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Darrah E, Giles JT, Davis RL, Naik P, Wang H, Konig MF, Cappelli LC, Bingham CO, Danoff SK, Andrade F. Autoantibodies to Peptidylarginine Deiminase 2 Are Associated With Less Severe Disease in Rheumatoid Arthritis. Front Immunol 2018; 9:2696. [PMID: 30515171 PMCID: PMC6255931 DOI: 10.3389/fimmu.2018.02696] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2018] [Accepted: 10/31/2018] [Indexed: 12/22/2022] Open
Abstract
Objective: Peptidylarginine deiminases (PAD) 2 and 4 are key enzymes in rheumatoid arthritis (RA) pathogenesis due to their ability to generate the protein targets of anti-citrullinated protein antibodies (ACPA). Anti-PAD4 antibodies that cross-react with PAD3 (anti-PAD3/4) have been identified and are associated with severe joint and lung disease. Here, we examined whether anti-PAD2 antibodies were present in patients with RA and defined their clinical significance. Patients and Methods: A PAD2 ELISA was established to screen for anti-PAD2 IgG in sera from RA patients from a prospective observational cohort study (n = 184) and healthy controls (n = 100). RA patient characteristics were compared according to anti-PAD2 antibody status. Multivariable models were constructed to explore the independent associations of anti-PAD2 antibodies with clinical variables. Results: Anti-PAD2 antibodies were found in 18.5% of RA patients and 3% of healthy controls (p < 0.001). Among RA patients, anti-PAD2 antibodies were not associated with traditional genetic or serologic RA risk factors, including HLA-DRβ1 shared epitope alleles, ACPA, rheumatoid factor (RF), or anti-PAD3/4 antibodies. In addition, antibodies to PAD2 were associated with fewer swollen joints, a lower prevalence of interstitial lung disease, and less progression of joint damage. In subset analyses in which patients were stratified by the baseline presence of ACPA/RF or anti-PAD3/4 antibodies, anti-PAD2 antibodies provided additional value in identifying patients with the least progressive joint disease. Conclusions: Anti-PAD2 antibodies represent a novel serologic marker in RA that identifies a genetically and clinically unique subset of patients with less severe joint and lung disease.
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Affiliation(s)
- Erika Darrah
- Division of Rheumatology, The Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Jon T Giles
- Division of Rheumatology, College of Physicians and Surgeons, Columbia University, New York, NY, United States
| | - Ryan L Davis
- Division of Rheumatology, The Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Pooja Naik
- Division of Rheumatology, The Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Hong Wang
- Division of Rheumatology, The Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Maximilian F Konig
- Division of Rheumatology, The Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Laura C Cappelli
- Division of Rheumatology, The Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Clifton O Bingham
- Division of Rheumatology, The Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Sonye K Danoff
- Division of Pulmonary and Critical Care Medicine, The Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Felipe Andrade
- Division of Rheumatology, The Johns Hopkins University School of Medicine, Baltimore, MD, United States
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DiRenzo D, Crespo-Bosque M, Gould N, Finan P, Nanavati J, Bingham CO. Systematic Review and Meta-analysis: Mindfulness-Based Interventions for Rheumatoid Arthritis. Curr Rheumatol Rep 2018; 20:75. [PMID: 30338418 PMCID: PMC6233984 DOI: 10.1007/s11926-018-0787-4] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
PURPOSE OF REVIEW To determine the efficacy of mindfulness-based interventions (MBIs) on clinical and patient-reported outcomes in rheumatoid arthritis (RA). RECENT FINDINGS We identified randomized clinical trials from inception through April 2018 from MEDLINE, PsycINFO, EMBASE, CINAHL, Web of Science, the Cochrane Library, and hand searches. After screening 338 references, we included five trials with one post-hoc analysis that evaluated MBIs and collectively included 399 participants. Outcome instruments were heterogeneous across studies. Three studies evaluated RA clinical outcomes by a rheumatologist; one study found improvements in disease activity. A limited meta-analysis found no statistically significant difference in the levels of DAS28-CRP in the two studies that evaluated this metric (- 0.44 (- 0.99, 0.12); I2 0%). Four studies evaluated heterogeneous psychological outcomes, and all found improvements including depressive symptoms, psychological distress, and self-efficacy. A meta-analysis of pain Visual Analog Scale (VAS) levels post intervention from three included studies was not significantly different between MBI participants and control group (- 0.58 (- 1.26, 0.10); I2 0%) although other studies not included in meta-analysis found improvement. There are few trials evaluating the effect of MBIs on outcomes in patients with RA. Preliminary findings suggest that MBIs may be a useful strategy to improve psychological distress in those with RA.
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Affiliation(s)
- Dana DiRenzo
- Division of Rheumatology, Johns Hopkins University School of Medicine, 5200 Eastern Avenue, MFL Building, Center Tower, Suite 4100, Baltimore, MD, 21224, USA.
| | - Monica Crespo-Bosque
- Division of Rheumatology, Johns Hopkins University School of Medicine, 5200 Eastern Avenue, MFL Building, Center Tower, Suite 4100, Baltimore, MD, 21224, USA
| | - Neda Gould
- Department of Psychiatry and Behavioral Services, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Patrick Finan
- Department of Psychiatry and Behavioral Services, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Julie Nanavati
- Welch Medical Library, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Clifton O Bingham
- Division of Rheumatology, Johns Hopkins University School of Medicine, 5200 Eastern Avenue, MFL Building, Center Tower, Suite 4100, Baltimore, MD, 21224, USA
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103
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Moseley KF, Naidoo J, Bingham CO, Carducci MA, Forde PM, Gibney GT, Lipson EJ, Shah AA, Sharfman WH, Cappelli LC. Immune-related adverse events with immune checkpoint inhibitors affecting the skeleton: a seminal case series. J Immunother Cancer 2018; 6:104. [PMID: 30305172 PMCID: PMC6180387 DOI: 10.1186/s40425-018-0417-8] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2018] [Accepted: 09/21/2018] [Indexed: 02/03/2023] Open
Abstract
Background The use of immune checkpoint inhibitors is increasing in cancer therapy today. It is critical that treatment teams become familiar with the organ systems potentially impacted by immune-related adverse events associated with these drugs. Here, we report adverse skeletal effects of immunotherapy, a phenomenon not previously described. Case presentations In this retrospective case series, clinical, laboratory and imaging data were obtained in patients referred to endocrinology or rheumatology with new fractures (n = 3) or resorptive bone lesions (n = 3) that developed while on agents targeting PD-1, CTLA-4 or both. The average age of patients was 59.3 (SD 8.6), and five were male. Cancer types included melanoma, renal cell carcinoma and non-small cell lung cancer. All fracture patients had vertebral compression, and two of the three had multiple fracture sites involved. Sites of resorptive lesions included the shoulder, hand and clavicle. Biochemically, elevated or high-normal markers of bone resorption were seen in five of the six patients. Erythrocyte sedimentation rate was elevated in three of the four patients where checked. Conclusions This case series represents the first description of potential skeletal adverse effects related to immune checkpoint inhibitors. These findings are important for providers caring for patients who experience musculoskeletal symptoms and may merit additional evaluation.
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Affiliation(s)
- Kendall F Moseley
- Department of Medicine, Division of Endocrinology, Diabetes & Metabolism, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
| | - Jarushka Naidoo
- Department of Oncology, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Clifton O Bingham
- Department of Medicine, Division of Rheumatology, Allergy and Immunology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Michael A Carducci
- Department of Oncology, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Patrick M Forde
- Department of Oncology, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Geoffrey T Gibney
- Department of Oncology, Georgetown Lombardi Comprehensive Cancer Center, Medstar Georgetown University Hospital, Washington D.C., USA
| | - Evan J Lipson
- Department of Oncology, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Ami A Shah
- Department of Medicine, Division of Rheumatology, Allergy and Immunology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - William H Sharfman
- Department of Oncology, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Laura C Cappelli
- Department of Medicine, Division of Rheumatology, Allergy and Immunology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
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104
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Mecoli CA, Park JK, Alexanderson H, Regardt M, Needham M, de Groot I, Sarver C, Lundberg IE, Shea B, de Visser M, Song YW, Bingham CO, Christopher-Stine L. Perceptions of Patients, Caregivers, and Healthcare Providers of Idiopathic Inflammatory Myopathies: An International OMERACT Study. J Rheumatol 2018; 46:106-111. [PMID: 30219767 DOI: 10.3899/jrheum.180353] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/28/2018] [Indexed: 11/22/2022]
Abstract
OBJECTIVE Patient-reported outcome measures (PROM) that incorporate the patient perspective have not been well established in idiopathic inflammatory myopathies (IIM). As part of our goal to develop IIM-specific PROM, the Outcome Measures in Rheumatology (OMERACT) Myositis special interest group sought to determine which aspects of disease and its effects are important to patients and healthcare providers (HCP). METHODS Based on a prior qualitative content analysis of focus groups, an initial list of 24 candidate domains was constructed. We subsequently conducted an international survey to identify the importance of each of the 24 domains to be assessed in clinical research. Patients with IIM, their caregivers, and HCP treating IIM completed the survey. RESULTS In this survey, a total of 638 respondents completed the survey, consisting of 510 patients, 101 HCP, and 27 caregivers from 48 countries. Overall, patients were more likely to rank "fatigue," "cognitive impact," and "difficulty sleeping" higher compared with HCP, who ranked "joint symptoms," "lung symptoms," and "dysphagia" higher. Both patients and providers rated muscle symptoms as their top domain. In general, patients from different countries were in agreement on which domains were most important. One notable exception was that patients from Sweden and the Netherlands ranked lung symptoms significantly higher compared to other countries including the United States and Australia (mean weighted rankings of 2.86 and 2.04 vs 0.76 and 0.80, respectively; p < 0.0001). CONCLUSION Substantial differences exist in how IIM is perceived by patients compared to HCP, with different domains prioritized. In contrast, patients' ratings across the world were largely similar.
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Affiliation(s)
- Christopher A Mecoli
- From the Division of Rheumatology, Department of Medicine, Johns Hopkins University, Baltimore, Maryland, USA; Division of Rheumatology, Department of Internal Medicine, Seoul National University Hospital, Seoul, South Korea; Department of Neurology, Care Science and Society, Division of Physiotherapy, and Department of Medicine, Rheumatology Unit, Karolinska Institutet; Function Area Occupational Therapy and Physical Therapy, Allied Health Professionals Function, Karolinska University Hospital; Department of Learning, Informatics and Medical Education, Karolinska Institutet, Solna, Sweden; Department of Neurology, Fiona Stanley Hospital, IIID Murdoch University and Notre Dame University, Murdoch, Australia; Patient Research Partner, the Netherlands and USA; Division of Rheumatology, Rheumatology Unit, Department of Medicine, Karolinska University, Karolinska Institutet, Solna, Sweden; Center for Global Health, University of Ottawa, Ottawa, Ontario, Canada; Department of Neurology, Academic Medical Center, University of Amsterdam, the Netherlands; Medical Research Center, College of Medicine, Department of Molecular Medicine and Biopharmaceutical Sciences, Seoul National University, Seoul, South Korea. .,C.A. Mecoli, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University; J.K. Park, MD, Division of Rheumatology, Department of Internal Medicine, Seoul National University Hospital; H. Alexanderson, PhD, Physiotherapist, Department of Neurology, Care Science and Society, Division of Physiotherapy, and Department of Medicine, Rheumatology Unit, Karolinska Institutet, and Function Area Occupational Therapy and Physical Therapy, Allied Health Professionals Function, Karolinska University Hospital; M. Regardt, PhD, Occupational Therapist, Department of Learning, Informatics and Medical Education, Karolinska Institutet, and Function Area Occupational Therapy and Physical Therapy, Allied Health Professionals Function, Karolinska University Hospital; M. Needham, MD, Department of Neurology, Fiona Stanley Hospital, IIID Murdoch University and Notre Dame University; I. de Groot, Patient Research Partner, the Netherlands;C. Sarver, Patient Research Partner, USA; I.E. Lundberg, MD, PhD, Division of Rheumatology, Rheumatology Unit, Department of Medicine, Karolinska University Hospital in Solna, Karolinska Institutet; B. Shea, MSN, Center for Global Health, University of Ottawa; M. de Visser, MD, Department of Neurology, Academic Medical Center, University of Amsterdam; Y.W. Song, MD, PhD, Division of Rheumatology, Department of Internal Medicine, Medical Research Center, College of Medicine, Department of Molecular Medicine and Biopharmaceutical Sciences, Seoul National University; C.O. Bingham 3rd, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University; L. Christopher-Stine, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University. Dr. Mecoli and Dr. Park are co-first authors.
| | - Jin Kyun Park
- From the Division of Rheumatology, Department of Medicine, Johns Hopkins University, Baltimore, Maryland, USA; Division of Rheumatology, Department of Internal Medicine, Seoul National University Hospital, Seoul, South Korea; Department of Neurology, Care Science and Society, Division of Physiotherapy, and Department of Medicine, Rheumatology Unit, Karolinska Institutet; Function Area Occupational Therapy and Physical Therapy, Allied Health Professionals Function, Karolinska University Hospital; Department of Learning, Informatics and Medical Education, Karolinska Institutet, Solna, Sweden; Department of Neurology, Fiona Stanley Hospital, IIID Murdoch University and Notre Dame University, Murdoch, Australia; Patient Research Partner, the Netherlands and USA; Division of Rheumatology, Rheumatology Unit, Department of Medicine, Karolinska University, Karolinska Institutet, Solna, Sweden; Center for Global Health, University of Ottawa, Ottawa, Ontario, Canada; Department of Neurology, Academic Medical Center, University of Amsterdam, the Netherlands; Medical Research Center, College of Medicine, Department of Molecular Medicine and Biopharmaceutical Sciences, Seoul National University, Seoul, South Korea.,C.A. Mecoli, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University; J.K. Park, MD, Division of Rheumatology, Department of Internal Medicine, Seoul National University Hospital; H. Alexanderson, PhD, Physiotherapist, Department of Neurology, Care Science and Society, Division of Physiotherapy, and Department of Medicine, Rheumatology Unit, Karolinska Institutet, and Function Area Occupational Therapy and Physical Therapy, Allied Health Professionals Function, Karolinska University Hospital; M. Regardt, PhD, Occupational Therapist, Department of Learning, Informatics and Medical Education, Karolinska Institutet, and Function Area Occupational Therapy and Physical Therapy, Allied Health Professionals Function, Karolinska University Hospital; M. Needham, MD, Department of Neurology, Fiona Stanley Hospital, IIID Murdoch University and Notre Dame University; I. de Groot, Patient Research Partner, the Netherlands;C. Sarver, Patient Research Partner, USA; I.E. Lundberg, MD, PhD, Division of Rheumatology, Rheumatology Unit, Department of Medicine, Karolinska University Hospital in Solna, Karolinska Institutet; B. Shea, MSN, Center for Global Health, University of Ottawa; M. de Visser, MD, Department of Neurology, Academic Medical Center, University of Amsterdam; Y.W. Song, MD, PhD, Division of Rheumatology, Department of Internal Medicine, Medical Research Center, College of Medicine, Department of Molecular Medicine and Biopharmaceutical Sciences, Seoul National University; C.O. Bingham 3rd, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University; L. Christopher-Stine, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University. Dr. Mecoli and Dr. Park are co-first authors
| | - Helene Alexanderson
- From the Division of Rheumatology, Department of Medicine, Johns Hopkins University, Baltimore, Maryland, USA; Division of Rheumatology, Department of Internal Medicine, Seoul National University Hospital, Seoul, South Korea; Department of Neurology, Care Science and Society, Division of Physiotherapy, and Department of Medicine, Rheumatology Unit, Karolinska Institutet; Function Area Occupational Therapy and Physical Therapy, Allied Health Professionals Function, Karolinska University Hospital; Department of Learning, Informatics and Medical Education, Karolinska Institutet, Solna, Sweden; Department of Neurology, Fiona Stanley Hospital, IIID Murdoch University and Notre Dame University, Murdoch, Australia; Patient Research Partner, the Netherlands and USA; Division of Rheumatology, Rheumatology Unit, Department of Medicine, Karolinska University, Karolinska Institutet, Solna, Sweden; Center for Global Health, University of Ottawa, Ottawa, Ontario, Canada; Department of Neurology, Academic Medical Center, University of Amsterdam, the Netherlands; Medical Research Center, College of Medicine, Department of Molecular Medicine and Biopharmaceutical Sciences, Seoul National University, Seoul, South Korea.,C.A. Mecoli, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University; J.K. Park, MD, Division of Rheumatology, Department of Internal Medicine, Seoul National University Hospital; H. Alexanderson, PhD, Physiotherapist, Department of Neurology, Care Science and Society, Division of Physiotherapy, and Department of Medicine, Rheumatology Unit, Karolinska Institutet, and Function Area Occupational Therapy and Physical Therapy, Allied Health Professionals Function, Karolinska University Hospital; M. Regardt, PhD, Occupational Therapist, Department of Learning, Informatics and Medical Education, Karolinska Institutet, and Function Area Occupational Therapy and Physical Therapy, Allied Health Professionals Function, Karolinska University Hospital; M. Needham, MD, Department of Neurology, Fiona Stanley Hospital, IIID Murdoch University and Notre Dame University; I. de Groot, Patient Research Partner, the Netherlands;C. Sarver, Patient Research Partner, USA; I.E. Lundberg, MD, PhD, Division of Rheumatology, Rheumatology Unit, Department of Medicine, Karolinska University Hospital in Solna, Karolinska Institutet; B. Shea, MSN, Center for Global Health, University of Ottawa; M. de Visser, MD, Department of Neurology, Academic Medical Center, University of Amsterdam; Y.W. Song, MD, PhD, Division of Rheumatology, Department of Internal Medicine, Medical Research Center, College of Medicine, Department of Molecular Medicine and Biopharmaceutical Sciences, Seoul National University; C.O. Bingham 3rd, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University; L. Christopher-Stine, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University. Dr. Mecoli and Dr. Park are co-first authors
| | - Malin Regardt
- From the Division of Rheumatology, Department of Medicine, Johns Hopkins University, Baltimore, Maryland, USA; Division of Rheumatology, Department of Internal Medicine, Seoul National University Hospital, Seoul, South Korea; Department of Neurology, Care Science and Society, Division of Physiotherapy, and Department of Medicine, Rheumatology Unit, Karolinska Institutet; Function Area Occupational Therapy and Physical Therapy, Allied Health Professionals Function, Karolinska University Hospital; Department of Learning, Informatics and Medical Education, Karolinska Institutet, Solna, Sweden; Department of Neurology, Fiona Stanley Hospital, IIID Murdoch University and Notre Dame University, Murdoch, Australia; Patient Research Partner, the Netherlands and USA; Division of Rheumatology, Rheumatology Unit, Department of Medicine, Karolinska University, Karolinska Institutet, Solna, Sweden; Center for Global Health, University of Ottawa, Ottawa, Ontario, Canada; Department of Neurology, Academic Medical Center, University of Amsterdam, the Netherlands; Medical Research Center, College of Medicine, Department of Molecular Medicine and Biopharmaceutical Sciences, Seoul National University, Seoul, South Korea.,C.A. Mecoli, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University; J.K. Park, MD, Division of Rheumatology, Department of Internal Medicine, Seoul National University Hospital; H. Alexanderson, PhD, Physiotherapist, Department of Neurology, Care Science and Society, Division of Physiotherapy, and Department of Medicine, Rheumatology Unit, Karolinska Institutet, and Function Area Occupational Therapy and Physical Therapy, Allied Health Professionals Function, Karolinska University Hospital; M. Regardt, PhD, Occupational Therapist, Department of Learning, Informatics and Medical Education, Karolinska Institutet, and Function Area Occupational Therapy and Physical Therapy, Allied Health Professionals Function, Karolinska University Hospital; M. Needham, MD, Department of Neurology, Fiona Stanley Hospital, IIID Murdoch University and Notre Dame University; I. de Groot, Patient Research Partner, the Netherlands;C. Sarver, Patient Research Partner, USA; I.E. Lundberg, MD, PhD, Division of Rheumatology, Rheumatology Unit, Department of Medicine, Karolinska University Hospital in Solna, Karolinska Institutet; B. Shea, MSN, Center for Global Health, University of Ottawa; M. de Visser, MD, Department of Neurology, Academic Medical Center, University of Amsterdam; Y.W. Song, MD, PhD, Division of Rheumatology, Department of Internal Medicine, Medical Research Center, College of Medicine, Department of Molecular Medicine and Biopharmaceutical Sciences, Seoul National University; C.O. Bingham 3rd, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University; L. Christopher-Stine, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University. Dr. Mecoli and Dr. Park are co-first authors
| | - Merrilee Needham
- From the Division of Rheumatology, Department of Medicine, Johns Hopkins University, Baltimore, Maryland, USA; Division of Rheumatology, Department of Internal Medicine, Seoul National University Hospital, Seoul, South Korea; Department of Neurology, Care Science and Society, Division of Physiotherapy, and Department of Medicine, Rheumatology Unit, Karolinska Institutet; Function Area Occupational Therapy and Physical Therapy, Allied Health Professionals Function, Karolinska University Hospital; Department of Learning, Informatics and Medical Education, Karolinska Institutet, Solna, Sweden; Department of Neurology, Fiona Stanley Hospital, IIID Murdoch University and Notre Dame University, Murdoch, Australia; Patient Research Partner, the Netherlands and USA; Division of Rheumatology, Rheumatology Unit, Department of Medicine, Karolinska University, Karolinska Institutet, Solna, Sweden; Center for Global Health, University of Ottawa, Ottawa, Ontario, Canada; Department of Neurology, Academic Medical Center, University of Amsterdam, the Netherlands; Medical Research Center, College of Medicine, Department of Molecular Medicine and Biopharmaceutical Sciences, Seoul National University, Seoul, South Korea.,C.A. Mecoli, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University; J.K. Park, MD, Division of Rheumatology, Department of Internal Medicine, Seoul National University Hospital; H. Alexanderson, PhD, Physiotherapist, Department of Neurology, Care Science and Society, Division of Physiotherapy, and Department of Medicine, Rheumatology Unit, Karolinska Institutet, and Function Area Occupational Therapy and Physical Therapy, Allied Health Professionals Function, Karolinska University Hospital; M. Regardt, PhD, Occupational Therapist, Department of Learning, Informatics and Medical Education, Karolinska Institutet, and Function Area Occupational Therapy and Physical Therapy, Allied Health Professionals Function, Karolinska University Hospital; M. Needham, MD, Department of Neurology, Fiona Stanley Hospital, IIID Murdoch University and Notre Dame University; I. de Groot, Patient Research Partner, the Netherlands;C. Sarver, Patient Research Partner, USA; I.E. Lundberg, MD, PhD, Division of Rheumatology, Rheumatology Unit, Department of Medicine, Karolinska University Hospital in Solna, Karolinska Institutet; B. Shea, MSN, Center for Global Health, University of Ottawa; M. de Visser, MD, Department of Neurology, Academic Medical Center, University of Amsterdam; Y.W. Song, MD, PhD, Division of Rheumatology, Department of Internal Medicine, Medical Research Center, College of Medicine, Department of Molecular Medicine and Biopharmaceutical Sciences, Seoul National University; C.O. Bingham 3rd, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University; L. Christopher-Stine, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University. Dr. Mecoli and Dr. Park are co-first authors
| | - Ingrid de Groot
- From the Division of Rheumatology, Department of Medicine, Johns Hopkins University, Baltimore, Maryland, USA; Division of Rheumatology, Department of Internal Medicine, Seoul National University Hospital, Seoul, South Korea; Department of Neurology, Care Science and Society, Division of Physiotherapy, and Department of Medicine, Rheumatology Unit, Karolinska Institutet; Function Area Occupational Therapy and Physical Therapy, Allied Health Professionals Function, Karolinska University Hospital; Department of Learning, Informatics and Medical Education, Karolinska Institutet, Solna, Sweden; Department of Neurology, Fiona Stanley Hospital, IIID Murdoch University and Notre Dame University, Murdoch, Australia; Patient Research Partner, the Netherlands and USA; Division of Rheumatology, Rheumatology Unit, Department of Medicine, Karolinska University, Karolinska Institutet, Solna, Sweden; Center for Global Health, University of Ottawa, Ottawa, Ontario, Canada; Department of Neurology, Academic Medical Center, University of Amsterdam, the Netherlands; Medical Research Center, College of Medicine, Department of Molecular Medicine and Biopharmaceutical Sciences, Seoul National University, Seoul, South Korea.,C.A. Mecoli, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University; J.K. Park, MD, Division of Rheumatology, Department of Internal Medicine, Seoul National University Hospital; H. Alexanderson, PhD, Physiotherapist, Department of Neurology, Care Science and Society, Division of Physiotherapy, and Department of Medicine, Rheumatology Unit, Karolinska Institutet, and Function Area Occupational Therapy and Physical Therapy, Allied Health Professionals Function, Karolinska University Hospital; M. Regardt, PhD, Occupational Therapist, Department of Learning, Informatics and Medical Education, Karolinska Institutet, and Function Area Occupational Therapy and Physical Therapy, Allied Health Professionals Function, Karolinska University Hospital; M. Needham, MD, Department of Neurology, Fiona Stanley Hospital, IIID Murdoch University and Notre Dame University; I. de Groot, Patient Research Partner, the Netherlands;C. Sarver, Patient Research Partner, USA; I.E. Lundberg, MD, PhD, Division of Rheumatology, Rheumatology Unit, Department of Medicine, Karolinska University Hospital in Solna, Karolinska Institutet; B. Shea, MSN, Center for Global Health, University of Ottawa; M. de Visser, MD, Department of Neurology, Academic Medical Center, University of Amsterdam; Y.W. Song, MD, PhD, Division of Rheumatology, Department of Internal Medicine, Medical Research Center, College of Medicine, Department of Molecular Medicine and Biopharmaceutical Sciences, Seoul National University; C.O. Bingham 3rd, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University; L. Christopher-Stine, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University. Dr. Mecoli and Dr. Park are co-first authors
| | - Catherine Sarver
- From the Division of Rheumatology, Department of Medicine, Johns Hopkins University, Baltimore, Maryland, USA; Division of Rheumatology, Department of Internal Medicine, Seoul National University Hospital, Seoul, South Korea; Department of Neurology, Care Science and Society, Division of Physiotherapy, and Department of Medicine, Rheumatology Unit, Karolinska Institutet; Function Area Occupational Therapy and Physical Therapy, Allied Health Professionals Function, Karolinska University Hospital; Department of Learning, Informatics and Medical Education, Karolinska Institutet, Solna, Sweden; Department of Neurology, Fiona Stanley Hospital, IIID Murdoch University and Notre Dame University, Murdoch, Australia; Patient Research Partner, the Netherlands and USA; Division of Rheumatology, Rheumatology Unit, Department of Medicine, Karolinska University, Karolinska Institutet, Solna, Sweden; Center for Global Health, University of Ottawa, Ottawa, Ontario, Canada; Department of Neurology, Academic Medical Center, University of Amsterdam, the Netherlands; Medical Research Center, College of Medicine, Department of Molecular Medicine and Biopharmaceutical Sciences, Seoul National University, Seoul, South Korea.,C.A. Mecoli, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University; J.K. Park, MD, Division of Rheumatology, Department of Internal Medicine, Seoul National University Hospital; H. Alexanderson, PhD, Physiotherapist, Department of Neurology, Care Science and Society, Division of Physiotherapy, and Department of Medicine, Rheumatology Unit, Karolinska Institutet, and Function Area Occupational Therapy and Physical Therapy, Allied Health Professionals Function, Karolinska University Hospital; M. Regardt, PhD, Occupational Therapist, Department of Learning, Informatics and Medical Education, Karolinska Institutet, and Function Area Occupational Therapy and Physical Therapy, Allied Health Professionals Function, Karolinska University Hospital; M. Needham, MD, Department of Neurology, Fiona Stanley Hospital, IIID Murdoch University and Notre Dame University; I. de Groot, Patient Research Partner, the Netherlands;C. Sarver, Patient Research Partner, USA; I.E. Lundberg, MD, PhD, Division of Rheumatology, Rheumatology Unit, Department of Medicine, Karolinska University Hospital in Solna, Karolinska Institutet; B. Shea, MSN, Center for Global Health, University of Ottawa; M. de Visser, MD, Department of Neurology, Academic Medical Center, University of Amsterdam; Y.W. Song, MD, PhD, Division of Rheumatology, Department of Internal Medicine, Medical Research Center, College of Medicine, Department of Molecular Medicine and Biopharmaceutical Sciences, Seoul National University; C.O. Bingham 3rd, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University; L. Christopher-Stine, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University. Dr. Mecoli and Dr. Park are co-first authors
| | - Ingrid E Lundberg
- From the Division of Rheumatology, Department of Medicine, Johns Hopkins University, Baltimore, Maryland, USA; Division of Rheumatology, Department of Internal Medicine, Seoul National University Hospital, Seoul, South Korea; Department of Neurology, Care Science and Society, Division of Physiotherapy, and Department of Medicine, Rheumatology Unit, Karolinska Institutet; Function Area Occupational Therapy and Physical Therapy, Allied Health Professionals Function, Karolinska University Hospital; Department of Learning, Informatics and Medical Education, Karolinska Institutet, Solna, Sweden; Department of Neurology, Fiona Stanley Hospital, IIID Murdoch University and Notre Dame University, Murdoch, Australia; Patient Research Partner, the Netherlands and USA; Division of Rheumatology, Rheumatology Unit, Department of Medicine, Karolinska University, Karolinska Institutet, Solna, Sweden; Center for Global Health, University of Ottawa, Ottawa, Ontario, Canada; Department of Neurology, Academic Medical Center, University of Amsterdam, the Netherlands; Medical Research Center, College of Medicine, Department of Molecular Medicine and Biopharmaceutical Sciences, Seoul National University, Seoul, South Korea.,C.A. Mecoli, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University; J.K. Park, MD, Division of Rheumatology, Department of Internal Medicine, Seoul National University Hospital; H. Alexanderson, PhD, Physiotherapist, Department of Neurology, Care Science and Society, Division of Physiotherapy, and Department of Medicine, Rheumatology Unit, Karolinska Institutet, and Function Area Occupational Therapy and Physical Therapy, Allied Health Professionals Function, Karolinska University Hospital; M. Regardt, PhD, Occupational Therapist, Department of Learning, Informatics and Medical Education, Karolinska Institutet, and Function Area Occupational Therapy and Physical Therapy, Allied Health Professionals Function, Karolinska University Hospital; M. Needham, MD, Department of Neurology, Fiona Stanley Hospital, IIID Murdoch University and Notre Dame University; I. de Groot, Patient Research Partner, the Netherlands;C. Sarver, Patient Research Partner, USA; I.E. Lundberg, MD, PhD, Division of Rheumatology, Rheumatology Unit, Department of Medicine, Karolinska University Hospital in Solna, Karolinska Institutet; B. Shea, MSN, Center for Global Health, University of Ottawa; M. de Visser, MD, Department of Neurology, Academic Medical Center, University of Amsterdam; Y.W. Song, MD, PhD, Division of Rheumatology, Department of Internal Medicine, Medical Research Center, College of Medicine, Department of Molecular Medicine and Biopharmaceutical Sciences, Seoul National University; C.O. Bingham 3rd, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University; L. Christopher-Stine, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University. Dr. Mecoli and Dr. Park are co-first authors
| | - Beverley Shea
- From the Division of Rheumatology, Department of Medicine, Johns Hopkins University, Baltimore, Maryland, USA; Division of Rheumatology, Department of Internal Medicine, Seoul National University Hospital, Seoul, South Korea; Department of Neurology, Care Science and Society, Division of Physiotherapy, and Department of Medicine, Rheumatology Unit, Karolinska Institutet; Function Area Occupational Therapy and Physical Therapy, Allied Health Professionals Function, Karolinska University Hospital; Department of Learning, Informatics and Medical Education, Karolinska Institutet, Solna, Sweden; Department of Neurology, Fiona Stanley Hospital, IIID Murdoch University and Notre Dame University, Murdoch, Australia; Patient Research Partner, the Netherlands and USA; Division of Rheumatology, Rheumatology Unit, Department of Medicine, Karolinska University, Karolinska Institutet, Solna, Sweden; Center for Global Health, University of Ottawa, Ottawa, Ontario, Canada; Department of Neurology, Academic Medical Center, University of Amsterdam, the Netherlands; Medical Research Center, College of Medicine, Department of Molecular Medicine and Biopharmaceutical Sciences, Seoul National University, Seoul, South Korea.,C.A. Mecoli, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University; J.K. Park, MD, Division of Rheumatology, Department of Internal Medicine, Seoul National University Hospital; H. Alexanderson, PhD, Physiotherapist, Department of Neurology, Care Science and Society, Division of Physiotherapy, and Department of Medicine, Rheumatology Unit, Karolinska Institutet, and Function Area Occupational Therapy and Physical Therapy, Allied Health Professionals Function, Karolinska University Hospital; M. Regardt, PhD, Occupational Therapist, Department of Learning, Informatics and Medical Education, Karolinska Institutet, and Function Area Occupational Therapy and Physical Therapy, Allied Health Professionals Function, Karolinska University Hospital; M. Needham, MD, Department of Neurology, Fiona Stanley Hospital, IIID Murdoch University and Notre Dame University; I. de Groot, Patient Research Partner, the Netherlands;C. Sarver, Patient Research Partner, USA; I.E. Lundberg, MD, PhD, Division of Rheumatology, Rheumatology Unit, Department of Medicine, Karolinska University Hospital in Solna, Karolinska Institutet; B. Shea, MSN, Center for Global Health, University of Ottawa; M. de Visser, MD, Department of Neurology, Academic Medical Center, University of Amsterdam; Y.W. Song, MD, PhD, Division of Rheumatology, Department of Internal Medicine, Medical Research Center, College of Medicine, Department of Molecular Medicine and Biopharmaceutical Sciences, Seoul National University; C.O. Bingham 3rd, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University; L. Christopher-Stine, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University. Dr. Mecoli and Dr. Park are co-first authors
| | - Marianne de Visser
- From the Division of Rheumatology, Department of Medicine, Johns Hopkins University, Baltimore, Maryland, USA; Division of Rheumatology, Department of Internal Medicine, Seoul National University Hospital, Seoul, South Korea; Department of Neurology, Care Science and Society, Division of Physiotherapy, and Department of Medicine, Rheumatology Unit, Karolinska Institutet; Function Area Occupational Therapy and Physical Therapy, Allied Health Professionals Function, Karolinska University Hospital; Department of Learning, Informatics and Medical Education, Karolinska Institutet, Solna, Sweden; Department of Neurology, Fiona Stanley Hospital, IIID Murdoch University and Notre Dame University, Murdoch, Australia; Patient Research Partner, the Netherlands and USA; Division of Rheumatology, Rheumatology Unit, Department of Medicine, Karolinska University, Karolinska Institutet, Solna, Sweden; Center for Global Health, University of Ottawa, Ottawa, Ontario, Canada; Department of Neurology, Academic Medical Center, University of Amsterdam, the Netherlands; Medical Research Center, College of Medicine, Department of Molecular Medicine and Biopharmaceutical Sciences, Seoul National University, Seoul, South Korea.,C.A. Mecoli, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University; J.K. Park, MD, Division of Rheumatology, Department of Internal Medicine, Seoul National University Hospital; H. Alexanderson, PhD, Physiotherapist, Department of Neurology, Care Science and Society, Division of Physiotherapy, and Department of Medicine, Rheumatology Unit, Karolinska Institutet, and Function Area Occupational Therapy and Physical Therapy, Allied Health Professionals Function, Karolinska University Hospital; M. Regardt, PhD, Occupational Therapist, Department of Learning, Informatics and Medical Education, Karolinska Institutet, and Function Area Occupational Therapy and Physical Therapy, Allied Health Professionals Function, Karolinska University Hospital; M. Needham, MD, Department of Neurology, Fiona Stanley Hospital, IIID Murdoch University and Notre Dame University; I. de Groot, Patient Research Partner, the Netherlands;C. Sarver, Patient Research Partner, USA; I.E. Lundberg, MD, PhD, Division of Rheumatology, Rheumatology Unit, Department of Medicine, Karolinska University Hospital in Solna, Karolinska Institutet; B. Shea, MSN, Center for Global Health, University of Ottawa; M. de Visser, MD, Department of Neurology, Academic Medical Center, University of Amsterdam; Y.W. Song, MD, PhD, Division of Rheumatology, Department of Internal Medicine, Medical Research Center, College of Medicine, Department of Molecular Medicine and Biopharmaceutical Sciences, Seoul National University; C.O. Bingham 3rd, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University; L. Christopher-Stine, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University. Dr. Mecoli and Dr. Park are co-first authors
| | - Yeong Wook Song
- From the Division of Rheumatology, Department of Medicine, Johns Hopkins University, Baltimore, Maryland, USA; Division of Rheumatology, Department of Internal Medicine, Seoul National University Hospital, Seoul, South Korea; Department of Neurology, Care Science and Society, Division of Physiotherapy, and Department of Medicine, Rheumatology Unit, Karolinska Institutet; Function Area Occupational Therapy and Physical Therapy, Allied Health Professionals Function, Karolinska University Hospital; Department of Learning, Informatics and Medical Education, Karolinska Institutet, Solna, Sweden; Department of Neurology, Fiona Stanley Hospital, IIID Murdoch University and Notre Dame University, Murdoch, Australia; Patient Research Partner, the Netherlands and USA; Division of Rheumatology, Rheumatology Unit, Department of Medicine, Karolinska University, Karolinska Institutet, Solna, Sweden; Center for Global Health, University of Ottawa, Ottawa, Ontario, Canada; Department of Neurology, Academic Medical Center, University of Amsterdam, the Netherlands; Medical Research Center, College of Medicine, Department of Molecular Medicine and Biopharmaceutical Sciences, Seoul National University, Seoul, South Korea.,C.A. Mecoli, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University; J.K. Park, MD, Division of Rheumatology, Department of Internal Medicine, Seoul National University Hospital; H. Alexanderson, PhD, Physiotherapist, Department of Neurology, Care Science and Society, Division of Physiotherapy, and Department of Medicine, Rheumatology Unit, Karolinska Institutet, and Function Area Occupational Therapy and Physical Therapy, Allied Health Professionals Function, Karolinska University Hospital; M. Regardt, PhD, Occupational Therapist, Department of Learning, Informatics and Medical Education, Karolinska Institutet, and Function Area Occupational Therapy and Physical Therapy, Allied Health Professionals Function, Karolinska University Hospital; M. Needham, MD, Department of Neurology, Fiona Stanley Hospital, IIID Murdoch University and Notre Dame University; I. de Groot, Patient Research Partner, the Netherlands;C. Sarver, Patient Research Partner, USA; I.E. Lundberg, MD, PhD, Division of Rheumatology, Rheumatology Unit, Department of Medicine, Karolinska University Hospital in Solna, Karolinska Institutet; B. Shea, MSN, Center for Global Health, University of Ottawa; M. de Visser, MD, Department of Neurology, Academic Medical Center, University of Amsterdam; Y.W. Song, MD, PhD, Division of Rheumatology, Department of Internal Medicine, Medical Research Center, College of Medicine, Department of Molecular Medicine and Biopharmaceutical Sciences, Seoul National University; C.O. Bingham 3rd, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University; L. Christopher-Stine, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University. Dr. Mecoli and Dr. Park are co-first authors
| | - Clifton O Bingham
- From the Division of Rheumatology, Department of Medicine, Johns Hopkins University, Baltimore, Maryland, USA; Division of Rheumatology, Department of Internal Medicine, Seoul National University Hospital, Seoul, South Korea; Department of Neurology, Care Science and Society, Division of Physiotherapy, and Department of Medicine, Rheumatology Unit, Karolinska Institutet; Function Area Occupational Therapy and Physical Therapy, Allied Health Professionals Function, Karolinska University Hospital; Department of Learning, Informatics and Medical Education, Karolinska Institutet, Solna, Sweden; Department of Neurology, Fiona Stanley Hospital, IIID Murdoch University and Notre Dame University, Murdoch, Australia; Patient Research Partner, the Netherlands and USA; Division of Rheumatology, Rheumatology Unit, Department of Medicine, Karolinska University, Karolinska Institutet, Solna, Sweden; Center for Global Health, University of Ottawa, Ottawa, Ontario, Canada; Department of Neurology, Academic Medical Center, University of Amsterdam, the Netherlands; Medical Research Center, College of Medicine, Department of Molecular Medicine and Biopharmaceutical Sciences, Seoul National University, Seoul, South Korea.,C.A. Mecoli, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University; J.K. Park, MD, Division of Rheumatology, Department of Internal Medicine, Seoul National University Hospital; H. Alexanderson, PhD, Physiotherapist, Department of Neurology, Care Science and Society, Division of Physiotherapy, and Department of Medicine, Rheumatology Unit, Karolinska Institutet, and Function Area Occupational Therapy and Physical Therapy, Allied Health Professionals Function, Karolinska University Hospital; M. Regardt, PhD, Occupational Therapist, Department of Learning, Informatics and Medical Education, Karolinska Institutet, and Function Area Occupational Therapy and Physical Therapy, Allied Health Professionals Function, Karolinska University Hospital; M. Needham, MD, Department of Neurology, Fiona Stanley Hospital, IIID Murdoch University and Notre Dame University; I. de Groot, Patient Research Partner, the Netherlands;C. Sarver, Patient Research Partner, USA; I.E. Lundberg, MD, PhD, Division of Rheumatology, Rheumatology Unit, Department of Medicine, Karolinska University Hospital in Solna, Karolinska Institutet; B. Shea, MSN, Center for Global Health, University of Ottawa; M. de Visser, MD, Department of Neurology, Academic Medical Center, University of Amsterdam; Y.W. Song, MD, PhD, Division of Rheumatology, Department of Internal Medicine, Medical Research Center, College of Medicine, Department of Molecular Medicine and Biopharmaceutical Sciences, Seoul National University; C.O. Bingham 3rd, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University; L. Christopher-Stine, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University. Dr. Mecoli and Dr. Park are co-first authors
| | - Lisa Christopher-Stine
- From the Division of Rheumatology, Department of Medicine, Johns Hopkins University, Baltimore, Maryland, USA; Division of Rheumatology, Department of Internal Medicine, Seoul National University Hospital, Seoul, South Korea; Department of Neurology, Care Science and Society, Division of Physiotherapy, and Department of Medicine, Rheumatology Unit, Karolinska Institutet; Function Area Occupational Therapy and Physical Therapy, Allied Health Professionals Function, Karolinska University Hospital; Department of Learning, Informatics and Medical Education, Karolinska Institutet, Solna, Sweden; Department of Neurology, Fiona Stanley Hospital, IIID Murdoch University and Notre Dame University, Murdoch, Australia; Patient Research Partner, the Netherlands and USA; Division of Rheumatology, Rheumatology Unit, Department of Medicine, Karolinska University, Karolinska Institutet, Solna, Sweden; Center for Global Health, University of Ottawa, Ottawa, Ontario, Canada; Department of Neurology, Academic Medical Center, University of Amsterdam, the Netherlands; Medical Research Center, College of Medicine, Department of Molecular Medicine and Biopharmaceutical Sciences, Seoul National University, Seoul, South Korea.,C.A. Mecoli, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University; J.K. Park, MD, Division of Rheumatology, Department of Internal Medicine, Seoul National University Hospital; H. Alexanderson, PhD, Physiotherapist, Department of Neurology, Care Science and Society, Division of Physiotherapy, and Department of Medicine, Rheumatology Unit, Karolinska Institutet, and Function Area Occupational Therapy and Physical Therapy, Allied Health Professionals Function, Karolinska University Hospital; M. Regardt, PhD, Occupational Therapist, Department of Learning, Informatics and Medical Education, Karolinska Institutet, and Function Area Occupational Therapy and Physical Therapy, Allied Health Professionals Function, Karolinska University Hospital; M. Needham, MD, Department of Neurology, Fiona Stanley Hospital, IIID Murdoch University and Notre Dame University; I. de Groot, Patient Research Partner, the Netherlands;C. Sarver, Patient Research Partner, USA; I.E. Lundberg, MD, PhD, Division of Rheumatology, Rheumatology Unit, Department of Medicine, Karolinska University Hospital in Solna, Karolinska Institutet; B. Shea, MSN, Center for Global Health, University of Ottawa; M. de Visser, MD, Department of Neurology, Academic Medical Center, University of Amsterdam; Y.W. Song, MD, PhD, Division of Rheumatology, Department of Internal Medicine, Medical Research Center, College of Medicine, Department of Molecular Medicine and Biopharmaceutical Sciences, Seoul National University; C.O. Bingham 3rd, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University; L. Christopher-Stine, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University. Dr. Mecoli and Dr. Park are co-first authors
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Bartlett SJ, Gutierrez AK, Butanis A, Bykerk VP, Curtis JR, Ginsberg S, Leong AL, Lyddiatt A, Nowell WB, Orbai AM, Smith KC, Bingham CO. Combining online and in-person methods to evaluate the content validity of PROMIS fatigue short forms in rheumatoid arthritis. Qual Life Res 2018; 27:2443-2451. [PMID: 29797175 PMCID: PMC6113070 DOI: 10.1007/s11136-018-1880-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/08/2018] [Indexed: 12/14/2022]
Abstract
PURPOSE Fatigue is frequent and often severe and disabling in RA, and there is no consensus on how to measure it. We used online surveys and in-person interviews to evaluate PROMIS Fatigue 7a and 8a short forms (SFs) in people with RA. METHODS We recruited people with RA from an online patient community (n = 200) and three academic medical centers (n = 84) in the US. Participants completed both SFs then rated the comprehensiveness and comprehensibility of the items to their fatigue experience. Cognitive debriefing of items was conducted in a subset of 32 clinic patients. Descriptive statistics were calculated, and associations were evaluated using Pearson and Spearman correlation coefficients. RESULTS Mean SF scores were similar (p ≥ .61) among clinic patients reflecting mild fatigue (i.e., 54.5-55.9), but were significantly higher (p < .001) in online participants. SF Fatigue scores correlated highly (r ≥ 0.82; p < .000) and moderately with patient assessments of disease activity (r ≥ 0.62; p = .000). Most (70-92%) reported that the items "completely" or "mostly" reflected their experience. Almost all (≥ 94%) could distinguish general fatigue from RA fatigue. Most (≥ 85%) rated individual items questions as "somewhat" or "very relevant" to their fatigue experience, averaged their fatigue over the past 7 days (58%), and rated fatigue impact versus severity (72 vs. 19%). 99% rated fatigue as an important symptom they considered when deciding how well their current treatment was controlling their RA. CONCLUSIONS Results suggest that items in the single-score PROMIS Fatigue SFs demonstrate content validity and can adequately capture the wide range of fatigue experiences of people with RA.
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Affiliation(s)
- S J Bartlett
- Center for Health Outcomes Research, McGill University, 5252 de Maisonneuve West, #3D-57, Montreal, QC, H4A 3S5, Canada.
- Division of Rheumatology, Johns Hopkins School of Medicine, Mason F Lord Tower, 5200 Eastern Avenue, Rm 404, Baltimore, MD, 21224, USA.
| | - A K Gutierrez
- Division of Rheumatology, Johns Hopkins School of Medicine, Mason F Lord Tower, 5200 Eastern Avenue, Rm 404, Baltimore, MD, 21224, USA
- Ateneo School of Medicine and Public Health, Pasig City, Philippines
| | - A Butanis
- Division of Rheumatology, Johns Hopkins School of Medicine, Mason F Lord Tower, 5200 Eastern Avenue, Rm 404, Baltimore, MD, 21224, USA
| | - V P Bykerk
- Hospital for Special Surgery, Weill Cornell Medical College, 525 East 71st St, 7th floor, New York, NY, 10021, USA
| | - J R Curtis
- Division of Rheumatology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - S Ginsberg
- Global Healthy Living Foundation, Upper Nyack, NY, USA
| | - A L Leong
- Healthy Motivation, Santa Barbara, CA, USA
| | | | - W B Nowell
- Global Healthy Living Foundation, Upper Nyack, NY, USA
| | - A M Orbai
- Division of Rheumatology, Johns Hopkins School of Medicine, Mason F Lord Tower, 5200 Eastern Avenue, Rm 404, Baltimore, MD, 21224, USA
| | - K C Smith
- Johns Hopkins Bloomberg School of Public Health Center for Qualitative Studies in Health and Medicine, Baltimore, MD, USA
| | - C O Bingham
- Division of Rheumatology, Johns Hopkins School of Medicine, Mason F Lord Tower, 5200 Eastern Avenue, Rm 404, Baltimore, MD, 21224, USA
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Kirwan JR, de Wit MPT, Bingham CO, Leong A, Richards P, Tugwell P, Voshaar M, Gossec L. Commentary: Patients as Partners: Building on the Experience of Outcome Measures in Rheumatology. Arthritis Rheumatol 2018; 68:1334-6. [PMID: 26991682 DOI: 10.1002/art.39678] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2015] [Accepted: 03/08/2016] [Indexed: 01/03/2023]
Affiliation(s)
- John R Kirwan
- University of Bristol and Bristol Royal Infirmary, Bristol, UK
| | | | | | - Amye Leong
- Global Alliance for Musculoskeletal Health/Bone and Joint Decade, Santa Barbara, California
| | - Pamela Richards
- University of Bristol and Bristol Royal Infirmary, Bristol, UK
| | | | | | - Laure Gossec
- Sorbonne Universités, Université Paris 6, Institut Pierre Louis d'Epidémiologie et de Santé Publique, and Pitie-Salpétrière Hospital, AP-HP, Paris, France. Members of the OMERACT Executive Committee are shown in Appendix A
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Cappelli LC, Naidoo J, Bingham CO, Shah AA. Inflammatory arthritis due to immune checkpoint inhibitors: challenges in diagnosis and treatment. Immunotherapy 2018; 9:5-8. [PMID: 28000525 DOI: 10.2217/imt-2016-0117] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Affiliation(s)
- Laura C Cappelli
- Division of Rheumatology, Department of Medicine, Johns Hopkins School of Medicine, 5200 Eastern Avenue, Baltimore MD, 21224, USA
| | - Jarushka Naidoo
- Department of Oncology, Johns Hopkins School of Medicine,440 Eastern Avenue, Baltimore MD, 21224, USA
| | - Clifton O Bingham
- Division of Rheumatology, Department of Medicine, Johns Hopkins School of Medicine, 5200 Eastern Avenue, Baltimore MD, 21224, USA
| | - Ami A Shah
- Division of Rheumatology, Department of Medicine, Johns Hopkins School of Medicine, 5200 Eastern Avenue, Baltimore MD, 21224, USA
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Turnbull AE, Dinglas VD, Friedman LA, Chessare CM, Sepúlveda KA, Bingham CO, Needham DM. A survey of Delphi panelists after core outcome set development revealed positive feedback and methods to facilitate panel member participation. J Clin Epidemiol 2018; 102:99-106. [PMID: 29966731 DOI: 10.1016/j.jclinepi.2018.06.007] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2017] [Revised: 04/08/2018] [Accepted: 06/14/2018] [Indexed: 02/08/2023]
Abstract
OBJECTIVES The objective of this study was to elicit feedback on consensus methodology used for core outcome set (COS) development. STUDY DESIGN AND SETTING An online survey of international Delphi panelists participating in a recent COS for clinical research studies evaluating acute respiratory failure (ARF) survivors was conducted. Panelists represented 14 countries (56% outside the United States). RESULTS Seventy (92%) panelists completed the survey, including 32 researchers, 19 professional association representatives, 4 research funding representatives, and 15 ARF survivors/caregiver members. Among respondents, 91% reported that the time required to participate was appropriate and 96% were not bothered by reminders for timely response. Attributes of measurement instruments and voting results from previous rounds were evaluated differently across stakeholder groups. When measurement properties were explained in the stem of the survey question, 59 (84%) panelists (including 73% of survivors/families) correctly interpreted information about an instrument's reliability. Without a reminder in the stem, only 20 (29%) panelists (including 38% of researchers) correctly identified properties of a COS. CONCLUSION This international Delphi panel, including >20% patients/caregivers, favorably reported on feasibility of the methodology. Providing all panelists pertinent information/reminders about the project's objective at each voting round is important to informed decision making across all stakeholder groups.
