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Meer E, Thrastardottir T, Wang X, Dubreuil M, Chen Y, Gelfand JM, Love TJ, Ogdie A. Risk factors for diagnosis of psoriatic arthritis, psoriasis, rheumatoid arthritis, and ankylosing spondylitis: A set of parallel case-control studies. J Rheumatol 2021; 49:53-59. [PMID: 34334358 DOI: 10.3899/jrheum.210006] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/16/2021] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To compare potential risk factors for the diagnosis of psoriatic arthritis (PsA), psoriasis, rheumatoid arthritis (RA), and ankylosing spondylitis (AS). METHODS Four parallel case-control studies were conducted within The Health Improvement Network using data between 1994 and 2015. Patients with PsA, psoriasis, RA, or AS were identified using validated code lists and matched to controls on age, sex, practice, and year. Risk factors were selected in the time prior to diagnosis. Multivariable logistic regression models were constructed for each disease using automated stepwise regression to test potential risk factors. RESULTS Patients with incident PsA (N=7,594), psoriasis (N=111,375), RA (N=28,341), and AS (N=3, 253) were identified and matched to 75,930, 1,113,345, 282,226, and 32,530 controls, respectively. Median diagnosis age was 48 (IQR 38-59), 41 (31-54), 43 (31-54), and 60 (48-71), respectively. In multivariable models, there were some shared and some differing risk factors across all 4 diseases: PsA was associated with obesity, pharyngitis, and skin infections; PsA and psoriasis were associated with obesity and moderate alcohol intake; PsA and AS were associated with uveitis; and PsA and RA were associated with preceding gout. Both RA and AS were associated with current smoking, former moderate drinking, anemia, osteoporosis, and inflammatory bowel disease. All shared former or current smoking as a risk factor; statin use was inversely associated with all 4 diseases. CONCLUSION Shared and different risk factors for PsA, psoriasis, RA, and AS were identified. Statin use was inversely associated with all 4 conditions.
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Affiliation(s)
- Elana Meer
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States; Department of Medicine/Rheumatology, University of Iceland and Landspitali, Reykjavik, Iceland; Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States; Department of Medicine/Rheumatology, Boston University, Boston, Massachusetts, United States; Department of Dermatology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States; Department of Medicine/Rheumatology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States. Source of Support: This work was supported in part by NIH K23 AR063764 (PI Ogdie) and internal funds from the University of Pennsylvania. Maureen Dubreil was supported by NIH K23 AR06912701. Conflict of Interest: Elana Meer, Telma Thrastardottir, Maureen Dubreuil, Xingmei Wang, and Yong Chen report no conflicts of interest. Joel Gelfand served as a consultant for BMS, Boehringer Ingelheim, Lilly, Janssen Biologics, Novartis Corp, UCB (DSMB), Neuroderm (DSMB), Dr. Reddy's Labs, Pfizer Inc., and Sun Pharma, receiving honoraria; receives research grants (to the Trustees of the University of Pennsylvania) from Abbvie, Boehringer Ingelheim, Janssen, Novartis Corp, Celgene, Ortho Dermatologics, and Pfizer Inc.; and received payment for continuing medical education work related to psoriasis that was supported indirectly by Lilly, Ortho Dermatologics, and Novartis. Dr. Gelfand is a co-patent holder of resiquimod for treatment of cutaneous T cell lymphoma. Dr. Gelfand is a Deputy Editor for the Journal of Investigative Dermatology receiving honoraria from the Society for Investigative Dermatology and is a member of the Board of Directors for the International Psoriasis Council, receiving no honoraria. Thorvardur Love has received reimbursement from Celgene for speaking about guidelines for the treatment of psoriatic arthritis. Alexis Ogdie has served as a consultant for Abbvie, Amgen, BMS, Celgene, Corrona, Global Health Living Foundation, Janssen, Lilly, Novartis, Pfizer, and Takeda and has received grants to the University of Pennsylvania from Pfizer and Novartis and to Forward from Amgen. Her husband has received royalties from Novartis. Corresponding Author: Alexis Ogdie, MD MSCE, University of Pennsylvania, Division of Rheumatology, 3400 Civic Center Blvd., Philadelphia, Pennsylvania 19104;
| | - Telma Thrastardottir
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States; Department of Medicine/Rheumatology, University of Iceland and Landspitali, Reykjavik, Iceland; Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States; Department of Medicine/Rheumatology, Boston University, Boston, Massachusetts, United States; Department of Dermatology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States; Department of Medicine/Rheumatology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States. Source of Support: This work was supported in part by NIH K23 AR063764 (PI Ogdie) and internal funds from the University of Pennsylvania. Maureen Dubreil was supported by NIH K23 AR06912701. Conflict of Interest: Elana Meer, Telma Thrastardottir, Maureen Dubreuil, Xingmei Wang, and Yong Chen report no conflicts of interest. Joel Gelfand served as a consultant for BMS, Boehringer Ingelheim, Lilly, Janssen Biologics, Novartis Corp, UCB (DSMB), Neuroderm (DSMB), Dr. Reddy's Labs, Pfizer Inc., and Sun Pharma, receiving honoraria; receives research grants (to the Trustees of the University of Pennsylvania) from Abbvie, Boehringer Ingelheim, Janssen, Novartis Corp, Celgene, Ortho Dermatologics, and Pfizer Inc.; and received payment for continuing medical education work related to psoriasis that was supported indirectly by Lilly, Ortho Dermatologics, and Novartis. Dr. Gelfand is a co-patent holder of resiquimod for treatment of cutaneous T cell lymphoma. Dr. Gelfand is a Deputy Editor for the Journal of Investigative Dermatology receiving honoraria from the Society for Investigative Dermatology and is a member of the Board of Directors for the International Psoriasis Council, receiving no honoraria. Thorvardur Love has received reimbursement from Celgene for speaking about guidelines for the treatment of psoriatic arthritis. Alexis Ogdie has served as a consultant for Abbvie, Amgen, BMS, Celgene, Corrona, Global Health Living Foundation, Janssen, Lilly, Novartis, Pfizer, and Takeda and has received grants to the University of Pennsylvania from Pfizer and Novartis and to Forward from Amgen. Her husband has received royalties from Novartis. Corresponding Author: Alexis Ogdie, MD MSCE, University of Pennsylvania, Division of Rheumatology, 3400 Civic Center Blvd., Philadelphia, Pennsylvania 19104;
| | - Xingmei Wang
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States; Department of Medicine/Rheumatology, University of Iceland and Landspitali, Reykjavik, Iceland; Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States; Department of Medicine/Rheumatology, Boston University, Boston, Massachusetts, United States; Department of Dermatology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States; Department of Medicine/Rheumatology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States. Source of Support: This work was supported in part by NIH K23 AR063764 (PI Ogdie) and internal funds from the University of Pennsylvania. Maureen Dubreil was supported by NIH K23 AR06912701. Conflict of Interest: Elana Meer, Telma Thrastardottir, Maureen Dubreuil, Xingmei Wang, and Yong Chen report no conflicts of interest. Joel Gelfand served as a consultant for BMS, Boehringer Ingelheim, Lilly, Janssen Biologics, Novartis Corp, UCB (DSMB), Neuroderm (DSMB), Dr. Reddy's Labs, Pfizer Inc., and Sun Pharma, receiving honoraria; receives research grants (to the Trustees of the University of Pennsylvania) from Abbvie, Boehringer Ingelheim, Janssen, Novartis Corp, Celgene, Ortho Dermatologics, and Pfizer Inc.; and received payment for continuing medical education work related to psoriasis that was supported indirectly by Lilly, Ortho Dermatologics, and Novartis. Dr. Gelfand is a co-patent holder of resiquimod for treatment of cutaneous T cell lymphoma. Dr. Gelfand is a Deputy Editor for the Journal of Investigative Dermatology receiving honoraria from the Society for Investigative Dermatology and is a member of the Board of Directors for the International Psoriasis Council, receiving no honoraria. Thorvardur Love has received reimbursement from Celgene for speaking about guidelines for the treatment of psoriatic arthritis. Alexis Ogdie has served as a consultant for Abbvie, Amgen, BMS, Celgene, Corrona, Global Health Living Foundation, Janssen, Lilly, Novartis, Pfizer, and Takeda and has received grants to the University of Pennsylvania from Pfizer and Novartis and to Forward from Amgen. Her husband has received royalties from Novartis. Corresponding Author: Alexis Ogdie, MD MSCE, University of Pennsylvania, Division of Rheumatology, 3400 Civic Center Blvd., Philadelphia, Pennsylvania 19104;
| | - Maureen Dubreuil
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States; Department of Medicine/Rheumatology, University of Iceland and Landspitali, Reykjavik, Iceland; Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States; Department of Medicine/Rheumatology, Boston University, Boston, Massachusetts, United States; Department of Dermatology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States; Department of Medicine/Rheumatology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States. Source of Support: This work was supported in part by NIH K23 AR063764 (PI Ogdie) and internal funds from the University of Pennsylvania. Maureen Dubreil was supported by NIH K23 AR06912701. Conflict of Interest: Elana Meer, Telma Thrastardottir, Maureen Dubreuil, Xingmei Wang, and Yong Chen report no conflicts of interest. Joel Gelfand served as a consultant for BMS, Boehringer Ingelheim, Lilly, Janssen Biologics, Novartis Corp, UCB (DSMB), Neuroderm (DSMB), Dr. Reddy's Labs, Pfizer Inc., and Sun Pharma, receiving honoraria; receives research grants (to the Trustees of the University of Pennsylvania) from Abbvie, Boehringer Ingelheim, Janssen, Novartis Corp, Celgene, Ortho Dermatologics, and Pfizer Inc.; and received payment for continuing medical education work related to psoriasis that was supported indirectly by Lilly, Ortho Dermatologics, and Novartis. Dr. Gelfand is a co-patent holder of resiquimod for treatment of cutaneous T cell lymphoma. Dr. Gelfand is a Deputy Editor for the Journal of Investigative Dermatology receiving honoraria from the Society for Investigative Dermatology and is a member of the Board of Directors for the International Psoriasis Council, receiving no honoraria. Thorvardur Love has received reimbursement from Celgene for speaking about guidelines for the treatment of psoriatic arthritis. Alexis Ogdie has served as a consultant for Abbvie, Amgen, BMS, Celgene, Corrona, Global Health Living Foundation, Janssen, Lilly, Novartis, Pfizer, and Takeda and has received grants to the University of Pennsylvania from Pfizer and Novartis and to Forward from Amgen. Her husband has received royalties from Novartis. Corresponding Author: Alexis Ogdie, MD MSCE, University of Pennsylvania, Division of Rheumatology, 3400 Civic Center Blvd., Philadelphia, Pennsylvania 19104;
