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Young JJ, Zywiel MG, Skou ST, Chandran V, Davey JR, Gandhi R, Mahomed NN, Syed K, Veillette CJH, Rampersaud YR, Perruccio AV. Total Knee Arthroplasty Versus Education and Exercise for Knee Osteoarthritis: A Propensity-Matched Analysis. Arthritis Care Res (Hoboken) 2024; 76:682-690. [PMID: 38191793 DOI: 10.1002/acr.25293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 12/19/2023] [Accepted: 12/22/2023] [Indexed: 01/10/2024]
Abstract
OBJECTIVE We estimate the treatment effect of total knee arthroplasty (TKA) versus an education and exercise (Edu+Ex) program on pain, function, and quality of life outcomes 3 and 12 months after treatment initiation for knee osteoarthritis (OA). METHODS Patients with knee OA who had undergone TKA were matched on a 1:1 ratio with participants in an Edu+Ex program based on a propensity score fitted to a range of pretreatment covariates. After matching, between-group differences in improvement (the treatment effect) in Knee Injury and Osteoarthritis Outcome Score 12-item version (0, worst to 100, best) pain, function, and quality of life from baseline to 3 and 12 months were estimated using linear mixed models, adjusting for unbalanced covariates, if any, after matching. RESULTS The matched sample consisted of 522 patients (Edu+Ex, n = 261; TKA, n = 261) who were balanced on all pretreatment characteristics. At 12-month follow-up, TKA resulted in significantly greater improvements in pain (mean difference [MD] 22.8; 95% confidence interval [95% CI] 19.7-25.8), function (MD 21.2; 95% CI 17.7-24.4), and quality of life (MD 18.3; 15.0-21.6). Even so, at least one-third of patients receiving Edu+Ex had a clinically meaningful improvement in outcomes at 12 months compared with 75% of patients with TKA. CONCLUSION TKA is associated with greater improvements in pain, function, and quality of life, but these findings also suggest that Edu+Ex may be a viable alternative to TKA in a meaningful proportion of patients, which may reduce overall TKA need. Confirmatory trials are needed.
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Affiliation(s)
- James J Young
- University Health Network, Toronto, Ontario, Canada, and University of Southern Denmark, Odense, Denmark
| | - Michael G Zywiel
- University Health Network and University of Toronto, Toronto, Ontario, Canada
| | - Søren T Skou
- University of Southern Denmark, Odense, Denmark, and Næstved-Slagelse-Ringsted Hospitals, Slagelse, Denmark
| | - Vinod Chandran
- University Health Network and University of Toronto, Toronto, Ontario, Canada
| | - J Rod Davey
- University Health Network and University of Toronto, Toronto, Ontario, Canada
| | - Rajiv Gandhi
- University Health Network and University of Toronto, Toronto, Ontario, Canada
| | - Nizar N Mahomed
- University Health Network and University of Toronto, Toronto, Ontario, Canada
| | - Khalid Syed
- University Health Network, Toronto, Ontario, Canada
| | | | - Y Raja Rampersaud
- University Health Network and University of Toronto, Toronto, Ontario, Canada
| | - Anthony V Perruccio
- University Health Network and University of Toronto, Toronto, Ontario, Canada
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Bowdish DME, Chandran V, Hitchon CA, Kaplan GG, Avina-Zubieta JA, Fortin PR, Larché MJ, Boire G, Gingras AC, Dayam RM, Colmegna I, Lukusa L, Lee JLF, Richards DP, Pereira D, Watts TH, Silverberg MS, Bernstein CN, Lacaille D, Benoit J, Kim J, Lalonde N, Gunderson J, Allard-Chamard H, Roux S, Quan J, Hracs L, Turnbull E, Valerio V, Bernatsky S. When Should I Get My Next COVID Vaccine? Data from the SUrveillance of responses to COVID-19 vaCcines in systEmic immunE mediated inflammatory Diseases (SUCCEED)study. J Rheumatol 2024:jrheum.2023-1214. [PMID: 38621797 DOI: 10.3899/jrheum.2023-1214] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/17/2024]
Abstract
OBJECTIVE To determine how serologic responses to COVID vaccination/infection in immunemediated inflammatory disease (IMID) are affected by time since last vaccination and other factors. METHODS Post-COVID-19 vaccination, data and dried blood spots/sera were collected from adults with rheumatoid arthritis, inflammatory bowel disease, systemic lupus, ankylosing spondylitis/spondylarthritis and psoriasis/psoriatic arthritis. First sample was at enrolment and then 2-4 weeks and 3, 6, and 12 months after latest vaccine dose. Multivariate generalized estimating equation regressions (including medications, demographics, and vaccination history) evaluated serologic response, based on log-transformed anti-RBD IgG titres; we also measured anti-nucleocapsid IgG. RESULTS Positive associations for log-transformed anti-RBD titres were seen with female sex, number of doses, and self-reported COVID infections in 2021-2023. Negative associations were seen with prednisone, anti-TNF agents, and rituximab.Over 2021-2023, most (94%) of anti-nucleocapsid positivity was associated with a self-reported infection in the 3 months prior. From March 2021 to Feb 2022, anti-nucleocapsid positivity was present in 5-15% of samples and was highest in the post-Omicron era, with anti-nucleocapsid positivity trending to 30-35% or higher as of March 2023. Anti-nucleocapsid positivity in IMID remained lower than Canada's general population seroprevalence (>50% in 2022 and >75% in 2023).Time since last vaccination was negatively associated with log-transformed anti-RBD titres, particularly after 210 days. CONCLUSION Ours is the first pan-Canadian IMID assessment of how vaccine history and other factors affect serologic COVID-19 vaccine responses. These findings may help individuals personalize vaccination decisions, including consideration of additional vaccination when >6 months has elapsed since last COVID vaccination/infection.
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Affiliation(s)
- Dawn M E Bowdish
- Dawn ME Bowdish PhD, Department of Medicine, McMaster University, 1280 Main St W, Hamilton, Ontario, Canada
| | - Vinod Chandran
- Vinod Chandran MD PhD, Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, Toronto, Ontario, Canada; Division of Rheumatology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Carol A Hitchon
- Carol A Hitchon MD MSc, Department of Internal Medicine, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
| | - Gilaad G Kaplan
- Gilaad G. Kaplan MD MPH, Division of Gastroenterology and Hepatology, Departments of Medicine and Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
| | - J Antonio Avina-Zubieta
- J. Antonio Avina-Zubieta MD PhD, Arthritis Research Canada and Division of Rheumatology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Paul R Fortin
- Paul R Fortin MD MPH, Centre de Recherche Arthrite, Division of Rheumatology, Department of Medicine, CHU de Québec - Université Laval, Québec City, Québec, Canada
| | - Maggie J Larché
- Maggie J. Larché MD PhD, Division of Rheumatology, Department of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Gilles Boire
- Gilles Boire MD MSc, Division of Rheumatology, Department of Medicine, Université de Sherbrooke, Sherbrooke, Québec, Canada
| | - Anne-Claude Gingras
- Anne-Claude Gingras PhD, Lunenfeld-Tanenbaum Research Institute at Mount Sinai Hospital, Sinai Health, Toronto, Ontario, Canada
| | - Roya M Dayam
- Roya M Dayam PhD, Lunenfeld-Tanenbaum Research Institute at Mount Sinai Hospital, Sinai Health, Toronto, Ontario, Canada
| | - Ines Colmegna
- Ines Colmegna MD, The Research Institute of the McGill University Health Centre, McGill University, Montreal, Quebec, Canada; Department of Medicine, Division of Rheumatology, McGill University, Montreal, Quebec, Canada
| | - Luck Lukusa
- Luck Lukusa MSc, The Research Institute of the McGill University Health Centre, McGill University, Montreal, Quebec, Canada
| | - Jennifer L F Lee
- Jennifer LF Lee BSc, The Research Institute of the McGill University Health Centre, McGill University, Montreal, Quebec, Canada
| | - Dawn P Richards
- Dawn P Richards PhD, Canadian Arthritis Patient Alliance, Toronto, Ontario, Canada
| | - Daniel Pereira
- Daniel Pereira BSc, Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, Toronto, Ontario, Canada
| | - Tania H Watts
- Tania H Watts PhD, Department of Immunology, University of Toronto, Toronto, Ontario, Canada
| | - Mark S Silverberg
- Mark S Silverberg MD PhD, Lunenfeld-Tanenbaum Research Institute at Mount Sinai Hospital, Sinai Health, Toronto, Ontario, Canada; Zane Cohen Centre for Digestive Diseases, Division of Gastroenterology, Mount Sinai Hospital, Sinai Health, Ontario, Canada
| | - Charles N Bernstein
- Charles N Bernstein MD, Department of Internal Medicine, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
| | - Diane Lacaille
- Diane Lacaille MD MHSc, Arthritis Research Canada and Division of Rheumatology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Jenna Benoit
- Jenna Benoit, Department of Medicine, McMaster University, 1280 Main St W, Hamilton, Ontario, Canada
| | - John Kim
- John Kim PhD, National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Manitoba, Canada
| | - Nadine Lalonde
- Nadine Lalonde BSc, Canadian Arthritis Patient Alliance, Toronto, Ontario, Canada
| | - Janet Gunderson
- Janet Gunderson BEd, Canadian Arthritis Patient Alliance, Toronto, Ontario, Canada
| | - Hugues Allard-Chamard
- Hugues Allard-Chamard MD PhD, Division of Rheumatology , Department of Medicine, Université de Sherbrooke, Sherbrooke, Québec, Canada
| | - Sophie Roux
- Sophie Roux MD PhD, Division of Rheumatology , Department of Medicine, Université de Sherbrooke, Sherbrooke, Québec, Canada
| | - Joshua Quan
- Joshua Quan MSc, Division of Gastroenterology and Hepatology, Departments of Medicine and Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
| | - Lindsay Hracs
- Lindsay Hracs PhD, Division of Gastroenterology and Hepatology, Departments of Medicine and Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
| | - Elizabeth Turnbull
- Elizabeth Turnbull RN, The Research Institute of the McGill University Health Centre, McGill University, Montreal, Quebec, Canada
| | - Valeria Valerio
- Valeria Valerio MD, The Research Institute of the McGill University Health Centre, McGill University, Montreal, Quebec, Canada
| | - Sasha Bernatsky
- Sasha Bernatsky MD PhD, The Research Institute of the McGill University Health Centre, McGill University, Montreal, Quebec, Canada; Department of Medicine, Division of Rheumatology, McGill University, Montreal, Quebec, Canada
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Li S, Looby N, Chandran V, Kulasingam V. Challenges in the Metabolomics-Based Biomarker Validation Pipeline. Metabolites 2024; 14:200. [PMID: 38668328 PMCID: PMC11051909 DOI: 10.3390/metabo14040200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 03/01/2024] [Revised: 03/27/2024] [Accepted: 03/31/2024] [Indexed: 04/28/2024] Open
Abstract
As end-products of the intersection between the genome and environmental influences, metabolites represent a promising approach to the discovery of novel biomarkers for diseases. However, many potential biomarker candidates identified by metabolomics studies fail to progress beyond analytical validation for routine implementation in clinics. Awareness of the challenges present can facilitate the development and advancement of innovative strategies that allow improved and more efficient applications of metabolite-based markers in clinical settings. This minireview provides a comprehensive summary of the pre-analytical factors, required analytical validation studies, and kit development challenges that must be resolved before the successful translation of novel metabolite biomarkers originating from research. We discuss the necessity for strict protocols for sample collection, storage, and the regulatory requirements to be fulfilled for a bioanalytical method to be considered as analytically validated. We focus especially on the blood as a biological matrix and liquid chromatography coupled with tandem mass spectrometry as the analytical platform for biomarker validation. Furthermore, we examine the challenges of developing a commercially viable metabolomics kit for distribution. To bridge the gap between the research lab and clinical implementation and utility of relevant metabolites, the understanding of the translational challenges for a biomarker panel is crucial for more efficient development of metabolomics-based precision medicine.
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Affiliation(s)
- Shenghan Li
- Division of Rheumatology, Psoriatic Arthritis Program, Schroeder Arthritis Program, University Health Network, Toronto, ON M5T 0S8, Canada; (S.L.); (N.L.)
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON M5S 1A1, Canada
- Krembil Research Institute, University Health Network, Toronto, ON M5T 0S8, Canada
| | - Nikita Looby
- Division of Rheumatology, Psoriatic Arthritis Program, Schroeder Arthritis Program, University Health Network, Toronto, ON M5T 0S8, Canada; (S.L.); (N.L.)
- Krembil Research Institute, University Health Network, Toronto, ON M5T 0S8, Canada
- Division of Orthopaedic Surgery, Osteoarthritis Research Program, Schroeder Arthritis Institute, University Health Network, Toronto, ON M5T 0S8, Canada
| | - Vinod Chandran
- Division of Rheumatology, Psoriatic Arthritis Program, Schroeder Arthritis Program, University Health Network, Toronto, ON M5T 0S8, Canada; (S.L.); (N.L.)
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON M5S 1A1, Canada
- Krembil Research Institute, University Health Network, Toronto, ON M5T 0S8, Canada
- Division of Rheumatology, Department of Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada
- Institute of Medical Science, University of Toronto, Toronto, ON M5S 1A8, Canada
| | - Vathany Kulasingam
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON M5S 1A1, Canada
- Division of Clinical Biochemistry, Laboratory Medicine Program, University Health Network, Toronto, ON M5G 2C4, Canada
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Chandran V, Bessette L, Thorne C, Sheriff M, Rahman P, Gladman DD, Anwar S, Jelley J, Gaudreau AJ, Chohan M, Sampalis JS. Use of Apremilast to Achieve Psoriatic Arthritis Treatment Goals and Satisfaction at 1 Year in the Canadian Real-World APPRAISE Study. Rheumatol Ther 2024; 11:443-455. [PMID: 38416391 PMCID: PMC10920604 DOI: 10.1007/s40744-024-00641-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Accepted: 01/16/2024] [Indexed: 02/29/2024] Open
Abstract
INTRODUCTION The APPRAISE study was conducted to better understand the 12-month effectiveness, tolerability, and patient satisfaction with apremilast treatment for patients with psoriatic arthritis (PsA) in real-world settings. METHODS APPRAISE (NCT03608657), a prospective, multicenter, observational study, enrolled adults with active PsA prescribed apremilast per routine care between July 2018 and March 2020. Patients were followed for 12 months with visits suggested every 4 months. The primary outcome measure was achievement of remission (REM) or low disease activity (LDA), defined as a Clinical Disease Activity Index for Psoriatic Arthritis (cDAPSA) score ≤ 13. RESULTS Of the 102 patients who enrolled, 45 (44.1%) discontinued the study by 12 months. Most patients (75.5%) had moderate or high disease activity, and 24.5% were in REM/LDA at baseline based on cDAPSA score. Achievement of cDAPSA REM/LDA was 63.7%, 67.2%, and 53.8% at months 4, 8, and 12, respectively. In those continuing in the study, significant improvements were seen in swollen and tender joint counts, pain visual analog scale, psoriasis body surface area, and complete dactylitis resolution. Enthesitis reduction was also observed. Improvements in treatment satisfaction and patient-reported outcomes, including Health Assessment Questionnaire-Disability Index and the 36-item Short Form physical and mental component scores, were observed over 12 months. The proportion of patients achieving a Patient-Acceptable Symptom State (PASS) increased significantly from baseline at months 4, 8, and 12 (P < 0.001). Apremilast was well tolerated; the most frequent adverse events (AEs) leading to discontinuation were diarrhea (9/102 [8.8%]), nausea (4/102 [3.9%]), and migraine (4/102 [3.9%]). CONCLUSION In this real-world study conducted in Canadian rheumatology clinics, apremilast demonstrated clinical effectiveness in patients with active PsA, along with patient satisfaction with treatment. Safety findings were consistent with previously reported clinical data. TRIAL REGISTRATION ClinicalTrials.gov identifier, NCT03608657.
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Affiliation(s)
- Vinod Chandran
- Schroeder Arthritis Institute, Krembil Research Institute, Toronto Western Hospital, 399 Bathurst St., 1E 416, Toronto, ON, M5T 2S8, Canada.
| | - Louis Bessette
- Laval University, 2325 Rue de l'Université, Québec, QC, G1V 0A6, Canada
| | - Carter Thorne
- Centre of Arthritis Excellence, 108-465 Davis Drive, Newmarket, ON, L3Y 7T9, Canada
| | - Maqbool Sheriff
- Nanaimo Regional General Hospital, 1200 Dufferin Crescent, Nanaimo, BC, V9S 2B7, Canada
| | - Proton Rahman
- Memorial University of Newfoundland, St John's, NL, Canada
| | - Dafna D Gladman
- Schroeder Arthritis Institute, Krembil Research Institute, Toronto Western Hospital, 399 Bathurst St., 1E 416, Toronto, ON, M5T 2S8, Canada
| | - Sabeen Anwar
- Windsor Regional Hospital, 1030 Ouellette Ave, Windsor, ON, N9A 1E1, Canada
| | - Jennifer Jelley
- Amgen Canada Inc., 6775 Financial Dr #300, Mississauga, ON, L5N 0A4, Canada
| | | | - Manprit Chohan
- Amgen Canada Inc., 6775 Financial Dr #300, Mississauga, ON, L5N 0A4, Canada
| | - John S Sampalis
- McGill University and JSS Medical Research, 9400 Henri Bourassa Blvd W, Saint-Laurent, QC, H4S 1N8, Canada
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Gladman DD, Chandran V, Rosen CF, Rohekar S, Boyd T, Eder L, Rahman P, Dutz J, Chan J, Haydey RP, Barac S, Laliberté MC, Girard T, Fournier PA, Sutton M, Pereira D, Chim T, Coupal L, Choquette D. Residual Disease Activity In Canadian Patients With Psoriatic Arthritis (PsA) Treated With Advanced Therapies: Results From A Multi-Registry Analysis (UNISON-PsA). J Rheumatol 2024:jrheum.2023-0716. [PMID: 38359937 DOI: 10.3899/jrheum.2023-0716] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2024]
Abstract
OBJECTIVE Although patient outcomes in psoriatic arthritis (PsA) have improved with the advent of advanced therapies, there remains a high unmet need to treat residual disease activity. The objective of the current study was to quantify residual disease activity and burden of disease in Canadian patients with PsA. METHODS This was a multi-region, observational, retrospective analysis of patient data extracted from the Rhumadata™ and the International Psoriasis and Arthritis Research Team (IPART) registries, analyzing de-identified data from patients who had initiated advanced therapy for the treatment of PsA between January 2010 and December 2019. The primary endpoint was the proportion of patients failing to achieve minimal disease activity (MDA) within 6 months; secondary endpoints included clinical and patient-reported burden of disease. Descriptive statistics included summaries by region, treatment class, and number of prior advanced therapies. RESULTS 1,596 patients were included. The proportion of patients who failed to achieve MDA within 6 months of an advanced therapy was 64.8% in Ontario, 68.3% in Western Canada, 74.8% in Québec and 75.0% in the Atlantic/East region. Failure to achieve MDA was higher amongst patients receiving an IL-17i compared with a TNFi in all regions except Atlantic/East. Between 73.2 to 78.6% of patients reported pain at 6 months, and continuing functional impairment varied from 24.0% in the West to 83.3% in the Atlantic/East. CONCLUSION There is substantial burden and unmet need for improved therapies for Canadians living with PsA. There is a wide regional variation in outcomes that requires further assessment.