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Affiliation(s)
- Alison E Turnbull
- Outcomes After Critical Illness and Surgery (OACIS) Group, Johns Hopkins University, Baltimore, MD, USA; Division of Pulmonary and Critical Care Medicine, School of Medicine, Johns Hopkins University, Baltimore, MD, USA; Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA.
| | - Victor D Dinglas
- Outcomes After Critical Illness and Surgery (OACIS) Group, Johns Hopkins University, Baltimore, MD, USA; Division of Pulmonary and Critical Care Medicine, School of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Lisa Aronson Friedman
- Outcomes After Critical Illness and Surgery (OACIS) Group, Johns Hopkins University, Baltimore, MD, USA; Division of Pulmonary and Critical Care Medicine, School of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Caroline M Chessare
- Outcomes After Critical Illness and Surgery (OACIS) Group, Johns Hopkins University, Baltimore, MD, USA; Division of Pulmonary and Critical Care Medicine, School of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Kristin A Sepúlveda
- Outcomes After Critical Illness and Surgery (OACIS) Group, Johns Hopkins University, Baltimore, MD, USA; Division of Pulmonary and Critical Care Medicine, School of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Clifton O Bingham
- Divisions of Rheumatology and Allergy and Clinical Immunology, Johns Hopkins University, Baltimore, MD, USA
| | - Dale M Needham
- Outcomes After Critical Illness and Surgery (OACIS) Group, Johns Hopkins University, Baltimore, MD, USA; Division of Pulmonary and Critical Care Medicine, School of Medicine, Johns Hopkins University, Baltimore, MD, USA; Department of Physical Medicine and Rehabilitation, School of Medicine, Johns Hopkins University, Baltimore, MD, USA
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Albayda J, Bingham CO, Shah AA, Kelly RJ, Cappelli L. Metastatic joint involvement or inflammatory arthritis? A conundrum with immune checkpoint inhibitor-related adverse events. Rheumatology (Oxford) 2018; 57:760-762. [PMID: 29342300 DOI: 10.1093/rheumatology/kex470] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Affiliation(s)
- Jemima Albayda
- Division of Rheumatology, Johns Hopkins University, Baltimore, MD, USA
| | - Clifton O Bingham
- Division of Rheumatology, Johns Hopkins University, Baltimore, MD, USA
| | - Ami A Shah
- Division of Rheumatology, Johns Hopkins University, Baltimore, MD, USA
| | - Ronan J Kelly
- Department of Oncology, Johns Hopkins University, Baltimore, MD, USA
| | - Laura Cappelli
- Division of Rheumatology, Johns Hopkins University, Baltimore, MD, USA
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Naidoo J, Cappelli L, Lipson EJ, Forde PM, Sharfman WH, Zhang J, Mammen J, Moseley K, Suresh K, Mehta S, Sander I, Probasco J, Parian A, Rouf R, Berkenstock M, Brothers P, Riemer J, Emens LA, Bingham CO, Brahmer JR. A multidisciplinary toxicity team for cancer immunotherapy-related adverse events. J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.15_suppl.6538] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Jarushka Naidoo
- Johns Hopkins Kimmel Comprehensive Cancer Center and Bloomberg-Kimmel Institute for Cancer Immunotherapy, Baltimore, MD
| | - Laura Cappelli
- Johns Hopkins University School of Medicine, Baltimore, MD
| | - Evan J. Lipson
- Johns Hopkins Kimmel Comprehensive Cancer Center and Bloomberg-Kimmel Institute for Cancer Immunotherapy, Baltimore, MD
| | - Patrick M. Forde
- Johns Hopkins Kimmel Comprehensive Cancer Center and Bloomberg-Kimmel Institute for Cancer Immunotherapy, Baltimore, MD
| | | | - Jiajia Zhang
- Johns Hopkins University School of Medicine, Baltimore, MD
| | - Jenna Mammen
- Johns Hopkins University School of Medicine, Baltimore, MD
| | | | - Karthik Suresh
- Johns Hopkins University School of Medicine, Baltimore, MD
| | - Seema Mehta
- Johns Hopkins University School of Medicine, Baltimore, MD
| | | | - John Probasco
- Johns Hopkins University School of Medicine, Baltimore, MD
| | - Alyssa Parian
- Johns Hopkins University School of Medicine, Baltimore, MD
| | - Rosanne Rouf
- Johns Hopkins University School of Medicine, Baltimore, MD
| | | | | | - Joanne Riemer
- Johns Hopkins Kimmel Comprehensive Cancer Center, Baltimore, MD
| | - Leisha A. Emens
- Johns Hopkins Kimmel Comprehensive Cancer Center and Bloomberg-Kimmel Institute for Cancer Immunotherapy, Baltimore, MD
| | | | - Julie R. Brahmer
- Johns Hopkins Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD
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Cappelli LC, Konig MF, Gelber AC, Bingham CO, Darrah E. Smoking is not linked to the development of anti-peptidylarginine deiminase 4 autoantibodies in rheumatoid arthritis. Arthritis Res Ther 2018; 20:59. [PMID: 29566742 PMCID: PMC5865363 DOI: 10.1186/s13075-018-1533-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2017] [Accepted: 02/01/2018] [Indexed: 12/17/2022] Open
Abstract
Background Defining environmental factors responsible for development of autoimmunity in rheumatoid arthritis (RA) is critical for understanding mechanisms of disease initiation and propagation. Notably, a history of cigarette smoking has been implicated in the genesis of RA and is associated with worse disease outcomes. Antibodies to peptidylarginine deiminase 4 (PAD4) are also associated with more severe RA. A subset of patients who have PAD4 autoantibodies that cross-react with PAD3 (anti-PAD3/4) are at the highest risk for interstitial lung disease, and this risk is augmented by a history of cigarette smoking. It is unclear, however, if smoking is etiologically linked to the development of anti-PAD4 antibodies. Methods Patients were included in this study if they had physician-diagnosed RA as well as DNA, serum, and a date-matched clinical assessment (n = 274). Anti-PAD4 and anti-CCP antibodies were measured by immunoprecipitation and ELISA, respectively; shared epitope (SE) status was determined by HLA-DRβ1 genotyping. Logistic regression analysis was used to evaluate associations of smoking with PAD4 antibodies, with adjustment for relevant demographic and clinical features. Stratified analyses by disease duration and shared epitope status were also performed. Results Anti-PAD4 antibodies were present in 25% of RA patients, with 50% of these individuals having anti-PAD3/4 cross-reactive antibodies. Anti-PAD4 antibodies were significantly associated with a longer disease duration, SE alleles, and anti-CCP antibodies. Importantly, there were no significant differences in smoking history between anti-PAD4 positive and negative groups in univariate analyses, stratified analyses, or multivariable models. However, an inverse relationship between smoking and anti-PAD4 antibodies was suggested by a lower prevalence of current smokers among patients with anti-PAD3/4 antibodies compared to antibody negative individuals (p = 0.04). Further, the lowest levels of anti-PAD4 antibodies were observed in current smokers (p = 0.14), and a significant association of SE and anti-PAD4 antibodies was only present among never smokers (p = 0.01). Conclusions Smoking history was not associated with anti-PAD4 antibodies in patients with RA. The finding that anti-PAD4 antibodies were not associated with smoking suggests that other environmental factors may contribute to the development of autoimmunity to PAD4 in these patients.
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Affiliation(s)
- Laura C Cappelli
- Division of Rheumatology, The Johns Hopkins School of Medicine, Baltimore, MD, 21224, USA
| | - Maximilian F Konig
- Division of Rheumatology, The Johns Hopkins School of Medicine, Baltimore, MD, 21224, USA.,Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, 02114, USA
| | - Allan C Gelber
- Division of Rheumatology, The Johns Hopkins School of Medicine, Baltimore, MD, 21224, USA
| | - Clifton O Bingham
- Division of Rheumatology, The Johns Hopkins School of Medicine, Baltimore, MD, 21224, USA
| | - Erika Darrah
- Division of Rheumatology, The Johns Hopkins School of Medicine, Baltimore, MD, 21224, USA.
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112
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Cappelli LC, Brahmer JR, Forde PM, Le DT, Lipson EJ, Naidoo J, Zheng L, Bingham CO, Shah AA. Clinical presentation of immune checkpoint inhibitor-induced inflammatory arthritis differs by immunotherapy regimen. Semin Arthritis Rheum 2018; 48:553-557. [PMID: 29573850 DOI: 10.1016/j.semarthrit.2018.02.011] [Citation(s) in RCA: 74] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2018] [Revised: 02/14/2018] [Accepted: 02/20/2018] [Indexed: 12/17/2022]
Abstract
INTRODUCTION Immune checkpoint inhibitors (ICIs) are a class of cancer immunotherapy, increasingly utilized to treat malignancies. Inflammatory arthritis (IA) is a potential consequence of ICI use, but there is limited information to guide evaluation and management of this immune-related adverse event (irAE). This study aimed to characterize clinical phenotypes, IA treatment and response in the largest cohort of patients with ICI-induced IA reported to date. METHODS Patients with rheumatologist-confirmed IA occurring during or after ICI treatment with no prior history of autoimmune disease were included. Data were analyzed by ICI treatment regimen; treatments included combination CTLA-4/PD-1 inhibition, anti-PD-1 or anti-PD-L1 monotherapy. Relationship to the development of other irAEs, management of IA, and outcomes of IA management were evaluated. RESULTS Of 30 patients identified, those treated with combination ICI therapy were more likely to present with knee arthritis, to have higher levels of C-reactive protein, to have already had another irAE, and to have a reactive arthritis-like phenotype. In contrast, patients treated with ICI monotherapy were more likely to have initial small joint involvement and to have IA as their only irAE. Ten patients required additional immunosuppression beyond corticosteroids, with TNF-inhibitors and/or methotrexate. Tumor progression while on non-corticosteroid immunosuppression was not seen in those with initial tumor response to ICIs. CONCLUSION These data suggest that distinct IA phenotypes may emerge with exposure to different ICI regimens. The majority of patients referred to rheumatology required systemic immunosuppression to manage their IA symptoms. Tumor progression was not seen in patients requiring TNF-inhibitors.
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Affiliation(s)
- Laura C Cappelli
- Johns Hopkins University, Division of Rheumatology, 5501 Hopkins Bayview Circle, Suite 1.B.1, Baltimore, MD.
| | - Julie R Brahmer
- Johns Hopkins University, Department of Oncology, Baltimore, MD
| | - Patrick M Forde
- Johns Hopkins University, Department of Oncology, Baltimore, MD
| | - Dung T Le
- Johns Hopkins University, Department of Oncology, Baltimore, MD
| | - Evan J Lipson
- Johns Hopkins University, Department of Oncology, Baltimore, MD
| | - Jarushka Naidoo
- Johns Hopkins University, Department of Oncology, Baltimore, MD
| | - Lei Zheng
- Johns Hopkins University, Department of Oncology, Baltimore, MD
| | - Clifton O Bingham
- Johns Hopkins University, Division of Rheumatology, 5501 Hopkins Bayview Circle, Suite 1.B.1, Baltimore, MD
| | - Ami A Shah
- Johns Hopkins University, Division of Rheumatology, 5501 Hopkins Bayview Circle, Suite 1.B.1, Baltimore, MD
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113
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Gutierrez MJ, Sullivan KE, Fuleihan R, Bingham CO. Phenotypic characterization of patients with rheumatologic manifestations of common variable immunodeficiency. Semin Arthritis Rheum 2018; 48:318-326. [PMID: 29599028 DOI: 10.1016/j.semarthrit.2018.02.013] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2017] [Revised: 01/31/2018] [Accepted: 02/20/2018] [Indexed: 12/12/2022]
Abstract
Patients with common variable immunodeficiency (CVID) have a higher incidence of rheumatologic disorders. To delineate this clinical association, we investigated the phenotypic features of patients with CVID affected by these conditions. METHODS We conducted a retrospective analysis of 870 pediatric and adult patients with CVID included in the United States Immunodeficiency Network (USIDNET) registry. Outcomes included clinical characteristics (age, gender, ethnicity, rheumatologic diagnosis, and comorbidities), infectious history and basic immunophenotype (serum immunoglobulin levels, CD19+ B cells, and CD4/CD8 ratio) in patients with CVID and rheumatologic disorders compared to those with non-inflammatory CVID. Demographic and clinical data were compared using chi-square, Fisher's exact or Wilcoxon-Mann-Whitney tests. Non-parametric tests, single and multiple logistic regression models were used to evaluate the relationship between CVID-associated rheumatologic disorders and basic immunophenotypic parameters (IgA, IgM, CD19+ B-cell counts, and CD4/CD8 ratios). RESULTS Physician-reported rheumatic diseases were present in 5.9% of patients with CVID (n = 51) included in the registry. Although CVID affects both sexes equally, and patients are of predominantly White-Caucasian ethnicity, there were more females (3.3:1 female to male ratio) and increased proportion of non-white patients in the rheumatologic disease group (p < 0.05). Specific disorders included: inflammatory arthritis (n = 18), Sjogren's syndrome (n = 11), SLE (n = 8), Raynaud's syndrome (n = 8), vasculitis (n = 9), MCTD (n = 3), and other (n = 5). In about one-third of patients, a rheumatologic condition was associated with an additional inflammatory complication or malignancy. In regards to the immunophenotype parameters compared (CD19+ B-cell counts, CD4/CD8 ratio, IgA, and IgM), no significant differences were demonstrated between the two groups. CONCLUSION Our findings highlight the coexistence of primary antibody immunodeficiencies and systemic rheumatologic disorders, describe the spectrum of rheumatologic manifestations, and contrast differences in relevant demographic, clinical and immunophenotype parameters in the largest registry of CVID patients in the U.S. In spite of its limitations, our study details the intersection of systemic autoimmunity and CVID and provides valuable insights into these two groups of disorders. Further delineating the link between systemic autoimmunity and humoral immunodeficiencies can provide novel insights into the immune abnormalities underlying these related conditions.
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Affiliation(s)
- Maria J Gutierrez
- Division of Pediatric Allergy and Immunology, Johns Hopkins University, Baltimore, PA.
| | - Kathleen E Sullivan
- Division of Allergy and Immunology, Children's Hospital of Philadelphia, Philadelphia, PA
| | - Ramsay Fuleihan
- Division of Allergy and Immunology, Ann & Robert H. Lurie Children's Hospital, Chicago, IL
| | | | - Clifton O Bingham
- Divisions of Rheumatology and Allergy and Clinical Immunology, Johns Hopkins University School of Medicine, Baltimore, MD
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Gutierrez MJ, Darrah E, Cappelli L, Jones M, Bingham CO. Soluble Markers of B-cell Homing, Activation and Survival and Infection Risk in Rheumatoid Arthritis. J Allergy Clin Immunol 2018. [DOI: 10.1016/j.jaci.2017.12.909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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115
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Orbai AM, Bingham CO. Towards improving measurement of stiffness in rheumatology. Rheumatology (Oxford) 2018; 57:206-208. [DOI: 10.1093/rheumatology/kex247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/26/2017] [Indexed: 11/12/2022] Open
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Dinglas VD, Chessare CM, Davis WE, Parker A, Friedman LA, Colantuoni E, Bingham CO, Turnbull AE, Needham DM. Perspectives of survivors, families and researchers on key outcomes for research in acute respiratory failure. Thorax 2018; 73:7-12. [PMID: 28756400 PMCID: PMC7430927 DOI: 10.1136/thoraxjnl-2017-210234] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2017] [Accepted: 06/19/2017] [Indexed: 02/05/2023]
Abstract
BACKGROUND There is heterogeneity among the outcomes evaluated in studies of survivors of acute respiratory failure (ARF). AIM To evaluate the importance of specific outcome domains to acute respiratory distress syndrome (ARDS) survivors, their family members and clinical researchers. METHODS Nineteen outcome domains were identified from the National Institutes of Health's Patient Reported Outcomes Measurement Information System; WHO's International Classification of Functioning, Disability, and Health; Society of Critical Care Medicine's Post-Intensive Care Syndrome (PICS); as well as patient, clinician and researcher input. We surveyed ARDS survivors, family members and critical care researchers, 279 respondents in total, using a 5-point scale (strongly disagree, disagree, neutral, agree and strongly agree) to rate the importance of measuring each domain in studies of ARF survivors' postdischarge outcomes. MEASUREMENTS AND MAIN RESULTS At least 80% of patients and family members supported (ie, rated 'agree' or 'strongly agree') that 15 of the 19 domains should be measured in all future studies. Among researchers, 6 of 19 domains were supported, with researchers less supportive for all domains, except survival (95% vs 72% support). Overall, four domains were supported by all groups: physical function, cognitive function, return to work or prior activities and mental health. CONCLUSION Patient, family and researcher groups supported inclusion of outcome domains that fit within the PICS framework. Patients and family members also supported many additional domains, emphasising the importance of including patients/family, along with researchers, in consensus processes to select core outcome domains for future research studies.
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Affiliation(s)
- Victor D Dinglas
- Outcomes After Critical Illness and Surgery Group, Johns Hopkins University, Baltimore, Maryland, USA
- Division of Pulmonary and Critical Care Medicine, School of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
| | - Caroline M Chessare
- Outcomes After Critical Illness and Surgery Group, Johns Hopkins University, Baltimore, Maryland, USA
- Division of Pulmonary and Critical Care Medicine, School of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
| | - Wesley E Davis
- Outcomes After Critical Illness and Surgery Group, Johns Hopkins University, Baltimore, Maryland, USA
| | - Ann Parker
- Outcomes After Critical Illness and Surgery Group, Johns Hopkins University, Baltimore, Maryland, USA
- Division of Pulmonary and Critical Care Medicine, School of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
| | - Lisa Aronson Friedman
- Outcomes After Critical Illness and Surgery Group, Johns Hopkins University, Baltimore, Maryland, USA
- Division of Pulmonary and Critical Care Medicine, School of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
| | - Elizabeth Colantuoni
- Outcomes After Critical Illness and Surgery Group, Johns Hopkins University, Baltimore, Maryland, USA
- Department of Biostatistics, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Clifton O Bingham
- Johns Hopkins Arthritis Center, Johns Hopkins University, Baltimore, Maryland, USA
- Rheumatic Diseases Research Core Center, Johns Hopkins University, Baltimore, Maryland, USA
- Divisions of Rheumatology and Allergy and Clinical Immunology, Johns Hopkins University, Baltimore, Maryland, USA
| | - Alison E Turnbull
- Outcomes After Critical Illness and Surgery Group, Johns Hopkins University, Baltimore, Maryland, USA
- Division of Pulmonary and Critical Care Medicine, School of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
- Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Dale M Needham
- Outcomes After Critical Illness and Surgery Group, Johns Hopkins University, Baltimore, Maryland, USA
- Division of Pulmonary and Critical Care Medicine, School of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
- Department of Physical Medicine and Rehabilitation, School of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
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de Wit M, Kirwan JR, Tugwell P, Beaton D, Boers M, Brooks P, Collins S, Conaghan PG, D'Agostino MA, Hofstetter C, Hughes R, Leong A, Lyddiatt A, March L, May J, Montie P, Richards P, Simon LS, Singh JA, Strand V, Voshaar M, Bingham CO, Gossec L. Successful Stepwise Development of Patient Research Partnership: 14 Years' Experience of Actions and Consequences in Outcome Measures in Rheumatology (OMERACT). Patient 2017; 10:141-152. [PMID: 27704486 PMCID: PMC5362656 DOI: 10.1007/s40271-016-0198-4] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
There is increasing interest in making patient participation an integral component of medical research. However, practical guidance on optimizing this engagement in healthcare is scarce. Since 2002, patient involvement has been one of the key features of the Outcome Measures in Rheumatology (OMERACT) international consensus effort. Based on a review of cumulative data from qualitative studies and internal surveys among OMERACT participants, we explored the potential benefits and challenges of involving patient research partners in conferences and working group activities. We supplemented our review with personal experiences and reflections regarding patient participation in the OMERACT process. We found that between 2002 and 2016, 67 patients have attended OMERACT conferences, of whom 28 had sustained involvement; many other patients contributed to OMERACT working groups. Their participation provided face validity to the OMERACT process and expanded the research agenda. Essential facilitators have been the financial commitment to guarantee sustainable involvement of patients at these conferences, procedures for recruitment, selection and support, and dedicated time allocated in the program for patient issues. Current challenges include the representativeness of the patient panel, risk of pseudo-professionalization, and disparity in patients’ and researchers’ perception of involvement. In conclusion, OMERACT has embedded long-term patient involvement in the consensus-building process on the measurement of core health outcomes. This integrative process continues to evolve iteratively. We believe that the practical points raised here can improve participatory research implementation.
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Affiliation(s)
- Maarten de Wit
- OMERACT Patient Research Partner, Amsterdam, The Netherlands. .,Department of Medical Humanities, VU University Medical Centre/EMGO+ instituut, Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands.
| | - John R Kirwan
- Academic Rheumatology Unit, Bristol Royal Infirmary, University of Bristol, Bristol, BS2 8HW, UK
| | - Peter Tugwell
- Department of Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Dorcas Beaton
- Musculoskeletal Health and Outcomes Research, Li Ka Shing Knowledge Institute, St Michael's Hospital, University of Toronto, Toronto, ON, Canada
| | - Maarten Boers
- Department of Epidemiology and Biostatistics, Amsterdam Rheumatology and Immunology Center, VU University Medical Center, Amsterdam, The Netherlands
| | - Peter Brooks
- Centre for Health Policy School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
| | | | - Philip G Conaghan
- NIHR Leeds Musculoskeletal Biomedical Research Unit, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK
| | - Maria-Antonietta D'Agostino
- Department of Rheumatology, Hôpital Ambroise Paré, APHP, Université Versailles Saint Quentin en Yvelines, Boulogne-Billancourt, France
| | | | - Rod Hughes
- Ashford St Peter's Foundation trust Hospital, Chertsey, Surrey, UK
| | - Amye Leong
- OMERACT Patient Research Partner, Santa Barbara, CA, USA.,Healthy Motivations, Santa Barbara, CA, 93108, USA.,Bone and Joint Decade, The Global Alliance for Musculoskeletal Health, Truro, Cornwall, UK
| | - Ann Lyddiatt
- OMERACT Patient Research Partner, Vancouver, BC, Canada
| | - Lyn March
- Institute of Bone and Joint Research, Sydney Medical School and School of Public Health, University of Sydney, Sydney, NSW, Australia.,Department of Rheumatology, Royal North Shore, St. Leonards, NSW, Australia
| | - James May
- OMERACT Patient Research Partner, Seattle, WA, USA
| | - Pamela Montie
- OMERACT Patient Research Partner, Vancouver, BC, Canada.,Arthritis Patient Advisory Board, Arthritis Research Centre Canada, Richmond, BC, Canada
| | - Pamela Richards
- Academic Rheumatology Unit, Bristol Royal Infirmary, University of Bristol, Bristol, BS2 8HW, UK.,OMERACT Patient Research Partner, Bristol, UK
| | | | - Jasvinder A Singh
- Medicine Service, VA Medical Center, Birmingham, AL, USA.,Division of Epidemiology at School of Public Health, Department of Medicine at School of Medicine, University of Alabama, Birmingham, AL, 35294-0022, USA.,Department of Orthopedic Surgery, Mayo Clinic College of Medicine, Rochester, MN, 55905, USA
| | - Vibeke Strand
- Division Immunology/Rheumatology, Stanford University School of Medicine, Palo Alto, CA, USA
| | - Marieke Voshaar
- OMERACT Patient Research Partner, Amsterdam, The Netherlands.,Department of Psychology, Health and Technology, University of Twente, Enschede, The Netherlands
| | - Clifton O Bingham
- Division of Rheumatology, Johns Hopkins University, Baltimore, MD, USA
| | - Laure Gossec
- Institut Pierre Louis d'Epidémiologie et de Santé Publique, Sorbonne Universités, UPMC Univ Paris 06, GRC-08, Paris, France.,Rheumatology Department, Pitie-Salpétrière Hospital, AP-HP, Paris, France
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Morgan EM, Riebschleger MP, Horonjeff J, Consolaro A, Munro JE, Thornhill S, Beukelman T, Brunner HI, Creek EL, Harris JG, Horton DB, Lovell DJ, Mannion ML, Olson JC, Rahimi H, Gallo MC, Calandra S, Ravelli A, Ringold S, Shenoi S, Stinson J, Toupin-April K, Strand V, Bingham CO. Evidence for Updating the Core Domain Set of Outcome Measures for Juvenile Idiopathic Arthritis: Report from a Special Interest Group at OMERACT 2016. J Rheumatol 2017; 44:1884-1888. [PMID: 28811355 PMCID: PMC5914507 DOI: 10.3899/jrheum.161389] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/09/2017] [Indexed: 06/07/2023]
Abstract
OBJECTIVE The current Juvenile Idiopathic Arthritis (JIA) Core Set was developed in 1997 to identify the outcome measures to be used in JIA clinical trials using statistical and consensus-based techniques, but without patient involvement. The importance of patient/parent input into the research process has increasingly been recognized over the years. An Outcome Measures in Rheumatology (OMERACT) JIA Core Set Working Group was formed to determine whether the outcome domains of the current core set are relevant to those involved or whether the core set domains should be revised. METHODS Twenty-four people from the United States, Canada, Australia, and Europe, including patient partners, formed the working group. Guided by the OMERACT Filter 2.0 process, we performed (1) a systematic literature review of outcome domains, (2) a Web-based survey (142 patients, 343 parents), (3) an idea-generation study (120 parents), (4) 4 online discussion boards (24 patients, 20 parents), and (5) a Special Interest Group (SIG) activity at the OMERACT 13 (2016) meeting. RESULTS A MEDLINE search of outcome domains used in studies of JIA yielded 5956 citations, of which 729 citations underwent full-text review, and identified additional domains to those included in the current JIA Core Set. Qualitative studies on the effect of JIA identified multiple additional domains, including pain and participation. Twenty-one participants in the SIG achieved consensus on the need to revise the entire JIA Core Set. CONCLUSION The results of qualitative studies and literature review support the need to expand the JIA Core Set, considering, among other things, additional patient/parent-centered outcomes, clinical data, and imaging data.
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Affiliation(s)
- Esi M Morgan
- Division of Rheumatology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; Pediatric Rheumatology and Pediatric Health Services Research, University of Michigan CS Mott Children's Hospital, Ann Arbor, Michigan; Office of Research, Division of Rheumatology, Columbia University Medical Center, New York; Division of Rheumatology, University of Rochester, Golisano Children's Hospital, Rochester, New York; Thornhill Associates, Hermosa Beach; Division of Immunology/Rheumatology, Stanford University, Stanford, California; Division of Rheumatology, University of Alabama at Birmingham, Birmingham, Alabama; Arthritis Foundation, Atlanta, Georgia; Division of Rheumatology, Children's Mercy, Kansas City, Missouri; Division of Pediatric Rheumatology, Rutgers Robert Wood Johnson Medical School, Institute for Health, Health Care Policy and Aging Research, New Brunswick, New Jersey; Medical College of Wisconsin, Milwaukee, Wisconsin; Division of Rheumatology, Seattle Children's Hospital, Seattle, Washington; Johns Hopkins Arthritis Center, Johns Hopkins University, Baltimore, Maryland, USA; Division of Rheumatology, Istituto Giannina Gaslini; University of Genoa, Genoa, Italy; Rheumatology, Royal Children's Hospital; Murdoch Children's Research Institute, Melbourne, Australia; The Hospital for Sick Children, and Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto; Children's Hospital of Eastern Ontario Research Institute, Department of Pediatrics and School of Rehabilitation Sciences, University of Ottawa, Ottawa, Ontario, Canada.
- E.M. Morgan, MD, Associate Professor, Division of Rheumatology, Cincinnati Children's Hospital Medical Center; M.P. Riebschleger, MD, Clinical Lecturer, Pediatric Rheumatology and Pediatric Health Services Research, University of Michigan CS Mott Children's Hospital; J. Horonjeff, PhD, Instructor, Office of Research, Division of Rheumatology, Columbia University Medical Center; A. Consolaro, MD, PhD, Assistant Professor, Division of Rheumatology, Istituto Giannina Gaslini, and University of Genoa; J.E. Munro, MBBS, Associate Professor, Head of Rheumatology at the Royal Children's Hospital, and Group Leader, Arthritis Research, Murdoch Children's Research Institute; S. Thornhill, AA, Qualitative Research Consultant, Thornhill Associates; T. Beukelman, MD, Associate Professor, Division of Rheumatology, University of Alabama at Birmingham; H.I. Brunner, Professor, Division of Rheumatology, Cincinnati Children's Hospital Medical Center; E.L. Creek, MBA, Senior Director, Help and Support, Arthritis Foundation; J.G. Harris, MD, Assistant Professor, Division of Rheumatology, Children's Mercy; D.B. Horton, MD, Assistant Professor, Division of Pediatric Rheumatology, Rutgers Robert Wood Johnson Medical School, Institute for Health, Health Care Policy and Aging Research; D.J. Lovell, MD, Professor, Division of Rheumatology, Cincinnati Children's Hospital Medical Center; M.L. Mannion, MD, Assistant Professor of Rheumatology, University of Alabama at Birmingham; J.C. Olson, MD, Associate Professor, Medical College of Wisconsin; H. Rahimi, MD, Assistant Professor, Division of Rheumatology, University of Rochester, Golisano Children's Hospital; M.C. Gallo, MD, Research Contract, Istituto Giannina Gaslini; S. Calandra, MD, Pediatric Resident, Istituto Giannina Gaslini; A. Ravelli, MD, Professor of Pediatrics, University of Genoa and Istituto Giannina Gaslini; S. Ringold, MD, Assistant Professor, Division of Rheumatology, Seattle Children's Hospital; S. Shenoi, MBBS, Assistant Professor, Seattle Children's Hospital; J. Stinson, PhD, Senior Scientist, The Hospital for Sick Children, and Associate Professor, Lawrence S. Bloomberg Faculty of Nursing, University of Toronto; K. Toupin-April, PhD, Associate Scientist, Children's Hospital of Eastern Ontario Research Institute, and Assistant Professor, Department of Pediatrics and School of Rehabilitation Sciences, University of Ottawa; V. Strand, MD, Adjunct Clinical Professor, Division of Immunology/Rheumatology, Stanford University; C.O. Bingham III, MD, Professor of Medicine, Director, Johns Hopkins Arthritis Center, Johns Hopkins University.
| | - Meredith P Riebschleger
- Division of Rheumatology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; Pediatric Rheumatology and Pediatric Health Services Research, University of Michigan CS Mott Children's Hospital, Ann Arbor, Michigan; Office of Research, Division of Rheumatology, Columbia University Medical Center, New York; Division of Rheumatology, University of Rochester, Golisano Children's Hospital, Rochester, New York; Thornhill Associates, Hermosa Beach; Division of Immunology/Rheumatology, Stanford University, Stanford, California; Division of Rheumatology, University of Alabama at Birmingham, Birmingham, Alabama; Arthritis Foundation, Atlanta, Georgia; Division of Rheumatology, Children's Mercy, Kansas City, Missouri; Division of Pediatric Rheumatology, Rutgers Robert Wood Johnson Medical School, Institute for Health, Health Care Policy and Aging Research, New Brunswick, New Jersey; Medical College of Wisconsin, Milwaukee, Wisconsin; Division of Rheumatology, Seattle Children's Hospital, Seattle, Washington; Johns Hopkins Arthritis Center, Johns Hopkins University, Baltimore, Maryland, USA; Division of Rheumatology, Istituto Giannina Gaslini; University of Genoa, Genoa, Italy; Rheumatology, Royal Children's Hospital; Murdoch Children's Research Institute, Melbourne, Australia; The Hospital for Sick Children, and Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto; Children's Hospital of Eastern Ontario Research Institute, Department of Pediatrics and School of Rehabilitation Sciences, University of Ottawa, Ottawa, Ontario, Canada
- E.M. Morgan, MD, Associate Professor, Division of Rheumatology, Cincinnati Children's Hospital Medical Center; M.P. Riebschleger, MD, Clinical Lecturer, Pediatric Rheumatology and Pediatric Health Services Research, University of Michigan CS Mott Children's Hospital; J. Horonjeff, PhD, Instructor, Office of Research, Division of Rheumatology, Columbia University Medical Center; A. Consolaro, MD, PhD, Assistant Professor, Division of Rheumatology, Istituto Giannina Gaslini, and University of Genoa; J.E. Munro, MBBS, Associate Professor, Head of Rheumatology at the Royal Children's Hospital, and Group Leader, Arthritis Research, Murdoch Children's Research Institute; S. Thornhill, AA, Qualitative Research Consultant, Thornhill Associates; T. Beukelman, MD, Associate Professor, Division of Rheumatology, University of Alabama at Birmingham; H.I. Brunner, Professor, Division of Rheumatology, Cincinnati Children's Hospital Medical Center; E.L. Creek, MBA, Senior Director, Help and Support, Arthritis Foundation; J.G. Harris, MD, Assistant Professor, Division of Rheumatology, Children's Mercy; D.B. Horton, MD, Assistant Professor, Division of Pediatric Rheumatology, Rutgers Robert Wood Johnson Medical School, Institute for Health, Health Care Policy and Aging Research; D.J. Lovell, MD, Professor, Division of Rheumatology, Cincinnati Children's Hospital Medical Center; M.L. Mannion, MD, Assistant Professor of Rheumatology, University of Alabama at Birmingham; J.C. Olson, MD, Associate Professor, Medical College of Wisconsin; H. Rahimi, MD, Assistant Professor, Division of Rheumatology, University of Rochester, Golisano Children's Hospital; M.C. Gallo, MD, Research Contract, Istituto Giannina Gaslini; S. Calandra, MD, Pediatric Resident, Istituto Giannina Gaslini; A. Ravelli, MD, Professor of Pediatrics, University of Genoa and Istituto Giannina Gaslini; S. Ringold, MD, Assistant Professor, Division of Rheumatology, Seattle Children's Hospital; S. Shenoi, MBBS, Assistant Professor, Seattle Children's Hospital; J. Stinson, PhD, Senior Scientist, The Hospital for Sick Children, and Associate Professor, Lawrence S. Bloomberg Faculty of Nursing, University of Toronto; K. Toupin-April, PhD, Associate Scientist, Children's Hospital of Eastern Ontario Research Institute, and Assistant Professor, Department of Pediatrics and School of Rehabilitation Sciences, University of Ottawa; V. Strand, MD, Adjunct Clinical Professor, Division of Immunology/Rheumatology, Stanford University; C.O. Bingham III, MD, Professor of Medicine, Director, Johns Hopkins Arthritis Center, Johns Hopkins University
| | - Jennifer Horonjeff
- Division of Rheumatology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; Pediatric Rheumatology and Pediatric Health Services Research, University of Michigan CS Mott Children's Hospital, Ann Arbor, Michigan; Office of Research, Division of Rheumatology, Columbia University Medical Center, New York; Division of Rheumatology, University of Rochester, Golisano Children's Hospital, Rochester, New York; Thornhill Associates, Hermosa Beach; Division of Immunology/Rheumatology, Stanford University, Stanford, California; Division of Rheumatology, University of Alabama at Birmingham, Birmingham, Alabama; Arthritis Foundation, Atlanta, Georgia; Division of Rheumatology, Children's Mercy, Kansas City, Missouri; Division of Pediatric Rheumatology, Rutgers Robert Wood Johnson Medical School, Institute for Health, Health Care Policy and Aging Research, New Brunswick, New Jersey; Medical College of Wisconsin, Milwaukee, Wisconsin; Division of Rheumatology, Seattle Children's Hospital, Seattle, Washington; Johns Hopkins Arthritis Center, Johns Hopkins University, Baltimore, Maryland, USA; Division of Rheumatology, Istituto Giannina Gaslini; University of Genoa, Genoa, Italy; Rheumatology, Royal Children's Hospital; Murdoch Children's Research Institute, Melbourne, Australia; The Hospital for Sick Children, and Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto; Children's Hospital of Eastern Ontario Research Institute, Department of Pediatrics and School of Rehabilitation Sciences, University of Ottawa, Ottawa, Ontario, Canada
- E.M. Morgan, MD, Associate Professor, Division of Rheumatology, Cincinnati Children's Hospital Medical Center; M.P. Riebschleger, MD, Clinical Lecturer, Pediatric Rheumatology and Pediatric Health Services Research, University of Michigan CS Mott Children's Hospital; J. Horonjeff, PhD, Instructor, Office of Research, Division of Rheumatology, Columbia University Medical Center; A. Consolaro, MD, PhD, Assistant Professor, Division of Rheumatology, Istituto Giannina Gaslini, and University of Genoa; J.E. Munro, MBBS, Associate Professor, Head of Rheumatology at the Royal Children's Hospital, and Group Leader, Arthritis Research, Murdoch Children's Research Institute; S. Thornhill, AA, Qualitative Research Consultant, Thornhill Associates; T. Beukelman, MD, Associate Professor, Division of Rheumatology, University of Alabama at Birmingham; H.I. Brunner, Professor, Division of Rheumatology, Cincinnati Children's Hospital Medical Center; E.L. Creek, MBA, Senior Director, Help and Support, Arthritis Foundation; J.G. Harris, MD, Assistant Professor, Division of Rheumatology, Children's Mercy; D.B. Horton, MD, Assistant Professor, Division of Pediatric Rheumatology, Rutgers Robert Wood Johnson Medical School, Institute for Health, Health Care Policy and Aging Research; D.J. Lovell, MD, Professor, Division of Rheumatology, Cincinnati Children's Hospital Medical Center; M.L. Mannion, MD, Assistant Professor of Rheumatology, University of Alabama at Birmingham; J.C. Olson, MD, Associate Professor, Medical College of Wisconsin; H. Rahimi, MD, Assistant Professor, Division of Rheumatology, University of Rochester, Golisano Children's Hospital; M.C. Gallo, MD, Research Contract, Istituto Giannina Gaslini; S. Calandra, MD, Pediatric Resident, Istituto Giannina Gaslini; A. Ravelli, MD, Professor of Pediatrics, University of Genoa and Istituto Giannina Gaslini; S. Ringold, MD, Assistant Professor, Division of Rheumatology, Seattle Children's Hospital; S. Shenoi, MBBS, Assistant Professor, Seattle Children's Hospital; J. Stinson, PhD, Senior Scientist, The Hospital for Sick Children, and Associate Professor, Lawrence S. Bloomberg Faculty of Nursing, University of Toronto; K. Toupin-April, PhD, Associate Scientist, Children's Hospital of Eastern Ontario Research Institute, and Assistant Professor, Department of Pediatrics and School of Rehabilitation Sciences, University of Ottawa; V. Strand, MD, Adjunct Clinical Professor, Division of Immunology/Rheumatology, Stanford University; C.O. Bingham III, MD, Professor of Medicine, Director, Johns Hopkins Arthritis Center, Johns Hopkins University
| | - Alessandro Consolaro
- Division of Rheumatology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; Pediatric Rheumatology and Pediatric Health Services Research, University of Michigan CS Mott Children's Hospital, Ann Arbor, Michigan; Office of Research, Division of Rheumatology, Columbia University Medical Center, New York; Division of Rheumatology, University of Rochester, Golisano Children's Hospital, Rochester, New York; Thornhill Associates, Hermosa Beach; Division of Immunology/Rheumatology, Stanford University, Stanford, California; Division of Rheumatology, University of Alabama at Birmingham, Birmingham, Alabama; Arthritis Foundation, Atlanta, Georgia; Division of Rheumatology, Children's Mercy, Kansas City, Missouri; Division of Pediatric Rheumatology, Rutgers Robert Wood Johnson Medical School, Institute for Health, Health Care Policy and Aging Research, New Brunswick, New Jersey; Medical College of Wisconsin, Milwaukee, Wisconsin; Division of Rheumatology, Seattle Children's Hospital, Seattle, Washington; Johns Hopkins Arthritis Center, Johns Hopkins University, Baltimore, Maryland, USA; Division of Rheumatology, Istituto Giannina Gaslini; University of Genoa, Genoa, Italy; Rheumatology, Royal Children's Hospital; Murdoch Children's Research Institute, Melbourne, Australia; The Hospital for Sick Children, and Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto; Children's Hospital of Eastern Ontario Research Institute, Department of Pediatrics and School of Rehabilitation Sciences, University of Ottawa, Ottawa, Ontario, Canada
- E.M. Morgan, MD, Associate Professor, Division of Rheumatology, Cincinnati Children's Hospital Medical Center; M.P. Riebschleger, MD, Clinical Lecturer, Pediatric Rheumatology and Pediatric Health Services Research, University of Michigan CS Mott Children's Hospital; J. Horonjeff, PhD, Instructor, Office of Research, Division of Rheumatology, Columbia University Medical Center; A. Consolaro, MD, PhD, Assistant Professor, Division of Rheumatology, Istituto Giannina Gaslini, and University of Genoa; J.E. Munro, MBBS, Associate Professor, Head of Rheumatology at the Royal Children's Hospital, and Group Leader, Arthritis Research, Murdoch Children's Research Institute; S. Thornhill, AA, Qualitative Research Consultant, Thornhill Associates; T. Beukelman, MD, Associate Professor, Division of Rheumatology, University of Alabama at Birmingham; H.I. Brunner, Professor, Division of Rheumatology, Cincinnati Children's Hospital Medical Center; E.L. Creek, MBA, Senior Director, Help and Support, Arthritis Foundation; J.G. Harris, MD, Assistant Professor, Division of Rheumatology, Children's Mercy; D.B. Horton, MD, Assistant Professor, Division of Pediatric Rheumatology, Rutgers Robert Wood Johnson Medical School, Institute for Health, Health Care Policy and Aging Research; D.J. Lovell, MD, Professor, Division of Rheumatology, Cincinnati Children's Hospital Medical Center; M.L. Mannion, MD, Assistant Professor of Rheumatology, University of Alabama at Birmingham; J.C. Olson, MD, Associate Professor, Medical College of Wisconsin; H. Rahimi, MD, Assistant Professor, Division of Rheumatology, University of Rochester, Golisano Children's Hospital; M.C. Gallo, MD, Research Contract, Istituto Giannina Gaslini; S. Calandra, MD, Pediatric Resident, Istituto Giannina Gaslini; A. Ravelli, MD, Professor of Pediatrics, University of Genoa and Istituto Giannina Gaslini; S. Ringold, MD, Assistant Professor, Division of Rheumatology, Seattle Children's Hospital; S. Shenoi, MBBS, Assistant Professor, Seattle Children's Hospital; J. Stinson, PhD, Senior Scientist, The Hospital for Sick Children, and Associate Professor, Lawrence S. Bloomberg Faculty of Nursing, University of Toronto; K. Toupin-April, PhD, Associate Scientist, Children's Hospital of Eastern Ontario Research Institute, and Assistant Professor, Department of Pediatrics and School of Rehabilitation Sciences, University of Ottawa; V. Strand, MD, Adjunct Clinical Professor, Division of Immunology/Rheumatology, Stanford University; C.O. Bingham III, MD, Professor of Medicine, Director, Johns Hopkins Arthritis Center, Johns Hopkins University
| | - Jane E Munro
- Division of Rheumatology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; Pediatric Rheumatology and Pediatric Health Services Research, University of Michigan CS Mott Children's Hospital, Ann Arbor, Michigan; Office of Research, Division of Rheumatology, Columbia University Medical Center, New York; Division of Rheumatology, University of Rochester, Golisano Children's Hospital, Rochester, New York; Thornhill Associates, Hermosa Beach; Division of Immunology/Rheumatology, Stanford University, Stanford, California; Division of Rheumatology, University of Alabama at Birmingham, Birmingham, Alabama; Arthritis Foundation, Atlanta, Georgia; Division of Rheumatology, Children's Mercy, Kansas City, Missouri; Division of Pediatric Rheumatology, Rutgers Robert Wood Johnson Medical School, Institute for Health, Health Care Policy and Aging Research, New Brunswick, New Jersey; Medical College of Wisconsin, Milwaukee, Wisconsin; Division of Rheumatology, Seattle Children's Hospital, Seattle, Washington; Johns Hopkins Arthritis Center, Johns Hopkins University, Baltimore, Maryland, USA; Division of Rheumatology, Istituto Giannina Gaslini; University of Genoa, Genoa, Italy; Rheumatology, Royal Children's Hospital; Murdoch Children's Research Institute, Melbourne, Australia; The Hospital for Sick Children, and Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto; Children's Hospital of Eastern Ontario Research Institute, Department of Pediatrics and School of Rehabilitation Sciences, University of Ottawa, Ottawa, Ontario, Canada
- E.M. Morgan, MD, Associate Professor, Division of Rheumatology, Cincinnati Children's Hospital Medical Center; M.P. Riebschleger, MD, Clinical Lecturer, Pediatric Rheumatology and Pediatric Health Services Research, University of Michigan CS Mott Children's Hospital; J. Horonjeff, PhD, Instructor, Office of Research, Division of Rheumatology, Columbia University Medical Center; A. Consolaro, MD, PhD, Assistant Professor, Division of Rheumatology, Istituto Giannina Gaslini, and University of Genoa; J.E. Munro, MBBS, Associate Professor, Head of Rheumatology at the Royal Children's Hospital, and Group Leader, Arthritis Research, Murdoch Children's Research Institute; S. Thornhill, AA, Qualitative Research Consultant, Thornhill Associates; T. Beukelman, MD, Associate Professor, Division of Rheumatology, University of Alabama at Birmingham; H.I. Brunner, Professor, Division of Rheumatology, Cincinnati Children's Hospital Medical Center; E.L. Creek, MBA, Senior Director, Help and Support, Arthritis Foundation; J.G. Harris, MD, Assistant Professor, Division of Rheumatology, Children's Mercy; D.B. Horton, MD, Assistant Professor, Division of Pediatric Rheumatology, Rutgers Robert Wood Johnson Medical School, Institute for Health, Health Care Policy and Aging Research; D.J. Lovell, MD, Professor, Division of Rheumatology, Cincinnati Children's Hospital Medical Center; M.L. Mannion, MD, Assistant Professor of Rheumatology, University of Alabama at Birmingham; J.C. Olson, MD, Associate Professor, Medical College of Wisconsin; H. Rahimi, MD, Assistant Professor, Division of Rheumatology, University of Rochester, Golisano Children's Hospital; M.C. Gallo, MD, Research Contract, Istituto Giannina Gaslini; S. Calandra, MD, Pediatric Resident, Istituto Giannina Gaslini; A. Ravelli, MD, Professor of Pediatrics, University of Genoa and Istituto Giannina Gaslini; S. Ringold, MD, Assistant Professor, Division of Rheumatology, Seattle Children's Hospital; S. Shenoi, MBBS, Assistant Professor, Seattle Children's Hospital; J. Stinson, PhD, Senior Scientist, The Hospital for Sick Children, and Associate Professor, Lawrence S. Bloomberg Faculty of Nursing, University of Toronto; K. Toupin-April, PhD, Associate Scientist, Children's Hospital of Eastern Ontario Research Institute, and Assistant Professor, Department of Pediatrics and School of Rehabilitation Sciences, University of Ottawa; V. Strand, MD, Adjunct Clinical Professor, Division of Immunology/Rheumatology, Stanford University; C.O. Bingham III, MD, Professor of Medicine, Director, Johns Hopkins Arthritis Center, Johns Hopkins University
| | - Susan Thornhill
- Division of Rheumatology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; Pediatric Rheumatology and Pediatric Health Services Research, University of Michigan CS Mott Children's Hospital, Ann Arbor, Michigan; Office of Research, Division of Rheumatology, Columbia University Medical Center, New York; Division of Rheumatology, University of Rochester, Golisano Children's Hospital, Rochester, New York; Thornhill Associates, Hermosa Beach; Division of Immunology/Rheumatology, Stanford University, Stanford, California; Division of Rheumatology, University of Alabama at Birmingham, Birmingham, Alabama; Arthritis Foundation, Atlanta, Georgia; Division of Rheumatology, Children's Mercy, Kansas City, Missouri; Division of Pediatric Rheumatology, Rutgers Robert Wood Johnson Medical School, Institute for Health, Health Care Policy and Aging Research, New Brunswick, New Jersey; Medical College of Wisconsin, Milwaukee, Wisconsin; Division of Rheumatology, Seattle Children's Hospital, Seattle, Washington; Johns Hopkins Arthritis Center, Johns Hopkins University, Baltimore, Maryland, USA; Division of Rheumatology, Istituto Giannina Gaslini; University of Genoa, Genoa, Italy; Rheumatology, Royal Children's Hospital; Murdoch Children's Research Institute, Melbourne, Australia; The Hospital for Sick Children, and Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto; Children's Hospital of Eastern Ontario Research Institute, Department of Pediatrics and School of Rehabilitation Sciences, University of Ottawa, Ottawa, Ontario, Canada
- E.M. Morgan, MD, Associate Professor, Division of Rheumatology, Cincinnati Children's Hospital Medical Center; M.P. Riebschleger, MD, Clinical Lecturer, Pediatric Rheumatology and Pediatric Health Services Research, University of Michigan CS Mott Children's Hospital; J. Horonjeff, PhD, Instructor, Office of Research, Division of Rheumatology, Columbia University Medical Center; A. Consolaro, MD, PhD, Assistant Professor, Division of Rheumatology, Istituto Giannina Gaslini, and University of Genoa; J.E. Munro, MBBS, Associate Professor, Head of Rheumatology at the Royal Children's Hospital, and Group Leader, Arthritis Research, Murdoch Children's Research Institute; S. Thornhill, AA, Qualitative Research Consultant, Thornhill Associates; T. Beukelman, MD, Associate Professor, Division of Rheumatology, University of Alabama at Birmingham; H.I. Brunner, Professor, Division of Rheumatology, Cincinnati Children's Hospital Medical Center; E.L. Creek, MBA, Senior Director, Help and Support, Arthritis Foundation; J.G. Harris, MD, Assistant Professor, Division of Rheumatology, Children's Mercy; D.B. Horton, MD, Assistant Professor, Division of Pediatric Rheumatology, Rutgers Robert Wood Johnson Medical School, Institute for Health, Health Care Policy and Aging Research; D.J. Lovell, MD, Professor, Division of Rheumatology, Cincinnati Children's Hospital Medical Center; M.L. Mannion, MD, Assistant Professor of Rheumatology, University of Alabama at Birmingham; J.C. Olson, MD, Associate Professor, Medical College of Wisconsin; H. Rahimi, MD, Assistant Professor, Division of Rheumatology, University of Rochester, Golisano Children's Hospital; M.C. Gallo, MD, Research Contract, Istituto Giannina Gaslini; S. Calandra, MD, Pediatric Resident, Istituto Giannina Gaslini; A. Ravelli, MD, Professor of Pediatrics, University of Genoa and Istituto Giannina Gaslini; S. Ringold, MD, Assistant Professor, Division of Rheumatology, Seattle Children's Hospital; S. Shenoi, MBBS, Assistant Professor, Seattle Children's Hospital; J. Stinson, PhD, Senior Scientist, The Hospital for Sick Children, and Associate Professor, Lawrence S. Bloomberg Faculty of Nursing, University of Toronto; K. Toupin-April, PhD, Associate Scientist, Children's Hospital of Eastern Ontario Research Institute, and Assistant Professor, Department of Pediatrics and School of Rehabilitation Sciences, University of Ottawa; V. Strand, MD, Adjunct Clinical Professor, Division of Immunology/Rheumatology, Stanford University; C.O. Bingham III, MD, Professor of Medicine, Director, Johns Hopkins Arthritis Center, Johns Hopkins University