| | - Yong Chen
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States; Department of Medicine/Rheumatology, University of Iceland and Landspitali, Reykjavik, Iceland; Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States; Department of Medicine/Rheumatology, Boston University, Boston, Massachusetts, United States; Department of Dermatology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States; Department of Medicine/Rheumatology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States. Source of Support: This work was supported in part by NIH K23 AR063764 (PI Ogdie) and internal funds from the University of Pennsylvania. Maureen Dubreil was supported by NIH K23 AR06912701. Conflict of Interest: Elana Meer, Telma Thrastardottir, Maureen Dubreuil, Xingmei Wang, and Yong Chen report no conflicts of interest. Joel Gelfand served as a consultant for BMS, Boehringer Ingelheim, Lilly, Janssen Biologics, Novartis Corp, UCB (DSMB), Neuroderm (DSMB), Dr. Reddy's Labs, Pfizer Inc., and Sun Pharma, receiving honoraria; receives research grants (to the Trustees of the University of Pennsylvania) from Abbvie, Boehringer Ingelheim, Janssen, Novartis Corp, Celgene, Ortho Dermatologics, and Pfizer Inc.; and received payment for continuing medical education work related to psoriasis that was supported indirectly by Lilly, Ortho Dermatologics, and Novartis. Dr. Gelfand is a co-patent holder of resiquimod for treatment of cutaneous T cell lymphoma. Dr. Gelfand is a Deputy Editor for the Journal of Investigative Dermatology receiving honoraria from the Society for Investigative Dermatology and is a member of the Board of Directors for the International Psoriasis Council, receiving no honoraria. Thorvardur Love has received reimbursement from Celgene for speaking about guidelines for the treatment of psoriatic arthritis. Alexis Ogdie has served as a consultant for Abbvie, Amgen, BMS, Celgene, Corrona, Global Health Living Foundation, Janssen, Lilly, Novartis, Pfizer, and Takeda and has received grants to the University of Pennsylvania from Pfizer and Novartis and to Forward from Amgen. Her husband has received royalties from Novartis. Corresponding Author: Alexis Ogdie, MD MSCE, University of Pennsylvania, Division of Rheumatology, 3400 Civic Center Blvd., Philadelphia, Pennsylvania 19104;
| | - Joel M Gelfand
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States; Department of Medicine/Rheumatology, University of Iceland and Landspitali, Reykjavik, Iceland; Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States; Department of Medicine/Rheumatology, Boston University, Boston, Massachusetts, United States; Department of Dermatology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States; Department of Medicine/Rheumatology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States. Source of Support: This work was supported in part by NIH K23 AR063764 (PI Ogdie) and internal funds from the University of Pennsylvania. Maureen Dubreil was supported by NIH K23 AR06912701. Conflict of Interest: Elana Meer, Telma Thrastardottir, Maureen Dubreuil, Xingmei Wang, and Yong Chen report no conflicts of interest. Joel Gelfand served as a consultant for BMS, Boehringer Ingelheim, Lilly, Janssen Biologics, Novartis Corp, UCB (DSMB), Neuroderm (DSMB), Dr. Reddy's Labs, Pfizer Inc., and Sun Pharma, receiving honoraria; receives research grants (to the Trustees of the University of Pennsylvania) from Abbvie, Boehringer Ingelheim, Janssen, Novartis Corp, Celgene, Ortho Dermatologics, and Pfizer Inc.; and received payment for continuing medical education work related to psoriasis that was supported indirectly by Lilly, Ortho Dermatologics, and Novartis. Dr. Gelfand is a co-patent holder of resiquimod for treatment of cutaneous T cell lymphoma. Dr. Gelfand is a Deputy Editor for the Journal of Investigative Dermatology receiving honoraria from the Society for Investigative Dermatology and is a member of the Board of Directors for the International Psoriasis Council, receiving no honoraria. Thorvardur Love has received reimbursement from Celgene for speaking about guidelines for the treatment of psoriatic arthritis. Alexis Ogdie has served as a consultant for Abbvie, Amgen, BMS, Celgene, Corrona, Global Health Living Foundation, Janssen, Lilly, Novartis, Pfizer, and Takeda and has received grants to the University of Pennsylvania from Pfizer and Novartis and to Forward from Amgen. Her husband has received royalties from Novartis. Corresponding Author: Alexis Ogdie, MD MSCE, University of Pennsylvania, Division of Rheumatology, 3400 Civic Center Blvd., Philadelphia, Pennsylvania 19104;
| | - Thorvardur Jon Love
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States; Department of Medicine/Rheumatology, University of Iceland and Landspitali, Reykjavik, Iceland; Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States; Department of Medicine/Rheumatology, Boston University, Boston, Massachusetts, United States; Department of Dermatology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States; Department of Medicine/Rheumatology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States. Source of Support: This work was supported in part by NIH K23 AR063764 (PI Ogdie) and internal funds from the University of Pennsylvania. Maureen Dubreil was supported by NIH K23 AR06912701. Conflict of Interest: Elana Meer, Telma Thrastardottir, Maureen Dubreuil, Xingmei Wang, and Yong Chen report no conflicts of interest. Joel Gelfand served as a consultant for BMS, Boehringer Ingelheim, Lilly, Janssen Biologics, Novartis Corp, UCB (DSMB), Neuroderm (DSMB), Dr. Reddy's Labs, Pfizer Inc., and Sun Pharma, receiving honoraria; receives research grants (to the Trustees of the University of Pennsylvania) from Abbvie, Boehringer Ingelheim, Janssen, Novartis Corp, Celgene, Ortho Dermatologics, and Pfizer Inc.; and received payment for continuing medical education work related to psoriasis that was supported indirectly by Lilly, Ortho Dermatologics, and Novartis. Dr. Gelfand is a co-patent holder of resiquimod for treatment of cutaneous T cell lymphoma. Dr. Gelfand is a Deputy Editor for the Journal of Investigative Dermatology receiving honoraria from the Society for Investigative Dermatology and is a member of the Board of Directors for the International Psoriasis Council, receiving no honoraria. Thorvardur Love has received reimbursement from Celgene for speaking about guidelines for the treatment of psoriatic arthritis. Alexis Ogdie has served as a consultant for Abbvie, Amgen, BMS, Celgene, Corrona, Global Health Living Foundation, Janssen, Lilly, Novartis, Pfizer, and Takeda and has received grants to the University of Pennsylvania from Pfizer and Novartis and to Forward from Amgen. Her husband has received royalties from Novartis. Corresponding Author: Alexis Ogdie, MD MSCE, University of Pennsylvania, Division of Rheumatology, 3400 Civic Center Blvd., Philadelphia, Pennsylvania 19104;
| | - Alexis Ogdie
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States; Department of Medicine/Rheumatology, University of Iceland and Landspitali, Reykjavik, Iceland; Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States; Department of Medicine/Rheumatology, Boston University, Boston, Massachusetts, United States; Department of Dermatology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States; Department of Medicine/Rheumatology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States. Source of Support: This work was supported in part by NIH K23 AR063764 (PI Ogdie) and internal funds from the University of Pennsylvania. Maureen Dubreil was supported by NIH K23 AR06912701. Conflict of Interest: Elana Meer, Telma Thrastardottir, Maureen Dubreuil, Xingmei Wang, and Yong Chen report no conflicts of interest. Joel Gelfand served as a consultant for BMS, Boehringer Ingelheim, Lilly, Janssen Biologics, Novartis Corp, UCB (DSMB), Neuroderm (DSMB), Dr. Reddy's Labs, Pfizer Inc., and Sun Pharma, receiving honoraria; receives research grants (to the Trustees of the University of Pennsylvania) from Abbvie, Boehringer Ingelheim, Janssen, Novartis Corp, Celgene, Ortho Dermatologics, and Pfizer Inc.; and received payment for continuing medical education work related to psoriasis that was supported indirectly by Lilly, Ortho Dermatologics, and Novartis. Dr. Gelfand is a co-patent holder of resiquimod for treatment of cutaneous T cell lymphoma. Dr. Gelfand is a Deputy Editor for the Journal of Investigative Dermatology receiving honoraria from the Society for Investigative Dermatology and is a member of the Board of Directors for the International Psoriasis Council, receiving no honoraria. Thorvardur Love has received reimbursement from Celgene for speaking about guidelines for the treatment of psoriatic arthritis. Alexis Ogdie has served as a consultant for Abbvie, Amgen, BMS, Celgene, Corrona, Global Health Living Foundation, Janssen, Lilly, Novartis, Pfizer, and Takeda and has received grants to the University of Pennsylvania from Pfizer and Novartis and to Forward from Amgen. Her husband has received royalties from Novartis. Corresponding Author: Alexis Ogdie, MD MSCE, University of Pennsylvania, Division of Rheumatology, 3400 Civic Center Blvd., Philadelphia, Pennsylvania 19104;
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Solmaz D, Kalyoncu U, Tinazzi I, Bakirci S, Bayindir O, Dogru A, Dalkilic E, Kimyon G, Ozisler C, Cetin GY, Kilic L, Omma A, Can M, Yilmaz S, Erden A, Aydin SZ. Current Smoking Is Increased in Axial Psoriatic Arthritis and Radiographic Sacroiliitis. J Rheumatol 2019; 47:jrheum.190722. [PMID: 31787608 DOI: 10.3899/jrheum.190722] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVE The effect of smoking in psoriatic arthritis (PsA) is under debate. Our aim was to test whether smoking is increased in axial PsA (axPsA). METHODS Included in the analysis were 1535 patients from PsArt-ID (PsA-International Database). The effect of smoking on axPsA (compared to other PsA phenotypes) and radiographic sacroiliitis were investigated. RESULTS Current smoking was more common in axPsA (28.6% vs 18.9%, p < 0.001). It also was found as an independent predictor of axPsA (OR 1.4) and radiographic sacroiliitis (OR 6.6). CONCLUSION Current smoking is significantly associated with both axPsA and radiographic sacroiliitis in patients with PsA.
