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P037 The NIHR IMID Bioresource: a descriptive analysis of the first 5000 participants
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Abstract
Background/Aims
The NIHR Immune-mediated inflammatory diseases (IMID)-Bioresource is a recallable resource of patients with an IMID, pre-disease states and unaffected first-degree relatives. Here, we report on the recruited cohort to date, focusing on co-existent comorbidities.
Methods
Patients are categorised into one of three primary IMID groups: rheumatoid arthritis (RA), axial-spondyloarthropathy-psoriasis spectrum (AxSpA-PsO: AxSpA, PsO, psoriatic arthritis [PsA], reactive arthritis) and systemic autoimmune rheumatic diseases (SARDs: systemic lupus erythematosus [SLE], mixed and undifferentiated connective tissue disease). Data were collected on clinical phenotype, secondary IMIDs, medications and key co-morbidities.
Results
5028 participants (4965 IMIDs, 46 pre-disease, 17 relatives) have been enrolled to the IMID-Bioresource Sept-2020-Aug-2022 from 63 UK-centres. Of those with a diagnosed IMID, RA (N = 2472) was the largest group, then AxSpA-PsO (N = 2012) and SARDs (n = 479). Two-thirds (N = 3210, 64.7%) female, median (IQR) age 57.9 (47.3-67.6) years. 1544 (62.5%) patients with primary IMID RA were seropositive. The commonest AxSpA-PsO diseases included PsO (N = 1232, 24.8%), PsA (N = 1116, 22.5%) and AxSpA (N = 467, 9.4%). SLE was the commonest SARD (N = 376, 7.6%), a third (N = 133, 35.4%) reported previous lupus nephritis. 1241 (25.0%) patients reported >1 IMID diagnoses. The commonest overlaps were PsO and RA (N = 108, 2.2%), PsO and AxSpA (N = 72, 1.5%) and RA and Sjögren’s syndrome (N = 65, 1.3%). 2880 (58.0%) reported minimum one (range 1-11) co-morbidity, the commonest, hypertension (N = 1201, 24.2%), depression (N = 820, 16.5%) and asthma (N = 580, 11.7%). 274 (5.5%) patients reported ischaemic heart disease, commonest in RA (N = 152, 6.2%). Interstitial lung disease was reported by 75 (1.5%) patients, again most frequent in RA (N = 48, 1.9%). Overall, 696 (14.0%) IMID patients had ≥3 co-morbidities. Oral steroid use was highest in SARD (N = 166, 34.7%). The commonest DMARD in all groups was methotrexate, followed by sulfasalazine in RA (N = 379, 15.3%) and AxSpA-PsO (N = 189, 9.4%) and mycophenolate mofetil in SARDs (N = 69, 14.4%). Overall, 2079 (41.9%) IMID patients were receiving a biological DMARD.
Conclusion
A high proportion of IMID patients have more than one IMID diagnoses. Significant multi-morbidity with cardiovascular, respiratory and mood disorders was observed and considerable ongoing glucocorticoid usage. The IMID-Bioresource aims to refine patient subsets based on shared immune mechanisms to ultimately, improve precision medicine and patient outcomes.
Disclosure
S. Dyball: Grants/research support; MRC. Other; GSK, UCB. E. Vital: None. S. Plein: None. D. McGonagle: None. A.G. Pratt: None. J. Isaacs: None. B. Griffiths: None. W. Ng: None. J. McBeth: None. C.E.M. Griffiths: None. B. Parker: Honoraria; Fresenius-Kabi, AbbVie. Grants/research support; GSK, Genzyme/Sanofi. Other; Eli Lilly, Roche. M.H. Buch: None. I. Bruce: Consultancies; ILTOO, AstraZeneca, Eli Lilly, GSK, Merck Serono, UCB. Grants/research support; Genzyme/Sanofi, GSK, UCB, Roche. Other; AstraZeneca, GSK, UCB.
