying One Session

PARALLEL SESSIONS
Session Type
PARALLEL SESSIONS
Session Time
08:00 - 10:00
Session Icon
Pre Recorded

DEVELOPMENT OF IMMUNE SYSTEM AND ALTERNATIVE AUTOIMMUNE RESPONSES IN INFANTS

Session Type
PARALLEL SESSIONS
Date
01.06.2021, Tuesday
Session Time
08:00 - 10:00
Room
HALL F
Lecture Time
08:00 - 08:20
Session Icon
Pre Recorded

JUVENILE IDIOPATHIC ARTHRITIS- A BREAKING BORDER DISEASE

Session Type
PARALLEL SESSIONS
Date
01.06.2021, Tuesday
Session Time
08:00 - 10:00
Room
HALL F
Lecture Time
08:20 - 08:40
Session Icon
Pre Recorded

THERAPEUTIC MANAGEMENT OF JUVENILE IDIOPATHIC ARTHRITIS WITH TOCILIZUMAB IN CENTRAL ASIA: PRELIMINARY DATA FROM A SINGLE TERTIARY CENTER EXPERIENCE IN KAZAKHSTAN.

Session Type
PARALLEL SESSIONS
Date
01.06.2021, Tuesday
Session Time
08:00 - 10:00
Room
HALL F
Lecture Time
08:40 - 08:50
Session Icon
Pre Recorded

Abstract

Background and Aims

In Kazakhstan, tocilizumab(TCZ) therapy was first authorized to treat systemic JIA(sJIA) patients in 2011 and, starting from 2014, it has been registered for poly-articular(pJIA) forms as well. TCZ was the only biologic registered in Kazakhstan for JIA therapy until 2015.

Methods

Data from children with JIA (n=81), who received TCZ in the 2011-2016 period, were retrospectively analyzed.

Results

TCZ was administered to 69 patients with sJIA and 12 patients with pJIA. Before TCZ, 53 patients received NSAIDs, DMARDs and glucocorticoids, whereas 28 patients immediately received it in monotherapy, due to the early onset of systemic manifestations.

In 96% of patients with sJIA, fever stopped after the first infusion and the skin manifestations completely resolved within 12 weeks in 85% of them; importantly, the articular involvement improved in all patients by 6 months. At this time point, TCZ was stopped in 23 patients and, eventually, only 3 of them relapsed and needed TCZ again.

As for pJIA, 11 patients reached the stage of inactive disease at 12 weeks of therapy. The ACRpedi 30/50/70/90 criteria at 6 months were fulfilled by 100%,75%,65% and 50% of these patients, respectively. The main factors of unfavorable prognosis resulted to be the disease duration before TCZ (>3 years) and the early onset of poly-articular involvement.

Seven patients had to stop TCZ for allergic reaction or leukopenia; 4 patients developed hepatitis, but needed only temporary suspension. One patient died, because of MAS.

Conclusions

TCZ has changed the JIA management in Kazakhstan/Central Asia and will improve its prognosis in these developing countries.

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GENETIC ANCESTRY AND ITS CONTRIBUTION TO COMPLEX TRAITS IN CHILDHOOD-ONSET SYSTEMIC LUPUS ERYTHEMATOSUS

Session Type
PARALLEL SESSIONS
Date
01.06.2021, Tuesday
Session Time
08:00 - 10:00
Room
HALL F
Lecture Time
08:50 - 09:00
Session Icon
Pre Recorded

Abstract

Background and Aims

Based on the hypothesis that ancestry influences the susceptibility and development of lupus, this study has evaluated the role of admixture degree in clinical manifestations of childhood-onset systemic lupus erythematosus (cSLE) in a tri-hybrid population.

Methods

The genome-wide human Cytoscan HD array was applied to genotype 2.6K markers in 107 cSLE Brazilian patients and 110 healthy controls. Quality control of the chip was carried out using Chromosome Analysis Suite software. A panel of 345 ancestry informative markers (AIMs) based on SNP data from Cytoscan HD array was used to infer the proportion of European, African and Amerindian ancestries of each cSLE and control subjects. The individual ancestral composition based on the SNP-AIMs set was estimated using Admixture. Statistical analyses to associate the genetic ancestry with different clinical traits were performed using the computing environment R.

Results

Ancestral composition analysis revealed that the main component of patients and control group was European (66.9% and 80.2%), followed by African (21.6% and 11.5%) and Amerindian (11.5% and 8.4%). Comparisons showed differences in European (p = 4.7 x 10-11, 95% CI -0.18− -0.10), African (p = 4.1 x 10-9, 95% CI 0.05 − 0.12) and Amerindian (p = 1.9 x 10-6, 95% CI -0.03 − 0.06) ancestries between cSLE and control groups. A higher proportion of Amerindian ancestry in cSLE was associated to development of photosensitivity (p = 0.035) and hematologic alterations (p = 0.025).

Conclusions

We show novel associations to clinical manifestations in cSLE according to the ancestry profile.

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ARE VACCINATIONS IN CHILDREN TREATED WITH ANTI-CYTOKINE THERAPY SAFE AND IMMUNOGENIC?

Session Type
PARALLEL SESSIONS
Date
01.06.2021, Tuesday
Session Time
08:00 - 10:00
Room
HALL F
Lecture Time
09:00 - 09:10
Session Icon
Pre Recorded

Abstract

Background and Aims

Vaccinations are especially important in children who are immunocompromised due to the disease or due to the therapy they receive. Children with immune mediated diseases are commonly treated with biologics. Infections are the most frequent adverse event in these patients. Before the year 2015, 15 studies on vaccines, including 296 patients treated with biologics, were published.