| | - Timothy Beukelman
- Division of Rheumatology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; Pediatric Rheumatology and Pediatric Health Services Research, University of Michigan CS Mott Children's Hospital, Ann Arbor, Michigan; Office of Research, Division of Rheumatology, Columbia University Medical Center, New York; Division of Rheumatology, University of Rochester, Golisano Children's Hospital, Rochester, New York; Thornhill Associates, Hermosa Beach; Division of Immunology/Rheumatology, Stanford University, Stanford, California; Division of Rheumatology, University of Alabama at Birmingham, Birmingham, Alabama; Arthritis Foundation, Atlanta, Georgia; Division of Rheumatology, Children's Mercy, Kansas City, Missouri; Division of Pediatric Rheumatology, Rutgers Robert Wood Johnson Medical School, Institute for Health, Health Care Policy and Aging Research, New Brunswick, New Jersey; Medical College of Wisconsin, Milwaukee, Wisconsin; Division of Rheumatology, Seattle Children's Hospital, Seattle, Washington; Johns Hopkins Arthritis Center, Johns Hopkins University, Baltimore, Maryland, USA; Division of Rheumatology, Istituto Giannina Gaslini; University of Genoa, Genoa, Italy; Rheumatology, Royal Children's Hospital; Murdoch Children's Research Institute, Melbourne, Australia; The Hospital for Sick Children, and Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto; Children's Hospital of Eastern Ontario Research Institute, Department of Pediatrics and School of Rehabilitation Sciences, University of Ottawa, Ottawa, Ontario, Canada
- E.M. Morgan, MD, Associate Professor, Division of Rheumatology, Cincinnati Children's Hospital Medical Center; M.P. Riebschleger, MD, Clinical Lecturer, Pediatric Rheumatology and Pediatric Health Services Research, University of Michigan CS Mott Children's Hospital; J. Horonjeff, PhD, Instructor, Office of Research, Division of Rheumatology, Columbia University Medical Center; A. Consolaro, MD, PhD, Assistant Professor, Division of Rheumatology, Istituto Giannina Gaslini, and University of Genoa; J.E. Munro, MBBS, Associate Professor, Head of Rheumatology at the Royal Children's Hospital, and Group Leader, Arthritis Research, Murdoch Children's Research Institute; S. Thornhill, AA, Qualitative Research Consultant, Thornhill Associates; T. Beukelman, MD, Associate Professor, Division of Rheumatology, University of Alabama at Birmingham; H.I. Brunner, Professor, Division of Rheumatology, Cincinnati Children's Hospital Medical Center; E.L. Creek, MBA, Senior Director, Help and Support, Arthritis Foundation; J.G. Harris, MD, Assistant Professor, Division of Rheumatology, Children's Mercy; D.B. Horton, MD, Assistant Professor, Division of Pediatric Rheumatology, Rutgers Robert Wood Johnson Medical School, Institute for Health, Health Care Policy and Aging Research; D.J. Lovell, MD, Professor, Division of Rheumatology, Cincinnati Children's Hospital Medical Center; M.L. Mannion, MD, Assistant Professor of Rheumatology, University of Alabama at Birmingham; J.C. Olson, MD, Associate Professor, Medical College of Wisconsin; H. Rahimi, MD, Assistant Professor, Division of Rheumatology, University of Rochester, Golisano Children's Hospital; M.C. Gallo, MD, Research Contract, Istituto Giannina Gaslini; S. Calandra, MD, Pediatric Resident, Istituto Giannina Gaslini; A. Ravelli, MD, Professor of Pediatrics, University of Genoa and Istituto Giannina Gaslini; S. Ringold, MD, Assistant Professor, Division of Rheumatology, Seattle Children's Hospital; S. Shenoi, MBBS, Assistant Professor, Seattle Children's Hospital; J. Stinson, PhD, Senior Scientist, The Hospital for Sick Children, and Associate Professor, Lawrence S. Bloomberg Faculty of Nursing, University of Toronto; K. Toupin-April, PhD, Associate Scientist, Children's Hospital of Eastern Ontario Research Institute, and Assistant Professor, Department of Pediatrics and School of Rehabilitation Sciences, University of Ottawa; V. Strand, MD, Adjunct Clinical Professor, Division of Immunology/Rheumatology, Stanford University; C.O. Bingham III, MD, Professor of Medicine, Director, Johns Hopkins Arthritis Center, Johns Hopkins University
| | - Hermine I Brunner
- Division of Rheumatology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; Pediatric Rheumatology and Pediatric Health Services Research, University of Michigan CS Mott Children's Hospital, Ann Arbor, Michigan; Office of Research, Division of Rheumatology, Columbia University Medical Center, New York; Division of Rheumatology, University of Rochester, Golisano Children's Hospital, Rochester, New York; Thornhill Associates, Hermosa Beach; Division of Immunology/Rheumatology, Stanford University, Stanford, California; Division of Rheumatology, University of Alabama at Birmingham, Birmingham, Alabama; Arthritis Foundation, Atlanta, Georgia; Division of Rheumatology, Children's Mercy, Kansas City, Missouri; Division of Pediatric Rheumatology, Rutgers Robert Wood Johnson Medical School, Institute for Health, Health Care Policy and Aging Research, New Brunswick, New Jersey; Medical College of Wisconsin, Milwaukee, Wisconsin; Division of Rheumatology, Seattle Children's Hospital, Seattle, Washington; Johns Hopkins Arthritis Center, Johns Hopkins University, Baltimore, Maryland, USA; Division of Rheumatology, Istituto Giannina Gaslini; University of Genoa, Genoa, Italy; Rheumatology, Royal Children's Hospital; Murdoch Children's Research Institute, Melbourne, Australia; The Hospital for Sick Children, and Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto; Children's Hospital of Eastern Ontario Research Institute, Department of Pediatrics and School of Rehabilitation Sciences, University of Ottawa, Ottawa, Ontario, Canada
- E.M. Morgan, MD, Associate Professor, Division of Rheumatology, Cincinnati Children's Hospital Medical Center; M.P. Riebschleger, MD, Clinical Lecturer, Pediatric Rheumatology and Pediatric Health Services Research, University of Michigan CS Mott Children's Hospital; J. Horonjeff, PhD, Instructor, Office of Research, Division of Rheumatology, Columbia University Medical Center; A. Consolaro, MD, PhD, Assistant Professor, Division of Rheumatology, Istituto Giannina Gaslini, and University of Genoa; J.E. Munro, MBBS, Associate Professor, Head of Rheumatology at the Royal Children's Hospital, and Group Leader, Arthritis Research, Murdoch Children's Research Institute; S. Thornhill, AA, Qualitative Research Consultant, Thornhill Associates; T. Beukelman, MD, Associate Professor, Division of Rheumatology, University of Alabama at Birmingham; H.I. Brunner, Professor, Division of Rheumatology, Cincinnati Children's Hospital Medical Center; E.L. Creek, MBA, Senior Director, Help and Support, Arthritis Foundation; J.G. Harris, MD, Assistant Professor, Division of Rheumatology, Children's Mercy; D.B. Horton, MD, Assistant Professor, Division of Pediatric Rheumatology, Rutgers Robert Wood Johnson Medical School, Institute for Health, Health Care Policy and Aging Research; D.J. Lovell, MD, Professor, Division of Rheumatology, Cincinnati Children's Hospital Medical Center; M.L. Mannion, MD, Assistant Professor of Rheumatology, University of Alabama at Birmingham; J.C. Olson, MD, Associate Professor, Medical College of Wisconsin; H. Rahimi, MD, Assistant Professor, Division of Rheumatology, University of Rochester, Golisano Children's Hospital; M.C. Gallo, MD, Research Contract, Istituto Giannina Gaslini; S. Calandra, MD, Pediatric Resident, Istituto Giannina Gaslini; A. Ravelli, MD, Professor of Pediatrics, University of Genoa and Istituto Giannina Gaslini; S. Ringold, MD, Assistant Professor, Division of Rheumatology, Seattle Children's Hospital; S. Shenoi, MBBS, Assistant Professor, Seattle Children's Hospital; J. Stinson, PhD, Senior Scientist, The Hospital for Sick Children, and Associate Professor, Lawrence S. Bloomberg Faculty of Nursing, University of Toronto; K. Toupin-April, PhD, Associate Scientist, Children's Hospital of Eastern Ontario Research Institute, and Assistant Professor, Department of Pediatrics and School of Rehabilitation Sciences, University of Ottawa; V. Strand, MD, Adjunct Clinical Professor, Division of Immunology/Rheumatology, Stanford University; C.O. Bingham III, MD, Professor of Medicine, Director, Johns Hopkins Arthritis Center, Johns Hopkins University
| | - Emily L Creek
- Division of Rheumatology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; Pediatric Rheumatology and Pediatric Health Services Research, University of Michigan CS Mott Children's Hospital, Ann Arbor, Michigan; Office of Research, Division of Rheumatology, Columbia University Medical Center, New York; Division of Rheumatology, University of Rochester, Golisano Children's Hospital, Rochester, New York; Thornhill Associates, Hermosa Beach; Division of Immunology/Rheumatology, Stanford University, Stanford, California; Division of Rheumatology, University of Alabama at Birmingham, Birmingham, Alabama; Arthritis Foundation, Atlanta, Georgia; Division of Rheumatology, Children's Mercy, Kansas City, Missouri; Division of Pediatric Rheumatology, Rutgers Robert Wood Johnson Medical School, Institute for Health, Health Care Policy and Aging Research, New Brunswick, New Jersey; Medical College of Wisconsin, Milwaukee, Wisconsin; Division of Rheumatology, Seattle Children's Hospital, Seattle, Washington; Johns Hopkins Arthritis Center, Johns Hopkins University, Baltimore, Maryland, USA; Division of Rheumatology, Istituto Giannina Gaslini; University of Genoa, Genoa, Italy; Rheumatology, Royal Children's Hospital; Murdoch Children's Research Institute, Melbourne, Australia; The Hospital for Sick Children, and Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto; Children's Hospital of Eastern Ontario Research Institute, Department of Pediatrics and School of Rehabilitation Sciences, University of Ottawa, Ottawa, Ontario, Canada
- E.M. Morgan, MD, Associate Professor, Division of Rheumatology, Cincinnati Children's Hospital Medical Center; M.P. Riebschleger, MD, Clinical Lecturer, Pediatric Rheumatology and Pediatric Health Services Research, University of Michigan CS Mott Children's Hospital; J. Horonjeff, PhD, Instructor, Office of Research, Division of Rheumatology, Columbia University Medical Center; A. Consolaro, MD, PhD, Assistant Professor, Division of Rheumatology, Istituto Giannina Gaslini, and University of Genoa; J.E. Munro, MBBS, Associate Professor, Head of Rheumatology at the Royal Children's Hospital, and Group Leader, Arthritis Research, Murdoch Children's Research Institute; S. Thornhill, AA, Qualitative Research Consultant, Thornhill Associates; T. Beukelman, MD, Associate Professor, Division of Rheumatology, University of Alabama at Birmingham; H.I. Brunner, Professor, Division of Rheumatology, Cincinnati Children's Hospital Medical Center; E.L. Creek, MBA, Senior Director, Help and Support, Arthritis Foundation; J.G. Harris, MD, Assistant Professor, Division of Rheumatology, Children's Mercy; D.B. Horton, MD, Assistant Professor, Division of Pediatric Rheumatology, Rutgers Robert Wood Johnson Medical School, Institute for Health, Health Care Policy and Aging Research; D.J. Lovell, MD, Professor, Division of Rheumatology, Cincinnati Children's Hospital Medical Center; M.L. Mannion, MD, Assistant Professor of Rheumatology, University of Alabama at Birmingham; J.C. Olson, MD, Associate Professor, Medical College of Wisconsin; H. Rahimi, MD, Assistant Professor, Division of Rheumatology, University of Rochester, Golisano Children's Hospital; M.C. Gallo, MD, Research Contract, Istituto Giannina Gaslini; S. Calandra, MD, Pediatric Resident, Istituto Giannina Gaslini; A. Ravelli, MD, Professor of Pediatrics, University of Genoa and Istituto Giannina Gaslini; S. Ringold, MD, Assistant Professor, Division of Rheumatology, Seattle Children's Hospital; S. Shenoi, MBBS, Assistant Professor, Seattle Children's Hospital; J. Stinson, PhD, Senior Scientist, The Hospital for Sick Children, and Associate Professor, Lawrence S. Bloomberg Faculty of Nursing, University of Toronto; K. Toupin-April, PhD, Associate Scientist, Children's Hospital of Eastern Ontario Research Institute, and Assistant Professor, Department of Pediatrics and School of Rehabilitation Sciences, University of Ottawa; V. Strand, MD, Adjunct Clinical Professor, Division of Immunology/Rheumatology, Stanford University; C.O. Bingham III, MD, Professor of Medicine, Director, Johns Hopkins Arthritis Center, Johns Hopkins University
| | - Julia G Harris
- Division of Rheumatology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; Pediatric Rheumatology and Pediatric Health Services Research, University of Michigan CS Mott Children's Hospital, Ann Arbor, Michigan; Office of Research, Division of Rheumatology, Columbia University Medical Center, New York; Division of Rheumatology, University of Rochester, Golisano Children's Hospital, Rochester, New York; Thornhill Associates, Hermosa Beach; Division of Immunology/Rheumatology, Stanford University, Stanford, California; Division of Rheumatology, University of Alabama at Birmingham, Birmingham, Alabama; Arthritis Foundation, Atlanta, Georgia; Division of Rheumatology, Children's Mercy, Kansas City, Missouri; Division of Pediatric Rheumatology, Rutgers Robert Wood Johnson Medical School, Institute for Health, Health Care Policy and Aging Research, New Brunswick, New Jersey; Medical College of Wisconsin, Milwaukee, Wisconsin; Division of Rheumatology, Seattle Children's Hospital, Seattle, Washington; Johns Hopkins Arthritis Center, Johns Hopkins University, Baltimore, Maryland, USA; Division of Rheumatology, Istituto Giannina Gaslini; University of Genoa, Genoa, Italy; Rheumatology, Royal Children's Hospital; Murdoch Children's Research Institute, Melbourne, Australia; The Hospital for Sick Children, and Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto; Children's Hospital of Eastern Ontario Research Institute, Department of Pediatrics and School of Rehabilitation Sciences, University of Ottawa, Ottawa, Ontario, Canada
- E.M. Morgan, MD, Associate Professor, Division of Rheumatology, Cincinnati Children's Hospital Medical Center; M.P. Riebschleger, MD, Clinical Lecturer, Pediatric Rheumatology and Pediatric Health Services Research, University of Michigan CS Mott Children's Hospital; J. Horonjeff, PhD, Instructor, Office of Research, Division of Rheumatology, Columbia University Medical Center; A. Consolaro, MD, PhD, Assistant Professor, Division of Rheumatology, Istituto Giannina Gaslini, and University of Genoa; J.E. Munro, MBBS, Associate Professor, Head of Rheumatology at the Royal Children's Hospital, and Group Leader, Arthritis Research, Murdoch Children's Research Institute; S. Thornhill, AA, Qualitative Research Consultant, Thornhill Associates; T. Beukelman, MD, Associate Professor, Division of Rheumatology, University of Alabama at Birmingham; H.I. Brunner, Professor, Division of Rheumatology, Cincinnati Children's Hospital Medical Center; E.L. Creek, MBA, Senior Director, Help and Support, Arthritis Foundation; J.G. Harris, MD, Assistant Professor, Division of Rheumatology, Children's Mercy; D.B. Horton, MD, Assistant Professor, Division of Pediatric Rheumatology, Rutgers Robert Wood Johnson Medical School, Institute for Health, Health Care Policy and Aging Research; D.J. Lovell, MD, Professor, Division of Rheumatology, Cincinnati Children's Hospital Medical Center; M.L. Mannion, MD, Assistant Professor of Rheumatology, University of Alabama at Birmingham; J.C. Olson, MD, Associate Professor, Medical College of Wisconsin; H. Rahimi, MD, Assistant Professor, Division of Rheumatology, University of Rochester, Golisano Children's Hospital; M.C. Gallo, MD, Research Contract, Istituto Giannina Gaslini; S. Calandra, MD, Pediatric Resident, Istituto Giannina Gaslini; A. Ravelli, MD, Professor of Pediatrics, University of Genoa and Istituto Giannina Gaslini; S. Ringold, MD, Assistant Professor, Division of Rheumatology, Seattle Children's Hospital; S. Shenoi, MBBS, Assistant Professor, Seattle Children's Hospital; J. Stinson, PhD, Senior Scientist, The Hospital for Sick Children, and Associate Professor, Lawrence S. Bloomberg Faculty of Nursing, University of Toronto; K. Toupin-April, PhD, Associate Scientist, Children's Hospital of Eastern Ontario Research Institute, and Assistant Professor, Department of Pediatrics and School of Rehabilitation Sciences, University of Ottawa; V. Strand, MD, Adjunct Clinical Professor, Division of Immunology/Rheumatology, Stanford University; C.O. Bingham III, MD, Professor of Medicine, Director, Johns Hopkins Arthritis Center, Johns Hopkins University
| | - Daniel B Horton
- Division of Rheumatology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; Pediatric Rheumatology and Pediatric Health Services Research, University of Michigan CS Mott Children's Hospital, Ann Arbor, Michigan; Office of Research, Division of Rheumatology, Columbia University Medical Center, New York; Division of Rheumatology, University of Rochester, Golisano Children's Hospital, Rochester, New York; Thornhill Associates, Hermosa Beach; Division of Immunology/Rheumatology, Stanford University, Stanford, California; Division of Rheumatology, University of Alabama at Birmingham, Birmingham, Alabama; Arthritis Foundation, Atlanta, Georgia; Division of Rheumatology, Children's Mercy, Kansas City, Missouri; Division of Pediatric Rheumatology, Rutgers Robert Wood Johnson Medical School, Institute for Health, Health Care Policy and Aging Research, New Brunswick, New Jersey; Medical College of Wisconsin, Milwaukee, Wisconsin; Division of Rheumatology, Seattle Children's Hospital, Seattle, Washington; Johns Hopkins Arthritis Center, Johns Hopkins University, Baltimore, Maryland, USA; Division of Rheumatology, Istituto Giannina Gaslini; University of Genoa, Genoa, Italy; Rheumatology, Royal Children's Hospital; Murdoch Children's Research Institute, Melbourne, Australia; The Hospital for Sick Children, and Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto; Children's Hospital of Eastern Ontario Research Institute, Department of Pediatrics and School of Rehabilitation Sciences, University of Ottawa, Ottawa, Ontario, Canada
- E.M. Morgan, MD, Associate Professor, Division of Rheumatology, Cincinnati Children's Hospital Medical Center; M.P. Riebschleger, MD, Clinical Lecturer, Pediatric Rheumatology and Pediatric Health Services Research, University of Michigan CS Mott Children's Hospital; J. Horonjeff, PhD, Instructor, Office of Research, Division of Rheumatology, Columbia University Medical Center; A. Consolaro, MD, PhD, Assistant Professor, Division of Rheumatology, Istituto Giannina Gaslini, and University of Genoa; J.E. Munro, MBBS, Associate Professor, Head of Rheumatology at the Royal Children's Hospital, and Group Leader, Arthritis Research, Murdoch Children's Research Institute; S. Thornhill, AA, Qualitative Research Consultant, Thornhill Associates; T. Beukelman, MD, Associate Professor, Division of Rheumatology, University of Alabama at Birmingham; H.I. Brunner, Professor, Division of Rheumatology, Cincinnati Children's Hospital Medical Center; E.L. Creek, MBA, Senior Director, Help and Support, Arthritis Foundation; J.G. Harris, MD, Assistant Professor, Division of Rheumatology, Children's Mercy; D.B. Horton, MD, Assistant Professor, Division of Pediatric Rheumatology, Rutgers Robert Wood Johnson Medical School, Institute for Health, Health Care Policy and Aging Research; D.J. Lovell, MD, Professor, Division of Rheumatology, Cincinnati Children's Hospital Medical Center; M.L. Mannion, MD, Assistant Professor of Rheumatology, University of Alabama at Birmingham; J.C. Olson, MD, Associate Professor, Medical College of Wisconsin; H. Rahimi, MD, Assistant Professor, Division of Rheumatology, University of Rochester, Golisano Children's Hospital; M.C. Gallo, MD, Research Contract, Istituto Giannina Gaslini; S. Calandra, MD, Pediatric Resident, Istituto Giannina Gaslini; A. Ravelli, MD, Professor of Pediatrics, University of Genoa and Istituto Giannina Gaslini; S. Ringold, MD, Assistant Professor, Division of Rheumatology, Seattle Children's Hospital; S. Shenoi, MBBS, Assistant Professor, Seattle Children's Hospital; J. Stinson, PhD, Senior Scientist, The Hospital for Sick Children, and Associate Professor, Lawrence S. Bloomberg Faculty of Nursing, University of Toronto; K. Toupin-April, PhD, Associate Scientist, Children's Hospital of Eastern Ontario Research Institute, and Assistant Professor, Department of Pediatrics and School of Rehabilitation Sciences, University of Ottawa; V. Strand, MD, Adjunct Clinical Professor, Division of Immunology/Rheumatology, Stanford University; C.O. Bingham III, MD, Professor of Medicine, Director, Johns Hopkins Arthritis Center, Johns Hopkins University
| | - Daniel J Lovell
- Division of Rheumatology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; Pediatric Rheumatology and Pediatric Health Services Research, University of Michigan CS Mott Children's Hospital, Ann Arbor, Michigan; Office of Research, Division of Rheumatology, Columbia University Medical Center, New York; Division of Rheumatology, University of Rochester, Golisano Children's Hospital, Rochester, New York; Thornhill Associates, Hermosa Beach; Division of Immunology/Rheumatology, Stanford University, Stanford, California; Division of Rheumatology, University of Alabama at Birmingham, Birmingham, Alabama; Arthritis Foundation, Atlanta, Georgia; Division of Rheumatology, Children's Mercy, Kansas City, Missouri; Division of Pediatric Rheumatology, Rutgers Robert Wood Johnson Medical School, Institute for Health, Health Care Policy and Aging Research, New Brunswick, New Jersey; Medical College of Wisconsin, Milwaukee, Wisconsin; Division of Rheumatology, Seattle Children's Hospital, Seattle, Washington; Johns Hopkins Arthritis Center, Johns Hopkins University, Baltimore, Maryland, USA; Division of Rheumatology, Istituto Giannina Gaslini; University of Genoa, Genoa, Italy; Rheumatology, Royal Children's Hospital; Murdoch Children's Research Institute, Melbourne, Australia; The Hospital for Sick Children, and Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto; Children's Hospital of Eastern Ontario Research Institute, Department of Pediatrics and School of Rehabilitation Sciences, University of Ottawa, Ottawa, Ontario, Canada
- E.M. Morgan, MD, Associate Professor, Division of Rheumatology, Cincinnati Children's Hospital Medical Center; M.P. Riebschleger, MD, Clinical Lecturer, Pediatric Rheumatology and Pediatric Health Services Research, University of Michigan CS Mott Children's Hospital; J. Horonjeff, PhD, Instructor, Office of Research, Division of Rheumatology, Columbia University Medical Center; A. Consolaro, MD, PhD, Assistant Professor, Division of Rheumatology, Istituto Giannina Gaslini, and University of Genoa; J.E. Munro, MBBS, Associate Professor, Head of Rheumatology at the Royal Children's Hospital, and Group Leader, Arthritis Research, Murdoch Children's Research Institute; S. Thornhill, AA, Qualitative Research Consultant, Thornhill Associates; T. Beukelman, MD, Associate Professor, Division of Rheumatology, University of Alabama at Birmingham; H.I. Brunner, Professor, Division of Rheumatology, Cincinnati Children's Hospital Medical Center; E.L. Creek, MBA, Senior Director, Help and Support, Arthritis Foundation; J.G. Harris, MD, Assistant Professor, Division of Rheumatology, Children's Mercy; D.B. Horton, MD, Assistant Professor, Division of Pediatric Rheumatology, Rutgers Robert Wood Johnson Medical School, Institute for Health, Health Care Policy and Aging Research; D.J. Lovell, MD, Professor, Division of Rheumatology, Cincinnati Children's Hospital Medical Center; M.L. Mannion, MD, Assistant Professor of Rheumatology, University of Alabama at Birmingham; J.C. Olson, MD, Associate Professor, Medical College of Wisconsin; H. Rahimi, MD, Assistant Professor, Division of Rheumatology, University of Rochester, Golisano Children's Hospital; M.C. Gallo, MD, Research Contract, Istituto Giannina Gaslini; S. Calandra, MD, Pediatric Resident, Istituto Giannina Gaslini; A. Ravelli, MD, Professor of Pediatrics, University of Genoa and Istituto Giannina Gaslini; S. Ringold, MD, Assistant Professor, Division of Rheumatology, Seattle Children's Hospital; S. Shenoi, MBBS, Assistant Professor, Seattle Children's Hospital; J. Stinson, PhD, Senior Scientist, The Hospital for Sick Children, and Associate Professor, Lawrence S. Bloomberg Faculty of Nursing, University of Toronto; K. Toupin-April, PhD, Associate Scientist, Children's Hospital of Eastern Ontario Research Institute, and Assistant Professor, Department of Pediatrics and School of Rehabilitation Sciences, University of Ottawa; V. Strand, MD, Adjunct Clinical Professor, Division of Immunology/Rheumatology, Stanford University; C.O. Bingham III, MD, Professor of Medicine, Director, Johns Hopkins Arthritis Center, Johns Hopkins University
| | - Melissa L Mannion
- Division of Rheumatology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; Pediatric Rheumatology and Pediatric Health Services Research, University of Michigan CS Mott Children's Hospital, Ann Arbor, Michigan; Office of Research, Division of Rheumatology, Columbia University Medical Center, New York; Division of Rheumatology, University of Rochester, Golisano Children's Hospital, Rochester, New York; Thornhill Associates, Hermosa Beach; Division of Immunology/Rheumatology, Stanford University, Stanford, California; Division of Rheumatology, University of Alabama at Birmingham, Birmingham, Alabama; Arthritis Foundation, Atlanta, Georgia; Division of Rheumatology, Children's Mercy, Kansas City, Missouri; Division of Pediatric Rheumatology, Rutgers Robert Wood Johnson Medical School, Institute for Health, Health Care Policy and Aging Research, New Brunswick, New Jersey; Medical College of Wisconsin, Milwaukee, Wisconsin; Division of Rheumatology, Seattle Children's Hospital, Seattle, Washington; Johns Hopkins Arthritis Center, Johns Hopkins University, Baltimore, Maryland, USA; Division of Rheumatology, Istituto Giannina Gaslini; University of Genoa, Genoa, Italy; Rheumatology, Royal Children's Hospital; Murdoch Children's Research Institute, Melbourne, Australia; The Hospital for Sick Children, and Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto; Children's Hospital of Eastern Ontario Research Institute, Department of Pediatrics and School of Rehabilitation Sciences, University of Ottawa, Ottawa, Ontario, Canada
- E.M. Morgan, MD, Associate Professor, Division of Rheumatology, Cincinnati Children's Hospital Medical Center; M.P. Riebschleger, MD, Clinical Lecturer, Pediatric Rheumatology and Pediatric Health Services Research, University of Michigan CS Mott Children's Hospital; J. Horonjeff, PhD, Instructor, Office of Research, Division of Rheumatology, Columbia University Medical Center; A. Consolaro, MD, PhD, Assistant Professor, Division of Rheumatology, Istituto Giannina Gaslini, and University of Genoa; J.E. Munro, MBBS, Associate Professor, Head of Rheumatology at the Royal Children's Hospital, and Group Leader, Arthritis Research, Murdoch Children's Research Institute; S. Thornhill, AA, Qualitative Research Consultant, Thornhill Associates; T. Beukelman, MD, Associate Professor, Division of Rheumatology, University of Alabama at Birmingham; H.I. Brunner, Professor, Division of Rheumatology, Cincinnati Children's Hospital Medical Center; E.L. Creek, MBA, Senior Director, Help and Support, Arthritis Foundation; J.G. Harris, MD, Assistant Professor, Division of Rheumatology, Children's Mercy; D.B. Horton, MD, Assistant Professor, Division of Pediatric Rheumatology, Rutgers Robert Wood Johnson Medical School, Institute for Health, Health Care Policy and Aging Research; D.J. Lovell, MD, Professor, Division of Rheumatology, Cincinnati Children's Hospital Medical Center; M.L. Mannion, MD, Assistant Professor of Rheumatology, University of Alabama at Birmingham; J.C. Olson, MD, Associate Professor, Medical College of Wisconsin; H. Rahimi, MD, Assistant Professor, Division of Rheumatology, University of Rochester, Golisano Children's Hospital; M.C. Gallo, MD, Research Contract, Istituto Giannina Gaslini; S. Calandra, MD, Pediatric Resident, Istituto Giannina Gaslini; A. Ravelli, MD, Professor of Pediatrics, University of Genoa and Istituto Giannina Gaslini; S. Ringold, MD, Assistant Professor, Division of Rheumatology, Seattle Children's Hospital; S. Shenoi, MBBS, Assistant Professor, Seattle Children's Hospital; J. Stinson, PhD, Senior Scientist, The Hospital for Sick Children, and Associate Professor, Lawrence S. Bloomberg Faculty of Nursing, University of Toronto; K. Toupin-April, PhD, Associate Scientist, Children's Hospital of Eastern Ontario Research Institute, and Assistant Professor, Department of Pediatrics and School of Rehabilitation Sciences, University of Ottawa; V. Strand, MD, Adjunct Clinical Professor, Division of Immunology/Rheumatology, Stanford University; C.O. Bingham III, MD, Professor of Medicine, Director, Johns Hopkins Arthritis Center, Johns Hopkins University
| | - Judyann C Olson
- Division of Rheumatology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; Pediatric Rheumatology and Pediatric Health Services Research, University of Michigan CS Mott Children's Hospital, Ann Arbor, Michigan; Office of Research, Division of Rheumatology, Columbia University Medical Center, New York; Division of Rheumatology, University of Rochester, Golisano Children's Hospital, Rochester, New York; Thornhill Associates, Hermosa Beach; Division of Immunology/Rheumatology, Stanford University, Stanford, California; Division of Rheumatology, University of Alabama at Birmingham, Birmingham, Alabama; Arthritis Foundation, Atlanta, Georgia; Division of Rheumatology, Children's Mercy, Kansas City, Missouri; Division of Pediatric Rheumatology, Rutgers Robert Wood Johnson Medical School, Institute for Health, Health Care Policy and Aging Research, New Brunswick, New Jersey; Medical College of Wisconsin, Milwaukee, Wisconsin; Division of Rheumatology, Seattle Children's Hospital, Seattle, Washington; Johns Hopkins Arthritis Center, Johns Hopkins University, Baltimore, Maryland, USA; Division of Rheumatology, Istituto Giannina Gaslini; University of Genoa, Genoa, Italy; Rheumatology, Royal Children's Hospital; Murdoch Children's Research Institute, Melbourne, Australia; The Hospital for Sick Children, and Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto; Children's Hospital of Eastern Ontario Research Institute, Department of Pediatrics and School of Rehabilitation Sciences, University of Ottawa, Ottawa, Ontario, Canada
- E.M. Morgan, MD, Associate Professor, Division of Rheumatology, Cincinnati Children's Hospital Medical Center; M.P. Riebschleger, MD, Clinical Lecturer, Pediatric Rheumatology and Pediatric Health Services Research, University of Michigan CS Mott Children's Hospital; J. Horonjeff, PhD, Instructor, Office of Research, Division of Rheumatology, Columbia University Medical Center; A. Consolaro, MD, PhD, Assistant Professor, Division of Rheumatology, Istituto Giannina Gaslini, and University of Genoa; J.E. Munro, MBBS, Associate Professor, Head of Rheumatology at the Royal Children's Hospital, and Group Leader, Arthritis Research, Murdoch Children's Research Institute; S. Thornhill, AA, Qualitative Research Consultant, Thornhill Associates; T. Beukelman, MD, Associate Professor, Division of Rheumatology, University of Alabama at Birmingham; H.I. Brunner, Professor, Division of Rheumatology, Cincinnati Children's Hospital Medical Center; E.L. Creek, MBA, Senior Director, Help and Support, Arthritis Foundation; J.G. Harris, MD, Assistant Professor, Division of Rheumatology, Children's Mercy; D.B. Horton, MD, Assistant Professor, Division of Pediatric Rheumatology, Rutgers Robert Wood Johnson Medical School, Institute for Health, Health Care Policy and Aging Research; D.J. Lovell, MD, Professor, Division of Rheumatology, Cincinnati Children's Hospital Medical Center; M.L. Mannion, MD, Assistant Professor of Rheumatology, University of Alabama at Birmingham; J.C. Olson, MD, Associate Professor, Medical College of Wisconsin; H. Rahimi, MD, Assistant Professor, Division of Rheumatology, University of Rochester, Golisano Children's Hospital; M.C. Gallo, MD, Research Contract, Istituto Giannina Gaslini; S. Calandra, MD, Pediatric Resident, Istituto Giannina Gaslini; A. Ravelli, MD, Professor of Pediatrics, University of Genoa and Istituto Giannina Gaslini; S. Ringold, MD, Assistant Professor, Division of Rheumatology, Seattle Children's Hospital; S. Shenoi, MBBS, Assistant Professor, Seattle Children's Hospital; J. Stinson, PhD, Senior Scientist, The Hospital for Sick Children, and Associate Professor, Lawrence S. Bloomberg Faculty of Nursing, University of Toronto; K. Toupin-April, PhD, Associate Scientist, Children's Hospital of Eastern Ontario Research Institute, and Assistant Professor, Department of Pediatrics and School of Rehabilitation Sciences, University of Ottawa; V. Strand, MD, Adjunct Clinical Professor, Division of Immunology/Rheumatology, Stanford University; C.O. Bingham III, MD, Professor of Medicine, Director, Johns Hopkins Arthritis Center, Johns Hopkins University
| | - Homaira Rahimi
- Division of Rheumatology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; Pediatric Rheumatology and Pediatric Health Services Research, University of Michigan CS Mott Children's Hospital, Ann Arbor, Michigan; Office of Research, Division of Rheumatology, Columbia University Medical Center, New York; Division of Rheumatology, University of Rochester, Golisano Children's Hospital, Rochester, New York; Thornhill Associates, Hermosa Beach; Division of Immunology/Rheumatology, Stanford University, Stanford, California; Division of Rheumatology, University of Alabama at Birmingham, Birmingham, Alabama; Arthritis Foundation, Atlanta, Georgia; Division of Rheumatology, Children's Mercy, Kansas City, Missouri; Division of Pediatric Rheumatology, Rutgers Robert Wood Johnson Medical School, Institute for Health, Health Care Policy and Aging Research, New Brunswick, New Jersey; Medical College of Wisconsin, Milwaukee, Wisconsin; Division of Rheumatology, Seattle Children's Hospital, Seattle, Washington; Johns Hopkins Arthritis Center, Johns Hopkins University, Baltimore, Maryland, USA; Division of Rheumatology, Istituto Giannina Gaslini; University of Genoa, Genoa, Italy; Rheumatology, Royal Children's Hospital; Murdoch Children's Research Institute, Melbourne, Australia; The Hospital for Sick Children, and Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto; Children's Hospital of Eastern Ontario Research Institute, Department of Pediatrics and School of Rehabilitation Sciences, University of Ottawa, Ottawa, Ontario, Canada
- E.M. Morgan, MD, Associate Professor, Division of Rheumatology, Cincinnati Children's Hospital Medical Center; M.P. Riebschleger, MD, Clinical Lecturer, Pediatric Rheumatology and Pediatric Health Services Research, University of Michigan CS Mott Children's Hospital; J. Horonjeff, PhD, Instructor, Office of Research, Division of Rheumatology, Columbia University Medical Center; A. Consolaro, MD, PhD, Assistant Professor, Division of Rheumatology, Istituto Giannina Gaslini, and University of Genoa; J.E. Munro, MBBS, Associate Professor, Head of Rheumatology at the Royal Children's Hospital, and Group Leader, Arthritis Research, Murdoch Children's Research Institute; S. Thornhill, AA, Qualitative Research Consultant, Thornhill Associates; T. Beukelman, MD, Associate Professor, Division of Rheumatology, University of Alabama at Birmingham; H.I. Brunner, Professor, Division of Rheumatology, Cincinnati Children's Hospital Medical Center; E.L. Creek, MBA, Senior Director, Help and Support, Arthritis Foundation; J.G. Harris, MD, Assistant Professor, Division of Rheumatology, Children's Mercy; D.B. Horton, MD, Assistant Professor, Division of Pediatric Rheumatology, Rutgers Robert Wood Johnson Medical School, Institute for Health, Health Care Policy and Aging Research; D.J. Lovell, MD, Professor, Division of Rheumatology, Cincinnati Children's Hospital Medical Center; M.L. Mannion, MD, Assistant Professor of Rheumatology, University of Alabama at Birmingham; J.C. Olson, MD, Associate Professor, Medical College of Wisconsin; H. Rahimi, MD, Assistant Professor, Division of Rheumatology, University of Rochester, Golisano Children's Hospital; M.C. Gallo, MD, Research Contract, Istituto Giannina Gaslini; S. Calandra, MD, Pediatric Resident, Istituto Giannina Gaslini; A. Ravelli, MD, Professor of Pediatrics, University of Genoa and Istituto Giannina Gaslini; S. Ringold, MD, Assistant Professor, Division of Rheumatology, Seattle Children's Hospital; S. Shenoi, MBBS, Assistant Professor, Seattle Children's Hospital; J. Stinson, PhD, Senior Scientist, The Hospital for Sick Children, and Associate Professor, Lawrence S. Bloomberg Faculty of Nursing, University of Toronto; K. Toupin-April, PhD, Associate Scientist, Children's Hospital of Eastern Ontario Research Institute, and Assistant Professor, Department of Pediatrics and School of Rehabilitation Sciences, University of Ottawa; V. Strand, MD, Adjunct Clinical Professor, Division of Immunology/Rheumatology, Stanford University; C.O. Bingham III, MD, Professor of Medicine, Director, Johns Hopkins Arthritis Center, Johns Hopkins University
| | - Maria Chiara Gallo
- Division of Rheumatology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; Pediatric Rheumatology and Pediatric Health Services Research, University of Michigan CS Mott Children's Hospital, Ann Arbor, Michigan; Office of Research, Division of Rheumatology, Columbia University Medical Center, New York; Division of Rheumatology, University of Rochester, Golisano Children's Hospital, Rochester, New York; Thornhill Associates, Hermosa Beach; Division of Immunology/Rheumatology, Stanford University, Stanford, California; Division of Rheumatology, University of Alabama at Birmingham, Birmingham, Alabama; Arthritis Foundation, Atlanta, Georgia; Division of Rheumatology, Children's Mercy, Kansas City, Missouri; Division of Pediatric Rheumatology, Rutgers Robert Wood Johnson Medical School, Institute for Health, Health Care Policy and Aging Research, New Brunswick, New Jersey; Medical College of Wisconsin, Milwaukee, Wisconsin; Division of Rheumatology, Seattle Children's Hospital, Seattle, Washington; Johns Hopkins Arthritis Center, Johns Hopkins University, Baltimore, Maryland, USA; Division of Rheumatology, Istituto Giannina Gaslini; University of Genoa, Genoa, Italy; Rheumatology, Royal Children's Hospital; Murdoch Children's Research Institute, Melbourne, Australia; The Hospital for Sick Children, and Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto; Children's Hospital of Eastern Ontario Research Institute, Department of Pediatrics and School of Rehabilitation Sciences, University of Ottawa, Ottawa, Ontario, Canada
- E.M. Morgan, MD, Associate Professor, Division of Rheumatology, Cincinnati Children's Hospital Medical Center; M.P. Riebschleger, MD, Clinical Lecturer, Pediatric Rheumatology and Pediatric Health Services Research, University of Michigan CS Mott Children's Hospital; J. Horonjeff, PhD, Instructor, Office of Research, Division of Rheumatology, Columbia University Medical Center; A. Consolaro, MD, PhD, Assistant Professor, Division of Rheumatology, Istituto Giannina Gaslini, and University of Genoa; J.E. Munro, MBBS, Associate Professor, Head of Rheumatology at the Royal Children's Hospital, and Group Leader, Arthritis Research, Murdoch Children's Research Institute; S. Thornhill, AA, Qualitative Research Consultant, Thornhill Associates; T. Beukelman, MD, Associate Professor, Division of Rheumatology, University of Alabama at Birmingham; H.I. Brunner, Professor, Division of Rheumatology, Cincinnati Children's Hospital Medical Center; E.L. Creek, MBA, Senior Director, Help and Support, Arthritis Foundation; J.G. Harris, MD, Assistant Professor, Division of Rheumatology, Children's Mercy; D.B. Horton, MD, Assistant Professor, Division of Pediatric Rheumatology, Rutgers Robert Wood Johnson Medical School, Institute for Health, Health Care Policy and Aging Research; D.J. Lovell, MD, Professor, Division of Rheumatology, Cincinnati Children's Hospital Medical Center; M.L. Mannion, MD, Assistant Professor of Rheumatology, University of Alabama at Birmingham; J.C. Olson, MD, Associate Professor, Medical College of Wisconsin; H. Rahimi, MD, Assistant Professor, Division of Rheumatology, University of Rochester, Golisano Children's Hospital; M.C. Gallo, MD, Research Contract, Istituto Giannina Gaslini; S. Calandra, MD, Pediatric Resident, Istituto Giannina Gaslini; A. Ravelli, MD, Professor of Pediatrics, University of Genoa and Istituto Giannina Gaslini; S. Ringold, MD, Assistant Professor, Division of Rheumatology, Seattle Children's Hospital; S. Shenoi, MBBS, Assistant Professor, Seattle Children's Hospital; J. Stinson, PhD, Senior Scientist, The Hospital for Sick Children, and Associate Professor, Lawrence S. Bloomberg Faculty of Nursing, University of Toronto; K. Toupin-April, PhD, Associate Scientist, Children's Hospital of Eastern Ontario Research Institute, and Assistant Professor, Department of Pediatrics and School of Rehabilitation Sciences, University of Ottawa; V. Strand, MD, Adjunct Clinical Professor, Division of Immunology/Rheumatology, Stanford University; C.O. Bingham III, MD, Professor of Medicine, Director, Johns Hopkins Arthritis Center, Johns Hopkins University
| | - Serena Calandra
- Division of Rheumatology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; Pediatric Rheumatology and Pediatric Health Services Research, University of Michigan CS Mott Children's Hospital, Ann Arbor, Michigan; Office of Research, Division of Rheumatology, Columbia University Medical Center, New York; Division of Rheumatology, University of Rochester, Golisano Children's Hospital, Rochester, New York; Thornhill Associates, Hermosa Beach; Division of Immunology/Rheumatology, Stanford University, Stanford, California; Division of Rheumatology, University of Alabama at Birmingham, Birmingham, Alabama; Arthritis Foundation, Atlanta, Georgia; Division of Rheumatology, Children's Mercy, Kansas City, Missouri; Division of Pediatric Rheumatology, Rutgers Robert Wood Johnson Medical School, Institute for Health, Health Care Policy and Aging Research, New Brunswick, New Jersey; Medical College of Wisconsin, Milwaukee, Wisconsin; Division of Rheumatology, Seattle Children's Hospital, Seattle, Washington; Johns Hopkins Arthritis Center, Johns Hopkins University, Baltimore, Maryland, USA; Division of Rheumatology, Istituto Giannina Gaslini; University of Genoa, Genoa, Italy; Rheumatology, Royal Children's Hospital; Murdoch Children's Research Institute, Melbourne, Australia; The Hospital for Sick Children, and Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto; Children's Hospital of Eastern Ontario Research Institute, Department of Pediatrics and School of Rehabilitation Sciences, University of Ottawa, Ottawa, Ontario, Canada
- E.M. Morgan, MD, Associate Professor, Division of Rheumatology, Cincinnati Children's Hospital Medical Center; M.P. Riebschleger, MD, Clinical Lecturer, Pediatric Rheumatology and Pediatric Health Services Research, University of Michigan CS Mott Children's Hospital; J. Horonjeff, PhD, Instructor, Office of Research, Division of Rheumatology, Columbia University Medical Center; A. Consolaro, MD, PhD, Assistant Professor, Division of Rheumatology, Istituto Giannina Gaslini, and University of Genoa; J.E. Munro, MBBS, Associate Professor, Head of Rheumatology at the Royal Children's Hospital, and Group Leader, Arthritis Research, Murdoch Children's Research Institute; S. Thornhill, AA, Qualitative Research Consultant, Thornhill Associates; T. Beukelman, MD, Associate Professor, Division of Rheumatology, University of Alabama at Birmingham; H.I. Brunner, Professor, Division of Rheumatology, Cincinnati Children's Hospital Medical Center; E.L. Creek, MBA, Senior Director, Help and Support, Arthritis Foundation; J.G. Harris, MD, Assistant Professor, Division of Rheumatology, Children's Mercy; D.B. Horton, MD, Assistant Professor, Division of Pediatric Rheumatology, Rutgers Robert Wood Johnson Medical School, Institute for Health, Health Care Policy and Aging Research; D.J. Lovell, MD, Professor, Division of Rheumatology, Cincinnati Children's Hospital Medical Center; M.L. Mannion, MD, Assistant Professor of Rheumatology, University of Alabama at Birmingham; J.C. Olson, MD, Associate Professor, Medical College of Wisconsin; H. Rahimi, MD, Assistant Professor, Division of Rheumatology, University of Rochester, Golisano Children's Hospital; M.C. Gallo, MD, Research Contract, Istituto Giannina Gaslini; S. Calandra, MD, Pediatric Resident, Istituto Giannina Gaslini; A. Ravelli, MD, Professor of Pediatrics, University of Genoa and Istituto Giannina Gaslini; S. Ringold, MD, Assistant Professor, Division of Rheumatology, Seattle Children's Hospital; S. Shenoi, MBBS, Assistant Professor, Seattle Children's Hospital; J. Stinson, PhD, Senior Scientist, The Hospital for Sick Children, and Associate Professor, Lawrence S. Bloomberg Faculty of Nursing, University of Toronto; K. Toupin-April, PhD, Associate Scientist, Children's Hospital of Eastern Ontario Research Institute, and Assistant Professor, Department of Pediatrics and School of Rehabilitation Sciences, University of Ottawa; V. Strand, MD, Adjunct Clinical Professor, Division of Immunology/Rheumatology, Stanford University; C.O. Bingham III, MD, Professor of Medicine, Director, Johns Hopkins Arthritis Center, Johns Hopkins University
| | - Angelo Ravelli
- Division of Rheumatology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; Pediatric Rheumatology and Pediatric Health Services Research, University of Michigan CS Mott Children's Hospital, Ann Arbor, Michigan; Office of Research, Division of Rheumatology, Columbia University Medical Center, New York; Division of Rheumatology, University of Rochester, Golisano Children's Hospital, Rochester, New York; Thornhill Associates, Hermosa Beach; Division of Immunology/Rheumatology, Stanford University, Stanford, California; Division of Rheumatology, University of Alabama at Birmingham, Birmingham, Alabama; Arthritis Foundation, Atlanta, Georgia; Division of Rheumatology, Children's Mercy, Kansas City, Missouri; Division of Pediatric Rheumatology, Rutgers Robert Wood Johnson Medical School, Institute for Health, Health Care Policy and Aging Research, New Brunswick, New Jersey; Medical College of Wisconsin, Milwaukee, Wisconsin; Division of Rheumatology, Seattle Children's Hospital, Seattle, Washington; Johns Hopkins Arthritis Center, Johns Hopkins University, Baltimore, Maryland, USA; Division of Rheumatology, Istituto Giannina Gaslini; University of Genoa, Genoa, Italy; Rheumatology, Royal Children's Hospital; Murdoch Children's Research Institute, Melbourne, Australia; The Hospital for Sick Children, and Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto; Children's Hospital of Eastern Ontario Research Institute, Department of Pediatrics and School of Rehabilitation Sciences, University of Ottawa, Ottawa, Ontario, Canada
- E.M. Morgan, MD, Associate Professor, Division of Rheumatology, Cincinnati Children's Hospital Medical Center; M.P. Riebschleger, MD, Clinical Lecturer, Pediatric Rheumatology and Pediatric Health Services Research, University of Michigan CS Mott Children's Hospital; J. Horonjeff, PhD, Instructor, Office of Research, Division of Rheumatology, Columbia University Medical Center; A. Consolaro, MD, PhD, Assistant Professor, Division of Rheumatology, Istituto Giannina Gaslini, and University of Genoa; J.E. Munro, MBBS, Associate Professor, Head of Rheumatology at the Royal Children's Hospital, and Group Leader, Arthritis Research, Murdoch Children's Research Institute; S. Thornhill, AA, Qualitative Research Consultant, Thornhill Associates; T. Beukelman, MD, Associate Professor, Division of Rheumatology, University of Alabama at Birmingham; H.I. Brunner, Professor, Division of Rheumatology, Cincinnati Children's Hospital Medical Center; E.L. Creek, MBA, Senior Director, Help and Support, Arthritis Foundation; J.G. Harris, MD, Assistant Professor, Division of Rheumatology, Children's Mercy; D.B. Horton, MD, Assistant Professor, Division of Pediatric Rheumatology, Rutgers Robert Wood Johnson Medical School, Institute for Health, Health Care Policy and Aging Research; D.J. Lovell, MD, Professor, Division of Rheumatology, Cincinnati Children's Hospital Medical Center; M.L. Mannion, MD, Assistant Professor of Rheumatology, University of Alabama at Birmingham; J.C. Olson, MD, Associate Professor, Medical College of Wisconsin; H. Rahimi, MD, Assistant Professor, Division of Rheumatology, University of Rochester, Golisano Children's Hospital; M.C. Gallo, MD, Research Contract, Istituto Giannina Gaslini; S. Calandra, MD, Pediatric Resident, Istituto Giannina Gaslini; A. Ravelli, MD, Professor of Pediatrics, University of Genoa and Istituto Giannina Gaslini; S. Ringold, MD, Assistant Professor, Division of Rheumatology, Seattle Children's Hospital; S. Shenoi, MBBS, Assistant Professor, Seattle Children's Hospital; J. Stinson, PhD, Senior Scientist, The Hospital for Sick Children, and Associate Professor, Lawrence S. Bloomberg Faculty of Nursing, University of Toronto; K. Toupin-April, PhD, Associate Scientist, Children's Hospital of Eastern Ontario Research Institute, and Assistant Professor, Department of Pediatrics and School of Rehabilitation Sciences, University of Ottawa; V. Strand, MD, Adjunct Clinical Professor, Division of Immunology/Rheumatology, Stanford University; C.O. Bingham III, MD, Professor of Medicine, Director, Johns Hopkins Arthritis Center, Johns Hopkins University
| | - Sarah Ringold
- Division of Rheumatology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; Pediatric Rheumatology and Pediatric Health Services Research, University of Michigan CS Mott Children's Hospital, Ann Arbor, Michigan; Office of Research, Division of Rheumatology, Columbia University Medical Center, New York; Division of Rheumatology, University of Rochester, Golisano Children's Hospital, Rochester, New York; Thornhill Associates, Hermosa Beach; Division of Immunology/Rheumatology, Stanford University, Stanford, California; Division of Rheumatology, University of Alabama at Birmingham, Birmingham, Alabama; Arthritis Foundation, Atlanta, Georgia; Division of Rheumatology, Children's Mercy, Kansas City, Missouri; Division of Pediatric Rheumatology, Rutgers Robert Wood Johnson Medical School, Institute for Health, Health Care Policy and Aging Research, New Brunswick, New Jersey; Medical College of Wisconsin, Milwaukee, Wisconsin; Division of Rheumatology, Seattle Children's Hospital, Seattle, Washington; Johns Hopkins Arthritis Center, Johns Hopkins University, Baltimore, Maryland, USA; Division of Rheumatology, Istituto Giannina Gaslini; University of Genoa, Genoa, Italy; Rheumatology, Royal Children's Hospital; Murdoch Children's Research Institute, Melbourne, Australia; The Hospital for Sick Children, and Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto; Children's Hospital of Eastern Ontario Research Institute, Department of Pediatrics and School of Rehabilitation Sciences, University of Ottawa, Ottawa, Ontario, Canada