Title: P037 The NIHR IMID Bioresource: a descriptive analysis of the first 5000 participants
Description:
Abstract
Background/Aims
The NIHR Immune-mediated inflammatory diseases (IMID)-Bioresource is a recallable resource of patients with an IMID, pre-disease states and unaffected first-degree relatives.
Here, we report on the recruited cohort to date, focusing on co-existent comorbidities.
Methods
Patients are categorised into one of three primary IMID groups: rheumatoid arthritis (RA), axial-spondyloarthropathy-psoriasis spectrum (AxSpA-PsO: AxSpA, PsO, psoriatic arthritis [PsA], reactive arthritis) and systemic autoimmune rheumatic diseases (SARDs: systemic lupus erythematosus [SLE], mixed and undifferentiated connective tissue disease).
Data were collected on clinical phenotype, secondary IMIDs, medications and key co-morbidities.
Results
5028 participants (4965 IMIDs, 46 pre-disease, 17 relatives) have been enrolled to the IMID-Bioresource Sept-2020-Aug-2022 from 63 UK-centres.
Of those with a diagnosed IMID, RA (N = 2472) was the largest group, then AxSpA-PsO (N = 2012) and SARDs (n = 479).
Two-thirds (N = 3210, 64.
7%) female, median (IQR) age 57.
9 (47.
3-67.
6) years.
1544 (62.
5%) patients with primary IMID RA were seropositive.
The commonest AxSpA-PsO diseases included PsO (N = 1232, 24.
8%), PsA (N = 1116, 22.
5%) and AxSpA (N = 467, 9.
4%).
SLE was the commonest SARD (N = 376, 7.
6%), a third (N = 133, 35.
4%) reported previous lupus nephritis.
1241 (25.
0%) patients reported >1 IMID diagnoses.
The commonest overlaps were PsO and RA (N = 108, 2.
2%), PsO and AxSpA (N = 72, 1.
5%) and RA and Sjögren’s syndrome (N = 65, 1.
3%).
2880 (58.
0%) reported minimum one (range 1-11) co-morbidity, the commonest, hypertension (N = 1201, 24.
2%), depression (N = 820, 16.
5%) and asthma (N = 580, 11.
7%).
274 (5.
5%) patients reported ischaemic heart disease, commonest in RA (N = 152, 6.
2%).
Interstitial lung disease was reported by 75 (1.
5%) patients, again most frequent in RA (N = 48, 1.
9%).
Overall, 696 (14.
0%) IMID patients had ≥3 co-morbidities.
Oral steroid use was highest in SARD (N = 166, 34.
7%).
The commonest DMARD in all groups was methotrexate, followed by sulfasalazine in RA (N = 379, 15.
3%) and AxSpA-PsO (N = 189, 9.
4%) and mycophenolate mofetil in SARDs (N = 69, 14.
4%).
Overall, 2079 (41.
9%) IMID patients were receiving a biological DMARD.
Conclusion
A high proportion of IMID patients have more than one IMID diagnoses.
Significant multi-morbidity with cardiovascular, respiratory and mood disorders was observed and considerable ongoing glucocorticoid usage.
The IMID-Bioresource aims to refine patient subsets based on shared immune mechanisms to ultimately, improve precision medicine and patient outcomes.
Disclosure
S.
Dyball: Grants/research support; MRC.
Other; GSK, UCB.
E.
Vital: None.
S.
Plein: None.
D.
McGonagle: None.
A.
G.
Pratt: None.
J.
Isaacs: None.
B.
Griffiths: None.
W.
Ng: None.
J.
McBeth: None.
C.
E.
M.
Griffiths: None.
B.
Parker: Honoraria; Fresenius-Kabi, AbbVie.
Grants/research support; GSK, Genzyme/Sanofi.
Other; Eli Lilly, Roche.
M.
H.
Buch: None.
I.
Bruce: Consultancies; ILTOO, AstraZeneca, Eli Lilly, GSK, Merck Serono, UCB.
Grants/research support; Genzyme/Sanofi, GSK, UCB, Roche.
Other; AstraZeneca, GSK, UCB.
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