Arthritis Research Canada at
ACR Convergence 2023
November 12
Personalizing Cardiovascular Risk Prediction for Patients with Systemic Lupus Erythematosus
Scientists at Arthritis Research Canada and Harvard created a new way to predict the risk of heart disease in people with Systemic Lupus Erythematosus (SLE). They developed a specialized tool called SLECRISK, which considers both standard heart disease risk factors and SLE-specific factors. They found that their new tool was better than traditional methods at identifying people with moderate to high risk of heart problems in SLE patients. This new tool could be a valuable addition to SLE management guidelines, helping doctors make informed decisions to prevent heart disease in people with SLE.
Research Team: Choi M, Guan H, Yoshida K, Kargere B, Ellrodt J, Stevens E, Cai T, Everett B, Weber B, Costenbader K.
Putting Lived Experience into Action: Flipping the Script on Living with a Chronic Disease
Two patients with JIA share their diagnosis stories and seeking out communities of support for youth living with the challenges of chronic autoimmune disease. Recognizing a gap in the chronic illness community led to the creation of Take a Pain Check (TAPC), a non-profit organization which supports, empowers, and provides an inclusive online space where youth with rheumatic diseases feel understood. TAPC runs ambassador programs, chronic illness-related events and hosts podcasts, and monthly hangouts.
Patient Authors: Trehan N, Abrahams N
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Effectiveness of a Technology-enabled Self-monitoring and Physical Therapist Counselling Program for Improving Self-management Ability in People with Rheumatoid Arthritis: A Randomized Controlled Trial
Are apps and wearables useful for people with arthritis? This study created and tested a new app in 132 people with rheumatoid arthritis enrolled during the COVID-19 pandemic. Half were given a Fitbit and an app allowing people to self-monitoring their symptoms, to use in remote counselling sessions with a physical therapist (Immediate Group), and the other half waited 6 months before receiving the same (Delayed Group). When people received the intervention, it significantly improved their ability to engage in self-care activities over 6 months. Improvement was also seen in their rheumatoid arthritis disease activity, fatigue, depression, and walking habits.
Research Team: Li LC, Xie H, Feehan LM, Lu N, Hoens AM, English K, Davidson E, Backman CL, Ramachandran S, Wang E, Therrien S, Mucha J, Liu-Ambrose T, Shaw C, Miller K, Lacaille D.
Risk of Incident Gout Associated with Initiation of Sodium-glucose cotransporter-2 Inhibitors versus Other Second-line Agents Among Metformin Users with Type 2 Diabetes
Many people have both type 2 diabetes and gout. We used data from the BC Ministry of Health to compare people with type 2 diabetes without gout as they started different glucose-lowering medications and found one, sodium-glucose cotransporter-2 inhibitors, was associated with a lower risk of developing gout in the future.
Research Team: McCormick N, Yokose C, Lu N, Choi HK.
Comparative Effectiveness of Sodium-glucose cotransporter-2 Inhibitors for Recurrent Gout Flares and Gout-primary Emergency Department Visits and Hospitalizations: A General Population Cohort Study.
Using data from the BC Ministry of Health, we compared 8150 adults with gout and type 2 diabetes who were starting two different glucose-lowering medications and found one, sodium-glucose cotransporter-2 inhibitors, was associated with lower rates of gout flares and gout-related hospitalisations and emergency department visits, as well as lower risk of heart attack. This may become a dual-purpose therapy for people with gout and diabetes.
Research Team: McCormick N, Yokose C, Wei J, Lu N, Wexler D, De Vera MA, Aviña-Zubieta JA, Zhang Y, Choi HK.
You Can’t Get This From a Doctor – The Role of a Support group for Young Adults with Rheumatic Diseases
Peer support groups for people with arthritis to meet each other in person are an effective approach to combatting anxiety and loneliness. I created an in-person support group “The Arthritis Social Hour” designed for people between the ages of 25-55 with any form of arthritis. The aim of this group was to provide a safe space for patients to express their concerns, share their journey, and learn from each other and from qualified professionals in a fun, and engaging environment.
Patient Author: Davidson E.