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Affiliation(s)
- Dafna D Gladman
- Dafna D. Gladman, University of Toronto, Department of Medicine, Division of Rheumatology, Toronto, ON, Canada; Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, Toronto, Ontario, Canada
| | - Vinod Chandran
- Vinod Chandran, University of Toronto, Department of Medicine, Division of Rheumatology, Toronto, ON, Canada; Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, Toronto, Ontario, Canada; Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada
| | - Cheryl F Rosen
- Cheryl F. Rosen, Division of Dermatology, Department of Medicine, University of Toronto, Toronto, ON, Canada; Division of Dermatology, Toronto Western Hospital, Toronto, ON, Canada
| | - Sherry Rohekar
- Sherry Rohekar, Division of Rheumatology, Western University, London, Ontario, Canada
| | - Tristan Boyd
- Tristan Boyd, Division of Rheumatology, Western University, London, ON, Canada; Division of Rheumatology, St. Joseph's Hospital, London, ON, Canada
| | - Lihi Eder
- Lihi Eder, Division of Rheumatology, Women's College Hospital, Toronto, ON M5S 1B2, Canada; Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - Proton Rahman
- Proton Rahman, Department of Medicine, Memorial University, St. John's, Newfoundland, Canada
| | - Jan Dutz
- Jan Dutz, Department of Dermatology and Skin Science, University of British Columbia, Vancouver, BC, Canada
| | - Jonathan Chan
- Jonathan Chan, Department of Medicine, Division of Rheumatology, University of British Columbia, and Arthritis Research Canada, Vancouver, British Columbia, Canada
| | | | - Snezana Barac
- Snezana Barac, Winnipeg Clinic, Winnipeg, MB, Canada
| | | | - Tanya Girard
- Tanya Girard, AbbVie Corporation, St. Laurent, Québec, Canada
| | | | - Mitchell Sutton
- Mitchell Sutton, Centre for Prognosis Studies in the Rheumatic Diseases, Psoriatic Disease Program, Toronto Western Hospital, University Health Network
| | - Daniel Pereira
- Daniel Pereira, Centre for Prognosis Studies in the Rheumatic Diseases, Psoriatic Disease Program, Toronto Western Hospital, University Health Network
| | - Tina Chim
- Tina Chim, Centre for Prognosis Studies in the Rheumatic Diseases, Psoriatic Disease Program, Toronto Western Hospital, University Health Network
| | - Louis Coupal
- Louis Coupal, Institut de Rhumatologie de Montréal, CHUM, University of Montréal, Montréal, QC Canada
| | - Denis Choquette
- Denis Choquette, Institut de Rhumatologie de Montréal, CHUM, University of Montréal, Montréal, QC Canada
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Colaco K, Lee KA, Akhtari S, Winer R, Chandran V, Harvey P, Cook RJ, Piguet V, Gladman DD, Eder L. Derivation and Internal Validation of a Disease-Specific Cardiovascular Risk Prediction Model for Patients With Psoriatic Arthritis and Psoriasis. Arthritis Rheumatol 2024; 76:238-246. [PMID: 37691498 DOI: 10.1002/art.42694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 09/25/2022] [Revised: 08/12/2023] [Accepted: 09/01/2023] [Indexed: 09/12/2023]
Abstract
OBJECTIVE To address suboptimal cardiovascular risk prediction in patients with psoriatic disease (PsD), we developed and internally validated a five-year disease-specific cardiovascular risk prediction model. METHODS We analyzed data from a prospective cohort of participants with PsD without a history of cardiovascular events. Traditional cardiovascular risk factors and PsD-related measures of disease activity were considered as potential predictors. The study outcome included nonfatal and fatal cardiovascular events. A base prediction model included 10 traditional cardiovascular risk factors. Eight PsD-related factors were assessed by adding them to the base model to create expanded models, which were controlled for PsD therapies. Variable selection was performed using Least Absolute Shrinkage and Selection Operator (LASSO) penalized regression with 10-fold cross-validation. Model performance was assessed using measures of discrimination and calibration and measures of sensitivity and specificity. RESULTS Between 1992 and 2020, 85 of 1,336 participants developed cardiovascular events. Discrimination of the base model (with traditional cardiovascular risk factors alone) was excellent, with an area under the receiver operator characteristic curve (AUC) of 85.5 (95% confidence interval [CI] 81.9-89.1). Optimal models did not select any of the tested disease-specific factors. In a sensitivity analysis, which excluded lipid lowering and antihypertensive treatments, the number of damaged joints was selected in the expanded model. However, this model did not improve risk discrimination compared to the base model (AUC 85.5, 95% CI 82.0-89.1). CONCLUSION Traditional cardiovascular risk factors alone are effective in predicting cardiovascular risk in patients with PsD. A risk score based on these factors performed well, indicating excellent discrimination and calibration.
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Affiliation(s)
- Keith Colaco
- Women's College Research Institute, Women's College Hospital, Toronto, Ontario, Canada
- Womens College Hospital and Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Ker-Ai Lee
- University of Waterloo, Waterloo, Ontario, Canada
| | - Shadi Akhtari
- Women's College Research Institute, Women's College Hospital, Toronto, Ontario, Canada
- Womens College Hospital and Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Raz Winer
- Rambam Health Care Campus, Haifa, Israel
| | - Vinod Chandran
- Womens College Hospital and Department of Medicine, University of Toronto, Toronto, Ontario, Canada
- Schroeder Arthritis Institute, University Health Network and Depertament of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Paula Harvey
- Women's College Research Institute, Women's College Hospital, Toronto, Ontario, Canada
- Womens College Hospital and Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | | | - Vincent Piguet
- Women's College Research Institute, Women's College Hospital, Toronto, Ontario, Canada
- Womens College Hospital and Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Dafna D Gladman
- Womens College Hospital and Department of Medicine, University of Toronto, Toronto, Ontario, Canada
- Schroeder Arthritis Institute, University Health Network and Depertament of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Lihi Eder
- Women's College Research Institute, Women's College Hospital, Toronto, Ontario, Canada
- Womens College Hospital and Department of Medicine, University of Toronto, Toronto, Ontario, Canada
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Koussiouris J, Looby N, Kotlyar M, Kulasingam V, Jurisica I, Chandran V. Classifying patients with psoriatic arthritis according to their disease activity status using serum metabolites and machine learning. Metabolomics 2024; 20:17. [PMID: 38267619 PMCID: PMC10810020 DOI: 10.1007/s11306-023-02079-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2023] [Accepted: 12/06/2023] [Indexed: 01/26/2024]
Abstract
INTRODUCTION Psoriatic arthritis (PsA) is a heterogeneous inflammatory arthritis, affecting approximately a quarter of patients with psoriasis. Accurate assessment of disease activity is difficult. There are currently no clinically validated biomarkers to stratify PsA patients based on their disease activity, which is important for improving clinical management. OBJECTIVES To identify metabolites capable of classifying patients with PsA according to their disease activity. METHODS An in-house solid-phase microextraction (SPME)-liquid chromatography-high resolution mass spectrometry (LC-HRMS) method for lipid analysis was used to analyze serum samples obtained from patients classified as having low (n = 134), moderate (n = 134) or high (n = 104) disease activity, based on psoriatic arthritis disease activity scores (PASDAS). Metabolite data were analyzed using eight machine learning methods to predict disease activity levels. Top performing methods were selected based on area under the curve (AUC) and significance. RESULTS The best model for predicting high disease activity from low disease activity achieved AUC 0.818. The best model for predicting high disease activity from moderate disease activity achieved AUC 0.74. The best model for classifying low disease activity from moderate and high disease activity achieved AUC 0.765. Compounds confirmed by MS/MS validation included metabolites from diverse compound classes such as sphingolipids, phosphatidylcholines and carboxylic acids. CONCLUSION Several lipids and other metabolites when combined in classifying models predict high disease activity from both low and moderate disease activity. Lipids of key interest included lysophosphatidylcholine and sphingomyelin. Quantitative MS assays based on selected reaction monitoring, are required to quantify the candidate biomarkers identified.
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Affiliation(s)
- John Koussiouris
- Division of Rheumatology, Psoriatic Arthritis Program, Schroeder Arthritis Institute, University Health Network, Toronto, Canada
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Canada
- Krembil Research Institute, University Health Network, Toronto, Canada
| | - Nikita Looby
- Division of Rheumatology, Psoriatic Arthritis Program, Schroeder Arthritis Institute, University Health Network, Toronto, Canada
- Osteoarthritis Research Program, Division of Orthopaedic Surgery, Schroeder Arthritis Institute, University Health Network, Toronto, Canada
- Krembil Research Institute, University Health Network, Toronto, Canada
| | - Max Kotlyar
- Osteoarthritis Research Program, Division of Orthopaedic Surgery, Schroeder Arthritis Institute, University Health Network, Toronto, Canada
- Data Science Discovery Centre for Chronic Diseases, Krembil Research Institute, University Health Network, Toronto, Canada
- Krembil Research Institute, University Health Network, Toronto, Canada
| | - Vathany Kulasingam
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Canada
- Division of Clinical Biochemistry, Laboratory Medicine Program, University Health Network, Toronto, Canada
| | - Igor Jurisica
- Osteoarthritis Research Program, Division of Orthopaedic Surgery, Schroeder Arthritis Institute, University Health Network, Toronto, Canada
- Data Science Discovery Centre for Chronic Diseases, Krembil Research Institute, University Health Network, Toronto, Canada
- Department of Computer Science, University of Toronto, Toronto, Canada
- Department of Medical Biophysics, University of Toronto, Toronto, Canada
- Krembil Research Institute, University Health Network, Toronto, Canada
| | - Vinod Chandran
- Division of Rheumatology, Psoriatic Arthritis Program, Schroeder Arthritis Institute, University Health Network, Toronto, Canada.
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Canada.
- Division of Rheumatology, Department of Medicine, University of Toronto, Toronto, Canada.
- Institute of Medical Science, University of Toronto, Toronto, Canada.
- Krembil Research Institute, University Health Network, Toronto, Canada.
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8
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Mease PJ, Nash P, Grieb S, Chandran V. Impact of COVID-19 on Patients With Psoriasis or Psoriatic Arthritis. J Rheumatol 2023; 50:27-30. [PMID: 37527863 DOI: 10.3899/jrheum.2023-0521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/30/2023] [Indexed: 08/03/2023]
Abstract
Given the impact of the coronavirus disease 2019 (COVID-19) on patients with psoriatic disease (PsD), a session was devoted at the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA) 2022 annual meeting to discussing the current understanding of the risk of severe COVID-19 in patients with PsD. The effects of PsD and its treatment on prevention and treatment of COVID-19 with vaccinations, antiviral drugs, and monoclonal antibodies were discussed. The session concluded with a presentation on the perspectives of patient research partners about their experiences with COVID-19.
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Affiliation(s)
- Philip J Mease
- P.J. Mease, MD, Swedish Medical Center/Providence St. Joseph Health, and University of Washington School of Medicine, Seattle, Washington, USA
| | - Peter Nash
- P. Nash, MBBS, School of Medicine, Griffith University, Nathan, Queensland, Australia
| | - Suzanne Grieb
- S. Grieb, PhD, MSPH, Patient Research Partner, New York, New York, USA
| | - Vinod Chandran
- V. Chandran, MBBS, MD, DM, PhD, Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, Toronto, and Division of Rheumatology, Department of Medicine, Department of Laboratory Medicine and Pathobiology, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
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9
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Siebert S, Pennington SR, Raychaudhuri SP, Chaudhari AJ, Jin JQ, Liao W, Chandran V, FitzGerald O. Novel Insights From Basic Science in Psoriatic Disease at the GRAPPA 2022 Annual Meeting. J Rheumatol 2023; 50:66-70. [PMID: 37527860 DOI: 10.3899/jrheum.2023-0535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/30/2023] [Indexed: 08/03/2023]
Abstract
Recent basic science advances in psoriatic disease (PsD) were presented and discussed at the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA) 2022 annual meeting. Topics included clinical applications of biomarkers, what the future of biomarkers for PsD may hold, the challenges of developing biomarker research to the point of clinical utility, advances in total-body positron emission tomography/computed tomography imaging, and emerging concepts from single-cell studies in PsD.
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Affiliation(s)
- Stefan Siebert
- S. Siebert, MD, PhD, School of Infection and Immunity, University of Glasgow, Glasgow, UK
| | - Stephen R Pennington
- S.R. Pennington, PhD, O. FitzGerald, MD, School of Medicine, UCD Conway Institute for Biomolecular Research, University College Dublin, Dublin, Ireland
| | - Siba P Raychaudhuri
- S.P. Raychaudhuri, MD, Department of Internal Medicine-Rheumatology, UC Davis School of Medicine and Northern California Veterans Affairs Medical Center, Mather, California, USA
| | - Abhijit J Chaudhari
- A.J. Chaudhari, PhD, Department of Radiology, UC Davis School of Medicine, Sacramento, California, USA
| | - Joy Q Jin
- J.Q. Jin, AB, School of Medicine, and Department of Dermatology, University of California San Francisco, San Francisco, California, USA
| | - Wilson Liao
- W. Liao, MD, Department of Dermatology, University of California San Francisco, San Francisco, California, USA
| | - Vinod Chandran
- V. Chandran, DM, PhD, Departments of Medicine, Laboratory Medicine, and Pathobiology and Institute of Medical Science, University of Toronto, and Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, Toronto, Ontario, Canada
| | - Oliver FitzGerald
- S.R. Pennington, PhD, O. FitzGerald, MD, School of Medicine, UCD Conway Institute for Biomolecular Research, University College Dublin, Dublin, Ireland;
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10
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Ng BCK, Jadon D, Behrens F, de Wit M, FitzGerald O, Gladman DD, Mease PJ, O'Sullivan D, Pennington SR, Schett G, Chandran V, de Vlam K. Proceedings of the Collaborative Research Network Meeting at the GRAPPA 2022 Annual Meeting. J Rheumatol 2023; 50:61-65. [PMID: 37527862 DOI: 10.3899/jrheum.2023-0534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/30/2023] [Indexed: 08/03/2023]
Abstract
At the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA) 2022 annual meeting, the Collaborative Research Network (CRN) met to present updates on several projects. These included the GRAPPA-Industry biomarker projects, Axial Psoriatic Arthritis Molecular and Clinical Characterisation Study, Axial Involvement in Psoriatic Arthritis Cohort (AXIS) study, and the Health Initiatives in Psoriasis and Psoriatic Arthritis Consortium European States (HIPPOCRATES). The meeting concluded with a discussion on pathways to further academia-industry collaboration.
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Affiliation(s)
- Beverly Cheok Kuan Ng
- B.C.K. Ng, MBBS, MSc, D. Jadon, MBBCh, PhD, Rheumatology Research Unit, Department of Medicine, University of Cambridge, Cambridge, UK
| | - Deepak Jadon
- B.C.K. Ng, MBBS, MSc, D. Jadon, MBBCh, PhD, Rheumatology Research Unit, Department of Medicine, University of Cambridge, Cambridge, UK
| | - Frank Behrens
- F. Behrens, MD, Goethe University and Fraunhofer Institute for Molecular Biology and Applied Ecology, Branch for Translational Medicine and Pharmacology and Cluster of Excellence for Immune-Mediated Diseases, Frankfurt, Germany
| | - Maarten de Wit
- M. de Wit, PhD, GRAPPA Patient Research Partner, Amsterdam, the Netherlands
| | - Oliver FitzGerald
- O. FitzGerald, MD, S.R. Pennington, BSc, ARCS, PhD, School of Medicine, and Conway Institute for Biomolecular Research, University College Dublin, Ireland
| | - Dafna D Gladman
- D.D. Gladman, MD, University of Toronto, Schroeder Arthritis Institute, Krembil Research Institute, Toronto Western Hospital, Toronto, Ontario, Canada
| | - Philip J Mease
- P.J. Mease, MD, Rheumatology Research, Swedish Medical Center/Providence St. Joseph Health and University of Washington, Seattle, Washington, USA
| | - Denis O'Sullivan
- D. O'Sullivan, BE, GRAPPA Patient Research Partner, Kildare, Ireland
| | - Stephen R Pennington
- O. FitzGerald, MD, S.R. Pennington, BSc, ARCS, PhD, School of Medicine, and Conway Institute for Biomolecular Research, University College Dublin, Ireland
| | - Georg Schett
- G. Schett, MD, Department of Internal Medicine - Rheumatology & Immunology, Friedrich-Alexander-Universität (FAU) Erlangen-Nürnberg and Universitatsklinikum Erlangen, Erlangen, Germany
| | - Vinod Chandran
- V. Chandran, MBBS, MD, DM, PhD, University of Toronto, Schroeder Arthritis Institute, Krembil Research Institute, Toronto Western Hospital, Toronto, Ontario, Canada
| | - Kurt de Vlam
- K. de Vlam MD, PhD, University Hospitals Leuven, Department of Rheumatology, Skeletal Biology and Engineering Research Center (SBE), Department of Development and Regeneration, KU Leuven, Leuven, Belgium.
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11
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Chandran V, Malkov VA, Ito KL, Liu Y, Vestergaard L, Yoon OK, Liu J, Trivedi M, Hertz A, Gladman D. Pharmacodynamic effects of filgotinib treatment driving clinical improvement in patients with active psoriatic arthritis enrolled in the EQUATOR trial. RMD Open 2023; 9:e003550. [PMID: 37945284 PMCID: PMC10649911 DOI: 10.1136/rmdopen-2023-003550] [Citation(s) in RCA: 0] [Impact Index Per Article: 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] [Received: 07/28/2023] [Accepted: 10/09/2023] [Indexed: 11/12/2023] Open
Abstract
OBJECTIVES The goal of this study was to identify protein and transcriptional biomarkers and pathways associated with baseline disease state, the effect of filgotinib (FIL) treatment on these biomarkers, and to investigate the mechanism of action of FIL on clinical improvement in patients with active psoriatic arthritis (PsA). METHODS The phase II EQUATOR (NCT03101670) trial evaluated the efficacy of FIL, a Janus kinase 1-preferential inhibitor, in patients with PsA. Peripheral protein and gene expression levels in association with clinical state at baseline and post-treatment were assessed in 121 patients using linear mixed effects models for repeated measures analyses. Mediation analysis and structural equation modelling (SEM) were performed to investigate the mechanism of action of FIL at week 4 on downstream clinical improvement at week 16. RESULTS Baseline analyses showed that markers of inflammation were significantly associated with multiple PsA clinical metrics, except for Psoriasis Area and Severity Index (PASI), which corresponded to Th17 markers. FIL treatment resulted in sustained transcriptional inhibition of immune genes and pathways, a sustained increase in B-cell fraction and mature B-cells in circulation, and a transient effect on other cell fractions. Mediation analysis revealed that changes in B cells, systemic inflammatory cytokines and neutrophils at week 4 were associated with changes in clinical metrics at week 16. SEM suggested that FIL improved PASI through reduction of IL-23 p19 and IL-12 p40 proteins. CONCLUSIONS Our results revealed that FIL treatment rapidly downregulates inflammatory and immune pathways associated with PsA disease activity corresponding to clinical improvement in PsA. TRIAL REGISTRATION NUMBER NCT03101670.
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Affiliation(s)
- Vinod Chandran
- Schroeder Arthritis Institute, University Health Network, Toronto, Ontario, Canada
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Vladislav A Malkov
- Clinical Bioinformatics & Exploratory Analytics, Gilead Sciences Inc, Foster City, California, USA
| | - Kaori L Ito
- Clinical Bioinformatics & Exploratory Analytics, Gilead Sciences Inc, Foster City, California, USA
| | - Yihua Liu
- Clinical Bioinformatics & Exploratory Analytics, Gilead Sciences Inc, Foster City, California, USA
| | - Lene Vestergaard
- Clinical Bioinformatics & Exploratory Analytics, Gilead Sciences Inc, Foster City, California, USA
| | - Oh Kyu Yoon
- Clinical Bioinformatics & Exploratory Analytics, Gilead Sciences Inc, Foster City, California, USA
| | - Jinfeng Liu
- Clinical Bioinformatics & Exploratory Analytics, Gilead Sciences Inc, Foster City, California, USA
| | - Mona Trivedi
- Clinical Development, Gilead Sciences Inc, Foster City, California, USA
| | - Angie Hertz
- Biomarker Sciences, Gilead Sciences Inc, Foster City, California, USA
| | - Dafna Gladman
- Schroeder Arthritis Institute, University Health Network, Toronto, Ontario, Canada
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada
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12
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Ng BCK, Jadon D, Adebajo A, Ayan G, Duffin KC, Chandran V, Coates LC, D'Agostino MA, de Vlam K, Deodhar A, Eder L, Garg A, Gladman DD, Goel N, Gottlieb AB, Husni ME, Katz A, Kavanaugh A, Lubrano E, Mease PJ, Merola JF, Nash P, Ogdie A, Pennington SR, Perez-Chada LM, Proft F, Rosen CF, Savage L, Goldenstein-Schainberg C, Siebert S, Soriano ER, Steinkoenig I, Tillett W, Armstrong AW, FitzGerald O. Proceedings of the GRAPPA 2022 Executive Retreat. J Rheumatol 2023; 50:71-77. [PMID: 37527861 DOI: 10.3899/jrheum.2023-0537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/30/2023] [Indexed: 08/03/2023]
Abstract
The Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA) leadership congregated for a strategic planning meeting before the 2022 GRAPPA annual meeting in New York, USA. Meeting aims were to review GRAPPA's performance in relation to its 2016 goals and identify successes and areas for further improvement, identify key GRAPPA priorities and activities for the next 5 years, and explore committee structures to best support these aims.