- E.M. Morgan, MD, Associate Professor, Division of Rheumatology, Cincinnati Children's Hospital Medical Center; M.P. Riebschleger, MD, Clinical Lecturer, Pediatric Rheumatology and Pediatric Health Services Research, University of Michigan CS Mott Children's Hospital; J. Horonjeff, PhD, Instructor, Office of Research, Division of Rheumatology, Columbia University Medical Center; A. Consolaro, MD, PhD, Assistant Professor, Division of Rheumatology, Istituto Giannina Gaslini, and University of Genoa; J.E. Munro, MBBS, Associate Professor, Head of Rheumatology at the Royal Children's Hospital, and Group Leader, Arthritis Research, Murdoch Children's Research Institute; S. Thornhill, AA, Qualitative Research Consultant, Thornhill Associates; T. Beukelman, MD, Associate Professor, Division of Rheumatology, University of Alabama at Birmingham; H.I. Brunner, Professor, Division of Rheumatology, Cincinnati Children's Hospital Medical Center; E.L. Creek, MBA, Senior Director, Help and Support, Arthritis Foundation; J.G. Harris, MD, Assistant Professor, Division of Rheumatology, Children's Mercy; D.B. Horton, MD, Assistant Professor, Division of Pediatric Rheumatology, Rutgers Robert Wood Johnson Medical School, Institute for Health, Health Care Policy and Aging Research; D.J. Lovell, MD, Professor, Division of Rheumatology, Cincinnati Children's Hospital Medical Center; M.L. Mannion, MD, Assistant Professor of Rheumatology, University of Alabama at Birmingham; J.C. Olson, MD, Associate Professor, Medical College of Wisconsin; H. Rahimi, MD, Assistant Professor, Division of Rheumatology, University of Rochester, Golisano Children's Hospital; M.C. Gallo, MD, Research Contract, Istituto Giannina Gaslini; S. Calandra, MD, Pediatric Resident, Istituto Giannina Gaslini; A. Ravelli, MD, Professor of Pediatrics, University of Genoa and Istituto Giannina Gaslini; S. Ringold, MD, Assistant Professor, Division of Rheumatology, Seattle Children's Hospital; S. Shenoi, MBBS, Assistant Professor, Seattle Children's Hospital; J. Stinson, PhD, Senior Scientist, The Hospital for Sick Children, and Associate Professor, Lawrence S. Bloomberg Faculty of Nursing, University of Toronto; K. Toupin-April, PhD, Associate Scientist, Children's Hospital of Eastern Ontario Research Institute, and Assistant Professor, Department of Pediatrics and School of Rehabilitation Sciences, University of Ottawa; V. Strand, MD, Adjunct Clinical Professor, Division of Immunology/Rheumatology, Stanford University; C.O. Bingham III, MD, Professor of Medicine, Director, Johns Hopkins Arthritis Center, Johns Hopkins University
| | - Susan Shenoi
- Division of Rheumatology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; Pediatric Rheumatology and Pediatric Health Services Research, University of Michigan CS Mott Children's Hospital, Ann Arbor, Michigan; Office of Research, Division of Rheumatology, Columbia University Medical Center, New York; Division of Rheumatology, University of Rochester, Golisano Children's Hospital, Rochester, New York; Thornhill Associates, Hermosa Beach; Division of Immunology/Rheumatology, Stanford University, Stanford, California; Division of Rheumatology, University of Alabama at Birmingham, Birmingham, Alabama; Arthritis Foundation, Atlanta, Georgia; Division of Rheumatology, Children's Mercy, Kansas City, Missouri; Division of Pediatric Rheumatology, Rutgers Robert Wood Johnson Medical School, Institute for Health, Health Care Policy and Aging Research, New Brunswick, New Jersey; Medical College of Wisconsin, Milwaukee, Wisconsin; Division of Rheumatology, Seattle Children's Hospital, Seattle, Washington; Johns Hopkins Arthritis Center, Johns Hopkins University, Baltimore, Maryland, USA; Division of Rheumatology, Istituto Giannina Gaslini; University of Genoa, Genoa, Italy; Rheumatology, Royal Children's Hospital; Murdoch Children's Research Institute, Melbourne, Australia; The Hospital for Sick Children, and Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto; Children's Hospital of Eastern Ontario Research Institute, Department of Pediatrics and School of Rehabilitation Sciences, University of Ottawa, Ottawa, Ontario, Canada
- E.M. Morgan, MD, Associate Professor, Division of Rheumatology, Cincinnati Children's Hospital Medical Center; M.P. Riebschleger, MD, Clinical Lecturer, Pediatric Rheumatology and Pediatric Health Services Research, University of Michigan CS Mott Children's Hospital; J. Horonjeff, PhD, Instructor, Office of Research, Division of Rheumatology, Columbia University Medical Center; A. Consolaro, MD, PhD, Assistant Professor, Division of Rheumatology, Istituto Giannina Gaslini, and University of Genoa; J.E. Munro, MBBS, Associate Professor, Head of Rheumatology at the Royal Children's Hospital, and Group Leader, Arthritis Research, Murdoch Children's Research Institute; S. Thornhill, AA, Qualitative Research Consultant, Thornhill Associates; T. Beukelman, MD, Associate Professor, Division of Rheumatology, University of Alabama at Birmingham; H.I. Brunner, Professor, Division of Rheumatology, Cincinnati Children's Hospital Medical Center; E.L. Creek, MBA, Senior Director, Help and Support, Arthritis Foundation; J.G. Harris, MD, Assistant Professor, Division of Rheumatology, Children's Mercy; D.B. Horton, MD, Assistant Professor, Division of Pediatric Rheumatology, Rutgers Robert Wood Johnson Medical School, Institute for Health, Health Care Policy and Aging Research; D.J. Lovell, MD, Professor, Division of Rheumatology, Cincinnati Children's Hospital Medical Center; M.L. Mannion, MD, Assistant Professor of Rheumatology, University of Alabama at Birmingham; J.C. Olson, MD, Associate Professor, Medical College of Wisconsin; H. Rahimi, MD, Assistant Professor, Division of Rheumatology, University of Rochester, Golisano Children's Hospital; M.C. Gallo, MD, Research Contract, Istituto Giannina Gaslini; S. Calandra, MD, Pediatric Resident, Istituto Giannina Gaslini; A. Ravelli, MD, Professor of Pediatrics, University of Genoa and Istituto Giannina Gaslini; S. Ringold, MD, Assistant Professor, Division of Rheumatology, Seattle Children's Hospital; S. Shenoi, MBBS, Assistant Professor, Seattle Children's Hospital; J. Stinson, PhD, Senior Scientist, The Hospital for Sick Children, and Associate Professor, Lawrence S. Bloomberg Faculty of Nursing, University of Toronto; K. Toupin-April, PhD, Associate Scientist, Children's Hospital of Eastern Ontario Research Institute, and Assistant Professor, Department of Pediatrics and School of Rehabilitation Sciences, University of Ottawa; V. Strand, MD, Adjunct Clinical Professor, Division of Immunology/Rheumatology, Stanford University; C.O. Bingham III, MD, Professor of Medicine, Director, Johns Hopkins Arthritis Center, Johns Hopkins University
| | - Jennifer Stinson
- Division of Rheumatology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; Pediatric Rheumatology and Pediatric Health Services Research, University of Michigan CS Mott Children's Hospital, Ann Arbor, Michigan; Office of Research, Division of Rheumatology, Columbia University Medical Center, New York; Division of Rheumatology, University of Rochester, Golisano Children's Hospital, Rochester, New York; Thornhill Associates, Hermosa Beach; Division of Immunology/Rheumatology, Stanford University, Stanford, California; Division of Rheumatology, University of Alabama at Birmingham, Birmingham, Alabama; Arthritis Foundation, Atlanta, Georgia; Division of Rheumatology, Children's Mercy, Kansas City, Missouri; Division of Pediatric Rheumatology, Rutgers Robert Wood Johnson Medical School, Institute for Health, Health Care Policy and Aging Research, New Brunswick, New Jersey; Medical College of Wisconsin, Milwaukee, Wisconsin; Division of Rheumatology, Seattle Children's Hospital, Seattle, Washington; Johns Hopkins Arthritis Center, Johns Hopkins University, Baltimore, Maryland, USA; Division of Rheumatology, Istituto Giannina Gaslini; University of Genoa, Genoa, Italy; Rheumatology, Royal Children's Hospital; Murdoch Children's Research Institute, Melbourne, Australia; The Hospital for Sick Children, and Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto; Children's Hospital of Eastern Ontario Research Institute, Department of Pediatrics and School of Rehabilitation Sciences, University of Ottawa, Ottawa, Ontario, Canada
- E.M. Morgan, MD, Associate Professor, Division of Rheumatology, Cincinnati Children's Hospital Medical Center; M.P. Riebschleger, MD, Clinical Lecturer, Pediatric Rheumatology and Pediatric Health Services Research, University of Michigan CS Mott Children's Hospital; J. Horonjeff, PhD, Instructor, Office of Research, Division of Rheumatology, Columbia University Medical Center; A. Consolaro, MD, PhD, Assistant Professor, Division of Rheumatology, Istituto Giannina Gaslini, and University of Genoa; J.E. Munro, MBBS, Associate Professor, Head of Rheumatology at the Royal Children's Hospital, and Group Leader, Arthritis Research, Murdoch Children's Research Institute; S. Thornhill, AA, Qualitative Research Consultant, Thornhill Associates; T. Beukelman, MD, Associate Professor, Division of Rheumatology, University of Alabama at Birmingham; H.I. Brunner, Professor, Division of Rheumatology, Cincinnati Children's Hospital Medical Center; E.L. Creek, MBA, Senior Director, Help and Support, Arthritis Foundation; J.G. Harris, MD, Assistant Professor, Division of Rheumatology, Children's Mercy; D.B. Horton, MD, Assistant Professor, Division of Pediatric Rheumatology, Rutgers Robert Wood Johnson Medical School, Institute for Health, Health Care Policy and Aging Research; D.J. Lovell, MD, Professor, Division of Rheumatology, Cincinnati Children's Hospital Medical Center; M.L. Mannion, MD, Assistant Professor of Rheumatology, University of Alabama at Birmingham; J.C. Olson, MD, Associate Professor, Medical College of Wisconsin; H. Rahimi, MD, Assistant Professor, Division of Rheumatology, University of Rochester, Golisano Children's Hospital; M.C. Gallo, MD, Research Contract, Istituto Giannina Gaslini; S. Calandra, MD, Pediatric Resident, Istituto Giannina Gaslini; A. Ravelli, MD, Professor of Pediatrics, University of Genoa and Istituto Giannina Gaslini; S. Ringold, MD, Assistant Professor, Division of Rheumatology, Seattle Children's Hospital; S. Shenoi, MBBS, Assistant Professor, Seattle Children's Hospital; J. Stinson, PhD, Senior Scientist, The Hospital for Sick Children, and Associate Professor, Lawrence S. Bloomberg Faculty of Nursing, University of Toronto; K. Toupin-April, PhD, Associate Scientist, Children's Hospital of Eastern Ontario Research Institute, and Assistant Professor, Department of Pediatrics and School of Rehabilitation Sciences, University of Ottawa; V. Strand, MD, Adjunct Clinical Professor, Division of Immunology/Rheumatology, Stanford University; C.O. Bingham III, MD, Professor of Medicine, Director, Johns Hopkins Arthritis Center, Johns Hopkins University
| | - Karine Toupin-April
- Division of Rheumatology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; Pediatric Rheumatology and Pediatric Health Services Research, University of Michigan CS Mott Children's Hospital, Ann Arbor, Michigan; Office of Research, Division of Rheumatology, Columbia University Medical Center, New York; Division of Rheumatology, University of Rochester, Golisano Children's Hospital, Rochester, New York; Thornhill Associates, Hermosa Beach; Division of Immunology/Rheumatology, Stanford University, Stanford, California; Division of Rheumatology, University of Alabama at Birmingham, Birmingham, Alabama; Arthritis Foundation, Atlanta, Georgia; Division of Rheumatology, Children's Mercy, Kansas City, Missouri; Division of Pediatric Rheumatology, Rutgers Robert Wood Johnson Medical School, Institute for Health, Health Care Policy and Aging Research, New Brunswick, New Jersey; Medical College of Wisconsin, Milwaukee, Wisconsin; Division of Rheumatology, Seattle Children's Hospital, Seattle, Washington; Johns Hopkins Arthritis Center, Johns Hopkins University, Baltimore, Maryland, USA; Division of Rheumatology, Istituto Giannina Gaslini; University of Genoa, Genoa, Italy; Rheumatology, Royal Children's Hospital; Murdoch Children's Research Institute, Melbourne, Australia; The Hospital for Sick Children, and Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto; Children's Hospital of Eastern Ontario Research Institute, Department of Pediatrics and School of Rehabilitation Sciences, University of Ottawa, Ottawa, Ontario, Canada
- E.M. Morgan, MD, Associate Professor, Division of Rheumatology, Cincinnati Children's Hospital Medical Center; M.P. Riebschleger, MD, Clinical Lecturer, Pediatric Rheumatology and Pediatric Health Services Research, University of Michigan CS Mott Children's Hospital; J. Horonjeff, PhD, Instructor, Office of Research, Division of Rheumatology, Columbia University Medical Center; A. Consolaro, MD, PhD, Assistant Professor, Division of Rheumatology, Istituto Giannina Gaslini, and University of Genoa; J.E. Munro, MBBS, Associate Professor, Head of Rheumatology at the Royal Children's Hospital, and Group Leader, Arthritis Research, Murdoch Children's Research Institute; S. Thornhill, AA, Qualitative Research Consultant, Thornhill Associates; T. Beukelman, MD, Associate Professor, Division of Rheumatology, University of Alabama at Birmingham; H.I. Brunner, Professor, Division of Rheumatology, Cincinnati Children's Hospital Medical Center; E.L. Creek, MBA, Senior Director, Help and Support, Arthritis Foundation; J.G. Harris, MD, Assistant Professor, Division of Rheumatology, Children's Mercy; D.B. Horton, MD, Assistant Professor, Division of Pediatric Rheumatology, Rutgers Robert Wood Johnson Medical School, Institute for Health, Health Care Policy and Aging Research; D.J. Lovell, MD, Professor, Division of Rheumatology, Cincinnati Children's Hospital Medical Center; M.L. Mannion, MD, Assistant Professor of Rheumatology, University of Alabama at Birmingham; J.C. Olson, MD, Associate Professor, Medical College of Wisconsin; H. Rahimi, MD, Assistant Professor, Division of Rheumatology, University of Rochester, Golisano Children's Hospital; M.C. Gallo, MD, Research Contract, Istituto Giannina Gaslini; S. Calandra, MD, Pediatric Resident, Istituto Giannina Gaslini; A. Ravelli, MD, Professor of Pediatrics, University of Genoa and Istituto Giannina Gaslini; S. Ringold, MD, Assistant Professor, Division of Rheumatology, Seattle Children's Hospital; S. Shenoi, MBBS, Assistant Professor, Seattle Children's Hospital; J. Stinson, PhD, Senior Scientist, The Hospital for Sick Children, and Associate Professor, Lawrence S. Bloomberg Faculty of Nursing, University of Toronto; K. Toupin-April, PhD, Associate Scientist, Children's Hospital of Eastern Ontario Research Institute, and Assistant Professor, Department of Pediatrics and School of Rehabilitation Sciences, University of Ottawa; V. Strand, MD, Adjunct Clinical Professor, Division of Immunology/Rheumatology, Stanford University; C.O. Bingham III, MD, Professor of Medicine, Director, Johns Hopkins Arthritis Center, Johns Hopkins University
| | - Vibeke Strand
- Division of Rheumatology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; Pediatric Rheumatology and Pediatric Health Services Research, University of Michigan CS Mott Children's Hospital, Ann Arbor, Michigan; Office of Research, Division of Rheumatology, Columbia University Medical Center, New York; Division of Rheumatology, University of Rochester, Golisano Children's Hospital, Rochester, New York; Thornhill Associates, Hermosa Beach; Division of Immunology/Rheumatology, Stanford University, Stanford, California; Division of Rheumatology, University of Alabama at Birmingham, Birmingham, Alabama; Arthritis Foundation, Atlanta, Georgia; Division of Rheumatology, Children's Mercy, Kansas City, Missouri; Division of Pediatric Rheumatology, Rutgers Robert Wood Johnson Medical School, Institute for Health, Health Care Policy and Aging Research, New Brunswick, New Jersey; Medical College of Wisconsin, Milwaukee, Wisconsin; Division of Rheumatology, Seattle Children's Hospital, Seattle, Washington; Johns Hopkins Arthritis Center, Johns Hopkins University, Baltimore, Maryland, USA; Division of Rheumatology, Istituto Giannina Gaslini; University of Genoa, Genoa, Italy; Rheumatology, Royal Children's Hospital; Murdoch Children's Research Institute, Melbourne, Australia; The Hospital for Sick Children, and Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto; Children's Hospital of Eastern Ontario Research Institute, Department of Pediatrics and School of Rehabilitation Sciences, University of Ottawa, Ottawa, Ontario, Canada
- E.M. Morgan, MD, Associate Professor, Division of Rheumatology, Cincinnati Children's Hospital Medical Center; M.P. Riebschleger, MD, Clinical Lecturer, Pediatric Rheumatology and Pediatric Health Services Research, University of Michigan CS Mott Children's Hospital; J. Horonjeff, PhD, Instructor, Office of Research, Division of Rheumatology, Columbia University Medical Center; A. Consolaro, MD, PhD, Assistant Professor, Division of Rheumatology, Istituto Giannina Gaslini, and University of Genoa; J.E. Munro, MBBS, Associate Professor, Head of Rheumatology at the Royal Children's Hospital, and Group Leader, Arthritis Research, Murdoch Children's Research Institute; S. Thornhill, AA, Qualitative Research Consultant, Thornhill Associates; T. Beukelman, MD, Associate Professor, Division of Rheumatology, University of Alabama at Birmingham; H.I. Brunner, Professor, Division of Rheumatology, Cincinnati Children's Hospital Medical Center; E.L. Creek, MBA, Senior Director, Help and Support, Arthritis Foundation; J.G. Harris, MD, Assistant Professor, Division of Rheumatology, Children's Mercy; D.B. Horton, MD, Assistant Professor, Division of Pediatric Rheumatology, Rutgers Robert Wood Johnson Medical School, Institute for Health, Health Care Policy and Aging Research; D.J. Lovell, MD, Professor, Division of Rheumatology, Cincinnati Children's Hospital Medical Center; M.L. Mannion, MD, Assistant Professor of Rheumatology, University of Alabama at Birmingham; J.C. Olson, MD, Associate Professor, Medical College of Wisconsin; H. Rahimi, MD, Assistant Professor, Division of Rheumatology, University of Rochester, Golisano Children's Hospital; M.C. Gallo, MD, Research Contract, Istituto Giannina Gaslini; S. Calandra, MD, Pediatric Resident, Istituto Giannina Gaslini; A. Ravelli, MD, Professor of Pediatrics, University of Genoa and Istituto Giannina Gaslini; S. Ringold, MD, Assistant Professor, Division of Rheumatology, Seattle Children's Hospital; S. Shenoi, MBBS, Assistant Professor, Seattle Children's Hospital; J. Stinson, PhD, Senior Scientist, The Hospital for Sick Children, and Associate Professor, Lawrence S. Bloomberg Faculty of Nursing, University of Toronto; K. Toupin-April, PhD, Associate Scientist, Children's Hospital of Eastern Ontario Research Institute, and Assistant Professor, Department of Pediatrics and School of Rehabilitation Sciences, University of Ottawa; V. Strand, MD, Adjunct Clinical Professor, Division of Immunology/Rheumatology, Stanford University; C.O. Bingham III, MD, Professor of Medicine, Director, Johns Hopkins Arthritis Center, Johns Hopkins University
| | - Clifton O Bingham
- Division of Rheumatology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; Pediatric Rheumatology and Pediatric Health Services Research, University of Michigan CS Mott Children's Hospital, Ann Arbor, Michigan; Office of Research, Division of Rheumatology, Columbia University Medical Center, New York; Division of Rheumatology, University of Rochester, Golisano Children's Hospital, Rochester, New York; Thornhill Associates, Hermosa Beach; Division of Immunology/Rheumatology, Stanford University, Stanford, California; Division of Rheumatology, University of Alabama at Birmingham, Birmingham, Alabama; Arthritis Foundation, Atlanta, Georgia; Division of Rheumatology, Children's Mercy, Kansas City, Missouri; Division of Pediatric Rheumatology, Rutgers Robert Wood Johnson Medical School, Institute for Health, Health Care Policy and Aging Research, New Brunswick, New Jersey; Medical College of Wisconsin, Milwaukee, Wisconsin; Division of Rheumatology, Seattle Children's Hospital, Seattle, Washington; Johns Hopkins Arthritis Center, Johns Hopkins University, Baltimore, Maryland, USA; Division of Rheumatology, Istituto Giannina Gaslini; University of Genoa, Genoa, Italy; Rheumatology, Royal Children's Hospital; Murdoch Children's Research Institute, Melbourne, Australia; The Hospital for Sick Children, and Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto; Children's Hospital of Eastern Ontario Research Institute, Department of Pediatrics and School of Rehabilitation Sciences, University of Ottawa, Ottawa, Ontario, Canada
- E.M. Morgan, MD, Associate Professor, Division of Rheumatology, Cincinnati Children's Hospital Medical Center; M.P. Riebschleger, MD, Clinical Lecturer, Pediatric Rheumatology and Pediatric Health Services Research, University of Michigan CS Mott Children's Hospital; J. Horonjeff, PhD, Instructor, Office of Research, Division of Rheumatology, Columbia University Medical Center; A. Consolaro, MD, PhD, Assistant Professor, Division of Rheumatology, Istituto Giannina Gaslini, and University of Genoa; J.E. Munro, MBBS, Associate Professor, Head of Rheumatology at the Royal Children's Hospital, and Group Leader, Arthritis Research, Murdoch Children's Research Institute; S. Thornhill, AA, Qualitative Research Consultant, Thornhill Associates; T. Beukelman, MD, Associate Professor, Division of Rheumatology, University of Alabama at Birmingham; H.I. Brunner, Professor, Division of Rheumatology, Cincinnati Children's Hospital Medical Center; E.L. Creek, MBA, Senior Director, Help and Support, Arthritis Foundation; J.G. Harris, MD, Assistant Professor, Division of Rheumatology, Children's Mercy; D.B. Horton, MD, Assistant Professor, Division of Pediatric Rheumatology, Rutgers Robert Wood Johnson Medical School, Institute for Health, Health Care Policy and Aging Research; D.J. Lovell, MD, Professor, Division of Rheumatology, Cincinnati Children's Hospital Medical Center; M.L. Mannion, MD, Assistant Professor of Rheumatology, University of Alabama at Birmingham; J.C. Olson, MD, Associate Professor, Medical College of Wisconsin; H. Rahimi, MD, Assistant Professor, Division of Rheumatology, University of Rochester, Golisano Children's Hospital; M.C. Gallo, MD, Research Contract, Istituto Giannina Gaslini; S. Calandra, MD, Pediatric Resident, Istituto Giannina Gaslini; A. Ravelli, MD, Professor of Pediatrics, University of Genoa and Istituto Giannina Gaslini; S. Ringold, MD, Assistant Professor, Division of Rheumatology, Seattle Children's Hospital; S. Shenoi, MBBS, Assistant Professor, Seattle Children's Hospital; J. Stinson, PhD, Senior Scientist, The Hospital for Sick Children, and Associate Professor, Lawrence S. Bloomberg Faculty of Nursing, University of Toronto; K. Toupin-April, PhD, Associate Scientist, Children's Hospital of Eastern Ontario Research Institute, and Assistant Professor, Department of Pediatrics and School of Rehabilitation Sciences, University of Ottawa; V. Strand, MD, Adjunct Clinical Professor, Division of Immunology/Rheumatology, Stanford University; C.O. Bingham III, MD, Professor of Medicine, Director, Johns Hopkins Arthritis Center, Johns Hopkins University
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Park JK, Mecoli CA, Alexanderson H, Regardt M, Christopher-Stine L, Casal-Domínguez M, de Groot I, Sarver C, Lundberg IE, Bingham CO, Song YW. Advancing the Development of Patient-reported Outcomes for Adult Myositis at OMERACT 2016: An International Delphi Study. J Rheumatol 2017; 44:1944. [PMID: 29196552 DOI: 10.3899/jrheum.161252.c1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Puzanov I, Diab A, Abdallah K, Bingham CO, Brogdon C, Dadu R, Hamad L, Kim S, Lacouture ME, LeBoeuf NR, Lenihan D, Onofrei C, Shannon V, Sharma R, Silk AW, Skondra D, Suarez-Almazor ME, Wang Y, Wiley K, Kaufman HL, Ernstoff MS. Managing toxicities associated with immune checkpoint inhibitors: consensus recommendations from the Society for Immunotherapy of Cancer (SITC) Toxicity Management Working Group. J Immunother Cancer 2017; 5:95. [PMID: 29162153 PMCID: PMC5697162 DOI: 10.1186/s40425-017-0300-z] [Citation(s) in RCA: 1239] [Impact Index Per Article: 177.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2017] [Accepted: 11/06/2017] [Indexed: 02/06/2023] Open
Abstract
Cancer immunotherapy has transformed the treatment of cancer. However, increasing use of immune-based therapies, including the widely used class of agents known as immune checkpoint inhibitors, has exposed a discrete group of immune-related adverse events (irAEs). Many of these are driven by the same immunologic mechanisms responsible for the drugs' therapeutic effects, namely blockade of inhibitory mechanisms that suppress the immune system and protect body tissues from an unconstrained acute or chronic immune response. Skin, gut, endocrine, lung and musculoskeletal irAEs are relatively common, whereas cardiovascular, hematologic, renal, neurologic and ophthalmologic irAEs occur much less frequently. The majority of irAEs are mild to moderate in severity; however, serious and occasionally life-threatening irAEs are reported in the literature, and treatment-related deaths occur in up to 2% of patients, varying by ICI. Immunotherapy-related irAEs typically have a delayed onset and prolonged duration compared to adverse events from chemotherapy, and effective management depends on early recognition and prompt intervention with immune suppression and/or immunomodulatory strategies. There is an urgent need for multidisciplinary guidance reflecting broad-based perspectives on how to recognize, report and manage organ-specific toxicities until evidence-based data are available to inform clinical decision-making. The Society for Immunotherapy of Cancer (SITC) established a multidisciplinary Toxicity Management Working Group, which met for a full-day workshop to develop recommendations to standardize management of irAEs. Here we present their consensus recommendations on managing toxicities associated with immune checkpoint inhibitor therapy.
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Affiliation(s)
- I Puzanov
- Roswell Park Cancer Institute, Elm & Carlton Streets, Buffalo, NY, 14263, USA
| | - A Diab
- University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - K Abdallah
- Merck & Co., Inc., Upper Gwynedd, PA, USA
| | - C O Bingham
- Johns Hopkins University, Baltimore, MD, USA
| | - C Brogdon
- Bristol-Myers Squibb Company, New York, NY, USA
| | - R Dadu
- University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - L Hamad
- Roswell Park Cancer Institute, Elm & Carlton Streets, Buffalo, NY, 14263, USA
| | - S Kim
- University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - M E Lacouture
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - N R LeBoeuf
- Dana Farber/Brigham and Women's Cancer Center, Boston, MA, USA
| | - D Lenihan
- Washington University in St Louis, St Louis, MO, USA
| | - C Onofrei
- Indiana University, Indianapolis, IN, USA
| | - V Shannon
- University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - R Sharma
- Roswell Park Cancer Institute, Elm & Carlton Streets, Buffalo, NY, 14263, USA
| | - A W Silk
- Massachusetts General Hospital, Boston, MA, USA
| | - D Skondra
- University of Chicago, Chicago, IL, USA
| | | | - Y Wang
- University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - K Wiley
- Oncology Nursing Society, Pittsburgh, PA, USA
| | - H L Kaufman
- Massachusetts General Hospital, Boston, MA, USA
| | - M S Ernstoff
- Roswell Park Cancer Institute, Elm & Carlton Streets, Buffalo, NY, 14263, USA.
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Needham DM, Sepulveda KA, Dinglas VD, Chessare CM, Friedman LA, Bingham CO, Turnbull AE. Core Outcome Measures for Clinical Research in Acute Respiratory Failure Survivors. An International Modified Delphi Consensus Study. Am J Respir Crit Care Med 2017; 196:1122-1130. [PMID: 28537429 DOI: 10.1164/rccm.201702-0372oc] [Citation(s) in RCA: 246] [Impact Index Per Article: 35.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
RATIONALE Research evaluating acute respiratory failure (ARF) survivors' outcomes after hospital discharge has substantial heterogeneity in terms of the measurement instruments used, creating barriers to synthesizing study data. OBJECTIVES To identify a minimum set of core outcome measures that are essential to include in all clinical research studies evaluating ARF survivors after discharge. METHODS We conducted a three-round modified Delphi consensus process with 77 participants (47% female, 55% outside the United States), including clinical researchers from more than 16 countries across six continents, patients/caregivers, clinicians, and research funders. Participants reviewed standardized information on measure instruments for seven consensus-derived outcomes plus one recommended outcome. MEASUREMENTS AND MAIN RESULTS Response rates were 91 to 97% across the three rounds. Among 75 measurement instruments evaluated, the following met a priori consensus criteria: EQ-5D and 36-item Short Form Health Survey version 2 (optional) for the "satisfaction with life and personal enjoyment" and "pain" outcomes, and both the Hospital Anxiety and Depression Scale and the Impact of Events Scale-Revised for the "mental health" outcome. No measures reached consensus for the following outcomes: cognition, muscle and/or nerve function, physical function, and pulmonary function. All measures considered for pulmonary function met consensus criteria for exclusion. The following measures did not reach the threshold for consensus but achieved the highest scores for their respective outcomes: the Montreal Cognitive Assessment (cognition), manual muscle testing and handgrip dynamometry (muscle and/or nerve function), and 6-minute-walk test (physical function). CONCLUSIONS This Core Outcome Measurement Set is recommended for use in all clinical research evaluating ARF survivors after hospital discharge. In the future, researchers should evaluate measures for outcomes not reaching consensus.
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Affiliation(s)
- Dale M Needham
- 1 Outcomes After Critical Illness and Surgery Group.,2 Division of Pulmonary and Critical Care Medicine, School of Medicine.,3 Department of Physical Medicine and Rehabilitation, School of Medicine
| | - Kristin A Sepulveda
- 1 Outcomes After Critical Illness and Surgery Group.,2 Division of Pulmonary and Critical Care Medicine, School of Medicine
| | - Victor D Dinglas
- 1 Outcomes After Critical Illness and Surgery Group.,2 Division of Pulmonary and Critical Care Medicine, School of Medicine
| | - Caroline M Chessare
- 1 Outcomes After Critical Illness and Surgery Group.,2 Division of Pulmonary and Critical Care Medicine, School of Medicine
| | - Lisa Aronson Friedman
- 1 Outcomes After Critical Illness and Surgery Group.,2 Division of Pulmonary and Critical Care Medicine, School of Medicine
| | - Clifton O Bingham
- 4 Division of Rheumatology, School of Medicine.,5 Division of Allergy and Clinical Immunology, School of Medicine, and
| | - Alison E Turnbull
- 1 Outcomes After Critical Illness and Surgery Group.,2 Division of Pulmonary and Critical Care Medicine, School of Medicine.,6 Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland
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Cappelli LC, Gutierrez AK, Bingham CO, Shah AA. Rheumatic and Musculoskeletal Immune-Related Adverse Events Due to Immune Checkpoint Inhibitors: A Systematic Review of the Literature. Arthritis Care Res (Hoboken) 2017; 69:1751-1763. [PMID: 27998041 PMCID: PMC5478477 DOI: 10.1002/acr.23177] [Citation(s) in RCA: 251] [Impact Index Per Article: 35.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2016] [Accepted: 12/13/2016] [Indexed: 12/13/2022]
Abstract
OBJECTIVE Immune checkpoint inhibitors (ICIs) are improving prognoses in advanced stage cancers, but they also lead to immune-related adverse events (IRAEs). IRAEs targeting many organ systems have been reported, but musculoskeletal and rheumatic IRAEs have not been well-characterized. We systematically reviewed published literature on musculoskeletal and rheumatic IRAEs to better understand prevalence and clinical characteristics. METHODS Medline and CENTRAL databases were searched for articles reporting rheumatic and musculoskeletal IRAEs secondary to ICI treatment. After screening abstracts and full texts in duplicate, clinical features, prevalence, and treatment data were extracted and summarized. RESULTS A total of 1,725 unique abstracts were screened; 231 contained original data and were about ICIs and went to full-text screening. Fifty-two of these contained information about musculoskeletal or rheumatic IRAEs or about treatment with ICIs in preexisting autoimmune disease. Of these, 33 were clinical trials, 3 were observational studies, and 16 were case reports or series. Arthralgia prevalence in clinical trials ranged 1-43%, and myalgia was reported in 2-20%. Arthritis was reported in 5 of 33 clinical trials, and vasculitis was reported in only 2. One observational study and 3 case reports described patients with preexisting autoimmune disease treated with ICIs. Case reports included development of inflammatory arthritis, vasculitis, myositis, and lupus nephritis. CONCLUSION Arthralgia and myalgia have been reported commonly in patients treated with ICIs. The prevalence of rheumatic IRAEs such as inflammatory arthritis, vasculitis, and sicca syndrome is less clear from current evidence. There is limited observational and case-level evidence describing ICI use in patients with preexisting autoimmune disease.
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Affiliation(s)
- Laura C. Cappelli
- Johns Hopkins University, Department of Medicine, Division of
Rheumatology. Baltimore, MD, 21224. United States of America
| | - Anna Kristina Gutierrez
- Johns Hopkins University, Department of Medicine, Division of
Rheumatology. Baltimore, MD, 21224. United States of America
| | - Clifton O. Bingham
- Johns Hopkins University, Department of Medicine, Division of
Rheumatology. Baltimore, MD, 21224. United States of America
| | - Ami A. Shah
- Johns Hopkins University, Department of Medicine, Division of
Rheumatology. Baltimore, MD, 21224. United States of America
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Shi J, Darrah E, Sims GP, Mustelin T, Sampson K, Konig MF, Bingham CO, Rosen A, Andrade F. Affinity maturation shapes the function of agonistic antibodies to peptidylarginine deiminase type 4 in rheumatoid arthritis. Ann Rheum Dis 2017; 77:141-148. [PMID: 29070531 DOI: 10.1136/annrheumdis-2017-211489] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2017] [Revised: 09/08/2017] [Accepted: 09/09/2017] [Indexed: 12/28/2022]
Abstract
OBJECTIVES The citrullinating enzyme peptidylarginine deiminase type 4 (PAD4) is the target of a polyclonal group of autoantibodies in patients with rheumatoid arthritis (RA). A subgroup of such antibodies, initially identified by cross-reactivity with peptidylarginine deiminase type 3 (PAD3), is strongly associated with progression of radiographic joint damage and interstitial lung disease and has the unique ability to activate PAD4. The features of these antibodies in terms of their T cell-dependent origin, genetic characteristics and effect of individual antibody specificities on PAD4 function remain to be defined. METHODS We used PAD4 tagged with the monomeric fluorescent protein mWasabi to isolate PAD4-specific memory B cells from anti-PAD4 positive patients with RA and applied single cell cloning technologies to obtain monoclonal antibodies. RESULTS Among 44 single B cells, we cloned five antibodies with PAD4-activating properties. Sequence analysis, germline reversion experiments and antigen specificity assays suggested that autoantibodies to PAD4 are not polyreactive and arise from PAD4-reactive precursors. Somatic mutations increase the agonistic activity of these antibodies at low calcium concentrations by facilitating their interaction with structural epitopes that modulate calcium-binding site 5 in PAD4. CONCLUSIONS PAD4-activating antibodies directly amplify a key process in disease pathogenesis, making them unique among other autoantibodies in RA. Understanding the molecular basis for their functionality may inform the design of future PAD4 inhibitors.
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Affiliation(s)
- Jing Shi
- Division of Rheumatology, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Erika Darrah
- Division of Rheumatology, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Gary P Sims
- Respiratory, Inflammation, and Autoimmunity, MedImmune LLC, Gaithersburg, Maryland, USA
| | - Tomas Mustelin
- Respiratory, Inflammation, and Autoimmunity, MedImmune LLC, Gaithersburg, Maryland, USA
| | - Kevon Sampson
- Division of Rheumatology, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Maximilian F Konig
- Division of Rheumatology, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Clifton O Bingham
- Division of Rheumatology, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Antony Rosen
- Division of Rheumatology, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Felipe Andrade
- Division of Rheumatology, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
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Cappelli LC, Palmer JL, Kremer J, Bingham CO. Tocilizumab treatment leads to improvement in disease activity regardless of CCP status in rheumatoid arthritis. Semin Arthritis Rheum 2017; 47:165-169. [PMID: 28477897 PMCID: PMC5623175 DOI: 10.1016/j.semarthrit.2017.03.024] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2017] [Accepted: 03/31/2017] [Indexed: 01/01/2023]
Abstract
OBJECTIVE Autoantibodies can be useful in predicting response to certain treatments in rheumatoid arthritis (RA). We aimed to evaluate initial response to tocilizumab (TCZ) by change in physician and patient-reported outcomes and laboratory parameters in a real-world cohort of patients with RA. We analyzed the data by autoantibody status to determine whether patients with seronegative RA had improved response to tocilizumab when compared to their seropositive counterparts. METHODS Data from the CORRONA RA registry were analyzed. Patients were included if they were started on TCZ and had data from a follow-up visit 4-8 months after initiation, as well as having information on serologic status. Serologic status was determined by presence of anti-cyclic citrullinated peptide (CCP) antibodies. Changes in disease activity measures from baseline to follow-up visit were evaluated. RESULTS Both CCP-negative and -positive groups had statistically significant improvement in physician-reported measurements (physician rating of disease activity and joint counts), patient-reported measures (disease activity, pain, and fatigue), and acute phase reactants after 4-8 months of treatment with tocilizumab. The magnitude of improvement, however, did not differ significantly by CCP status. CONCLUSION Tocilizumab led to statistically significant improvement in all patient- and physician-reported measures of disease activity evaluated in this cohort of patient with RA. The response to tocilizumab did not differ by CCP status.
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Affiliation(s)
- Laura C Cappelli
- Division of Rheumatology, Johns Hopkins University, School of Medicine, Baltimore, MD.
| | | | - Joel Kremer
- Corrona Research Foundation, Albany, NY; Center for Rheumatology, Albany Medical College, Albany, New York, USA
| | - Clifton O Bingham
- Division of Rheumatology, Johns Hopkins University, School of Medicine, Baltimore, MD
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Zhou Y, Chen B, Mittereder N, Chaerkady R, Strain M, An LL, Rahman S, Ma W, Low CP, Chan D, Neal F, Bingham CO, Sampson K, Darrah E, Siegel RM, Hasni S, Andrade F, Vousden KA, Mustelin T, Sims GP. Spontaneous Secretion of the Citrullination Enzyme PAD2 and Cell Surface Exposure of PAD4 by Neutrophils. Front Immunol 2017; 8:1200. [PMID: 28993780 PMCID: PMC5622307 DOI: 10.3389/fimmu.2017.01200] [Citation(s) in RCA: 71] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2017] [Accepted: 09/11/2017] [Indexed: 01/08/2023] Open
Abstract
Autoantibodies directed against citrullinated epitopes of proteins are highly diagnostic of rheumatoid arthritis (RA), and elevated levels of protein citrullination can be found in the joints of patients with RA. Calcium-dependent peptidyl-arginine deiminases (PAD) are the enzymes responsible for citrullination. PAD2 and PAD4 are enriched in neutrophils and likely drive citrullination under inflammatory conditions. PADs may be released during NETosis or cell death, but the mechanisms responsible for PAD activity under physiological conditions have not been fully elucidated. To understand how PADs citrullinate extracellular proteins, we investigated the cellular localization and activity of PAD2 and PAD4, and we report that viable neutrophils from healthy donors have active PAD4 exposed on their surface and spontaneously secrete PAD2. Neutrophil activation by some stimulatory agents increased the levels of immunoreactive PAD4 on the cell surface, and some stimuli reduced PAD2 secretion. Our data indicate that live neutrophils have the inherent capacity to express active extracellular PADs. These novel pathways are distinguished from intracellular PAD activation during NETosis and calcium influx-mediated hypercitrullination. Our study implies that extracellular PADs may have a physiological role under non-pathogenic conditions as well as a pathological role in RA.
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Affiliation(s)
- Yebin Zhou
- Department of Respiratory, Inflammation, and Autoimmunity, MedImmune LLC, Gaithersburg, MD, United States
| | - Bo Chen
- Department of Respiratory, Inflammation, and Autoimmunity, MedImmune LLC, Gaithersburg, MD, United States
| | - Nanette Mittereder
- Department of Respiratory, Inflammation, and Autoimmunity, MedImmune LLC, Gaithersburg, MD, United States
| | - Raghothama Chaerkady
- Antibody Discovery and Protein Engineering, MedImmune LLC., Gaithersburg, MD, United States
| | - Martin Strain
- Antibody Discovery and Protein Engineering, MedImmune LTD., Cambridge, United Kingdom
| | - Ling-Ling An
- Department of Respiratory, Inflammation, and Autoimmunity, MedImmune LLC, Gaithersburg, MD, United States
| | - Saifur Rahman
- Department of Respiratory, Inflammation, and Autoimmunity, MedImmune LLC, Gaithersburg, MD, United States
| | - Wenting Ma
- Department of Respiratory, Inflammation, and Autoimmunity, MedImmune LLC, Gaithersburg, MD, United States
| | - Choon Pei Low
- Antibody Discovery and Protein Engineering, MedImmune LTD., Cambridge, United Kingdom
| | - Denice Chan
- Antibody Discovery and Protein Engineering, MedImmune LTD., Cambridge, United Kingdom
| | - Frances Neal
- Antibody Discovery and Protein Engineering, MedImmune LTD., Cambridge, United Kingdom
| | - Clifton O Bingham
- Division of Rheumatology, Department of Medicine, School of Medicine, Johns Hopkins University, Baltimore, MD, United States
| | - Kevon Sampson
- Division of Rheumatology, Department of Medicine, School of Medicine, Johns Hopkins University, Baltimore, MD, United States
| | - Erika Darrah
- Division of Rheumatology, Department of Medicine, School of Medicine, Johns Hopkins University, Baltimore, MD, United States
| | - Richard M Siegel
- Immunoregulation Section, Autoimmunity Branch, National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), NIH, Bethesda, MD, United States
| | - Sarfaraz Hasni
- Office of the Clinical Director, National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), NIH, Bethesda, MD, United States
| | - Felipe Andrade
- Division of Rheumatology, Department of Medicine, School of Medicine, Johns Hopkins University, Baltimore, MD, United States
| | - Katherine A Vousden
- Antibody Discovery and Protein Engineering, MedImmune LTD., Cambridge, United Kingdom
| | - Tomas Mustelin
- Department of Respiratory, Inflammation, and Autoimmunity, MedImmune LLC, Gaithersburg, MD, United States
| | - Gary P Sims
- Department of Respiratory, Inflammation, and Autoimmunity, MedImmune LLC, Gaithersburg, MD, United States
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126
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Weinblatt ME, Bingham CO, Burmester GR, Bykerk VP, Furst DE, Mariette X, van der Heijde D, van Vollenhoven R, VanLunen B, Ecoffet C, Cioffi C, Emery P. A Phase III Study Evaluating Continuation, Tapering, and Withdrawal of Certolizumab Pegol After One Year of Therapy in Patients With Early Rheumatoid Arthritis. Arthritis Rheumatol 2017; 69:1937-1948. [PMID: 28666080 PMCID: PMC5656933 DOI: 10.1002/art.40196] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2016] [Accepted: 06/27/2017] [Indexed: 11/16/2022]
Abstract
Objective In disease‐modifying antirheumatic drug–naive patients with early rheumatoid arthritis (RA) who had achieved sustained low disease activity (a Disease Activity Score in 28 joints using the erythrocyte sedimentation rate of ≤3.2 at both week 40 and week 52) after 1 year of treatment with certolizumab pegol (CZP) at a standard dose (200 mg every 2 weeks plus optimized methotrexate [MTX]), we evaluated whether continuation of CZP treatment at a standard dose or at a reduced frequency (200 mg every 4 weeks plus MTX) was superior to stopping CZP (placebo plus MTX) in maintaining low disease activity for 1 additional year. Methods A total of 293 patients from period 1 of our study were re‐randomized 2:3:2 in period 2 to CZP at a standard dose (n = 84), CZP at a reduced frequency (n = 127), or placebo plus MTX (CZP stopped) (n = 82). The primary end point was the percentage of patients who maintained low disease activity throughout weeks 52–104 without flares. We used a hierarchical testing scheme, comparing CZP at a standard dose with CZP stopped. If P < 0.05 was achieved, then CZP at a reduced frequency was compared with CZP stopped (nonresponder imputation). Results The 293 patients from period 1 represented 36% fewer patients than projected, yielding a smaller number of patients eligible for period 2. Higher proportions of patients treated with the standard and reduced frequency regimens maintained low disease activity than those who had stopped CZP (48.8% and 53.2%, respectively, versus 39.2% [P = 0.112 and P = 0.041, respectively; nominal P value, first hierarchical test not significant]). Similar trends were observed for radiographic nonprogression (change from baseline of ≤0.5 in modified Sharp/van der Heijde score; 79.2% and 77.9% of patients, respectively, versus 70.3%) and normative physical function (Health Assessment Questionnaire disability index score of ≤0.5; 71.4% and 70.6% of patients, respectively, versus 57.0%). Safety profiles were similar between all groups, with no new safety signals identified for continuing CZP to week 104. No deaths were reported. Conclusion The study failed to meet its primary end point. However, there were no clinically meaningful differences between the standard and reduced frequency doses of CZP plus MTX; both controlled RA more effectively than stopping CZP.
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Affiliation(s)
| | | | | | | | | | - Xavier Mariette
- Université Paris-Sud, AP-HP, Hôpitaux Universitaires Paris-Sud, INSERM U1184, Le Kremlin Bicêtre, France
| | | | | | | | | | | | - Paul Emery
- University of Leeds and NIHR Leeds Musculoskeletal Biomedical Research Unit, Leeds Teaching Hospitals NHS Trust, Leeds, UK
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127
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Ahmed S, Ware P, Gardner W, Witter J, Bingham CO, Kairy D, Bartlett SJ. Montreal Accord on Patient-Reported Outcomes (PROs) use series – Paper 8: patient-reported outcomes in electronic health records can inform clinical and policy decisions. J Clin Epidemiol 2017; 89:160-167. [DOI: 10.1016/j.jclinepi.2017.04.011] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2015] [Revised: 03/28/2017] [Accepted: 04/10/2017] [Indexed: 12/22/2022]
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128
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Noonan VK, Lyddiatt A, Ware P, Jaglal SB, Riopelle RJ, Bingham CO, Figueiredo S, Sawatzky R, Santana M, Bartlett SJ, Ahmed S. Montreal Accord on Patient-Reported Outcomes (PROs) use series – Paper 3: patient-reported outcomes can facilitate shared decision-making and guide self-management. J Clin Epidemiol 2017; 89:125-135. [DOI: 10.1016/j.jclinepi.2017.04.017] [Citation(s) in RCA: 55] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2015] [Revised: 04/05/2017] [Accepted: 04/09/2017] [Indexed: 01/17/2023]
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129
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Bartlett SJ, Barbic SP, Bykerk VP, Choy EH, Alten R, Christensen R, den Broeder A, Fautrel B, Furst DE, Guillemin F, Hewlett S, Leong AL, Lyddiatt A, March L, Montie P, Pohl C, Scholte Voshaar M, Woodworth TG, Bingham CO. Content and Construct Validity, Reliability, and Responsiveness of the Rheumatoid Arthritis Flare Questionnaire: OMERACT 2016 Workshop Report. J Rheumatol 2017; 44:1536-1543. [PMID: 28811351 DOI: 10.3899/jrheum.161145] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/31/2017] [Indexed: 12/30/2022]
Abstract
OBJECTIVE The Outcome Measures in Rheumatology (OMERACT) Rheumatoid Arthritis (RA) Flare Group was established to develop a reliable way to identify and measure RA flares in randomized controlled trials (RCT). Here, we summarized the development and field testing of the RA Flare Questionnaire (RA-FQ), and the voting results at OMERACT 2016. METHODS Classic and modern psychometric methods were used to assess reliability, validity, sensitivity, factor structure, scoring, and thresholds. Interviews with patients and clinicians also assessed content validity, utility, and meaningfulness of RA-FQ scores. RESULTS People with RA in observational trials in Canada (n = 896) and France (n = 138), and an RCT in the Netherlands (n = 178) completed 5 items (11-point numerical rating scale) representing RA Flare core domains. There was moderate to high evidence of reliability, content and construct validity, and responsiveness. Factor analysis supported unidimensionality. Rasch analysis showed acceptable fit to the Rasch model, with items and people covering a broad measurement continuum and evidence of appropriate targeting of items to people, ordered thresholds, minimal differential item functioning by language, sex, or age. A summative score across items is defensible, yielding an interval score (0-50) where higher scores reflect worsening flare. The RA-FQ received endorsement from 88% of attendees that it passed the OMERACT Filter 2.0 "Eyeball Test" for instrument selection. CONCLUSION The RA-FQ has been developed to identify and measure RA flares. Its review through OMERACT Filter 2.0 shows evidence of reliability, content and construct validity, and responsiveness. These properties merit its further validation as an outcome for clinical trials.