Methods

Research articles on vaccination in children treated with anti-cytokine therapy published 2015 or latter were searched in Pubmed. Articles were divided in two groups- vaccination with non-live vaccines and vaccination with live attenuated vaccines in children on anti-cytokine therapy. We concentrate on safety and immunogenicity of vaccinations on anti-cytokine therapy.

Results

Altogether we found 12 studies including 286 children treated with anti-cytokine therapy at the time of vaccination. Seven studies included 150 children that received non-live vaccine and 5 included 136 patients received live attenuated vaccine. Except for pneumococcal vaccine in patients with CAPS, vaccination with non-live and live vaccines was safe and immunogenic. Most patients who were vaccinated with live attenuated vaccines received booster dose- 125/136 patients; in 11 who received first dose no vaccinal infection appeared. Vaccination with booster dose of live attenuated vaccine MMR/V was safe in a large cohort of patients treated also with anti-cytokine therapy. Decline in immunogenicity comparing to healthy controls was observed in some studies.

Conclusions

Anti-cytokine therapy does not have impact on the safety of vaccination, however long term immunogenicity could be compromised and booster doses are probably needed.

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ANAKINRA DRUG RETENTION RATE AND PREDICTIVE FACTORS OF LONG-TERM RESPONSE IN SYSTEMIC JUVENILE IDIOPATHIC ARTHRITIS AND ADULT ONSET STILL DISEASE

Session Type
PARALLEL SESSIONS
Date
01.06.2021, Tuesday
Session Time
08:00 - 10:00
Room
HALL F
Lecture Time
09:10 - 09:20
Session Icon
Pre Recorded

Abstract

Background and Aims

Multicenter retrospective study analyzing 61 patients with systemic juvenile idiopathic arthritis (sJIA) and 76 with Adult onset Still disease (AOSD), all treated with anakinra (ANA) in 25 Italian referral centers.

Methods

Examine drug retention rate (DRR) of ANA in sJIA and AOSD as well as the impact of biologic line and concomitant treatments on DRR.

Results

The cumulative DRR of ANA at 12-, 24-, 48-, and 60-month of follow-up was 74.3%, 62.9%, 49.4%, and 49.4%, respectively, without significant differences between sJIA and AOSD patients (p=0.164), and between patients treated in monotherapy compared with the subgroup coadministered with conventional disease-modifying antirheumatic drugs (cDMARDs) (p=0.473). A significant difference in DRR was found between biologic-naïve patients and those previously treated with biotechnologic drugs (p=0.009), which persisted even after adjustment for pathology (p=0.013). In regression analysis, patients experiencing adverse events (AEs) {hazards ratio (HR)=3.029 [confidence interval (CI) 1.750–5.242], p<0.0001} and those previously treated with other biologic agents [HR=1.818 (CI 1.007–3.282), p=0.047] were associated with a higher risk of ANA discontinuation. The median treatment delay was significantly higher among patients discontinuing ANA (p<0.0001). Significant corticosteroid-sparing (p=0.033) and cDMARD-sparing effects (p<0.0001) were also recorded. Less than one-third of our cohort developed AEs, and 85% were deemed mild in nature.

Conclusions

Our findings display an excellent long-term DRR of ANA for both sJIA and AOSD, that may be further optimized by monitoring safety profile and employing ANA as a first-line biologic as early as possible. ANA showed a significant drug-sparing effect and an overall good safety profile.

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SPECIFIC COPING STRATEGIES IN DEPRESSION AND ANXIETY ASSOCIATED WITH JUVENILE SYSTEMIC LUPUS ERYTHEMATOSUS

Session Type
PARALLEL SESSIONS
Date
01.06.2021, Tuesday
Session Time
08:00 - 10:00
Room
HALL F
Lecture Time
09:20 - 09:30
Session Icon
Pre Recorded

Abstract

Background and Aims

Patients with Juvenile-onset Systemic lupus erythematosus (jSLE) have to overcome the burden of un unpredictable and disabling disorder and often deal with anxiety and depression. Coping strategies influence patient’s ability to cope with negative emotions, treatment exigences and physical impairment related with the disease. Our aim was to characterize the specific coping strategies reported by a population of young jSLE patients and to explore the relationship between coping mechanisms and the presence of anxiety and depression.

Methods

Thirty jSLE patients answered the Brief Coping Orientation to Problems Experienced (COPE) questionnaire, the Hospital Anxiety and Depression Questionnaire (HADS) and the Subjective Happiness Scale (SHS). Statistical analyses were performed with SPSS software, version 25.

Results

Clinically relevant anxiety (63.3%) and depressive symptoms (13.3%) (defined as ≥8 in HADS for each subscale) were present in the jSLE patients. Our population showed higher coping scores for problem-focused (0,7±0,2), emotion-focused (0,6±0,2) and social supported coping (0,5±0,2), than avoidant coping (0,3± 0,1). Higher depression scores and lower subjective happiness levels correlated with higher anxiety scores (r=0.673, p=0.000 and r=0.592, p=0.001, respectively). Problem focused coping was associated with higher self-reported happiness (r=0.564, p=0.002) and avoidant coping was positively correlated with higher number of anxious symptoms (r=0.560, p=0.002).

Conclusions

Adaptive coping strategies led to greater happiness, while avoidant coping strategies were associated with higher anxiety. Teaching of adaptive coping mechanisms, in combination with psychoeducational and supportive interventions are likely to enhance the patients’ ability to respond to the multiple physical, social and emotional challenges imposed by this autoimmune disorder.

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