Arthritis Research Canada at EULAR 2024

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 takes place in Vienna between June 12 and June 15.

To learn about Arthritis Research Canada research presented at the EULAR European Congress of Rheumatology (Day 2), please scroll down.

Risk of mortality in patients with tophaceous versus non-tophaceous gout

This study found that individuals who have tophi with their gout face higher risks of mortality, heart attacks, and end-stage renal disease compared to those with no tophi. These risks were consistently higher at both 1-year and 5-year follow-up periods. The findings call for investigating whether more intensive urate-lowering therapies are needed to reduce these elevated risks in people with tophaceous gout.

Research Team:Challener G, Ma KSK, McCormick N, Yokose C, Tinianow A,Choi H.

Comparative effectiveness of sodium-glucose cotransporter-2 inhibitors vs sulfonylureas for primary and secondary gout prevention among patients with type 2 diabetes receiving metformin monotherapy: target trial emulation studies

This study mimicked a clinical trial to compare the effectiveness of two diabetes medications, SGLT2 inhibitors and sulfonylureas, when added to metformin, for reducing the risk of gout and recurrent flares in people with diabetes. Analyzing real-world data from over 34,000 patients with type 2 diabetes, the study found that SGLT2 inhibitors were associated with a lower incidence of gout, fewer recurrent flares among those already diagnosed with gout, and a reduced risk of major adverse cardiovascular events compared to sulfonylureas.

Research Team: McCormick N, Yokose C, Lu L, Wexler D, Avina-Zubieta JA, De Vera M, McCoy R, Choi H.

Increased risk of severe infection in patients with antineutrophil cytoplasmic antibody-associated vasculitides: A population-based trend analysis

This research found that individuals with ANCA-associated vasculitis, a condition marked by inflammation of small and medium-sized blood vessels, are significantly more prone to serious infections compared to the general population. The study emphasizes the need for vigilant healthcare management to mitigate these risks.

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

Relationships between job self-efficacy and risk of work disability in people with systemic sclerosis enrolled in the Making It Work Systemic Sclerosis program

This study investigated people living with systemic sclerosis (SSc) who participated in a trial aimed at supporting their employment, called Making it Work-Systemic Sclerosis (MiW-SS). It revealed that participants enrolled in MiW-SS generally had medium job-related self-efficacy levels and faced a moderate risk of work disability. Confidence in adapting tasks and expressing needs at work was correlated with specific job demands like concentration, pacing, and working in awkward positions. Findings suggest that learning how to adapt tasks and obtain job accommodations could improve employment outcomes for people with systemic sclerosis.

Research Team:Poole JL, Carandang K, Thelander-Hill M,Lacaille D, Dionne T.

Getting research into the hands of people living with rheumatoid arthritis: a novel approach from the Canadian Early Arthritis Cohort (CATCH)

This study from the CATCH cohort developed a series of videos to help patients with rheumatoid arthritis (RA) understand research findings and participate in decision-making. Led by Knowledge translation specialists with RA, 100 English and French short videos covering various RA-related topics were created. These videos, along with other resources, were shared on social media platforms, reaching a wide audience.

Research Team:Proulx L, Richards D, Coish J, Schieir O, Kern J, Keystone E, Pope J, Thorne C, Boire G,Bartlett SJ,Hazlewood G, Tin D, Hitchon CA, Veilleux ME, Beaulieu MC, Bykerk V.

Safety and efficacy of sulfasalazine in treatment of immune checkpoint inhibitor-inflammatory arthritis

This research examined the use of sulfasalazine (SSZ) to treat inflammatory arthritis from immune checkpoint inhibitors, medications that treat cancer by turning on the immune system to attack cancer cells. In this study including 37 patients, over half experienced adverse events, including a quarter with a rash, possibly due to hypersensitivity reactions, and most reactions occurred within 5 weeks of starting sulfasalazine. Only a few patients achieved good control of the arthritis. This study highlights the potential risks and limited effectiveness of sulfasalazine for this type of arthritis.

Research Team:Challener G, Kohler MJ, Yokose C, Yinh J,Choi H.

Do policies that improve biosimilar uptake also help achieve greater expenditure control? A cross-country policy analysis.

This study compared how much was spent on three anti-TNF products among countries with different health policies that aim to promote adoption of biosimilars, which are less expensive versions of biologics, to help control spending on biologics. We found that procuring anti-TNF products by inviting pharmaceutical companies to bid on contracts (i.e., tendering) may help promote biosimilar adoption (for use in hospital and out-patient pharmacy settings) and in decreasing how much is spent on biologics  (in pharmacy settings only).  However, mandating small discounts on the price of biosimilars (e.g., –20% of the reference product price) do not appear to be helpful. More data are needed to evaluate health policies involving prescribing targets (i.e., quotas).

Research Team:Tam A, Badesha J, Guh D, Bansback N,Hollis A, Grootendorst P, Bae SC, Anis A, Zhang W.

