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Abstract Number: 83

Feverprints: A Crowdsourcing Study of Temperature in Health and Disease

Jonathan S. Hausmann1,2, Nitin Gujral3, Soleh Al Ayubi3, Jared B. Hawkins3, John S. Brownstein3 and Fatma Dedeoglu2, 1Rheumatology, Beth Israel Deaconess Medical Center, Boston, MA, 2Rheumatology, Boston Children's Hospital, Boston, MA, 3Innovation & Digital Health Accelerator, Boston Children's Hospital, Boston, MA

Meeting: 2017 Pediatric Rheumatology Symposium

Keywords: Fever, patient engagement, patient-reported outcome measures and technology

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Session Information

Date: Thursday, May 18, 2017

Title: Clinical and Therapeutic Poster Session

Session Type: Abstract Submissions

Session Time: 5:30PM-7:00PM

Background/Purpose:

Autoinflammatory diseases (AIDs) are a rare group of illnesses characterized by unprovoked episodes of fever and systemic inflammation.  An understanding of their pathophysiology has led to the development of effective treatment guidelines. Unfortunately, many patients with recurrent fevers have symptoms that do not match any of the known AIDs. There is an unmet need to provide effective treatment to these patients with undefined AIDs (uAIDs). Colchicine, a treatment for patients with familial Mediterranean fever, is sometimes used to treat patients with uAIDs. We examined the efficacy of colchicine in patients with uAIDs and identified clinical factors that predicted a good colchicine response.

Methods:

We conducted a retrospective chart review of patients with a clinical diagnosis of uAIDs who tolerated colchicine from a large pediatric rheumatology clinic in Boston. Good colchicine response was defined as a decrease in the frequency, severity, and length of febrile episodes without requiring additional medications. Partial response was defined as decreasing the frequency, severity, or length of episodes; additional medicines may have been required.

Results:

184 patients with uAIDs were identified and 68 had used colchicine. Of these, 33 (48.5%) were good colchicine responders, 30 (44.1%) were partial responders, and five patients (7.4%) did not respond. Patient and disease characteristics are shown in Table 1. Ethnicity of colchicine responders is shown in Figure 1; ethnicity of partial and non-responders is shown in Figure 2.

Conclusion:

Colchicine was effective treatment for most patients with uAIDs, with 48% and 44% of patients having a good or partial response, respectively. Patients were more likely to have a good colchicine response if they had vomiting during flares; abdominal pain approached statistical significance. The presence of aphthous stomatitis predicted a partial response.  Mutations in genes associated with AIDs, a family history of recurrent fevers, and age of disease onset did not predict colchicine response.

Good colchicine responders, N=33 (n,%)

Partial and non-responders n=35 (n,%)

p-value

Patient characteristics

Female

17 (52)

20 (57)

0.8078

Age at disease onset (in months)

50.0

49.9

0.9908

Family history of recurrent fevers

2 (6.1)

7 (20)

0.1510

Mean duration of follow-up while on colchicine (in months)

37.8

32.4

0.4782

Mean colchicine dose (in mg)

0.58

0.61

0.7184

Periodic fever syndrome panel test sent

24 (73)

29 (83)

0.3866

Patients with heterozygous MEFV mutations

8 (24)

9 (26)

1.000

Periodic fever syndrome panel negative

11/24 (46)

16/29 (55)

0.5857

Clinical characteristics of febrile episodes

Aphthous stomatitis

6 (18)

18 (51)

0.0054

Fatigue

5 (15)

8 (23)

0.5415

Myalgia

6 (18)

8 (23)

0.7669

Headache

12 (36)

12 (34)

1.000

Lymphadenopathy

5 (15)

8 (23)

0.5415

Pharyngitis

2 (6)

2 (6)

1.000

Chest pain

2 (6)

2 (6)

1.000

Abdominal pain

21 (64)

14 (40)

0.0580

Vomiting

14 (42)

5 (14)

0.0145

Diarrhea

7 (21)

3 (9)

0.1809

Arthralgia

16 (48)

10 (29)

0.1341

Rash

6 (18)

8 (23)

0.7669

Table 1. Patient and disease characteristics.

Figure 1. Word cloud of ethnicity for good colchicine responders.

Figure 2. Word cloud of ethnicity for partial and non-responders.


Disclosure: J. S. Hausmann, None; N. Gujral, None; S. Al Ayubi, None; J. B. Hawkins, None; J. S. Brownstein, None; F. Dedeoglu, None.

To cite this abstract in AMA style:

Hausmann JS, Gujral N, Al Ayubi S, Hawkins JB, Brownstein JS, Dedeoglu F. Feverprints: A Crowdsourcing Study of Temperature in Health and Disease [abstract]. Arthritis Rheumatol. 2017; 69 (suppl 4). https://acrabstracts.org/abstract/feverprints-a-crowdsourcing-study-of-temperature-in-health-and-disease/. Accessed .
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