Arthritis Research Canada at
ACR Convergence 2025
Day 3: October 28
Translating findings on urate-metabolizing bacterial genes and urate levels at the human population level: a gut microbiome analysis of three independent cohorts of men and women
This study explored the link between gut bacteria and levels of urate, the crystal causing gout attacks. Researchers found that certain gut bacteria carry genes that can break down urate, and the presence of these genes was correlated with blood urate levels in humans. They identified several bacterial species with this potential, some showing sex-specific patterns. The results suggest that the gut microbiome may help regulate urate levels and could be a new target for treating or preventing gout.
Research Team: Rai S, McCormick N, Morgan X, Nayor M, Terkeltaub R, Dodd D, Nazzal L, Li H, Curhan G, Huttenhower C, Choi HK.
Lung Transplant Outcomes in Patients with Rheumatoid Arthritis Associated Interstitial Lung Disease Compared to Idiopathic Pulmonary Fibrosis: A Multicentric Retrospective Analysis and Meta-analysis
This study compared lung transplant outcomes in patients with interstitial lung disease from rheumatoid arthritis and people with no underlying cause, i.e. idiopathic pulmonary fibrosis. It found that while patients with rheumatoid arthritis were younger and more likely to be on medications that suppress the immune system, their survival, lung function, and complications after transplant were similar to those of patients with idiopathic pulmonary fibrosis, suggesting that lung transplant is a good treatment option in people with RA with severe lung disease not responding to medical treatment. A review of prior studies also showed that survival for both groups has improved compared to older studies.
Research Team: AlHajeri S, Major M, Jalaledin DS, Daviault B, Shah A, Yu A, Hoa S, Levy R, Wilson J, CPoirier C, Choi J, Yee J, Landon-Cardinal O, Huang K, Kim H.
Direct and Indirect Costs Associated with Damage Accrual: Results from the Systemic Lupus International Collaborating Clinics (SLICC) Inception Cohort
This study looks at the healthcare costs for people with lupus over time. It found that as the disease causes more damage, both medical costs and costs from missed work increase, with most of the costs coming from lost unpaid labor. The research suggests that new treatments that slow down disease damage could save a lot of money, especially by reducing the impact of lost work.
Research Team: Barber M, Hanly J, Urowitz M, IBruce I, St-Pierre Y, Gordon C, Bae SC, Romero-Diaz J, Panchez-Guerrero F, Bernatsky S, Wallace D, Isenberg DA, Rahman A, Merril J, Fortin P, Gladman DD, Petri M, Ginzler E, Dooley1 MA, Ramsey-Goldman R, Manzi S, Jönsen A, Alarcón G, van Vollenhoven R, Aranow C, Mackay M, Ruiz-Irastorza G, Lim S, Inanç M, Kalunian K, Jacobsen S, Peschken C, Kamen D, Askanase A, Clarke AE.
Dried Blood Spots for Remote ANA and Autoantibody Screening
This study found that testing for antinuclear antibody and lupus-related antibodies in lupus patients was as reliable when using dried blood spot (using a drop of blood from a finger prick onto a testing kit) as the traditional testing drawing a blood sample. Even when stored under different temperatures and time conditions, dried blood spots testing produced comparable results. This new type of testing could offer a more accessible and cost-effective method to screen for and diagnose lupus, especially in remote areas or areas with limited resources.
Research Team: Li M, Sciore P, Fritzler MJ, Clarke A, Ocampo W, Buhler K, Seni J, Crowshoe L, Mosher D, Choi M.
Maternal and Fetal Outcomes Associated with IL-17 Inhibitor Exposure During Pregnancy in Patients with Seronegative Arthritis: A Case Series of Nine
This study investigates the disease activity and pregnancy outcomes for 9 patients on Biologics during their pregnancy, specifically IL-17 inhibitors: Secukinumab and Ixekizumab. In this prospective case series, IL-17 inhibitor exposure during pregnancy was not associated with an increased risk of congenital anomalies or adverse neonatal outcomes. This suggests that IL-17 inhibitors may be a safe treatment option for select pregnant patients with seronegative inflammatory arthritis during pregnancy, however larger multicenter studies are needed to confirm these observations.
Research Team: Waring A, Rieger-Torres S, Tan J, Pavlova V, Amiri N.
Defining Safe Hydroxychloroquine Blood Levels: Time to Switch to Precision Monitoring for Optimized Lupus Care
This study shows that blood level monitoring can help tailor hydroxychloroquine dosing to balance effectiveness and safety for people with lupus. The researchers found that blood levels below 750 ng/mL were linked to higher chances of poorly controlled disease, while levels above 1150 ng/mL increased the risk of toxicity. Patients with chronic kidney disease were more likely to have toxic levels, even at lower hydroxychloroquine doses.
Research Team: Rai S, McCormick N, Yokose C. Terkeltaub R, Dodd D, Nazzal L, Li H, Sun Q, Choi HK.
Cardiovascular Risk Prediction in Systemic Lupus Erythematosus: Comparing the PREVENT and SLECRISK Models
This study compared two models for predicting cardiovascular risk in people with lupus: SLECRISK and PREVENT. Both models were similar in predicting risk, but SLECRISK was better at identifying younger patients with more lupus-related immune activity and showed better accuracy in matching predicted and actual outcomes. This shows SLECRISK is a useful tool for accurately assessing cardiovascular risk in lupus patients.