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Affiliation(s)
- Beverly Cheok Kuan Ng
- B.C.K. Ng, MBBS, MSc, D. Jadon, MBBCh, PhD, Rheumatology Research Unit, Department of Medicine, University of Cambridge, Cambridge, UK
| | - Deepak Jadon
- B.C.K. Ng, MBBS, MSc, D. Jadon, MBBCh, PhD, Rheumatology Research Unit, Department of Medicine, University of Cambridge, Cambridge, UK
| | - Adewale Adebajo
- A. Adebajo, MD, MBE, Faculty of Medicine, Dentistry and Health, University of Sheffield, Sheffield, UK
| | - Gizem Ayan
- G. Ayan, MD, Division of Rheumatology, Department of Internal Medicine, Hacettepe University Medical Faculty, Ankara, Turkey
| | - Kristina Callis Duffin
- K. Callis Duffin, MD, MS, Department of Dermatology, University of Utah, Salt Lake City, Utah, USA
| | - Vinod Chandran
- V. Chandran, MD, DM, PhD, Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, and Division of Rheumatology, Department of Medicine, University of Toronto, Toronto, Canada
| | - Laura C Coates
- L.C. Coates, MD, PhD, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | | | - Kurt de Vlam
- K. de Vlam, MD, PhD, University Hospitals Leuven, Leuven, Belgium
| | - Atul Deodhar
- A. Deodhar, MD, Division of Arthritis and Rheumatic Diseases, Oregon Health & Science University, Portland, Oregon, USA
| | - Lihi Eder
- L. Eder, MD, PhD, Women's College Research Institute and University of Toronto, Toronto, Ontario, Canada
| | - Amit Garg
- A. Garg, MD, Department of Dermatology, Donald and Barbara Zucker School of Medicine at Hofstra Northwell, Hempstead, New York, USA
| | - Dafna D Gladman
- D.D. Gladman, MD, Division of Rheumatology, Department of Medicine, University of Toronto, Toronto, Canada
| | - Niti Goel
- N. Goel, MD, Patient Research Partner, Division of Rheumatology, Department of Medicine, Duke University School of Medicine, Durham, North Carolina, USA
| | - Alice B Gottlieb
- A.B. Gottlieb, MD, PhD, Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - M Elaine Husni
- M.E. Husni, MD, MPH, Department of Rheumatic and Immunologic Diseases, Cleveland Clinic, Cleveland, Ohio, USA
| | - Arnon Katz
- A. Katz, MSc, Technion Israel Institute of Technology, Haifa, Israel
| | - Arthur Kavanaugh
- A. Kavanaugh, MD, Division of Rheumatology, Allergy, and Immunology, University of California San Diego, La Jolla, California, USA
| | - Ennio Lubrano
- E. Lubrano, MD, PhD, Department of Medicine and Health Sciences, University of Molise, Campobasso, Italy
| | - Philip J Mease
- P.J. Mease, MD, Rheumatology Research, Swedish Medical Center and University of Washington, Seattle, Washington, USA
| | - Joseph F Merola
- J.F. Merola, MD, MMSc, Department of Dermatology and Department of Medicine, Division of Rheumatology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Peter Nash
- P. Nash, MBBS, MD, School of Medicine, Griffith University, Brisbane, Australia
| | - Alexis Ogdie
- A. Ogdie, MD, MSCE, Division of Rheumatology, Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA
| | - Stephen R Pennington
- S.R. Pennington, PhD, O. FitzGerald, MBBCh, MD, School of Medicine, and Conway Institute for Biomolecular Research, University College Dublin, Dublin, Ireland
| | - Lourdes M Perez-Chada
- L.M. Perez-Chada, MD, MMSc, Department of Dermatology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Fabian Proft
- F. Proft, MD, Department of Gastroenterology, Infectiology and Rheumatology (including Nutrition Medicine), Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Cheryl F Rosen
- C.F. Rosen, MD, Toronto Western Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Laura Savage
- L. Savage, MBChB, PhD, Department of Dermatology, University of Leeds, Leeds, UK
| | - Claudia Goldenstein-Schainberg
- C. Goldenstein-Schainberg, MD, PhD, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Stefan Siebert
- S. Siebert, MD, School of Infection and Immunity, University of Glasgow, Glasgow, UK
| | - Enrique R Soriano
- E.R. Soriano, MD, MS, University Institute and Rheumatology Unit, Internal Medicine Services, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | | | - William Tillett
- W. Tillet, MBChB, PhD, Department of Life Sciences, Centre for Therapeutic Innovation, Royal National Hospital for Rheumatic Diseases, Bath, UK
| | - April W Armstrong
- A.W. Armstrong, MD, MPH, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| | - Oliver FitzGerald
- S.R. Pennington, PhD, O. FitzGerald, MBBCh, MD, School of Medicine, and Conway Institute for Biomolecular Research, University College Dublin, Dublin, Ireland;
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13
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Choksi H, Li S, Looby N, Kotlyar M, Jurisica I, Kulasingam V, Chandran V. Identifying Serum Metabolomic Markers Associated with Skin Disease Activity in Patients with Psoriatic Arthritis. Int J Mol Sci 2023; 24:15299. [PMID: 37894979 PMCID: PMC10607811 DOI: 10.3390/ijms242015299] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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] [Received: 09/09/2023] [Revised: 10/05/2023] [Accepted: 10/12/2023] [Indexed: 10/29/2023] Open
Abstract
Psoriatic arthritis (PsA) is a chronic, systemic, immune-mediated inflammatory disease causing cutaneous and musculoskeletal inflammation that affects 25% of patients with psoriasis. Current methods for evaluating PsA disease activity are not accurate enough for precision medicine. A metabolomics-based approach can elucidate psoriatic disease pathogenesis, providing potential objective biomarkers. With the hypothesis that serum metabolites are associated with skin disease activity, we aimed to identify serum metabolites associated with skin activity in PsA patients. We obtained serum samples from patients with PsA (n = 150) who were classified into mild, moderate and high disease activity groups based on the Psoriasis Area Severity Index. We used solid-phase microextraction (SPME) for sample preparation, followed by data acquisition via an untargeted liquid chromatography-mass spectrometry (LC-MS) approach. Disease activity levels were predicted using identified metabolites and machine learning algorithms. Some metabolites tentatively identified include eicosanoids with anti- or pro-inflammatory properties, like 12-Hydroxyeicosatetraenoic acid, which was previously implicated in joint disease activity in PsA. Other metabolites of interest were associated with dysregulation of fatty acid metabolism and belonged to classes such as bile acids, oxidized phospholipids, and long-chain fatty acids. We have identified potential metabolites associated with skin disease activity in PsA patients.
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Affiliation(s)
- Hani Choksi
- Schroeder Arthritis Program, Krembil Research Institute, University Health Network, Toronto, ON M5T 0S8, Canada; (H.C.); (S.L.); (N.L.)
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON M5S 1A1, Canada
| | - Shenghan Li
- Schroeder Arthritis Program, Krembil Research Institute, University Health Network, Toronto, ON M5T 0S8, Canada; (H.C.); (S.L.); (N.L.)
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON M5S 1A1, Canada
| | - Nikita Looby
- Schroeder Arthritis Program, Krembil Research Institute, University Health Network, Toronto, ON M5T 0S8, Canada; (H.C.); (S.L.); (N.L.)
| | - Max Kotlyar
- Osteoarthritis Research Program, Division of Orthopedic Surgery, Schroeder Arthritis Institute and Data Science Discovery Centre for Chronic Diseases, Krembil Research Institute, Toronto, ON M5T 0S8, Canada; (M.K.); (I.J.)
| | - Igor Jurisica
- Osteoarthritis Research Program, Division of Orthopedic Surgery, Schroeder Arthritis Institute and Data Science Discovery Centre for Chronic Diseases, Krembil Research Institute, Toronto, ON M5T 0S8, Canada; (M.K.); (I.J.)
- Departments of Medical Biophysics and Computer Science, and Faculty of Dentistry, University of Toronto, Toronto, ON M5S 1A1, Canada
- Institute of Neuroimmunology, Slovak Academy of Sciences, Dubravská cesta 9, 845 10 Bratislava, Slovakia
| | - Vathany Kulasingam
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON M5S 1A1, Canada
- Division of Clinical Biochemistry, Laboratory Medicine Program, University Health Network, Toronto, ON M5T 0S8, Canada
| | - Vinod Chandran
- Schroeder Arthritis Program, Krembil Research Institute, University Health Network, Toronto, ON M5T 0S8, Canada; (H.C.); (S.L.); (N.L.)
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON M5S 1A1, Canada
- Division of Rheumatology, Department of Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada
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14
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Dand N, Stuart PE, Bowes J, Ellinghaus D, Nititham J, Saklatvala JR, Teder-Laving M, Thomas LF, Traks T, Uebe S, Assmann G, Baudry D, Behrens F, Billi AC, Brown MA, Burkhardt H, Capon F, Chung R, Curtis CJ, Duckworth M, Ellinghaus E, FitzGerald O, Gerdes S, Griffiths CEM, Gulliver S, Helliwell P, Ho P, Hoffmann P, Holmen OL, Huang ZM, Hveem K, Jadon D, Köhm M, Kraus C, Lamacchia C, Lee SH, Ma F, Mahil SK, McHugh N, McManus R, Modalsli EH, Nissen MJ, Nöthen M, Oji V, Oksenberg JR, Patrick MT, Perez-White BE, Ramming A, Rech J, Rosen C, Sarkar MK, Schett G, Schmidt B, Tejasvi T, Traupe H, Voorhees JJ, Wacker EM, Warren RB, Wasikowski R, Weidinger S, Wen X, Zhang Z, Barton A, Chandran V, Esko T, Foerster J, Franke A, Gladman DD, Gudjonsson JE, Gulliver W, Hüffmeier U, Kingo K, Kõks S, Liao W, Løset M, Mägi R, Nair RP, Rahman P, Reis A, Smith CH, Di Meglio P, Barker JN, Tsoi LC, Simpson MA, Elder JT. GWAS meta-analysis of psoriasis identifies new susceptibility alleles impacting disease mechanisms and therapeutic targets. medRxiv 2023:2023.10.04.23296543. [PMID: 37873414 PMCID: PMC10593001 DOI: 10.1101/2023.10.04.23296543] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2023]
Abstract
Psoriasis is a common, debilitating immune-mediated skin disease. Genetic studies have identified biological mechanisms of psoriasis risk, including those targeted by effective therapies. However, the genetic liability to psoriasis is not fully explained by variation at robustly identified risk loci. To move towards a saturation map of psoriasis susceptibility we meta-analysed 18 GWAS comprising 36,466 cases and 458,078 controls and identified 109 distinct psoriasis susceptibility loci, including 45 that have not been previously reported. These include susceptibility variants at loci in which the therapeutic targets IL17RA and AHR are encoded, and deleterious coding variants supporting potential new drug targets (including in STAP2, CPVL and POU2F3). We conducted a transcriptome-wide association study to identify regulatory effects of psoriasis susceptibility variants and cross-referenced these against single cell expression profiles in psoriasis-affected skin, highlighting roles for the transcriptional regulation of haematopoietic cell development and epigenetic modulation of interferon signalling in psoriasis pathobiology.
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Affiliation(s)
- Nick Dand
- Department of Medical & Molecular Genetics, School of Basic & Medical Biosciences, Faculty of Life Sciences & Medicine, King's College London, London, UK
- Health Data Research UK, London, UK
| | - Philip E Stuart
- Department of Dermatology, University of Michigan Medical School, Ann Arbor, MI, USA
| | - John Bowes
- Centre for Genetics and Genomics Versus Arthritis, The University of Manchester, Manchester, UK
- National Institute for Health and Care Research (NIHR) Manchester Biomedical Research Centre, The University of Manchester, Manchester, UK
| | - David Ellinghaus
- Institute of Clinical Molecular Biology, Christian-Albrechts-University of Kiel, Kiel, Germany
| | - Joanne Nititham
- Deparment of Dermatology, University of California San Francisco, San Francisco, CA, USA
| | - Jake R Saklatvala
- Department of Medical & Molecular Genetics, School of Basic & Medical Biosciences, Faculty of Life Sciences & Medicine, King's College London, London, UK
| | | | - Laurent F Thomas
- Department of Clinical and Molecular Medicine, NTNU - Norwegian University of Science and Technology, Trondheim, Norway
- K.G. Jebsen Center for Genetic Epidemiology, Department of Public Health and Nursing, NTNU - Norwegian University of Science and Technology, Trondheim, Norway
- BioCore - Bioinformatics Core Facility, NTNU - Norwegian University of Science and Technology, Trondheim, Norway
- Clinic of Laboratory Medicine, St.Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Tanel Traks
- Department of Dermatology and Venereology, Institute of Clinical Medicine, University of Tartu, Tartu, Estonia
| | - Steffen Uebe
- Institute of Human Genetics, Universitätsklinikum Erlangen, FAU Erlangen-Nürnberg, Erlangen, Germany
| | - Gunter Assmann
- RUB University Hospital JWK Minden, Department of Rheumatology, Minden, Germany
- Jose-Carreras Centrum for Immuno- and Gene Therapy, University of Saarland Medical School, Homburg, Germany
| | - David Baudry
- St John's Institute of Dermatology, School of Basic & Medical Biosciences, Faculty of Life Sciences & Medicine, King's College London, London, UK
| | - Frank Behrens
- Division of Translational Rheumatology, Immunology - Inflammation Medicine, University Hospital, Goethe University, Frankfurt am Main, Germany
- Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Frankfurt am Main, Germany
- Fraunhofer Cluster of Excellence Immune-mediated Diseases CIMD, Frankfurt am Main, Germany
- Division of Rheumatology, University Hospital, Goethe University, Frankfurt am Main, Germany
| | - Allison C Billi
- Department of Dermatology, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Matthew A Brown
- Department of Medical & Molecular Genetics, School of Basic & Medical Biosciences, Faculty of Life Sciences & Medicine, King's College London, London, UK
- Genomics England, Canary Wharf, London, UK
| | - Harald Burkhardt
- Division of Rheumatology, University Hospital, Goethe University, Frankfurt am Main, Germany
- Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Frankfurt am Main, Germany
- Fraunhofer Cluster of Excellence Immune-mediated Diseases CIMD, Frankfurt am Main, Germany
| | - Francesca Capon
- Department of Medical & Molecular Genetics, School of Basic & Medical Biosciences, Faculty of Life Sciences & Medicine, King's College London, London, UK
| | - Raymond Chung
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, Denmark Hill, Camberwell, London, UK
- National Institute for Health and Care Research (NIHR) Biomedical Research Centre, South London and Maudsley Hospital, London, UK
| | - Charles J Curtis
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, Denmark Hill, Camberwell, London, UK
- National Institute for Health and Care Research (NIHR) Biomedical Research Centre, South London and Maudsley Hospital, London, UK
| | - Michael Duckworth
- St John's Institute of Dermatology, School of Basic & Medical Biosciences, Faculty of Life Sciences & Medicine, King's College London, London, UK
| | - Eva Ellinghaus
- Institute of Clinical Molecular Biology, Christian-Albrechts-University of Kiel, Kiel, Germany
| | - Oliver FitzGerald
- UCD School of Medicine and Medical Sciences and Conway Institute of Biomolecular and Biomedical Research, University College Dublin, Ireland
| | - Sascha Gerdes
- Department of Dermatology, Venereology and Allergy, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Christopher E M Griffiths
- Centre for Dermatology Research, University of Manchester, NIHR Manchester Biomedical Research Centre, Manchester, UK
- St John's Institute of Dermatology, School of Basic & Medical Biosciences, Faculty of Life Sciences & Medicine, King's College London, London, UK
- Department of Dermatology, King's College Hospital NHS Foundation Trust, London, UK
| | | | - Philip Helliwell
- National Institute for Health and Care Research (NIHR) Leeds Biomedical Research Centre, Leeds Teaching Hospitals Trust, UK
- Leeds Institute of Rheumatic and Musculoskeletal Disease, University of Leeds, UK
| | - Pauline Ho
- Centre for Genetics and Genomics Versus Arthritis, The University of Manchester, Manchester, UK
- National Institute for Health and Care Research (NIHR) Manchester Biomedical Research Centre, The University of Manchester, Manchester, UK
- The Kellgren Centre for Rheumatology, Manchester University NHS Foundation Trust, Manchester, UK
| | - Per Hoffmann
- Institute of Human Genetics, University of Bonn, School of Medicine & University Hospital Bonn, Bonn, Germany
| | - Oddgeir L Holmen
- HUNT Research Centre, Department of Public Health and Nursing, NTNU - Norwegian University of Science and Technology, Levanger, Norway
- Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger, Norway
| | - Zhi-Ming Huang
- Deparment of Dermatology, University of California San Francisco, San Francisco, CA, USA
| | - Kristian Hveem
- K.G. Jebsen Center for Genetic Epidemiology, Department of Public Health and Nursing, NTNU - Norwegian University of Science and Technology, Trondheim, Norway
- HUNT Research Centre, Department of Public Health and Nursing, NTNU - Norwegian University of Science and Technology, Levanger, Norway
- Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger, Norway
| | - Deepak Jadon
- Department of Medicine, University of Cambridge, Cambridge, UK
| | - Michaela Köhm
- Division of Translational Rheumatology, Immunology - Inflammation Medicine, University Hospital, Goethe University, Frankfurt am Main, Germany
- Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Frankfurt am Main, Germany
- Fraunhofer Cluster of Excellence Immune-mediated Diseases CIMD, Frankfurt am Main, Germany
- Division of Rheumatology, University Hospital, Goethe University, Frankfurt am Main, Germany
| | - Cornelia Kraus
- Institute of Human Genetics, Universitätsklinikum Erlangen, FAU Erlangen-Nürnberg, Erlangen, Germany
| | - Céline Lamacchia
- Division of Rheumatology, Geneva University Hospital, Geneva, Switzerland
| | - Sang Hyuck Lee
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, Denmark Hill, Camberwell, London, UK
- National Institute for Health and Care Research (NIHR) Biomedical Research Centre, South London and Maudsley Hospital, London, UK
| | - Feiyang Ma
- Department of Dermatology, University of Michigan Medical School, Ann Arbor, MI, USA
- Department of Computational Medicine and Bioinformatics, University of Michigan, Ann Arbor, MI, USA
| | - Satveer K Mahil
- St John's Institute of Dermatology, School of Basic & Medical Biosciences, Faculty of Life Sciences & Medicine, King's College London, London, UK
- St John's Institute of Dermatology, Guy's and St Thomas' National Health Service (NHS) Foundation Trust, London, UK
| | - Neil McHugh
- Royal National Hospital for Rheumatic Diseases and Dept Pharmacy and Pharmacology, University of Bath, UK
| | - Ross McManus
- Department of Clinical Medicine, Trinity Translational Medicine Institute, Trinity College Dublin, Ireland
| | - Ellen H Modalsli
- Department of Clinical and Molecular Medicine, NTNU - Norwegian University of Science and Technology, Trondheim, Norway
- Department of Dermatology, Clinic of Orthopedy, Rheumatology and Dermatology, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Michael J Nissen
- Division of Rheumatology, Geneva University Hospital, Geneva, Switzerland
| | - Markus Nöthen
- Institute of Human Genetics, University of Bonn, School of Medicine & University Hospital Bonn, Bonn, Germany
| | - Vinzenz Oji
- Department of Dermatology, University of Münster, Münster, Germany
| | - Jorge R Oksenberg
- Weill Institute for Neurosciences, Department of Neurology, University of California, San Francisco, CA, USA
| | - Matthew T Patrick
- Department of Dermatology, University of Michigan Medical School, Ann Arbor, MI, USA
| | | | - Andreas Ramming
- Department of Internal Medicine 3, Friedrich-Alexander-University Erlangen-Nürnberg (FAU) and Universitätsklinikum Erlangen, Ulmenweg 18, 91054, Erlangen, Germany
- Deutsches Zentrum Immuntherapie (DZI), Friedrich-Alexander-University Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany
| | - Jürgen Rech
- Department of Internal Medicine 3, Friedrich-Alexander-University Erlangen-Nürnberg (FAU) and Universitätsklinikum Erlangen, Ulmenweg 18, 91054, Erlangen, Germany
- Deutsches Zentrum Immuntherapie (DZI), Friedrich-Alexander-University Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany
| | - Cheryl Rosen
- Division of Dermatology, Toronto Western Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Mrinal K Sarkar
- Department of Dermatology, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Georg Schett
- Department of Internal Medicine 3, Friedrich-Alexander-University Erlangen-Nürnberg (FAU) and Universitätsklinikum Erlangen, Ulmenweg 18, 91054, Erlangen, Germany
- Deutsches Zentrum Immuntherapie (DZI), Friedrich-Alexander-University Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany
| | - Börge Schmidt
- Institute of Medical Informatics, Biometry and Epidemiology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Trilokraj Tejasvi
- Department of Dermatology, University of Michigan Medical School, Ann Arbor, MI, USA
- Ann Arbor Veterans Affairs Hospital, Ann Arbor, MI, USA
| | - Heiko Traupe
- Department of Dermatology, University of Münster, Münster, Germany
| | - John J Voorhees
- Department of Dermatology, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Eike Matthias Wacker
- Institute of Clinical Molecular Biology, Christian-Albrechts-University of Kiel, Kiel, Germany
| | - Richard B Warren
- Division of Musculoskeletal and Dermatological Sciences, School of Biological Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, UK
- Centre for Dermatology Research, Salford Royal Hospital, Northern Care Alliance NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, M6 8HD, UK