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Affiliation(s)
- Dilek Solmaz
- From the University of Ottawa Faculty of Medicine, Rheumatology, and Ottawa Hospital Research Institute, Ottawa, Ontario, Canada; Hacettepe University, Faculty of Medicine, Department of Internal Medicine, Division of Rheumatology, Hacettepe University Hospital, Ankara, Turkey; Unit of Rheumatology, Sacro Cuore-Don Calabria Hospital, Negrar, Verona, Italy; Ege University, Department of Internal Medicine, Division of Rheumatology, Izmir, Turkey; Suleyman Demirel University, Department of Internal Medicine, Division of Rheumatology, Isparta, Turkey; Uludag University, Department of Internal Medicine, Division of Rheumatology, Bursa, Turkey; Mustafa Kemal University, Department of Internal Medicine, Division of Rheumatology, Hatay, Turkey; Diskapi Yildirim Beyazit Education and Research Hospital, Department of Internal Medicine, Division of Rheumatology, Ankara, Turkey; Kahramanmaras Sutcu Imam University, Department of Internal Medicine, Division of Rheumatology, Kahramanmaras, Turkey; Ankara Numune Education and Research Hospital, Department of Internal Medicine, Division of Rheumatology, Ankara, Turkey; Marmara University, Department of Internal Medicine, Division of Rheumatology, Istanbul, Turkey; Selcuk University, Department of Internal Medicine, Division of Rheumatology, Konya, Turkey. D. Solmaz had funding from Union ChimiqueBelge (UCB) for an axial spondyloarthritis fellowship. S. Bakirci had funding from the Turkish Society for Rheumatology (TRD). S.Z. Aydin received honoraria from Abbvie, Celgene, UCB, Novartis, Jannsen, and Sanofi. D. Solmaz, MD, University of Ottawa Faculty of Medicine, Rheumatology; U. Kalyoncu, MD, Associate Professor, Hacettepe University, Faculty of Medicine, Department of Internal Medicine, Division of Rheumatology; I. Tinazzi, MD, Unit of Rheumatology, Sacro Cuore-Don Calabria Hospital; S. Bakirci, MD, University of Ottawa Faculty of Medicine, Rheumatology; O. Bayindir, MD, Ege University, Department of Internal Medicine, Division of Rheumatology; A. Dogru, MD, Suleyman Demirel University, Department of Internal Medicine, Division of Rheumatology; E. Dalkilic, MD, Associate Professor, Uludag University, Department of Internal Medicine, Division of Rheumatology; G. Kimyon, MD, Mustafa Kemal University, Department of Internal Medicine, Division of Rheumatology; C. Ozisler, MD, Diskapi Yildirim Beyazit Education and Research Hospital, Department of Internal Medicine, Division of Rheumatology; G.Y. Cetin, MD, Associate Professor, Kahramanmaras Sutcu Imam University, Department of Internal Medicine, Division of Rheumatology; L. Kilic, MD, Hacettepe University, Department of Internal Medicine, Division of Rheumatology, Hacettepe University Hospital; A. Omma, MD, Ankara Numune Education and Research Hospital, Department of Internal Medicine, Division of Rheumatology; M. Can, MD, Associate Professor, Marmara University, Department of Internal Medicine, Division of Rheumatology; S. Yilmaz, MD, Professor, Selcuk University, Department of Internal Medicine, Division of Rheumatology; A. Erden, MD, Hacettepe University, Department of Internal Medicine, Division of Rheumatology; S.Z. Aydin, MD, Associate Professor, University of Ottawa Faculty of Medicine, Ottawa Hospital Research Institute. Address correspondence to Dr. S.Z. Aydin, 1967 Riverside Drive, Ottawa, Ontario K1H 7W9, Canada. E-mail: . Accepted for publication November 13, 2019
| | - Umut Kalyoncu
- From the University of Ottawa Faculty of Medicine, Rheumatology, and Ottawa Hospital Research Institute, Ottawa, Ontario, Canada; Hacettepe University, Faculty of Medicine, Department of Internal Medicine, Division of Rheumatology, Hacettepe University Hospital, Ankara, Turkey; Unit of Rheumatology, Sacro Cuore-Don Calabria Hospital, Negrar, Verona, Italy; Ege University, Department of Internal Medicine, Division of Rheumatology, Izmir, Turkey; Suleyman Demirel University, Department of Internal Medicine, Division of Rheumatology, Isparta, Turkey; Uludag University, Department of Internal Medicine, Division of Rheumatology, Bursa, Turkey; Mustafa Kemal University, Department of Internal Medicine, Division of Rheumatology, Hatay, Turkey; Diskapi Yildirim Beyazit Education and Research Hospital, Department of Internal Medicine, Division of Rheumatology, Ankara, Turkey; Kahramanmaras Sutcu Imam University, Department of Internal Medicine, Division of Rheumatology, Kahramanmaras, Turkey; Ankara Numune Education and Research Hospital, Department of Internal Medicine, Division of Rheumatology, Ankara, Turkey; Marmara University, Department of Internal Medicine, Division of Rheumatology, Istanbul, Turkey; Selcuk University, Department of Internal Medicine, Division of Rheumatology, Konya, Turkey. D. Solmaz had funding from Union ChimiqueBelge (UCB) for an axial spondyloarthritis fellowship. S. Bakirci had funding from the Turkish Society for Rheumatology (TRD). S.Z. Aydin received honoraria from Abbvie, Celgene, UCB, Novartis, Jannsen, and Sanofi. D. Solmaz, MD, University of Ottawa Faculty of Medicine, Rheumatology; U. Kalyoncu, MD, Associate Professor, Hacettepe University, Faculty of Medicine, Department of Internal Medicine, Division of Rheumatology; I. Tinazzi, MD, Unit of Rheumatology, Sacro Cuore-Don Calabria Hospital; S. Bakirci, MD, University of Ottawa Faculty of Medicine, Rheumatology; O. Bayindir, MD, Ege University, Department of Internal Medicine, Division of Rheumatology; A. Dogru, MD, Suleyman Demirel University, Department of Internal Medicine, Division of Rheumatology; E. Dalkilic, MD, Associate Professor, Uludag University, Department of Internal Medicine, Division of Rheumatology; G. Kimyon, MD, Mustafa Kemal University, Department of Internal Medicine, Division of Rheumatology; C. Ozisler, MD, Diskapi Yildirim Beyazit Education and Research Hospital, Department of Internal Medicine, Division of Rheumatology; G.Y. Cetin, MD, Associate Professor, Kahramanmaras Sutcu Imam University, Department of Internal Medicine, Division of Rheumatology; L. Kilic, MD, Hacettepe University, Department of Internal Medicine, Division of Rheumatology, Hacettepe University Hospital; A. Omma, MD, Ankara Numune Education and Research Hospital, Department of Internal Medicine, Division of Rheumatology; M. Can, MD, Associate Professor, Marmara University, Department of Internal Medicine, Division of Rheumatology; S. Yilmaz, MD, Professor, Selcuk University, Department of Internal Medicine, Division of Rheumatology; A. Erden, MD, Hacettepe University, Department of Internal Medicine, Division of Rheumatology; S.Z. Aydin, MD, Associate Professor, University of Ottawa Faculty of Medicine, Ottawa Hospital Research Institute. Address correspondence to Dr. S.Z. Aydin, 1967 Riverside Drive, Ottawa, Ontario K1H 7W9, Canada. E-mail: . Accepted for publication November 13, 2019
| | - Ilaria Tinazzi
- From the University of Ottawa Faculty of Medicine, Rheumatology, and Ottawa Hospital Research Institute, Ottawa, Ontario, Canada; Hacettepe University, Faculty of Medicine, Department of Internal Medicine, Division of Rheumatology, Hacettepe University Hospital, Ankara, Turkey; Unit of Rheumatology, Sacro Cuore-Don Calabria Hospital, Negrar, Verona, Italy; Ege University, Department of Internal Medicine, Division of Rheumatology, Izmir, Turkey; Suleyman Demirel University, Department of Internal Medicine, Division of Rheumatology, Isparta, Turkey; Uludag University, Department of Internal Medicine, Division of Rheumatology, Bursa, Turkey; Mustafa Kemal University, Department of Internal Medicine, Division of Rheumatology, Hatay, Turkey; Diskapi Yildirim Beyazit Education and Research Hospital, Department of Internal Medicine, Division of Rheumatology, Ankara, Turkey; Kahramanmaras Sutcu Imam University, Department of Internal Medicine, Division of Rheumatology, Kahramanmaras, Turkey; Ankara Numune Education and Research Hospital, Department of Internal Medicine, Division of Rheumatology, Ankara, Turkey; Marmara University, Department of Internal Medicine, Division of Rheumatology, Istanbul, Turkey; Selcuk University, Department of Internal Medicine, Division of Rheumatology, Konya, Turkey. D. Solmaz had funding from Union ChimiqueBelge (UCB) for an axial spondyloarthritis fellowship. S. Bakirci had funding from the Turkish Society for Rheumatology (TRD). S.Z. Aydin received honoraria from Abbvie, Celgene, UCB, Novartis, Jannsen, and Sanofi. D. Solmaz, MD, University of Ottawa Faculty of Medicine, Rheumatology; U. Kalyoncu, MD, Associate Professor, Hacettepe University, Faculty of Medicine, Department of Internal Medicine, Division of Rheumatology; I. Tinazzi, MD, Unit of Rheumatology, Sacro Cuore-Don Calabria Hospital; S. Bakirci, MD, University of Ottawa Faculty of Medicine, Rheumatology; O. Bayindir, MD, Ege University, Department of Internal Medicine, Division of Rheumatology; A. Dogru, MD, Suleyman Demirel University, Department of Internal Medicine, Division of Rheumatology; E. Dalkilic, MD, Associate Professor, Uludag University, Department of Internal Medicine, Division of Rheumatology; G. Kimyon, MD, Mustafa Kemal University, Department of Internal Medicine, Division of Rheumatology; C. Ozisler, MD, Diskapi Yildirim Beyazit Education and Research Hospital, Department of Internal Medicine, Division of Rheumatology; G.Y. Cetin, MD, Associate Professor, Kahramanmaras Sutcu Imam University, Department of Internal Medicine, Division of Rheumatology; L. Kilic, MD, Hacettepe University, Department of Internal Medicine, Division of Rheumatology, Hacettepe University Hospital; A. Omma, MD, Ankara Numune Education and Research Hospital, Department of Internal Medicine, Division of Rheumatology; M. Can, MD, Associate Professor, Marmara University, Department of Internal Medicine, Division of Rheumatology; S. Yilmaz, MD, Professor, Selcuk University, Department of Internal Medicine, Division of Rheumatology; A. Erden, MD, Hacettepe University, Department of Internal Medicine, Division of Rheumatology; S.Z. Aydin, MD, Associate Professor, University of Ottawa Faculty of Medicine, Ottawa Hospital Research Institute. Address correspondence to Dr. S.Z. Aydin, 1967 Riverside Drive, Ottawa, Ontario K1H 7W9, Canada. E-mail: . Accepted for publication November 13, 2019