Research Team: Kim Y, Guan H, Oakes E, Zhong K, Paude M, Choi M, Liao K, Weber B, Costenbader KH.
Effectiveness of Upadacitinib in Patients with Rheumatoid Arthritis in Canadian Real-World Practice: Final Results from the CLOSE-UP Post-Marketing Observational Study
This study included Canadian real-world data from patients with moderate-to-severe rheumatoid arthritis and found that upadacitinib reduced disease activity and improved pain, fatigue, and function. Results were consistent whether patients used upadacitinib alone or in combination with other medications like methotrexate, and whether people had tried other advanced therapy. Upadacitinib was well-tolerated, with a safety profile similar to clinical trials.
Research Team: Bessette L, Chow A, Rai R, Allard-Chamard H, Boulos P, Roy G, Liazoghli D.
Autoantibody Clusters and SIGLEC1 are Predictive of Systemic Lupus Erythematosus Development
Researchers studied people with suspected lupus to find markers that might predict who will develop lupus or other autoimmune diseases. They looked at patients’ autoantibody profiles and a protein called SIGLEC1, which is linked to inflammation. People with multiple lupus-related autoantibodies (anti-RNP, dsDNA, Ro60/SSA) and higher SIGLEC1 levels were more likely to progress to lupus or another connective tissue disease. This research offers important insights as these markers could help doctors identify and monitor high-risk patients earlier.
Research Team: Horisberger A, Oakes E, Dillon E, Adejoorin I, Caldropoli J, Marks K, Sasaki T, Moghaddam F, Sciore P, Fritzler MJ, Rao D, Choi M, Costenbader KH
Storytelling and Navigation to Improve Gout Follow-up: A Multicenter, Randomized Controlled Trial
This study tested whether a behavioral intervention could improve outpatient follow-up for gout after an emergency department visit. The intervention included a storytelling video and phone-based navigation to encourage follow-up care. While the intervention did not lead to a significant improvement in outpatient gout follow-up, it did lead to a higher rate of starting allopurinol medication (usually recommended for gout) and fewer repeat emergency department visits. These findings suggest that patient activation strategies alone may not be enough and more comprehensive approaches are needed to improve gout care.
Research Team: Jackson L, Begum R, cutter G, Choi HK, Faine B, Singer NG, McCormick N, Shokoohi H, Parry B, Nelson O, Booth J, Armor Z, Osborne J, Saag K, Danila MI.
Lupus Damage Index Revision – Item Generation and Reduction Phases
A revised Systemic Lupus Erythematosus Damage Index (SDI) is being developed to improve how we measure damage caused by lupus. Using a Delphi process to get consensus from experts and patients , the group chose to keep 39 items across 13 clinical domains and removed outdated items, replacing them with new ones. The next step involves weighting these items, to reflect their importance. this research will ensure we can better track changes in a patient’s condition over time.
Research Team: Kundakci B, Barber M, Clarke AE, Johnson S, Bruce I.
Exposure to Anaerobic Antibiotics and Risk of Gout Flares: Target Trial Emulation for the Potential Role of the Gut Microbiome in Gout and Chronic Kidney Disease (CKD)
This study found that exposure to clindamycin (an antibiotic targeting both aerobic and anaerobic bacteria) was associated with a three-fold higher rate of gout flares compared to trimethoprim/sulfamethoxazole (an antibiotic that doesn’t really target anaerobic acteria) in individuals with chronic kidney disease. These findings suggest that anaerobic gut bacteria that can degrade purineplay an important role in getting rid of urate and preventing gout flares. This highlights the importance of gut microbiome in managing gout, especially in people with chronic kidney disease.
Research Team: McCormick N, Rai S, Yokose C, Lu L, Terkeltaub R, Nazzal L, Li H, Dodd D, Choi HK.
Hydroxychloroquine and Pregnancy Outcomes in Lupus: Results from a population-based cohort study
Pregnant people with lupus are at higher risk of complications like preeclampsia and preterm birth. This study found that taking hydroxychloroquine during early pregnancy did not clearly change these risks. A small potential benefit for preeclampsia was seen, but more research is needed.
Research Team: Sediqi S, Lu L, Avina-Zubieta JA, Simard JF.
Pilot Study: Testing the Accuracy of a Capillary Point-of-Care Device Compared to Traditional Venous Analysis for Serum Urate Measurements Among Patients with Gout
This study found that a capillary point-of-care device (using a drop of blood from a finger prick) accurately measured serum urate levels in gout patients, closely matching results of tests obtained from drawing blood at a lab. The point of care device correctly identified 93% of patients with levels above the target range for treatment. These results suggest that a simple device could be used in clinical practice to monitor, in real time, whether urate levels are adequately controlled and guide treatment decisions while patients are seen in clinic.
Research Team: Tianianow A, Chigurupati S, Carey E, Wang J, Rai S, Challener G, Choi HK.
The Prevalence of Multimorbidity and Polypharmacy Among US Adults with Gout: A General Population-Based Study
This study found that people with gout in the United States are more likely to have multiple chronic conditions and take several medications compared to people without gout. Common conditions included high blood pressure, high cholesterol, and obesity. These results emphasize the need for better care strategies to manage both gout and related health issues.
Research Team: Yokose C, McCormick N, Wang J, Rai S, Lu L, Choi HK.
