Arthritis Research Canada at
ACR Convergence 2024
November 17
Avoidable Hospitalizations by Persons with Rheumatoid Arthritis: A Population-Based Study Using Administrative Data
This study looked at data from Alberta, Canada, involving over 52,000 individuals with rheumatoid arthritis (RA) and a matched control group. Researchers tracked hospitalizations for various conditions where improving ambulatory care can prevent the need for hospitalization, from 2002 to 2023. They found that people with RA had a higher risk of being hospitalized for conditions like heart failure compared to controls. Key factors that increased the risk of avoidable hospitalizations included older age, lack of regular medical visits, living in a rural area and having other co-existing health issues.
Research Team: Contreras D, Barber CEH, Avina-Zubieta JA, Quan H, Lee S, King J, Barnabe C.
Early Antimalarial Adherence Reduces Future Hospitalization Cost in Rheumatoid Arthritis and Systemic Lupus Erythematosus Patients: Evidence from a Population-based Study
This study looked at whether taking antimalarial medications as prescribed affects hospital costs in patients newly diagnosed with rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE). Patients who consistently took their antimalarials had lower hospitalization costs over the following year, saving about $550 per person compared to those who didn’t take their medication regularly.
Patient Authors: Hoque MR, Lacaille D, Avina-Zubieta JA, De Vera MA, Qian Y, Esdaile J, Xie H.
Comparing the Risk of Severe Infections Associated with Different Classes of Biologic or Targeted Synthetic Agents for Inflammatory Arthritis: A Population-based Study
This study provides real-world evidence comparing the risk of severe infections with the use of different types of biologic and targeted synthetic DMARDs for inflammatory arthritis. The study followed 24,005 patients in British Columbia over several years and found that the risk of severe infections within one year and 5 years was significantly higher for people using rituximab and anti-IL6 drugs compared to people using anti-TNF biologics. The five year risk was also higher with Janus Kinase inhibitors (JAKi). There was no difference in infection risk for other biologics like abatacept or anti-IL17 compared to anti-TNFs. These findings provide real-world evidence that will help patients and clinicians make informed treatment decisions when weighing the risks and benefits of different biologic and advanced DMARD therapies.
Research Team: Moolooghy K, Xie H, Zheng Y, Avina-Zubieta JA, Lacaille D.
Anti-synthetase Syndrome (ASSD) Related Interstitial Lung Disease (ILD) in Comparison to Non-ASSD Related ILDs: Analysis from the “Classification Criteria for Anti-synthetase Syndrome (CLASS)” Project Database
Anti-synthetase syndrome, a rare form of autoimmune muscle disease, can cause acute and severe lung disease. This study found that the risk of hospitalization and death from lung disease is higher in this subset of patients compared to patients with other rheumatic diseases who also have lung disease.
Research Team: Bae S, Bozan F, Rivero Gallegos D, Zanframundo G, Faghihi-Kashani S, Ventura J, Dourado E, Loganathan A, Sambataro G, Yoshida A, Bonella F, Corte TJ, Doyle TJ, Forentino D, Gonzalez-Gay MA, Hudson M, Kuwana M, Notarnicola A, Mammen A, McHugh N, Miller F, Montecucco C, Oddis C, Rojas-Serrano J, Schmidt J, Scire C, Selva-O’Callaghan A, Werth V, Cavagna L, Aggarwal R.
Living with Antiphospholipid Antibodies: A Photovoice Exploration
This study explored the experiences of people with antiphospholipid syndrome (APS) using a method where participants took photos to express what living with the condition means to them. Eleven participants shared images related to their healthcare journeys, emotional struggles, and lifestyle changes. Key themes included the emotional toll of their condition, challenges in getting care, and impacts on family planning and social life. Results will inform the development of patient resources.
Research Team: Cardwell F, Elliott SJ, Gibson PS, Soliman N, Skeith L, Clarke AE, Barber M.
