Arthritis Research Canada – Research Spotlights

from American College of Rheumatology’s ACR Convergence 2020

Day 2 – Friday, November 6 | 9 to 11 AM ET.

Arthritis Research Canada, Research Scientists: Dr. Hazlewood (Calgary), Dr. Bartlett (McGill) research poster presented.

Title: Canadian Early Arthritis Cohort (CATCH) Investigators. Regional and Widespread Patterns of Non-articular Pain Are Common at RA Diagnosis and Contribute to Poor Outcomes at 12 Months: A Prospective Study of Pain Patterns in Canadians with RA.

In the Canadian Early Arthritis Cohort (CATCH), we looked at how common co-existing non-articular pain (i.e., not related to disease activity) was in the first year of RA. We found that 55% of CATCH participants reported non-articular pain around diagnosis and 33% continued to report non-articular pain at 1 year. Non-articular pain was also associated with lower odds of achieving remission by 12 months, suggesting that this type of pain should also be evaluated in RA patients and when present may indicate the need for different treatment approaches.

Research Team: Bykerk V, Schieir O, Valois MF, Bessette L, Boire G, Hazlewood G, Hitchon C, Keystone E, Tin D, Thorne C, Pope J, Bartlett S and Canadian Early Arthritis Cohort (CATCH)

Arthritis Research Canada. Research Trainee, Viviane Ta (McGill). Research Scientist: Dr. S. Bartlett (McGill) research poster #0151 presented.

Title: More Than Half of Newly Diagnosed RA Patients Are Not Convinced of the Necessity of RA Medicines: Associations with RA Characteristics, Symptoms, and Function in the Canadian Early Arthritis Cohort (CATCH).

We found that more than half of patients with early rheumatoid arthritis (RA) were Indifferent about their RA medications i.e. not convinced of their necessity and not concerned about taking them; and one third were Accepting of their RA medications meaning that they believed their RA medications were necessary and had low concerns about taking them. Our work suggests that it is important to talk with newly diagnosed patients about their medication beliefs and concerns.

Research Team: Ta V, Schieir O, Valois MF, Tin D, Hitchon C, Bessette L, Thorne C, Pope J, Boire G, Keystone E, Bykerk V, Bartlett S, and Canadian Early Arthritis Cohort (CATCH) Investigators.

Arthritis Research Canada, Research Scientists: Dr. I. Colmegna (McGill), Dr. D. Lacaille (UBC). Poster Presentation.

Title: Safety of Low Dose Methotrexate (MTX) and Tuberculosis (TB).

This study looked at the safety of using methotrexate, the most commonly used medication for treating rheumatic diseases, in areas of the world where tuberculosis is common, and emphasized the importance of screening for tuberculosis, and prescribing medications to prevent reactivation of tuberculosis if needed, when methotrexate is prescribed in these areas.

Research Team: Davidson A, Gunay A, Colmegna I, Lacaille D, Loewen H, Meltzer M, Tadese Y, Yirsaw Z, Bernatsky S, Hitchon C.

Arthritis Research Canada, Research Scientists: Dr. M. Choi (Calgary), Dr. P. Fortin (Laval), Dr. A. Clarke (Calgary). Poster Presentation.

Title: Dynamics of Anti-Nuclear Antibodies in a Longitudinal Study of a Large Systemic Lupus Erythematosus Cohort

In this international study of 759 patients with lupus, patients who had at least one negative ANA result (a screening blood test for lupus) over the first five years of disease had lower disease activity or were less likely to be on steroids or immune suppressing medications compared to patients who had repeatedly positive ANA tests.

Research Team: Choi M, Fritzler M, Costenbader K, Urowitz M, Hanly J, Gordon C, St. Pierre Y, Bae SC, Romero-Díaz J, Sanchez-Guerrero FJ, Bernatsky S, Wallace D, Isenberg D, Rahman A, Merrill J, Fortin P, Gladman D, Bruce I, Petri M, Ginzler EM, Dooley MA, Ramsey-Goldman R, Manzi S, Jönsen A, Alarcón G, Van Vollenhoven RF, Aranow C, Mackay M, Ruiz-Irastorza G, Lim SS, Inanc M, Kalunian K, Jacobsen S, Peschken C, Kamen D, Askanase A, Clarke A.