| | - Sibel Bakirci
- From the University of Ottawa Faculty of Medicine, Rheumatology, and Ottawa Hospital Research Institute, Ottawa, Ontario, Canada; Hacettepe University, Faculty of Medicine, Department of Internal Medicine, Division of Rheumatology, Hacettepe University Hospital, Ankara, Turkey; Unit of Rheumatology, Sacro Cuore-Don Calabria Hospital, Negrar, Verona, Italy; Ege University, Department of Internal Medicine, Division of Rheumatology, Izmir, Turkey; Suleyman Demirel University, Department of Internal Medicine, Division of Rheumatology, Isparta, Turkey; Uludag University, Department of Internal Medicine, Division of Rheumatology, Bursa, Turkey; Mustafa Kemal University, Department of Internal Medicine, Division of Rheumatology, Hatay, Turkey; Diskapi Yildirim Beyazit Education and Research Hospital, Department of Internal Medicine, Division of Rheumatology, Ankara, Turkey; Kahramanmaras Sutcu Imam University, Department of Internal Medicine, Division of Rheumatology, Kahramanmaras, Turkey; Ankara Numune Education and Research Hospital, Department of Internal Medicine, Division of Rheumatology, Ankara, Turkey; Marmara University, Department of Internal Medicine, Division of Rheumatology, Istanbul, Turkey; Selcuk University, Department of Internal Medicine, Division of Rheumatology, Konya, Turkey. D. Solmaz had funding from Union ChimiqueBelge (UCB) for an axial spondyloarthritis fellowship. S. Bakirci had funding from the Turkish Society for Rheumatology (TRD). S.Z. Aydin received honoraria from Abbvie, Celgene, UCB, Novartis, Jannsen, and Sanofi. D. Solmaz, MD, University of Ottawa Faculty of Medicine, Rheumatology; U. Kalyoncu, MD, Associate Professor, Hacettepe University, Faculty of Medicine, Department of Internal Medicine, Division of Rheumatology; I. Tinazzi, MD, Unit of Rheumatology, Sacro Cuore-Don Calabria Hospital; S. Bakirci, MD, University of Ottawa Faculty of Medicine, Rheumatology; O. Bayindir, MD, Ege University, Department of Internal Medicine, Division of Rheumatology; A. Dogru, MD, Suleyman Demirel University, Department of Internal Medicine, Division of Rheumatology; E. Dalkilic, MD, Associate Professor, Uludag University, Department of Internal Medicine, Division of Rheumatology; G. Kimyon, MD, Mustafa Kemal University, Department of Internal Medicine, Division of Rheumatology; C. Ozisler, MD, Diskapi Yildirim Beyazit Education and Research Hospital, Department of Internal Medicine, Division of Rheumatology; G.Y. Cetin, MD, Associate Professor, Kahramanmaras Sutcu Imam University, Department of Internal Medicine, Division of Rheumatology; L. Kilic, MD, Hacettepe University, Department of Internal Medicine, Division of Rheumatology, Hacettepe University Hospital; A. Omma, MD, Ankara Numune Education and Research Hospital, Department of Internal Medicine, Division of Rheumatology; M. Can, MD, Associate Professor, Marmara University, Department of Internal Medicine, Division of Rheumatology; S. Yilmaz, MD, Professor, Selcuk University, Department of Internal Medicine, Division of Rheumatology; A. Erden, MD, Hacettepe University, Department of Internal Medicine, Division of Rheumatology; S.Z. Aydin, MD, Associate Professor, University of Ottawa Faculty of Medicine, Ottawa Hospital Research Institute. Address correspondence to Dr. S.Z. Aydin, 1967 Riverside Drive, Ottawa, Ontario K1H 7W9, Canada. E-mail: . Accepted for publication November 13, 2019
| | - Ozun Bayindir
- From the University of Ottawa Faculty of Medicine, Rheumatology, and Ottawa Hospital Research Institute, Ottawa, Ontario, Canada; Hacettepe University, Faculty of Medicine, Department of Internal Medicine, Division of Rheumatology, Hacettepe University Hospital, Ankara, Turkey; Unit of Rheumatology, Sacro Cuore-Don Calabria Hospital, Negrar, Verona, Italy; Ege University, Department of Internal Medicine, Division of Rheumatology, Izmir, Turkey; Suleyman Demirel University, Department of Internal Medicine, Division of Rheumatology, Isparta, Turkey; Uludag University, Department of Internal Medicine, Division of Rheumatology, Bursa, Turkey; Mustafa Kemal University, Department of Internal Medicine, Division of Rheumatology, Hatay, Turkey; Diskapi Yildirim Beyazit Education and Research Hospital, Department of Internal Medicine, Division of Rheumatology, Ankara, Turkey; Kahramanmaras Sutcu Imam University, Department of Internal Medicine, Division of Rheumatology, Kahramanmaras, Turkey; Ankara Numune Education and Research Hospital, Department of Internal Medicine, Division of Rheumatology, Ankara, Turkey; Marmara University, Department of Internal Medicine, Division of Rheumatology, Istanbul, Turkey; Selcuk University, Department of Internal Medicine, Division of Rheumatology, Konya, Turkey. D. Solmaz had funding from Union ChimiqueBelge (UCB) for an axial spondyloarthritis fellowship. S. Bakirci had funding from the Turkish Society for Rheumatology (TRD). S.Z. Aydin received honoraria from Abbvie, Celgene, UCB, Novartis, Jannsen, and Sanofi. D. Solmaz, MD, University of Ottawa Faculty of Medicine, Rheumatology; U. Kalyoncu, MD, Associate Professor, Hacettepe University, Faculty of Medicine, Department of Internal Medicine, Division of Rheumatology; I. Tinazzi, MD, Unit of Rheumatology, Sacro Cuore-Don Calabria Hospital; S. Bakirci, MD, University of Ottawa Faculty of Medicine, Rheumatology; O. Bayindir, MD, Ege University, Department of Internal Medicine, Division of Rheumatology; A. Dogru, MD, Suleyman Demirel University, Department of Internal Medicine, Division of Rheumatology; E. Dalkilic, MD, Associate Professor, Uludag University, Department of Internal Medicine, Division of Rheumatology; G. Kimyon, MD, Mustafa Kemal University, Department of Internal Medicine, Division of Rheumatology; C. Ozisler, MD, Diskapi Yildirim Beyazit Education and Research Hospital, Department of Internal Medicine, Division of Rheumatology; G.Y. Cetin, MD, Associate Professor, Kahramanmaras Sutcu Imam University, Department of Internal Medicine, Division of Rheumatology; L. Kilic, MD, Hacettepe University, Department of Internal Medicine, Division of Rheumatology, Hacettepe University Hospital; A. Omma, MD, Ankara Numune Education and Research Hospital, Department of Internal Medicine, Division of Rheumatology; M. Can, MD, Associate Professor, Marmara University, Department of Internal Medicine, Division of Rheumatology; S. Yilmaz, MD, Professor, Selcuk University, Department of Internal Medicine, Division of Rheumatology; A. Erden, MD, Hacettepe University, Department of Internal Medicine, Division of Rheumatology; S.Z. Aydin, MD, Associate Professor, University of Ottawa Faculty of Medicine, Ottawa Hospital Research Institute. Address correspondence to Dr. S.Z. Aydin, 1967 Riverside Drive, Ottawa, Ontario K1H 7W9, Canada. E-mail: . Accepted for publication November 13, 2019
| | - Atalay Dogru