Risk of Mortality and Major Cardiovascular-Kidney Outcomes in Patients with Tophaceous versus Non-Tophaceous Gout
People with tophaceous gout, a more severe, disabling form of the disease where uric acid deposits under the skin, had decreased survival compared to people with non-tophaceous (less-severe) gout, and were more likely to develop heart attacks and severe kidney disease, even after accounting for shared risk factors. More intensive treatments to lower levels of urate in the blood, the causal factor for gout, may help in preventing and treating this type of gout.
Research Team: Challener G, Sheng-kai Ma K, McCormick N, Yokose C, Tinianow A, Choi HK.
Cognitive Impairment Prevalence and Most Affected Domains in Patients with SLE by the ACR Comprehensive Neuropsychological Battery
This study examined cognitive impairment among a sample of 362 patients with systemic lupus erythematosus (SLE), and found that about 44% of participants experienced some form of cognitive difficulty. The most commonly affected areas were visual spatial skills, learning and memory.
Research Team: Dobrowolski C, Diaz Martinez JP, Bingham K, Barraclough M, Kretzmann R, Tartaglia MC, Ruttan L, Choi M, Appenzeller S, Marzouk S, Bonilla D, Katz P, Beaton D, Green R, Wither J, Whittall Garcia LP, Gladman D, Touma Z.
A Theory of Change for Patient-Initiated Follow-Up Care in Rheumatoid Arthritis
The researchers worked with individuals with rheumatoid arthritis, rheumatologists, and other care providers to improve timeliness and access in rheumatoid arthritis care. Together, they co-created a new approach called “Appointments By Choice”, where people with stable disease only see their rheumatologist when they feel they need it, rather than at pre-scheduled follow-up times.
Research Team: Ester M, White K, Dhiman K, Zafar S, Charlton A, Hazlewood G, Zimmermann GL, Hoens A, Manske SL, Lacaille D, Perry MG, Barber MRW, Fifi-Mah A, Panich N, Szpunar M, Then K, Osinski K, Subdar S, Al-Azem H, Jung M, Barber CEH.
Identifying Patient Priorities for Patient-Reported Outcome Measures in Rheumatoid Arthritis: A Modified Delphi Consensus Study
This study utilized a modified Delphi consensus approach with rheumatoid arthritis (RA) patients to prioritize patient-reported outcome measures (PROMs) for routine collection in RA care, highlighting the importance of patient engagement in selecting measures that align with their preferences and needs to enhance patient-centric care and health system performance.
Research Team: Githumbi R, Katz S, Kania-Richmond A, Giroux K, Wallace Y, Barnabe C, Hazlewood G, Jones CA, Steiman A, Ambasta A, Lacaille D, Yacyshyn E, Widdifield J, Gakhal N, Williamson T, Barber CEH.
Comparing the Prevalence of Sarcoidosis in Canadian Rural, Urban, and Farming Populations
This large retrospective study used administrative health data to compare the prevalence of sarcoidosis among rural, urban and farm populations within Alberta, Canada. In contrast to previous studies that have identified an increased prevalence of sarcoidosis among rural populations, this study found no significant difference in the prevalence of sarcoidosis among Albertan rural (16.9 per 100,000), urban (19.8 per 100,000) and farm (20.4 per 100,000) populations.
Research Team: Hans V, Voaklander D, Jones CA, Yacyshyn E.
Specific Causes for Hospitalization in Persons with Inflammatory Arthritis Conditions and Gout: A Systematic Review
Knowing which diagnoses result in a high frequency of hospitalization in persons with inflammatory arthritis (IA) or gout can inform health system planning and interventions to reduce avoidable acute care use. A systematic review was done to estimate the frequency of specific causes of hospitalization for those with inflammatory arthritis (IA) or gout reported in the literature. Overall, the most frequent reason for admission to hospital was for IA flares followed by infections.
Research Team: Irwin, K, Huo R, Ward A, Sudheer C, Li A, Barber CEH, Barnabe C.
