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Arthritis Research Canada at EULAR 2022

The EULAR European Congress of Rheumatology is the primary platform for exchange of scientific and clinical information in Europe. It seeks to provide a forum of the highest standard for scientific, educational and social exchange between professionals involved in rheumatology. It also incorporates liaising with patient organizations in order to achieve progress in the clinical care of people with rheumatic diseases.

The EULAR Congress attracts more than 18,000 delegates from over 130 countries and takes place in a major European city. This year, the EULAR Congress took place in Copenhagen between June 1 and 4. However, people could also attend the event virtually.

To learn more about Arthritis Research Canada research presented at the 2022 EULAR European Congress of Rheumatology, please scroll down.

Oral Presentations: June 1 – 3

Day 1: June 1, 2022

Reducing the burden of low back pain: results from a new microsimulation model.

This is the first study using population data and microsimulation modeling to compare the impact of different prevention strategies for Low Back Pain on the number of Years Lived with Disability that can be averted at the population level by these strategies.

Research Team:Kopec J, Sayre EC, Cibere J, Li L,Wong H, Okhmatovskaia A,Esdaile J.

Risk of arrhythmia among new users of hydroxychloroquine: A longitudinal population-based cohort study on newly Diagnosed Rheumatoid Arthritis and Systemic Lupus Erythematosus Patients.

This study looked at whether hydroxychloroquine  increased the risk of  abnormal heart rhythms among people newly diagnosed with RA and lupus in British Columbia and found no increased risk.  The results of this large population-based study is reassuring for the many people with RA and lupus who use hydroxychloroquine for the management of their disease.

Research Team: Hoque R, Lu N, Daftarian N, Esdaile J, Xie H, Avina-Zubieta JA.

Increased risk of severe infections and mortality in patients with newly diagnosed antineutrophil cytoplasmic antibody associated vasculitis: A population-based study.

This study quantifies the risk of severe infections in antineutrophil cytoplasmic antibody-associated vasculitis (AAV) patients in British Columbia. Our findings showed that almost one in three AAV patients developed severe infection and people had a higher risk of severe infection and mortality due to infection.

Research Team: Zhao K, Xie H, Dehghan N, Esdaile JM, Aviña-Zubieta JA.

Day 2: June 2, 2022

Chronic kidney disease and amplification of serum urate impact on gout risk: population-based study of > 450,000 UK Biobank participants.

High blood urate levels are known to cause gout, and here, studying data from > 450,000 people over 10 years, we found that in each urate level category, the risk of developing gout was even greater among people with chronic kidney disease than without.  These findings could tell us more about the biological pathways that lead to gout.

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

A population-based, prospective metabolomics study in the UK biobank identifies glycoprotein acetyls as a novel biomarker of incident gout.

We analyzed data from >100,000 adults and discovered a potential new inflammatory blood biomarker for the development of gout; higher levels at study baseline were associated with increased risk of developing gout, up to 10 years later.  This finding may help with prevention efforts by identifying more people at risk for gout.

Research Team:Joshi AD,McCormick N, Yokose C, Lu N, Choi HK.

Day 3: June 3, 2022

Severe COVID-19 outcomes among patients with autoimmune rheumatic diseases: A population-based study.

Information from BC health databases was used to see whether people with rheumatic diseases have a higher risk of severe outcomes if they get COVID19.  We found that COVID-19 patients with certain rheumatic diseases, such as rheumatoid arthritis ankylosing spondylitis and lupus, were more likely to be admitted to hospital, and to need ICU care,  than COVID-19 patients without rheumatic disease; but they were not at a higher risk of death from COVID-19. 

Research Team:Marozoff S, Fazal ZF, Tan J, Lu N, Hoens AM, Lacaille D, Kopec JA, Xie H, Loree JM,Esdaile JM, Avina-Zubieta JA.

More than half of RA patients with a lifetime history of mood disorders were anxious and depressed during the COVID-19 pandemic: Results from the Canadian Early Arthritis Cohort (CATCH).

This study of Canadian adults with rheumatoid arthritis found that people who reported having had mood disorders at some point in their life were more than twice as likely to report anxiety and depression during the pandemic. Depression was more common early in the pandemic and anxiety grew with each successive wave in the first year.

Research Team: Bartlett SJ, Schieir O, Valois MF, Boire G, Hazlewood G,Thorne C, Tin D, Hitchon C, Pope J, Keystone E, Bessette L, Bykerk V on behalf of CATCH Investigators.