- From the University of Ottawa Faculty of Medicine, Rheumatology, and Ottawa Hospital Research Institute, Ottawa, Ontario, Canada; Hacettepe University, Faculty of Medicine, Department of Internal Medicine, Division of Rheumatology, Hacettepe University Hospital, Ankara, Turkey; Unit of Rheumatology, Sacro Cuore-Don Calabria Hospital, Negrar, Verona, Italy; Ege University, Department of Internal Medicine, Division of Rheumatology, Izmir, Turkey; Suleyman Demirel University, Department of Internal Medicine, Division of Rheumatology, Isparta, Turkey; Uludag University, Department of Internal Medicine, Division of Rheumatology, Bursa, Turkey; Mustafa Kemal University, Department of Internal Medicine, Division of Rheumatology, Hatay, Turkey; Diskapi Yildirim Beyazit Education and Research Hospital, Department of Internal Medicine, Division of Rheumatology, Ankara, Turkey; Kahramanmaras Sutcu Imam University, Department of Internal Medicine, Division of Rheumatology, Kahramanmaras, Turkey; Ankara Numune Education and Research Hospital, Department of Internal Medicine, Division of Rheumatology, Ankara, Turkey; Marmara University, Department of Internal Medicine, Division of Rheumatology, Istanbul, Turkey; Selcuk University, Department of Internal Medicine, Division of Rheumatology, Konya, Turkey. D. Solmaz had funding from Union ChimiqueBelge (UCB) for an axial spondyloarthritis fellowship. S. Bakirci had funding from the Turkish Society for Rheumatology (TRD). S.Z. Aydin received honoraria from Abbvie, Celgene, UCB, Novartis, Jannsen, and Sanofi. D. Solmaz, MD, University of Ottawa Faculty of Medicine, Rheumatology; U. Kalyoncu, MD, Associate Professor, Hacettepe University, Faculty of Medicine, Department of Internal Medicine, Division of Rheumatology; I. Tinazzi, MD, Unit of Rheumatology, Sacro Cuore-Don Calabria Hospital; S. Bakirci, MD, University of Ottawa Faculty of Medicine, Rheumatology; O. Bayindir, MD, Ege University, Department of Internal Medicine, Division of Rheumatology; A. Dogru, MD, Suleyman Demirel University, Department of Internal Medicine, Division of Rheumatology; E. Dalkilic, MD, Associate Professor, Uludag University, Department of Internal Medicine, Division of Rheumatology; G. Kimyon, MD, Mustafa Kemal University, Department of Internal Medicine, Division of Rheumatology; C. Ozisler, MD, Diskapi Yildirim Beyazit Education and Research Hospital, Department of Internal Medicine, Division of Rheumatology; G.Y. Cetin, MD, Associate Professor, Kahramanmaras Sutcu Imam University, Department of Internal Medicine, Division of Rheumatology; L. Kilic, MD, Hacettepe University, Department of Internal Medicine, Division of Rheumatology, Hacettepe University Hospital; A. Omma, MD, Ankara Numune Education and Research Hospital, Department of Internal Medicine, Division of Rheumatology; M. Can, MD, Associate Professor, Marmara University, Department of Internal Medicine, Division of Rheumatology; S. Yilmaz, MD, Professor, Selcuk University, Department of Internal Medicine, Division of Rheumatology; A. Erden, MD, Hacettepe University, Department of Internal Medicine, Division of Rheumatology; S.Z. Aydin, MD, Associate Professor, University of Ottawa Faculty of Medicine, Ottawa Hospital Research Institute. Address correspondence to Dr. S.Z. Aydin, 1967 Riverside Drive, Ottawa, Ontario K1H 7W9, Canada. E-mail: . Accepted for publication November 13, 2019
| | - Ediz Dalkilic
- From the University of Ottawa Faculty of Medicine, Rheumatology, and Ottawa Hospital Research Institute, Ottawa, Ontario, Canada; Hacettepe University, Faculty of Medicine, Department of Internal Medicine, Division of Rheumatology, Hacettepe University Hospital, Ankara, Turkey; Unit of Rheumatology, Sacro Cuore-Don Calabria Hospital, Negrar, Verona, Italy; Ege University, Department of Internal Medicine, Division of Rheumatology, Izmir, Turkey; Suleyman Demirel University, Department of Internal Medicine, Division of Rheumatology, Isparta, Turkey; Uludag University, Department of Internal Medicine, Division of Rheumatology, Bursa, Turkey; Mustafa Kemal University, Department of Internal Medicine, Division of Rheumatology, Hatay, Turkey; Diskapi Yildirim Beyazit Education and Research Hospital, Department of Internal Medicine, Division of Rheumatology, Ankara, Turkey; Kahramanmaras Sutcu Imam University, Department of Internal Medicine, Division of Rheumatology, Kahramanmaras, Turkey; Ankara Numune Education and Research Hospital, Department of Internal Medicine, Division of Rheumatology, Ankara, Turkey; Marmara University, Department of Internal Medicine, Division of Rheumatology, Istanbul, Turkey; Selcuk University, Department of Internal Medicine, Division of Rheumatology, Konya, Turkey. D. Solmaz had funding from Union ChimiqueBelge (UCB) for an axial spondyloarthritis fellowship. S. Bakirci had funding from the Turkish Society for Rheumatology (TRD). S.Z. Aydin received honoraria from Abbvie, Celgene, UCB, Novartis, Jannsen, and Sanofi. D. Solmaz, MD, University of Ottawa Faculty of Medicine, Rheumatology; U. Kalyoncu, MD, Associate Professor, Hacettepe University, Faculty of Medicine, Department of Internal Medicine, Division of Rheumatology; I. Tinazzi, MD, Unit of Rheumatology, Sacro Cuore-Don Calabria Hospital; S. Bakirci, MD, University of Ottawa Faculty of Medicine, Rheumatology; O. Bayindir, MD, Ege University, Department of Internal Medicine, Division of Rheumatology; A. Dogru, MD, Suleyman Demirel University, Department of Internal Medicine, Division of Rheumatology; E. Dalkilic, MD, Associate Professor, Uludag University, Department of Internal Medicine, Division of Rheumatology; G. Kimyon, MD, Mustafa Kemal University, Department of Internal Medicine, Division of Rheumatology; C. Ozisler, MD, Diskapi Yildirim Beyazit Education and Research Hospital, Department of Internal Medicine, Division of Rheumatology; G.Y. Cetin, MD, Associate Professor, Kahramanmaras Sutcu Imam University, Department of Internal Medicine, Division of Rheumatology; L. Kilic, MD, Hacettepe University, Department of Internal Medicine, Division of Rheumatology, Hacettepe University Hospital; A. Omma, MD, Ankara Numune Education and Research Hospital, Department of Internal Medicine, Division of Rheumatology; M. Can, MD, Associate Professor, Marmara University, Department of Internal Medicine, Division of Rheumatology; S. Yilmaz, MD, Professor, Selcuk University, Department of Internal Medicine, Division of Rheumatology; A. Erden, MD, Hacettepe University, Department of Internal Medicine, Division of Rheumatology; S.Z. Aydin, MD, Associate Professor, University of Ottawa Faculty of Medicine, Ottawa Hospital Research Institute. Address correspondence to Dr. S.Z. Aydin, 1967 Riverside Drive, Ottawa, Ontario K1H 7W9, Canada. E-mail: . Accepted for publication November 13, 2019
| | - Gezmis Kimyon
- From the University of Ottawa Faculty of Medicine, Rheumatology, and Ottawa Hospital Research Institute, Ottawa, Ontario, Canada; Hacettepe University, Faculty of Medicine, Department of Internal Medicine, Division of Rheumatology, Hacettepe University Hospital, Ankara, Turkey; Unit of Rheumatology, Sacro Cuore-Don Calabria Hospital, Negrar, Verona, Italy; Ege University, Department of Internal Medicine, Division of Rheumatology, Izmir, Turkey; Suleyman Demirel University, Department of Internal Medicine, Division of Rheumatology, Isparta, Turkey; Uludag University, Department of Internal Medicine, Division of Rheumatology, Bursa, Turkey; Mustafa Kemal University, Department of Internal Medicine, Division of Rheumatology, Hatay, Turkey; Diskapi Yildirim Beyazit Education and Research Hospital, Department of Internal Medicine, Division of Rheumatology, Ankara, Turkey; Kahramanmaras Sutcu Imam University, Department of Internal Medicine, Division of Rheumatology, Kahramanmaras, Turkey; Ankara Numune Education and Research Hospital, Department of Internal Medicine, Division of Rheumatology, Ankara, Turkey; Marmara University, Department of Internal Medicine, Division of Rheumatology, Istanbul, Turkey; Selcuk University, Department of Internal Medicine, Division of Rheumatology, Konya, Turkey. D. Solmaz had funding from Union ChimiqueBelge (UCB) for an axial spondyloarthritis fellowship. S. Bakirci had funding from the Turkish Society for Rheumatology (TRD). S.Z. Aydin received honoraria from Abbvie, Celgene, UCB, Novartis, Jannsen, and Sanofi. D. Solmaz, MD, University of Ottawa Faculty of Medicine, Rheumatology; U. Kalyoncu, MD, Associate Professor, Hacettepe University, Faculty of Medicine, Department of Internal Medicine, Division of Rheumatology; I. Tinazzi, MD, Unit of Rheumatology, Sacro Cuore-Don Calabria Hospital; S. Bakirci, MD, University of Ottawa Faculty of Medicine, Rheumatology; O. Bayindir, MD, Ege University, Department of Internal Medicine, Division of Rheumatology; A. Dogru, MD, Suleyman Demirel University, Department of Internal Medicine, Division of Rheumatology; E. Dalkilic, MD, Associate Professor, Uludag University, Department of Internal Medicine, Division of Rheumatology; G. Kimyon, MD, Mustafa Kemal University, Department of Internal Medicine, Division of Rheumatology; C. Ozisler, MD, Diskapi Yildirim Beyazit Education and Research Hospital, Department of Internal Medicine, Division of Rheumatology; G.Y. Cetin, MD, Associate Professor, Kahramanmaras Sutcu Imam University, Department of Internal Medicine, Division of Rheumatology; L. Kilic, MD, Hacettepe University, Department of Internal Medicine, Division of Rheumatology, Hacettepe University Hospital; A. Omma, MD, Ankara Numune Education and Research Hospital, Department of Internal Medicine, Division of Rheumatology; M. Can, MD, Associate Professor, Marmara University, Department of Internal Medicine, Division of Rheumatology; S. Yilmaz, MD, Professor, Selcuk University, Department of Internal Medicine, Division of Rheumatology; A. Erden, MD, Hacettepe University, Department of Internal Medicine, Division of Rheumatology; S.Z. Aydin, MD, Associate Professor, University of Ottawa Faculty of Medicine, Ottawa Hospital Research Institute. Address correspondence to Dr. S.Z. Aydin, 1967 Riverside Drive, Ottawa, Ontario K1H 7W9, Canada. E-mail: . Accepted for publication November 13, 2019