Pre-diagnostic Immunomodulatory amino acid metabolites and risk of gout, accounting for serum urate: A prospective study of 249,677 individuals and mendelian randomization analyses

This study looked at the link between metabolites in the blood and the risk of severe gout flares requiring hospitalization. Analyzing data from nearly 250,000 participants, the researchers found that certain amino acids, like glycine and glutamine, were associated with a lower risk of being hospitalized for a gout flare, even after adjusting for levels of uric acid (responsible for gout flares). The study suggests that using supplements of glycine and glutamine might help reduce the risk of gout flares, based on their known immune-modulating properties.

Research Team:McCormick N, Joshi A, Yokose C, Yu B, Tin A, Terkeltaub R, Merriman T, Zeleznik O,  Eliassen A.H, Curhan G, Ea H.K, Nayor M, Raffield L, Choi H.

Pulmonary Functions and Respiratory Muscle Strength in Patients with Axial Spondyloarthritis

Researchers compared lung function and respiratory muscle strength between patients with axial spondyloarthritis (axSpA) and healthy individuals. They found that axSpA patients had more difficulty breathing and lower lung function measures compared to healthy controls. There were no significant differences observed in respiratory muscle strength between the two groups.

Research Team: Bayraktar D, Sarac DC, Inanc I, Başkan F, Ugur E, Özkan A, Gucenmez S, Solmmaz D, Akar S.

“I couldn’t carry on taking a drug like that”: a qualitative study of patient perspectives on side effects from drug treatment in rheumatology from the OMERACT safety working group

The authors explored what patients with inflammatory arthritis consider important concerning side effects from prescription drugs. Through focus groups and interviews with 34 participants across Europe, Australia and North America, patients highlighted the impact of medications on daily life, including family, work, and social aspects, as well as psychological and physical effects like limitations in physical function and emotional well-being. Patients also emphasized the burden of extra tests, hospital visits, and paying for medications on time, energy, and finances. Patients recognized the balance between benefits and harms of medication. This research will inform better methods to measure medication side-effects from the perspective of patients.

Research Team: Berthelsen DB, Nielsen SM, Rasmussen MU, Voshaar M, Richards P, Bartlett SJ, Hazlewood G,Shea B, Tugwell P, Ellingsen T, Jorgensen TS, Kristensen S, Simon L, Christensen R, Flurey C, on behalf of the OMERACT Safety Working Group.

Lupus Damage Index Revision – Item Generation and Reduction Phase

This project is an international collaboration of different organizations (the Systemic Lupus International Collaborating Clinics (SLICC), American College of Rheumatology (ACR), and Lupus Foundation of America (LFA)) aimed at revising an outcome measure which evaluates the damage caused by lupus – the Systemic Lupus Erythematosus (SLE) Damage Index (SDI) so it is more up-to-date. Through literature reviews and a consensus process with lupus experts and patient partners, the group has identified new items and revised outdated definitions.

Research Team:Kundacki B,Barber M, Clarke AE, Johnson SR, Bruce IN, And on Behalf of The Revised Systemic Lupus Erythematosus Organ Damage Index Collaborators.

Comparable Safety and Effectiveness Among New Users of Biosimilar vs Originator Anti-TNFs in Inflammatory Arthritis: Population-based Evidence from a Policy Change.

British Columbia’s health policy mandated that, for medication costs to be covered under the universal drug plan, all new prescriptions for biologics started after June 2017 should use biosimilars when available, because of their lower cost. Using population-based data for the entire province, they showed that people starting biosimilar etanercept and infliximab did not have higher rates of infections, did not use more healthcare services (i.e. hospitalizations, physician and emergency department visits,) and did not need more other inflammatory arthritis medications, compared to people using originator biologics. This real-world evidence suggests that they are equally safe and effective as originator biologics when used for inflammatory arthritis and that the biosimilar policy had no unintended adverse consequences.

Research Team: Lacaille D, Moolooghy K, Aviña-Zubieta JA, Zheng Y, Lu N, Xie H.

Population-based analysis of the association between SARS-CoV-2 infection and incident autoimmune diseases

The authors looked at whether people in British Columbia who had COVID-19 anytime between February 2020 and January 2022, were at a higher risk of new autoimmune diseases following that infection. They found that those who had had COVID-19 were at a higher risk of developing rheumatoid arthritis, type 1 diabetes mellitus, Graves’ disease, alopecia areata, vitiligo, immune thrombocytopenic purpura, Guillain-Barre syndrome, pemphigus vulgaris, transverse myelitis, and a combined group of any autoimmune disease, compared to people who hadn’t had COVID-19.

Research Team: Marozoff S,Lu N, Loree JM, Xie H, Lacaille D, Esdaile JM, Corradetti B, Malone P, Koehn CL, Mennell P, Hoens A, Avina-Zubieta JA. 

Want to learn about more Arthritis Research Canada research?