Poster Presentations: June 1 – 4

Identifying the new emergence of racial disparities in gout over the past 3 decades – US National Survey and Prospective Cohort Data.

Using two separate datasets, we found that gout cases have risen among Black adults far more than White adults over the past 30 years, meaning gout has only recently become more common Black people in the US than White people.  Increasing BMI levels may explain the growing disparity among Black women.

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

Testing a new approach to identify and assess patient-valued treatment goals in rheumatoid arthritis (RA): A patient-engaged healthcare valuation strategy.

Goals relevant for RA treatment evaluation can be efficiently identified and rated for importance by patients. Patient-important goals can be incorporated into deliberative healthcare valuation using this method to permit “crowd-sourced” input from people living with RA and to capture diverse patient perspectives in healthcare valuation.

Research Team:Bartlett SJ,Bingham C, Predmore Z, Concannon T, Chen E, Schrandt S, Xie R, Chapman R, Frank L.

Reading the waves: Identifying distinct phenotypes of multisystem inflammatory syndrome in children in a single Canadian centre during the 2020-2021 COVID-19 Pandemic.

A shift in the manifestation of a severe multisystem inflammatory disease seen in some children with COVID-19 was identified across the successive COVID-19 waves, including the predominance of features associated with macrophage activation syndrome in later stages. These findings may reflect the impact of distinct SARS-CoV-2 variants. A blood biomarker, NT-proBNP, was found to be the most important feature predicting admission to intensive care unit.

Research Team: Renson T, Miettunen P, Parsons S, Dhalla M, Johnson N, Luca N, Schmeling H, Stevenson R, Twilt M, Hamiwka L, Benseler S.

Risks of severe infection after the introduction of bDMARDs in newly diagnosed rheumatoid arthritis patients: A population-based interrupted time-series analysis.

We examined the long-term impact of introduction of bDMARDs on severe infection among population-based cohorts of incident RA patients diagnosed between 1995 – 2007 in British Columbia. We observed a significant increase in trends of first and all severe infection rates among RA patients diagnosed after bDMARDs introduction, as compared to no trend changes among non-RA individuals. Five years after bDMARDs introduction, ASI rate increased significantly by 20.4% (6.05/29.62) than expected rate assuming no bDMARDs introduction.

Research Team:Zhou V, Lacaille D, Lu N, Kopec JA, Qian Y, Nosyk B, Aviña-Zubieta JA, Esdaile JM, Xie H.

Risks of cardiovascular events after the introduction of bDMARDs in newly diagnosed rheumatoid arthritis patients: A population-based interrupted time-series analysis.

We examined the long-term impact of introduction of bDMARDs on the risk of incident cardiovascular (CV) events among population-based cohorts of incident RA patients diagnosed between 1995-2007 in British Columbia. We found a significant reduction in the level of CV event rates among RA patients diagnosed after the introduction of bDMARDs, while no change was observed in non-RA individuals.

Research Team: Zhou VY, Lacaille D, Lu N, Kopec JA, Qian Y, Nosyk B, Aviña-Zubieta JA, Esdaile JM, Xie H.

What drives racial disparities in gout in the US? – Population-based, sex-specific, casual mediation analysis.

Using data from the US general population, we found that, contrary to historical beliefs, gout is more common among Black adults in the US, especially Black women, than White adults. Different factors explained the racial differences among women and among men; for example, higher BMI and poverty levels explained much of the difference between Black vs. White women, but very little of the difference between Black vs. White men.

Research Team: McCormick N,Lu N,Yokose C, Joshi AD, Merriman T, Saag K, Zhang Y, Choi HK.

The Canadian Research Group of Rheumatology in Immuno-Oncology (CanRIO): A nationwide multi-center prospective cohort.

Immune checkpoint inhibitors have revolutionized cancer treatment by activating the immune system to fight the cancer.  Their use is limited by development of autoimmune reactions, including rheumatic disease.  CanRIO is a Canadian study which includes patients who develop new rheumatic symptoms after exposure to immune checkpoint inhibitors and patients with pre-existing rheumatic disease who are exposed to immune checkpoint inhibitors, and follows these patients over time to understand how these medications affect auto-immune diseases. 

Research Team: Gonzalez Arreola L, Tan J, Ye C, Roberts J, Fifi-Mah A, Hudson M,Hoa S, Pope J, Maltez N, Appleton T, Choi M, Colmegna I, Dutz J, Ennis D, Himmel M, Rottapel R, Saltman A, Tisseverasinghe A, Jamal S.