| | - Rachael Wasikowski
- Department of Dermatology, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Stephan Weidinger
- Department of Dermatology, Venereology and Allergy, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Xiaoquan Wen
- Department of Biostatistics, Center for Statistical Genetics, University of Michigan, Ann Arbor, MI, USA
| | - Zhaolin Zhang
- Department of Dermatology, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Anne Barton
- Centre for Genetics and Genomics Versus Arthritis, The University of Manchester, Manchester, UK
- National Institute for Health and Care Research (NIHR) Manchester Biomedical Research Centre, The University of Manchester, Manchester, UK
- The Kellgren Centre for Rheumatology, Manchester University NHS Foundation Trust, Manchester, UK
| | - Vinod Chandran
- Schroeder Arthritis Institute, Krembil Research Institute, and Toronto Western Hospital, University Health Network and University of Toronto, Toronto, Ontario, Canada
| | - Tõnu Esko
- Institute of Genomics, University of Tartu, Tartu, Estonia
| | - John Foerster
- College of Medicine, Dentistry, and Nursing, University of Dundee, Dundee, UK
| | - Andre Franke
- Institute of Clinical Molecular Biology, Christian-Albrechts-University of Kiel, Kiel, Germany
| | - Dafna D Gladman
- Schroeder Arthritis Institute, Krembil Research Institute, and Toronto Western Hospital, University Health Network and University of Toronto, Toronto, Ontario, Canada
| | - Johann E Gudjonsson
- Department of Dermatology, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Wayne Gulliver
- Newlab Clinical Research Inc, St. John's, NL, Canada
- Department of Dermatology, Discipline of Medicine, Faculty of Medicine, Memorial University of Newfoundland, St. John's, NL, Canada
| | - Ulrike Hüffmeier
- Institute of Human Genetics, Universitätsklinikum Erlangen, FAU Erlangen-Nürnberg, Erlangen, Germany
| | - Külli Kingo
- Department of Dermatology and Venereology, Institute of Clinical Medicine, University of Tartu, Tartu, Estonia
- Dermatology Clinic, Tartu University Hospital, Tartu, Estonia
| | - Sulev Kõks
- Perron Institute for Neurological and Translational Science, Nedlands, WA 6009, Australia
- Centre for Molecular Medicine and Innovative Therapeutics, Health Futures Institute, Murdoch University, Perth, WA 6150, Australia
| | - Wilson Liao
- Deparment of Dermatology, University of California San Francisco, San Francisco, CA, USA
| | - Mari Løset
- K.G. Jebsen Center for Genetic Epidemiology, Department of Public Health and Nursing, NTNU - Norwegian University of Science and Technology, Trondheim, Norway
- Department of Dermatology, Clinic of Orthopedy, Rheumatology and Dermatology, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Reedik Mägi
- Estonian Genome Centre, Institute of Genomics, University of Tartu, Tartu, Estonia
| | - Rajan P Nair
- Department of Dermatology, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Proton Rahman
- Memorial University of Newfoundland, St. John's, NL, Canada
| | - André Reis
- Institute of Human Genetics, Universitätsklinikum Erlangen, FAU Erlangen-Nürnberg, Erlangen, Germany
| | - Catherine H Smith
- St John's Institute of Dermatology, School of Basic & Medical Biosciences, Faculty of Life Sciences & Medicine, King's College London, London, UK
- St John's Institute of Dermatology, Guy's and St Thomas' National Health Service (NHS) Foundation Trust, London, UK
| | - Paola Di Meglio
- St John's Institute of Dermatology, School of Basic & Medical Biosciences, Faculty of Life Sciences & Medicine, King's College London, London, UK
| | - Jonathan N Barker
- St John's Institute of Dermatology, School of Basic & Medical Biosciences, Faculty of Life Sciences & Medicine, King's College London, London, UK
- St John's Institute of Dermatology, Guy's and St Thomas' National Health Service (NHS) Foundation Trust, London, UK
| | - Lam C Tsoi
- Department of Dermatology, University of Michigan Medical School, Ann Arbor, MI, USA
- Department of Computational Medicine and Bioinformatics, University of Michigan, Ann Arbor, MI, USA
- Department of Biostatistics, Center for Statistical Genetics, University of Michigan, Ann Arbor, MI, USA
| | - Michael A Simpson
- Department of Medical & Molecular Genetics, School of Basic & Medical Biosciences, Faculty of Life Sciences & Medicine, King's College London, London, UK
| | - James T Elder
- Department of Dermatology, University of Michigan Medical School, Ann Arbor, MI, USA
- Ann Arbor Veterans Affairs Hospital, Ann Arbor, MI, USA
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15
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Rida MA, Lee KA, Chandran V, Cook RJ, Gladman DD. Persistence of Biologics in the Treatment of Psoriatic Arthritis: Data From a Large Hospital-Based Longitudinal Cohort. Arthritis Care Res (Hoboken) 2023; 75:2174-2181. [PMID: 36913183 DOI: 10.1002/acr.25112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Revised: 02/17/2023] [Accepted: 03/09/2023] [Indexed: 03/14/2023]
Abstract
OBJECTIVE To analyze the trends in biologics use at a specialized center over a period of 20 years. METHODS We performed a retrospective analysis of 571 patients diagnosed with psoriatic arthritis enrolled in the Toronto cohort who initiated biologic therapy between January 1, 2000, and July 7, 2020. The probability of drug persistence over time was estimated nonparametrically. The time to discontinuation of first and second treatment was analyzed using Cox regression models, whereas a semiparametric failure time model with a gamma frailty was used to analyze the discontinuation of treatment over successive administrations of biologic therapy. RESULTS The highest 3-year persistence probability was observed with certolizumab when used as first biologic treatment, while interleukin-17 inhibitors had the lowest probability. However, when used as second medication, certolizumab had the lowest drug survival even when accounting for selection bias. Depression and/or anxiety were associated with a higher rate of drug discontinuation due to all causes (relative risk [RR] 1.68, P = 0.01), while having higher education was associated with lower rates (RR 0.65, P = 0.03). In the analysis accommodating multiple courses of biologics, a higher tender joint count was associated with a higher rate of discontinuation due to all causes (RR 1.02, P = 0.01). Older age at the start of first treatment was associated with a higher rate of discontinuation due to side effects (RR 1.03, P = 0.01), while obesity had a protective role (RR 0.56, P = 0.05). CONCLUSION Persistence in taking biologics depends on whether the biologic was used as first or second treatment. Depression and anxiety, higher tender joint count, and older age lead to drug discontinuation.
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Affiliation(s)
- Mohamad-Ali Rida
- Schroeder Arthritis Institute, Krembil Research Institute, and Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada
| | - Ker-Ai Lee
- University of Waterloo, Waterloo, Ontario, Canada
| | - Vinod Chandran
- Schroeder Arthritis Institute, Krembil Research Institute, and Toronto Western Hospital, University Health Network and University of Toronto, Toronto, Ontario, Canada
| | | | - Dafna D Gladman
- Schroeder Arthritis Institute, Krembil Research Institute, and Toronto Western Hospital, University Health Network and University of Toronto, Toronto, Ontario, Canada
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Pirouzmand N, Pereira D, Sutton M, Mathew AJ, Chandran V, Gladman DD. Psoriatic Arthritis and COVID-19: Patient Perspectives in a Large Psoriatic Arthritis Cohort. J Rheumatol 2023:jrheum.2022-1265. [PMID: 37657794 DOI: 10.3899/jrheum.2022-1265] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/03/2023]
Abstract
OBJECTIVE To estimate the prevalence of coronavirus disease 2019 (COVID-19) infection among patients with psoriatic arthritis (PsA), understand patients' perspectives regarding their risk of COVID-19 infection, and evaluate the standard of virtual care offered during the early phases of the pandemic. METHODS An online survey was conducted between June 2021 and September 2021 in patients with PsA who had consented to email contact. The survey was completed by 152/193 (79%) patients who had consented to the study. RESULTS There were 86 (56.6%) men and 66 (43.4%) women with a mean age of 58 years and mean disease duration of 19 years. During the pandemic, the mean patient-reported symptom severity was 4.10, 3.24, and 3.72 for joint, skin, and overall symptom severity, respectively. Seventy-four percent of respondents would accept the effect of their PsA over the past month for the next few months. Of 79 patients who were tested for severe acute respiratory syndrome coronavirus 2, 4 tested positive. All 4 were admitted to hospital; 2 required oxygen. One hundred fifty-one patients (99%) had received at least 1 vaccine dose. Fifty-nine (38.8%) participants believed their PsA medications increased their COVID-19 infection risk. Of the 130 patients who had a telemedicine assessment, 83.1% were happy with their virtual consultations. Most were happy to continue with virtual consultations until the pandemic resolved. The average satisfaction level regarding pandemic care was 7.87 on a sliding 10-point scale. CONCLUSION COVID-19 prevalence was low among our patients. Patients were satisfied with their care during the pandemic. Most patients would happily continue with virtual care for the duration of the pandemic.
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Affiliation(s)
- Neda Pirouzmand
- N. Pirouzmand, BSc, medical student, Temerty Faculty of Medicine, University of Toronto
| | - Daniel Pereira
- D. Pereira, BSc, Psoriatic Arthritis Program, University Health Network, Toronto Western Hospital
| | - Mitchell Sutton
- M. Sutton, MSc, Psoriatic Arthritis Program, University Health Network, Toronto Western Hospital
| | - Ashish J Mathew
- A.J. Mathew, DNB, DM, Psoriatic Arthritis Program, University Health Network, Toronto Western Hospital, and University of Toronto
| | - Vinod Chandran
- V. Chandran, DM, PhD, Psoriatic Arthritis Program, University Health Network, Toronto Western Hospital, and University of Toronto, and Krembil Research Institute, Toronto Western Hospital, Toronto, Ontario, Canada
| | - Dafna D Gladman
- D.D. Gladman, MD, Psoriatic Arthritis Program, University Health Network, Toronto Western Hospital, and University of Toronto, and Krembil Research Institute, Toronto Western Hospital, Toronto, Ontario, Canada
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17
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Koussiouris J, Looby N, Kulasingam V, Chandran V. A Solid-Phase Microextraction-Liquid Chromatography-Mass Spectrometry Method for Analyzing Serum Lipids in Psoriatic Disease. Metabolites 2023; 13:963. [PMID: 37623906 PMCID: PMC10456752 DOI: 10.3390/metabo13080963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 07/13/2023] [Revised: 08/16/2023] [Accepted: 08/18/2023] [Indexed: 08/26/2023] Open
Abstract
Approximately 25% of psoriasis patients have an inflammatory arthritis termed psoriatic arthritis (PsA). There is strong interest in identifying and validating biomarkers that can accurately and reliably predict conversion from psoriasis to PsA using novel technologies such as metabolomics. Lipids, in particular, are of key interest in psoriatic disease. We sought to develop a liquid chromatography-mass spectrometry (LC-MS) method to be used in conjunction with solid-phase microextraction (SPME) for analyzing fatty acids and similar molecules. A total of 25 chromatographic methods based on published lipid studies were tested on two LC columns. As a proof of concept, serum samples from psoriatic disease patients (n = 27 psoriasis and n = 26 PsA) were processed using SPME and run on the selected LC-MS method. The method that was best for analyzing fatty acids and fatty acid-like molecules was optimized and applied to serum samples. A total of 18 tentatively annotated features classified as fatty acids and other lipid compounds were statistically significant between psoriasis and PsA groups using both multivariate and univariate approaches. The SPME-LC-MS method developed and optimized was capable of detecting fatty acids and similar lipids that may aid in differentiating psoriasis and PsA patients.
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Affiliation(s)
- John Koussiouris
- Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, Toronto, ON M5T 0S8, Canada; (J.K.); (N.L.)
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON M5S 1A8, Canada;
| | - Nikita Looby
- Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, Toronto, ON M5T 0S8, Canada; (J.K.); (N.L.)
| | - Vathany Kulasingam
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON M5S 1A8, Canada;
- Division of Clinical Biochemistry, Laboratory Medicine Program, University Health Network, Toronto, ON M5G 2C4, Canada
| | - Vinod Chandran
- Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, Toronto, ON M5T 0S8, Canada; (J.K.); (N.L.)
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON M5S 1A8, Canada;
- Division of Rheumatology, Department of Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada
- Institute of Medical Science, University of Toronto, Toronto, ON M5S 1A8, Canada
- Department of Medicine, Memorial University, St. John’s, NL A1B 3V6, Canada
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18
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Eder L, Lee KA, Chandran V, Widdifield J, Drucker AM, Ritchlin C, Rosen CF, Cook RJ, Gladman DD. Derivation of a Multivariable Psoriatic Arthritis Risk Estimation Tool (PRESTO): A Step Towards Prevention. Arthritis Rheumatol 2023. [PMID: 37555242 DOI: 10.1002/art.42661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 05/28/2023] [Accepted: 06/14/2023] [Indexed: 08/10/2023]
Abstract
OBJECTIVE A simple, scalable tool that identifies psoriasis patients at high risk for developing psoriatic arthritis (PsA) could improve early diagnosis. We aimed to develop a risk prediction model for the development of PsA and to assess its performance among patients with psoriasis. METHODS We analyzed data from a prospective cohort of psoriasis patients without PsA at enrollment. Participants were assessed annually by a rheumatologist for the development of PsA. Information about their demographics, psoriasis characteristics, comorbidities, medications, and musculoskeletal symptoms was used to develop prediction models for PsA. Penalized binary regression models were used for variable selection while adjusting for psoriasis duration. Risks of developing PsA over 1- and 5-year time periods were estimated. Model performance was assessed by the area under the curve (AUC) and calibration plots. RESULTS Among 635 psoriasis patients, 51 and 71 developed PsA during the 1-year and 5-year follow-up periods, respectively. The risk of developing PsA within 1 year was associated with younger age, male sex, family history of psoriasis, back stiffness, nail pitting, joint stiffness, use of biologic medications, patient global health, and pain severity (AUC 72.3). The risk of developing PsA within 5 years was associated with morning stiffness, psoriatic nail lesion, psoriasis severity, fatigue, pain, and use of systemic nonbiologic medication or phototherapy (AUC 74.9). Calibration plots showed reasonable agreement between predicted and observed probabilities. CONCLUSIONS The development of PsA within clinically meaningful time frames can be predicted with reasonable accuracy for psoriasis patients using readily available clinical variables.
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Affiliation(s)
- Lihi Eder
- Women's College Research Institute, Women's College Hospital, Toronto, Ontario, Canada, and Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Ker-Ai Lee
- Department of Statistics and Actuarial Science, University of Waterloo, Waterloo, Ontario, Canada
| | - Vinod Chandran
- Department of Medicine, University of Toronto, and Schroder Arthritis Institute, Krembil Research Institute, Toronto Western Hospital, Toronto, Ontario, Canada
| | - Jessica Widdifield
- Sunnybrook Research Institute, Sunnybrook Hospital, and Institute for Clinical Evaluative Sciences (ICES), and Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
| | - Aaron M Drucker
- Women's College Research Institute, Women's College Hospital, and Department of Medicine, University of Toronto, and ICES, and Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
| | | | - Cheryl F Rosen
- Department of Medicine, University of Toronto, and Schroder Arthritis Institute, Krembil Research Institute, Toronto Western Hospital, Toronto, Ontario, Canada
| | - Richard J Cook
- Department of Statistics and Actuarial Science, University of Waterloo, Waterloo, Ontario, Canada
| | - Dafna D Gladman
- Department of Medicine, University of Toronto, and Schroder Arthritis Institute, Krembil Research Institute, Toronto Western Hospital, Toronto, Ontario, Canada
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19
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Mohamed Abdul Cader AJ, Banks J, Chandran V. Fingerprint Systems: Sensors, Image Acquisition, Interoperability and Challenges. Sensors (Basel) 2023; 23:6591. [PMID: 37514887 PMCID: PMC10384471 DOI: 10.3390/s23146591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Revised: 06/17/2023] [Accepted: 06/26/2023] [Indexed: 07/30/2023]
Abstract
The fingerprint is a widely adopted biometric trait in forensic and civil applications. Fingerprint biometric systems have been investigated using contact prints and latent and contactless images which range from low to high resolution. While the imaging techniques are advancing with sensor variations, the input fingerprint images also vary. A general fingerprint recognition pipeline consists of a sensor module to acquire images, followed by feature representation, matching and decision modules. In the sensor module, the image quality of the biometric traits significantly affects the biometric system's accuracy and performance. Imaging modality, such as contact and contactless, plays a key role in poor image quality, and therefore, paying attention to imaging modality is important to obtain better performance. Further, underlying physical principles and the working of the sensor can lead to their own forms of distortions during acquisition. There are certain challenges in each module of the fingerprint recognition pipeline, particularly sensors, image acquisition and feature representation. Present reviews in fingerprint systems only analyze the imaging techniques in fingerprint sensing that have existed for a decade. However, the latest emerging trends and recent advances in fingerprint sensing, image acquisition and their challenges have been left behind. Since the present reviews are either obsolete or restricted to a particular subset of the fingerprint systems, this work comprehensively analyzes the state of the art in the field of contact-based, contactless 2D and 3D fingerprint systems and their challenges in the aspects of sensors, image acquisition and interoperability. It outlines the open issues and challenges encountered in fingerprint systems, such as fingerprint performance, environmental factors, acceptability and interoperability, and alternate directions are proposed for a better fingerprint system.
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Affiliation(s)
- Akmal Jahan Mohamed Abdul Cader
- School of Electrical Engineering and Robotics, Queensland University of Technology, Brisbane 4000, Australia
- Department of Computer Science, South Eastern University of Sri Lanka, Sammanthurai 32200, Sri Lanka
| | - Jasmine Banks
- School of Electrical Engineering and Robotics, Queensland University of Technology, Brisbane 4000, Australia
| | - Vinod Chandran
- School of Electrical Engineering and Robotics, Queensland University of Technology, Brisbane 4000, Australia
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20
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Nakamura A, Chandran V. Risankizumab for the treatment of active psoriatic arthritis in adults. Expert Rev Clin Immunol 2023; 19:1435-1448. [PMID: 37772959 DOI: 10.1080/1744666x.2023.2265567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Accepted: 09/27/2023] [Indexed: 09/30/2023]
Abstract
INTRODUCTION Psoriatic arthritis (PsA) is a chronic rheumatic disease that displays a variety of clinical manifestations. Although new treatments have emerged over the last 2 decades, challenges remain in controlling inflammation in multiple PsA clinical domains. AREAS COVERED Risankizumab, one of the biologic disease modification anti-rheumatic drugs (bDMARDs) that target the interleukin (IL)-23 p19 subunit, was recently approved for PsA worldwide. This review primarily highlights the recent clinical trials of risankizumab covering its physiological evaluation, patient-reported outcomes, and safety profiles in patients with PsA. We also provide evidence for anti-IL-23 therapies against extra-articular manifestations and axial symptoms of PsA. Furthermore, potential distinct efficacies and mechanisms of action in anti-IL-23 therapies are discussed. Overall, risankizumab is effective in a variety of clinical signs and symptoms of PsA regardless of prior bDMARDs experience. EXPERT OPINION Accumulating evidence shows that anti-IL-23 drugs, including risankizumab, are promising treatments that can be used as first- or second-line therapies for PsA. However, multiple challenges remain, including confirming efficacy for axial symptoms and identifying the phenotype of specific patients who respond better to risankizumab than other drugs. Lastly, future data focusing on the long-term efficacy and safety of risankizumab beyond the 1-year observation period are also needed.
