Arthritis Research Canada at

ACR Convergence 2023

November 14

How Did a Mandatory Switch Policy Influence the Uptake of Adalimumab Biosimilar and Other TNF Inhibitors?

British Columbia attempted to increase the uptake of biosimilars through mandatory switch policy. This work evaluates the impact of the policy, and finds the uptake of biosimilar adalimumab was as successful as the previous uptake of etanercept and infliximab.

Research Team: Bansback N, Law M, Clemont F, Tadrous M, Blitz S, Harrison M.



Evaluation of the Receipt of Adequate Pharmacological and Psychological Treatment for Incident Depression and Anxiety in Individuals Living with Inflammatory Arthritis

This study evaluated whether people living with inflammatory arthritis newly diagnosed with depression and anxiety received adequate mental health care. The findings emphasize substantial undertreatment of depression and anxiety, with only half of people receiving medications and one in five people receiving provincially-funded mental health services.

Research Team: Howren A, Avina-Zubieta JA, Sayre EC, Puyat, J, Da Costa D, Gupta A, Xie H, De Vera MA.



Predictors of Adherence to Cervical Cancer Screening Guidelines Among Patients with Systemic Lupus Erythematosus

Women living with systemic lupus erythematous (SLE) are at increased risk for developing cervical cancer. Using data from the Lupus Clinic at our centre, we found that less than half of women with SLE were receiving screening for cervical cancer in accordance with current guidelines. Future work will aim to identify facilitators and barriers to cervical cancer screening in this at-risk population.

Research Team: Cho L, Legge A.



Specific Symptom Clusters at Diagnosis Signal a Poorer Early RA Prognosis: Data from the Canadian Early Arthritis Cohort (CATCH)

This study aimed to understand how clusters of symptom at the onset of rheumatoid arthritis (RA) predicted response to treatment over the first six months of treatment with methotrexate (MTX), using data from the Canadian Early Arthritis Cohort (CATCH) study. . They found that people with emotional symptoms at the time of RA diagnosis were less likely to have improvement in their RA with treatment, highlighting the need for addressing mental health for people newly diagnosed with RA.

Research Team: Bartlett S, Binghan C, Schieir O, Valois MF, Pope J, Bessette L, Boire G, Hitchonn C, Kekystone E, Thorne C, Tin D, Hazlewood G, Bykerk V.



Adaptation of the Making it WorkTM for People with Systemic Sclerosis

This study found that workers with scleroderma have unique needs that are different from workers with other rheumatic conditions. The next step is to work with people with scleroderma and other experts to adapt the Making it WorkTM program designed for arthritis to scleroderma.

Research Team: Poole J, Carandang K, Hill MT, Koch AM, Rogers P, Lacaille D.



Switch or Stay the Same? Preferences of People with Autoimmune Disease on Rituximab for Different Types of COVID-19 Vaccine Boosters


The scope of this study is to understand the preferences of patients taking rituximab for a booster with the same vaccine that they previously received (i.e Moderna or Pfizer), versus a switch to a different vaccine. Data indicate that patients who had received prior Moderna or Pfizer COVID-19 vaccines preferred to stay with the same vaccines.


Research Team: Wilson T, Fortin PR, Colmegna I, Theriault S, Amiable N, Godbout A, Hazlewood G.



Exploring Experiences and Perspectives of Canadian Patients with Lupus Nephritis Through Photovoice

his study explored patients experiences and perspectives of lupus nephritis (when lupus affects the kidneys) using an innovative photovoice exercise (e.g., sharing photos and discussing them in virtual focus groups). Thirteen patients participated, and described the physical and psychosocial impact of lupus nephritis, including symptoms like fatigue and joint pain, as well as fear, stress, and social exclusion. They also discussed the burden of managing medications and their side effects.

Research Team: Cardwell F, Elliot S, Barber MRW, Cheema K, George S, Boucher A, Clarke AE.




Direct Health Care Costs Differ by SLE Autoantibody Machine Learning Clusters in an International Inception

This study used artificial intelligence to predict the cost of health care utilization among patients with lupus with different blood proteins.

Research Team: Choi M, Costenbader K, Fritzler M, St. Pierre Y, Urowitz M, Hanly JG, Gordon C, Bae SC, Romero-Diaz J, Sanchez-Guerrero J, Bernatsky S, Wallace D, Isenberg D, Rahman A, Merrill J, Fortin PR, Gladman D, BruceI, Petri M, Ginzler1 E, Dooley MA, Ramsey-Goldman R, Manzi S, Jonsen A, Alarcón GS, van Vollenhoven R, Aranow C, MacKay M, Ruiz-Irastorza G, Lim SS, Inanc M, Kalunian K, Jacobsen S, Peschken C, Kamen DL, Askanase A, Buyon J, Clarke A.