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Affiliation(s)
- Susan J Bartlett
- From McGill University, Montreal, Quebec; University of British Columbia, Vancouver, British Columbia, Canada; Johns Hopkins University, Baltimore, Maryland; Hospital for Special Surgery, New York, New York; University of California, Los Angeles; Healthy Motivation, Santa Barbara, California, USA; Cardiff University, Cardiff; University of the West of England, Bristol, UK; Schlosspark-Klinik University Medicine, Berlin, Germany; Parker Institute, Copenhagen University, Copenhagen, Denmark; Sint Maartenskliniek, Nijmege; Vrije Universiteit (VU), Amsterdam, the Netherlands; Pierre et Marie Curie University, Paris; University of Lorraine, Lorraine, France; University of Sydney, Sydney, Australia. .,S.J. Bartlett, PhD, McGill University, and Johns Hopkins University; S.P. Barbic, PhD, University of British Columbia; V.P. Bykerk, MD, Hospital for Special Surgery; E.H. Choy, MD, Cardiff University; R. Alten, MD, Schlosspark-Klinik University Medicine; R. Christensen, PhD, Parker Institute, Copenhagen University; A. den Broeder, MD, PhD, Sint Maartenskliniek; B. Fautrel, MD, PhD, Pierre et Marie Curie University; D.E. Furst, MD, University of California; F. Guillemin, MD, PhD, University of Lorraine; S. Hewlett, PhD, RN, University of the West of England; A.L. Leong, MBA, Healthy Motivation; A. Lyddiatt, Patient Research Partner; L. March, MD, PhD, University of Sydney; P. Montie, Patient Research Partner; C. Pohl, MD, Schlosspark-Klinik University Medicine; M. Scholte Voshaar, MSc, VU; T.G. Woodworth, MD, University of California; C.O. Bingham III, MD, Johns Hopkins University.
| | - Skye P Barbic
- From McGill University, Montreal, Quebec; University of British Columbia, Vancouver, British Columbia, Canada; Johns Hopkins University, Baltimore, Maryland; Hospital for Special Surgery, New York, New York; University of California, Los Angeles; Healthy Motivation, Santa Barbara, California, USA; Cardiff University, Cardiff; University of the West of England, Bristol, UK; Schlosspark-Klinik University Medicine, Berlin, Germany; Parker Institute, Copenhagen University, Copenhagen, Denmark; Sint Maartenskliniek, Nijmege; Vrije Universiteit (VU), Amsterdam, the Netherlands; Pierre et Marie Curie University, Paris; University of Lorraine, Lorraine, France; University of Sydney, Sydney, Australia.,S.J. Bartlett, PhD, McGill University, and Johns Hopkins University; S.P. Barbic, PhD, University of British Columbia; V.P. Bykerk, MD, Hospital for Special Surgery; E.H. Choy, MD, Cardiff University; R. Alten, MD, Schlosspark-Klinik University Medicine; R. Christensen, PhD, Parker Institute, Copenhagen University; A. den Broeder, MD, PhD, Sint Maartenskliniek; B. Fautrel, MD, PhD, Pierre et Marie Curie University; D.E. Furst, MD, University of California; F. Guillemin, MD, PhD, University of Lorraine; S. Hewlett, PhD, RN, University of the West of England; A.L. Leong, MBA, Healthy Motivation; A. Lyddiatt, Patient Research Partner; L. March, MD, PhD, University of Sydney; P. Montie, Patient Research Partner; C. Pohl, MD, Schlosspark-Klinik University Medicine; M. Scholte Voshaar, MSc, VU; T.G. Woodworth, MD, University of California; C.O. Bingham III, MD, Johns Hopkins University
| | - Vivian P Bykerk
- From McGill University, Montreal, Quebec; University of British Columbia, Vancouver, British Columbia, Canada; Johns Hopkins University, Baltimore, Maryland; Hospital for Special Surgery, New York, New York; University of California, Los Angeles; Healthy Motivation, Santa Barbara, California, USA; Cardiff University, Cardiff; University of the West of England, Bristol, UK; Schlosspark-Klinik University Medicine, Berlin, Germany; Parker Institute, Copenhagen University, Copenhagen, Denmark; Sint Maartenskliniek, Nijmege; Vrije Universiteit (VU), Amsterdam, the Netherlands; Pierre et Marie Curie University, Paris; University of Lorraine, Lorraine, France; University of Sydney, Sydney, Australia.,S.J. Bartlett, PhD, McGill University, and Johns Hopkins University; S.P. Barbic, PhD, University of British Columbia; V.P. Bykerk, MD, Hospital for Special Surgery; E.H. Choy, MD, Cardiff University; R. Alten, MD, Schlosspark-Klinik University Medicine; R. Christensen, PhD, Parker Institute, Copenhagen University; A. den Broeder, MD, PhD, Sint Maartenskliniek; B. Fautrel, MD, PhD, Pierre et Marie Curie University; D.E. Furst, MD, University of California; F. Guillemin, MD, PhD, University of Lorraine; S. Hewlett, PhD, RN, University of the West of England; A.L. Leong, MBA, Healthy Motivation; A. Lyddiatt, Patient Research Partner; L. March, MD, PhD, University of Sydney; P. Montie, Patient Research Partner; C. Pohl, MD, Schlosspark-Klinik University Medicine; M. Scholte Voshaar, MSc, VU; T.G. Woodworth, MD, University of California; C.O. Bingham III, MD, Johns Hopkins University
| | - Ernest H Choy
- From McGill University, Montreal, Quebec; University of British Columbia, Vancouver, British Columbia, Canada; Johns Hopkins University, Baltimore, Maryland; Hospital for Special Surgery, New York, New York; University of California, Los Angeles; Healthy Motivation, Santa Barbara, California, USA; Cardiff University, Cardiff; University of the West of England, Bristol, UK; Schlosspark-Klinik University Medicine, Berlin, Germany; Parker Institute, Copenhagen University, Copenhagen, Denmark; Sint Maartenskliniek, Nijmege; Vrije Universiteit (VU), Amsterdam, the Netherlands; Pierre et Marie Curie University, Paris; University of Lorraine, Lorraine, France; University of Sydney, Sydney, Australia.,S.J. Bartlett, PhD, McGill University, and Johns Hopkins University; S.P. Barbic, PhD, University of British Columbia; V.P. Bykerk, MD, Hospital for Special Surgery; E.H. Choy, MD, Cardiff University; R. Alten, MD, Schlosspark-Klinik University Medicine; R. Christensen, PhD, Parker Institute, Copenhagen University; A. den Broeder, MD, PhD, Sint Maartenskliniek; B. Fautrel, MD, PhD, Pierre et Marie Curie University; D.E. Furst, MD, University of California; F. Guillemin, MD, PhD, University of Lorraine; S. Hewlett, PhD, RN, University of the West of England; A.L. Leong, MBA, Healthy Motivation; A. Lyddiatt, Patient Research Partner; L. March, MD, PhD, University of Sydney; P. Montie, Patient Research Partner; C. Pohl, MD, Schlosspark-Klinik University Medicine; M. Scholte Voshaar, MSc, VU; T.G. Woodworth, MD, University of California; C.O. Bingham III, MD, Johns Hopkins University
| | - Rieke Alten
- From McGill University, Montreal, Quebec; University of British Columbia, Vancouver, British Columbia, Canada; Johns Hopkins University, Baltimore, Maryland; Hospital for Special Surgery, New York, New York; University of California, Los Angeles; Healthy Motivation, Santa Barbara, California, USA; Cardiff University, Cardiff; University of the West of England, Bristol, UK; Schlosspark-Klinik University Medicine, Berlin, Germany; Parker Institute, Copenhagen University, Copenhagen, Denmark; Sint Maartenskliniek, Nijmege; Vrije Universiteit (VU), Amsterdam, the Netherlands; Pierre et Marie Curie University, Paris; University of Lorraine, Lorraine, France; University of Sydney, Sydney, Australia.,S.J. Bartlett, PhD, McGill University, and Johns Hopkins University; S.P. Barbic, PhD, University of British Columbia; V.P. Bykerk, MD, Hospital for Special Surgery; E.H. Choy, MD, Cardiff University; R. Alten, MD, Schlosspark-Klinik University Medicine; R. Christensen, PhD, Parker Institute, Copenhagen University; A. den Broeder, MD, PhD, Sint Maartenskliniek; B. Fautrel, MD, PhD, Pierre et Marie Curie University; D.E. Furst, MD, University of California; F. Guillemin, MD, PhD, University of Lorraine; S. Hewlett, PhD, RN, University of the West of England; A.L. Leong, MBA, Healthy Motivation; A. Lyddiatt, Patient Research Partner; L. March, MD, PhD, University of Sydney; P. Montie, Patient Research Partner; C. Pohl, MD, Schlosspark-Klinik University Medicine; M. Scholte Voshaar, MSc, VU; T.G. Woodworth, MD, University of California; C.O. Bingham III, MD, Johns Hopkins University
| | - Robin Christensen
- From McGill University, Montreal, Quebec; University of British Columbia, Vancouver, British Columbia, Canada; Johns Hopkins University, Baltimore, Maryland; Hospital for Special Surgery, New York, New York; University of California, Los Angeles; Healthy Motivation, Santa Barbara, California, USA; Cardiff University, Cardiff; University of the West of England, Bristol, UK; Schlosspark-Klinik University Medicine, Berlin, Germany; Parker Institute, Copenhagen University, Copenhagen, Denmark; Sint Maartenskliniek, Nijmege; Vrije Universiteit (VU), Amsterdam, the Netherlands; Pierre et Marie Curie University, Paris; University of Lorraine, Lorraine, France; University of Sydney, Sydney, Australia.,S.J. Bartlett, PhD, McGill University, and Johns Hopkins University; S.P. Barbic, PhD, University of British Columbia; V.P. Bykerk, MD, Hospital for Special Surgery; E.H. Choy, MD, Cardiff University; R. Alten, MD, Schlosspark-Klinik University Medicine; R. Christensen, PhD, Parker Institute, Copenhagen University; A. den Broeder, MD, PhD, Sint Maartenskliniek; B. Fautrel, MD, PhD, Pierre et Marie Curie University; D.E. Furst, MD, University of California; F. Guillemin, MD, PhD, University of Lorraine; S. Hewlett, PhD, RN, University of the West of England; A.L. Leong, MBA, Healthy Motivation; A. Lyddiatt, Patient Research Partner; L. March, MD, PhD, University of Sydney; P. Montie, Patient Research Partner; C. Pohl, MD, Schlosspark-Klinik University Medicine; M. Scholte Voshaar, MSc, VU; T.G. Woodworth, MD, University of California; C.O. Bingham III, MD, Johns Hopkins University
| | - Alfons den Broeder
- From McGill University, Montreal, Quebec; University of British Columbia, Vancouver, British Columbia, Canada; Johns Hopkins University, Baltimore, Maryland; Hospital for Special Surgery, New York, New York; University of California, Los Angeles; Healthy Motivation, Santa Barbara, California, USA; Cardiff University, Cardiff; University of the West of England, Bristol, UK; Schlosspark-Klinik University Medicine, Berlin, Germany; Parker Institute, Copenhagen University, Copenhagen, Denmark; Sint Maartenskliniek, Nijmege; Vrije Universiteit (VU), Amsterdam, the Netherlands; Pierre et Marie Curie University, Paris; University of Lorraine, Lorraine, France; University of Sydney, Sydney, Australia.,S.J. Bartlett, PhD, McGill University, and Johns Hopkins University; S.P. Barbic, PhD, University of British Columbia; V.P. Bykerk, MD, Hospital for Special Surgery; E.H. Choy, MD, Cardiff University; R. Alten, MD, Schlosspark-Klinik University Medicine; R. Christensen, PhD, Parker Institute, Copenhagen University; A. den Broeder, MD, PhD, Sint Maartenskliniek; B. Fautrel, MD, PhD, Pierre et Marie Curie University; D.E. Furst, MD, University of California; F. Guillemin, MD, PhD, University of Lorraine; S. Hewlett, PhD, RN, University of the West of England; A.L. Leong, MBA, Healthy Motivation; A. Lyddiatt, Patient Research Partner; L. March, MD, PhD, University of Sydney; P. Montie, Patient Research Partner; C. Pohl, MD, Schlosspark-Klinik University Medicine; M. Scholte Voshaar, MSc, VU; T.G. Woodworth, MD, University of California; C.O. Bingham III, MD, Johns Hopkins University
| | - Bruno Fautrel
- From McGill University, Montreal, Quebec; University of British Columbia, Vancouver, British Columbia, Canada; Johns Hopkins University, Baltimore, Maryland; Hospital for Special Surgery, New York, New York; University of California, Los Angeles; Healthy Motivation, Santa Barbara, California, USA; Cardiff University, Cardiff; University of the West of England, Bristol, UK; Schlosspark-Klinik University Medicine, Berlin, Germany; Parker Institute, Copenhagen University, Copenhagen, Denmark; Sint Maartenskliniek, Nijmege; Vrije Universiteit (VU), Amsterdam, the Netherlands; Pierre et Marie Curie University, Paris; University of Lorraine, Lorraine, France; University of Sydney, Sydney, Australia.,S.J. Bartlett, PhD, McGill University, and Johns Hopkins University; S.P. Barbic, PhD, University of British Columbia; V.P. Bykerk, MD, Hospital for Special Surgery; E.H. Choy, MD, Cardiff University; R. Alten, MD, Schlosspark-Klinik University Medicine; R. Christensen, PhD, Parker Institute, Copenhagen University; A. den Broeder, MD, PhD, Sint Maartenskliniek; B. Fautrel, MD, PhD, Pierre et Marie Curie University; D.E. Furst, MD, University of California; F. Guillemin, MD, PhD, University of Lorraine; S. Hewlett, PhD, RN, University of the West of England; A.L. Leong, MBA, Healthy Motivation; A. Lyddiatt, Patient Research Partner; L. March, MD, PhD, University of Sydney; P. Montie, Patient Research Partner; C. Pohl, MD, Schlosspark-Klinik University Medicine; M. Scholte Voshaar, MSc, VU; T.G. Woodworth, MD, University of California; C.O. Bingham III, MD, Johns Hopkins University
| | - Daniel E Furst
- From McGill University, Montreal, Quebec; University of British Columbia, Vancouver, British Columbia, Canada; Johns Hopkins University, Baltimore, Maryland; Hospital for Special Surgery, New York, New York; University of California, Los Angeles; Healthy Motivation, Santa Barbara, California, USA; Cardiff University, Cardiff; University of the West of England, Bristol, UK; Schlosspark-Klinik University Medicine, Berlin, Germany; Parker Institute, Copenhagen University, Copenhagen, Denmark; Sint Maartenskliniek, Nijmege; Vrije Universiteit (VU), Amsterdam, the Netherlands; Pierre et Marie Curie University, Paris; University of Lorraine, Lorraine, France; University of Sydney, Sydney, Australia.,S.J. Bartlett, PhD, McGill University, and Johns Hopkins University; S.P. Barbic, PhD, University of British Columbia; V.P. Bykerk, MD, Hospital for Special Surgery; E.H. Choy, MD, Cardiff University; R. Alten, MD, Schlosspark-Klinik University Medicine; R. Christensen, PhD, Parker Institute, Copenhagen University; A. den Broeder, MD, PhD, Sint Maartenskliniek; B. Fautrel, MD, PhD, Pierre et Marie Curie University; D.E. Furst, MD, University of California; F. Guillemin, MD, PhD, University of Lorraine; S. Hewlett, PhD, RN, University of the West of England; A.L. Leong, MBA, Healthy Motivation; A. Lyddiatt, Patient Research Partner; L. March, MD, PhD, University of Sydney; P. Montie, Patient Research Partner; C. Pohl, MD, Schlosspark-Klinik University Medicine; M. Scholte Voshaar, MSc, VU; T.G. Woodworth, MD, University of California; C.O. Bingham III, MD, Johns Hopkins University
| | - Francis Guillemin
- From McGill University, Montreal, Quebec; University of British Columbia, Vancouver, British Columbia, Canada; Johns Hopkins University, Baltimore, Maryland; Hospital for Special Surgery, New York, New York; University of California, Los Angeles; Healthy Motivation, Santa Barbara, California, USA; Cardiff University, Cardiff; University of the West of England, Bristol, UK; Schlosspark-Klinik University Medicine, Berlin, Germany; Parker Institute, Copenhagen University, Copenhagen, Denmark; Sint Maartenskliniek, Nijmege; Vrije Universiteit (VU), Amsterdam, the Netherlands; Pierre et Marie Curie University, Paris; University of Lorraine, Lorraine, France; University of Sydney, Sydney, Australia.,S.J. Bartlett, PhD, McGill University, and Johns Hopkins University; S.P. Barbic, PhD, University of British Columbia; V.P. Bykerk, MD, Hospital for Special Surgery; E.H. Choy, MD, Cardiff University; R. Alten, MD, Schlosspark-Klinik University Medicine; R. Christensen, PhD, Parker Institute, Copenhagen University; A. den Broeder, MD, PhD, Sint Maartenskliniek; B. Fautrel, MD, PhD, Pierre et Marie Curie University; D.E. Furst, MD, University of California; F. Guillemin, MD, PhD, University of Lorraine; S. Hewlett, PhD, RN, University of the West of England; A.L. Leong, MBA, Healthy Motivation; A. Lyddiatt, Patient Research Partner; L. March, MD, PhD, University of Sydney; P. Montie, Patient Research Partner; C. Pohl, MD, Schlosspark-Klinik University Medicine; M. Scholte Voshaar, MSc, VU; T.G. Woodworth, MD, University of California; C.O. Bingham III, MD, Johns Hopkins University
| | - Sarah Hewlett
- From McGill University, Montreal, Quebec; University of British Columbia, Vancouver, British Columbia, Canada; Johns Hopkins University, Baltimore, Maryland; Hospital for Special Surgery, New York, New York; University of California, Los Angeles; Healthy Motivation, Santa Barbara, California, USA; Cardiff University, Cardiff; University of the West of England, Bristol, UK; Schlosspark-Klinik University Medicine, Berlin, Germany; Parker Institute, Copenhagen University, Copenhagen, Denmark; Sint Maartenskliniek, Nijmege; Vrije Universiteit (VU), Amsterdam, the Netherlands; Pierre et Marie Curie University, Paris; University of Lorraine, Lorraine, France; University of Sydney, Sydney, Australia.,S.J. Bartlett, PhD, McGill University, and Johns Hopkins University; S.P. Barbic, PhD, University of British Columbia; V.P. Bykerk, MD, Hospital for Special Surgery; E.H. Choy, MD, Cardiff University; R. Alten, MD, Schlosspark-Klinik University Medicine; R. Christensen, PhD, Parker Institute, Copenhagen University; A. den Broeder, MD, PhD, Sint Maartenskliniek; B. Fautrel, MD, PhD, Pierre et Marie Curie University; D.E. Furst, MD, University of California; F. Guillemin, MD, PhD, University of Lorraine; S. Hewlett, PhD, RN, University of the West of England; A.L. Leong, MBA, Healthy Motivation; A. Lyddiatt, Patient Research Partner; L. March, MD, PhD, University of Sydney; P. Montie, Patient Research Partner; C. Pohl, MD, Schlosspark-Klinik University Medicine; M. Scholte Voshaar, MSc, VU; T.G. Woodworth, MD, University of California; C.O. Bingham III, MD, Johns Hopkins University
| | - Amye L Leong
- From McGill University, Montreal, Quebec; University of British Columbia, Vancouver, British Columbia, Canada; Johns Hopkins University, Baltimore, Maryland; Hospital for Special Surgery, New York, New York; University of California, Los Angeles; Healthy Motivation, Santa Barbara, California, USA; Cardiff University, Cardiff; University of the West of England, Bristol, UK; Schlosspark-Klinik University Medicine, Berlin, Germany; Parker Institute, Copenhagen University, Copenhagen, Denmark; Sint Maartenskliniek, Nijmege; Vrije Universiteit (VU), Amsterdam, the Netherlands; Pierre et Marie Curie University, Paris; University of Lorraine, Lorraine, France; University of Sydney, Sydney, Australia.,S.J. Bartlett, PhD, McGill University, and Johns Hopkins University; S.P. Barbic, PhD, University of British Columbia; V.P. Bykerk, MD, Hospital for Special Surgery; E.H. Choy, MD, Cardiff University; R. Alten, MD, Schlosspark-Klinik University Medicine; R. Christensen, PhD, Parker Institute, Copenhagen University; A. den Broeder, MD, PhD, Sint Maartenskliniek; B. Fautrel, MD, PhD, Pierre et Marie Curie University; D.E. Furst, MD, University of California; F. Guillemin, MD, PhD, University of Lorraine; S. Hewlett, PhD, RN, University of the West of England; A.L. Leong, MBA, Healthy Motivation; A. Lyddiatt, Patient Research Partner; L. March, MD, PhD, University of Sydney; P. Montie, Patient Research Partner; C. Pohl, MD, Schlosspark-Klinik University Medicine; M. Scholte Voshaar, MSc, VU; T.G. Woodworth, MD, University of California; C.O. Bingham III, MD, Johns Hopkins University
| | - Anne Lyddiatt
- From McGill University, Montreal, Quebec; University of British Columbia, Vancouver, British Columbia, Canada; Johns Hopkins University, Baltimore, Maryland; Hospital for Special Surgery, New York, New York; University of California, Los Angeles; Healthy Motivation, Santa Barbara, California, USA; Cardiff University, Cardiff; University of the West of England, Bristol, UK; Schlosspark-Klinik University Medicine, Berlin, Germany; Parker Institute, Copenhagen University, Copenhagen, Denmark; Sint Maartenskliniek, Nijmege; Vrije Universiteit (VU), Amsterdam, the Netherlands; Pierre et Marie Curie University, Paris; University of Lorraine, Lorraine, France; University of Sydney, Sydney, Australia.,S.J. Bartlett, PhD, McGill University, and Johns Hopkins University; S.P. Barbic, PhD, University of British Columbia; V.P. Bykerk, MD, Hospital for Special Surgery; E.H. Choy, MD, Cardiff University; R. Alten, MD, Schlosspark-Klinik University Medicine; R. Christensen, PhD, Parker Institute, Copenhagen University; A. den Broeder, MD, PhD, Sint Maartenskliniek; B. Fautrel, MD, PhD, Pierre et Marie Curie University; D.E. Furst, MD, University of California; F. Guillemin, MD, PhD, University of Lorraine; S. Hewlett, PhD, RN, University of the West of England; A.L. Leong, MBA, Healthy Motivation; A. Lyddiatt, Patient Research Partner; L. March, MD, PhD, University of Sydney; P. Montie, Patient Research Partner; C. Pohl, MD, Schlosspark-Klinik University Medicine; M. Scholte Voshaar, MSc, VU; T.G. Woodworth, MD, University of California; C.O. Bingham III, MD, Johns Hopkins University
| | - Lyn March
- From McGill University, Montreal, Quebec; University of British Columbia, Vancouver, British Columbia, Canada; Johns Hopkins University, Baltimore, Maryland; Hospital for Special Surgery, New York, New York; University of California, Los Angeles; Healthy Motivation, Santa Barbara, California, USA; Cardiff University, Cardiff; University of the West of England, Bristol, UK; Schlosspark-Klinik University Medicine, Berlin, Germany; Parker Institute, Copenhagen University, Copenhagen, Denmark; Sint Maartenskliniek, Nijmege; Vrije Universiteit (VU), Amsterdam, the Netherlands; Pierre et Marie Curie University, Paris; University of Lorraine, Lorraine, France; University of Sydney, Sydney, Australia.,S.J. Bartlett, PhD, McGill University, and Johns Hopkins University; S.P. Barbic, PhD, University of British Columbia; V.P. Bykerk, MD, Hospital for Special Surgery; E.H. Choy, MD, Cardiff University; R. Alten, MD, Schlosspark-Klinik University Medicine; R. Christensen, PhD, Parker Institute, Copenhagen University; A. den Broeder, MD, PhD, Sint Maartenskliniek; B. Fautrel, MD, PhD, Pierre et Marie Curie University; D.E. Furst, MD, University of California; F. Guillemin, MD, PhD, University of Lorraine; S. Hewlett, PhD, RN, University of the West of England; A.L. Leong, MBA, Healthy Motivation; A. Lyddiatt, Patient Research Partner; L. March, MD, PhD, University of Sydney; P. Montie, Patient Research Partner; C. Pohl, MD, Schlosspark-Klinik University Medicine; M. Scholte Voshaar, MSc, VU; T.G. Woodworth, MD, University of California; C.O. Bingham III, MD, Johns Hopkins University
| | - Pamela Montie
- From McGill University, Montreal, Quebec; University of British Columbia, Vancouver, British Columbia, Canada; Johns Hopkins University, Baltimore, Maryland; Hospital for Special Surgery, New York, New York; University of California, Los Angeles; Healthy Motivation, Santa Barbara, California, USA; Cardiff University, Cardiff; University of the West of England, Bristol, UK; Schlosspark-Klinik University Medicine, Berlin, Germany; Parker Institute, Copenhagen University, Copenhagen, Denmark; Sint Maartenskliniek, Nijmege; Vrije Universiteit (VU), Amsterdam, the Netherlands; Pierre et Marie Curie University, Paris; University of Lorraine, Lorraine, France; University of Sydney, Sydney, Australia.,S.J. Bartlett, PhD, McGill University, and Johns Hopkins University; S.P. Barbic, PhD, University of British Columbia; V.P. Bykerk, MD, Hospital for Special Surgery; E.H. Choy, MD, Cardiff University; R. Alten, MD, Schlosspark-Klinik University Medicine; R. Christensen, PhD, Parker Institute, Copenhagen University; A. den Broeder, MD, PhD, Sint Maartenskliniek; B. Fautrel, MD, PhD, Pierre et Marie Curie University; D.E. Furst, MD, University of California; F. Guillemin, MD, PhD, University of Lorraine; S. Hewlett, PhD, RN, University of the West of England; A.L. Leong, MBA, Healthy Motivation; A. Lyddiatt, Patient Research Partner; L. March, MD, PhD, University of Sydney; P. Montie, Patient Research Partner; C. Pohl, MD, Schlosspark-Klinik University Medicine; M. Scholte Voshaar, MSc, VU; T.G. Woodworth, MD, University of California; C.O. Bingham III, MD, Johns Hopkins University
| | - Christoph Pohl
- From McGill University, Montreal, Quebec; University of British Columbia, Vancouver, British Columbia, Canada; Johns Hopkins University, Baltimore, Maryland; Hospital for Special Surgery, New York, New York; University of California, Los Angeles; Healthy Motivation, Santa Barbara, California, USA; Cardiff University, Cardiff; University of the West of England, Bristol, UK; Schlosspark-Klinik University Medicine, Berlin, Germany; Parker Institute, Copenhagen University, Copenhagen, Denmark; Sint Maartenskliniek, Nijmege; Vrije Universiteit (VU), Amsterdam, the Netherlands; Pierre et Marie Curie University, Paris; University of Lorraine, Lorraine, France; University of Sydney, Sydney, Australia.,S.J. Bartlett, PhD, McGill University, and Johns Hopkins University; S.P. Barbic, PhD, University of British Columbia; V.P. Bykerk, MD, Hospital for Special Surgery; E.H. Choy, MD, Cardiff University; R. Alten, MD, Schlosspark-Klinik University Medicine; R. Christensen, PhD, Parker Institute, Copenhagen University; A. den Broeder, MD, PhD, Sint Maartenskliniek; B. Fautrel, MD, PhD, Pierre et Marie Curie University; D.E. Furst, MD, University of California; F. Guillemin, MD, PhD, University of Lorraine; S. Hewlett, PhD, RN, University of the West of England; A.L. Leong, MBA, Healthy Motivation; A. Lyddiatt, Patient Research Partner; L. March, MD, PhD, University of Sydney; P. Montie, Patient Research Partner; C. Pohl, MD, Schlosspark-Klinik University Medicine; M. Scholte Voshaar, MSc, VU; T.G. Woodworth, MD, University of California; C.O. Bingham III, MD, Johns Hopkins University
| | - Marieke Scholte Voshaar
- From McGill University, Montreal, Quebec; University of British Columbia, Vancouver, British Columbia, Canada; Johns Hopkins University, Baltimore, Maryland; Hospital for Special Surgery, New York, New York; University of California, Los Angeles; Healthy Motivation, Santa Barbara, California, USA; Cardiff University, Cardiff; University of the West of England, Bristol, UK; Schlosspark-Klinik University Medicine, Berlin, Germany; Parker Institute, Copenhagen University, Copenhagen, Denmark; Sint Maartenskliniek, Nijmege; Vrije Universiteit (VU), Amsterdam, the Netherlands; Pierre et Marie Curie University, Paris; University of Lorraine, Lorraine, France; University of Sydney, Sydney, Australia.,S.J. Bartlett, PhD, McGill University, and Johns Hopkins University; S.P. Barbic, PhD, University of British Columbia; V.P. Bykerk, MD, Hospital for Special Surgery; E.H. Choy, MD, Cardiff University; R. Alten, MD, Schlosspark-Klinik University Medicine; R. Christensen, PhD, Parker Institute, Copenhagen University; A. den Broeder, MD, PhD, Sint Maartenskliniek; B. Fautrel, MD, PhD, Pierre et Marie Curie University; D.E. Furst, MD, University of California; F. Guillemin, MD, PhD, University of Lorraine; S. Hewlett, PhD, RN, University of the West of England; A.L. Leong, MBA, Healthy Motivation; A. Lyddiatt, Patient Research Partner; L. March, MD, PhD, University of Sydney; P. Montie, Patient Research Partner; C. Pohl, MD, Schlosspark-Klinik University Medicine; M. Scholte Voshaar, MSc, VU; T.G. Woodworth, MD, University of California; C.O. Bingham III, MD, Johns Hopkins University
| | - Thasia G Woodworth
- From McGill University, Montreal, Quebec; University of British Columbia, Vancouver, British Columbia, Canada; Johns Hopkins University, Baltimore, Maryland; Hospital for Special Surgery, New York, New York; University of California, Los Angeles; Healthy Motivation, Santa Barbara, California, USA; Cardiff University, Cardiff; University of the West of England, Bristol, UK; Schlosspark-Klinik University Medicine, Berlin, Germany; Parker Institute, Copenhagen University, Copenhagen, Denmark; Sint Maartenskliniek, Nijmege; Vrije Universiteit (VU), Amsterdam, the Netherlands; Pierre et Marie Curie University, Paris; University of Lorraine, Lorraine, France; University of Sydney, Sydney, Australia.,S.J. Bartlett, PhD, McGill University, and Johns Hopkins University; S.P. Barbic, PhD, University of British Columbia; V.P. Bykerk, MD, Hospital for Special Surgery; E.H. Choy, MD, Cardiff University; R. Alten, MD, Schlosspark-Klinik University Medicine; R. Christensen, PhD, Parker Institute, Copenhagen University; A. den Broeder, MD, PhD, Sint Maartenskliniek; B. Fautrel, MD, PhD, Pierre et Marie Curie University; D.E. Furst, MD, University of California; F. Guillemin, MD, PhD, University of Lorraine; S. Hewlett, PhD, RN, University of the West of England; A.L. Leong, MBA, Healthy Motivation; A. Lyddiatt, Patient Research Partner; L. March, MD, PhD, University of Sydney; P. Montie, Patient Research Partner; C. Pohl, MD, Schlosspark-Klinik University Medicine; M. Scholte Voshaar, MSc, VU; T.G. Woodworth, MD, University of California; C.O. Bingham III, MD, Johns Hopkins University
| | - Clifton O Bingham
- From McGill University, Montreal, Quebec; University of British Columbia, Vancouver, British Columbia, Canada; Johns Hopkins University, Baltimore, Maryland; Hospital for Special Surgery, New York, New York; University of California, Los Angeles; Healthy Motivation, Santa Barbara, California, USA; Cardiff University, Cardiff; University of the West of England, Bristol, UK; Schlosspark-Klinik University Medicine, Berlin, Germany; Parker Institute, Copenhagen University, Copenhagen, Denmark; Sint Maartenskliniek, Nijmege; Vrije Universiteit (VU), Amsterdam, the Netherlands; Pierre et Marie Curie University, Paris; University of Lorraine, Lorraine, France; University of Sydney, Sydney, Australia.,S.J. Bartlett, PhD, McGill University, and Johns Hopkins University; S.P. Barbic, PhD, University of British Columbia; V.P. Bykerk, MD, Hospital for Special Surgery; E.H. Choy, MD, Cardiff University; R. Alten, MD, Schlosspark-Klinik University Medicine; R. Christensen, PhD, Parker Institute, Copenhagen University; A. den Broeder, MD, PhD, Sint Maartenskliniek; B. Fautrel, MD, PhD, Pierre et Marie Curie University; D.E. Furst, MD, University of California; F. Guillemin, MD, PhD, University of Lorraine; S. Hewlett, PhD, RN, University of the West of England; A.L. Leong, MBA, Healthy Motivation; A. Lyddiatt, Patient Research Partner; L. March, MD, PhD, University of Sydney; P. Montie, Patient Research Partner; C. Pohl, MD, Schlosspark-Klinik University Medicine; M. Scholte Voshaar, MSc, VU; T.G. Woodworth, MD, University of California; C.O. Bingham III, MD, Johns Hopkins University
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Adler BL, Albayda J, Shores JT, Lee WPA, Brandacher G, Bingham CO. Erosive Rheumatoid Arthritis After Bilateral Hand Transplantation. Ann Intern Med 2017; 167:216-218. [PMID: 28654973 PMCID: PMC6615553 DOI: 10.7326/l16-0588] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Affiliation(s)
- Brittany L Adler
- From Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Jemima Albayda
- From Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Jamie T Shores
- From Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - W P Andrew Lee
- From Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Gerald Brandacher
- From Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Clifton O Bingham
- From Johns Hopkins University School of Medicine, Baltimore, Maryland
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Tunis SR, Maxwell LJ, Graham ID, Shea BJ, Beaton DE, Bingham CO, Brooks P, Conaghan PG, D'Agostino MA, de Wit MP, Gossec L, March LM, Simon LS, Singh JA, Strand V, Wells GA, Tugwell P. Engaging Stakeholders and Promoting Uptake of OMERACT Core Outcome Instrument Sets. J Rheumatol 2017; 44:1551-1559. [PMID: 28765256 DOI: 10.3899/jrheum.161273] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/31/2017] [Indexed: 12/30/2022]
Abstract
OBJECTIVE While there has been substantial progress in the development of core outcomes sets, the degree to which these are used by researchers is variable. We convened a special workshop on knowledge translation at the Outcome Measures in Rheumatology (OMERACT) 2016 with 2 main goals. The first focused on the development of a formal knowledge translation framework and the second on promoting uptake of recommended core outcome domain and instrument sets. METHODS We invited all 189 OMERACT 2016 attendees to the workshop; 86 attended, representing patient research partners (n = 15), healthcare providers/clinician researchers (n = 52), industry (n = 4), regulatory agencies (n = 4), and OMERACT fellows (n = 11). Participants were given an introduction to knowledge translation and were asked to propose and discuss recommendations for the OMERACT community to (1) strengthen stakeholder involvement in the core outcome instrument set development process, and (2) promote uptake of core outcome sets with a specific focus on the potential role of post-regulatory decision makers. RESULTS We developed the novel "OMERACT integrated knowledge translation" framework, which formalizes OMERACT's knowledge translation strategies. We produced strategies to improve stakeholder engagement throughout the process of core outcome set development and created a list of creative and innovative ways to promote the uptake of OMERACT's core outcome sets. CONCLUSION The guidance provided in this paper is preliminary and is based on the views of the participants. Future work will engage OMERACT groups, "post-regulatory decision makers," and a broad range of different stakeholders to identify and evaluate the most useful methods and processes, and to revise guidance accordingly.
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Affiliation(s)
- Sean R Tunis
- From the Center for Medical Technology Policy; Division of Rheumatology, Department of Medicine, Johns Hopkins University, Baltimore, Maryland; University of Alabama at Birmingham and Birmingham Veterans Affairs Medical Center, Birmingham, Alabama; SDG LLC, Cambridge, Massachusetts; Division of Immunology/Rheumatology, Stanford University School of Medicine, Palo Alto, California, USA; Centre for Practice-Changing Research, Ottawa Hospital Research Institute; Ottawa Hospital Research Institute, Clinical Epidemiology Program; School of Epidemiology, Public Health and Preventive Medicine, Faculty of Medicine, University of Ottawa; Cardiovascular Research Methods Centre, University of Ottawa Heart Institute; Department of Epidemiology and Community Medicine, University of Ottawa; Department of Medicine, Faculty of Medicine, University of Ottawa; Cochrane Musculoskeletal, University of Ottawa, Ottawa; Musculoskeletal Health and Outcomes Research, St. Michael's Hospital; Institute for Work and Health; Department of Occupational Science and Occupational Therapy, Rehabilitation Sciences Institute and the Institute for Health Policy Management and Evaluation, University of Toronto, Toronto, Ontario, Canada; Centre for Health Policy, Melbourne School of Population and Global Health, University of Melbourne, Melbourne; Sydney Medical School, Institute of Bone and Joint Research and Department of Rheumatology, Royal North Shore Hospital, St. Leonards, Australia; Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds and UK National Institute for Health Research (NIHR) Leeds Musculoskeletal Biomedical Research Unit, Leeds, UK; Hôpital Ambroise Paré, Rheumatology Department, Boulogne-Billancourt; INSERM U1173, Laboratoire d'Excellence INFLAMEX, UFR Simone Veil, Versailles-Saint-Quentin University, Montigny-le-Bretonneux; Sorbonne Universités, UPMC Univ Paris 06; AP-HP, Pitié Salpêtrière Hospital, Department of Rheumatology, Paris, France; Department of Medical Humanities, VU University Medical Centre/EMGO+ Institute, Amsterdam, the Netherlands.,IDG is a recipient of a Canadian Institutes of Health Research (CIHR) Foundation Grant Scheme (RFN #143237), focused on understanding the process and effect of integrated knowledge translation. COB has received funding from a Eugene Washington Engagement Award (EIAN 1988) from the Patient Centered Outcomes Research Institute (PCORI). All statements and views expressed in this report, including its findings and conclusions, are solely those of the authors and do not necessarily represent the views of PCORI, its board of governors, or methodology committee; or the UK National Health Service, the NIHR, or the Department of Health; or the position or policy of the US Department of Veterans Affairs or the US government. PGC is funded in part by the NIHR Leeds Musculoskeletal Biomedical Research Unit. This article presents independent research funded by the NIHR. JAS has received research grants from Takeda and Savient, and consultant fees from Takeda and the American College of Rheumatology. JAS serves as the principal investigator for an investigator-initiated study funded by Horizon pharmaceuticals through a grant to DINORA Inc., a 501 (c)(3) entity.,S.R. Tunis, MD, MSc, President and CEO, Center for Medical Technology Policy; L.J. Maxwell, PhD, Cochrane Musculoskeletal, University of Ottawa and Centre for Practice-Changing Research, Ottawa Hospital Research Institute; I.D. Graham, PhD, School of Epidemiology, Public Health and Preventive Medicine, Faculty of Medicine, University of Ottawa, and Ottawa Hospital Research Institute, Clinical Epidemiology Program; B.J. Shea, PhD, School of Epidemiology, Public Health and Preventive Medicine, Faculty of Medicine, University of Ottawa, and Ottawa Hospital Research Institute, Clinical Epidemiology Program; D.E. Beaton, BScOT, PhD, Musculoskeletal Health and Outcomes Research, St. Michael's Hospital, and Institute for Work and Health, and Department of Occupational Science and Occupational Therapy, Rehabilitation Sciences Institute and the Institute for Health Policy Management and Evaluation, University of Toronto; C.O. Bingham III, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University; P. Brooks, MD, FRACP, Centre for Health Policy, Melbourne School of Population and Global Health, University of Melbourne; P.G. Conaghan, MD, PhD, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds and NIHR Leeds Musculoskeletal Biomedical Research Unit; M.A. D'Agostino, MD, PhD, APHP, Hôpital Ambroise Paré, Rheumatology Department, and INSERM U1173, Laboratoire d'Excellence INFLAMEX, UFR Simone Veil, Versailles-Saint-Quentin University; M.P. de Wit, PhD, Patient Research Partner, Department of Medical Humanities, VU University Medical Centre/EMGO+ Institute; L. Gossec, MD, PhD, Sorbonne Universités, UPMC Univ Paris 06, and AP-HP, Pitié Salpêtrière Hospital, Department of Rheumatology; L.M. March, MBBS, PhD, Liggins Professor of Rheumatology and Musculoskeletal Epidemiology, Sydney Medical School, Institute of Bone and Joint Research and Department of Rheumatology, Royal North Shore Hospital; L.S. Simon, MD, Co-managing Director of SDG LLC; J.A. Singh, MD, MPH, Professor of Medicine and Epidemiology, University of Alabama at Birmingham, and Staff Physician, Birmingham Veterans Affairs Medical Center; V. Strand, MD, Adjunct Clinical Professor, Division of Immunology/Rheumatology, Stanford University School of Medicine; G.A. Wells, MSc, PhD, Director, Cardiovascular Research Methods Centre, University of Ottawa Heart Institute, and Professor, Department of Epidemiology and Community Medicine, University of Ottawa; P. Tugwell, MD, MSc, Department of Medicine, Faculty of Medicine, University of Ottawa, and Ottawa Hospital Research Institute, Clinical Epidemiology Program, and School of Epidemiology, Public Health and Preventive Medicine, Faculty of Medicine, University of Ottawa
| | - Lara J Maxwell
- From the Center for Medical Technology Policy; Division of Rheumatology, Department of Medicine, Johns Hopkins University, Baltimore, Maryland; University of Alabama at Birmingham and Birmingham Veterans Affairs Medical Center, Birmingham, Alabama; SDG LLC, Cambridge, Massachusetts; Division of Immunology/Rheumatology, Stanford University School of Medicine, Palo Alto, California, USA; Centre for Practice-Changing Research, Ottawa Hospital Research Institute; Ottawa Hospital Research Institute, Clinical Epidemiology Program; School of Epidemiology, Public Health and Preventive Medicine, Faculty of Medicine, University of Ottawa; Cardiovascular Research Methods Centre, University of Ottawa Heart Institute; Department of Epidemiology and Community Medicine, University of Ottawa; Department of Medicine, Faculty of Medicine, University of Ottawa; Cochrane Musculoskeletal, University of Ottawa, Ottawa; Musculoskeletal Health and Outcomes Research, St. Michael's Hospital; Institute for Work and Health; Department of Occupational Science and Occupational Therapy, Rehabilitation Sciences Institute and the Institute for Health Policy Management and Evaluation, University of Toronto, Toronto, Ontario, Canada; Centre for Health Policy, Melbourne School of Population and Global Health, University of Melbourne, Melbourne; Sydney Medical School, Institute of Bone and Joint Research and Department of Rheumatology, Royal North Shore Hospital, St. Leonards, Australia; Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds and UK National Institute for Health Research (NIHR) Leeds Musculoskeletal Biomedical Research Unit, Leeds, UK; Hôpital Ambroise Paré, Rheumatology Department, Boulogne-Billancourt; INSERM U1173, Laboratoire d'Excellence INFLAMEX, UFR Simone Veil, Versailles-Saint-Quentin University, Montigny-le-Bretonneux; Sorbonne Universités, UPMC Univ Paris 06; AP-HP, Pitié Salpêtrière Hospital, Department of Rheumatology, Paris, France; Department of Medical Humanities, VU University Medical Centre/EMGO+ Institute, Amsterdam, the Netherlands. .,IDG is a recipient of a Canadian Institutes of Health Research (CIHR) Foundation Grant Scheme (RFN #143237), focused on understanding the process and effect of integrated knowledge translation. COB has received funding from a Eugene Washington Engagement Award (EIAN 1988) from the Patient Centered Outcomes Research Institute (PCORI). All statements and views expressed in this report, including its findings and conclusions, are solely those of the authors and do not necessarily represent the views of PCORI, its board of governors, or methodology committee; or the UK National Health Service, the NIHR, or the Department of Health; or the position or policy of the US Department of Veterans Affairs or the US government. PGC is funded in part by the NIHR Leeds Musculoskeletal Biomedical Research Unit. This article presents independent research funded by the NIHR. JAS has received research grants from Takeda and Savient, and consultant fees from Takeda and the American College of Rheumatology. JAS serves as the principal investigator for an investigator-initiated study funded by Horizon pharmaceuticals through a grant to DINORA Inc., a 501 (c)(3) entity. .,S.R. Tunis, MD, MSc, President and CEO, Center for Medical Technology Policy; L.J. Maxwell, PhD, Cochrane Musculoskeletal, University of Ottawa and Centre for Practice-Changing Research, Ottawa Hospital Research Institute; I.D. Graham, PhD, School of Epidemiology, Public Health and Preventive Medicine, Faculty of Medicine, University of Ottawa, and Ottawa Hospital Research Institute, Clinical Epidemiology Program; B.J. Shea, PhD, School of Epidemiology, Public Health and Preventive Medicine, Faculty of Medicine, University of Ottawa, and Ottawa Hospital Research Institute, Clinical Epidemiology Program; D.E. Beaton, BScOT, PhD, Musculoskeletal Health and Outcomes Research, St. Michael's Hospital, and Institute for Work and Health, and Department of Occupational Science and Occupational Therapy, Rehabilitation Sciences Institute and the Institute for Health Policy Management and Evaluation, University of Toronto; C.O. Bingham III, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University; P. Brooks, MD, FRACP, Centre for Health Policy, Melbourne School of Population and Global Health, University of Melbourne; P.G. Conaghan, MD, PhD, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds and NIHR Leeds Musculoskeletal Biomedical Research Unit; M.A. D'Agostino, MD, PhD, APHP, Hôpital Ambroise Paré, Rheumatology Department, and INSERM U1173, Laboratoire d'Excellence INFLAMEX, UFR Simone Veil, Versailles-Saint-Quentin University; M.P. de Wit, PhD, Patient Research Partner, Department of Medical Humanities, VU University Medical Centre/EMGO+ Institute; L. Gossec, MD, PhD, Sorbonne Universités, UPMC Univ Paris 06, and AP-HP, Pitié Salpêtrière Hospital, Department of Rheumatology; L.M. March, MBBS, PhD, Liggins Professor of Rheumatology and Musculoskeletal Epidemiology, Sydney Medical School, Institute of Bone and Joint Research and Department of Rheumatology, Royal North Shore Hospital; L.S. Simon, MD, Co-managing Director of SDG LLC; J.A. Singh, MD, MPH, Professor of Medicine and Epidemiology, University of Alabama at Birmingham, and Staff Physician, Birmingham Veterans Affairs Medical Center; V. Strand, MD, Adjunct Clinical Professor, Division of Immunology/Rheumatology, Stanford University School of Medicine; G.A. Wells, MSc, PhD, Director, Cardiovascular Research Methods Centre, University of Ottawa Heart Institute, and Professor, Department of Epidemiology and Community Medicine, University of Ottawa; P. Tugwell, MD, MSc, Department of Medicine, Faculty of Medicine, University of Ottawa, and Ottawa Hospital Research Institute, Clinical Epidemiology Program, and School of Epidemiology, Public Health and Preventive Medicine, Faculty of Medicine, University of Ottawa.