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Affiliation(s)
- Akihiro Nakamura
- Department of Medicine, Division of Rheumatology, Queen's University, Kingston, Ontario, Canada
- Translational Institute of Medicine, School of Medicine, Queen's University, Kingston, Ontario, Canada
- Rheumatology Clinic, Kingston Health Science Centre, Kingston, Ontario, Canada
| | - Vinod Chandran
- Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, Toronto, Ontario, Canada
- Division of Rheumatology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada
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21
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Edwards A, Chandran V, Rahman P. Investigational monoclonal antibodies in early development for psoriatic arthritis: beyond the biosimilars. Expert Opin Investig Drugs 2023; 32:741-753. [PMID: 37655430 DOI: 10.1080/13543784.2023.2254684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 08/08/2023] [Accepted: 08/30/2023] [Indexed: 09/02/2023]
Abstract
INTRODUCTION Psoriatic Arthritis (PsA) is an inflammatory arthritis that is present in approximately 25% of psoriasis patients. Currently, several targeted therapies are available to manage PsA; however, many patients fail these therapies. Several new therapeutic options, with differing mechanisms of action, are currently being evaluated. AREAS COVERED This article reviews available results from phase I to phase III trials of several investigational monoclonal antibodies that the FDA has not yet approved for PsA. The proposed mechanisms of the new therapeutic agents and their relevance to the pathogenesis of PsA will be discussed. The investigational agents' efficacy and safety will be summarized, and their potential clinical applications for managing PsA will be contemplated. EXPERT OPINION Due to recent advances in understanding psoriatic arthritis, therapeutic agents are increasingly focused on inhibiting interleukin-17 and interleukin-23 pathways. Various strategies have been used to inhibit these cytokines, demonstrating favorable efficacy and acceptable safety profile.
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Affiliation(s)
- Anna Edwards
- Faculty of Pharmacy, Memorial University of Newfoundland, St. John's, Newfoundland, Canada
| | - Vinod Chandran
- Department of Medicine, Division of Rheumatology, University of Toronto, Toronto, Ontario, Canada
| | - Proton Rahman
- Department of Medicine, Division of Rheumatology, Memorial University of Newfoundland, St. John's, Newfoundland, Canada
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22
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Cheung MW, Dayam RM, Shapiro JR, Law JC, Chao GYC, Pereira D, Goetgebuer RL, Croitoru D, Stempak JM, Acheampong L, Rizwan S, Lee JD, Jacob L, Ganatra D, Law R, Rodriguez-Castellanos VE, Kern-Smith M, Delgado-Brand M, Mailhot G, Haroon N, Inman RD, Piguet V, Chandran V, Silverberg MS, Watts TH, Gingras AC. Third and Fourth Vaccine Doses Broaden and Prolong Immunity to SARS-CoV-2 in Adult Patients with Immune-Mediated Inflammatory Diseases. J Immunol 2023:ji2300190. [PMID: 37326480 DOI: 10.4049/jimmunol.2300190] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 05/25/2023] [Indexed: 06/17/2023]
Abstract
Previous studies have reported impaired humoral responses after SARS-CoV-2 mRNA vaccination in patients with immune-mediated inflammatory diseases (IMIDs), particularly those treated with anti-TNF biologics. We previously reported that IMID patients diagnosed with inflammatory bowel disease, psoriasis, psoriatic arthritis, ankylosing spondylitis, or rheumatoid arthritis exhibited greater waning of Ab and T cell responses than healthy control subjects after SARS-CoV-2 vaccine dose 2. Fewer data are available on the effects of third and fourth doses. This observational cohort study collected plasma and PBMCs from healthy control subjects and untreated or treated patients with IMIDs prevaccination and after one to four doses of SARS-CoV-2 mRNA vaccine (BNT162b2 or mRNA-1273). SARS-CoV-2-specific Ab levels, neutralization, and T cell cytokine release were measured against wild-type and Omicron BA.1 and BA.5 variants of concern. Third vaccine doses substantially restored and prolonged Ab and T cell responses in patients with IMIDs and broadened responses against variants of concern. Fourth-dose effects were subtle but also prolonged Ab responses. However, patients with IMIDs treated with anti-TNF, especially patients with inflammatory bowel disease, exhibited lower Ab responses even after the fourth dose. Although T cell IFN-γ responses were maximal after one dose, IL-2 and IL-4 production increased with successive doses, and early production of these cytokines was predictive of neutralization responses at 3-4 mo postvaccination. Our study demonstrates that third and fourth doses of the SARS-CoV-2 mRNA vaccines sustain and broaden immune responses to SARS-CoV-2, supporting the recommendation for three- and four-dose vaccination regimens in patients with IMIDs.
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Affiliation(s)
- Michelle W Cheung
- Department of Immunology, University of Toronto, Toronto, Ontario, Canada
| | - Roya M Dayam
- Lunenfeld-Tanenbaum Research Institute at Mount Sinai Hospital, Sinai Health, Toronto, Ontario, Canada
| | - Janna R Shapiro
- Department of Immunology, University of Toronto, Toronto, Ontario, Canada
| | - Jaclyn C Law
- Department of Immunology, University of Toronto, Toronto, Ontario, Canada
| | - Gary Y C Chao
- Department of Immunology, University of Toronto, Toronto, Ontario, Canada
| | - Daniel Pereira
- Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, Toronto, Ontario, Canada
| | - Rogier L Goetgebuer
- Zane Cohen Centre for Digestive Diseases, Division of Gastroenterology, Mount Sinai Hospital, Sinai Health, Toronto, Ontario, Canada
| | - David Croitoru
- Division of Dermatology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Joanne M Stempak
- Zane Cohen Centre for Digestive Diseases, Division of Gastroenterology, Mount Sinai Hospital, Sinai Health, Toronto, Ontario, Canada
| | - Lily Acheampong
- Division of Dermatology, Department of Medicine, Women's College Hospital, Toronto, Ontario, Canada
| | - Saima Rizwan
- Zane Cohen Centre for Digestive Diseases, Division of Gastroenterology, Mount Sinai Hospital, Sinai Health, Toronto, Ontario, Canada
| | - Jenny D Lee
- Zane Cohen Centre for Digestive Diseases, Division of Gastroenterology, Mount Sinai Hospital, Sinai Health, Toronto, Ontario, Canada
| | - Liz Jacob
- Zane Cohen Centre for Digestive Diseases, Division of Gastroenterology, Mount Sinai Hospital, Sinai Health, Toronto, Ontario, Canada
| | - Darshini Ganatra
- Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, Toronto, Ontario, Canada
| | - Ryan Law
- Department of Immunology, University of Toronto, Toronto, Ontario, Canada
| | | | | | - Melanie Delgado-Brand
- Lunenfeld-Tanenbaum Research Institute at Mount Sinai Hospital, Sinai Health, Toronto, Ontario, Canada
| | - Genevieve Mailhot
- Lunenfeld-Tanenbaum Research Institute at Mount Sinai Hospital, Sinai Health, Toronto, Ontario, Canada
| | - Nigil Haroon
- Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, Toronto, Ontario, Canada
- Division of Rheumatology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Robert D Inman
- Department of Immunology, University of Toronto, Toronto, Ontario, Canada
- Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, Toronto, Ontario, Canada
- Division of Rheumatology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Vincent Piguet
- Division of Dermatology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
- Division of Dermatology, Department of Medicine, Women's College Hospital, Toronto, Ontario, Canada
| | - Vinod Chandran
- Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, Toronto, Ontario, Canada
- Division of Rheumatology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
- Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada
| | - Mark S Silverberg
- Lunenfeld-Tanenbaum Research Institute at Mount Sinai Hospital, Sinai Health, Toronto, Ontario, Canada
- Zane Cohen Centre for Digestive Diseases, Division of Gastroenterology, Mount Sinai Hospital, Sinai Health, Toronto, Ontario, Canada
- Division of Gastroenterology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Tania H Watts
- Department of Immunology, University of Toronto, Toronto, Ontario, Canada
| | - Anne-Claude Gingras
- Lunenfeld-Tanenbaum Research Institute at Mount Sinai Hospital, Sinai Health, Toronto, Ontario, Canada
- Department of Molecular Genetics, University of Toronto, Toronto, Ontario, Canada
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23
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Koussiouris J, Chandran V. Autoantibodies in psoriatic disease. Adv Clin Chem 2023; 115:135-174. [PMID: 37673519 DOI: 10.1016/bs.acc.2023.03.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/08/2023]
Abstract
Psoriasis is an inflammatory skin disease affecting over 8 million people in the US and Canada. Approximately, a quarter of psoriasis patients have an inflammatory arthritis termed psoriatic arthritis (PsA). Psoriatic disease encompassing both psoriasis and PsA is regarded as an immune-mediated inflammatory disease, exhibiting both autoimmune and autoinflammatory features. A review of the current literature on the presence and clinical significance of autoantibodies found in psoriatic disease are presented. The frequency of several autoantibodies in psoriasis and PsA patients as well as their clinical significance regarding disease diagnosis, disease activity and treatment response are reviewed. Additionally, the basic principles of antibody assays are presented, and the methods used for each study are analyzed. Despite historically described as a rheumatoid factor negative (seronegative) disease, an array of autoantibodies has been identified in patients with psoriatic disease. This points to an autoimmune component potentially playing a role in psoriatic disease; however, additional evidence is needed to determine the clinical utility of these autoantibodies.
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Affiliation(s)
- John Koussiouris
- Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, Toronto, ON, Canada; Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada
| | - Vinod Chandran
- Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, Toronto, ON, Canada; Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada; Division of Rheumatology, Department of Medicine, University of Toronto, Toronto, ON, Canada; Institute of Medical Science, University of Toronto, Toronto, ON, Canada; Department of Medicine, Memorial University, St. John's, NL, Canada.
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24
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Nazri JM, Oikonomopoulou K, de Araujo ED, Kraskouskaya D, Gunning PT, Chandran V. Histone deacetylase inhibitors as a potential new treatment for psoriatic disease and other inflammatory conditions. Crit Rev Clin Lab Sci 2023; 60:300-320. [PMID: 36846924 DOI: 10.1080/10408363.2023.2177251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/01/2023]
Abstract
Collectively known as psoriatic disease, psoriasis and psoriatic arthritis (PsA) are immune-mediated inflammatory diseases in which patients present with cutaneous and musculoskeletal inflammation. Affecting roughly 2-3% of the world's total population, there remains unmet therapeutic needs in both psoriasis and PsA despite the availability of current immunomodulatory treatments. As a result, patients with psoriatic disease often experience reduced quality of life. Recently, a class of small molecules, commonly investigated as anti-cancer agents, called histone deacetylase (HDAC) inhibitors, have been proposed as a new promising anti-inflammatory treatment for immune- and inflammatory-related diseases. In inflammatory diseases, current evidence is derived from studies on diseases like rheumatoid arthritis (RA) and systematic lupus erythematosus (SLE), and while there are some reports studying psoriasis, data on PsA patients are not yet available. In this review, we provide a brief overview of psoriatic disease, psoriasis, and PsA, as well as HDACs, and discuss the rationale behind the potential use of HDAC inhibitors in the management of persistent inflammation to suggest its possible use in psoriatic disease.
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Affiliation(s)
- Jehan Mohammad Nazri
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Canada
| | | | - Elvin D de Araujo
- Department of Chemical and Physical Sciences, University of Toronto, Mississauga, Canada
| | - Dziyana Kraskouskaya
- Department of Chemical and Physical Sciences, University of Toronto, Mississauga, Canada
| | - Patrick T Gunning
- Department of Chemical and Physical Sciences, University of Toronto, Mississauga, Canada.,Department of Chemistry, University of Toronto, Toronto, Canada
| | - Vinod Chandran
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Canada.,Schroeder Arthritis Institute, University Health Network, Toronto, Canada.,Department of Medicine, University of Toronto, Toronto, Canada.,Institute of Medical Science, University of Toronto, Toronto, Canada.,Department of Medicine, Memorial University, St. John's, Canada
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25
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Al-Dulaimi K, Banks J, Al-Sabaawi A, Nguyen K, Chandran V, Tomeo-Reyes I. Classification of HEp-2 Staining Pattern Images Using Adapted Multilayer Perceptron Neural Network-Based Intra-Class Variation of Cell Shape. Sensors (Basel) 2023; 23:2195. [PMID: 36850793 PMCID: PMC9959868 DOI: 10.3390/s23042195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 02/01/2023] [Accepted: 02/08/2023] [Indexed: 06/18/2023]
Abstract
There exists a growing interest from the clinical practice research communities in the development of methods to automate HEp-2 stained cells classification procedure from histopathological images. Challenges faced by these methods include variations in cell densities and cell patterns, overfitting of features, large-scale data volume and stained cells. In this paper, a multi-class multilayer perceptron technique is adapted by adding a new hidden layer to calculate the variation in the mean, scale, kurtosis and skewness of higher order spectra features of the cell shape information. The adapted technique is then jointly trained and the probability of classification calculated using a Softmax activation function. This method is proposed to address overfitting, stained and large-scale data volume problems, and classify HEp-2 staining cells into six classes. An extensive experimental analysis is studied to verify the results of the proposed method. The technique has been trained and tested on the dataset from ICPR-2014 and ICPR-2016 competitions using the Task-1. The experimental results have shown that the proposed model achieved higher accuracy of 90.3% (with data augmentation) than of 87.5% (with no data augmentation). In addition, the proposed framework is compared with existing methods, as well as, the results of methods using in ICPR2014 and ICPR2016 competitions.The results demonstrate that our proposed method effectively outperforms recent methods.
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Affiliation(s)
- Khamael Al-Dulaimi
- School of Electrical Engineering and Robotics, Queensland University of Technology (QUT), Brisbane, QLD 4000, Australia
| | - Jasmine Banks
- School of Electrical Engineering and Robotics, Queensland University of Technology (QUT), Brisbane, QLD 4000, Australia
| | - Aiman Al-Sabaawi
- School of Computer Science, Queensland University of Technology (QUT), Brisbane, QLD 4000, Australia
| | - Kien Nguyen
- School of Electrical Engineering and Robotics, Queensland University of Technology (QUT), Brisbane, QLD 4000, Australia
| | - Vinod Chandran
- School of Electrical Engineering and Robotics, Queensland University of Technology (QUT), Brisbane, QLD 4000, Australia
| | - Inmaculada Tomeo-Reyes
- School of Electrical Engineering and Telecommunications, University of New South Wales, Sydney, NSW 2052, Australia
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26
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Bassini A, Sartoretto S, Jurisica L, Magno-França A, Anderson L, Pearson T, Razavi M, Chandran V, Martin L, Jurisica I, Cameron LC. Sportomics method to assess acute phase proteins in Olympic level athletes using dried blood spots and multiplex assay. Sci Rep 2022; 12:19824. [PMID: 36400821 PMCID: PMC9672598 DOI: 10.1038/s41598-022-23300-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [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: 04/22/2022] [Accepted: 10/29/2022] [Indexed: 11/19/2022] Open
Abstract
Sportomics is a subject-centered holistic method similar to metabolomics focusing on sports as the metabolic challenge. Dried blood spot is emerging as a technique due to its simplicity and reproducibility. In addition, mass spectrometry and integrative computational biology enhance our ability to understand exercise-induced modifications. We studied inflammatory blood proteins (Alpha-1-acid glycoprotein-A1AG1; Albumin; Cystatin C; C-reactive protein-CRP; Hemoglobin-HBA; Haptoglobin-HPT; Insulin-like growth factor 1; Lipopolysaccharide binding protein-LBP; Mannose-binding lectin-MBL2; Myeloperoxidase-PERM and Serum amyloid A1-SAA1), in 687 samples from 97 World-class and Olympic athletes across 16 sports in nine states. Data were analyzed with Spearman's rank-order correlation. Major correlations with CRP, LBP; MBL2; A1AG1, and SAA1 were found. The pairs CRP-SAA1 and CRP-LBP appeared with a robust positive correlation. Other pairs, LBP-SAA1; A1AG1-CRP; A1AG1-SAA1; A1AG1-MBL, and A1AG1-LBP, showed a broader correlation across the sports. The protein-protein interaction map revealed 1500 interactions with 44 core proteins, 30 of them linked to immune system processing. We propose that the inflammation follow-up in exercise can provide knowledge for internal cargo management in training, competition, recovery, doping control, and a deeper understanding of health and disease.
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Affiliation(s)
- Adriana Bassini
- grid.467095.90000 0001 2237 7915Laboratory of Protein Biochemistry, Federal University of State of Rio de Janeiro, Av. Pasteur, 296 – Urca, Rio de Janeiro, R.J. 22290-350 Brazil ,SOmics, Vila Velha, ES Brazil
| | - Silvia Sartoretto
- grid.467095.90000 0001 2237 7915Laboratory of Protein Biochemistry, Federal University of State of Rio de Janeiro, Av. Pasteur, 296 – Urca, Rio de Janeiro, R.J. 22290-350 Brazil
| | - Lukas Jurisica
- grid.467095.90000 0001 2237 7915Laboratory of Protein Biochemistry, Federal University of State of Rio de Janeiro, Av. Pasteur, 296 – Urca, Rio de Janeiro, R.J. 22290-350 Brazil ,grid.34428.390000 0004 1936 893XSchool of Computer Science, Carleton University, Ottawa, Canada ,grid.17063.330000 0001 2157 2938Department of Computer Science, University of Toronto, Toronto, Canada
| | - Alexandre Magno-França
- grid.467095.90000 0001 2237 7915Laboratory of Protein Biochemistry, Federal University of State of Rio de Janeiro, Av. Pasteur, 296 – Urca, Rio de Janeiro, R.J. 22290-350 Brazil
| | | | - Terry Pearson
- SISCAPA Assay Technologies, Inc., Washington, DC USA
| | - Morty Razavi
- SISCAPA Assay Technologies, Inc., Washington, DC USA
| | - Vinod Chandran
- grid.231844.80000 0004 0474 0428Arthritis Program, Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, Toronto, ON Canada ,grid.17063.330000 0001 2157 2938Faculty of Medicine, University of Toronto, Toronto, ON Canada
| | - LeRoy Martin
- grid.433801.d0000 0004 0580 039XWaters Technologies, Milford, MA USA
| | - Igor Jurisica
- grid.231844.80000 0004 0474 0428Osteoarthritis Research Program, Division of Orthopedic Surgery, Schroeder Arthritis Institute, and Data Science Discovery Centre for Chronic Diseases, Krembil Research Institute, University Health Network, Toronto, Canada ,grid.17063.330000 0001 2157 2938Departments of Medical Biophysics and Computer Science, and Faculty of Dentistry, University of Toronto, Toronto, ON Canada ,grid.419303.c0000 0001 2180 9405Institute of Neuroimmunology, Slovak Academy of Sciences, Bratislava, Slovakia
| | - L. C. Cameron
- grid.467095.90000 0001 2237 7915Laboratory of Protein Biochemistry, Federal University of State of Rio de Janeiro, Av. Pasteur, 296 – Urca, Rio de Janeiro, R.J. 22290-350 Brazil
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Kwok TSH, Sutton M, Cook RJ, Pereira D, Chandran V, Gladman DD. Musculoskeletal Surgery in Psoriatic Arthritis: Prevalence and Risk Factors. J Rheumatol 2022; 50:497-503. [PMID: 36379576 DOI: 10.3899/jrheum.220908] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/27/2022] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Despite medical therapy, damage occurs in patients with psoriatic arthritis (PsA) requiring musculoskeletal (MSK) surgery. We aimed to describe MSK surgery in patients with PsA and identify risk factors for undergoing first MSK surgery attributable to PsA. METHODS A single-center cohort identified patients with PsA fulfilling Classification Criteria for Psoriatic Arthritis who had MSK surgery between January 1978 and December 2019 inclusive. Charts were reviewed to confirm surgeries were MSK-related and attributable to PsA. Descriptive statistics determined MSK surgery prevalence and types. Cox proportional hazards models evaluated clinical variables for undergoing first MSK surgery using time-dependent covariates. Using a dataset with 1-to-1 matching on markers of PsA disease severity, a Cox proportional hazards model evaluated the effect of targeted therapies, namely biologics on time to first MSK surgery. RESULTS Of 1574 patients, 185 patients had 379 MSK surgeries related to PsA. The total number of damaged joints (hazard ratio [HR] 1.03, P < 0.001), tender/swollen joints (HR 1.04, P = 0.01), presence of nail lesions (HR 2.08, P < 0.01), higher Health Assessment Questionnaire scores (HR 2.01, P < 0.001), elevated erythrocyte sedimentation rate (HR 2.37, P = 0.02), and HLA-B27 positivity (HR 2.22, P = 0.048) were associated with increased risk of surgery, whereas higher Psoriasis Area Severity Index (HR 0.88, P < 0.002) conferred a protective effect in a multivariate model. The effect of biologics did not reach statistical significance. CONCLUSION MSK surgery attributable to PsA is not rare, affecting 11.8% of patients. Markers of cumulative disease activity and damage are associated with a greater risk of requiring surgery.
