Arthritis Research Canada at

ACR Convergence 2021

Research Spotlight



Riding multiple waves of uncertainty: Real world Canadian rheumatoid arthritis patient outcomes over 1 year of COVID-19 restrictions


During the COVID-19 pandemic, Canadians with rheumatoid arthritis (RA) faced considerable uncertainty due to greater risk of infection, hospitalization, changing access to RA medications, and very limited access to in-person RA care due to pandemic-related restrictions. We examined trends in perceived stress, physical, emotional, and social health, self-assessed disease activity and RA flares prior to and during the first two waves of the COVID-19 pandemic (April – June 2020 and Oct – Jan 2021) in adults with RA. As compared to 6 months pre-pandemic, the first two waves of COVID were associated with increased stress, worsening physical, emotional, and social health, higher disease activity and more frequent flares. More than 1 in 3 experienced moderate-severe pain and disability; 1 in 4 had moderate-severe anxiety, depression and fatigue; and 1 in 5 had moderate-severe sleep disturbance and reduced participation.


Research Team: Schieir O, Bartlett S, Valois MF, Bessette L, Boire G, Hazlewood G, Hitchon C, Keystone E, Pope J, Tin D, Thorne C, Bykerk V; CATCH Investigators



To learn more about Arthritis Research Canada research presented at American College of Rheumatology (ACR) Convergence 2021, please scroll down. We have research on COVID-19 and arthritis, rheumatoid arthritis, osteoarthritis, lupus, and much more.

“From where I stand”: Using multiple anchors yields different benchmarks for meaningful improvement and worsening in the rheumatoid arthritis flare Questionnaire (RA-FQ)

The RA-Flare Questionnaire is a patient-reported measure designed to capture increases in disease activity, i.e. flares, in rheumatoid arthritis (RA). Among 808 Canadian adults with RA, we found that it was highly responsive to changes when evaluated in relation to other widely used measures of RA disease activity. Our results add to growing evidence about the usefulness of this new measure and offer initial guidance about the amount of change needed to show meaningful improvement or worsening of RA.

Research Team: Bartlett S, Bykerk V, Schieir O, Valois MF, Bessette L, Boire G, Hazlewood G, Hitchon C, Keystone E, Pope J, Tin D, Thorne C, Bingham C; CATCH Investigators



Identifying clusters of longitudinal autoantibody profiles associated with systemic lupus erythematosus disease outcomes

Using artificial intelligence, we found that long-term blood marker results could be used to identify subgroups of lupus patients with different disease outcomes.

Research Team: Choi M, Chen I, Clarke A, Fritzler M, Buhler K, Urowitz M, Hanly J, Gordon C, St.Pierre Y, Bae SC, Romero-Diaz J, Sanchez-Guerrero F, Bernatsky S, Wallace D, Isenberg D, Rahman A, Merrill J, Fortin PR, Gladman D, Bruce I, Petri M, Ginzler E, Dooley MA, Ramsey-Goldman R, Manzi S, Jansen A, Alarcn G, van Vollenhoven R, Aranow C, Mackay M, Ruiz-Irastorza G, Lim SS, Inanc M, Kalunian K, Jacobsen S, Peschken C, Kamen D, Askanase A, Sontag D, Costenbader K



Impact of antimalarial adherence on cardiovascular mortality among patients with newly diagnosed rheumatoid arthritis and systemic lupus erythematosus: A population-based study

This population-based study aimed to examine the association between adherence to hydroxychloroquine and risk of cardiovascular events (heart attacks, strokes and venous clots) and of mortality among newly diagnosed lupus and rheumatoid arthritis (RA) patients. Using a novel statistical method, we found that when lupus and RA patients took at least 90% of their prescribed doses of hydroxychloroquine, they had a reduction in risk of cardiovascular events by more than half (53%) and in mortality by about one third (30%), compared to when they took less than 90% of the doses.

Research Team: Hoque R, Avina-Zubieta JA, Lacaille D, De Vera MA, Qian Y, Esdaile JM, Xie H



Effectiveness of the Making It Work™ program at improving absenteeism in workers with inflammatory arthritis – Results of a randomized controlled trial

A Canadian randomized controlled trial evaluating the effectiveness of the Making-it-WorkTM program over 2 years found that, in addition to improving productivity while at work, the program was effective at reducing sick days and preventing work interruptions in workers with inflammatory arthritis. The program, designed to help workers with arthritis deal with employment issues, consists of 5 online modules, online group meetings, an ergonomic assessment and vocational counselling.

Research Team: Luquini A, Zheng Y, Xie H, Backman C, Rogers P, Kwok A, Knight A, Gignac M, Mosher D, Li L, Esdaile J, Thorne C, Lacaille D



Has the incidence of total joint arthroplasty in rheumatoid arthritis decreased in the era of biologics use? A population-based incident cohort study 1995–2015

Our study followed for 10 years all newly diagnosed rheumatoid arthritis (RA) and osteoarthritis (OA) patients in British Columbia to compare the patterns of total joint replacement surgery in people diagnosed from 1995 to 2015. We found a 26.9% and 12.6% reduction in total hip and knee replacements for RA patients diagnosed five years after the introduction of biologics, in stark contrast with 11.7% and 16.6% increases in those procedures in OA over the same time period. This suggests that contemporary treatment of RA has been effective at reducing the need for joint replacement surgery.

Research Team: Zhou V, Lacaille D, Lu N, Kopec J, Garbuz D, Qian Y, Avina-Zubieta JA, Esdaile J, Xie H



COVID-19 vaccine hesitancy among patients with rheumatic and other diseases

Prior to vaccine roll-out, Covid-19 vaccine hesitancy among rheumatic disease patients was higher than among other immunosuppressed patients and the general population. Factors associated with vaccine hesitancy are not unique to rheumatic diseases. Education about the benefits and safety of COVID-19 vaccines might enhance vaccine uptake among patients with a rheumatic disease.

Research Team: Valerio V, Rampakakis E, Hudson M, Bernatsky S, Hazel EM, Colmegna I



Many better, many worse: Mean PROMIS-29 scores mask significant shifts during COVID-19 in rheumatoid arthritis

The COVID pandemic has been particularly challenging for people with rheumatic diseases. We evaluated changes in health-related quality of life in the initial months of the COVID-19 pandemic in adults in Baltimore, USA with rheumatic diseases. While the average quality of life scores evaluated at the group level did not change much, a substantial proportion of people experienced worse (30%) or improved (27%) anxiety. Similar patterns of change were seen in disease activity and other aspects of quality of life.

Research Team: Bartlett S, DiRenzo D, Jones M, Bingham C



Identification of mitochondrial antigens targeted by autoantibodies in systemic lupus erythematosus (SLE)

The aim of this study was to identify new auto-antibodies in patients with lupus. The target of two new antibodies were identified.

Research Team: Becker Y, Gagné JF, Julien AS, Lévesque T, Gougeard N, Rubio V, Boisvert FM, Jean D, Poirier G, Fortin PR, Boilard E



Sex-stratified patterns of multimorbidity at rheumatoid arthritis onset and associated longitudinal impacts on disability over the first year follow up: Results from the Canadian Early Arthritis Cohort (CATCH)

We looked at the other chronic diseases that people with rheumatoid arthritis have at the time of diagnosis and estimated their effect on disability over the first year of living with rheumatoid arthritis (RA) in 2576 Canadian women and men. Hypertension, lung disease and depression were the most common conditions in women, while hypertension and cardiovascular diseases were the most common in men. Depression, lung disease and hypertension were associated with higher disability over time in both men and women, highlighting the importance of identifying and treating those conditions.

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



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