Patient and Physician Preferences for Pain Relief Treatment for Moderate-to-Severe Pain Associated with Knee Osteoarthritis: A Qualitative Exploration
Through interviews with 48 patients and 24 physicians across six countries, this research explored how patients and physicians perceive treatments for knee osteoarthritis (KOA) pain relief. The study found that both groups value pain relief, improved function, and the ability to maintain daily activities. While physicians were generally more aware of potential side effects, patients reported mixed feelings about how treatments are administered.
Research Team: Henderson N, Theakston C, Chowhury S, Mott D, Skedgel C, Freitas R, Ivanicius S, Petersen G, Schofield S, Botto-van Bemden A, Hiligsmann M, larrainzar R, Marshall D, Tervonen T, Walsh D.
Nailfold Videocapillaroscopy Abnormalities in Different Autoimmune Inflammatory Myopathy Subsets
This study examined nailfold videocapillaroscopy changes in various autoimmune inflammatory myopathies to see if these patterns could help classify the conditions better. Researchers analyzed images from 100 patients. Overall, while videocapilooroscopy abnormalities were common in some subsets, the patterns were not helpful for accurate classification.
Research Team: Cotton T, Leclair V, Berger C, Troyanov Y, Hudson M, Gyger G, and Canadian Inflammatory Myopathy Study (CIMS).
Novel Analytes Associated with Cognitive Impairment in Patients with Systemic Lupus Erythematosus: Serum S100A8/A9, MMP-9 and IL-6
This study explores cognitive impairment in patients with Systemic Lupus Erythematosus (SLE) and how it relates to certain serum markers. The researchers found that higher levels of specific markers, including S100A8/A9, MMP-9, and IL-6, were linked to poorer cognitive performance.
Research Team: Neary E, Munoz-Grajales C, Wither J, Diaz Martinez P, Barraclough M, Bingham K, Kretzmann R, Tartaglia MC, Ruttan L, Choi M, Appenzeller S, Marzouk S, Bonilla D, Katz P, Beaton D, Green R, Whittall Garcia LP, Gladman D, Touma Z.
Work-Related Disability and Function in Systemic Lupus Erythematosus (SLE): Outcomes of an Exploratory Study from Different Canadian Centres
This study investigates how systemic lupus erythematosus (SLE) affects patients’ ability to work and perform daily activities. Researchers collected data from patients across seven Canadian facilities, measuring factors such as health status and disability. The results showed that patients experience high levels of disability, with factors like fatigue, depression, and pain significantly impacting their work and daily functioning.
Research Team: Nowrouzi-Kia B, Avina-Zubieta JA, Fox M, Shaw W, Ho M, Li Q, Ivory C, Fortin P, Keeling S, Reynolds J, Haaland D, Pope H, Lim L, Katz P, Urowitz M, Whittall Garcia LP, Gladman D, Touma Z.
Assessing Subjective Cognitive Impairment in a Cohort of Canadian Systemic Lupus Erythematosus Patients: Construct Validity of PDQ-20
This study looks at how people with systemic lupus erythematosus (SLE) perceive their cognitive difficulties. Researchers used a tool called the Perceived Deficits Questionnaire (PDQ-20) to assess cognitive impairments in 398 SLE patients across Canada. They found two distinct groups: one with more severe subjective cognitive issues, particularly in attention and planning, and another with milder difficulties.
Research Team: Marzouk O, Avina-Zubieta JA, Fox M, Shaw W, Ho M, Li Q, Ivory C, Fortin P, Bingham K, Keeling S, Reynolds J, Haaland D, Pope J, Lim L, Katz P, Urowitz M, Whittall Garcia LP, Gladman D, Nowrouzi-Kia B, Touma Z.