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Affiliation(s)
- Timothy S H Kwok
- T.S.H. Kwok, MD, Division of Rheumatology, Department of Medicine, Temerty Faculty of Medicine, University of Toronto, Toronto
| | - Mitchell Sutton
- M. Sutton, MSc, Centre for Prognosis Studies in the Rheumatic Diseases, Krembil Research Institute, Toronto Western Hospital, University Health Network, Toronto
| | - Richard J Cook
- R.J. Cook, PhD, Department of Statistics and Actuarial Sciences, University of Waterloo, Waterloo
| | - Daniel Pereira
- D. Pereira, BSc, Centre for Prognosis Studies in the Rheumatic Diseases, Krembil Research Institute, Toronto Western Hospital, University Health Network, Toronto
| | - Vinod Chandran
- V. Chandran, MBBS, MD, DM, PhD, Division of Rheumatology, Department of Medicine, Temerty Faculty of Medicine, University of Toronto, Toronto, and Centre for Prognosis Studies in the Rheumatic Diseases, Krembil Research Institute, Toronto Western Hospital, University Health Network, Toronto, and Schroeder Arthritis Institute, Krembil Research Institute, Toronto Western Hospital, University Health Network, Toronto, and Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada
| | - Dafna D Gladman
- D.D. Gladman, MD, Division of Rheumatology, Department of Medicine, Temerty Faculty of Medicine, University of Toronto, Toronto, and Centre for Prognosis Studies in the Rheumatic Diseases, Krembil Research Institute, Toronto Western Hospital, University Health Network, Toronto, and Schroeder Arthritis Institute, Krembil Research Institute, Toronto Western Hospital, University Health Network, Toronto, and Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada
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28
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Vinod R, Swathi, Chandran V. A review on the effectiveness of various masks in protection against COVID-19. Biomedicine (Taipei) 2022. [DOI: 10.51248/.v42i5.1513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
As of June1st 2021, more than 17 crore people have been infected with COVID-19 across the globe, and almost 3 crore people have been infected in India. The virus can spread through even normal actions like talking with particle emission rates inversely correlating with word frequency and volume, which can be reduced by covering the mouth. However, there is debate concerning the effectiveness of the various face mask types in preventing respiratory infections. Many have reported that wearing a mask is uncomfortable, especially when worn for long hours and while performing strenuous activities. Another disease that has raised its head is mucormycosis. However, COVID-19 can be a serious infection in many, with many fatalities. It is not yet clear how much protection vaccines give, and in a hugely populated country like India, it may be very difficult to vaccinate the whole population. Moreover, the vaccination for pediatric groups has just started. So, it is imperative to wear masks that can be protective against infection. However, some people believe that a straightforward cotton mask is insufficient. We set out to analyze the efficacy of masks through this investigation. According to the results of this systematic review, there are no studies that give conclusive evidence that using face masks as recommended by current public health guidelines will stop this condition. This is a significant discovery that should be communicated to the scientific community and calls into question the rationale for inconsistent and differing public health recommendations.
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29
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Cheung MW, Dayam RM, Law JC, Goetgebuer RL, Chao GYC, Finkelstein N, Stempak JM, Pereira D, Croitoru D, Acheampong L, Rizwan S, Lee JD, Ganatra D, Law R, Delgado-Brand M, Mailhot G, Piguet V, Silverberg MS, Watts TH, Gingras AC, Chandran V. Third dose corrects waning immunity to SARS-CoV-2 mRNA vaccines in immunocompromised patients with immune-mediated inflammatory diseases. RMD Open 2022. [PMCID: PMC9471210 DOI: 10.1136/rmdopen-2022-002622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Affiliation(s)
- Michelle W Cheung
- Department of Immunology, University of Toronto, Toronto, Ontario, Canada
| | - Roya M Dayam
- Lunenfeld-Tanenbaum Research Institute at Mount Sinai Hospital, Sinai Health, Toronto, Ontario, Canada
| | - Jaclyn C Law
- Department of Immunology, University of Toronto, Toronto, Ontario, Canada
| | - Rogier L Goetgebuer
- Zane Cohen Centre for Digestive Diseases, Division of Gastroenterology, Mount Sinai Hospital, Sinai Health, Toronto, Ontario, Canada
- Department of Gastroenterology and Hepatology, Amsterdam University Medical Centres, Duivendrecht, The Netherlands
| | - Gary Y C Chao
- Department of Immunology, University of Toronto, Toronto, Ontario, Canada
| | - Naomi Finkelstein
- Psoriatic Arthritis Program, Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, Toronto, Ontario, Canada
- Division of Rheumatology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Joanne M Stempak
- Zane Cohen Centre for Digestive Diseases, Division of Gastroenterology, Mount Sinai Hospital, Sinai Health, Toronto, Ontario, Canada
| | - Daniel Pereira
- Psoriatic Arthritis Program, Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, Toronto, Ontario, Canada
| | - David Croitoru
- Division of Dermatology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Lily Acheampong
- Division of Dermatology, Department of Medicine, Women's College Hospital, Toronto, Ontario, Canada
| | - Saima Rizwan
- Zane Cohen Centre for Digestive Diseases, Division of Gastroenterology, Mount Sinai Hospital, Sinai Health, Toronto, Ontario, Canada
| | - Jenny D Lee
- Zane Cohen Centre for Digestive Diseases, Division of Gastroenterology, Mount Sinai Hospital, Sinai Health, Toronto, Ontario, Canada
| | - Darshini Ganatra
- Psoriatic Arthritis Program, Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, Toronto, Ontario, Canada
| | - Ryan Law
- Department of Immunology, University of Toronto, Toronto, Ontario, Canada
| | - Melanie Delgado-Brand
- Lunenfeld-Tanenbaum Research Institute at Mount Sinai Hospital, Sinai Health, Toronto, Ontario, Canada
| | - Geneviève Mailhot
- Lunenfeld-Tanenbaum Research Institute at Mount Sinai Hospital, Sinai Health, Toronto, Ontario, Canada
| | - Vincent Piguet
- Division of Dermatology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
- Division of Dermatology, Department of Medicine, Women's College Hospital, Toronto, Ontario, Canada
| | - Mark S Silverberg
- Lunenfeld-Tanenbaum Research Institute at Mount Sinai Hospital, Sinai Health, Toronto, Ontario, Canada
- Zane Cohen Centre for Digestive Diseases, Division of Gastroenterology, Mount Sinai Hospital, Sinai Health, Toronto, Ontario, Canada
- Division of Gastroenterology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Tania H Watts
- Department of Immunology, University of Toronto, Toronto, Ontario, Canada
| | - Anne-Claude Gingras
- Lunenfeld-Tanenbaum Research Institute at Mount Sinai Hospital, Sinai Health, Toronto, Ontario, Canada
- Department of Molecular Genetics, University of Toronto, Toronto, Ontario, Canada
| | - Vinod Chandran
- Psoriatic Arthritis Program, Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, Toronto, Ontario, Canada
- Division of Rheumatology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
- Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada
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Kwok TSH, Sutton M, Pereira D, Cook RJ, Chandran V, Haroon N, Inman RD, Gladman DD. Isolated axial disease in psoriatic arthritis and ankylosing spondylitis with psoriasis. Ann Rheum Dis 2022; 81:1678-1684. [PMID: 35973805 DOI: 10.1136/ard-2022-222537] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [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: 03/24/2022] [Accepted: 07/23/2022] [Indexed: 11/04/2022]
Abstract
OBJECTIVES To compare isolated axial psoriatic arthritis (PsA), axial PsA with peripheral involvement and isolated axial ankylosing spondylitis (AS) with psoriasis. To evaluate predictors for developing peripheral disease from isolated axial PsA over time. METHODS Two PsA and AS cohorts identified patients with PsA with axial disease and isolated axial patients with AS with psoriasis. Logistic regression compared isolated axial PsA to axial PsA with peripheral involvement and isolated axial AS with psoriasis. Cox proportional hazards model evaluated predictors for developing peripheral disease from isolated axial PsA. RESULTS Of 1576 patients with PsA, 2.03% had isolated axial disease and 29.38% had axial and peripheral disease. human leucocyte antigen HLA-B*27 positivity (OR 25.00, 95% CI 3.03 to 206.11) and lower Health Assessment Questionnaire scores (OR 0.004, 95% CI 0.00 to 0.28) were associated with isolated axial disease. HLA-B*27 also predicted peripheral disease development over time (HR 7.54, 95% CI 1.79 to 31.77). Of 1688 patients with AS, 4.86% had isolated axial disease with psoriasis. Isolated axial patients with PsA were older at diagnosis (OR 1.06, 95% CI 1.01 to 1.13), more likely to have nail lesions (OR 12.37, 95% CI 2.22 to 69.07) and less likely to have inflammatory back pain (OR 0.12, 95% CI 0.02 to 0.61) compared with patients with isolated axial AS with psoriasis. CONCLUSIONS Isolated axial PsA and AS with psoriasis are uncommon. HLA-B*27 positivity is associated with isolated axial PsA and may identify those who develop peripheral disease over time. Isolated axial PsA is associated with better functional status. Isolated axial PsA appears clinically distinct from isolated axial AS with psoriasis.
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Affiliation(s)
- Timothy S H Kwok
- Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Mitchell Sutton
- Centre for Prognosis Studies in the Rheumatic Diseases, Schroeder Arthritis Institute, University Health Network, Toronto, Ontario, Canada
| | - Daniel Pereira
- Centre for Prognosis Studies in the Rheumatic Diseases, Schroeder Arthritis Institute, University Health Network, Toronto, Ontario, Canada
| | - Richard J Cook
- Statistics and Actuarial Science, University of Waterloo, Waterloo, Ontario, Canada
| | - Vinod Chandran
- Centre for Prognosis Studies in the Rheumatic Diseases, Schroeder Arthritis Institute, University Health Network, Toronto, Ontario, Canada.,Termerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Nigil Haroon
- Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.,Schroeder Arthritis Institute, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada
| | - Robert D Inman
- Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.,Schroeder Arthritis Institute, Toronto Western Hospital, Spondylitis Program, University Health Network, Toronto, Ontario, Canada
| | - Dafna D Gladman
- Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada .,Centre for Prognosis Studies in the Rheumatic Diseases, Schroeder Arthritis Institute, University Health Network, Toronto, Ontario, Canada
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Dayam RM, Law JC, Goetgebuer RL, Chao GY, Abe KT, Sutton M, Finkelstein N, Stempak JM, Pereira D, Croitoru D, Acheampong L, Rizwan S, Rymaszewski K, Milgrom R, Ganatra D, Batista NV, Girard M, Lau I, Law R, Cheung MW, Rathod B, Kitaygorodsky J, Samson R, Hu Q, Hardy WR, Haroon N, Inman RD, Piguet V, Chandran V, Silverberg MS, Gingras AC, Watts TH. Accelerated waning of immunity to SARS-CoV-2 mRNA vaccines in patients with immune-mediated inflammatory diseases. JCI Insight 2022; 7:e159721. [PMID: 35471956 PMCID: PMC9220925 DOI: 10.1172/jci.insight.159721] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [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] [Received: 02/28/2022] [Accepted: 04/22/2022] [Indexed: 11/17/2022] Open
Abstract
BACKGROUNDLimited information is available on the impact of immunosuppressants on COVID-19 vaccination in patients with immune-mediated inflammatory diseases (IMID).METHODSThis observational cohort study examined the immunogenicity of SARS-CoV-2 mRNA vaccines in adult patients with inflammatory bowel disease, rheumatoid arthritis, ankylosing spondylitis, or psoriatic disease, with or without maintenance immunosuppressive therapies. Ab and T cell responses to SARS-CoV-2, including neutralization against SARS-CoV-2 variants, were determined before and after 1 and 2 vaccine doses.RESULTSWe prospectively followed 150 subjects, 26 healthy controls, 9 patients with IMID on no treatment, 44 on anti-TNF, 16 on anti-TNF with methotrexate/azathioprine (MTX/AZA), 10 on anti-IL-23, 28 on anti-IL-12/23, 9 on anti-IL-17, and 8 on MTX/AZA. Ab and T cell responses to SARS-CoV-2 were detected in all participants, increasing from dose 1 to dose 2 and declining 3 months later, with greater attrition in patients with IMID compared with healthy controls. Ab levels and neutralization efficacy against variants of concern were substantially lower in anti-TNF-treated patients than in healthy controls and were undetectable against Omicron by 3 months after dose 2.CONCLUSIONSOur findings support the need for a third dose of the mRNA vaccine and for continued monitoring of immunity in these patient groups.FUNDINGFunded by a donation from Juan and Stefania Speck and by Canadian Institutes of Health (CIHR)/COVID-Immunity Task Force (CITF) grants VR-1 172711 and VS1-175545 (to THW and ACG), CIHR FDN-143250 (to THW), GA2-177716 (to VC, ACG, and THW), and GA1-177703 (to ACG) and the CIHR rapid response network to SARS-CoV-2 variants, CoVaRR-Net (to ACG).
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Affiliation(s)
- Roya M. Dayam
- Lunenfeld-Tanenbaum Research Institute at Mount Sinai Hospital, Sinai Health, Toronto, Ontario, Canada
| | - Jaclyn C. Law
- Department of Immunology, University of Toronto, Toronto, Ontario, Canada
| | - Rogier L. Goetgebuer
- Zane Cohen Centre for Digestive Diseases, Division of Gastroenterology, Mount Sinai Hospital, Sinai Health
| | - Gary Y.C. Chao
- Department of Immunology, University of Toronto, Toronto, Ontario, Canada
| | - Kento T. Abe
- Lunenfeld-Tanenbaum Research Institute at Mount Sinai Hospital, Sinai Health, Toronto, Ontario, Canada
- Department of Molecular Genetics
| | - Mitchell Sutton
- Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, Division of Rheumatology, Department of Medicine, and
| | - Naomi Finkelstein
- Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, Division of Rheumatology, Department of Medicine, and
| | - Joanne M. Stempak
- Zane Cohen Centre for Digestive Diseases, Division of Gastroenterology, Mount Sinai Hospital, Sinai Health
| | - Daniel Pereira
- Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, Division of Rheumatology, Department of Medicine, and
| | - David Croitoru
- Division of Dermatology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Lily Acheampong
- Division of Dermatology, Department of Medicine, Women’s College Hospital, Toronto, Ontario, Canada
| | - Saima Rizwan
- Zane Cohen Centre for Digestive Diseases, Division of Gastroenterology, Mount Sinai Hospital, Sinai Health
| | - Klaudia Rymaszewski
- Zane Cohen Centre for Digestive Diseases, Division of Gastroenterology, Mount Sinai Hospital, Sinai Health
| | - Raquel Milgrom
- Zane Cohen Centre for Digestive Diseases, Division of Gastroenterology, Mount Sinai Hospital, Sinai Health
| | - Darshini Ganatra
- Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, Division of Rheumatology, Department of Medicine, and
| | | | - Melanie Girard
- Department of Immunology, University of Toronto, Toronto, Ontario, Canada
| | - Irene Lau
- Department of Immunology, University of Toronto, Toronto, Ontario, Canada
| | - Ryan Law
- Department of Immunology, University of Toronto, Toronto, Ontario, Canada
| | - Michelle W. Cheung
- Department of Immunology, University of Toronto, Toronto, Ontario, Canada
| | - Bhavisha Rathod
- Lunenfeld-Tanenbaum Research Institute at Mount Sinai Hospital, Sinai Health, Toronto, Ontario, Canada
| | - Julia Kitaygorodsky
- Lunenfeld-Tanenbaum Research Institute at Mount Sinai Hospital, Sinai Health, Toronto, Ontario, Canada
- Department of Molecular Genetics
| | - Reuben Samson
- Lunenfeld-Tanenbaum Research Institute at Mount Sinai Hospital, Sinai Health, Toronto, Ontario, Canada
- Department of Molecular Genetics
| | - Queenie Hu
- Lunenfeld-Tanenbaum Research Institute at Mount Sinai Hospital, Sinai Health, Toronto, Ontario, Canada
| | - W. Rod Hardy
- Lunenfeld-Tanenbaum Research Institute at Mount Sinai Hospital, Sinai Health, Toronto, Ontario, Canada
| | - Nigil Haroon
- Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, Division of Rheumatology, Department of Medicine, and
| | - Robert D. Inman
- Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, Division of Rheumatology, Department of Medicine, and
| | - Vincent Piguet
- Division of Dermatology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
- Division of Dermatology, Department of Medicine, Women’s College Hospital, Toronto, Ontario, Canada
| | - Vinod Chandran
- Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, Division of Rheumatology, Department of Medicine, and
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada
| | - Mark S. Silverberg
- Lunenfeld-Tanenbaum Research Institute at Mount Sinai Hospital, Sinai Health, Toronto, Ontario, Canada
- Zane Cohen Centre for Digestive Diseases, Division of Gastroenterology, Mount Sinai Hospital, Sinai Health
| | - Anne-Claude Gingras
- Lunenfeld-Tanenbaum Research Institute at Mount Sinai Hospital, Sinai Health, Toronto, Ontario, Canada
- Department of Molecular Genetics
| | - Tania H. Watts
- Department of Immunology, University of Toronto, Toronto, Ontario, Canada
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Mathew AJ, Sutton M, Pereira D, Gladman DD, Chandran V. POS1093 EFFECT OF DISEASE MODIFYING ANTI-RHEUMATIC DRUGS ON DEPRESSION IN PATIENTS WITH PSORIATIC ARTHRITIS IN A LONGITUDINAL COHORT. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.3826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundDepression, and its improvement with disease modifying anti-rheumatic drugs (DMARDs) is understudied in psoriatic arthritis (PsA).ObjectivesTo determine the effectiveness of DMARDs on depression in PsA patients.MethodsPatients enrolled from January 2000 to May 2020 in a large PsA cohort were included. Depression was defined as medical outcomes study short form-36 (SF-36) mental component summary score (MCS) ≤ 40 or mental health (MH) subscale score ≤ 56. Primary outcome was resolution of depression within 1 year of DMARDs, defined by two definitions: 1) MCS > 40 and/or MH subscale score of > 56; 2) Increase in MCS by 2.5 and MH subscale score by 5, the minimal clinically important difference (MCID). Baseline medications [non-steroidal anti-inflammatory drugs (NSAIDs) and/or conventional or targeted (c/t) DMARDs] were recorded for all patients and stratified into 3 mutually exclusive ordinal categories: I-No treatment/NSAIDs; II-cDMARDs±NSAIDs without tDMARDs; III-tDMARDs±cDMARDs/NSAIDs. Univariable and multivariable logistic regression models were created to determine the association between medications and resolution of depression, after controlling for age, sex, disease duration and baseline MCS/MH subscale score.ResultsBased on the MCS and MH subscale score definitions, 608 (48%) and 655 (52%) of the 1270 patients, respectively were depressed at baseline. 374 (50.8% males) and 399 (52.4% males) patients were followed up in the groups defined by MCS and MH subscales, respectively for 1 year. Patients in both groups had comparable body mass indices, baseline psoriasis area and severity index and active joint count. Mean MCS and MH subscale scores (standard deviation) were 33.2 (5.2) and 46.0 (10.2). A mean of 11.9 and 11.7 months was noted for resolution of depression in the MCS based analysis and MH subscale-based analysis groups, respectively. More patients achieved resolution of depression based on definition 2 (MCS, 64.7%; MH, 62.2%) as compared to definition 1 (MCS, 54.5%; MH, 53.9). The proportion of patients on each category of medications in both models is shown in the Figure 1. Table 1 depicts the univariate and multivariable regression results by both the definitions of primary outcome in the MH subscales model. The global p-value for medication categories showed a trend towards significance in both models using definition 2. There was a trend towards higher likelihood of response when comparing patients in treatment category III vs category I. A significant response was noted when comparing patients in category III with category II as reference (OR 1.71; 95% CI 1.05-2.76; p 0.03). No significant effect of treatment category on depression was noted using definition 1.Table 1.Association between treatment and resolution of depression in the MH Subscale model (n = 399)VariableResolution by MCIDResolution by MH subscale reductionUnivariable modelMultivariable modelUnivariate modelMultivariate modelOR (95% CI)p valueOR (95% CI)p valueOR (95% CI)p valueOR (95% CI)p valueMale vs. Female0.81 (0.54–1.22)0.310.83 (0.5–1.26)0.391.02 (0.68–1.51)0.940.94 (0.63 –1.42)0.79Baseline age1.01 (1.00 –1.03)0.091.01 (1.00 –1.03)0.161.02 (1.00–1.03)0.051.01 (0.99 –1.03)0.30Baseline PsA duration1.02 (1.00 –1.04)0.121.01 (0.99 –1.03)0.371.02 (1.00– 1.04)0.071.01 (0.99 –1.03)0.22Baseline MH subscale score0.98 (0.96 –1.00)0.030.98 (0.95 –1.00)0.021.04 (1.02– 1.06)<0.00011.04 (1.02 –1.06)<0.0001Medication category0.07*0.09*0.20*0.20* IReference II0.81 (0.48 –1.36)0.420.83 (0.48 –1.41)0.481.09 (0.65– 1.82)0.751.12 (0.66 –1.91)0.67 III1.40 (0.84 –2.36)0.201.41 (0.83 –2.38)0.201.51 (0.92– 2.49)0.101.55 (0.92 –2.59)0.10*global p valueFigure 1.Patients in each drug category.ConclusionIn an observational setting, resolution of depression occurs in majority of patients with PsA within 1 year. Patients on t-DMARDs may experience better improvement in depression compared to other treatments. Future effectiveness studies warrant better definitions of depression and treatment response.AcknowledgementsAJM was supported by the National Psoriasis Foundation Fellowship grant.Disclosure of InterestsAshish Jacob Mathew Speakers bureau: Novartis, IPCA Laboratories, Grant/research support from: Novartis, IPCA Laboratories, Mitchell Sutton: None declared, Daniel Pereira: None declared, Dafna D Gladman Consultant of: AstraZeneca, Grant/research support from: AbbVie, Vinod Chandran Consultant of: AbbVie, Amgen, BMS, Eli Lilly, Janssen, Novartis, Pfizer and UCB, Grant/research support from: AbbVie, Amgen and Eli-Lilly
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Groen SS, Holm Nielsen S, Bay-Jensen AC, Rasti M, Ganatra D, Oikonomopoulou K, Chandran V. OP0031 SEROLOGICAL COLLAGEN BIOMARKERS CAN DIFFERENTIATE PATIENTS WITH PSORIASIS FROM PSORIATIC ARTHRITIS. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.4363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundPsoriasis is a common chronic immune-mediated skin disease. About 25% of psoriasis patients have psoriatic arthritis (PsA) which is a chronic inflammatory disease affecting the joints, enthesis, and axial skeleton. Delayed diagnosis of PsA is associated with joint damage and disability. Therefore, optimized screening methods including identifying predictors of arthritis in patients with psoriasis have become a medical priority. Collagens are major proteins in all tissues, including skin, bone, cartilage, and connective tissues, which are affected by inflammatory processes present in both psoriasis and PsA. Throughout degradation and remodelling of the extracellular matrix (ECM), proteases cleave collagens leading to protein breakdown products which are released into the circulation. These collagen fragments can be quantified in serum as biomarkers of tissue remodelling and may be helpful in screening patients with psoriasis that have or will develop PsA.ObjectivesOur aim is to identify serum biomarkers that can differentiate patients with psoriasis without PsA (PsC) from PsAMethodsPatients with PsC (n=87, mean ±SD age 42.01 ±12.20, 44% female; underwent a full rheumatologic assessment to exclude PsA) and patients with PsA (n=99, mean ±SD age 45.94 ±12.47, 49% female) were recruited at the Toronto Western Hospital, Canada, after appropriate ethics approval. ECM remodelling was estimated using as indices serological anabolic biomarkers quantifying formation of type III, IV, and VI collagen (PRO-C3, PRO-C4, and PRO-C6 respectively), and catabolic biomarkers measuring degradation of type I, III, IV and VI collagen (C1M, C3M, C4M, C6M respectively). Data are presented as mean ± standard deviation (SD). Statistically significant difference between the two groups was calculated by Mann-Whitney U test and a p-value below 0.05 was considered significant. Area under the receiver operating characteristic (ROC) curve (AUC) analysis was performed to describe the discrimination accuracy of each biomarker between the two patient groups.ResultsPatients with PsA presented higher levels of C1M, C3M, C6M, and PRO-C6 compared to PsC (p<0.0460-p<0.0009, Figure 1 A, B, D, G), while biomarkers levels of C4M, PRO-C3, and PRO-C4 were not significantly different between PsC and PsA patients (Figure 1 C, E, F). Moreover, C1M and C6M were able to separate between PsC and PsA patients with an AUROC=0.6277 (p=0.0027) and AUROC=0.6446 (p=0.0010), respectively, indicating that these biomarkers may be markers of joint involvement (Figure 1 H, I).ConclusionThis work provides evidence that serum degradation biomarkers of type I and VI collagen were able to differentiate patients with PsA from PsC and may be potential biomarkers of inflammatory systemic musculoskeletal involvement. These findings suggest that serological biomarkers may be used to identify the 25% of psoriasis patients that have PsA.Disclosure of InterestsSolveig Skovlund Groen: None declared, Signe Holm Nielsen Employee of: Signe Holm Nielsen is employed by Nordic Bioscience, Anne-Christine Bay-Jensen Shareholder of: Anne C. Bay-Jensen holds stock in Nordic Bioscience, Employee of: Anne C. Bay-Jensen is employed by Nordic Bioscience, Mozhgan Rasti: None declared, Darshini Ganatra: None declared, Katerina Oikonomopoulou: None declared, Vinod Chandran: None declared.