Triple the rate of emergency room visits and hospitalizations for gout among US Blacks vs Whites – 2019 Nationwide Analysis.

We found that Black adults had much higher rates of emergency room visits and hospitalizations for gout than White adults, and longer hospital stays.  These findings could reflect a higher risk of gout among Black adults than White, and potentially lower quality of care.

Research Team: Yokose C, McCormick N, Lu N, Joshi A, Jackson L, Kohler M, Yinh J, Zhang Y, Saag K, Choi HK.

Excess risk of all-cause and cardiovascular mortality in females with gout – A prospective cohort study of 105,502 women.

We analysed data from >100,000 women followed over 30 years and found women with gout had more cardiovascular risk factors (i.e., high blood pressure, high cholesterol) than women without gout and tended to die earlier, particularly from cardiovascular diseases.

Research Team: Yokose C, McCormick N, Lu N, Joshi A, Curhan G, Choi HK

Hydroxychloroquine reduces the titers of anti-domain 1 antibodies over time in patients with persistently positive antiphospholipid antibodies: Results from the APS Action Clinical Database and Repository (“Registry”).

The aim of this project was to define factors that could predict the fluctuation of an antibody (named anti-D1) which is associated with the formation of blood clots that may block veins or arteries in patients living with anti-phospholipid syndrome. Data indicate that treatment with hydroxychloroquine is associated with a decrease in anti-D1 amount. A better understanding of the factors that cause anti-D1 fluctuations will help anticipate clotting episodes in these patients.

Research Team: Chighizola C, Pregnolato F, Andrade D, Tektonidou M, Sciascia S, Pengo V, Ugarte A, Belmont HM, Gerosa M, Fortin PR, Lopez Pedrera C, Zhang Z, Atsumi T, De Jesùs G, Kello N, Ware Branch D, Andreoli L, Wahl D, Petri MA, Rodríguez Almarez E, Cervera R, Pons Estel G, Knight J, Willis R, Barber M, Artim Esen B, Cohen H, Erkan D, Bertolaccini ML.

More meticulously following Treat-To-Target in RA does not lead to less radiographic progression: A longitudinal analysis in BIODAM.

In this cohort from real life clinical practice, more meticulously following Treat-to-Target (T2T) principles did not result in greater reduction of radiographic progression than a somewhat more liberal T2T approach. One possible interpretation of these results is that the intention to apply T2T already suffices and that a more stringent approach does not further improve outcome.

Research Team: Ramiro S, Landewe R, van der Heijde D, Sepriano A, Fitzgerald O, Ostergaard M, Homik J, Elkayam O, Thorne C, Larche M, Ferraccioli G, Backhaus M, Boire G, Combe B, Schaeverbeke T, Saraux A, Dougados M, Rossini M, Govoni M, Sinigaglia L, Cantagrel A, Allaart C, Barnabe C, Bingham C, van Schaardenburg D, Hammer H, Dadashova R, Hutchings E, Paschke J, Maksymowych W.

Equity considerations in COVID-19 vaccination studies of individuals with autoimmune inflammatory rheumatic diseases.

It is unknown whether COVID-19 vaccine studies on individuals with autoimmune inflammatory rheumatic diseases are applicable to populations experiencing health inequities, as key inequity factors beyond age and sex are no reported or analyzed.

Research Team: Wang H, Dewidar O, Whittle S, Ghogomu E, Hazlewood G, Mbuagbaw L, Pardo Pardo J, Robinson P, Buchbinder R, Welch V.

The 2021 EULAR and ACR points to consider for diagnosis, management and monitoring of the IL 1 Mediated autoinflammatory diseases: Caps, Traps, MKD, and DIRA.

The 2021 EULAR/ACR points to consider provide state-of-the-art knowledge based on published data and expert opinion to guide diagnostic evaluation, treatment, and monitoring of patients with a series of inflammatory diseases, called CAPS, TRAPS, MKD and DIRA, and inform how to optimize patient care to improve disease outcomes.

Research Team: Romano M, Arici ZS, Piskin D, Alehashemi S, Aletaha D, Barron K, Benseler S, Berard R, Broderick L, Dedeoglu F, Diebold M, Durrant K, Ferguson P, Foell D, Hausmann J, Jones O, Kastner D, Lachmann HJ, Laxer R, Rivera D, Rupert N, Simon A, Twilt M, Frenkel J, Hoffman H, De Jesus A, Kuemmerle-deschnenr J, Ozen S, Gattorno M, Goldbach-Mansky R, Demirkaya E on behalf of EULAR/ACR IL1 mediated group.

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