Effect on Lupus Outcomes of the Protective Allele at rs1876453 in the Complement Receptor 2 Gene

This study evaluated the genetic variation – single-nucleotide polymorphism (SNP) rs1876453 – on the clinical outcomes of systemic lupus erythematosus, to see if it delayed disease onset and improved clinical outcomes. They found that people with this genetic variant were diagnosed with lupus at a later age, and they had a higher risk of developing damage from the disease within 5 years but had a lower mortality rate.

Research Team: Oganesyan A, Sharp R, O’Neill P, Aranow C, Arnaud L, Askanase A, Cheol Bae S, Bernatsky S, Bruce I, JBuyon J, Chatham W, Clarke AE, Costedoat-Chalumeau N, Dooley MA, Fortin PR, Ginzler E, Gladman D, Gordon C, Hanly JG, Inanç M, Isenberg D, Jacobsen S, Jonsen A, Kalunian K, Kamen DL, Lim SS, Mak A, Morand E, Peschken C, Petri M, Pons-Estel BA, Rahman A, Ramsey-Goldman R, Reynolds J, Romero-Diaz J, Ruiz-Irastorza G, Sanchez-Guerrero J, Steinsson K, Urowitz M, van Vollenhoven R, Vinet E, Voskuyl A, Wallace D, Manzi S, Jones KL, Boackle SA.



Delivery of Rheumatology Education to Internal Medicine Residents in Rwanda: Evaluation of a New Virtual Rheumatology Course Supplemented by On-site Clinical Teaching

This collaborative work describes the implementation and acceptance of a virtual rheumatology educational intervention targeting Internal Medicine Residents working in sub-Saharan African countries with limited or non-existing rheumatology capacity. The take home message of this work is that although a virtual course is a feasible way to provide rheumatology education to residents, it does not replace the need for in person teaching.

Research Team: Hitchon C, Abdissa Adugna B, Akintayo R, Caldron P, Colmegna I, Dey I, McGill P, Ponce A, Scuccimarri R, Tikly M, Mody G, Meltzer M.



Systemic Lupus Erythematosus and Functional Work Disability: A Qualitative Perspective Using a Work Disability Prevention Approach

Work disability is experienced by about 20-50% of people with systemic lupus erythematosus (SLE). In this study, persons with SLE were interviewed and four common factors were found to be associated with work disability: a) modifiable workplace factors like schedule and workload flexibility, b) workplace expectations and stigma with work performance, c) availability of workplace support and accommodations, d) physical limitations and feelings of safety at work. This study identified important factors to consider to help improve work outcomes in individuals with SLE.

Research Team: Howe A, Li A, Jules K, Tan J, Sadek M, Kakvan M, Chattu B, Bani-Fatemi A, Bonilla D, Nielsen W, Anderson N, Avina-Zubieta JA, Fox M, Shaw W, Haaland D, Pope J, Fortin PR, Bingham K, Rozenbojm N, Peschkennn C, Su J, Reynolds J, Ivory C, Gladman D, Urowitz M, Zahi Touma F, Nowrouzi-Kia BB.



Longitudinal Effect of Guselkumab on Biomarkers of Inflammation and Cardiovascular Risk in Bionaive Patients with Active Psoriatic Arthritis and High Systemic Inflammatory Burden: Post-hoc Analysis of a Phase 3, Randomized, Double-blind, Placebo-Controlled Study

This study looked at the impact of a new biologic medication called Guselkumab on patients with psoriatic arthritis (PsA) who have a high risk of cardiovascular disease due to inflammation. Using two blood markers of inflammation, Neutrophil-to-Lymphocyte ratio (NLR) and high-sensitivity CRP (hsCRP), they showed that this new medication significantly reduced inflammation in the blood. Other cardiovascular risk factors like blood pressure and body mass index remained stable over two years of Guselkumab treatment.

Research Team: Kavanaugh A, Soriano E, Dutz J, Selmi C, Rampakakis E, Shiff N, Nantel F, Lavie F, Coates L.



From Clinical Amyopathy to Severe Oropharyngeal Dysphagia in Pure Dermatomyositis: A Greater Extent of Muscle Weakness Is Associated with a Higher Cancer Prevalence

In this study on dermatomyositis (an autoimmune disease characterised by skin rashes and muscle weakness), the authors found that severity of the muscle weakness was associated with a higher risk of having cancer within 3 years of the diagnosis of dermatomyositis.

Research Team: Shen HC, Ivensky V, Troyanov Y, Bourre-Tessier J, Zarka F, Hoa S, Nehme J, Makhzoum JP, Mansour AM, Meunier RS, Mereniuk A, Lim D, Raynauld JP, Rich E, Goulet JR, Landry M, Bouchard-Marmen M, Leclair V, Allard-Chamard H, Hudson M, O’Ferrall E, Massie R, Karamchandani J, Ellezam B, Targoff IN, Satoh M, Fritzler M, J Senecal JL, Meyer A, Landon-Cardinal O.