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Stober C, McInnes IB, Raychaudhuri S, Mease PJ, Pennington SR, Scher JU, Chandran V, Armstrong AW, Wit MD, Cauli A, Jadon DR, Löve TJ, Ogdie A, O'Sullivan D, van Mens LJJ, Ritchlin CT, FitzGerald O. Proceedings of the 2021 GRAPPA-Collaborative Research Network (CRN) Meeting. J Rheumatol Suppl 2022; 49:57-63. [PMID: 35365578 DOI: 10.3899/jrheum.211336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 12/07/2021] [Indexed: 10/18/2022]
Abstract
At the 2021 Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA)-Collaborative Research Network (CRN) annual meeting, the GRAPPA-CRN group presented a number of project updates, including a pilot investigator-initiated study to evaluate liquid and tissue biomarkers associated with axial involvement in psoriatic arthritis (PsA). The GRAPPA-CRN session updated progress made with 3 parallel international research initiatives based on 3 previously defined unmet needs in PsA. The Health Initiatives in Psoriasis and PsOriatic arthritis ConsoRTium European States (HIPPOCRATES) is a European research consortium formed to address unmet clinical needs in PsA. The Preventing Arthritis in a multicenter Psoriasis At-Risk Population (PAMPA) is a US-based organization that has defined consensus terminology for preclinical phases of PsA and is interested in the transition process from psoriasis to PsA. An overview of the Accelerating Medicines Partnership Autoimmune and Immune-Mediated Diseases (AMP AIM) program 2.0, a consortium including GRAPPA-CRN members that addressed these 3 unmet needs in PsA, was also presented.
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Affiliation(s)
- Carmel Stober
- C. Stober, MBChB, MRCP, PhD, MSc, Cambridge University Hospital NHS Trust and Department of Medicine, University of Cambridge, Cambridge, UK
| | - Iain B McInnes
- I.B. McInnes, CBE, PhD, FRCP, FRSE, FMedSci, Muirhead Chair of Medicine and Versus Arthritis Professor of Rheumatology, Institute of Infection, Immunity and Inflammation, University of Glasgow, Glasgow, UK
| | - Soumya Raychaudhuri
- S. Raychaudhuri, MD, PhD, Professor of Medicine and Associate Professor of Biomedical Informatics, Center for Data Sciences, Brigham and Women's Hospital, Harvard Medical School, Boston, Department of Medicine, Brigham and Women's Hospital, Boston, Program in Medical and Population Genetics, Broad Institute, Cambridge, and Department of Biomedical Informatics, Harvard Medical School, Boston, Massachusetts, USA
| | - Philip J Mease
- P.J. Mease, MD, MACR, Director of Rheumatology Research, Swedish Medical Center/Providence-St Joseph Health, and Clinical Professor, University of Washington School of Medicine, Seattle, Washington, USA
| | - Stephen R Pennington
- S.R. Pennington, PhD, O. FitzGerald, MD, FRCPI, FRCP, Newman Clinical Research Professor, School of Medicine, Conway Institute of Biomolecular and Biomedical Research, University College Dublin, Dublin, Ireland
| | - Jose U Scher
- J.U. Scher, MD, Department of Medicine, New York University Grossman School of Medicine, New York, New York, USA
| | - Vinod Chandran
- V. Chandran, MD, DM, PhD, Department of Medicine, Division of Rheumatology, University of Toronto, Toronto Western Hospital, Krembil Research Institute, Toronto, Ontario, Canada
| | - April W Armstrong
- A.W. Armstrong, MD, PhD, Professor of Dermatology, Associate Dean for Clinical Research, Director of Clinical Research Support, Southern California Clinical and Translational Science Institute, Vice Chair Director, Clinical Trials and Outcomes Research Director, Psoriasis Program, Department of Dermatology, Keck School of Medicine of USC, University of Southern California, Los Angeles, California, USA
| | - Maarten de Wit
- M. de Wit, PhD, GRAPPA Patient Research Partner, the Netherlands
| | - Alberto Cauli
- A. Cauli, MD, PhD, Rheumatology Unit, University Clinic and Azienda Ospedaliera Universitaria di Cagliari, Monserrato, Cagliari, Italy
| | - Deepak R Jadon
- D.R. Jadon, MBBCh, MRCP, PhD, Department of Medicine, University of Cambridge, Cambridge, UK
| | - Thorvardur J Löve
- T. J. Löve, MD, PhD, Faculty of Medicine, University of Iceland, and Department of Research, Landspitali University Hospital, Reykjavik, Iceland
| | - Alexis Ogdie
- A. Ogdie, MD, MSCE, Associate Professor of Medicine and Epidemiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Denis O'Sullivan
- D. O'Sullivan, GRAPPA Patient Research Partner, Our Lady's Hospice & Care Services, Rheumatic & Musculoskeletal Disease Unit, Dublin, Ireland
| | - Leonieke J J van Mens
- L.J.J. van Mens, MD, PhD, Amsterdam University Medical Centers/University of Amsterdam, Department of Clinical Immunology and Rheumatology Amsterdam, Infection & Immunity Institute, Amsterdam, the Netherlands
| | - Christopher T Ritchlin
- C.T. Ritchlin, MD, MPH, Professor of Medicine, Division of Allergy, Immunology and Rheumatology, University of Rochester Medical Center, Rochester, New York, USA
| | - Oliver FitzGerald
- S.R. Pennington, PhD, O. FitzGerald, MD, FRCPI, FRCP, Newman Clinical Research Professor, School of Medicine, Conway Institute of Biomolecular and Biomedical Research, University College Dublin, Dublin, Ireland;
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Mathew AJ, Sutton M, Pereira D, Gladman DD, Chandran V. Effectiveness of Disease Modifying Anti-Rheumatic Drugs for Enthesitis in a Prospective Longitudinal Psoriatic Arthritis Cohort. J Rheumatol 2022; 49:1020-1025. [PMID: 35649547 DOI: 10.3899/jrheum.211231] [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] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/17/2022] [Indexed: 10/18/2022]
Abstract
OBJECTIVE Our objective was to assess the effectiveness of conventional and targeted disease modifying anti-rheumatic drugs (cDMARDs and tDMARDs, respectively) in treating enthesitis in PsA. METHODS Patients with active enthesitis, defined as ≥1 tender entheses (of 29 sites included in the spondyloarthritis research consortium of Canada enthesitis index, the Leeds enthesitis index, and the Maastricht ankylosing spondylitis enthesitis score), enrolled in a large PsA cohort were included. Medications at baseline were classified into 3 mutually exclusive categories: 1.'no treatment/non-steroidal anti-inflammatory drugs (NSAIDs)', 2. 'cDMARDs±NSAIDs' and 3.'tDMARDs±cDMARDs/NSAIDs'. Complete resolution of enthesitis (no tender entheseal site) at 12 months was the primary outcome. Logistic regression models were developed to determine the association between medication category and enthesitis resolution. RESULTS Of the 1270 patients studied, 628(49.44%) had enthesitis; 526 patients (51.71% males; mean age (standard deviation, s.d.) - 49.02(13.12) years; mean enthesitis score (s.d.) 2.13(2.16) with adequate follow-up were analysed. Complete resolution of enthesitis was noted in 453(86%) patients, within a mean period of 8.73 months from baseline. In the regression analysis, though not significant, DMARDs (Categories 2 and 3) had higher odds ratio compared to category 1 for resolution of enthesitis. Enthesitis resolution was associated with lower joint activity (OR 0.97; 95% CI 0.95 - 0.99; p = 0.01) and male sex (OR 1.66; 95% CI 0.97 - 2.84; p = 0.06). CONCLUSION Resolution of enthesitis was observed in 86% of patients in an observational setting regardless of the medication used. Future effectiveness studies may warrant evaluation of enthesitis using advanced imaging.
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Affiliation(s)
- Ashish Jacob Mathew
- AJ Mathew DNB, DM Centre for Prognosis Studies in the Rheumatic Diseases, Psoriatic Arthritis Program, Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, Toronto Ontario, Canada. Division of Rheumatology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada. The Copenhagen Center for Arthritis and Research (COPECARE), Center for Rheumatology and Spine Diseases, Centre of Head and Orthopedics, Copenhagen University Hospital - Rigshospitalet, Glostrup, Denmark. Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark. Department of Clinical Immunology and Rheumatology, Christian Medical College, Vellore, India. M Sutton MSc Centre for Prognosis Studies in the Rheumatic Diseases, Psoriatic Arthritis Program, Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, Toronto Ontario, Canada. D Pereira MSc Centre for Prognosis Studies in the Rheumatic Diseases, Psoriatic Arthritis Program, Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, Toronto Ontario, Canada. DD Gladman MD, FRCPC Centre for Prognosis Studies in the Rheumatic Diseases, Psoriatic Arthritis Program, Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, Toronto Ontario, Canada. Division of Rheumatology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada. Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada. V Chandran DM, PhD, FRCPC Centre for Prognosis Studies in the Rheumatic Diseases, Psoriatic Arthritis Program, Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, Toronto Ontario, Canada. Division of Rheumatology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada. Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada. Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada. Potential conflicts of interest: None. Address for correspondence: Dr. Vinod Chandran, 1E416, Toronto Western Hospital, 399 Bathurst Street, Toronto Ontario, Canada, M5T2S8.
| | - Mitchell Sutton
- AJ Mathew DNB, DM Centre for Prognosis Studies in the Rheumatic Diseases, Psoriatic Arthritis Program, Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, Toronto Ontario, Canada. Division of Rheumatology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada. The Copenhagen Center for Arthritis and Research (COPECARE), Center for Rheumatology and Spine Diseases, Centre of Head and Orthopedics, Copenhagen University Hospital - Rigshospitalet, Glostrup, Denmark. Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark. Department of Clinical Immunology and Rheumatology, Christian Medical College, Vellore, India. M Sutton MSc Centre for Prognosis Studies in the Rheumatic Diseases, Psoriatic Arthritis Program, Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, Toronto Ontario, Canada. D Pereira MSc Centre for Prognosis Studies in the Rheumatic Diseases, Psoriatic Arthritis Program, Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, Toronto Ontario, Canada. DD Gladman MD, FRCPC Centre for Prognosis Studies in the Rheumatic Diseases, Psoriatic Arthritis Program, Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, Toronto Ontario, Canada. Division of Rheumatology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada. Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada. V Chandran DM, PhD, FRCPC Centre for Prognosis Studies in the Rheumatic Diseases, Psoriatic Arthritis Program, Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, Toronto Ontario, Canada. Division of Rheumatology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada. Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada. Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada. Potential conflicts of interest: None. Address for correspondence: Dr. Vinod Chandran, 1E416, Toronto Western Hospital, 399 Bathurst Street, Toronto Ontario, Canada, M5T2S8.
| | - Daniel Pereira
- AJ Mathew DNB, DM Centre for Prognosis Studies in the Rheumatic Diseases, Psoriatic Arthritis Program, Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, Toronto Ontario, Canada. Division of Rheumatology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada. The Copenhagen Center for Arthritis and Research (COPECARE), Center for Rheumatology and Spine Diseases, Centre of Head and Orthopedics, Copenhagen University Hospital - Rigshospitalet, Glostrup, Denmark. Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark. Department of Clinical Immunology and Rheumatology, Christian Medical College, Vellore, India. M Sutton MSc Centre for Prognosis Studies in the Rheumatic Diseases, Psoriatic Arthritis Program, Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, Toronto Ontario, Canada. D Pereira MSc Centre for Prognosis Studies in the Rheumatic Diseases, Psoriatic Arthritis Program, Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, Toronto Ontario, Canada. DD Gladman MD, FRCPC Centre for Prognosis Studies in the Rheumatic Diseases, Psoriatic Arthritis Program, Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, Toronto Ontario, Canada. Division of Rheumatology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada. Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada. V Chandran DM, PhD, FRCPC Centre for Prognosis Studies in the Rheumatic Diseases, Psoriatic Arthritis Program, Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, Toronto Ontario, Canada. Division of Rheumatology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada. Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada. Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada. Potential conflicts of interest: None. Address for correspondence: Dr. Vinod Chandran, 1E416, Toronto Western Hospital, 399 Bathurst Street, Toronto Ontario, Canada, M5T2S8.
| | - Dafna D Gladman
- AJ Mathew DNB, DM Centre for Prognosis Studies in the Rheumatic Diseases, Psoriatic Arthritis Program, Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, Toronto Ontario, Canada. Division of Rheumatology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada. The Copenhagen Center for Arthritis and Research (COPECARE), Center for Rheumatology and Spine Diseases, Centre of Head and Orthopedics, Copenhagen University Hospital - Rigshospitalet, Glostrup, Denmark. Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark. Department of Clinical Immunology and Rheumatology, Christian Medical College, Vellore, India. M Sutton MSc Centre for Prognosis Studies in the Rheumatic Diseases, Psoriatic Arthritis Program, Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, Toronto Ontario, Canada. D Pereira MSc Centre for Prognosis Studies in the Rheumatic Diseases, Psoriatic Arthritis Program, Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, Toronto Ontario, Canada. DD Gladman MD, FRCPC Centre for Prognosis Studies in the Rheumatic Diseases, Psoriatic Arthritis Program, Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, Toronto Ontario, Canada. Division of Rheumatology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada. Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada. V Chandran DM, PhD, FRCPC Centre for Prognosis Studies in the Rheumatic Diseases, Psoriatic Arthritis Program, Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, Toronto Ontario, Canada. Division of Rheumatology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada. Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada. Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada. Potential conflicts of interest: None. Address for correspondence: Dr. Vinod Chandran, 1E416, Toronto Western Hospital, 399 Bathurst Street, Toronto Ontario, Canada, M5T2S8.
| | - Vinod Chandran
- AJ Mathew DNB, DM Centre for Prognosis Studies in the Rheumatic Diseases, Psoriatic Arthritis Program, Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, Toronto Ontario, Canada. Division of Rheumatology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada. The Copenhagen Center for Arthritis and Research (COPECARE), Center for Rheumatology and Spine Diseases, Centre of Head and Orthopedics, Copenhagen University Hospital - Rigshospitalet, Glostrup, Denmark. Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark. Department of Clinical Immunology and Rheumatology, Christian Medical College, Vellore, India. M Sutton MSc Centre for Prognosis Studies in the Rheumatic Diseases, Psoriatic Arthritis Program, Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, Toronto Ontario, Canada. D Pereira MSc Centre for Prognosis Studies in the Rheumatic Diseases, Psoriatic Arthritis Program, Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, Toronto Ontario, Canada. DD Gladman MD, FRCPC Centre for Prognosis Studies in the Rheumatic Diseases, Psoriatic Arthritis Program, Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, Toronto Ontario, Canada. Division of Rheumatology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada. Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada. V Chandran DM, PhD, FRCPC Centre for Prognosis Studies in the Rheumatic Diseases, Psoriatic Arthritis Program, Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, Toronto Ontario, Canada. Division of Rheumatology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada. Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada. Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada. Potential conflicts of interest: None. Address for correspondence: Dr. Vinod Chandran, 1E416, Toronto Western Hospital, 399 Bathurst Street, Toronto Ontario, Canada, M5T2S8.