| | - Ian D Graham
- From the Center for Medical Technology Policy; Division of Rheumatology, Department of Medicine, Johns Hopkins University, Baltimore, Maryland; University of Alabama at Birmingham and Birmingham Veterans Affairs Medical Center, Birmingham, Alabama; SDG LLC, Cambridge, Massachusetts; Division of Immunology/Rheumatology, Stanford University School of Medicine, Palo Alto, California, USA; Centre for Practice-Changing Research, Ottawa Hospital Research Institute; Ottawa Hospital Research Institute, Clinical Epidemiology Program; School of Epidemiology, Public Health and Preventive Medicine, Faculty of Medicine, University of Ottawa; Cardiovascular Research Methods Centre, University of Ottawa Heart Institute; Department of Epidemiology and Community Medicine, University of Ottawa; Department of Medicine, Faculty of Medicine, University of Ottawa; Cochrane Musculoskeletal, University of Ottawa, Ottawa; Musculoskeletal Health and Outcomes Research, St. Michael's Hospital; Institute for Work and Health; Department of Occupational Science and Occupational Therapy, Rehabilitation Sciences Institute and the Institute for Health Policy Management and Evaluation, University of Toronto, Toronto, Ontario, Canada; Centre for Health Policy, Melbourne School of Population and Global Health, University of Melbourne, Melbourne; Sydney Medical School, Institute of Bone and Joint Research and Department of Rheumatology, Royal North Shore Hospital, St. Leonards, Australia; Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds and UK National Institute for Health Research (NIHR) Leeds Musculoskeletal Biomedical Research Unit, Leeds, UK; Hôpital Ambroise Paré, Rheumatology Department, Boulogne-Billancourt; INSERM U1173, Laboratoire d'Excellence INFLAMEX, UFR Simone Veil, Versailles-Saint-Quentin University, Montigny-le-Bretonneux; Sorbonne Universités, UPMC Univ Paris 06; AP-HP, Pitié Salpêtrière Hospital, Department of Rheumatology, Paris, France; Department of Medical Humanities, VU University Medical Centre/EMGO+ Institute, Amsterdam, the Netherlands.,IDG is a recipient of a Canadian Institutes of Health Research (CIHR) Foundation Grant Scheme (RFN #143237), focused on understanding the process and effect of integrated knowledge translation. COB has received funding from a Eugene Washington Engagement Award (EIAN 1988) from the Patient Centered Outcomes Research Institute (PCORI). All statements and views expressed in this report, including its findings and conclusions, are solely those of the authors and do not necessarily represent the views of PCORI, its board of governors, or methodology committee; or the UK National Health Service, the NIHR, or the Department of Health; or the position or policy of the US Department of Veterans Affairs or the US government. PGC is funded in part by the NIHR Leeds Musculoskeletal Biomedical Research Unit. This article presents independent research funded by the NIHR. JAS has received research grants from Takeda and Savient, and consultant fees from Takeda and the American College of Rheumatology. JAS serves as the principal investigator for an investigator-initiated study funded by Horizon pharmaceuticals through a grant to DINORA Inc., a 501 (c)(3) entity.,S.R. Tunis, MD, MSc, President and CEO, Center for Medical Technology Policy; L.J. Maxwell, PhD, Cochrane Musculoskeletal, University of Ottawa and Centre for Practice-Changing Research, Ottawa Hospital Research Institute; I.D. Graham, PhD, School of Epidemiology, Public Health and Preventive Medicine, Faculty of Medicine, University of Ottawa, and Ottawa Hospital Research Institute, Clinical Epidemiology Program; B.J. Shea, PhD, School of Epidemiology, Public Health and Preventive Medicine, Faculty of Medicine, University of Ottawa, and Ottawa Hospital Research Institute, Clinical Epidemiology Program; D.E. Beaton, BScOT, PhD, Musculoskeletal Health and Outcomes Research, St. Michael's Hospital, and Institute for Work and Health, and Department of Occupational Science and Occupational Therapy, Rehabilitation Sciences Institute and the Institute for Health Policy Management and Evaluation, University of Toronto; C.O. Bingham III, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University; P. Brooks, MD, FRACP, Centre for Health Policy, Melbourne School of Population and Global Health, University of Melbourne; P.G. Conaghan, MD, PhD, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds and NIHR Leeds Musculoskeletal Biomedical Research Unit; M.A. D'Agostino, MD, PhD, APHP, Hôpital Ambroise Paré, Rheumatology Department, and INSERM U1173, Laboratoire d'Excellence INFLAMEX, UFR Simone Veil, Versailles-Saint-Quentin University; M.P. de Wit, PhD, Patient Research Partner, Department of Medical Humanities, VU University Medical Centre/EMGO+ Institute; L. Gossec, MD, PhD, Sorbonne Universités, UPMC Univ Paris 06, and AP-HP, Pitié Salpêtrière Hospital, Department of Rheumatology; L.M. March, MBBS, PhD, Liggins Professor of Rheumatology and Musculoskeletal Epidemiology, Sydney Medical School, Institute of Bone and Joint Research and Department of Rheumatology, Royal North Shore Hospital; L.S. Simon, MD, Co-managing Director of SDG LLC; J.A. Singh, MD, MPH, Professor of Medicine and Epidemiology, University of Alabama at Birmingham, and Staff Physician, Birmingham Veterans Affairs Medical Center; V. Strand, MD, Adjunct Clinical Professor, Division of Immunology/Rheumatology, Stanford University School of Medicine; G.A. Wells, MSc, PhD, Director, Cardiovascular Research Methods Centre, University of Ottawa Heart Institute, and Professor, Department of Epidemiology and Community Medicine, University of Ottawa; P. Tugwell, MD, MSc, Department of Medicine, Faculty of Medicine, University of Ottawa, and Ottawa Hospital Research Institute, Clinical Epidemiology Program, and School of Epidemiology, Public Health and Preventive Medicine, Faculty of Medicine, University of Ottawa
| | - Beverley J Shea
- From the Center for Medical Technology Policy; Division of Rheumatology, Department of Medicine, Johns Hopkins University, Baltimore, Maryland; University of Alabama at Birmingham and Birmingham Veterans Affairs Medical Center, Birmingham, Alabama; SDG LLC, Cambridge, Massachusetts; Division of Immunology/Rheumatology, Stanford University School of Medicine, Palo Alto, California, USA; Centre for Practice-Changing Research, Ottawa Hospital Research Institute; Ottawa Hospital Research Institute, Clinical Epidemiology Program; School of Epidemiology, Public Health and Preventive Medicine, Faculty of Medicine, University of Ottawa; Cardiovascular Research Methods Centre, University of Ottawa Heart Institute; Department of Epidemiology and Community Medicine, University of Ottawa; Department of Medicine, Faculty of Medicine, University of Ottawa; Cochrane Musculoskeletal, University of Ottawa, Ottawa; Musculoskeletal Health and Outcomes Research, St. Michael's Hospital; Institute for Work and Health; Department of Occupational Science and Occupational Therapy, Rehabilitation Sciences Institute and the Institute for Health Policy Management and Evaluation, University of Toronto, Toronto, Ontario, Canada; Centre for Health Policy, Melbourne School of Population and Global Health, University of Melbourne, Melbourne; Sydney Medical School, Institute of Bone and Joint Research and Department of Rheumatology, Royal North Shore Hospital, St. Leonards, Australia; Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds and UK National Institute for Health Research (NIHR) Leeds Musculoskeletal Biomedical Research Unit, Leeds, UK; Hôpital Ambroise Paré, Rheumatology Department, Boulogne-Billancourt; INSERM U1173, Laboratoire d'Excellence INFLAMEX, UFR Simone Veil, Versailles-Saint-Quentin University, Montigny-le-Bretonneux; Sorbonne Universités, UPMC Univ Paris 06; AP-HP, Pitié Salpêtrière Hospital, Department of Rheumatology, Paris, France; Department of Medical Humanities, VU University Medical Centre/EMGO+ Institute, Amsterdam, the Netherlands.,IDG is a recipient of a Canadian Institutes of Health Research (CIHR) Foundation Grant Scheme (RFN #143237), focused on understanding the process and effect of integrated knowledge translation. COB has received funding from a Eugene Washington Engagement Award (EIAN 1988) from the Patient Centered Outcomes Research Institute (PCORI). All statements and views expressed in this report, including its findings and conclusions, are solely those of the authors and do not necessarily represent the views of PCORI, its board of governors, or methodology committee; or the UK National Health Service, the NIHR, or the Department of Health; or the position or policy of the US Department of Veterans Affairs or the US government. PGC is funded in part by the NIHR Leeds Musculoskeletal Biomedical Research Unit. This article presents independent research funded by the NIHR. JAS has received research grants from Takeda and Savient, and consultant fees from Takeda and the American College of Rheumatology. JAS serves as the principal investigator for an investigator-initiated study funded by Horizon pharmaceuticals through a grant to DINORA Inc., a 501 (c)(3) entity.,S.R. Tunis, MD, MSc, President and CEO, Center for Medical Technology Policy; L.J. Maxwell, PhD, Cochrane Musculoskeletal, University of Ottawa and Centre for Practice-Changing Research, Ottawa Hospital Research Institute; I.D. Graham, PhD, School of Epidemiology, Public Health and Preventive Medicine, Faculty of Medicine, University of Ottawa, and Ottawa Hospital Research Institute, Clinical Epidemiology Program; B.J. Shea, PhD, School of Epidemiology, Public Health and Preventive Medicine, Faculty of Medicine, University of Ottawa, and Ottawa Hospital Research Institute, Clinical Epidemiology Program; D.E. Beaton, BScOT, PhD, Musculoskeletal Health and Outcomes Research, St. Michael's Hospital, and Institute for Work and Health, and Department of Occupational Science and Occupational Therapy, Rehabilitation Sciences Institute and the Institute for Health Policy Management and Evaluation, University of Toronto; C.O. Bingham III, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University; P. Brooks, MD, FRACP, Centre for Health Policy, Melbourne School of Population and Global Health, University of Melbourne; P.G. Conaghan, MD, PhD, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds and NIHR Leeds Musculoskeletal Biomedical Research Unit; M.A. D'Agostino, MD, PhD, APHP, Hôpital Ambroise Paré, Rheumatology Department, and INSERM U1173, Laboratoire d'Excellence INFLAMEX, UFR Simone Veil, Versailles-Saint-Quentin University; M.P. de Wit, PhD, Patient Research Partner, Department of Medical Humanities, VU University Medical Centre/EMGO+ Institute; L. Gossec, MD, PhD, Sorbonne Universités, UPMC Univ Paris 06, and AP-HP, Pitié Salpêtrière Hospital, Department of Rheumatology; L.M. March, MBBS, PhD, Liggins Professor of Rheumatology and Musculoskeletal Epidemiology, Sydney Medical School, Institute of Bone and Joint Research and Department of Rheumatology, Royal North Shore Hospital; L.S. Simon, MD, Co-managing Director of SDG LLC; J.A. Singh, MD, MPH, Professor of Medicine and Epidemiology, University of Alabama at Birmingham, and Staff Physician, Birmingham Veterans Affairs Medical Center; V. Strand, MD, Adjunct Clinical Professor, Division of Immunology/Rheumatology, Stanford University School of Medicine; G.A. Wells, MSc, PhD, Director, Cardiovascular Research Methods Centre, University of Ottawa Heart Institute, and Professor, Department of Epidemiology and Community Medicine, University of Ottawa; P. Tugwell, MD, MSc, Department of Medicine, Faculty of Medicine, University of Ottawa, and Ottawa Hospital Research Institute, Clinical Epidemiology Program, and School of Epidemiology, Public Health and Preventive Medicine, Faculty of Medicine, University of Ottawa
| | - Dorcas E Beaton
- From the Center for Medical Technology Policy; Division of Rheumatology, Department of Medicine, Johns Hopkins University, Baltimore, Maryland; University of Alabama at Birmingham and Birmingham Veterans Affairs Medical Center, Birmingham, Alabama; SDG LLC, Cambridge, Massachusetts; Division of Immunology/Rheumatology, Stanford University School of Medicine, Palo Alto, California, USA; Centre for Practice-Changing Research, Ottawa Hospital Research Institute; Ottawa Hospital Research Institute, Clinical Epidemiology Program; School of Epidemiology, Public Health and Preventive Medicine, Faculty of Medicine, University of Ottawa; Cardiovascular Research Methods Centre, University of Ottawa Heart Institute; Department of Epidemiology and Community Medicine, University of Ottawa; Department of Medicine, Faculty of Medicine, University of Ottawa; Cochrane Musculoskeletal, University of Ottawa, Ottawa; Musculoskeletal Health and Outcomes Research, St. Michael's Hospital; Institute for Work and Health; Department of Occupational Science and Occupational Therapy, Rehabilitation Sciences Institute and the Institute for Health Policy Management and Evaluation, University of Toronto, Toronto, Ontario, Canada; Centre for Health Policy, Melbourne School of Population and Global Health, University of Melbourne, Melbourne; Sydney Medical School, Institute of Bone and Joint Research and Department of Rheumatology, Royal North Shore Hospital, St. Leonards, Australia; Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds and UK National Institute for Health Research (NIHR) Leeds Musculoskeletal Biomedical Research Unit, Leeds, UK; Hôpital Ambroise Paré, Rheumatology Department, Boulogne-Billancourt; INSERM U1173, Laboratoire d'Excellence INFLAMEX, UFR Simone Veil, Versailles-Saint-Quentin University, Montigny-le-Bretonneux; Sorbonne Universités, UPMC Univ Paris 06; AP-HP, Pitié Salpêtrière Hospital, Department of Rheumatology, Paris, France; Department of Medical Humanities, VU University Medical Centre/EMGO+ Institute, Amsterdam, the Netherlands.,IDG is a recipient of a Canadian Institutes of Health Research (CIHR) Foundation Grant Scheme (RFN #143237), focused on understanding the process and effect of integrated knowledge translation. COB has received funding from a Eugene Washington Engagement Award (EIAN 1988) from the Patient Centered Outcomes Research Institute (PCORI). All statements and views expressed in this report, including its findings and conclusions, are solely those of the authors and do not necessarily represent the views of PCORI, its board of governors, or methodology committee; or the UK National Health Service, the NIHR, or the Department of Health; or the position or policy of the US Department of Veterans Affairs or the US government. PGC is funded in part by the NIHR Leeds Musculoskeletal Biomedical Research Unit. This article presents independent research funded by the NIHR. JAS has received research grants from Takeda and Savient, and consultant fees from Takeda and the American College of Rheumatology. JAS serves as the principal investigator for an investigator-initiated study funded by Horizon pharmaceuticals through a grant to DINORA Inc., a 501 (c)(3) entity.,S.R. Tunis, MD, MSc, President and CEO, Center for Medical Technology Policy; L.J. Maxwell, PhD, Cochrane Musculoskeletal, University of Ottawa and Centre for Practice-Changing Research, Ottawa Hospital Research Institute; I.D. Graham, PhD, School of Epidemiology, Public Health and Preventive Medicine, Faculty of Medicine, University of Ottawa, and Ottawa Hospital Research Institute, Clinical Epidemiology Program; B.J. Shea, PhD, School of Epidemiology, Public Health and Preventive Medicine, Faculty of Medicine, University of Ottawa, and Ottawa Hospital Research Institute, Clinical Epidemiology Program; D.E. Beaton, BScOT, PhD, Musculoskeletal Health and Outcomes Research, St. Michael's Hospital, and Institute for Work and Health, and Department of Occupational Science and Occupational Therapy, Rehabilitation Sciences Institute and the Institute for Health Policy Management and Evaluation, University of Toronto; C.O. Bingham III, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University; P. Brooks, MD, FRACP, Centre for Health Policy, Melbourne School of Population and Global Health, University of Melbourne; P.G. Conaghan, MD, PhD, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds and NIHR Leeds Musculoskeletal Biomedical Research Unit; M.A. D'Agostino, MD, PhD, APHP, Hôpital Ambroise Paré, Rheumatology Department, and INSERM U1173, Laboratoire d'Excellence INFLAMEX, UFR Simone Veil, Versailles-Saint-Quentin University; M.P. de Wit, PhD, Patient Research Partner, Department of Medical Humanities, VU University Medical Centre/EMGO+ Institute; L. Gossec, MD, PhD, Sorbonne Universités, UPMC Univ Paris 06, and AP-HP, Pitié Salpêtrière Hospital, Department of Rheumatology; L.M. March, MBBS, PhD, Liggins Professor of Rheumatology and Musculoskeletal Epidemiology, Sydney Medical School, Institute of Bone and Joint Research and Department of Rheumatology, Royal North Shore Hospital; L.S. Simon, MD, Co-managing Director of SDG LLC; J.A. Singh, MD, MPH, Professor of Medicine and Epidemiology, University of Alabama at Birmingham, and Staff Physician, Birmingham Veterans Affairs Medical Center; V. Strand, MD, Adjunct Clinical Professor, Division of Immunology/Rheumatology, Stanford University School of Medicine; G.A. Wells, MSc, PhD, Director, Cardiovascular Research Methods Centre, University of Ottawa Heart Institute, and Professor, Department of Epidemiology and Community Medicine, University of Ottawa; P. Tugwell, MD, MSc, Department of Medicine, Faculty of Medicine, University of Ottawa, and Ottawa Hospital Research Institute, Clinical Epidemiology Program, and School of Epidemiology, Public Health and Preventive Medicine, Faculty of Medicine, University of Ottawa
| | - Clifton O Bingham
- From the Center for Medical Technology Policy; Division of Rheumatology, Department of Medicine, Johns Hopkins University, Baltimore, Maryland; University of Alabama at Birmingham and Birmingham Veterans Affairs Medical Center, Birmingham, Alabama; SDG LLC, Cambridge, Massachusetts; Division of Immunology/Rheumatology, Stanford University School of Medicine, Palo Alto, California, USA; Centre for Practice-Changing Research, Ottawa Hospital Research Institute; Ottawa Hospital Research Institute, Clinical Epidemiology Program; School of Epidemiology, Public Health and Preventive Medicine, Faculty of Medicine, University of Ottawa; Cardiovascular Research Methods Centre, University of Ottawa Heart Institute; Department of Epidemiology and Community Medicine, University of Ottawa; Department of Medicine, Faculty of Medicine, University of Ottawa; Cochrane Musculoskeletal, University of Ottawa, Ottawa; Musculoskeletal Health and Outcomes Research, St. Michael's Hospital; Institute for Work and Health; Department of Occupational Science and Occupational Therapy, Rehabilitation Sciences Institute and the Institute for Health Policy Management and Evaluation, University of Toronto, Toronto, Ontario, Canada; Centre for Health Policy, Melbourne School of Population and Global Health, University of Melbourne, Melbourne; Sydney Medical School, Institute of Bone and Joint Research and Department of Rheumatology, Royal North Shore Hospital, St. Leonards, Australia; Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds and UK National Institute for Health Research (NIHR) Leeds Musculoskeletal Biomedical Research Unit, Leeds, UK; Hôpital Ambroise Paré, Rheumatology Department, Boulogne-Billancourt; INSERM U1173, Laboratoire d'Excellence INFLAMEX, UFR Simone Veil, Versailles-Saint-Quentin University, Montigny-le-Bretonneux; Sorbonne Universités, UPMC Univ Paris 06; AP-HP, Pitié Salpêtrière Hospital, Department of Rheumatology, Paris, France; Department of Medical Humanities, VU University Medical Centre/EMGO+ Institute, Amsterdam, the Netherlands.,IDG is a recipient of a Canadian Institutes of Health Research (CIHR) Foundation Grant Scheme (RFN #143237), focused on understanding the process and effect of integrated knowledge translation. COB has received funding from a Eugene Washington Engagement Award (EIAN 1988) from the Patient Centered Outcomes Research Institute (PCORI). All statements and views expressed in this report, including its findings and conclusions, are solely those of the authors and do not necessarily represent the views of PCORI, its board of governors, or methodology committee; or the UK National Health Service, the NIHR, or the Department of Health; or the position or policy of the US Department of Veterans Affairs or the US government. PGC is funded in part by the NIHR Leeds Musculoskeletal Biomedical Research Unit. This article presents independent research funded by the NIHR. JAS has received research grants from Takeda and Savient, and consultant fees from Takeda and the American College of Rheumatology. JAS serves as the principal investigator for an investigator-initiated study funded by Horizon pharmaceuticals through a grant to DINORA Inc., a 501 (c)(3) entity.,S.R. Tunis, MD, MSc, President and CEO, Center for Medical Technology Policy; L.J. Maxwell, PhD, Cochrane Musculoskeletal, University of Ottawa and Centre for Practice-Changing Research, Ottawa Hospital Research Institute; I.D. Graham, PhD, School of Epidemiology, Public Health and Preventive Medicine, Faculty of Medicine, University of Ottawa, and Ottawa Hospital Research Institute, Clinical Epidemiology Program; B.J. Shea, PhD, School of Epidemiology, Public Health and Preventive Medicine, Faculty of Medicine, University of Ottawa, and Ottawa Hospital Research Institute, Clinical Epidemiology Program; D.E. Beaton, BScOT, PhD, Musculoskeletal Health and Outcomes Research, St. Michael's Hospital, and Institute for Work and Health, and Department of Occupational Science and Occupational Therapy, Rehabilitation Sciences Institute and the Institute for Health Policy Management and Evaluation, University of Toronto; C.O. Bingham III, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University; P. Brooks, MD, FRACP, Centre for Health Policy, Melbourne School of Population and Global Health, University of Melbourne; P.G. Conaghan, MD, PhD, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds and NIHR Leeds Musculoskeletal Biomedical Research Unit; M.A. D'Agostino, MD, PhD, APHP, Hôpital Ambroise Paré, Rheumatology Department, and INSERM U1173, Laboratoire d'Excellence INFLAMEX, UFR Simone Veil, Versailles-Saint-Quentin University; M.P. de Wit, PhD, Patient Research Partner, Department of Medical Humanities, VU University Medical Centre/EMGO+ Institute; L. Gossec, MD, PhD, Sorbonne Universités, UPMC Univ Paris 06, and AP-HP, Pitié Salpêtrière Hospital, Department of Rheumatology; L.M. March, MBBS, PhD, Liggins Professor of Rheumatology and Musculoskeletal Epidemiology, Sydney Medical School, Institute of Bone and Joint Research and Department of Rheumatology, Royal North Shore Hospital; L.S. Simon, MD, Co-managing Director of SDG LLC; J.A. Singh, MD, MPH, Professor of Medicine and Epidemiology, University of Alabama at Birmingham, and Staff Physician, Birmingham Veterans Affairs Medical Center; V. Strand, MD, Adjunct Clinical Professor, Division of Immunology/Rheumatology, Stanford University School of Medicine; G.A. Wells, MSc, PhD, Director, Cardiovascular Research Methods Centre, University of Ottawa Heart Institute, and Professor, Department of Epidemiology and Community Medicine, University of Ottawa; P. Tugwell, MD, MSc, Department of Medicine, Faculty of Medicine, University of Ottawa, and Ottawa Hospital Research Institute, Clinical Epidemiology Program, and School of Epidemiology, Public Health and Preventive Medicine, Faculty of Medicine, University of Ottawa
| | - Peter Brooks
- From the Center for Medical Technology Policy; Division of Rheumatology, Department of Medicine, Johns Hopkins University, Baltimore, Maryland; University of Alabama at Birmingham and Birmingham Veterans Affairs Medical Center, Birmingham, Alabama; SDG LLC, Cambridge, Massachusetts; Division of Immunology/Rheumatology, Stanford University School of Medicine, Palo Alto, California, USA; Centre for Practice-Changing Research, Ottawa Hospital Research Institute; Ottawa Hospital Research Institute, Clinical Epidemiology Program; School of Epidemiology, Public Health and Preventive Medicine, Faculty of Medicine, University of Ottawa; Cardiovascular Research Methods Centre, University of Ottawa Heart Institute; Department of Epidemiology and Community Medicine, University of Ottawa; Department of Medicine, Faculty of Medicine, University of Ottawa; Cochrane Musculoskeletal, University of Ottawa, Ottawa; Musculoskeletal Health and Outcomes Research, St. Michael's Hospital; Institute for Work and Health; Department of Occupational Science and Occupational Therapy, Rehabilitation Sciences Institute and the Institute for Health Policy Management and Evaluation, University of Toronto, Toronto, Ontario, Canada; Centre for Health Policy, Melbourne School of Population and Global Health, University of Melbourne, Melbourne; Sydney Medical School, Institute of Bone and Joint Research and Department of Rheumatology, Royal North Shore Hospital, St. Leonards, Australia; Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds and UK National Institute for Health Research (NIHR) Leeds Musculoskeletal Biomedical Research Unit, Leeds, UK; Hôpital Ambroise Paré, Rheumatology Department, Boulogne-Billancourt; INSERM U1173, Laboratoire d'Excellence INFLAMEX, UFR Simone Veil, Versailles-Saint-Quentin University, Montigny-le-Bretonneux; Sorbonne Universités, UPMC Univ Paris 06; AP-HP, Pitié Salpêtrière Hospital, Department of Rheumatology, Paris, France; Department of Medical Humanities, VU University Medical Centre/EMGO+ Institute, Amsterdam, the Netherlands.,IDG is a recipient of a Canadian Institutes of Health Research (CIHR) Foundation Grant Scheme (RFN #143237), focused on understanding the process and effect of integrated knowledge translation. COB has received funding from a Eugene Washington Engagement Award (EIAN 1988) from the Patient Centered Outcomes Research Institute (PCORI). All statements and views expressed in this report, including its findings and conclusions, are solely those of the authors and do not necessarily represent the views of PCORI, its board of governors, or methodology committee; or the UK National Health Service, the NIHR, or the Department of Health; or the position or policy of the US Department of Veterans Affairs or the US government. PGC is funded in part by the NIHR Leeds Musculoskeletal Biomedical Research Unit. This article presents independent research funded by the NIHR. JAS has received research grants from Takeda and Savient, and consultant fees from Takeda and the American College of Rheumatology. JAS serves as the principal investigator for an investigator-initiated study funded by Horizon pharmaceuticals through a grant to DINORA Inc., a 501 (c)(3) entity.,S.R. Tunis, MD, MSc, President and CEO, Center for Medical Technology Policy; L.J. Maxwell, PhD, Cochrane Musculoskeletal, University of Ottawa and Centre for Practice-Changing Research, Ottawa Hospital Research Institute; I.D. Graham, PhD, School of Epidemiology, Public Health and Preventive Medicine, Faculty of Medicine, University of Ottawa, and Ottawa Hospital Research Institute, Clinical Epidemiology Program; B.J. Shea, PhD, School of Epidemiology, Public Health and Preventive Medicine, Faculty of Medicine, University of Ottawa, and Ottawa Hospital Research Institute, Clinical Epidemiology Program; D.E. Beaton, BScOT, PhD, Musculoskeletal Health and Outcomes Research, St. Michael's Hospital, and Institute for Work and Health, and Department of Occupational Science and Occupational Therapy, Rehabilitation Sciences Institute and the Institute for Health Policy Management and Evaluation, University of Toronto; C.O. Bingham III, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University; P. Brooks, MD, FRACP, Centre for Health Policy, Melbourne School of Population and Global Health, University of Melbourne; P.G. Conaghan, MD, PhD, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds and NIHR Leeds Musculoskeletal Biomedical Research Unit; M.A. D'Agostino, MD, PhD, APHP, Hôpital Ambroise Paré, Rheumatology Department, and INSERM U1173, Laboratoire d'Excellence INFLAMEX, UFR Simone Veil, Versailles-Saint-Quentin University; M.P. de Wit, PhD, Patient Research Partner, Department of Medical Humanities, VU University Medical Centre/EMGO+ Institute; L. Gossec, MD, PhD, Sorbonne Universités, UPMC Univ Paris 06, and AP-HP, Pitié Salpêtrière Hospital, Department of Rheumatology; L.M. March, MBBS, PhD, Liggins Professor of Rheumatology and Musculoskeletal Epidemiology, Sydney Medical School, Institute of Bone and Joint Research and Department of Rheumatology, Royal North Shore Hospital; L.S. Simon, MD, Co-managing Director of SDG LLC; J.A. Singh, MD, MPH, Professor of Medicine and Epidemiology, University of Alabama at Birmingham, and Staff Physician, Birmingham Veterans Affairs Medical Center; V. Strand, MD, Adjunct Clinical Professor, Division of Immunology/Rheumatology, Stanford University School of Medicine; G.A. Wells, MSc, PhD, Director, Cardiovascular Research Methods Centre, University of Ottawa Heart Institute, and Professor, Department of Epidemiology and Community Medicine, University of Ottawa; P. Tugwell, MD, MSc, Department of Medicine, Faculty of Medicine, University of Ottawa, and Ottawa Hospital Research Institute, Clinical Epidemiology Program, and School of Epidemiology, Public Health and Preventive Medicine, Faculty of Medicine, University of Ottawa
| | - Philip G Conaghan
- From the Center for Medical Technology Policy; Division of Rheumatology, Department of Medicine, Johns Hopkins University, Baltimore, Maryland; University of Alabama at Birmingham and Birmingham Veterans Affairs Medical Center, Birmingham, Alabama; SDG LLC, Cambridge, Massachusetts; Division of Immunology/Rheumatology, Stanford University School of Medicine, Palo Alto, California, USA; Centre for Practice-Changing Research, Ottawa Hospital Research Institute; Ottawa Hospital Research Institute, Clinical Epidemiology Program; School of Epidemiology, Public Health and Preventive Medicine, Faculty of Medicine, University of Ottawa; Cardiovascular Research Methods Centre, University of Ottawa Heart Institute; Department of Epidemiology and Community Medicine, University of Ottawa; Department of Medicine, Faculty of Medicine, University of Ottawa; Cochrane Musculoskeletal, University of Ottawa, Ottawa; Musculoskeletal Health and Outcomes Research, St. Michael's Hospital; Institute for Work and Health; Department of Occupational Science and Occupational Therapy, Rehabilitation Sciences Institute and the Institute for Health Policy Management and Evaluation, University of Toronto, Toronto, Ontario, Canada; Centre for Health Policy, Melbourne School of Population and Global Health, University of Melbourne, Melbourne; Sydney Medical School, Institute of Bone and Joint Research and Department of Rheumatology, Royal North Shore Hospital, St. Leonards, Australia; Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds and UK National Institute for Health Research (NIHR) Leeds Musculoskeletal Biomedical Research Unit, Leeds, UK; Hôpital Ambroise Paré, Rheumatology Department, Boulogne-Billancourt; INSERM U1173, Laboratoire d'Excellence INFLAMEX, UFR Simone Veil, Versailles-Saint-Quentin University, Montigny-le-Bretonneux; Sorbonne Universités, UPMC Univ Paris 06; AP-HP, Pitié Salpêtrière Hospital, Department of Rheumatology, Paris, France; Department of Medical Humanities, VU University Medical Centre/EMGO+ Institute, Amsterdam, the Netherlands.,IDG is a recipient of a Canadian Institutes of Health Research (CIHR) Foundation Grant Scheme (RFN #143237), focused on understanding the process and effect of integrated knowledge translation. COB has received funding from a Eugene Washington Engagement Award (EIAN 1988) from the Patient Centered Outcomes Research Institute (PCORI). All statements and views expressed in this report, including its findings and conclusions, are solely those of the authors and do not necessarily represent the views of PCORI, its board of governors, or methodology committee; or the UK National Health Service, the NIHR, or the Department of Health; or the position or policy of the US Department of Veterans Affairs or the US government. PGC is funded in part by the NIHR Leeds Musculoskeletal Biomedical Research Unit. This article presents independent research funded by the NIHR. JAS has received research grants from Takeda and Savient, and consultant fees from Takeda and the American College of Rheumatology. JAS serves as the principal investigator for an investigator-initiated study funded by Horizon pharmaceuticals through a grant to DINORA Inc., a 501 (c)(3) entity.,S.R. Tunis, MD, MSc, President and CEO, Center for Medical Technology Policy; L.J. Maxwell, PhD, Cochrane Musculoskeletal, University of Ottawa and Centre for Practice-Changing Research, Ottawa Hospital Research Institute; I.D. Graham, PhD, School of Epidemiology, Public Health and Preventive Medicine, Faculty of Medicine, University of Ottawa, and Ottawa Hospital Research Institute, Clinical Epidemiology Program; B.J. Shea, PhD, School of Epidemiology, Public Health and Preventive Medicine, Faculty of Medicine, University of Ottawa, and Ottawa Hospital Research Institute, Clinical Epidemiology Program; D.E. Beaton, BScOT, PhD, Musculoskeletal Health and Outcomes Research, St. Michael's Hospital, and Institute for Work and Health, and Department of Occupational Science and Occupational Therapy, Rehabilitation Sciences Institute and the Institute for Health Policy Management and Evaluation, University of Toronto; C.O. Bingham III, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University; P. Brooks, MD, FRACP, Centre for Health Policy, Melbourne School of Population and Global Health, University of Melbourne; P.G. Conaghan, MD, PhD, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds and NIHR Leeds Musculoskeletal Biomedical Research Unit; M.A. D'Agostino, MD, PhD, APHP, Hôpital Ambroise Paré, Rheumatology Department, and INSERM U1173, Laboratoire d'Excellence INFLAMEX, UFR Simone Veil, Versailles-Saint-Quentin University; M.P. de Wit, PhD, Patient Research Partner, Department of Medical Humanities, VU University Medical Centre/EMGO+ Institute; L. Gossec, MD, PhD, Sorbonne Universités, UPMC Univ Paris 06, and AP-HP, Pitié Salpêtrière Hospital, Department of Rheumatology; L.M. March, MBBS, PhD, Liggins Professor of Rheumatology and Musculoskeletal Epidemiology, Sydney Medical School, Institute of Bone and Joint Research and Department of Rheumatology, Royal North Shore Hospital; L.S. Simon, MD, Co-managing Director of SDG LLC; J.A. Singh, MD, MPH, Professor of Medicine and Epidemiology, University of Alabama at Birmingham, and Staff Physician, Birmingham Veterans Affairs Medical Center; V. Strand, MD, Adjunct Clinical Professor, Division of Immunology/Rheumatology, Stanford University School of Medicine; G.A. Wells, MSc, PhD, Director, Cardiovascular Research Methods Centre, University of Ottawa Heart Institute, and Professor, Department of Epidemiology and Community Medicine, University of Ottawa; P. Tugwell, MD, MSc, Department of Medicine, Faculty of Medicine, University of Ottawa, and Ottawa Hospital Research Institute, Clinical Epidemiology Program, and School of Epidemiology, Public Health and Preventive Medicine, Faculty of Medicine, University of Ottawa
| | - Maria Antonietta D'Agostino
- From the Center for Medical Technology Policy; Division of Rheumatology, Department of Medicine, Johns Hopkins University, Baltimore, Maryland; University of Alabama at Birmingham and Birmingham Veterans Affairs Medical Center, Birmingham, Alabama; SDG LLC, Cambridge, Massachusetts; Division of Immunology/Rheumatology, Stanford University School of Medicine, Palo Alto, California, USA; Centre for Practice-Changing Research, Ottawa Hospital Research Institute; Ottawa Hospital Research Institute, Clinical Epidemiology Program; School of Epidemiology, Public Health and Preventive Medicine, Faculty of Medicine, University of Ottawa; Cardiovascular Research Methods Centre, University of Ottawa Heart Institute; Department of Epidemiology and Community Medicine, University of Ottawa; Department of Medicine, Faculty of Medicine, University of Ottawa; Cochrane Musculoskeletal, University of Ottawa, Ottawa; Musculoskeletal Health and Outcomes Research, St. Michael's Hospital; Institute for Work and Health; Department of Occupational Science and Occupational Therapy, Rehabilitation Sciences Institute and the Institute for Health Policy Management and Evaluation, University of Toronto, Toronto, Ontario, Canada; Centre for Health Policy, Melbourne School of Population and Global Health, University of Melbourne, Melbourne; Sydney Medical School, Institute of Bone and Joint Research and Department of Rheumatology, Royal North Shore Hospital, St. Leonards, Australia; Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds and UK National Institute for Health Research (NIHR) Leeds Musculoskeletal Biomedical Research Unit, Leeds, UK; Hôpital Ambroise Paré, Rheumatology Department, Boulogne-Billancourt; INSERM U1173, Laboratoire d'Excellence INFLAMEX, UFR Simone Veil, Versailles-Saint-Quentin University, Montigny-le-Bretonneux; Sorbonne Universités, UPMC Univ Paris 06; AP-HP, Pitié Salpêtrière Hospital, Department of Rheumatology, Paris, France; Department of Medical Humanities, VU University Medical Centre/EMGO+ Institute, Amsterdam, the Netherlands.,IDG is a recipient of a Canadian Institutes of Health Research (CIHR) Foundation Grant Scheme (RFN #143237), focused on understanding the process and effect of integrated knowledge translation. COB has received funding from a Eugene Washington Engagement Award (EIAN 1988) from the Patient Centered Outcomes Research Institute (PCORI). All statements and views expressed in this report, including its findings and conclusions, are solely those of the authors and do not necessarily represent the views of PCORI, its board of governors, or methodology committee; or the UK National Health Service, the NIHR, or the Department of Health; or the position or policy of the US Department of Veterans Affairs or the US government. PGC is funded in part by the NIHR Leeds Musculoskeletal Biomedical Research Unit. This article presents independent research funded by the NIHR. JAS has received research grants from Takeda and Savient, and consultant fees from Takeda and the American College of Rheumatology. JAS serves as the principal investigator for an investigator-initiated study funded by Horizon pharmaceuticals through a grant to DINORA Inc., a 501 (c)(3) entity.,S.R. Tunis, MD, MSc, President and CEO, Center for Medical Technology Policy; L.J. Maxwell, PhD, Cochrane Musculoskeletal, University of Ottawa and Centre for Practice-Changing Research, Ottawa Hospital Research Institute; I.D. Graham, PhD, School of Epidemiology, Public Health and Preventive Medicine, Faculty of Medicine, University of Ottawa, and Ottawa Hospital Research Institute, Clinical Epidemiology Program; B.J. Shea, PhD, School of Epidemiology, Public Health and Preventive Medicine, Faculty of Medicine, University of Ottawa, and Ottawa Hospital Research Institute, Clinical Epidemiology Program; D.E. Beaton, BScOT, PhD, Musculoskeletal Health and Outcomes Research, St. Michael's Hospital, and Institute for Work and Health, and Department of Occupational Science and Occupational Therapy, Rehabilitation Sciences Institute and the Institute for Health Policy Management and Evaluation, University of Toronto; C.O. Bingham III, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University; P. Brooks, MD, FRACP, Centre for Health Policy, Melbourne School of Population and Global Health, University of Melbourne; P.G. Conaghan, MD, PhD, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds and NIHR Leeds Musculoskeletal Biomedical Research Unit; M.A. D'Agostino, MD, PhD, APHP, Hôpital Ambroise Paré, Rheumatology Department, and INSERM U1173, Laboratoire d'Excellence INFLAMEX, UFR Simone Veil, Versailles-Saint-Quentin University; M.P. de Wit, PhD, Patient Research Partner, Department of Medical Humanities, VU University Medical Centre/EMGO+ Institute; L. Gossec, MD, PhD, Sorbonne Universités, UPMC Univ Paris 06, and AP-HP, Pitié Salpêtrière Hospital, Department of Rheumatology; L.M. March, MBBS, PhD, Liggins Professor of Rheumatology and Musculoskeletal Epidemiology, Sydney Medical School, Institute of Bone and Joint Research and Department of Rheumatology, Royal North Shore Hospital; L.S. Simon, MD, Co-managing Director of SDG LLC; J.A. Singh, MD, MPH, Professor of Medicine and Epidemiology, University of Alabama at Birmingham, and Staff Physician, Birmingham Veterans Affairs Medical Center; V. Strand, MD, Adjunct Clinical Professor, Division of Immunology/Rheumatology, Stanford University School of Medicine; G.A. Wells, MSc, PhD, Director, Cardiovascular Research Methods Centre, University of Ottawa Heart Institute, and Professor, Department of Epidemiology and Community Medicine, University of Ottawa; P. Tugwell, MD, MSc, Department of Medicine, Faculty of Medicine, University of Ottawa, and Ottawa Hospital Research Institute, Clinical Epidemiology Program, and School of Epidemiology, Public Health and Preventive Medicine, Faculty of Medicine, University of Ottawa
| | - Maarten P de Wit
- From the Center for Medical Technology Policy; Division of Rheumatology, Department of Medicine, Johns Hopkins University, Baltimore, Maryland; University of Alabama at Birmingham and Birmingham Veterans Affairs Medical Center, Birmingham, Alabama; SDG LLC, Cambridge, Massachusetts; Division of Immunology/Rheumatology, Stanford University School of Medicine, Palo Alto, California, USA; Centre for Practice-Changing Research, Ottawa Hospital Research Institute; Ottawa Hospital Research Institute, Clinical Epidemiology Program; School of Epidemiology, Public Health and Preventive Medicine, Faculty of Medicine, University of Ottawa; Cardiovascular Research Methods Centre, University of Ottawa Heart Institute; Department of Epidemiology and Community Medicine, University of Ottawa; Department of Medicine, Faculty of Medicine, University of Ottawa; Cochrane Musculoskeletal, University of Ottawa, Ottawa; Musculoskeletal Health and Outcomes Research, St. Michael's Hospital; Institute for Work and Health; Department of Occupational Science and Occupational Therapy, Rehabilitation Sciences Institute and the Institute for Health Policy Management and Evaluation, University of Toronto, Toronto, Ontario, Canada; Centre for Health Policy, Melbourne School of Population and Global Health, University of Melbourne, Melbourne; Sydney Medical School, Institute of Bone and Joint Research and Department of Rheumatology, Royal North Shore Hospital, St. Leonards, Australia; Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds and UK National Institute for Health Research (NIHR) Leeds Musculoskeletal Biomedical Research Unit, Leeds, UK; Hôpital Ambroise Paré, Rheumatology Department, Boulogne-Billancourt; INSERM U1173, Laboratoire d'Excellence INFLAMEX, UFR Simone Veil, Versailles-Saint-Quentin University, Montigny-le-Bretonneux; Sorbonne Universités, UPMC Univ Paris 06; AP-HP, Pitié Salpêtrière Hospital, Department of Rheumatology, Paris, France; Department of Medical Humanities, VU University Medical Centre/EMGO+ Institute, Amsterdam, the Netherlands.,IDG is a recipient of a Canadian Institutes of Health Research (CIHR) Foundation Grant Scheme (RFN #143237), focused on understanding the process and effect of integrated knowledge translation. COB has received funding from a Eugene Washington Engagement Award (EIAN 1988) from the Patient Centered Outcomes Research Institute (PCORI). All statements and views expressed in this report, including its findings and conclusions, are solely those of the authors and do not necessarily represent the views of PCORI, its board of governors, or methodology committee; or the UK National Health Service, the NIHR, or the Department of Health; or the position or policy of the US Department of Veterans Affairs or the US government. PGC is funded in part by the NIHR Leeds Musculoskeletal Biomedical Research Unit. This article presents independent research funded by the NIHR. JAS has received research grants from Takeda and Savient, and consultant fees from Takeda and the American College of Rheumatology. JAS serves as the principal investigator for an investigator-initiated study funded by Horizon pharmaceuticals through a grant to DINORA Inc., a 501 (c)(3) entity.,S.R. Tunis, MD, MSc, President and CEO, Center for Medical Technology Policy; L.J. Maxwell, PhD, Cochrane Musculoskeletal, University of Ottawa and Centre for Practice-Changing Research, Ottawa Hospital Research Institute; I.D. Graham, PhD, School of Epidemiology, Public Health and Preventive Medicine, Faculty of Medicine, University of Ottawa, and Ottawa Hospital Research Institute, Clinical Epidemiology Program; B.J. Shea, PhD, School of Epidemiology, Public Health and Preventive Medicine, Faculty of Medicine, University of Ottawa, and Ottawa Hospital Research Institute, Clinical Epidemiology Program; D.E. Beaton, BScOT, PhD, Musculoskeletal Health and Outcomes Research, St. Michael's Hospital, and Institute for Work and Health, and Department of Occupational Science and Occupational Therapy, Rehabilitation Sciences Institute and the Institute for Health Policy Management and Evaluation, University of Toronto; C.O. Bingham III, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University; P. Brooks, MD, FRACP, Centre for Health Policy, Melbourne School of Population and Global Health, University of Melbourne; P.G. Conaghan, MD, PhD, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds and NIHR Leeds Musculoskeletal Biomedical Research Unit; M.A. D'Agostino, MD, PhD, APHP, Hôpital Ambroise Paré, Rheumatology Department, and INSERM U1173, Laboratoire d'Excellence INFLAMEX, UFR Simone Veil, Versailles-Saint-Quentin University; M.P. de Wit, PhD, Patient Research Partner, Department of Medical Humanities, VU University Medical Centre/EMGO+ Institute; L. Gossec, MD, PhD, Sorbonne Universités, UPMC Univ Paris 06, and AP-HP, Pitié Salpêtrière Hospital, Department of Rheumatology; L.M. March, MBBS, PhD, Liggins Professor of Rheumatology and Musculoskeletal Epidemiology, Sydney Medical School, Institute of Bone and Joint Research and Department of Rheumatology, Royal North Shore Hospital; L.S. Simon, MD, Co-managing Director of SDG LLC; J.A. Singh, MD, MPH, Professor of Medicine and Epidemiology, University of Alabama at Birmingham, and Staff Physician, Birmingham Veterans Affairs Medical Center; V. Strand, MD, Adjunct Clinical Professor, Division of Immunology/Rheumatology, Stanford University School of Medicine; G.A. Wells, MSc, PhD, Director, Cardiovascular Research Methods Centre, University of Ottawa Heart Institute, and Professor, Department of Epidemiology and Community Medicine, University of Ottawa; P. Tugwell, MD, MSc, Department of Medicine, Faculty of Medicine, University of Ottawa, and Ottawa Hospital Research Institute, Clinical Epidemiology Program, and School of Epidemiology, Public Health and Preventive Medicine, Faculty of Medicine, University of Ottawa
| | - Laure Gossec
- From the Center for Medical Technology Policy; Division of Rheumatology, Department of Medicine, Johns Hopkins University, Baltimore, Maryland; University of Alabama at Birmingham and Birmingham Veterans Affairs Medical Center, Birmingham, Alabama; SDG LLC, Cambridge, Massachusetts; Division of Immunology/Rheumatology, Stanford University School of Medicine, Palo Alto, California, USA; Centre for Practice-Changing Research, Ottawa Hospital Research Institute; Ottawa Hospital Research Institute, Clinical Epidemiology Program; School of Epidemiology, Public Health and Preventive Medicine, Faculty of Medicine, University of Ottawa; Cardiovascular Research Methods Centre, University of Ottawa Heart Institute; Department of Epidemiology and Community Medicine, University of Ottawa; Department of Medicine, Faculty of Medicine, University of Ottawa; Cochrane Musculoskeletal, University of Ottawa, Ottawa; Musculoskeletal Health and Outcomes Research, St. Michael's Hospital; Institute for Work and Health; Department of Occupational Science and Occupational Therapy, Rehabilitation Sciences Institute and the Institute for Health Policy Management and Evaluation, University of Toronto, Toronto, Ontario, Canada; Centre for Health Policy, Melbourne School of Population and Global Health, University of Melbourne, Melbourne; Sydney Medical School, Institute of Bone and Joint Research and Department of Rheumatology, Royal North Shore Hospital, St. Leonards, Australia; Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds and UK National Institute for Health Research (NIHR) Leeds Musculoskeletal Biomedical Research Unit, Leeds, UK; Hôpital Ambroise Paré, Rheumatology Department, Boulogne-Billancourt; INSERM U1173, Laboratoire d'Excellence INFLAMEX, UFR Simone Veil, Versailles-Saint-Quentin University, Montigny-le-Bretonneux; Sorbonne Universités, UPMC Univ Paris 06; AP-HP, Pitié Salpêtrière Hospital, Department of Rheumatology, Paris, France; Department of Medical Humanities, VU University Medical Centre/EMGO+ Institute, Amsterdam, the Netherlands.,IDG is a recipient of a Canadian Institutes of Health Research (CIHR) Foundation Grant Scheme (RFN #143237), focused on understanding the process and effect of integrated knowledge translation. COB has received funding from a Eugene Washington Engagement Award (EIAN 1988) from the Patient Centered Outcomes Research Institute (PCORI). All statements and views expressed in this report, including its findings and conclusions, are solely those of the authors and do not necessarily represent the views of PCORI, its board of governors, or methodology committee; or the UK National Health Service, the NIHR, or the Department of Health; or the position or policy of the US Department of Veterans Affairs or the US government. PGC is funded in part by the NIHR Leeds Musculoskeletal Biomedical Research Unit. This article presents independent research funded by the NIHR. JAS has received research grants from Takeda and Savient, and consultant fees from Takeda and the American College of Rheumatology. JAS serves as the principal investigator for an investigator-initiated study funded by Horizon pharmaceuticals through a grant to DINORA Inc., a 501 (c)(3) entity.,S.R. Tunis, MD, MSc, President and CEO, Center for Medical Technology Policy; L.J. Maxwell, PhD, Cochrane Musculoskeletal, University of Ottawa and Centre for Practice-Changing Research, Ottawa Hospital Research Institute; I.D. Graham, PhD, School of Epidemiology, Public Health and Preventive Medicine, Faculty of Medicine, University of Ottawa, and Ottawa Hospital Research Institute, Clinical Epidemiology Program; B.J. Shea, PhD, School of Epidemiology, Public Health and Preventive Medicine, Faculty of Medicine, University of Ottawa, and Ottawa Hospital Research Institute, Clinical Epidemiology Program; D.E. Beaton, BScOT, PhD, Musculoskeletal Health and Outcomes Research, St. Michael's Hospital, and Institute for Work and Health, and Department of Occupational Science and Occupational Therapy, Rehabilitation Sciences Institute and the Institute for Health Policy Management and Evaluation, University of Toronto; C.O. Bingham III, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University; P. Brooks, MD, FRACP, Centre for Health Policy, Melbourne School of Population and Global Health, University of Melbourne; P.G. Conaghan, MD, PhD, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds and NIHR Leeds Musculoskeletal Biomedical Research Unit; M.A. D'Agostino, MD, PhD, APHP, Hôpital Ambroise Paré, Rheumatology Department, and INSERM U1173, Laboratoire d'Excellence INFLAMEX, UFR Simone Veil, Versailles-Saint-Quentin University; M.P. de Wit, PhD, Patient Research Partner, Department of Medical Humanities, VU University Medical Centre/EMGO+ Institute; L. Gossec, MD, PhD, Sorbonne Universités, UPMC Univ Paris 06, and AP-HP, Pitié Salpêtrière Hospital, Department of Rheumatology; L.M. March, MBBS, PhD, Liggins Professor of Rheumatology and Musculoskeletal Epidemiology, Sydney Medical School, Institute of Bone and Joint Research and Department of Rheumatology, Royal North Shore Hospital; L.S. Simon, MD, Co-managing Director of SDG LLC; J.A. Singh, MD, MPH, Professor of Medicine and Epidemiology, University of Alabama at Birmingham, and Staff Physician, Birmingham Veterans Affairs Medical Center; V. Strand, MD, Adjunct Clinical Professor, Division of Immunology/Rheumatology, Stanford University School of Medicine; G.A. Wells, MSc, PhD, Director, Cardiovascular Research Methods Centre, University of Ottawa Heart Institute, and Professor, Department of Epidemiology and Community Medicine, University of Ottawa; P. Tugwell, MD, MSc, Department of Medicine, Faculty of Medicine, University of Ottawa, and Ottawa Hospital Research Institute, Clinical Epidemiology Program, and School of Epidemiology, Public Health and Preventive Medicine, Faculty of Medicine, University of Ottawa
| | - Lyn M March
- From the Center for Medical Technology Policy; Division of Rheumatology, Department of Medicine, Johns Hopkins University, Baltimore, Maryland; University of Alabama at Birmingham and Birmingham Veterans Affairs Medical Center, Birmingham, Alabama; SDG LLC, Cambridge, Massachusetts; Division of Immunology/Rheumatology, Stanford University School of Medicine, Palo Alto, California, USA; Centre for Practice-Changing Research, Ottawa Hospital Research Institute; Ottawa Hospital Research Institute, Clinical Epidemiology Program; School of Epidemiology, Public Health and Preventive Medicine, Faculty of Medicine, University of Ottawa; Cardiovascular Research Methods Centre, University of Ottawa Heart Institute; Department of Epidemiology and Community Medicine, University of Ottawa; Department of Medicine, Faculty of Medicine, University of Ottawa; Cochrane Musculoskeletal, University of Ottawa, Ottawa; Musculoskeletal Health and Outcomes Research, St. Michael's Hospital; Institute for Work and Health; Department of Occupational Science and Occupational Therapy, Rehabilitation Sciences Institute and the Institute for Health Policy Management and Evaluation, University of Toronto, Toronto, Ontario, Canada; Centre for Health Policy, Melbourne School of Population and Global Health, University of Melbourne, Melbourne; Sydney Medical School, Institute of Bone and Joint Research and Department of Rheumatology, Royal North Shore Hospital, St. Leonards, Australia; Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds and UK National Institute for Health Research (NIHR) Leeds Musculoskeletal Biomedical Research Unit, Leeds, UK; Hôpital Ambroise Paré, Rheumatology Department, Boulogne-Billancourt; INSERM U1173, Laboratoire d'Excellence INFLAMEX, UFR Simone Veil, Versailles-Saint-Quentin University, Montigny-le-Bretonneux; Sorbonne Universités, UPMC Univ Paris 06; AP-HP, Pitié Salpêtrière Hospital, Department of Rheumatology, Paris, France; Department of Medical Humanities, VU University Medical Centre/EMGO+ Institute, Amsterdam, the Netherlands.,IDG is a recipient of a Canadian Institutes of Health Research (CIHR) Foundation Grant Scheme (RFN #143237), focused on understanding the process and effect of integrated knowledge translation. COB has received funding from a Eugene Washington Engagement Award (EIAN 1988) from the Patient Centered Outcomes Research Institute (PCORI). All statements and views expressed in this report, including its findings and conclusions, are solely those of the authors and do not necessarily represent the views of PCORI, its board of governors, or methodology committee; or the UK National Health Service, the NIHR, or the Department of Health; or the position or policy of the US Department of Veterans Affairs or the US government. PGC is funded in part by the NIHR Leeds Musculoskeletal Biomedical Research Unit. This article presents independent research funded by the NIHR. JAS has received research grants from Takeda and Savient, and consultant fees from Takeda and the American College of Rheumatology. JAS serves as the principal investigator for an investigator-initiated study funded by Horizon pharmaceuticals through a grant to DINORA Inc., a 501 (c)(3) entity.,S.R. Tunis, MD, MSc, President and CEO, Center for Medical Technology Policy; L.J. Maxwell, PhD, Cochrane Musculoskeletal, University of Ottawa and Centre for Practice-Changing Research, Ottawa Hospital Research Institute; I.D. Graham, PhD, School of Epidemiology, Public Health and Preventive Medicine, Faculty of Medicine, University of Ottawa, and Ottawa Hospital Research Institute, Clinical Epidemiology Program; B.J. Shea, PhD, School of Epidemiology, Public Health and Preventive Medicine, Faculty of Medicine, University of Ottawa, and Ottawa Hospital Research Institute, Clinical Epidemiology Program; D.E. Beaton, BScOT, PhD, Musculoskeletal Health and Outcomes Research, St. Michael's Hospital, and Institute for Work and Health, and Department of Occupational Science and Occupational Therapy, Rehabilitation Sciences Institute and the Institute for Health Policy Management and Evaluation, University of Toronto; C.O. Bingham III, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University; P. Brooks, MD, FRACP, Centre for Health Policy, Melbourne School of Population and Global Health, University of Melbourne; P.G. Conaghan, MD, PhD, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds and NIHR Leeds Musculoskeletal Biomedical Research Unit; M.A. D'Agostino, MD, PhD, APHP, Hôpital Ambroise Paré, Rheumatology Department, and INSERM U1173, Laboratoire d'Excellence INFLAMEX, UFR Simone Veil, Versailles-Saint-Quentin University; M.P. de Wit, PhD, Patient Research Partner, Department of Medical Humanities, VU University Medical Centre/EMGO+ Institute; L. Gossec, MD, PhD, Sorbonne Universités, UPMC Univ Paris 06, and AP-HP, Pitié Salpêtrière Hospital, Department of Rheumatology; L.M. March, MBBS, PhD, Liggins Professor of Rheumatology and Musculoskeletal Epidemiology, Sydney Medical School, Institute of Bone and Joint Research and Department of Rheumatology, Royal North Shore Hospital; L.S. Simon, MD, Co-managing Director of SDG LLC; J.A. Singh, MD, MPH, Professor of Medicine and Epidemiology, University of Alabama at Birmingham, and Staff Physician, Birmingham Veterans Affairs Medical Center; V. Strand, MD, Adjunct Clinical Professor, Division of Immunology/Rheumatology, Stanford University School of Medicine; G.A. Wells, MSc, PhD, Director, Cardiovascular Research Methods Centre, University of Ottawa Heart Institute, and Professor, Department of Epidemiology and Community Medicine, University of Ottawa; P. Tugwell, MD, MSc, Department of Medicine, Faculty of Medicine, University of Ottawa, and Ottawa Hospital Research Institute, Clinical Epidemiology Program, and School of Epidemiology, Public Health and Preventive Medicine, Faculty of Medicine, University of Ottawa