| | - Cem Ozisler
- From the University of Ottawa Faculty of Medicine, Rheumatology, and Ottawa Hospital Research Institute, Ottawa, Ontario, Canada; Hacettepe University, Faculty of Medicine, Department of Internal Medicine, Division of Rheumatology, Hacettepe University Hospital, Ankara, Turkey; Unit of Rheumatology, Sacro Cuore-Don Calabria Hospital, Negrar, Verona, Italy; Ege University, Department of Internal Medicine, Division of Rheumatology, Izmir, Turkey; Suleyman Demirel University, Department of Internal Medicine, Division of Rheumatology, Isparta, Turkey; Uludag University, Department of Internal Medicine, Division of Rheumatology, Bursa, Turkey; Mustafa Kemal University, Department of Internal Medicine, Division of Rheumatology, Hatay, Turkey; Diskapi Yildirim Beyazit Education and Research Hospital, Department of Internal Medicine, Division of Rheumatology, Ankara, Turkey; Kahramanmaras Sutcu Imam University, Department of Internal Medicine, Division of Rheumatology, Kahramanmaras, Turkey; Ankara Numune Education and Research Hospital, Department of Internal Medicine, Division of Rheumatology, Ankara, Turkey; Marmara University, Department of Internal Medicine, Division of Rheumatology, Istanbul, Turkey; Selcuk University, Department of Internal Medicine, Division of Rheumatology, Konya, Turkey. D. Solmaz had funding from Union ChimiqueBelge (UCB) for an axial spondyloarthritis fellowship. S. Bakirci had funding from the Turkish Society for Rheumatology (TRD). S.Z. Aydin received honoraria from Abbvie, Celgene, UCB, Novartis, Jannsen, and Sanofi. D. Solmaz, MD, University of Ottawa Faculty of Medicine, Rheumatology; U. Kalyoncu, MD, Associate Professor, Hacettepe University, Faculty of Medicine, Department of Internal Medicine, Division of Rheumatology; I. Tinazzi, MD, Unit of Rheumatology, Sacro Cuore-Don Calabria Hospital; S. Bakirci, MD, University of Ottawa Faculty of Medicine, Rheumatology; O. Bayindir, MD, Ege University, Department of Internal Medicine, Division of Rheumatology; A. Dogru, MD, Suleyman Demirel University, Department of Internal Medicine, Division of Rheumatology; E. Dalkilic, MD, Associate Professor, Uludag University, Department of Internal Medicine, Division of Rheumatology; G. Kimyon, MD, Mustafa Kemal University, Department of Internal Medicine, Division of Rheumatology; C. Ozisler, MD, Diskapi Yildirim Beyazit Education and Research Hospital, Department of Internal Medicine, Division of Rheumatology; G.Y. Cetin, MD, Associate Professor, Kahramanmaras Sutcu Imam University, Department of Internal Medicine, Division of Rheumatology; L. Kilic, MD, Hacettepe University, Department of Internal Medicine, Division of Rheumatology, Hacettepe University Hospital; A. Omma, MD, Ankara Numune Education and Research Hospital, Department of Internal Medicine, Division of Rheumatology; M. Can, MD, Associate Professor, Marmara University, Department of Internal Medicine, Division of Rheumatology; S. Yilmaz, MD, Professor, Selcuk University, Department of Internal Medicine, Division of Rheumatology; A. Erden, MD, Hacettepe University, Department of Internal Medicine, Division of Rheumatology; S.Z. Aydin, MD, Associate Professor, University of Ottawa Faculty of Medicine, Ottawa Hospital Research Institute. Address correspondence to Dr. S.Z. Aydin, 1967 Riverside Drive, Ottawa, Ontario K1H 7W9, Canada. E-mail: . Accepted for publication November 13, 2019
| | - Gozde Yildirim Cetin
- From the University of Ottawa Faculty of Medicine, Rheumatology, and Ottawa Hospital Research Institute, Ottawa, Ontario, Canada; Hacettepe University, Faculty of Medicine, Department of Internal Medicine, Division of Rheumatology, Hacettepe University Hospital, Ankara, Turkey; Unit of Rheumatology, Sacro Cuore-Don Calabria Hospital, Negrar, Verona, Italy; Ege University, Department of Internal Medicine, Division of Rheumatology, Izmir, Turkey; Suleyman Demirel University, Department of Internal Medicine, Division of Rheumatology, Isparta, Turkey; Uludag University, Department of Internal Medicine, Division of Rheumatology, Bursa, Turkey; Mustafa Kemal University, Department of Internal Medicine, Division of Rheumatology, Hatay, Turkey; Diskapi Yildirim Beyazit Education and Research Hospital, Department of Internal Medicine, Division of Rheumatology, Ankara, Turkey; Kahramanmaras Sutcu Imam University, Department of Internal Medicine, Division of Rheumatology, Kahramanmaras, Turkey; Ankara Numune Education and Research Hospital, Department of Internal Medicine, Division of Rheumatology, Ankara, Turkey; Marmara University, Department of Internal Medicine, Division of Rheumatology, Istanbul, Turkey; Selcuk University, Department of Internal Medicine, Division of Rheumatology, Konya, Turkey. D. Solmaz had funding from Union ChimiqueBelge (UCB) for an axial spondyloarthritis fellowship. S. Bakirci had funding from the Turkish Society for Rheumatology (TRD). S.Z. Aydin received honoraria from Abbvie, Celgene, UCB, Novartis, Jannsen, and Sanofi. D. Solmaz, MD, University of Ottawa Faculty of Medicine, Rheumatology; U. Kalyoncu, MD, Associate Professor, Hacettepe University, Faculty of Medicine, Department of Internal Medicine, Division of Rheumatology; I. Tinazzi, MD, Unit of Rheumatology, Sacro Cuore-Don Calabria Hospital; S. Bakirci, MD, University of Ottawa Faculty of Medicine, Rheumatology; O. Bayindir, MD, Ege University, Department of Internal Medicine, Division of Rheumatology; A. Dogru, MD, Suleyman Demirel University, Department of Internal Medicine, Division of Rheumatology; E. Dalkilic, MD, Associate Professor, Uludag University, Department of Internal Medicine, Division of Rheumatology; G. Kimyon, MD, Mustafa Kemal University, Department of Internal Medicine, Division of Rheumatology; C. Ozisler, MD, Diskapi Yildirim Beyazit Education and Research Hospital, Department of Internal Medicine, Division of Rheumatology; G.Y. Cetin, MD, Associate Professor, Kahramanmaras Sutcu Imam University, Department of Internal Medicine, Division of Rheumatology; L. Kilic, MD, Hacettepe University, Department of Internal Medicine, Division of Rheumatology, Hacettepe University Hospital; A. Omma, MD, Ankara Numune Education and Research Hospital, Department of Internal Medicine, Division of Rheumatology; M. Can, MD, Associate Professor, Marmara University, Department of Internal Medicine, Division of Rheumatology; S. Yilmaz, MD, Professor, Selcuk University, Department of Internal Medicine, Division of Rheumatology; A. Erden, MD, Hacettepe University, Department of Internal Medicine, Division of Rheumatology; S.Z. Aydin, MD, Associate Professor, University of Ottawa Faculty of Medicine, Ottawa Hospital Research Institute. Address correspondence to Dr. S.Z. Aydin, 1967 Riverside Drive, Ottawa, Ontario K1H 7W9, Canada. E-mail: . Accepted for publication November 13, 2019
| | - Levent Kilic
- From the University of Ottawa Faculty of Medicine, Rheumatology, and Ottawa Hospital Research Institute, Ottawa, Ontario, Canada; Hacettepe University, Faculty of Medicine, Department of Internal Medicine, Division of Rheumatology, Hacettepe University Hospital, Ankara, Turkey; Unit of Rheumatology, Sacro Cuore-Don Calabria Hospital, Negrar, Verona, Italy; Ege University, Department of Internal Medicine, Division of Rheumatology, Izmir, Turkey; Suleyman Demirel University, Department of Internal Medicine, Division of Rheumatology, Isparta, Turkey; Uludag University, Department of Internal Medicine, Division of Rheumatology, Bursa, Turkey; Mustafa Kemal University, Department of Internal Medicine, Division of Rheumatology, Hatay, Turkey; Diskapi Yildirim Beyazit Education and Research Hospital, Department of Internal Medicine, Division of Rheumatology, Ankara, Turkey; Kahramanmaras Sutcu Imam University, Department of Internal Medicine, Division of Rheumatology, Kahramanmaras, Turkey; Ankara Numune Education and Research Hospital, Department of Internal Medicine, Division of Rheumatology, Ankara, Turkey; Marmara University, Department of Internal Medicine, Division of Rheumatology, Istanbul, Turkey; Selcuk University, Department of Internal Medicine, Division of Rheumatology, Konya, Turkey. D. Solmaz had funding from Union ChimiqueBelge (UCB) for an axial spondyloarthritis fellowship. S. Bakirci had funding from the Turkish Society for Rheumatology (TRD). S.Z. Aydin received honoraria from Abbvie, Celgene, UCB, Novartis, Jannsen, and Sanofi. D. Solmaz, MD, University of Ottawa Faculty of Medicine, Rheumatology; U. Kalyoncu, MD, Associate Professor, Hacettepe University, Faculty of Medicine, Department of Internal Medicine, Division of Rheumatology; I. Tinazzi, MD, Unit of Rheumatology, Sacro Cuore-Don Calabria Hospital; S. Bakirci, MD, University of Ottawa Faculty of Medicine, Rheumatology; O. Bayindir, MD, Ege University, Department of Internal Medicine, Division of Rheumatology; A. Dogru, MD, Suleyman Demirel University, Department of Internal Medicine, Division of Rheumatology; E. Dalkilic, MD, Associate Professor, Uludag University, Department of Internal Medicine, Division of Rheumatology; G. Kimyon, MD, Mustafa Kemal University, Department of Internal Medicine, Division of Rheumatology; C. Ozisler, MD, Diskapi Yildirim Beyazit Education and Research Hospital, Department of Internal Medicine, Division of Rheumatology; G.Y. Cetin, MD, Associate Professor, Kahramanmaras Sutcu Imam University, Department of Internal Medicine, Division of Rheumatology; L. Kilic, MD, Hacettepe University, Department of Internal Medicine, Division of Rheumatology, Hacettepe University Hospital; A. Omma, MD, Ankara Numune Education and Research Hospital, Department of Internal Medicine, Division of Rheumatology; M. Can, MD, Associate Professor, Marmara University, Department of Internal Medicine, Division of Rheumatology; S. Yilmaz, MD, Professor, Selcuk University, Department of Internal Medicine, Division of Rheumatology; A. Erden, MD, Hacettepe University, Department of Internal Medicine, Division of Rheumatology; S.Z. Aydin, MD, Associate Professor, University of Ottawa Faculty of Medicine, Ottawa Hospital Research Institute. Address correspondence to Dr. S.Z. Aydin, 1967 Riverside Drive, Ottawa, Ontario K1H 7W9, Canada. E-mail: . Accepted for publication November 13, 2019