Antiphospholipid Antibody-related Clinical Manifestations Presenting During Childhood versus Adulthood: Descriptive Results from the AntiPhospholipid Syndrome Alliance for Clinical Trials and InternatiOnal Networking (APS ACTION) Clinical Database and Repository (“Registry”)
This international study looked at patients with antiphospholipid syndrome who tested positive for antiphospholipid antibodies, focusing on differences between those who showed symptoms in childhood versus adulthood. Younger patients (under 18) were more likely to have non-vascular problems as their first symptoms compared to adults.
Research Team: Pandya J, Andrade D, Clarke AE, Tektonidou M, Pengo V, Radin M, Pardos-Gea J, Kello N, Paredes-Ruiz D, Aguirre-Zamorano MA, Belmont HM, Fortin PR, Signorelli FV, Atsumi T, Zhang Z, Efthymiou M, Branch D, Pazzola G, Tincani A, Duarte-Garcia A, Rodriguez-Almaraz E, Petri M, Cervera R, Esen BA, Pons-Estel G, Shi H, Zuo Y, Willis R, Meroni P, Roubey R, Bertolaccini ML, Cohen H, Erkan D, and on behalf of APS ACTION
Distinct Metabolomic Signatures of Insulinemia and Incident Gout Risk: A Prospective Cohort Study Among Women
Using a large ongoing prospective cohort of women, the authors identified a hyperinsulinemic dietary pattern as well as three combinations of blood markers that are associated with the risk of developing gout. These findings give insight into the role of raised insulin levels in gout pathogenesis, providing compelling targets for future research as well as dietary recommendations.
Research Team: Rai S, Choi HK, Yokose C, McCormick N.
Deciphering Variation in Real-World Early RA Outcomes: A Longitudinal Analysis of the Canadian Early Arthritis Cohort (CATCH) Study
This study examined how well early rheumatoid arthritis (RA) patients from the CATCH cohort responded to treatment over time. While most patients improved, about 16% still had moderate to severe symptoms after a year, and 4% struggled with active disease throughout the study. Factors like social determinants of health, medical history, and concerns about treatment influenced outcomes.
Research Team: Schieir O, Valois MF, Boire G, Bessette L, Thorne C, Bartlett S, Hazlewood G, Hitchon C, Tin D, Allard-Chamard H, Kuriya B, Pope J, Bykerk V, and on behalf of CATCH Investigators.
Barriers and Facilitators of Access to Physical Therapy: A Scoping Review
This scoping review identified 48 studies, which highlighted barriers and facilitators to accessing physical therapy, with most studies focusing on individual-level factors like distance to service, out-of-pocket costs, and lack of patient knowledge. Supply-side issues such as limited physical therapist availability and inadequate funding were also frequently reported, with little evidence of change in these barriers over time.
Research Team: Worthington H, Wang E, Bayraktar D, Therrien S, Primeau C, Whittaker J, Hoens A, Avina-Zubieta JA, Xie H, Li LC
Coronary Dual-Energy Computed Tomography for the Detection of Monosodium Urate Crystal Deposition in the Arteries of Individuals with and Without Gout (CORODECT): A Multi-Center Prospective Imaging Study
This study investigated whether people with gout have more deposits of urate crystals (MSU) in their coronary arteries compared to those without gout. Researchers found that individuals with gout were more likely to have these crystal deposits, especially when using advanced imaging methods.
Research Team: Yokose C, Pascart T, Randhawa M, Kennedy P, Schwabl C, Chigurupati S, Jiang B, Lu L, Held J, Widmann G, Simeone FJ, Ghoshhajra B, Sheikh A, Shojania K, Feuchtner G, Klauser A, Nicolaou S, Budzik JF, Becce F, Choi HK.
The Contemporary Prevalence of Comorbid Gout and Chronic Kidney Disease, Two Common Conditions with High Morbidity, in the US General Population
This study found that people with gout were more than twice as likely to have chronic kidney disease than people without gout, even after accounting for sex, age, and other risk factors. Approximately 2.6 million US adults have both gout and chronic kidney disease.
Research Team: Yokose C, Lu L, Rai S, McCormick N, Choi HK.