| | - Lee S Simon
- From the Center for Medical Technology Policy; Division of Rheumatology, Department of Medicine, Johns Hopkins University, Baltimore, Maryland; University of Alabama at Birmingham and Birmingham Veterans Affairs Medical Center, Birmingham, Alabama; SDG LLC, Cambridge, Massachusetts; Division of Immunology/Rheumatology, Stanford University School of Medicine, Palo Alto, California, USA; Centre for Practice-Changing Research, Ottawa Hospital Research Institute; Ottawa Hospital Research Institute, Clinical Epidemiology Program; School of Epidemiology, Public Health and Preventive Medicine, Faculty of Medicine, University of Ottawa; Cardiovascular Research Methods Centre, University of Ottawa Heart Institute; Department of Epidemiology and Community Medicine, University of Ottawa; Department of Medicine, Faculty of Medicine, University of Ottawa; Cochrane Musculoskeletal, University of Ottawa, Ottawa; Musculoskeletal Health and Outcomes Research, St. Michael's Hospital; Institute for Work and Health; Department of Occupational Science and Occupational Therapy, Rehabilitation Sciences Institute and the Institute for Health Policy Management and Evaluation, University of Toronto, Toronto, Ontario, Canada; Centre for Health Policy, Melbourne School of Population and Global Health, University of Melbourne, Melbourne; Sydney Medical School, Institute of Bone and Joint Research and Department of Rheumatology, Royal North Shore Hospital, St. Leonards, Australia; Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds and UK National Institute for Health Research (NIHR) Leeds Musculoskeletal Biomedical Research Unit, Leeds, UK; Hôpital Ambroise Paré, Rheumatology Department, Boulogne-Billancourt; INSERM U1173, Laboratoire d'Excellence INFLAMEX, UFR Simone Veil, Versailles-Saint-Quentin University, Montigny-le-Bretonneux; Sorbonne Universités, UPMC Univ Paris 06; AP-HP, Pitié Salpêtrière Hospital, Department of Rheumatology, Paris, France; Department of Medical Humanities, VU University Medical Centre/EMGO+ Institute, Amsterdam, the Netherlands.,IDG is a recipient of a Canadian Institutes of Health Research (CIHR) Foundation Grant Scheme (RFN #143237), focused on understanding the process and effect of integrated knowledge translation. COB has received funding from a Eugene Washington Engagement Award (EIAN 1988) from the Patient Centered Outcomes Research Institute (PCORI). All statements and views expressed in this report, including its findings and conclusions, are solely those of the authors and do not necessarily represent the views of PCORI, its board of governors, or methodology committee; or the UK National Health Service, the NIHR, or the Department of Health; or the position or policy of the US Department of Veterans Affairs or the US government. PGC is funded in part by the NIHR Leeds Musculoskeletal Biomedical Research Unit. This article presents independent research funded by the NIHR. JAS has received research grants from Takeda and Savient, and consultant fees from Takeda and the American College of Rheumatology. JAS serves as the principal investigator for an investigator-initiated study funded by Horizon pharmaceuticals through a grant to DINORA Inc., a 501 (c)(3) entity.,S.R. Tunis, MD, MSc, President and CEO, Center for Medical Technology Policy; L.J. Maxwell, PhD, Cochrane Musculoskeletal, University of Ottawa and Centre for Practice-Changing Research, Ottawa Hospital Research Institute; I.D. Graham, PhD, School of Epidemiology, Public Health and Preventive Medicine, Faculty of Medicine, University of Ottawa, and Ottawa Hospital Research Institute, Clinical Epidemiology Program; B.J. Shea, PhD, School of Epidemiology, Public Health and Preventive Medicine, Faculty of Medicine, University of Ottawa, and Ottawa Hospital Research Institute, Clinical Epidemiology Program; D.E. Beaton, BScOT, PhD, Musculoskeletal Health and Outcomes Research, St. Michael's Hospital, and Institute for Work and Health, and Department of Occupational Science and Occupational Therapy, Rehabilitation Sciences Institute and the Institute for Health Policy Management and Evaluation, University of Toronto; C.O. Bingham III, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University; P. Brooks, MD, FRACP, Centre for Health Policy, Melbourne School of Population and Global Health, University of Melbourne; P.G. Conaghan, MD, PhD, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds and NIHR Leeds Musculoskeletal Biomedical Research Unit; M.A. D'Agostino, MD, PhD, APHP, Hôpital Ambroise Paré, Rheumatology Department, and INSERM U1173, Laboratoire d'Excellence INFLAMEX, UFR Simone Veil, Versailles-Saint-Quentin University; M.P. de Wit, PhD, Patient Research Partner, Department of Medical Humanities, VU University Medical Centre/EMGO+ Institute; L. Gossec, MD, PhD, Sorbonne Universités, UPMC Univ Paris 06, and AP-HP, Pitié Salpêtrière Hospital, Department of Rheumatology; L.M. March, MBBS, PhD, Liggins Professor of Rheumatology and Musculoskeletal Epidemiology, Sydney Medical School, Institute of Bone and Joint Research and Department of Rheumatology, Royal North Shore Hospital; L.S. Simon, MD, Co-managing Director of SDG LLC; J.A. Singh, MD, MPH, Professor of Medicine and Epidemiology, University of Alabama at Birmingham, and Staff Physician, Birmingham Veterans Affairs Medical Center; V. Strand, MD, Adjunct Clinical Professor, Division of Immunology/Rheumatology, Stanford University School of Medicine; G.A. Wells, MSc, PhD, Director, Cardiovascular Research Methods Centre, University of Ottawa Heart Institute, and Professor, Department of Epidemiology and Community Medicine, University of Ottawa; P. Tugwell, MD, MSc, Department of Medicine, Faculty of Medicine, University of Ottawa, and Ottawa Hospital Research Institute, Clinical Epidemiology Program, and School of Epidemiology, Public Health and Preventive Medicine, Faculty of Medicine, University of Ottawa
| | - Jasvinder A Singh
- From the Center for Medical Technology Policy; Division of Rheumatology, Department of Medicine, Johns Hopkins University, Baltimore, Maryland; University of Alabama at Birmingham and Birmingham Veterans Affairs Medical Center, Birmingham, Alabama; SDG LLC, Cambridge, Massachusetts; Division of Immunology/Rheumatology, Stanford University School of Medicine, Palo Alto, California, USA; Centre for Practice-Changing Research, Ottawa Hospital Research Institute; Ottawa Hospital Research Institute, Clinical Epidemiology Program; School of Epidemiology, Public Health and Preventive Medicine, Faculty of Medicine, University of Ottawa; Cardiovascular Research Methods Centre, University of Ottawa Heart Institute; Department of Epidemiology and Community Medicine, University of Ottawa; Department of Medicine, Faculty of Medicine, University of Ottawa; Cochrane Musculoskeletal, University of Ottawa, Ottawa; Musculoskeletal Health and Outcomes Research, St. Michael's Hospital; Institute for Work and Health; Department of Occupational Science and Occupational Therapy, Rehabilitation Sciences Institute and the Institute for Health Policy Management and Evaluation, University of Toronto, Toronto, Ontario, Canada; Centre for Health Policy, Melbourne School of Population and Global Health, University of Melbourne, Melbourne; Sydney Medical School, Institute of Bone and Joint Research and Department of Rheumatology, Royal North Shore Hospital, St. Leonards, Australia; Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds and UK National Institute for Health Research (NIHR) Leeds Musculoskeletal Biomedical Research Unit, Leeds, UK; Hôpital Ambroise Paré, Rheumatology Department, Boulogne-Billancourt; INSERM U1173, Laboratoire d'Excellence INFLAMEX, UFR Simone Veil, Versailles-Saint-Quentin University, Montigny-le-Bretonneux; Sorbonne Universités, UPMC Univ Paris 06; AP-HP, Pitié Salpêtrière Hospital, Department of Rheumatology, Paris, France; Department of Medical Humanities, VU University Medical Centre/EMGO+ Institute, Amsterdam, the Netherlands.,IDG is a recipient of a Canadian Institutes of Health Research (CIHR) Foundation Grant Scheme (RFN #143237), focused on understanding the process and effect of integrated knowledge translation. COB has received funding from a Eugene Washington Engagement Award (EIAN 1988) from the Patient Centered Outcomes Research Institute (PCORI). All statements and views expressed in this report, including its findings and conclusions, are solely those of the authors and do not necessarily represent the views of PCORI, its board of governors, or methodology committee; or the UK National Health Service, the NIHR, or the Department of Health; or the position or policy of the US Department of Veterans Affairs or the US government. PGC is funded in part by the NIHR Leeds Musculoskeletal Biomedical Research Unit. This article presents independent research funded by the NIHR. JAS has received research grants from Takeda and Savient, and consultant fees from Takeda and the American College of Rheumatology. JAS serves as the principal investigator for an investigator-initiated study funded by Horizon pharmaceuticals through a grant to DINORA Inc., a 501 (c)(3) entity.,S.R. Tunis, MD, MSc, President and CEO, Center for Medical Technology Policy; L.J. Maxwell, PhD, Cochrane Musculoskeletal, University of Ottawa and Centre for Practice-Changing Research, Ottawa Hospital Research Institute; I.D. Graham, PhD, School of Epidemiology, Public Health and Preventive Medicine, Faculty of Medicine, University of Ottawa, and Ottawa Hospital Research Institute, Clinical Epidemiology Program; B.J. Shea, PhD, School of Epidemiology, Public Health and Preventive Medicine, Faculty of Medicine, University of Ottawa, and Ottawa Hospital Research Institute, Clinical Epidemiology Program; D.E. Beaton, BScOT, PhD, Musculoskeletal Health and Outcomes Research, St. Michael's Hospital, and Institute for Work and Health, and Department of Occupational Science and Occupational Therapy, Rehabilitation Sciences Institute and the Institute for Health Policy Management and Evaluation, University of Toronto; C.O. Bingham III, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University; P. Brooks, MD, FRACP, Centre for Health Policy, Melbourne School of Population and Global Health, University of Melbourne; P.G. Conaghan, MD, PhD, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds and NIHR Leeds Musculoskeletal Biomedical Research Unit; M.A. D'Agostino, MD, PhD, APHP, Hôpital Ambroise Paré, Rheumatology Department, and INSERM U1173, Laboratoire d'Excellence INFLAMEX, UFR Simone Veil, Versailles-Saint-Quentin University; M.P. de Wit, PhD, Patient Research Partner, Department of Medical Humanities, VU University Medical Centre/EMGO+ Institute; L. Gossec, MD, PhD, Sorbonne Universités, UPMC Univ Paris 06, and AP-HP, Pitié Salpêtrière Hospital, Department of Rheumatology; L.M. March, MBBS, PhD, Liggins Professor of Rheumatology and Musculoskeletal Epidemiology, Sydney Medical School, Institute of Bone and Joint Research and Department of Rheumatology, Royal North Shore Hospital; L.S. Simon, MD, Co-managing Director of SDG LLC; J.A. Singh, MD, MPH, Professor of Medicine and Epidemiology, University of Alabama at Birmingham, and Staff Physician, Birmingham Veterans Affairs Medical Center; V. Strand, MD, Adjunct Clinical Professor, Division of Immunology/Rheumatology, Stanford University School of Medicine; G.A. Wells, MSc, PhD, Director, Cardiovascular Research Methods Centre, University of Ottawa Heart Institute, and Professor, Department of Epidemiology and Community Medicine, University of Ottawa; P. Tugwell, MD, MSc, Department of Medicine, Faculty of Medicine, University of Ottawa, and Ottawa Hospital Research Institute, Clinical Epidemiology Program, and School of Epidemiology, Public Health and Preventive Medicine, Faculty of Medicine, University of Ottawa
| | - Vibeke Strand
- From the Center for Medical Technology Policy; Division of Rheumatology, Department of Medicine, Johns Hopkins University, Baltimore, Maryland; University of Alabama at Birmingham and Birmingham Veterans Affairs Medical Center, Birmingham, Alabama; SDG LLC, Cambridge, Massachusetts; Division of Immunology/Rheumatology, Stanford University School of Medicine, Palo Alto, California, USA; Centre for Practice-Changing Research, Ottawa Hospital Research Institute; Ottawa Hospital Research Institute, Clinical Epidemiology Program; School of Epidemiology, Public Health and Preventive Medicine, Faculty of Medicine, University of Ottawa; Cardiovascular Research Methods Centre, University of Ottawa Heart Institute; Department of Epidemiology and Community Medicine, University of Ottawa; Department of Medicine, Faculty of Medicine, University of Ottawa; Cochrane Musculoskeletal, University of Ottawa, Ottawa; Musculoskeletal Health and Outcomes Research, St. Michael's Hospital; Institute for Work and Health; Department of Occupational Science and Occupational Therapy, Rehabilitation Sciences Institute and the Institute for Health Policy Management and Evaluation, University of Toronto, Toronto, Ontario, Canada; Centre for Health Policy, Melbourne School of Population and Global Health, University of Melbourne, Melbourne; Sydney Medical School, Institute of Bone and Joint Research and Department of Rheumatology, Royal North Shore Hospital, St. Leonards, Australia; Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds and UK National Institute for Health Research (NIHR) Leeds Musculoskeletal Biomedical Research Unit, Leeds, UK; Hôpital Ambroise Paré, Rheumatology Department, Boulogne-Billancourt; INSERM U1173, Laboratoire d'Excellence INFLAMEX, UFR Simone Veil, Versailles-Saint-Quentin University, Montigny-le-Bretonneux; Sorbonne Universités, UPMC Univ Paris 06; AP-HP, Pitié Salpêtrière Hospital, Department of Rheumatology, Paris, France; Department of Medical Humanities, VU University Medical Centre/EMGO+ Institute, Amsterdam, the Netherlands.,IDG is a recipient of a Canadian Institutes of Health Research (CIHR) Foundation Grant Scheme (RFN #143237), focused on understanding the process and effect of integrated knowledge translation. COB has received funding from a Eugene Washington Engagement Award (EIAN 1988) from the Patient Centered Outcomes Research Institute (PCORI). All statements and views expressed in this report, including its findings and conclusions, are solely those of the authors and do not necessarily represent the views of PCORI, its board of governors, or methodology committee; or the UK National Health Service, the NIHR, or the Department of Health; or the position or policy of the US Department of Veterans Affairs or the US government. PGC is funded in part by the NIHR Leeds Musculoskeletal Biomedical Research Unit. This article presents independent research funded by the NIHR. JAS has received research grants from Takeda and Savient, and consultant fees from Takeda and the American College of Rheumatology. JAS serves as the principal investigator for an investigator-initiated study funded by Horizon pharmaceuticals through a grant to DINORA Inc., a 501 (c)(3) entity.,S.R. Tunis, MD, MSc, President and CEO, Center for Medical Technology Policy; L.J. Maxwell, PhD, Cochrane Musculoskeletal, University of Ottawa and Centre for Practice-Changing Research, Ottawa Hospital Research Institute; I.D. Graham, PhD, School of Epidemiology, Public Health and Preventive Medicine, Faculty of Medicine, University of Ottawa, and Ottawa Hospital Research Institute, Clinical Epidemiology Program; B.J. Shea, PhD, School of Epidemiology, Public Health and Preventive Medicine, Faculty of Medicine, University of Ottawa, and Ottawa Hospital Research Institute, Clinical Epidemiology Program; D.E. Beaton, BScOT, PhD, Musculoskeletal Health and Outcomes Research, St. Michael's Hospital, and Institute for Work and Health, and Department of Occupational Science and Occupational Therapy, Rehabilitation Sciences Institute and the Institute for Health Policy Management and Evaluation, University of Toronto; C.O. Bingham III, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University; P. Brooks, MD, FRACP, Centre for Health Policy, Melbourne School of Population and Global Health, University of Melbourne; P.G. Conaghan, MD, PhD, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds and NIHR Leeds Musculoskeletal Biomedical Research Unit; M.A. D'Agostino, MD, PhD, APHP, Hôpital Ambroise Paré, Rheumatology Department, and INSERM U1173, Laboratoire d'Excellence INFLAMEX, UFR Simone Veil, Versailles-Saint-Quentin University; M.P. de Wit, PhD, Patient Research Partner, Department of Medical Humanities, VU University Medical Centre/EMGO+ Institute; L. Gossec, MD, PhD, Sorbonne Universités, UPMC Univ Paris 06, and AP-HP, Pitié Salpêtrière Hospital, Department of Rheumatology; L.M. March, MBBS, PhD, Liggins Professor of Rheumatology and Musculoskeletal Epidemiology, Sydney Medical School, Institute of Bone and Joint Research and Department of Rheumatology, Royal North Shore Hospital; L.S. Simon, MD, Co-managing Director of SDG LLC; J.A. Singh, MD, MPH, Professor of Medicine and Epidemiology, University of Alabama at Birmingham, and Staff Physician, Birmingham Veterans Affairs Medical Center; V. Strand, MD, Adjunct Clinical Professor, Division of Immunology/Rheumatology, Stanford University School of Medicine; G.A. Wells, MSc, PhD, Director, Cardiovascular Research Methods Centre, University of Ottawa Heart Institute, and Professor, Department of Epidemiology and Community Medicine, University of Ottawa; P. Tugwell, MD, MSc, Department of Medicine, Faculty of Medicine, University of Ottawa, and Ottawa Hospital Research Institute, Clinical Epidemiology Program, and School of Epidemiology, Public Health and Preventive Medicine, Faculty of Medicine, University of Ottawa
| | - George A Wells
- From the Center for Medical Technology Policy; Division of Rheumatology, Department of Medicine, Johns Hopkins University, Baltimore, Maryland; University of Alabama at Birmingham and Birmingham Veterans Affairs Medical Center, Birmingham, Alabama; SDG LLC, Cambridge, Massachusetts; Division of Immunology/Rheumatology, Stanford University School of Medicine, Palo Alto, California, USA; Centre for Practice-Changing Research, Ottawa Hospital Research Institute; Ottawa Hospital Research Institute, Clinical Epidemiology Program; School of Epidemiology, Public Health and Preventive Medicine, Faculty of Medicine, University of Ottawa; Cardiovascular Research Methods Centre, University of Ottawa Heart Institute; Department of Epidemiology and Community Medicine, University of Ottawa; Department of Medicine, Faculty of Medicine, University of Ottawa; Cochrane Musculoskeletal, University of Ottawa, Ottawa; Musculoskeletal Health and Outcomes Research, St. Michael's Hospital; Institute for Work and Health; Department of Occupational Science and Occupational Therapy, Rehabilitation Sciences Institute and the Institute for Health Policy Management and Evaluation, University of Toronto, Toronto, Ontario, Canada; Centre for Health Policy, Melbourne School of Population and Global Health, University of Melbourne, Melbourne; Sydney Medical School, Institute of Bone and Joint Research and Department of Rheumatology, Royal North Shore Hospital, St. Leonards, Australia; Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds and UK National Institute for Health Research (NIHR) Leeds Musculoskeletal Biomedical Research Unit, Leeds, UK; Hôpital Ambroise Paré, Rheumatology Department, Boulogne-Billancourt; INSERM U1173, Laboratoire d'Excellence INFLAMEX, UFR Simone Veil, Versailles-Saint-Quentin University, Montigny-le-Bretonneux; Sorbonne Universités, UPMC Univ Paris 06; AP-HP, Pitié Salpêtrière Hospital, Department of Rheumatology, Paris, France; Department of Medical Humanities, VU University Medical Centre/EMGO+ Institute, Amsterdam, the Netherlands.,IDG is a recipient of a Canadian Institutes of Health Research (CIHR) Foundation Grant Scheme (RFN #143237), focused on understanding the process and effect of integrated knowledge translation. COB has received funding from a Eugene Washington Engagement Award (EIAN 1988) from the Patient Centered Outcomes Research Institute (PCORI). All statements and views expressed in this report, including its findings and conclusions, are solely those of the authors and do not necessarily represent the views of PCORI, its board of governors, or methodology committee; or the UK National Health Service, the NIHR, or the Department of Health; or the position or policy of the US Department of Veterans Affairs or the US government. PGC is funded in part by the NIHR Leeds Musculoskeletal Biomedical Research Unit. This article presents independent research funded by the NIHR. JAS has received research grants from Takeda and Savient, and consultant fees from Takeda and the American College of Rheumatology. JAS serves as the principal investigator for an investigator-initiated study funded by Horizon pharmaceuticals through a grant to DINORA Inc., a 501 (c)(3) entity.,S.R. Tunis, MD, MSc, President and CEO, Center for Medical Technology Policy; L.J. Maxwell, PhD, Cochrane Musculoskeletal, University of Ottawa and Centre for Practice-Changing Research, Ottawa Hospital Research Institute; I.D. Graham, PhD, School of Epidemiology, Public Health and Preventive Medicine, Faculty of Medicine, University of Ottawa, and Ottawa Hospital Research Institute, Clinical Epidemiology Program; B.J. Shea, PhD, School of Epidemiology, Public Health and Preventive Medicine, Faculty of Medicine, University of Ottawa, and Ottawa Hospital Research Institute, Clinical Epidemiology Program; D.E. Beaton, BScOT, PhD, Musculoskeletal Health and Outcomes Research, St. Michael's Hospital, and Institute for Work and Health, and Department of Occupational Science and Occupational Therapy, Rehabilitation Sciences Institute and the Institute for Health Policy Management and Evaluation, University of Toronto; C.O. Bingham III, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University; P. Brooks, MD, FRACP, Centre for Health Policy, Melbourne School of Population and Global Health, University of Melbourne; P.G. Conaghan, MD, PhD, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds and NIHR Leeds Musculoskeletal Biomedical Research Unit; M.A. D'Agostino, MD, PhD, APHP, Hôpital Ambroise Paré, Rheumatology Department, and INSERM U1173, Laboratoire d'Excellence INFLAMEX, UFR Simone Veil, Versailles-Saint-Quentin University; M.P. de Wit, PhD, Patient Research Partner, Department of Medical Humanities, VU University Medical Centre/EMGO+ Institute; L. Gossec, MD, PhD, Sorbonne Universités, UPMC Univ Paris 06, and AP-HP, Pitié Salpêtrière Hospital, Department of Rheumatology; L.M. March, MBBS, PhD, Liggins Professor of Rheumatology and Musculoskeletal Epidemiology, Sydney Medical School, Institute of Bone and Joint Research and Department of Rheumatology, Royal North Shore Hospital; L.S. Simon, MD, Co-managing Director of SDG LLC; J.A. Singh, MD, MPH, Professor of Medicine and Epidemiology, University of Alabama at Birmingham, and Staff Physician, Birmingham Veterans Affairs Medical Center; V. Strand, MD, Adjunct Clinical Professor, Division of Immunology/Rheumatology, Stanford University School of Medicine; G.A. Wells, MSc, PhD, Director, Cardiovascular Research Methods Centre, University of Ottawa Heart Institute, and Professor, Department of Epidemiology and Community Medicine, University of Ottawa; P. Tugwell, MD, MSc, Department of Medicine, Faculty of Medicine, University of Ottawa, and Ottawa Hospital Research Institute, Clinical Epidemiology Program, and School of Epidemiology, Public Health and Preventive Medicine, Faculty of Medicine, University of Ottawa
| | - Peter Tugwell
- From the Center for Medical Technology Policy; Division of Rheumatology, Department of Medicine, Johns Hopkins University, Baltimore, Maryland; University of Alabama at Birmingham and Birmingham Veterans Affairs Medical Center, Birmingham, Alabama; SDG LLC, Cambridge, Massachusetts; Division of Immunology/Rheumatology, Stanford University School of Medicine, Palo Alto, California, USA; Centre for Practice-Changing Research, Ottawa Hospital Research Institute; Ottawa Hospital Research Institute, Clinical Epidemiology Program; School of Epidemiology, Public Health and Preventive Medicine, Faculty of Medicine, University of Ottawa; Cardiovascular Research Methods Centre, University of Ottawa Heart Institute; Department of Epidemiology and Community Medicine, University of Ottawa; Department of Medicine, Faculty of Medicine, University of Ottawa; Cochrane Musculoskeletal, University of Ottawa, Ottawa; Musculoskeletal Health and Outcomes Research, St. Michael's Hospital; Institute for Work and Health; Department of Occupational Science and Occupational Therapy, Rehabilitation Sciences Institute and the Institute for Health Policy Management and Evaluation, University of Toronto, Toronto, Ontario, Canada; Centre for Health Policy, Melbourne School of Population and Global Health, University of Melbourne, Melbourne; Sydney Medical School, Institute of Bone and Joint Research and Department of Rheumatology, Royal North Shore Hospital, St. Leonards, Australia; Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds and UK National Institute for Health Research (NIHR) Leeds Musculoskeletal Biomedical Research Unit, Leeds, UK; Hôpital Ambroise Paré, Rheumatology Department, Boulogne-Billancourt; INSERM U1173, Laboratoire d'Excellence INFLAMEX, UFR Simone Veil, Versailles-Saint-Quentin University, Montigny-le-Bretonneux; Sorbonne Universités, UPMC Univ Paris 06; AP-HP, Pitié Salpêtrière Hospital, Department of Rheumatology, Paris, France; Department of Medical Humanities, VU University Medical Centre/EMGO+ Institute, Amsterdam, the Netherlands.,IDG is a recipient of a Canadian Institutes of Health Research (CIHR) Foundation Grant Scheme (RFN #143237), focused on understanding the process and effect of integrated knowledge translation. COB has received funding from a Eugene Washington Engagement Award (EIAN 1988) from the Patient Centered Outcomes Research Institute (PCORI). All statements and views expressed in this report, including its findings and conclusions, are solely those of the authors and do not necessarily represent the views of PCORI, its board of governors, or methodology committee; or the UK National Health Service, the NIHR, or the Department of Health; or the position or policy of the US Department of Veterans Affairs or the US government. PGC is funded in part by the NIHR Leeds Musculoskeletal Biomedical Research Unit. This article presents independent research funded by the NIHR. JAS has received research grants from Takeda and Savient, and consultant fees from Takeda and the American College of Rheumatology. JAS serves as the principal investigator for an investigator-initiated study funded by Horizon pharmaceuticals through a grant to DINORA Inc., a 501 (c)(3) entity.,S.R. Tunis, MD, MSc, President and CEO, Center for Medical Technology Policy; L.J. Maxwell, PhD, Cochrane Musculoskeletal, University of Ottawa and Centre for Practice-Changing Research, Ottawa Hospital Research Institute; I.D. Graham, PhD, School of Epidemiology, Public Health and Preventive Medicine, Faculty of Medicine, University of Ottawa, and Ottawa Hospital Research Institute, Clinical Epidemiology Program; B.J. Shea, PhD, School of Epidemiology, Public Health and Preventive Medicine, Faculty of Medicine, University of Ottawa, and Ottawa Hospital Research Institute, Clinical Epidemiology Program; D.E. Beaton, BScOT, PhD, Musculoskeletal Health and Outcomes Research, St. Michael's Hospital, and Institute for Work and Health, and Department of Occupational Science and Occupational Therapy, Rehabilitation Sciences Institute and the Institute for Health Policy Management and Evaluation, University of Toronto; C.O. Bingham III, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University; P. Brooks, MD, FRACP, Centre for Health Policy, Melbourne School of Population and Global Health, University of Melbourne; P.G. Conaghan, MD, PhD, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds and NIHR Leeds Musculoskeletal Biomedical Research Unit; M.A. D'Agostino, MD, PhD, APHP, Hôpital Ambroise Paré, Rheumatology Department, and INSERM U1173, Laboratoire d'Excellence INFLAMEX, UFR Simone Veil, Versailles-Saint-Quentin University; M.P. de Wit, PhD, Patient Research Partner, Department of Medical Humanities, VU University Medical Centre/EMGO+ Institute; L. Gossec, MD, PhD, Sorbonne Universités, UPMC Univ Paris 06, and AP-HP, Pitié Salpêtrière Hospital, Department of Rheumatology; L.M. March, MBBS, PhD, Liggins Professor of Rheumatology and Musculoskeletal Epidemiology, Sydney Medical School, Institute of Bone and Joint Research and Department of Rheumatology, Royal North Shore Hospital; L.S. Simon, MD, Co-managing Director of SDG LLC; J.A. Singh, MD, MPH, Professor of Medicine and Epidemiology, University of Alabama at Birmingham, and Staff Physician, Birmingham Veterans Affairs Medical Center; V. Strand, MD, Adjunct Clinical Professor, Division of Immunology/Rheumatology, Stanford University School of Medicine; G.A. Wells, MSc, PhD, Director, Cardiovascular Research Methods Centre, University of Ottawa Heart Institute, and Professor, Department of Epidemiology and Community Medicine, University of Ottawa; P. Tugwell, MD, MSc, Department of Medicine, Faculty of Medicine, University of Ottawa, and Ottawa Hospital Research Institute, Clinical Epidemiology Program, and School of Epidemiology, Public Health and Preventive Medicine, Faculty of Medicine, University of Ottawa
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Park JK, Mecoli CA, Alexanderson H, Regardt M, Christopher-Stine L, Casal-Domínguez M, de Groot I, Sarver C, Lundberg IE, Bingham CO, Song YW. Advancing the Development of Patient-reported Outcomes for Adult Myositis at OMERACT 2016: An International Delphi Study. J Rheumatol 2017; 44:1683-1687. [PMID: 28765245 DOI: 10.3899/jrheum.161252] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/09/2017] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To define a set of core patient-reported domains and respective instruments for use in idiopathic inflammatory myopathies (IIM). Previously, we reported a systematic literature review on patient-reported outcomes (PRO) in IIM followed by conducting international focus groups to elicit patient perspectives of myositis symptoms and effects. METHODS Based on qualitative content analysis of focus groups, an initial list of 26 candidate domains was constructed. We subsequently conducted an international modified Delphi survey to identify the importance of each of the 26 domains. Participants were asked to rate each domain on a scale of 0-10 (0 = not important, 10 = very important). RESULTS In this first round of the Delphi survey, 643 patients participated from the United States (n = 543), Sweden (n = 49), and South Korea (n = 51). Of the 26 domains, 19 (73%) were rated of high importance (≥ 7/10). The top 5 domains were muscle symptoms, fatigue, interactions with healthcare, medication side effects, and pain. During Outcome Measures in Rheumatology (OMERACT) 2016, we discussed the goal for ultimate reduction in the number of domains and the importance of considering representation of healthcare providers from other specialties, caregivers, representatives of pharmaceutical industries, and regulatory authorities in the next rounds of Delphi to represent broader perspectives on IIM. CONCLUSION Further prioritization and a reduction in the number of domains will be needed for the next Delphi. At the next biennial OMERACT meeting, we aim to present and seek voting on a Myositis Preliminary PRO Core Set to enable ultimate measure selection and development.
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Affiliation(s)
- Jin Kyun Park
- From the Division of Rheumatology, Department of Internal Medicine, Medical Research Center, College of Medicine, and Department of Molecular Medicine and Biopharmaceutical Sciences, Seoul National University, Seoul, South Korea; Department of Neurology, Care Science and Society, Division of Physiotherapy, and Department of Learning, Informatics and Medical Education, Karolinska Institutet; Function Area Occupational Therapy and Physical Therapy, Allied Health Professionals Function, Karolinska University Hospital; Division of Rheumatology, Rheumatology Unit, Department of Medicine, Karolinska University Hospital in Solna, Sweden; Division of Rheumatology, Department of Medicine, Johns Hopkins University, Baltimore, Maryland, USA.,J.K. Park, MD, Division of Rheumatology, Department of Internal Medicine, Seoul National University Hospital; H. Alexanderson, PhD, Physiotherapist, Department of Neurology, Care Science and Society, Division of Physiotherapy, Karolinska Institutet, and Function Area Occupational Therapy and Physical Therapy, Allied Health Professionals Function, Karolinska University Hospital; M. Regardt, PhD, Occupational Therapist, Department of Learning, Informatics and Medical Education, Karolinska Institutet, and Function Area Occupational Therapy and Physical Therapy, Allied Health Professionals Function, Karolinska University Hospital; L. Christopher-Stine, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University; C.A. Mecoli, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University; M.C. Domínguez, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University; C. Sarver, Patient Research Partner; I. de Groot, Patient Research Partner; I.E. Lundberg, MD, PhD, Division of Rheumatology, Rheumatology Unit, Department of Medicine, Karolinska University, and Hospital in Solna, Karolinska Institutet; C.O. Bingham 3rd, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University; Y.W. Song, MD, PhD, Division of Rheumatology, Department of Internal Medicine, Medical Research Center, College of Medicine, Department of Molecular Medicine and Biopharmaceutical Sciences, Seoul National University. Dr. Park and Dr. Mecoli contributed equally to this work
| | - Christopher A Mecoli
- From the Division of Rheumatology, Department of Internal Medicine, Medical Research Center, College of Medicine, and Department of Molecular Medicine and Biopharmaceutical Sciences, Seoul National University, Seoul, South Korea; Department of Neurology, Care Science and Society, Division of Physiotherapy, and Department of Learning, Informatics and Medical Education, Karolinska Institutet; Function Area Occupational Therapy and Physical Therapy, Allied Health Professionals Function, Karolinska University Hospital; Division of Rheumatology, Rheumatology Unit, Department of Medicine, Karolinska University Hospital in Solna, Sweden; Division of Rheumatology, Department of Medicine, Johns Hopkins University, Baltimore, Maryland, USA.,J.K. Park, MD, Division of Rheumatology, Department of Internal Medicine, Seoul National University Hospital; H. Alexanderson, PhD, Physiotherapist, Department of Neurology, Care Science and Society, Division of Physiotherapy, Karolinska Institutet, and Function Area Occupational Therapy and Physical Therapy, Allied Health Professionals Function, Karolinska University Hospital; M. Regardt, PhD, Occupational Therapist, Department of Learning, Informatics and Medical Education, Karolinska Institutet, and Function Area Occupational Therapy and Physical Therapy, Allied Health Professionals Function, Karolinska University Hospital; L. Christopher-Stine, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University; C.A. Mecoli, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University; M.C. Domínguez, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University; C. Sarver, Patient Research Partner; I. de Groot, Patient Research Partner; I.E. Lundberg, MD, PhD, Division of Rheumatology, Rheumatology Unit, Department of Medicine, Karolinska University, and Hospital in Solna, Karolinska Institutet; C.O. Bingham 3rd, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University; Y.W. Song, MD, PhD, Division of Rheumatology, Department of Internal Medicine, Medical Research Center, College of Medicine, Department of Molecular Medicine and Biopharmaceutical Sciences, Seoul National University. Dr. Park and Dr. Mecoli contributed equally to this work
| | - Helene Alexanderson
- From the Division of Rheumatology, Department of Internal Medicine, Medical Research Center, College of Medicine, and Department of Molecular Medicine and Biopharmaceutical Sciences, Seoul National University, Seoul, South Korea; Department of Neurology, Care Science and Society, Division of Physiotherapy, and Department of Learning, Informatics and Medical Education, Karolinska Institutet; Function Area Occupational Therapy and Physical Therapy, Allied Health Professionals Function, Karolinska University Hospital; Division of Rheumatology, Rheumatology Unit, Department of Medicine, Karolinska University Hospital in Solna, Sweden; Division of Rheumatology, Department of Medicine, Johns Hopkins University, Baltimore, Maryland, USA.,J.K. Park, MD, Division of Rheumatology, Department of Internal Medicine, Seoul National University Hospital; H. Alexanderson, PhD, Physiotherapist, Department of Neurology, Care Science and Society, Division of Physiotherapy, Karolinska Institutet, and Function Area Occupational Therapy and Physical Therapy, Allied Health Professionals Function, Karolinska University Hospital; M. Regardt, PhD, Occupational Therapist, Department of Learning, Informatics and Medical Education, Karolinska Institutet, and Function Area Occupational Therapy and Physical Therapy, Allied Health Professionals Function, Karolinska University Hospital; L. Christopher-Stine, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University; C.A. Mecoli, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University; M.C. Domínguez, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University; C. Sarver, Patient Research Partner; I. de Groot, Patient Research Partner; I.E. Lundberg, MD, PhD, Division of Rheumatology, Rheumatology Unit, Department of Medicine, Karolinska University, and Hospital in Solna, Karolinska Institutet; C.O. Bingham 3rd, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University; Y.W. Song, MD, PhD, Division of Rheumatology, Department of Internal Medicine, Medical Research Center, College of Medicine, Department of Molecular Medicine and Biopharmaceutical Sciences, Seoul National University. Dr. Park and Dr. Mecoli contributed equally to this work
| | - Malin Regardt
- From the Division of Rheumatology, Department of Internal Medicine, Medical Research Center, College of Medicine, and Department of Molecular Medicine and Biopharmaceutical Sciences, Seoul National University, Seoul, South Korea; Department of Neurology, Care Science and Society, Division of Physiotherapy, and Department of Learning, Informatics and Medical Education, Karolinska Institutet; Function Area Occupational Therapy and Physical Therapy, Allied Health Professionals Function, Karolinska University Hospital; Division of Rheumatology, Rheumatology Unit, Department of Medicine, Karolinska University Hospital in Solna, Sweden; Division of Rheumatology, Department of Medicine, Johns Hopkins University, Baltimore, Maryland, USA.,J.K. Park, MD, Division of Rheumatology, Department of Internal Medicine, Seoul National University Hospital; H. Alexanderson, PhD, Physiotherapist, Department of Neurology, Care Science and Society, Division of Physiotherapy, Karolinska Institutet, and Function Area Occupational Therapy and Physical Therapy, Allied Health Professionals Function, Karolinska University Hospital; M. Regardt, PhD, Occupational Therapist, Department of Learning, Informatics and Medical Education, Karolinska Institutet, and Function Area Occupational Therapy and Physical Therapy, Allied Health Professionals Function, Karolinska University Hospital; L. Christopher-Stine, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University; C.A. Mecoli, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University; M.C. Domínguez, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University; C. Sarver, Patient Research Partner; I. de Groot, Patient Research Partner; I.E. Lundberg, MD, PhD, Division of Rheumatology, Rheumatology Unit, Department of Medicine, Karolinska University, and Hospital in Solna, Karolinska Institutet; C.O. Bingham 3rd, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University; Y.W. Song, MD, PhD, Division of Rheumatology, Department of Internal Medicine, Medical Research Center, College of Medicine, Department of Molecular Medicine and Biopharmaceutical Sciences, Seoul National University. Dr. Park and Dr. Mecoli contributed equally to this work
| | - Lisa Christopher-Stine
- From the Division of Rheumatology, Department of Internal Medicine, Medical Research Center, College of Medicine, and Department of Molecular Medicine and Biopharmaceutical Sciences, Seoul National University, Seoul, South Korea; Department of Neurology, Care Science and Society, Division of Physiotherapy, and Department of Learning, Informatics and Medical Education, Karolinska Institutet; Function Area Occupational Therapy and Physical Therapy, Allied Health Professionals Function, Karolinska University Hospital; Division of Rheumatology, Rheumatology Unit, Department of Medicine, Karolinska University Hospital in Solna, Sweden; Division of Rheumatology, Department of Medicine, Johns Hopkins University, Baltimore, Maryland, USA.,J.K. Park, MD, Division of Rheumatology, Department of Internal Medicine, Seoul National University Hospital; H. Alexanderson, PhD, Physiotherapist, Department of Neurology, Care Science and Society, Division of Physiotherapy, Karolinska Institutet, and Function Area Occupational Therapy and Physical Therapy, Allied Health Professionals Function, Karolinska University Hospital; M. Regardt, PhD, Occupational Therapist, Department of Learning, Informatics and Medical Education, Karolinska Institutet, and Function Area Occupational Therapy and Physical Therapy, Allied Health Professionals Function, Karolinska University Hospital; L. Christopher-Stine, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University; C.A. Mecoli, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University; M.C. Domínguez, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University; C. Sarver, Patient Research Partner; I. de Groot, Patient Research Partner; I.E. Lundberg, MD, PhD, Division of Rheumatology, Rheumatology Unit, Department of Medicine, Karolinska University, and Hospital in Solna, Karolinska Institutet; C.O. Bingham 3rd, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University; Y.W. Song, MD, PhD, Division of Rheumatology, Department of Internal Medicine, Medical Research Center, College of Medicine, Department of Molecular Medicine and Biopharmaceutical Sciences, Seoul National University. Dr. Park and Dr. Mecoli contributed equally to this work
| | - María Casal-Domínguez
- From the Division of Rheumatology, Department of Internal Medicine, Medical Research Center, College of Medicine, and Department of Molecular Medicine and Biopharmaceutical Sciences, Seoul National University, Seoul, South Korea; Department of Neurology, Care Science and Society, Division of Physiotherapy, and Department of Learning, Informatics and Medical Education, Karolinska Institutet; Function Area Occupational Therapy and Physical Therapy, Allied Health Professionals Function, Karolinska University Hospital; Division of Rheumatology, Rheumatology Unit, Department of Medicine, Karolinska University Hospital in Solna, Sweden; Division of Rheumatology, Department of Medicine, Johns Hopkins University, Baltimore, Maryland, USA.,J.K. Park, MD, Division of Rheumatology, Department of Internal Medicine, Seoul National University Hospital; H. Alexanderson, PhD, Physiotherapist, Department of Neurology, Care Science and Society, Division of Physiotherapy, Karolinska Institutet, and Function Area Occupational Therapy and Physical Therapy, Allied Health Professionals Function, Karolinska University Hospital; M. Regardt, PhD, Occupational Therapist, Department of Learning, Informatics and Medical Education, Karolinska Institutet, and Function Area Occupational Therapy and Physical Therapy, Allied Health Professionals Function, Karolinska University Hospital; L. Christopher-Stine, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University; C.A. Mecoli, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University; M.C. Domínguez, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University; C. Sarver, Patient Research Partner; I. de Groot, Patient Research Partner; I.E. Lundberg, MD, PhD, Division of Rheumatology, Rheumatology Unit, Department of Medicine, Karolinska University, and Hospital in Solna, Karolinska Institutet; C.O. Bingham 3rd, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University; Y.W. Song, MD, PhD, Division of Rheumatology, Department of Internal Medicine, Medical Research Center, College of Medicine, Department of Molecular Medicine and Biopharmaceutical Sciences, Seoul National University. Dr. Park and Dr. Mecoli contributed equally to this work
| | - Ingrid de Groot
- From the Division of Rheumatology, Department of Internal Medicine, Medical Research Center, College of Medicine, and Department of Molecular Medicine and Biopharmaceutical Sciences, Seoul National University, Seoul, South Korea; Department of Neurology, Care Science and Society, Division of Physiotherapy, and Department of Learning, Informatics and Medical Education, Karolinska Institutet; Function Area Occupational Therapy and Physical Therapy, Allied Health Professionals Function, Karolinska University Hospital; Division of Rheumatology, Rheumatology Unit, Department of Medicine, Karolinska University Hospital in Solna, Sweden; Division of Rheumatology, Department of Medicine, Johns Hopkins University, Baltimore, Maryland, USA.,J.K. Park, MD, Division of Rheumatology, Department of Internal Medicine, Seoul National University Hospital; H. Alexanderson, PhD, Physiotherapist, Department of Neurology, Care Science and Society, Division of Physiotherapy, Karolinska Institutet, and Function Area Occupational Therapy and Physical Therapy, Allied Health Professionals Function, Karolinska University Hospital; M. Regardt, PhD, Occupational Therapist, Department of Learning, Informatics and Medical Education, Karolinska Institutet, and Function Area Occupational Therapy and Physical Therapy, Allied Health Professionals Function, Karolinska University Hospital; L. Christopher-Stine, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University; C.A. Mecoli, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University; M.C. Domínguez, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University; C. Sarver, Patient Research Partner; I. de Groot, Patient Research Partner; I.E. Lundberg, MD, PhD, Division of Rheumatology, Rheumatology Unit, Department of Medicine, Karolinska University, and Hospital in Solna, Karolinska Institutet; C.O. Bingham 3rd, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University; Y.W. Song, MD, PhD, Division of Rheumatology, Department of Internal Medicine, Medical Research Center, College of Medicine, Department of Molecular Medicine and Biopharmaceutical Sciences, Seoul National University. Dr. Park and Dr. Mecoli contributed equally to this work
| | - Catherine Sarver
- From the Division of Rheumatology, Department of Internal Medicine, Medical Research Center, College of Medicine, and Department of Molecular Medicine and Biopharmaceutical Sciences, Seoul National University, Seoul, South Korea; Department of Neurology, Care Science and Society, Division of Physiotherapy, and Department of Learning, Informatics and Medical Education, Karolinska Institutet; Function Area Occupational Therapy and Physical Therapy, Allied Health Professionals Function, Karolinska University Hospital; Division of Rheumatology, Rheumatology Unit, Department of Medicine, Karolinska University Hospital in Solna, Sweden; Division of Rheumatology, Department of Medicine, Johns Hopkins University, Baltimore, Maryland, USA.,J.K. Park, MD, Division of Rheumatology, Department of Internal Medicine, Seoul National University Hospital; H. Alexanderson, PhD, Physiotherapist, Department of Neurology, Care Science and Society, Division of Physiotherapy, Karolinska Institutet, and Function Area Occupational Therapy and Physical Therapy, Allied Health Professionals Function, Karolinska University Hospital; M. Regardt, PhD, Occupational Therapist, Department of Learning, Informatics and Medical Education, Karolinska Institutet, and Function Area Occupational Therapy and Physical Therapy, Allied Health Professionals Function, Karolinska University Hospital; L. Christopher-Stine, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University; C.A. Mecoli, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University; M.C. Domínguez, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University; C. Sarver, Patient Research Partner; I. de Groot, Patient Research Partner; I.E. Lundberg, MD, PhD, Division of Rheumatology, Rheumatology Unit, Department of Medicine, Karolinska University, and Hospital in Solna, Karolinska Institutet; C.O. Bingham 3rd, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University; Y.W. Song, MD, PhD, Division of Rheumatology, Department of Internal Medicine, Medical Research Center, College of Medicine, Department of Molecular Medicine and Biopharmaceutical Sciences, Seoul National University. Dr. Park and Dr. Mecoli contributed equally to this work
| | - Ingrid E Lundberg
- From the Division of Rheumatology, Department of Internal Medicine, Medical Research Center, College of Medicine, and Department of Molecular Medicine and Biopharmaceutical Sciences, Seoul National University, Seoul, South Korea; Department of Neurology, Care Science and Society, Division of Physiotherapy, and Department of Learning, Informatics and Medical Education, Karolinska Institutet; Function Area Occupational Therapy and Physical Therapy, Allied Health Professionals Function, Karolinska University Hospital; Division of Rheumatology, Rheumatology Unit, Department of Medicine, Karolinska University Hospital in Solna, Sweden; Division of Rheumatology, Department of Medicine, Johns Hopkins University, Baltimore, Maryland, USA.,J.K. Park, MD, Division of Rheumatology, Department of Internal Medicine, Seoul National University Hospital; H. Alexanderson, PhD, Physiotherapist, Department of Neurology, Care Science and Society, Division of Physiotherapy, Karolinska Institutet, and Function Area Occupational Therapy and Physical Therapy, Allied Health Professionals Function, Karolinska University Hospital; M. Regardt, PhD, Occupational Therapist, Department of Learning, Informatics and Medical Education, Karolinska Institutet, and Function Area Occupational Therapy and Physical Therapy, Allied Health Professionals Function, Karolinska University Hospital; L. Christopher-Stine, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University; C.A. Mecoli, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University; M.C. Domínguez, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University; C. Sarver, Patient Research Partner; I. de Groot, Patient Research Partner; I.E. Lundberg, MD, PhD, Division of Rheumatology, Rheumatology Unit, Department of Medicine, Karolinska University, and Hospital in Solna, Karolinska Institutet; C.O. Bingham 3rd, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University; Y.W. Song, MD, PhD, Division of Rheumatology, Department of Internal Medicine, Medical Research Center, College of Medicine, Department of Molecular Medicine and Biopharmaceutical Sciences, Seoul National University. Dr. Park and Dr. Mecoli contributed equally to this work
| | - Clifton O Bingham
- From the Division of Rheumatology, Department of Internal Medicine, Medical Research Center, College of Medicine, and Department of Molecular Medicine and Biopharmaceutical Sciences, Seoul National University, Seoul, South Korea; Department of Neurology, Care Science and Society, Division of Physiotherapy, and Department of Learning, Informatics and Medical Education, Karolinska Institutet; Function Area Occupational Therapy and Physical Therapy, Allied Health Professionals Function, Karolinska University Hospital; Division of Rheumatology, Rheumatology Unit, Department of Medicine, Karolinska University Hospital in Solna, Sweden; Division of Rheumatology, Department of Medicine, Johns Hopkins University, Baltimore, Maryland, USA.,J.K. Park, MD, Division of Rheumatology, Department of Internal Medicine, Seoul National University Hospital; H. Alexanderson, PhD, Physiotherapist, Department of Neurology, Care Science and Society, Division of Physiotherapy, Karolinska Institutet, and Function Area Occupational Therapy and Physical Therapy, Allied Health Professionals Function, Karolinska University Hospital; M. Regardt, PhD, Occupational Therapist, Department of Learning, Informatics and Medical Education, Karolinska Institutet, and Function Area Occupational Therapy and Physical Therapy, Allied Health Professionals Function, Karolinska University Hospital; L. Christopher-Stine, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University; C.A. Mecoli, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University; M.C. Domínguez, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University; C. Sarver, Patient Research Partner; I. de Groot, Patient Research Partner; I.E. Lundberg, MD, PhD, Division of Rheumatology, Rheumatology Unit, Department of Medicine, Karolinska University, and Hospital in Solna, Karolinska Institutet; C.O. Bingham 3rd, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University; Y.W. Song, MD, PhD, Division of Rheumatology, Department of Internal Medicine, Medical Research Center, College of Medicine, Department of Molecular Medicine and Biopharmaceutical Sciences, Seoul National University. Dr. Park and Dr. Mecoli contributed equally to this work
| | - Yeong Wook Song
- From the Division of Rheumatology, Department of Internal Medicine, Medical Research Center, College of Medicine, and Department of Molecular Medicine and Biopharmaceutical Sciences, Seoul National University, Seoul, South Korea; Department of Neurology, Care Science and Society, Division of Physiotherapy, and Department of Learning, Informatics and Medical Education, Karolinska Institutet; Function Area Occupational Therapy and Physical Therapy, Allied Health Professionals Function, Karolinska University Hospital; Division of Rheumatology, Rheumatology Unit, Department of Medicine, Karolinska University Hospital in Solna, Sweden; Division of Rheumatology, Department of Medicine, Johns Hopkins University, Baltimore, Maryland, USA. .,J.K. Park, MD, Division of Rheumatology, Department of Internal Medicine, Seoul National University Hospital; H. Alexanderson, PhD, Physiotherapist, Department of Neurology, Care Science and Society, Division of Physiotherapy, Karolinska Institutet, and Function Area Occupational Therapy and Physical Therapy, Allied Health Professionals Function, Karolinska University Hospital; M. Regardt, PhD, Occupational Therapist, Department of Learning, Informatics and Medical Education, Karolinska Institutet, and Function Area Occupational Therapy and Physical Therapy, Allied Health Professionals Function, Karolinska University Hospital; L. Christopher-Stine, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University; C.A. Mecoli, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University; M.C. Domínguez, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University; C. Sarver, Patient Research Partner; I. de Groot, Patient Research Partner; I.E. Lundberg, MD, PhD, Division of Rheumatology, Rheumatology Unit, Department of Medicine, Karolinska University, and Hospital in Solna, Karolinska Institutet; C.O. Bingham 3rd, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University; Y.W. Song, MD, PhD, Division of Rheumatology, Department of Internal Medicine, Medical Research Center, College of Medicine, Department of Molecular Medicine and Biopharmaceutical Sciences, Seoul National University. Dr. Park and Dr. Mecoli contributed equally to this work.