| | - Ahmet Omma
- From the University of Ottawa Faculty of Medicine, Rheumatology, and Ottawa Hospital Research Institute, Ottawa, Ontario, Canada; Hacettepe University, Faculty of Medicine, Department of Internal Medicine, Division of Rheumatology, Hacettepe University Hospital, Ankara, Turkey; Unit of Rheumatology, Sacro Cuore-Don Calabria Hospital, Negrar, Verona, Italy; Ege University, Department of Internal Medicine, Division of Rheumatology, Izmir, Turkey; Suleyman Demirel University, Department of Internal Medicine, Division of Rheumatology, Isparta, Turkey; Uludag University, Department of Internal Medicine, Division of Rheumatology, Bursa, Turkey; Mustafa Kemal University, Department of Internal Medicine, Division of Rheumatology, Hatay, Turkey; Diskapi Yildirim Beyazit Education and Research Hospital, Department of Internal Medicine, Division of Rheumatology, Ankara, Turkey; Kahramanmaras Sutcu Imam University, Department of Internal Medicine, Division of Rheumatology, Kahramanmaras, Turkey; Ankara Numune Education and Research Hospital, Department of Internal Medicine, Division of Rheumatology, Ankara, Turkey; Marmara University, Department of Internal Medicine, Division of Rheumatology, Istanbul, Turkey; Selcuk University, Department of Internal Medicine, Division of Rheumatology, Konya, Turkey. D. Solmaz had funding from Union ChimiqueBelge (UCB) for an axial spondyloarthritis fellowship. S. Bakirci had funding from the Turkish Society for Rheumatology (TRD). S.Z. Aydin received honoraria from Abbvie, Celgene, UCB, Novartis, Jannsen, and Sanofi. D. Solmaz, MD, University of Ottawa Faculty of Medicine, Rheumatology; U. Kalyoncu, MD, Associate Professor, Hacettepe University, Faculty of Medicine, Department of Internal Medicine, Division of Rheumatology; I. Tinazzi, MD, Unit of Rheumatology, Sacro Cuore-Don Calabria Hospital; S. Bakirci, MD, University of Ottawa Faculty of Medicine, Rheumatology; O. Bayindir, MD, Ege University, Department of Internal Medicine, Division of Rheumatology; A. Dogru, MD, Suleyman Demirel University, Department of Internal Medicine, Division of Rheumatology; E. Dalkilic, MD, Associate Professor, Uludag University, Department of Internal Medicine, Division of Rheumatology; G. Kimyon, MD, Mustafa Kemal University, Department of Internal Medicine, Division of Rheumatology; C. Ozisler, MD, Diskapi Yildirim Beyazit Education and Research Hospital, Department of Internal Medicine, Division of Rheumatology; G.Y. Cetin, MD, Associate Professor, Kahramanmaras Sutcu Imam University, Department of Internal Medicine, Division of Rheumatology; L. Kilic, MD, Hacettepe University, Department of Internal Medicine, Division of Rheumatology, Hacettepe University Hospital; A. Omma, MD, Ankara Numune Education and Research Hospital, Department of Internal Medicine, Division of Rheumatology; M. Can, MD, Associate Professor, Marmara University, Department of Internal Medicine, Division of Rheumatology; S. Yilmaz, MD, Professor, Selcuk University, Department of Internal Medicine, Division of Rheumatology; A. Erden, MD, Hacettepe University, Department of Internal Medicine, Division of Rheumatology; S.Z. Aydin, MD, Associate Professor, University of Ottawa Faculty of Medicine, Ottawa Hospital Research Institute. Address correspondence to Dr. S.Z. Aydin, 1967 Riverside Drive, Ottawa, Ontario K1H 7W9, Canada. E-mail: . Accepted for publication November 13, 2019
| | - Meryem Can
- From the University of Ottawa Faculty of Medicine, Rheumatology, and Ottawa Hospital Research Institute, Ottawa, Ontario, Canada; Hacettepe University, Faculty of Medicine, Department of Internal Medicine, Division of Rheumatology, Hacettepe University Hospital, Ankara, Turkey; Unit of Rheumatology, Sacro Cuore-Don Calabria Hospital, Negrar, Verona, Italy; Ege University, Department of Internal Medicine, Division of Rheumatology, Izmir, Turkey; Suleyman Demirel University, Department of Internal Medicine, Division of Rheumatology, Isparta, Turkey; Uludag University, Department of Internal Medicine, Division of Rheumatology, Bursa, Turkey; Mustafa Kemal University, Department of Internal Medicine, Division of Rheumatology, Hatay, Turkey; Diskapi Yildirim Beyazit Education and Research Hospital, Department of Internal Medicine, Division of Rheumatology, Ankara, Turkey; Kahramanmaras Sutcu Imam University, Department of Internal Medicine, Division of Rheumatology, Kahramanmaras, Turkey; Ankara Numune Education and Research Hospital, Department of Internal Medicine, Division of Rheumatology, Ankara, Turkey; Marmara University, Department of Internal Medicine, Division of Rheumatology, Istanbul, Turkey; Selcuk University, Department of Internal Medicine, Division of Rheumatology, Konya, Turkey. D. Solmaz had funding from Union ChimiqueBelge (UCB) for an axial spondyloarthritis fellowship. S. Bakirci had funding from the Turkish Society for Rheumatology (TRD). S.Z. Aydin received honoraria from Abbvie, Celgene, UCB, Novartis, Jannsen, and Sanofi. D. Solmaz, MD, University of Ottawa Faculty of Medicine, Rheumatology; U. Kalyoncu, MD, Associate Professor, Hacettepe University, Faculty of Medicine, Department of Internal Medicine, Division of Rheumatology; I. Tinazzi, MD, Unit of Rheumatology, Sacro Cuore-Don Calabria Hospital; S. Bakirci, MD, University of Ottawa Faculty of Medicine, Rheumatology; O. Bayindir, MD, Ege University, Department of Internal Medicine, Division of Rheumatology; A. Dogru, MD, Suleyman Demirel University, Department of Internal Medicine, Division of Rheumatology; E. Dalkilic, MD, Associate Professor, Uludag University, Department of Internal Medicine, Division of Rheumatology; G. Kimyon, MD, Mustafa Kemal University, Department of Internal Medicine, Division of Rheumatology; C. Ozisler, MD, Diskapi Yildirim Beyazit Education and Research Hospital, Department of Internal Medicine, Division of Rheumatology; G.Y. Cetin, MD, Associate Professor, Kahramanmaras Sutcu Imam University, Department of Internal Medicine, Division of Rheumatology; L. Kilic, MD, Hacettepe University, Department of Internal Medicine, Division of Rheumatology, Hacettepe University Hospital; A. Omma, MD, Ankara Numune Education and Research Hospital, Department of Internal Medicine, Division of Rheumatology; M. Can, MD, Associate Professor, Marmara University, Department of Internal Medicine, Division of Rheumatology; S. Yilmaz, MD, Professor, Selcuk University, Department of Internal Medicine, Division of Rheumatology; A. Erden, MD, Hacettepe University, Department of Internal Medicine, Division of Rheumatology; S.Z. Aydin, MD, Associate Professor, University of Ottawa Faculty of Medicine, Ottawa Hospital Research Institute. Address correspondence to Dr. S.Z. Aydin, 1967 Riverside Drive, Ottawa, Ontario K1H 7W9, Canada. E-mail: . Accepted for publication November 13, 2019
| | - Sema Yilmaz