Arthritis Research Canada. Research Trainee: Viviane Ta (McGill). Research Scientists: Dr. G. Hazlewood (Calgary), Dr. S. Bartlett (McGill). Poster Presentation.

Title: How Stable Are Medication Necessity Beliefs and Safety Concerns in the First Year of RA?

We found that patients with early rheumatoid arthritis had stable beliefs about the necessity and safety concerns of their RA medications over the course of their first year. Two main findings were: 1) Minority status was associated with lower beliefs at diagnosis in the necessity for medications and greater change in concerns at 1 year; and 2) Methotrexate use was associated with higher necessity beliefs at diagnosis and greater change in concerns at 1 year.

Research Team: Ta V, Schieir O, Valois MF, Bessette L, Boire G, Hazlewood G, Hitchon C, Keystone E, Pope J, Thorne C, Tin D, Andersen N, Bykerk V, Bartlett S, and Canadian Early Arthritis Cohort (CATCH) Investigators.

Arthritis Research Canada, Research Scientist: Dr. M. Abrahamowicz (McGill). Poster Presentation.

Title: Hydroxychloroquine and Chloroquine and Hospitalizations for Viral Infection in the Pre-COVID-19 Era.

While we saw no clear effect of HCQ/CQ, comorbidity, ER presentation, older age, and MMF, azathioprine, and corticosteroids were all significantly associated with hospitalized viral infection in RA and SLE.

Research Team: Moura C, Machado M, Almeida-Brasil C, Curtis JR, Winthrop K, Abrahamowicz M, Bernatsky S.

Day 2 – Friday, November 6 | 11:30 to 1 PM ET.

Plenary Session

Arthritis Research Canada: N. Leo Lu, Research Scientist:  Dr. HK. Choi (UBC, Harvard), Plenary presented.

Title: Outcomes of Coronavirus Disease 2019 Infection Among Patients Living with Rheumatic Diseases: A Matched Cohort Study from a US Multi-Center Research Network

This study compared the outcomes of COVID19 infection in patients with and without auto-immune rheumatic diseases using electronic health record data from >52 million patients across 35 healthcare organizations in the US. The study showed that people with rheumatic diseases had more pre-existing diseases involving the lung, heart, and kidneys, which are known to be risk factors for more severe COVID19 infections, and they were at higher risk of serious outcomes from  COVID19 infection, than people without rheumatic diseases of similar age, sex and race/ethnicity. Specifically, they were found to have a 23% higher risk of needing admission to hospital, a 75% higher risk of admission to an intensive care unit, a 77% higher risk of needing help from a machine to breathe, and a higher risk of complications to the kidneys (83%) or heart (3 fold), than people without auto-immune rheumatic diseases.

Research Team: D’Silva K, Jorge A, Lu N, Zhang Y, Wallace Z, Choi HK

Day 2 – Friday, November 6 | 3 to 3:50 PM ET.

Arthritis Research Canada, Research Scientists:  Dr. G. Hazlewood (Calgary), Dr. S. Bartlett (McGill)

Title: Can a Clinical Disease Activity Index Based on Patient-Reported Joint Counts (PT-CDAI) Be Used to Inform Target-Based Care in Telemedicine? An Analysis of 2 Early RA Cohort Studies.

As many people with RA now have telemedicine visits due to COVID-19, we evaluated the agreement between patient and physician reports of swollen and tender joints (data collected at previous in-person visits) as an indicator of how well patients and their doctors agree about RA disease activity levels. We found that there was reasonably good agreement between patients and physicians on total swollen and tender joints when disease activity was low, but discrepancies emerged as RA worsened. There was no consistent pattern as to when physician vs. patient joint counts were higher.

Research Team: Benson C, Valois MF, Schieir O, Vitone G, Tirpack A, Jones M, Bessette L, Boire G, Hazlewood G, Hitchon C, Keystone EC, Pope J, Thorne C, Bartlett S, Bingham III C, Bykerk V and Canadian Early Arthritis Cohort (CATCH) Investigators.