When Should I Get My Next Booster? Active Surveillance of COVID-19 Breakthrough Infections in Canadian Patients with Immune-Mediated Inflammatory Diseases
This study of Canadian immune-mediated inflammatory disease patients found that 5% experienced COVID-19 infections after vaccination, similar to rates in the general population. Those who tested positive had a longer time elapsed since vaccination, with most infections occurring 7-8 months after the last dose.
Research Team: Tan J, Avina-Zubieta JA, Lee JLF, Fortin PR, Colmegna I, Gonzalez Arreola L, Berger C, Larch M, Hitchon C, Richards D, Bernatsky S.
What Are the Characteristics of a Cost-Effective Psoriatic Arthritis Biomarker Test? An Early Health Technology Assessment
There is considerable investment in developing biomarkers that would detect which patients with psoriasis will go on to develop psoriatic arthritis – so that we can treat them early and prevent joint damage. This study determined how good these biomarkers need to be, and what is the maximum price they could be, for them to be successful in the market. This study offers guidance to developers of biomarkers so they make cost-effective products.
Research Team: Bansback N, Tam A, Gladman D, Kulasingam V, Spackman E, Chandran V.
A Population-Based Study of Vasculitis Among Farmers and Urban Residents in Alberta
This study explored the epidemiology of vasculitis in farmers compared to other populations in Alberta, focusing on the impact of environmental factors and geographic location. This study found that the farm population in Alberta experienced a higher burden of vasculitis, as indicated by higher diagnosis rates and more hospital admissions compared to other populations.
Research Team: Yacyshyn E, Gulati S, Hung W, Voaklander D, Jones A.
A Mix-and-match COVID-19 Vaccination Strategy in Patients with Rheumatic Diseases on Rituximab
Patients with rheumatic diseases on rituximab have reduced response to COVID-19 vaccine. A new vaccine which is different from the Moderna or Pfizer vaccine was tested in patients on rituximab who had already received >3 Moderna or Pfizer vaccine doses. Results indicate that this new vaccine does not enhance vaccine response in these patients.
Research Team: Amiable N, Benlarbi M, Dube M, Theriault S, Godbout A, Julien AS, Ortega-Delgado GG, Duchesne M, Cloutier R, JPerreault J, Gravel A, Fournier L, Alfonso G, Bourre-Tessier J, Hudson M, Richard N, Makhzoum JP, Mendel A, Bernatsky S, Dionne M, Libman M, De Serres G, Dieudé M, Flamand L, Kaufmann D, Finzi A, Bazin R, Colmegna I, Fortin PR.
Predictors of Mortality in Antiphospholipid Antibody Positive Patients: Prospective Results from Antiphospholipid Syndrome Alliance for Clinical Trials and International Networking (APS ACTION) Clinical Database and Repository “Registry”
This study looked at mortality in people with a specific inflammatory disease (i.e., patients who have an antiphospholipid antibody, which predisposes to clotting). The study found that the mortality level was 5% after a follow-up of five years and that people who were older (age > 60), had a prior history of clots in their arteries, of heart disease or of other auto-immune diseases, were at higher risk of future mortality.
Research Team: Ahmadzadeh Y, Magder L Ozdemir Z, Andrade D, Barber MRW, Tektonidou M, Sciascia S, Pengo V, Anunciación-Llunell A, Ruiz-Irastorza G, Aguirre MA, Belmont M, Nina K Fortin PR, Wahl D, Gerosa M, De Jesús G, Zhang Z, Atsuma T, Efthymiou M, Ware Branch D, Tincani A, Rodriguez Almaraz E, Pazzola G, Cervera R, Esen BA, Shi H, Knight J, Pons-Estel G, Willis R, Duarte-Garcia A, Bertolaccini ML, Cohen H, Petri M, Erkan D, and On Behalf Of APS ACTION
Transient Ischemic Attack in Antiphospholipid Antibody-positive Patients: Retrospective and Prospective Results from the AntiPhospholipid Syndrome Alliance for Clinical Trials and InternatiOnal Networking (APS ACTION) Clinical Database and Repository (“Registry”).