Safety & ImmUnogenicity of COVID-19 VaCcines in SystEmic immunE Mediated Inflammatory Diseases (SUCCEED)

This study describes how drugs, clinical factors, and vaccine history influence response (level of immunity achieved) to vaccination in inflammatory disease. Results indicate that past infections and number of COVID-19 vaccine doses are associated with higher immunity and that time since vaccination is associated with lower immunity.

Research Team: Tsyruk O, Chandran V, Hitchon C, J. Avina-Zubieta A, Colmegna I, Fortin PR, Larche M, Boire G, Lukusa L, Bowish D, Kaplan GG, Pereira D, Dayam R, Lee JLF, Turnbull E, Valerio V, Proulx L, Gunderson J, Gingras AC, Bernatsky S.



Lupus Damage Index Revision – Item Generation and Reduction Phase

This study from an international collaboration of lupus clinical experts and patients aims to improve the Systemic Lupus Erythematosus Damage Index (SDI), a tool used to assess long-term damage in lupus patients. The existing SDI had limitations, such as incomplete items and not being suitable for children. After a comprehensive review of the literature, 220 potential items were identified to measure damage in various organ systems. Using a consensus method (Delphi) with a diverse group of 146 participants from 35 countries, 64 candidate items were selected for further evaluation, based on current evidence and international standards.

Research Team: Kundakci B, Barber M, Clarke AE, Johnson S, Bruce I, and On behalf of the revised SLE organ damage index (SDI) collaborators.



Exploring the health and cannabis use among young and middle-aged adults with rheumatologic conditions in Alberta, Canada

This study examined the health profiles and cannabis use patterns among 193 rheumatology patients in Alberta aged 18- to 45. they found that almost half (48.7%) were currently using cannabis, over a third (38.6%) had used cannabis in the past , and a fifth (20.7%) had never used cannabis. Current and past cannabis users reported higher pain scores and lower well-being compared to never users. Among cannabis users, current users had higher pain scores than past users, and they reported using cannabis for pain control and stress management.

Research Team: Yacyshyn E, Gulati S, Lowe S, Jones A, Turk T, Yamamoto S, Gregg K, Kolewaski L, Olson J, Paul P, Sadowski C.



Investigating the Health Profiles and the Prevalence and Correlates of Cannabis Use Among Patients Accessing Rheumatologic Care in Alberta, Canada

This study examined factors associated with cannabis use among patients with rheumatic diseases in Alberta using a survey. Factors associated with cannabis use included being younger, male, experiencing mental illness and sleep disturbances, having high levels of pain, lacking health insurance, being a previous or current smoker, and consuming four or more alcoholic drinks per week.

Research Team:Yacyshyn E, Gulati S, Lowe S, Jones A, Turk T, Yamamoto S, Gregg K, Kolewaski L, Olson J, Paul P, Sadowski C.



Healthy People with Lupus 2030: Goals to Improve the Quality of Care and Health of All People with Lupus in the United States

The goal of Healthy People with Lupus is to support the widespread adoption of 5 new quality measures for lupus clinical care in the United States. The key priorities, developed with patient involvement, are increasing the use of hydroxychloroquine, reducing glucocorticoid exposure, regular monitoring for lupus nephritis (to prevent loss to follow-up and kidney failure), reducing disability, and reducing depression and suicide among people with lupus.

Research Team: Yazdany J, Jorge A, Barber C, Barnado A, Bermas B, Duarte-Garcia A, Bennett A, Feldman C, Garg S, Haseley L, Jatwani S, Johansson T, Limanni A, Machua W, Rodgers W, Rovin B, Santiago-Casas Y, Suter L, Zell J, Katz P, Bartels CM.



Unclosing Premature Mortality Gap Among Gout Patients in the US General Population, Independent of Serum Urate and Atherosclerotic Cardiovascular Risk Factors

Gout has been associated with decreased survival and we found that, despite improvements in survival in more recent years for the general population, this has not happened for people with gout. These findings from the USA and UK suggest there are ongoing gaps in gout care that need to be addressed.

Research Team: McCormick N, Link, Yokose C, Lu N, Zhang Y, Choi HK.



Effect of Conventional and Biologic Disease-Modifying Anti-Rheumatic Drugs on the Antibody Response to Four Doses of COVID-19 mRNA Vaccines in Children with Autoimmune and Rheumatic Diseases

This study looked at how different treatments (e.g., conventional and biologic DMARDs) for autoimmune and rheumatic diseases in children affected their antibody response to COVID-19 vaccination. Blood samples were collected from children after each vaccine dose and antibodies against the COVID-19 virus were measured. Children treated with biologic drugs (bDMARDs) had weaker and faster-fading antibody responses after the second vaccine dose compared to those on other treatments or not receiving any treatment. However, by the fourth dose, all treatment groups had similar antibody responses. The vaccine did not worsen the children’s disease activity.

Research Team:  Shapiro J, Choi F, Xu A, Duong T, Gingras AC, Bernatsky S, Benseler S, Yeung R.



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