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Naidoo J, Cappelli LC, Forde PM, Marrone KA, Lipson EJ, Hammers HJ, Sharfman WH, Le DT, Baer AN, Shah AA, Albayda J, Manno RL, Haque U, Gutierrez AK, Bingham CO, Brahmer JR. Inflammatory Arthritis: A Newly Recognized Adverse Event of Immune Checkpoint Blockade. Oncologist 2017; 22:627-630. [PMID: 28576858 PMCID: PMC5469592 DOI: 10.1634/theoncologist.2016-0390] [Citation(s) in RCA: 54] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2016] [Accepted: 02/02/2017] [Indexed: 12/26/2022] Open
Abstract
This commentary summarizes current knowledge on the clinical presentation, management, and outcomes of the inflammatory arthritis which may occur as an immune‐related adverse evet of immune checkpoint inhibitor therapy. Herein, we propose a new algorithm aimed at assisting oncologists in the diagnosis and management of this immune‐related adverse event.
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Affiliation(s)
- Jarushka Naidoo
- Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Laura C Cappelli
- Division of Rheumatology, Department of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
| | - Patrick M Forde
- Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Kristen A Marrone
- Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Evan J Lipson
- Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Hans J Hammers
- Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - William H Sharfman
- Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Dung T Le
- Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Alan N Baer
- Division of Rheumatology, Department of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
| | - Ami A Shah
- Division of Rheumatology, Department of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
| | - Jemima Albayda
- Division of Rheumatology, Department of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
| | - Rebecca L Manno
- Division of Rheumatology, Department of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
| | - Uzma Haque
- Division of Rheumatology, Department of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
| | - Anna Kristina Gutierrez
- Division of Rheumatology, Department of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
| | - Clifton O Bingham
- Division of Rheumatology, Department of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
| | - Julie R Brahmer
- Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
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Turnbull AE, Sepulveda KA, Dinglas VD, Chessare CM, Bingham CO, Needham DM. Core Domains for Clinical Research in Acute Respiratory Failure Survivors: An International Modified Delphi Consensus Study. Crit Care Med 2017; 45:1001-1010. [PMID: 28375853 PMCID: PMC5433919 DOI: 10.1097/ccm.0000000000002435] [Citation(s) in RCA: 63] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
OBJECTIVES To identify the "core domains" (i.e., patient outcomes, health-related conditions, or aspects of health) that relevant stakeholders agree are essential to assess in all clinical research studies evaluating the outcomes of acute respiratory failure survivors after hospital discharge. DESIGN A two-round consensus process, using a modified Delphi methodology, with participants from 16 countries, including patient and caregiver representatives. Prior to voting, participants were asked to review 1) results from surveys of clinical researchers, acute respiratory failure survivors, and caregivers that rated the importance of 19 preliminary outcome domains and 2) results from a qualitative study of acute respiratory failure survivors' outcomes after hospital discharge, as related to the 19 preliminary outcome domains. Participants also were asked to suggest any additional potential domains for evaluation in the first Delphi survey. SETTING Web-based surveys of participants representing four stakeholder groups relevant to clinical research evaluating postdischarge outcomes of acute respiratory failure survivors: clinical researchers, clinicians, patients and caregivers, and U.S. federal research funding organizations. SUBJECTS None. INTERVENTIONS None. MEASUREMENTS AND MAIN RESULTS Survey response rates were 97% and 99% in round 1 and round 2, respectively. There were seven domains that met the a priori consensus criteria to be designated as core domains: physical function, cognition, mental health, survival, pulmonary function, pain, and muscle and/or nerve function. CONCLUSIONS This study generated a consensus-based list of core domains that should be assessed in all clinical research studies evaluating acute respiratory failure survivors after hospital discharge. Identifying appropriate measurement instruments to assess these core domains is an important next step toward developing a set of core outcome measures for this field of research.
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Affiliation(s)
- Alison E. Turnbull
- Outcomes After Critical Illness and Surgery (OACIS) Group, Johns Hopkins University, Baltimore, MD
- Division of Pulmonary and Critical Care Medicine, School of Medicine, Johns Hopkins University, Baltimore, MD
- Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD
| | - Kristin A. Sepulveda
- Outcomes After Critical Illness and Surgery (OACIS) Group, Johns Hopkins University, Baltimore, MD
- Division of Pulmonary and Critical Care Medicine, School of Medicine, Johns Hopkins University, Baltimore, MD
| | - Victor D. Dinglas
- Outcomes After Critical Illness and Surgery (OACIS) Group, Johns Hopkins University, Baltimore, MD
- Division of Pulmonary and Critical Care Medicine, School of Medicine, Johns Hopkins University, Baltimore, MD
| | - Caroline M. Chessare
- Outcomes After Critical Illness and Surgery (OACIS) Group, Johns Hopkins University, Baltimore, MD
- Division of Pulmonary and Critical Care Medicine, School of Medicine, Johns Hopkins University, Baltimore, MD
| | - Clifton O. Bingham
- Divisions of Rheumatology and Allergy and Clinical Immunology, Johns Hopkins University, Baltimore, MD
| | - Dale M. Needham
- Outcomes After Critical Illness and Surgery (OACIS) Group, Johns Hopkins University, Baltimore, MD
- Division of Pulmonary and Critical Care Medicine, School of Medicine, Johns Hopkins University, Baltimore, MD
- Department of Physical Medicine and Rehabilitation, School of Medicine, Johns Hopkins University, Baltimore
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Zhou Y, Chen B, Mittereder N, Chaerkady R, Strain M, Rahman S, Ma W, Low CP, Chan D, Neal F, Bingham CO, Sampson K, Darrah E, Bowen M, Andrade F, Vousden K, Sims GP, Mustelin TM. Spontaneous secretion of peptidyl-arginine deiminase 2 and cell surface exposure of peptidyl-arginine deiminase 4 by neutrophils. The Journal of Immunology 2017. [DOI: 10.4049/jimmunol.198.supp.207.5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Abstract
Autoantibodies directed against citrullinated epitopes of proteins are highly diagnostic of rheumatoid arthritis (RA) and elevated levels of protein citrullination can be found in the joints of RA patients. Although the pathophysiological mechanisms and the cell type(s) responsible for the increase in protein citrullination remain incompletely understood, the neutrophil is emerging as a prime suspect. Here we report that fully viable resting neutrophils from healthy donors have enzymatically active PAD4 exposed on their surface and that they spontaneously secrete enzymatically active PAD2. Activation of the neutrophils by several stimulatory agents, such as immune complexes, tumor necrosis factor a, phorbol myristate acetate, and agonists of Toll-like receptors1, 5, 7, and 9, increased the immunoreactive amount of PAD4 on the cells. However, immune complex, LPS and PMA stimulation reduced PAD2 secretion. The presence of extracellular PAD2 and PAD4 was not caused by NETosis, apoptosis, or lysis of the cells, as verified by gating on live cells and adding NETosis inhibitor in flow cytometry experiments. Neutrophils from the blood of RA patients also exposed PAD4 on their surface at levels similar to those from healthy subjects. Our data add a novel pathway for the extracellular citrullination of proteins by PAD2 and PAD4 in RA and suggest that this pathway is part of normal neutrophil biology also in the absence of disease.
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Bingham CO, Noonan VK, Auger C, Feldman DE, Ahmed S, Bartlett SJ. Montreal Accord on Patient-Reported Outcomes (PROs) use series - Paper 4: patient-reported outcomes can inform clinical decision making in chronic care. J Clin Epidemiol 2017; 89:136-141. [PMID: 28433678 DOI: 10.1016/j.jclinepi.2017.04.014] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2015] [Revised: 03/16/2017] [Accepted: 04/09/2017] [Indexed: 12/15/2022]
Abstract
BACKGROUND Providing patient-centered health care requires that patient needs, preferences, and valued outcomes are more fully integrated into all decisions. Patient-reported outcome (PRO) measures provide unique information from the patient perspective on overall health, symptoms, burden, and treatment response. OBJECTIVE We sought to describe applications of PROs in clinical settings and considerations for implementation from the perspectives of PRO researchers, clinicians, administrators, policy makers, and patients attending a multidisciplinary meeting. DISCUSSION Clinical applications of PROs include individual level use for medical decision making and aggregate use for comparative effectiveness research, program evaluation, quality improvement, and performance assessments. Considerations of feasibility on workflow impact and patient burden, display of results, and administration frequency are important. PROs with strong psychometric properties, actionable thresholds, and interpretable results should be selected. We provide current exemplars of PRO use in various clinical applications, initial lessons learned, and highlight conceptual, logistical, and consequential considerations of PRO data collection. A research agenda is proposed to address critical knowledge gaps. In conclusion, PROs can be used in clinical settings to support patient-centered care. This requires an assessment of feasibility in the intended setting of use, measurement considerations, and process measures to optimize integration and use.
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Affiliation(s)
- Clifton O Bingham
- Johns Hopkins Division of Rheumatology, 5200 Eastern Avenue, Mason F. Lord Bldg, Suite 4100, Baltimore, MD 21224, USA.
| | - Vanessa K Noonan
- Rick Hansen Institute, Blusson Spinal Cord Centre, 818 West 10th Avenue, Vancouver, British Columbia, Canada V5Z 1M9
| | - Claudine Auger
- Center for Interdisciplinary Research in Rehabilitation of Greater Montreal, CRLB, 2275 Laurier East, Montréal, Québec, Canada H2H 2N8
| | - Debbie E Feldman
- Direction de la Santé Publique, Montréal, 1301 Sherbrooke East, Montreal, Québec, Canada H2L 1M3
| | - Sara Ahmed
- Department of Medicine, McGill University/McGill University Health Center (RVH), 687 Pine Avenue West, Ross Pavilion R4.29, Montreal, Québec, Canada H3A 1A1; School of Physical and Occupational Therapy, McGill University, 3654 Prom Sir-William-Osler, Montreal, Québec, Canada H3G 1Y5; Centre de recherche interdisciplinaire en réadaptation (CRIR), 2275 Laurier Ave E, Montreal, Quebec, Canada H2H 2N8
| | - Susan J Bartlett
- Johns Hopkins Division of Rheumatology, 5200 Eastern Avenue, Mason F. Lord Bldg, Suite 4100, Baltimore, MD 21224, USA; Department of Medicine, McGill University/McGill University Health Center (RVH), 687 Pine Avenue West, Ross Pavilion R4.29, Montreal, Québec, Canada H3A 1A1
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Aletaha D, Bingham CO, Tanaka Y, Agarwal P, Kurrasch R, Tak PP, Popik S. Efficacy and safety of sirukumab in patients with active rheumatoid arthritis refractory to anti-TNF therapy (SIRROUND-T): a randomised, double-blind, placebo-controlled, parallel-group, multinational, phase 3 study. Lancet 2017; 389:1206-1217. [PMID: 28215362 DOI: 10.1016/s0140-6736(17)30401-4] [Citation(s) in RCA: 83] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2017] [Revised: 01/31/2017] [Accepted: 02/01/2017] [Indexed: 01/08/2023]
Abstract
BACKGROUND Sirukumab, a human monoclonal antibody that selectively binds to the interleukin-6 cytokine with high affinity, is under development for the treatment of rheumatoid arthritis and other diseases. We aimed to assess the efficacy and safety of sirukumab for rheumatoid arthritis in a phase 3 study (SIRROUND-T). METHODS We did a randomised, double-blind, placebo-controlled, parallel-group, multicentre study at 183 hospitals and private rheumatology clinics in 20 countries (Argentina, Australia, Austria, Belgium, Canada, France, Germany, Italy, Japan, Lithuania, Mexico, Netherlands, Poland, Portugal, Russia, South Korea, Spain, Taiwan, UK, and USA). Eligible participants were patients with active rheumatoid arthritis aged at least 18 years, with four or more of 68 tender joints and four or more of 66 swollen joints, who were refractory or intolerant to previous treatment with at least one anti-TNF drug. We randomly assigned patients (1:1:1) via a central interactive voice or web response system to either placebo every 2 weeks, 50 mg sirukumab every 4 weeks, or 100 mg sirukumab every 2 weeks, all given for 52 weeks or less. We allowed participants to continue using any concomitant disease-modifying antirheumatic drugs (DMARDs). We based the randomisation on a computer-generated, permuted-block schedule stratified by use of methotrexate at baseline (0, >0 to <12·5 mg/week, or ≥12·5 mg/week). Masking was achieved with the use of multipart labels on the study drug containers which contained directions for use and other information, but not the drug's identity. Treatments were administered by subcutaneous injection; patients assigned to 50 mg sirukumab given every 4 weeks also received a placebo injection every 2 weeks to maintain masking. At week 18, placebo-treated patients meeting early escape criteria (<20% improvement in swollen and tender joint counts) were randomly reassigned to either 50 mg or 100 mg of sirukumab. All remaining placebo-treated patients were subsequently randomly reassigned at week 24 to either sirukumab dose (crossover). The primary outcome was the proportion of patients who achieved a response of at least 20% improvement at week 16 according to American College of Rheumatology criteria (ACR20) in the intention-to-treat population (all randomly assigned participants). Safety analyses included all participants who received at least one dose (partial or complete) of study drug. This study is registered at EudraCT (number: 2010-022243-38) and ClinicalTrials.gov (number: NCT01606761). FINDINGS Between July 25, 2012, and Jan 12, 2016, we randomly assigned 878 patients to treatment: 294 to placebo, 292 to 50 mg sirukumab every 4 weeks, and 292 to 100 mg sirukumab every 2 weeks. 523 (60%) of 878 patients had previously received two or more biological treatments including non-TNF drugs, and 166 (19%) of 878 were not taking a DMARD at baseline. The proportions of patients who achieved an ACR20 response at week 16 were 117 (40%) of 292 with 50 mg sirukumab every 4 weeks, and 132 (45%) of 292 with 100 mg sirukumab every 2 weeks versus 71 (24%) of 294 with placebo; differences compared with placebo were 0·16 (95% CI 0·09-0·23) for 50 mg sirukumab every 4 weeks and 0·21 (0·14-0·29) for 100 mg sirukumab every 2 weeks (both p<0·0001). Adverse event incidences in the 24-week placebo-controlled period were similar across groups (at least one event occurred for 182 patients assigned to placebo [62%, including early escape patients switched to sirukumab at week 18] of 294; 194 [66%] of 292 with 50 mg sirukumab every 4 weeks; and 207 [71%] of 292 with 100 mg sirukumab every 2 weeks). The most common adverse events in this period were injection-site erythema (four [1%] with placebo, 22 [8%] with 50 mg sirukumab every 4 weeks, and 41 [14%] with 100 mg sirukumab every 2 weeks). At week 52, of all patients receiving sirukumab including those reassigned from placebo, the most common adverse events were again injection-site erythema (33 [8%] of 416 with 50 mg sirukumab every 4 weeks and 66 [16%] of 418 with 100 mg sirukumab every 2 weeks). INTERPRETATION In patients with active rheumatoid arthritis who were refractory or intolerant to anti-TNF drugs and other biological treatments, both dosing regimens of sirukumab were well tolerated and significantly improved signs and symptoms of the disease, compared with placebo, in this difficult-to-treat population. FUNDING Janssen Research & Development, LLC, and GlaxoSmithKline.
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Affiliation(s)
- Daniel Aletaha
- Division of Rheumatology, Department of Internal Medicine 3, Medical University of Vienna, Vienna, Austria
| | - Clifton O Bingham
- Division of Rheumatology, Johns Hopkins University, Baltimore, MD, USA
| | - Yoshiya Tanaka
- Department of Internal Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan
| | | | | | - Paul P Tak
- GlaxoSmithKline, Stevenage, Hertfordshire, UK.
| | - Sharon Popik
- Janssen Research & Development, LLC, Spring House, PA, USA
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Abstract
Immune checkpoint inhibitors (ICIs) are increasingly studied and used as therapy for a growing number of malignancies. ICIs work by blocking inhibitory pathways of T-cell activation, leading to an immune response directed against tumors. Such nonspecific immunologic activation can lead to immune-related adverse events (IRAEs). Some IRAEs, including inflammatory arthritis, sicca syndrome, myositis, and vasculitis, are of special interest to rheumatologists. As use of ICIs increases, recognition of these IRAEs and developing treatment strategies will become important. In this review, the current literature on rheumatic and musculoskeletal IRAEs is summarized. The incidence, clinical presentations, and treatment considerations are highlighted.
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Affiliation(s)
- Laura C Cappelli
- Division of Rheumatology, Johns Hopkins School of Medicine, 5501 Hopkins Bayview Circle, Suite 1.B1, Baltimore, MD, USA.
| | - Ami A Shah
- Division of Rheumatology, Johns Hopkins School of Medicine, 5501 Hopkins Bayview Circle, Suite 1.B1, Baltimore, MD, USA
| | - Clifton O Bingham
- Division of Rheumatology, Johns Hopkins School of Medicine, 5501 Hopkins Bayview Circle, Suite 1.B1, Baltimore, MD, USA
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Halls S, Sinnathurai P, Hewlett S, Mackie SL, March L, Bartlett SJ, Bingham CO, Alten R, Campbell I, Hill CL, Holt RJ, Hughes R, Kirwan JR, Leong AL, Leung YY, Lyddiatt A, Neill L, Orbai AM. Stiffness Is the Cardinal Symptom of Inflammatory Musculoskeletal Diseases, Yet Still Variably Measured: Report from the OMERACT 2016 Stiffness Special Interest Group. J Rheumatol 2016; 44:1904-1910. [DOI: 10.3899/jrheum.161073] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Objective.The objectives of the Outcome Measures in Rheumatology (OMERACT) Stiffness special interest group (SIG) are to characterize stiffness as an outcome in rheumatic disease and to identify and validate a stiffness patient-reported outcome (PRO) in rheumatology.Methods.At OMERACT 2016, international groups presented and discussed results of several concurrent research projects on stiffness: a literature review of rheumatoid arthritis (RA) stiffness PRO measures, a qualitative investigation into the RA and polymyalgia rheumatica patient perspective of stiffness, data-driven stiffness conceptual model development, development and testing of an RA stiffness PRO measure, and a quantitative work testing stiffness items in patients with RA and psoriatic arthritis.Results.The literature review identified 52 individual stiffness PRO measures assessing morning or early morning stiffness severity/intensity or duration. Items were heterogeneous, had little or inconsistent psychometric property evidence, and did not appear to have been developed according to the PRO development guidelines. A poor match between current stiffness PRO and the conceptual model identifying the RA patient experience of stiffness was identified, highlighting a major flaw in PRO selection according to the OMERACT filter 2.0.Conclusion.Discussions within the Stiffness SIG highlighted the importance of further research on stiffness and defined a research agenda.
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Cappelli LC, Shah AA, Bingham CO. Cancer immunotherapy-induced rheumatic diseases emerge as new clinical entities. RMD Open 2016; 2:e000321. [PMID: 27752360 PMCID: PMC5051426 DOI: 10.1136/rmdopen-2016-000321] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2016] [Revised: 08/29/2016] [Accepted: 09/07/2016] [Indexed: 01/05/2023] Open
Abstract
Immune checkpoint inhibitors (ICIs) are newly approved treatments for advanced malignancies that are increasing survival. The mechanism of these drugs, non-specifically activating T cells, also leads to immune-mediated damage of tissue or immune-related adverse events (IRAE). IRAEs with rheumatic phenotypes are increasingly being recognised. Inflammatory arthritis, sicca syndrome, inflammatory myopathy, vasculitis and lupus nephritis have been described as a result of ICIs. Use of ICIs will be expanding in the coming years for several reasons. ICIs will be used in earlier stage cancer, for more indications, and additional drugs will be approved. The rheumatologist plays a critical role in evaluating and treating these patients. The expertise of rheumatologists in evaluating rheumatic signs and symptoms and treating patients with immunosuppression are critical in ensuring the optimal outcomes for patients with rheumatic IRAE. Collaboration between oncology and rheumatology for clinical care and research will enhance understanding of these new disease entities.
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Affiliation(s)
- Laura C Cappelli
- Department of Medicine, Division of Rheumatology , Johns Hopkins University , Baltimore, Maryland , USA
| | - Ami A Shah
- Department of Medicine, Division of Rheumatology , Johns Hopkins University , Baltimore, Maryland , USA
| | - Clifton O Bingham
- Department of Medicine, Division of Rheumatology , Johns Hopkins University , Baltimore, Maryland , USA
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Emery P, Bingham CO, Burmester GR, Bykerk VP, Furst DE, Mariette X, Heijde DVD, Vollenhoven RV, Arendt C, Mountian I, Purcaru O, Tatla D, VanLunen B, Weinblatt ME. Response to: 'Let's stop fooling ourselves. In RA, only ACR/EULAR criteria define remission and equate with absence of disease!' by Boers. Ann Rheum Dis 2016; 75:e69. [PMID: 27519773 DOI: 10.1136/annrheumdis-2016-210083] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2016] [Accepted: 07/03/2016] [Indexed: 11/03/2022]
Affiliation(s)
- P Emery
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds and NIHR Leeds Musculoskeletal Biomedical Research Unit, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | | | - G R Burmester
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds and NIHR Leeds Musculoskeletal Biomedical Research Unit, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - V P Bykerk
- Weill Cornell Medical College, Division of Rheumatology, Hospital for Special Surgery, New York, USA
| | - D E Furst
- Division of Rheumatology, David Geffen School of Medicine at UCLA, Los Angeles, USA
| | - X Mariette
- Université Paris-Sud, Hôpitaux Universitaires Paris-Sud, AP-HP, INSERM U1184, Le Kremlin Bicêtre, France
| | | | - R van Vollenhoven
- Unit for Clinical Therapy Research, Inflammatory Disease, Karolinska Institute, Stockholm, Sweden
| | | | | | | | | | | | - M E Weinblatt
- Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital, Boston, USA
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Bingham CO, Bartlett SJ, Merkel PA, Mielenz TJ, Pilkonis PA, Edmundson L, Moore E, Sabharwal RK. Using patient-reported outcomes and PROMIS in research and clinical applications: experiences from the PCORI pilot projects. Qual Life Res 2016; 25:2109-16. [PMID: 26914103 PMCID: PMC4946989 DOI: 10.1007/s11136-016-1246-1] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/04/2016] [Indexed: 01/22/2023]
Abstract
PURPOSE The field of patient-centered outcomes research (PCOR) continues to develop. Patient-reported outcomes and, in particular the Patient-Reported Outcomes Measurement Information System (PROMIS) contribute complementary data to clinician-derived outcomes traditionally used in health decision-making. However, there has been little work to understand how PROMIS measures may inform or be integrated into PCOR or clinical applications. METHODS Lead investigators from four pilot projects funded by the Patient-Centered Outcomes Research Institute (PCORI) collaborated to discuss lessons learned about the use of PROMIS in PCOR studies via virtual and in-person meetings. In addition, a qualitative data collection tool was used to assess the pilot projects' experiences. RESULTS Lessons learned from the pilot projects centered on practical elements of research design, such as choosing the right outcomes to study, considering the advantages and limitations of the PROMIS short forms and computer adaptive technology versions, planning ahead for a feasible data collection process, maintaining the focus on patients by ensuring that the research is truly patient-centered, and helping patients and providers make the most of PROMIS in care. CONCLUSION The PCORI pilot projects demonstrated that PROMIS can be successfully used to conduct research that will help patients make decisions about their care. Interest in PCOR continues to grow and the lessons learned from these projects about the use of PROMIS will be helpful to investigators. Given the numerous benefits of PROMIS, implementing this tool in research and care will hopefully lead to significant progress in measuring health outcomes that are meaningful and relevant to all stakeholders.
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Affiliation(s)
- Clifton O Bingham
- Division of Rheumatology, Johns Hopkins University, 5200 Eastern Avenue, MFL Center Tower Room 404, Baltimore, MD, 21224, USA.
| | - Susan J Bartlett
- Divisions of Clinical Epidemiology, Rheumatology and Respiratory Epidemiology and Clinical Trials Unit, McGill University/Royal Victoria Hospital, 687 Av des Pins Ouest, Ross Pavillion R4.31, Montreal, QC, H3A 1A1, Canada
| | - Peter A Merkel
- Division of Rheumatology and Department of Biostatistics and Clinical Epidemiology, University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA, 19104, USA
| | - Thelma J Mielenz
- Department of Epidemiology, Columbia University Mailman School of Public Health, 722 West 168th St., New York, NY, 10032, USA
| | - Paul A Pilkonis
- Department of Psychiatry, University of Pittsburgh, 3811 O'Hara St., Pittsburgh, PA, 15213, USA
| | - Lauren Edmundson
- Swedish Medical Center, 5300 Tallman Ave NW, Seattle, WA, 98107, USA
| | - Emily Moore
- University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI, 48109-2029, USA
| | - Rajeev K Sabharwal
- AcademyHealth, 1150 17th Street NW, Suite 600, Washington, DC, 20036, USA
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Mecoli CA, Delev NG, Bingham CO. Measuring transaminases in patients with rheumatoid arthritis on weekly methotrexate: does timing of blood testing matter? Clin Rheumatol 2016; 35:3053-3056. [PMID: 27473088 DOI: 10.1007/s10067-016-3361-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2016] [Revised: 06/16/2016] [Accepted: 07/16/2016] [Indexed: 10/21/2022]
Abstract
The change in transaminase levels over a single week during therapy with methotrexate (MTX) has not been investigated or reported to date. In clinical practice, it is common to observe abnormal transaminase levels upon routine blood work for toxicity monitoring. Many have suggested that such lab abnormalities can sometimes be attributed to sampling blood for toxicity monitoring proximately following MTX dosing. The aim of our study was to evaluate changes in transaminase levels (AST/ALT) over 1 week after MTX administration in rheumatoid arthritis (RA) patients. In this small proof of concept study, we evaluated 13 patients with RA taking stable doses of methotrexate and background medications (e.g., NSAIDs and prednisone), but no other disease-modifying anti-rheumatic drugs (DMARDs). All patients were on a stable dose of folic acid. Patients received their usual doses of MTX administered at a specified time, and then sequential blood samples were obtained over the course of 7 days. Peripheral blood was obtained at each time point to measure serum transaminases. We did not observe any significant change in sequential transaminases over 1 week in relationship to MTX administration. It is possible that MTX therapy alone does not lead to significant weekly transaminase variations, contrary to our clinical expectations. The addition of other medications (i.e., NSAIDs) to stable MTX regimen may result in transaminase abnormalities.
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Affiliation(s)
- Christopher A Mecoli
- Johns Hopkins Division of Rheumatology, 5200 Eastern Avenue, MFL Center Tower, Room 404, Baltimore, MD, 21224, USA.
| | - Nikolay G Delev
- Johns Hopkins Division of Rheumatology, 5200 Eastern Avenue, MFL Center Tower, Room 404, Baltimore, MD, 21224, USA
| | - Clifton O Bingham
- Johns Hopkins Division of Rheumatology, 5200 Eastern Avenue, MFL Center Tower, Room 404, Baltimore, MD, 21224, USA
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Cappelli LC, Gutierrez AK, Baer AN, Albayda J, Manno RL, Haque U, Lipson EJ, Bleich KB, Shah AA, Naidoo J, Brahmer JR, Le D, Bingham CO. Inflammatory arthritis and sicca syndrome induced by nivolumab and ipilimumab. Ann Rheum Dis 2016; 76:43-50. [PMID: 27307501 DOI: 10.1136/annrheumdis-2016-209595] [Citation(s) in RCA: 262] [Impact Index Per Article: 32.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2016] [Revised: 05/16/2016] [Accepted: 05/27/2016] [Indexed: 12/19/2022]
Abstract
OBJECTIVES Immune checkpoint inhibitors (ICIs) targeting the cytotoxic T-lymphocyte-associated protein 4 (CTLA-4) and programmed cell death protein 1 (PD-1) pathways have demonstrated survival improvements in multiple advanced cancers, but also cause immune-related adverse events (IRAEs). IRAEs with clinical features similar to rheumatic diseases have not been well described. We report patients with inflammatory arthritis and sicca syndrome secondary to ICIs. METHODS We report patients evaluated in the Johns Hopkins Rheumatology clinics from 2012 to 2016 identified as having new rheumatological symptoms in the context of treatment with ipilimumab (anti-CTLA-4) and/or nivolumab (anti-PD-1) for solid tumours. RESULTS We identified 13 patients who received ICIs and developed rheumatological IRAEs. Mean age was 58.7 years. Cancer types included melanoma, non-small cell lung cancer, small cell lung cancer and renal cell carcinoma. ICI regimens included nivolumab or ipilimumab as monotherapy (n=5), or combination nivolumab and ipilimumab (n=8). Nine of 13 patients developed an inflammatory arthritis, 4 with synovitis confirmed on imaging (3 ultrasound, 1 MRI) and 4 with inflammatory synovial fluid. Four patients developed sicca syndrome with severe salivary hypofunction. Other IRAEs included: pneumonitis, colitis, interstitial nephritis and thyroiditis. Antinuclear antibodies were positive in 5 out of 13 patients. All 13 patients were treated with corticosteroids with varying response. Two patients were treated with methotrexate and antitumor necrosis factor therapy for inflammatory arthritis. CONCLUSIONS As ICIs are increasingly used for a range of malignancies, new cases of rheumatic IRAEs are likely to emerge. Further research is required to understand mechanisms, determine risk factors and develop management algorithms for rheumatic IRAEs.
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Affiliation(s)
- Laura C Cappelli
- Division of Rheumatology, Department of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
| | - Anna Kristina Gutierrez
- Division of Rheumatology, Department of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
| | - Alan N Baer
- Division of Rheumatology, Department of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
| | - Jemima Albayda
- Division of Rheumatology, Department of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
| | - Rebecca L Manno
- Division of Rheumatology, Department of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
| | - Uzma Haque
- Division of Rheumatology, Department of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
| | - Evan J Lipson
- Department of Oncology, Johns Hopkins University, Baltimore, Maryland, USA
| | - Karen B Bleich
- Department of Radiology, Johns Hopkins University, Baltimore, Maryland, USA
| | - Ami A Shah
- Division of Rheumatology, Department of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
| | - Jarushka Naidoo
- Department of Oncology, Johns Hopkins University, Baltimore, Maryland, USA
| | - Julie R Brahmer
- Department of Oncology, Johns Hopkins University, Baltimore, Maryland, USA
| | - Dung Le
- Department of Oncology, Johns Hopkins University, Baltimore, Maryland, USA
| | - Clifton O Bingham
- Division of Rheumatology, Department of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
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Bykerk VP, Bingham CO, Choy EH, Lin D, Alten R, Christensen R, Furst DE, Hewlett S, Leong A, March L, Woodworth T, Boire G, Haraoui B, Hitchon C, Jamal S, Keystone EC, Pope J, Tin D, Thorne JC, Bartlett SJ. Identifying flares in rheumatoid arthritis: reliability and construct validation of the OMERACT RA Flare Core Domain Set. RMD Open 2016; 2:e000225. [PMID: 27252895 PMCID: PMC4885442 DOI: 10.1136/rmdopen-2015-000225] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2015] [Revised: 04/21/2016] [Accepted: 04/22/2016] [Indexed: 12/13/2022] Open
Abstract
Objective To evaluate the reliability of concurrent flare identification using 3 methods (patient, rheumatologist and Disease Activity Score (DAS)28 criteria), and construct validity of candidate items representing the Outcome Measures in Rheumatology Clinical Trials (OMERACT) RA Flare Core Domain Set. Methods Candidate flare questions and legacy measures were administered at consecutive visits to Canadian Early Arthritis Cohort (CATCH) patients between November 2011 and November 2014. The American College of Rheumatology (ACR) core set indicators were recorded. Concordance to identify flares was assessed using the agreement coefficient. Construct validity of flare questions was examined: convergent (Spearman's r); discriminant (mean differences between flaring/non-flaring patients); and consequential (proportions with prior treatment reductions and intended therapeutic change postflare). Results The 849 patients were 75% female, 81% white, 42% were in remission/low disease activity (R/LDA), and 16–32% were flaring at the second visit. Agreement of flare status was low–strong (κ's 0.17–0.88) and inversely related to RA disease activity level. Flare domains correlated highly (r's≥0.70) with each other, patient global (r's≥0.66) and corresponding measures (r's 0.49–0.92); and moderately highly with MD and patient-reported joint counts (r's 0.29–0.62). When MD/patients agreed the patient was flaring, mean flare domain between-group differences were 2.1–3.0; 36% had treatment reductions prior to flare, with escalation planned in 61%. Conclusions Flares are common in rheumatoid arthritis (RA) and are often preceded by treatment reductions. Patient/MD/DAS agreement of flare status is highest in patients worsening from R/LDA. OMERACT RA flare questions can discriminate between patients with/without flare and have strong evidence of construct and consequential validity. Ongoing work will identify optimal scoring and cut points to identify RA flares.
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Affiliation(s)
- Vivian P Bykerk
- Department of Rheumatology, Hospital for Special Surgery, Weill Cornell Medical College, New York, New York, USA; Rebecca McDonald Center for Arthritis & Autoimmune Disease, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Clifton O Bingham
- Division of Rheumatology , Johns Hopkins School of Medicine , Baltimore, Maryland , USA
| | - Ernest H Choy
- Section of Rheumatology , Arthritis Research UK & Health and Care Research Wales CREATE Centre, Cardiff University , Cardiff , UK
| | - Daming Lin
- Rebecca McDonald Center for Arthritis & Autoimmune Disease, Mount Sinai Hospital, University of Toronto , Toronto, Ontario , Canada
| | - Rieke Alten
- Schlosspark Klinik, Charité University Medicine , Berlin , Germany
| | - Robin Christensen
- Musculoskeletal Statistics Unit, Department of Rheumatology , The Parker Institute , Copenhagen University Hospital, Bispebjerg and Frederiksberg , Denmark
| | - Daniel E Furst
- Division of Rheumatology, University of California, Los Angeles, Los Angeles, California, USA (Emeritus); University of Washington, Seattle Wash; University of Florence, Florence, Italy
| | | | - Amye Leong
- Bone and Joint Decade, Healthy Motivation , Santa Barbara, California , USA
| | - Lyn March
- Department of Rheumatology , University of Sydney, Institute of Bone and Joint Research, Royal North Shore Hospital , St Leonards, New South Wales , Australia
| | - Thasia Woodworth
- Division of Rheumatology , University of California, Los Angeles , Los Angeles, California , USA
| | - Gilles Boire
- Division of Rheumatology , Université de Sherbrooke , Sherbrooke, Québec , Canada
| | - Boulos Haraoui
- Rheumatic Disease Unit , Institut de Rheumatologie , Montreal, Québec , Canada
| | - Carol Hitchon
- Arthritis Center, University of Manitoba , Winnipeg, Manitoba , Canada
| | - Shahin Jamal
- Vancouver Coastal Health Institute , Vancouver, British Columbia , Canada
| | - Edward C Keystone
- Rebecca McDonald Center for Arthritis & Autoimmune Disease, Mount Sinai Hospital, University of Toronto , Toronto, Ontario , Canada
| | - Janet Pope
- Division of Rheumatology , St. Joseph's Health Care London, University of Western Ontario , London, Ontario , Canada
| | - Diane Tin
- Southlake Regional Health Centre , Newmarket, Ontario , Canada
| | - J Carter Thorne
- Southlake Regional Health Centre , Newmarket, Ontario , Canada
| | - Susan J Bartlett
- Division of Rheumatology, Johns Hopkins School of Medicine, Baltimore, Maryland, USA; Divisions of Clinical Epidemiology, Rheumatology, and Respiratory Clinical Trials Unit, McGill University, Montreal, Québec, Canada
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146
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Alten R, Bingham CO, Cohen SB, Curtis JR, Kelly S, Wong D, Genovese MC. Antibody response to pneumococcal and influenza vaccination in patients with rheumatoid arthritis receiving abatacept. BMC Musculoskelet Disord 2016; 17:231. [PMID: 27229685 PMCID: PMC4880815 DOI: 10.1186/s12891-016-1082-z] [Citation(s) in RCA: 51] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2015] [Accepted: 05/13/2016] [Indexed: 12/18/2022] Open
Abstract
Background Patients with rheumatoid arthritis (RA), including those treated with biologics, are at increased risk of some vaccine-preventable infections. We evaluated the antibody response to standard 23-valent pneumococcal polysaccharide vaccine (PPSV23) and the 2011–2012 trivalent seasonal influenza vaccine in adults with RA receiving subcutaneous (SC) abatacept and background disease-modifying anti-rheumatic drugs (DMARDs). Methods Two multicenter, open-label sub-studies enrolled patients from the ACQUIRE (pneumococcal and influenza) and ATTUNE (pneumococcal) studies at any point during their SC abatacept treatment cycle following completion of ≥3 months’ SC abatacept. All patients received fixed-dose abatacept 125 mg/week with background DMARDs. A pre-vaccination blood sample was taken, and after 28 ± 3 days a final post-vaccination sample was collected. The primary endpoint was the proportion of patients achieving an immunologic response to the vaccine at Day 28 among patients without a protective antibody level to the vaccine antigens at baseline (pneumococcal: defined as ≥2-fold increase in post-vaccination titers to ≥3 of 5 antigens and protective antibody level of ≥1.6 μg/mL to ≥3 of 5 antigens; influenza: defined as ≥4-fold increase in post-vaccination titers to ≥2 of 3 antigens and protective antibody level of ≥1:40 to ≥2 of 3 antigens). Safety and tolerability were evaluated throughout the sub-studies. Results Pre- and post-vaccination titers were available for 113/125 and 186/191 enrolled patients receiving the PPSV23 and influenza vaccine, respectively. Among vaccinated patients, 47/113 pneumococcal and 121/186 influenza patients were without protective antibody levels at baseline. Among patients with available data, 73.9 % (34/46) and 61.3 % (73/119) met the primary endpoint and achieved an immunologic response to PPSV23 or influenza vaccine, respectively. In patients with pre- and post-vaccination data available, 83.9 % in the pneumococcal study demonstrated protective antibody levels with PPSV23 (titer ≥1.6 μg/mL to ≥3 of 5 antigens), and 81.2 % in the influenza study achieved protective antibody levels (titer ≥1:40 to ≥2 of 3 antigens) at Day 28 post-vaccination. Vaccines were well tolerated with SC abatacept with background DMARDs. Conclusions In these sub-studies, patients with RA receiving SC abatacept and background DMARDs were able to mount an appropriate immune response to pneumococcal and influenza vaccines. Trial registration NCT00559585 (registered 15 November 2007) and NCT00663702 (registered 18 April 2008). Electronic supplementary material The online version of this article (doi:10.1186/s12891-016-1082-z) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Rieke Alten
- Schlosspark-Klinik University Medicine, Berlin, Germany. .,University Medicine Berlin, Berlin, 14059, Germany.
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147
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Bingham CO, Mendelsohn AM, Kim L, Xu Z, Leu J, Han C, Lo KH, Westhovens R, Weinblatt ME. Maintenance of Clinical and Radiographic Benefit With Intravenous Golimumab Therapy in Patients With Active Rheumatoid Arthritis Despite Methotrexate Therapy: Week-112 Efficacy and Safety Results of the Open-Label Long-Term Extension of a Phase III, Double-Blind, Randomized, Placebo-Controlled Trial. Arthritis Care Res (Hoboken) 2016; 67:1627-36. [PMID: 25623393 PMCID: PMC5063174 DOI: 10.1002/acr.22556] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2014] [Revised: 12/18/2014] [Accepted: 01/20/2015] [Indexed: 01/08/2023]
Abstract
Objective To evaluate the safety, efficacy, pharmacokinetics, immunogenicity, and radiographic progression through 2 years of treatment with intravenous (IV) golimumab plus methotrexate (MTX) in an open‐label extension of a phase III trial of patients with active rheumatoid arthritis (RA) despite MTX therapy. Methods In the phase III, double‐blind, randomized, placebo‐controlled GO‐FURTHER trial, 592 patients with active RA were randomized (2:1) to intravenous golimumab 2 mg/kg plus MTX (Group 1) or placebo plus MTX (Group 2) at weeks 0 and 4, then every 8 weeks thereafter; placebo patients crossed over to golimumab at week 16 (early escape) or week 24 (crossover). The final golimumab infusion was at week 100. Assessments included American College of Rheumatology 20%, 50%, 70% (ACR20, ACR50, ACR70) response criteria, 28‐joint count disease activity score using the C‐reactive protein level (DAS28‐CRP), physical function and quality of life measures, and changes in the modified Sharp/van der Heijde scores (SHS). Safety was monitored through week 112. Results In total, 486 patients (82.1%) continued treatment through week 100, and 68.1%, 43.8%, and 23.5% had an ACR20/50/70 response, respectively, at week 100. Clinical response and improvements in physical function and quality of life were generally maintained from week 24 through 2 years. Mean change from baseline to week 100 in SHS score was 0.74 in Group 1 and 2.10 in Group 2 (P = 0.005); progression from week 52 to week 100 was clinically insignificant in both groups. A total of 481 patients completed the safety followup through week 112; 79.1% had an adverse event, and 18.2% had a serious adverse event. Conclusion Clinical response to IV golimumab plus MTX was maintained through week 100. Radiographic progression following golimumab treatment was clinically insignificant between week 52 and week 100. No unexpected adverse events occurred through week 112, and the safety profile was consistent with anti–tumor necrosis factor therapy.
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Affiliation(s)
| | | | - Lilianne Kim
- Janssen Research and Development, Spring House, Pennsylvania
| | - Zhenhua Xu
- Janssen Research and Development, Spring House, Pennsylvania
| | - Jocelyn Leu
- Janssen Research and Development, Spring House, Pennsylvania
| | | | - Kim Hung Lo
- Janssen Research and Development, Spring House, Pennsylvania
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148
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Emery P, Bingham CO, Burmester GR, Bykerk VP, Furst DE, Mariette X, van der Heijde D, van Vollenhoven R, Arendt C, Mountian I, Purcaru O, Tatla D, VanLunen B, Weinblatt ME. Certolizumab pegol in combination with dose-optimised methotrexate in DMARD-naïve patients with early, active rheumatoid arthritis with poor prognostic factors: 1-year results from C-EARLY, a randomised, double-blind, placebo-controlled phase III study. Ann Rheum Dis 2016; 76:96-104. [PMID: 27165179 PMCID: PMC5264210 DOI: 10.1136/annrheumdis-2015-209057] [Citation(s) in RCA: 67] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2015] [Revised: 04/08/2016] [Accepted: 04/09/2016] [Indexed: 11/13/2022]
Abstract
Objectives To assess the efficacy and safety of certolizumab pegol (CZP)+dose-optimised methotrexate (MTX) versus placebo (PBO)+dose-optimised MTX in inducing and sustaining clinical remission in DMARD-naïve patients with moderate-to-severe, active, progressive rheumatoid arthritis (RA), with poor prognostic factors over 52 weeks. Methods DMARD-naïve patients with ≤1 year of active RA were randomised (3:1) in a double-blind manner to CZP (400 mg Weeks 0, 2, 4, then 200 mg Q2W to Week 52)+MTX or PBO+MTX (the mean optimised-MTX dose=21 and 22 mg/week, respectively). Sustained remission (sREM) and sustained low disease activity (sLDA; DAS28(ESR)<2.6 and DAS28(ESR)≤3.2, respectively, at both Weeks 40 and 52) were the primary and secondary endpoints. Results Patients were randomised to CZP+MTX (n=660) and PBO+MTX (n=219). At Week 52, significantly more patients assigned to CZP+MTX compared with PBO+MTX achieved sREM (28.9% vs 15.0%, p<0.001) and sLDA (43.8% vs 28.6%, p<0.001). Inhibition of radiographic progression and improvements in physical functioning were significantly greater for CZP+MTX versus PBO+MTX (van der Heijde modified total Sharp score (mTSS) mean absolute change from baseline (CFB): 0.2 vs 1.8, p<0.001, rate of mTSS non-progressors: 70.3% vs 49.7%, p<0.001; least squares (LS) mean CFB in Health Assessment Questionnaire-Disability Index (HAQ-DI): −1.00 vs −0.82, p<0.001). Incidence of adverse events (AEs) and serious AEs was similar between treatment groups. Infection was the most frequent AE, with higher incidence for CZP+MTX (71.8/100 patient-years (PY)) versus PBO+MTX (52.7/100 PY); the rate of serious infection was similar between CZP+MTX (3.3/100 PY) and PBO+MTX (3.7/100 PY). Conclusions CZP+dose-optimised MTX treatment of DMARD-naïve early RA resulted in significantly more patients achieving sREM and sLDA, improved physical function and inhibited structural damage compared with PBO+dose-optimised MTX. Trial registration number NCT01519791.
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Affiliation(s)
- P Emery
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK.,NIHR Leeds Musculoskeletal Biomedical Research Unit, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - C O Bingham
- Johns Hopkins University, Baltimore, Maryland, USA
| | - G R Burmester
- Rheumatology and Clinical Immunology, Charité-University Medicine, Berlin, Germany
| | - V P Bykerk
- Division of Rheumatology, Weill Cornell Medical College, Hospital for Special Surgery, New York, New York, USA
| | - D E Furst
- Division of Rheumatology, David Geffen School of Medicine at UCLA, Los Angeles, California, USA
| | - X Mariette
- Université Paris-Sud, Hôpitaux Universitaires Paris-Sud, AP-HP, Le Kremlin Bicêtre, France
| | - D van der Heijde
- Deprtment of Rheumatology, Leiden University Medical Centre, Leiden, The Netherlands
| | - R van Vollenhoven
- Unit for Clinical Therapy Research, Inflammatory Disease, Karolinska Institute, Stockholm, Sweden
| | | | | | | | - D Tatla
- UCB Pharma, Raleigh, North Carolina, USA
| | | | - M E Weinblatt
- UCB Pharma, Raleigh, North Carolina, USA.,Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital, Boston, Massachusetts, USA
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149
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Kilic L, Erden A, Bingham CO, Gossec L, Kalyoncu U. The Reporting of Patient-reported Outcomes in Studies of Patients with Rheumatoid Arthritis: A Systematic Review of 250 Articles. J Rheumatol 2016; 43:1300-5. [DOI: 10.3899/jrheum.151177] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/07/2016] [Indexed: 12/20/2022]
Abstract
Objective.Patient-reported outcomes (PRO) in rheumatoid arthritis (RA) provide important information regarding disease effect. The study objective was to assess the frequency of PRO use in recent RA studies and compare results with a previous systematic review (SR) in 2005–2007.Methods.An SR was performed in PubMed MEDLINE (January 2015). Publications were identified using these MEdical Subject Headings terms: “arthritis, rheumatoid” with a limitation to “humans,” “all adults: 19+ years,” “English,” “published in the last 2 years,” and “clinical trials.” All studies were assessed, whatever their designs. All PRO reported in publications were classified according to general domains of health by 2 authors. Statistics were descriptive.Results.Two hundred fifty articles were analyzed. Of them, 113 (45.2%) were randomized controlled trials; 138 different PRO were reported. The most frequent PRO, similar to the 2007 SR, were function (68.0%), pain (40.0%), patient’s global assessment (49.2%), and health-related quality of life (18.4%). Fatigue (14.4%), morning stiffness (10.0%), psychological status (9.6%), productivity losses (6.4%), utility (5.2%), sleep disturbance (2.4%), and coping (2.0%) were rarely reported. Although frequent domains were reported using well-validated questionnaires, the others were reported using heterogeneous questionnaires.Conclusion.The PRO collected and reported in RA studies are remarkably consistent with those seen in 2005–2007, and reflect the existing RA Core Set measures. Other domains of health prioritized by patients including fatigue, psychological status, productivity losses, sleep disturbance, and coping remain rarely reported. Further, heterogeneity in outcome measures used presents challenges in interpreting true disease effect and response to therapy.
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150
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Kalyoncu U, Ogdie A, Campbell W, Bingham CO, de Wit M, Gladman DD, Mease P, Steinkoenig I, Strand V, Riese VG, Orbai AM. Systematic literature review of domains assessed in psoriatic arthritis to inform the update of the psoriatic arthritis core domain set. RMD Open 2016; 2:e000217. [PMID: 26966554 PMCID: PMC4780312 DOI: 10.1136/rmdopen-2015-000217] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2015] [Revised: 12/31/2015] [Accepted: 01/07/2016] [Indexed: 12/15/2022] Open
Abstract
The objectives of this systematic literature review (SLR) were to identify domains and outcome measures used in psoriatic arthritis (PsA) studies in the past 5 years, and to compare the measurement of the Outcome Measures in Rheumatology (OMERACT) 2006 PsA Core Domain Set in studies published in 2010–2015 vs those published in 2006–2010. We performed a systematic literature search in two databases, PubMed and Embase, to identify randomised controlled trials (RCTs) in PsA. We also identified PsA longitudinal observational studies (LOS). Three patient research partners provided input into study conception, and data collection and interpretation. We identified 41 studies representing 22 unique RCTs, 27 LOS and 12 registries. Across all studies, we identified 24 domains and 169 outcome measures. In addition to the PsA Core Domain Set (6 domains), the following domains were also assessed in more than 30% of RCTs: acute phase reactants, dactylitis, enthesitis, fatigue and work productivity. We identified a range of 1–15 outcome measures per domain with a mean (SD) of 7 (4.7) per domain. The complete PsA Core Domain Set was assessed in 59% of RCTs in 2010–2015 compared to 23.5% RCTs in 2006–2010. There has been increased measurement of the PsA Core Domain Set in RCTs and LOS in the past 5 years. Numerous additional outcomes were also measured. The PsA Core Domain Set needs an update to standardise PsA outcome assessments. This SLR will inform the development of an updated PsA Core Domain Set with patient research partner input.
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Affiliation(s)
- Umut Kalyoncu
- Division of Rheumatology, Johns Hopkins University, Baltimore, Maryland, USA; Division of Rheumatology, Hacettepe University, Ankara, Turkey
| | - Alexis Ogdie
- University of Pennsylvania , Philadelphia, Pennsylvania , USA
| | | | - Clifton O Bingham
- Division of Rheumatology , Johns Hopkins University , Baltimore, Maryland , USA
| | - Maarten de Wit
- Department of Medical Humanities , Patient Research Partner, VU University Medical Centre , Amsterdam , The Netherlands
| | - Dafna D Gladman
- Toronto Western Hospital, University of Toronto , Toronto, Ontario , Canada
| | - Philip Mease
- Swedish Medical Center and University of Washington , Seattle, Washington , USA
| | | | - Vibeke Strand
- Division of Immunology , Stanford University , Palo Alto, California , USA
| | - Victoria G Riese
- Division of Rheumatology, Johns Hopkins University, Baltimore, Maryland, USA; National Institutes of Health Library, Education Services Branch, Bethesda, Maryland, USA
| | - Ana-Maria Orbai
- Division of Rheumatology , Johns Hopkins University , Baltimore, Maryland , USA
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