The APS ACTION Registry studies disease progression in people with certain antibodies, called antiphospholipid antibodies (aPL). These antibodies predispose to clots and can lead to conditions like transient ischemic attack (TIA), which are like small strokes that are temporary. The study found that 8% of people with this antibody had had a TIA in the past, and of these, 7-8% got another TIA during the study; whereas the rate of new TIAin people who never had one was less than one percent. Carefully designed studies are needed to evaluate TIAs in these patients.
Research Team: Belce Erton Z, Thaler J, Andrade D, Barber MRW, Tektonidou M, Sciascia S, Pengo V, Pardos-Gea J, Ruiz-Irastorza G, Lopez-Pedrera C, Belmont HM, Nina K, Fortin PR, Zuily S, Chighizola C, Signorelli FV, Zhang Z, Atsuma T, Efthymiou M, Ware Branch D, Nalli C, Rodriguez Almaraz, Petri M, Pazzola G, Cervera R, Esen BA, Shi H, Zuo Y, Quintana RM, Willis R, Duarte-Garcia A, Bertolaccini ML, Cohen H, Erkan D, and On Behalf Of APS ACTION
Mortality After Autologous Hematopoietic Stem Cell Transplant for Autoimmune Disease: Do Scleroderma Patients Fare Worse?
Stem cell transplantation provides new hope for patients with deadly autoimmune diseases, including scleroderma, for whom standard treatments have failed. As concerns about toxicity and treatment-related mortality remain, we explored real-world data on Canadian transplant programs. We found that hematopoietic stem cell transplants are on the rise for several types of autoimmune diseases, and survival is improving, although it remains slightly lower for patients with scleroderma.
Research Team: Birck M, Neville A, Storek J, Atkins H, Hudson M, Colmegna I, R. Lavoie J, Gao J, Bernatsky S.
Elevated Serum Levels of S100A8/A9 Discriminate Systemic Lupus Erythematosus Patients with Cognitive Impairment from Patients Without Impairment
In a cohort of 290 people living with systemic lupus, blood levels of a protein called S100A8/A9 was found to best differentiate between people who experienced cognition issues and those who did not.
Research Team: Munoz-Grajales C, Barraclough M, Diaz Martinez JP, Su J, Bingham K, Kakvan M, Kretzmann R, Tartaglia C, Ruttan L, Choi M, Appenzeller S, Marzouk S, Bonilla D, Katz P, Beaton D, Green R, WitherJ, Touma Z.
Elevated Serum Levels of S100A8/A9 Discriminate Systemic Lupus Erythematosus Patients with Cognitive Impairment from Patients Without Impairment
In a cohort of 290 people living with systemic lupus, blood levels of a protein called S100A8/A9 was found to best differentiate between people who experienced cognition issues and those who did not.
Research Team: Munoz-Grajales C, Barraclough M, Diaz Martinez JP, Su J, Bingham K, Kakvan M, Kretzmann R, Tartaglia C, Ruttan L, Choi M, Appenzeller S, Marzouk S, Bonilla D, Katz P, Beaton D, Green R, WitherJ, Touma Z.
Post-COVID-19 Autoimmune Serologies and Immunophenotypes
Patients who developed COVID in the early waves of the pandemic were more likely to develop auto-antibodies and symptoms of a new autoimmune rheumatic disease than people who got COVID in the later waves of the pandemic.
Research Team: Oakes EG, Buhler K, Adejoorin I, Marks K, Dillon E, Ellrodt J, Yee J, Rao D, Choi M, Costenbader K.
Depression, Anxiety and Post-Traumatic Stress Disorder in Association with Cardiovascular Disease Among Patients with Systemic Lupus Erythematosus and Rheumatoid Arthritis in the All of Us Research Program
Patients with rheumatoid arthritis or lupus and also depression, anxiety or PTSD were found to be at increased risk of heart attack, stroke or death compared to those without depression, anxiety or PTSD after taking into account smoking status, obesity and other medical conditions.
Research Team: Yee J, Oakes EG, Choi M, Feldman C, Karlson E, Costenbader K.