- From the University of Ottawa Faculty of Medicine, Rheumatology, and Ottawa Hospital Research Institute, Ottawa, Ontario, Canada; Hacettepe University, Faculty of Medicine, Department of Internal Medicine, Division of Rheumatology, Hacettepe University Hospital, Ankara, Turkey; Unit of Rheumatology, Sacro Cuore-Don Calabria Hospital, Negrar, Verona, Italy; Ege University, Department of Internal Medicine, Division of Rheumatology, Izmir, Turkey; Suleyman Demirel University, Department of Internal Medicine, Division of Rheumatology, Isparta, Turkey; Uludag University, Department of Internal Medicine, Division of Rheumatology, Bursa, Turkey; Mustafa Kemal University, Department of Internal Medicine, Division of Rheumatology, Hatay, Turkey; Diskapi Yildirim Beyazit Education and Research Hospital, Department of Internal Medicine, Division of Rheumatology, Ankara, Turkey; Kahramanmaras Sutcu Imam University, Department of Internal Medicine, Division of Rheumatology, Kahramanmaras, Turkey; Ankara Numune Education and Research Hospital, Department of Internal Medicine, Division of Rheumatology, Ankara, Turkey; Marmara University, Department of Internal Medicine, Division of Rheumatology, Istanbul, Turkey; Selcuk University, Department of Internal Medicine, Division of Rheumatology, Konya, Turkey. D. Solmaz had funding from Union ChimiqueBelge (UCB) for an axial spondyloarthritis fellowship. S. Bakirci had funding from the Turkish Society for Rheumatology (TRD). S.Z. Aydin received honoraria from Abbvie, Celgene, UCB, Novartis, Jannsen, and Sanofi. D. Solmaz, MD, University of Ottawa Faculty of Medicine, Rheumatology; U. Kalyoncu, MD, Associate Professor, Hacettepe University, Faculty of Medicine, Department of Internal Medicine, Division of Rheumatology; I. Tinazzi, MD, Unit of Rheumatology, Sacro Cuore-Don Calabria Hospital; S. Bakirci, MD, University of Ottawa Faculty of Medicine, Rheumatology; O. Bayindir, MD, Ege University, Department of Internal Medicine, Division of Rheumatology; A. Dogru, MD, Suleyman Demirel University, Department of Internal Medicine, Division of Rheumatology; E. Dalkilic, MD, Associate Professor, Uludag University, Department of Internal Medicine, Division of Rheumatology; G. Kimyon, MD, Mustafa Kemal University, Department of Internal Medicine, Division of Rheumatology; C. Ozisler, MD, Diskapi Yildirim Beyazit Education and Research Hospital, Department of Internal Medicine, Division of Rheumatology; G.Y. Cetin, MD, Associate Professor, Kahramanmaras Sutcu Imam University, Department of Internal Medicine, Division of Rheumatology; L. Kilic, MD, Hacettepe University, Department of Internal Medicine, Division of Rheumatology, Hacettepe University Hospital; A. Omma, MD, Ankara Numune Education and Research Hospital, Department of Internal Medicine, Division of Rheumatology; M. Can, MD, Associate Professor, Marmara University, Department of Internal Medicine, Division of Rheumatology; S. Yilmaz, MD, Professor, Selcuk University, Department of Internal Medicine, Division of Rheumatology; A. Erden, MD, Hacettepe University, Department of Internal Medicine, Division of Rheumatology; S.Z. Aydin, MD, Associate Professor, University of Ottawa Faculty of Medicine, Ottawa Hospital Research Institute. Address correspondence to Dr. S.Z. Aydin, 1967 Riverside Drive, Ottawa, Ontario K1H 7W9, Canada. E-mail: . Accepted for publication November 13, 2019
| | - Abdulsamet Erden
- From the University of Ottawa Faculty of Medicine, Rheumatology, and Ottawa Hospital Research Institute, Ottawa, Ontario, Canada; Hacettepe University, Faculty of Medicine, Department of Internal Medicine, Division of Rheumatology, Hacettepe University Hospital, Ankara, Turkey; Unit of Rheumatology, Sacro Cuore-Don Calabria Hospital, Negrar, Verona, Italy; Ege University, Department of Internal Medicine, Division of Rheumatology, Izmir, Turkey; Suleyman Demirel University, Department of Internal Medicine, Division of Rheumatology, Isparta, Turkey; Uludag University, Department of Internal Medicine, Division of Rheumatology, Bursa, Turkey; Mustafa Kemal University, Department of Internal Medicine, Division of Rheumatology, Hatay, Turkey; Diskapi Yildirim Beyazit Education and Research Hospital, Department of Internal Medicine, Division of Rheumatology, Ankara, Turkey; Kahramanmaras Sutcu Imam University, Department of Internal Medicine, Division of Rheumatology, Kahramanmaras, Turkey; Ankara Numune Education and Research Hospital, Department of Internal Medicine, Division of Rheumatology, Ankara, Turkey; Marmara University, Department of Internal Medicine, Division of Rheumatology, Istanbul, Turkey; Selcuk University, Department of Internal Medicine, Division of Rheumatology, Konya, Turkey. D. Solmaz had funding from Union ChimiqueBelge (UCB) for an axial spondyloarthritis fellowship. S. Bakirci had funding from the Turkish Society for Rheumatology (TRD). S.Z. Aydin received honoraria from Abbvie, Celgene, UCB, Novartis, Jannsen, and Sanofi. D. Solmaz, MD, University of Ottawa Faculty of Medicine, Rheumatology; U. Kalyoncu, MD, Associate Professor, Hacettepe University, Faculty of Medicine, Department of Internal Medicine, Division of Rheumatology; I. Tinazzi, MD, Unit of Rheumatology, Sacro Cuore-Don Calabria Hospital; S. Bakirci, MD, University of Ottawa Faculty of Medicine, Rheumatology; O. Bayindir, MD, Ege University, Department of Internal Medicine, Division of Rheumatology; A. Dogru, MD, Suleyman Demirel University, Department of Internal Medicine, Division of Rheumatology; E. Dalkilic, MD, Associate Professor, Uludag University, Department of Internal Medicine, Division of Rheumatology; G. Kimyon, MD, Mustafa Kemal University, Department of Internal Medicine, Division of Rheumatology; C. Ozisler, MD, Diskapi Yildirim Beyazit Education and Research Hospital, Department of Internal Medicine, Division of Rheumatology; G.Y. Cetin, MD, Associate Professor, Kahramanmaras Sutcu Imam University, Department of Internal Medicine, Division of Rheumatology; L. Kilic, MD, Hacettepe University, Department of Internal Medicine, Division of Rheumatology, Hacettepe University Hospital; A. Omma, MD, Ankara Numune Education and Research Hospital, Department of Internal Medicine, Division of Rheumatology; M. Can, MD, Associate Professor, Marmara University, Department of Internal Medicine, Division of Rheumatology; S. Yilmaz, MD, Professor, Selcuk University, Department of Internal Medicine, Division of Rheumatology; A. Erden, MD, Hacettepe University, Department of Internal Medicine, Division of Rheumatology; S.Z. Aydin, MD, Associate Professor, University of Ottawa Faculty of Medicine, Ottawa Hospital Research Institute. Address correspondence to Dr. S.Z. Aydin, 1967 Riverside Drive, Ottawa, Ontario K1H 7W9, Canada. E-mail: . Accepted for publication November 13, 2019
| | - Sibel Zehra Aydin
- From the University of Ottawa Faculty of Medicine, Rheumatology, and Ottawa Hospital Research Institute, Ottawa, Ontario, Canada; Hacettepe University, Faculty of Medicine, Department of Internal Medicine, Division of Rheumatology, Hacettepe University Hospital, Ankara, Turkey; Unit of Rheumatology, Sacro Cuore-Don Calabria Hospital, Negrar, Verona, Italy; Ege University, Department of Internal Medicine, Division of Rheumatology, Izmir, Turkey; Suleyman Demirel University, Department of Internal Medicine, Division of Rheumatology, Isparta, Turkey; Uludag University, Department of Internal Medicine, Division of Rheumatology, Bursa, Turkey; Mustafa Kemal University, Department of Internal Medicine, Division of Rheumatology, Hatay, Turkey; Diskapi Yildirim Beyazit Education and Research Hospital, Department of Internal Medicine, Division of Rheumatology, Ankara, Turkey; Kahramanmaras Sutcu Imam University, Department of Internal Medicine, Division of Rheumatology, Kahramanmaras, Turkey; Ankara Numune Education and Research Hospital, Department of Internal Medicine, Division of Rheumatology, Ankara, Turkey; Marmara University, Department of Internal Medicine, Division of Rheumatology, Istanbul, Turkey; Selcuk University, Department of Internal Medicine, Division of Rheumatology, Konya, Turkey. D. Solmaz had funding from Union ChimiqueBelge (UCB) for an axial spondyloarthritis fellowship. S. Bakirci had funding from the Turkish Society for Rheumatology (TRD). S.Z. Aydin received honoraria from Abbvie, Celgene, UCB, Novartis, Jannsen, and Sanofi. D. Solmaz, MD, University of Ottawa Faculty of Medicine, Rheumatology; U. Kalyoncu, MD, Associate Professor, Hacettepe University, Faculty of Medicine, Department of Internal Medicine, Division of Rheumatology; I. Tinazzi, MD, Unit of Rheumatology, Sacro Cuore-Don Calabria Hospital; S. Bakirci, MD, University of Ottawa Faculty of Medicine, Rheumatology; O. Bayindir, MD, Ege University, Department of Internal Medicine, Division of Rheumatology; A. Dogru, MD, Suleyman Demirel University, Department of Internal Medicine, Division of Rheumatology; E. Dalkilic, MD, Associate Professor, Uludag University, Department of Internal Medicine, Division of Rheumatology; G. Kimyon, MD, Mustafa Kemal University, Department of Internal Medicine, Division of Rheumatology; C. Ozisler, MD, Diskapi Yildirim Beyazit Education and Research Hospital, Department of Internal Medicine, Division of Rheumatology; G.Y. Cetin, MD, Associate Professor, Kahramanmaras Sutcu Imam University, Department of Internal Medicine, Division of Rheumatology; L. Kilic, MD, Hacettepe University, Department of Internal Medicine, Division of Rheumatology, Hacettepe University Hospital; A. Omma, MD, Ankara Numune Education and Research Hospital, Department of Internal Medicine, Division of Rheumatology; M. Can, MD, Associate Professor, Marmara University, Department of Internal Medicine, Division of Rheumatology; S. Yilmaz, MD, Professor, Selcuk University, Department of Internal Medicine, Division of Rheumatology; A. Erden, MD, Hacettepe University, Department of Internal Medicine, Division of Rheumatology; S.Z. Aydin, MD, Associate Professor, University of Ottawa Faculty of Medicine, Ottawa Hospital Research Institute. Address correspondence to Dr. S.Z. Aydin, 1967 Riverside Drive, Ottawa, Ontario K1H 7W9, Canada. E-mail: . Accepted for publication November 13, 2019
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