Artificial Intelligence Models for Computer-Assisted Joint Detection and Sharp-van Der Heijde Score Prediction in Hand Radiographs from Patients with Rheumatoid Arthritis
This research developed a deep learning system to automate the detection and prediction of joint damage in rheumatoid arthritis (RA) patients’ hand radiographs. The system accurately identified target joints and predicted joint damage scores with high precision. These systems may aid in monitoring joint damage in clinical care.
Research Team: Hitchon C, Al Islam S, Fung DLX, Liu Q, Lac L, Bartlett S, Bessette L, Boire G, Bykerk V, Hazlewood G, Keystone E, Pope J, Schieir O, Thorne C, Tin D, Valois MF, van der Heijde D, Canadian Early Arthritis Cohort (CATCH) Investigators1, O’Neil L, Hu P.
Adverse Events Among Patients with and Without Autoimmune Rheumatic Disease Prescribed SGLT2 Inhibitors
This study showed that people with autoimmune rheumatic diseases were more likely than people without auto-immune rheumatic diseases to develop side-effects from SGLT2 inhibitors, a new class of medications used for diabetes. Further studies evaluating the effectiveness and safety of these medications in people with rheumatic diseases is needed.
Research Team: Oakes EG, Ellrod J, Choi M, Yee J, Guan H, Costenbader K.
Sleep Disturbance Predicts Pain Interference in Patients with Early Rheumatoid Arthritis in a Prospective Real-World Cohort
Sleep disturbances are common in people living with rheumatoid arthritis (RA) and little is known about how they impact pain in the long run. This study used data from patients across Canada with newly diagnosed RA (the CATCH cohort) followed over 2 years. The study found that people who had better sleep experienced less pain interference in their lives six months later. Pain interference is the extent to which pain affects a person’s physical, mental and emotional functioning.
Research Team: Aydemir B, Schieir O, Valois MF, Muhammad L, Song J, Dunlop D, Bartlett S, Bessette L, Boire G, Hazelwood G, Hitchon C, Keystone E, Pope J, Thorne C, Tin D, Bykerk V, Lee Y and Canadian Early Arthritis Cohort (CATCH) Investigators.
Real World Patterns of Advanced Therapy Tapering in Early Rheumatoid Arthritis: Data from the Canadian Early Arthritis Cohort
This study aimed to investigate the real-world patterns of tapering advanced therapy in Canadian patients with early rheumatoid arthritis (RA) who achieved sustained remission or low disease activity for at least 6 months, as per recent Canadian treatment recommendations, using data from the Canadian early ArThritis CoHort (CATCH). Tapering advanced therapy was tried in 24% of these patients, usually after 14 months of remission. Tapering was done less often in people who experienced fatigue, and also depended on the type of advanced therapy (TNF inhibitors: 23%, JAK inhibitors: 12%, other biologics: 42%).
Research Team: Powell M, Bykerk V, Schieir O, Valois MF, Bartlett S, Bessette L, Boire G, Hitchon C, Keystone E, Pope J, Thorne C, Tin D, Hazlewood G and Canadian Early Arthritis Cohort (CATCH) Investigators
Melanoma and Combination Immune Checkpoint Inhibitors Are More Clearly Associated with the Development of Chronic Inflammatory Arthritis Than Pre-existing Autoimmune Disease: A Cross-Sectional Study of Administrative Health Data
The study investigated the association between pre-existing autoimmune diseases and the chronicity of immune-related arthritis (IA) in patients treated with immune checkpoint inhibitors (ICIs). Among 395 individuals with ICI-induced IA, 38% had pre-existing autoimmune conditions, but initial findings did not strongly associate these with increased chronicity. Common pre-existing autoimmune diseases included gastrointestinal, ophthalmologic, rheumatic, and endocrine conditions. The study found associations between chronic ICI-IA and factors such as melanoma, combination ICI, and potentially anti-CTLA-4. Ongoing multivariate analyses aim to provide more comprehensive insights and are currently underway.
Research Team: Ladouceur A, Hudson M, Behlouli H, Curtis J, Pilote L, Bernatsky S.