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Waddington J, Zhou R, Coleman O, Wundervald B, Parnell A, Mease PJ, Chandran V, Fallon L, Chapman D, Pollock R, Deng S, Fitzgerald O, Pennington S. POS1045 MASS SPECTROMETRY-BASED PROTEOMICS FOR THE IDENTIFICATION OF CANDIDATE SERUM PROTEIN BIOMARKERS THAT MAY PREDICT TREATMENT RESPONSE IN PATIENTS WITH PSORIATIC ARTHRITIS. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.2091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundThe Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA) has identified a need for biomarkers to predict which patients (pts) with psoriatic arthritis (PsA) are most likely to respond to a specific therapy. Failure to identify effective treatments early on results in sub-optimal PsA disease management. Tofacitinib is an oral JAK inhibitor for the treatment of PsA. The efficacy and safety of tofacitinib 5 and 10 mg twice daily (BID) in pts with PsA have been demonstrated.1,2ObjectivesTo identify protein biomarker candidates, which may identify responders (R) vs non-responders (NR) to treatment of PsA, using mass spectrometry-based proteomics.MethodsBaseline (BL) serum samples from pts with PsA receiving tofacitinib 5 or 10 mg BID, adalimumab or placebo in OPAL Broaden (NCT01877668)1 were analysed. Pts were identified as R and NR based on the Psoriatic Arthritis Disease Activity Score (PASDAS) at Month 3; pts with lowest PASDAS ≤3.2 were defined as R, those with highest PASDAS >3.2 as NR. Two proteomic strategies were employed for analysis of BL serum samples: (1) targeted mass spectrometric multiple reaction monitoring analysis of an in-house panel (‘PAPRICA’) comprising of 206 proteins, originally developed to distinguish between different arthropathies, and (2) unbiased discovery liquid chromatography-tandem mass spectrometry (LC-MS/MS). PAPRICA data were normalised using two methods: normalisation to stable isotopically labelled peptide spike-ins (SIL; corrects for fluctuations in sample injections/mass spectrometry loading amounts), and normalisation to an endogenous peptide panel representing total serum protein abundance (TSPA; corrects for different amounts of total serum protein across samples). Univariate analyses (Student’s t-test) and multivariate machine learning Random Forest (RF) modelling3 were performed. Univariate analysis of the PAPRICA panel of proteins was performed on R vs NR, and within each treatment arm, with no adjustment for multiplicity.Results96 pts were identified as 47 R and 49 NR based on PASDAS scores. Of pts receiving tofacitinib 5 or 10 mg BID (data pooled), adalimumab or placebo, there were 26 R vs 26 NR, 13 R vs 13 NR and 8 R vs 10 NR, respectively. Results from univariate analysis identified 110 differentially expressed PAPRICA peptides between R vs NR (p≤0.05). RF multivariate analysis of all data (n=96) revealed a set of PAPRICA peptide signatures with the ability to differentiate between R and NR. Two RF models generated from the PAPRICA peptide data had training area under curves (AUCs) 0.956 [95% CI 0.93, 0.99] (TSPA) and 0.959 [95% CI 0.94, 0.98] (SIL). In total, 115 PAPRICA peptides representing 87 proteins were identified as potential biomarkers for predicting treatment response. Using unbiased discovery LC-MS/MS, univariate analysis of all data revealed one candidate peptide biomarker (p≤0.05). RF modelling revealed peptides that contributed to two prediction models with training AUCs of 0.903 [95% CI 0.86, 0.96] and 0.928 [95% CI 0.89, 0.96]. In total, from unbiased discovery LC-MS/MS, 66 peptides representing 39 proteins that may act as potential peptide biomarkers were identified in univariate and multivariate analyses.ConclusionUsing two complementary proteomic approaches and a combination of univariate and machine learning models, a total of 181 candidate biomarker peptides corresponding to 106 proteins have been identified that may act as potential biomarkers for predicting response to treatment of PsA. Further study is required to verify and evaluate these candidate biomarkers, and we will report how these proteins map to biological processes, pathways and networks.References[1]Mease et al. N Engl J Med 2017; 377: 1537-1550.[2]Gladman et al. N Engl J Med 2017; 377: 1525-1536.[3]Breiman. Machine Learning 2001; 45: 5-32.AcknowledgementsStudy sponsored by Pfizer Inc. Medical writing support was provided by Lauren Hogarth, CMC Connect, and funded by Pfizer Inc.Disclosure of InterestsJames Waddington Employee of: Atturos, Ruoyi Zhou Employee of: Atturos, Orla Coleman Employee of: Atturos, Bruna Wundervald Employee of: Atturos, Andrew Parnell: None declared, Philip J Mease Speakers bureau: AbbVie, Amgen, Janssen, Novartis, Pfizer Inc and UCB, Consultant of: AbbVie, Amgen, Bristol-Myers Squibb, Celgene, CorEvitas, Eli Lilly, Galapagos, Gilead Sciences, GlaxoSmithKline, Janssen, Merck, Novartis, Pfizer Inc, Sun Pharma and UCB, Grant/research support from: AbbVie, Amgen, Bristol-Myers Squibb, Celgene, Eli Lilly, Janssen, Novartis, Pfizer Inc, Sun Pharma and UCB, Vinod Chandran Consultant of: AbbVie, Amgen, BMS, Eli Lilly, Janssen, Novartis, Pfizer Inc and UCB, Grant/research support from: AbbVie, Amgen, Eli Lilly, Lara Fallon Shareholder of: Pfizer Inc, Employee of: Pfizer Inc, Douglass Chapman Shareholder of: Pfizer Inc, Employee of: Pfizer Inc, Remy Pollock Shareholder of: Pfizer Inc, Employee of: Pfizer Inc, Shibing Deng Shareholder of: Pfizer Inc, Employee of: Pfizer Inc, Oliver FitzGerald Shareholder of: Atturos, Speakers bureau: AbbVie, Amgen, Bristol-Myers Squibb, Celgene, Eli Lilly, Janssen, Novartis, Pfizer Inc and UCB, Employee of: University College Dublin, Stephen Pennington Shareholder of: Atturos, Employee of: University College Dublin
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Groen SS, Holm Nielsen S, Bay-Jensen AC, Rasti M, Ganatra D, Oikonomopoulou K, Chandran V. POS1097 BIOMARKERS OF INFLAMMATION AND JOINT TISSUE TURNOVER CAN HELP IMPROVING THE DIFFERENTIATION BETWEEN OSTEOARTHRITIS AND PSORIATIC ARTHRITIS PATIENTS. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.4605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BackgroundOsteoarthritis (OA) is a slow progressive disease characterized by degeneration within the joint cartilage, leading to destruction and dysfunction of the involved joints. Psoriatic arthritis (PsA) is a chronic inflammatory disease manifesting itself in skin lesions and progressive inflammatory changes within the musculoskeletal system, leading to joint damage and functional limitation. Although OA and PsA are considered to be distinct diseases, they share overlapping clinical and inflammatory features that can cause diagnostic challenges. Throughout these inflammatory and degenerative processes in the joint tissues, proteases hold a major role in remodelling of the extracellular matrix (ECM) which results in protein breakdown products released into the synovial fluid (SF). These protein fragments can be quantified in SF as biomarkers of tissue remodelling and may be helpful in characterizing disease-specific or overlapping pathologies between OA and PsA.ObjectivesOur aim of this study is to measure biomarkers of inflammation and joint tissue turnover in SF to explore the distinct and overlapping pathologies between OA and PsA.MethodsSF samples were collected from patients with OA (n=54, mean ±SD age 62.1 ±11.9, 48% female) and patients with PsA (n=59, mean ±SD age 47.8±13.3, 37% female) recruited through Toronto Western Hospital, Canada. Study was approved by the local ethics committee. Biomarkers of inflammation reflecting macrophage activity (VICM) and neutrophil activity (CPa9-HNE) were measured in the SF samples. Moreover, ECM remodelling was assessed in the SF samples by biomarkers quantifying type II collagen formation (PRO-C2), fibronectin turnover (FBN-C), and aggrecan degradation (ARGS). Data were log-transformed and presented as mean ± standard deviation (SD). An ANCOVA corrected for age was applied to test the difference between biomarker levels across the two patient groups and a p-value below 0.05 was considered significant. Area under the receiver operating characteristic (ROC) curve (AUC) analysis was performed to describe the discrimination accuracy of each biomarker between the two patient groups.ResultsPsA patients presented significantly higher levels of macrophage; VICM, activity compared to OA (p<0.001, Figure 1A). On the other hand, OA patients demonstrated increased type II collagen formation and aggrecan degradation compared to PsA (p<0.001, Figure 1C, E). Interestingly, no significant difference in biomarkers levels of neutrophil activity and fibronectin remodelling was observed between the two disease groups. Moreover, VICM, PRO-C2, and ARGS showed high distributional difference between OA and PsA patients with an AUROC=0.915 (p<0.001, Figure 1F), AUROC=0.737 (p<0.001, Figure 1G), and AUROC=0.725 (p<0.001, Figure 1H), respectively.ConclusionPsA patients demonstrated higher macrophage activity in the SF compared to the OA patients, while higher levels of cartilage formation and degradation were observed in OA patients compared to PsA. No differences between OA and PsA were observed in neutrophil activity and fibronectin turnover, which may mirror the clinical difficulty in telling the two arthritides apart. Identifying the unique characteristics of the pathological processes underlying the two diseases may improve diagnosis and allow for the precise management of both OA and PsA patients.Disclosure of InterestsSolveig Skovlund Groen: None declared, Signe Holm Nielsen Employee of: Signe is employed by Nordic Bioscience, Anne-Christine Bay-Jensen Shareholder of: Anne C. Bay-Jensen holds stock in Nordic Bioscience, Employee of: Anne C. Bay-Jensen is employed by Nordic Bioscience, Mozhgan Rasti: None declared, Darshini Ganatra: None declared, Katerina Oikonomopoulou: None declared, Vinod Chandran: None declared
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Finkelstein N, Dayam RM, Law J, Goetgebuer R, Chao G, Abe KT, Sutton M, Stempak JM, Pereira D, Croitoru D, Acheampong L, Rizwan S, Rymaszewski K, Milgrom R, Ganatra D, Batista NV, Girard M, Lau I, Law R, Cheung M, Rathod B, Kitaygorodsky J, Samson R, Hu Q, Haroon N, Inman R, Piguet V, Silverberg M, Grigras AC, Watts TH, Chandran V. POS1217 ANTI-TNF THERAPY FOR IMMUNE MEDIATED INFLAMMATORY DISEASES MAY BE ASSOCIATED WITH LOWER ANTIBODY LEVELS AND VIRUS NEUTRALIZATION EFFICACY FOLLOWING SARS-CoV-2 mRNA VACCINATION. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.1667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BackgroundThe impact of immunosuppressants on COVID-19 vaccination response and durability in patients with immune-mediated inflammatory diseases (IMID) is yet to be fully characterized. Humoral response may be attenuated in these patients especially those on B cell depleting therapy and higher doses of corticosteroids, but data regarding other immunosuppressants are scarce.ObjectivesWe aimed to investigate antibody and T cell responses and durability to SARS-CoV-2 mRNA vaccines (BNT162b and/or mRNA 1273) in IMID patients on immunomodulatory maintenance therapy other than B-cell depleting therapy and corticosteroids.MethodsThis prospective observational cohort study examined the immunogenicity of SARS-CoV-2 mRNA vaccines in adult patients with IMIDs (psoriatic arthritis, psoriasis, inflammatory bowel disease and rheumatoid arthritis) with or without maintenance immunosuppressive therapies (anti-TNF, methotrexate/azathioprine [MTX/AZA], anti-TNF + MTX/AZA, anti IL12/23, anti-IL-17, anti-IL23) compared to healthy controls. Automated ELISA for IgGs to spike trimer, spike receptor binding domain (RBD) and the nucleocapsid (NP) and T-cell release of 9 cytokines (IFNg, IL2, IL4, IL17A, TNF) and cytotoxic molecules (sFasL, GzmA, GzmB, Perforinin) in cell culture supernatants following stimulation with spike or NP peptide arrays were conducted at 4 time points: T1=pre vaccination, T2=median 26 days after dose 1, T3=median 16 days after dose 2 and T4=median 106 days after dose 2. Neutralization assays against four SARS-CoV-2 variants (wild type, delta, beta and gamma) were conducted at T3.ResultsWe followed 150 subjects: 26 healthy controls and 124 IMID patients: 9 untreated, 44 on anti-TNF, 16 on anti-TNF with MTX/AZA, 10 on anti-IL23, 28 on anti-IL12/23, 9 on anti-IL17, 8 on MTX/AZA (Table 1). Most patients mounted antibody and T cell responses with increases from dose 1 to dose 2 (100% seroconversion at T3) and some decline by T4, with variability within groups. Antibody levels and neutralization efficacy was lower in anti-TNFgroups (anti-TNF, anti-TNF + MTX/AZA) compared to controls and waned by T4 (Figure 1). T cell responses were not consistently different between groups. Pooled data showed a higher antibody response to mRNA-1273 compared to BNT162b.Table 1.Baseline characteristics of study participantsControluntreated IMIDAnti- TNFAnti- TNF +MTX/AZAAnti-IL-23Anti -IL-12/23Anti -IL-17MTX/AZAn=26n=9n=44n=16n=10n=28n=9n=8p-valueIMID*N/A IBD9301002704 Psoriasis1318122 PA0732172 AS0830010 RA1100011Age median years [IQR]36 [26-46]33 [27-41]38 [30-51]53 [44-59]48 [45-61]34 [28-47]49 [46-61]42 [31-55]<0.001^Sex male (%)16 (62)5 (56)18 (41)8 (50)5 (50)13 (46)6 (67)4 (50)0.772~BMImedian kg/m2 [IQR]25 [23-28]26 [22-27]22 [24-26]26 [24-28]27 [24-35]22 [21-24]32 [26-34]26[25-33]0.001^Vaccine interval median days [IQR]74 [35-84]54 [31-64]60 [45-69]64 [50-72]74 [35-84]62 [49-69]65 [52-75]58 [21-97]0.372^*multiple IMIDs per patient possibleFigure 1.Antibody responses (A) Anti spike and anti RBD IgG levels at indicated time points. Blue line represents median ratio in convalescent patients. The red line is the seropositivity threshold: the median antibody level of those that pass both a 1% false positive rate and show ≥3SD from the log means of the negative controls. (B) Relative ratio of RBD, spike and NP across time. Black and gray lines indicate median and mean values, respectively. *p≤0.05, **p≤0.01, ***p≤0.001, ****p≤0.0001ConclusionFollowing 2 doses of mRNA vaccination there is 100% seroconversion in IMID patients on maintenance therapy. Antibody levels and neutralization efficacy in anti-TNF group are lower than controls, and wane substantially by 3 months after dose 2. These findings highlight the need for third dose in patients undergoing treatment with anti-TNF therapy and continued monitoring of immunity in these patient groups, taking into consideration newer variants and additional vaccine doses.AcknowledgementsThis work was funded by a donation from Juan and Stefania Speck and by grants VR-1 172711, VS1-175545, FDN-143250, GA1- 177703 and GA2- 177716, from Canadian Institutes of Health Research and COVID Immunity task force and by Sinai Health FoundationDisclosure of InterestsNaomi Finkelstein: None declared, Roya M. Dayam: None declared, Jaclyn Law: None declared, Rogier Goetgebuer: None declared, Gary Chao: None declared, Kento T. Abe: None declared, Mitchell Sutton: None declared, Joanne M. Stempak: None declared, Daniel Pereira: None declared, David Croitoru: None declared, Lily Acheampong: None declared, Saima Rizwan: None declared, Klaudia Rymaszewski: None declared, Raquel Milgrom: None declared, Darshini Ganatra: None declared, Nathalia V. Batista: None declared, Melanie Girard: None declared, Irene Lau: None declared, Ryan Law: None declared, Michelle Cheung: None declared, Bhavisha Rathod: None declared, Julia Kitaygorodsky: None declared, Reuben Samson: None declared, Queenie Hu: None declared, Nigil Haroon: None declared, Robert Inman Consultant of: AbbVie, Janssen, Lilly, Novartis., Grant/research support from: AbbVie, Novartis, Vincent Piguet Consultant of: AbbVie, Almirall, Celgene, Janssen, Kyowa Kirin Co. Ltd, LEO Pharma,Novartis, Pfizer, Sanofi, UCB, and Union Therapeutic, Grant/research support from: Unrestricted educational grants from AbbVie, Bausch Health, Celgene, Janssen, LEO Pharma, Lilly, L’Oréal, NAOS, Novartis, Pfizer, Pierre-Fabre, Sandoz, and Sanofi, Mark Silverberg Speakers bureau: AbbVie, Janssen, Takeda, Pfizer, Gilead and Amgen, Consultant of: AbbVie, Janssen, Takeda, Pfizer, Gilead and Amgen, Grant/research support from: AbbVie, Janssen, Takeda, Pfizer, Gilead and Amgen, Anne-Claude Grigras: None declared, Tania H. Watts: None declared, Vinod Chandran Consultant of: AbbVie, Amgen, BMS, Eli Lilly, Janssen, Novartis, Pfizer and UCB, Grant/research support from: AbbVie, Amgen, Eli-Lilly.
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Choquette D, Chandran V, Laliberté MC, Fournier PA, Girard T, Sutton M, Gladman DD. AB0895 Residual burden and disease activity of Canadian PsA patients treated with advanced therapies: preliminary results from a multiple registry analysis (UNISON-PsA). Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.1606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundGiven the availability of advanced therapies in PsA with different modes of action, it is of interest to characterize their impact on overall clinical outcomes.ObjectivesTo describe residual disease activity in Canadians with PsA treated with advanced therapies.MethodsMulti-region, observational, retrospective analysis of data from Rhumadata (Quebec) and International Psoriasis and Arthritis Research Team (IPART) Canadian registries was performed. Data from each registry and region were analyzed separately using a common statistical analysis plan to generate descriptive statistics. Patients included in the registries were eligible if they were adults at the time of PsA diagnosis and were treated with an advanced therapy for ≥6 months initiated between January 2010 and December 2019. Residual disease activity was defined as failing to achieve MDA (defined as achieving ≥5 of: TJC ≤1; SJC ≤1; PASI ≤1 or BSA ≤3%; patient pain VAS score of ≤15 mm; patient global disease activity VAS score of ≤20 mm; HAQ score ≤0.5; and tender entheseal points ≤1) (primary endpoint), or DAPSA score ≥14 (secondary endpoint) within 6 months of initiation of an advanced therapy (TNFi, IL-12/23i, IL-17i, PDE4i, CTLA4i or JAKi).Results1,866 subjects (Atlantic [IPART; Newfoundland]: N=83; Quebec [Rhumadata]: N=687; Ontario [IPART]: N=966; West [IPART; British Columbia, Manitoba]: N=130) were included in this preliminary analysis. Baseline characteristics are presented in Table 1. Overall, 899 were receiving their 1st advanced therapy, 464 were receiving their 2nd, and 264 had received ≥3. The most common therapy class was TNFi, followed by IL-17i. 18/21 (85.7%) subjects in the Atlantic region with an assessment, 184/246 (74.8%) in Quebec, 391/571 (68.1%) in Ontario, and 30/43 (69.8%) in Western Canada failed to achieve MDA within 6 months following advanced therapy initiation. Failure to achieve MDA within the allotted period was higher among patients receiving an IL-17i compared with a TNFi. There was no appreciable effect of lines of therapy. Also, 74 of 110 (67.3%) patients with an assessment in Quebec, 201/365 (55.1%) in Ontario and 3/3 (100%) in the West failed to achieve at least low disease activity (LDA; DAPSA ≤14) within 6 months following initiation of an advanced therapy. Data were not available for the Atlantic region. The proportion of patients not achieving LDA by advanced therapy was similar for those receiving a TNFi and IL-17i but increased with line of therapy.Table 1.Patient demographic and baseline characteristics, and response to treatmentAtlantic (N=83)Quebec (N=687)Ontario (N=966)West (N=130)Age (years, mean [SD])50.3 (11.1)50.7 (12.1)49.1 (12.9)46.7 (12.1)Female (n [%])44/83 (53.0)346/687 (50.4)427/966 (44.2)81/128 (62.3)BMI (kg/m2, n, mean [SD])15, 30.8 (3.6)553, 29.6 (6.6)579, 30.6 (6.9)45, 32.8 (10.6)Time since diagnosis (years, N, mean [SD])83, 8.7 (8.7)687, 7.1 (7.9)895, 11.7 (11.1)74, 11.7 (8.9)HLA-B27 positive (n/N [%])N/A58/335 (17.3)86/648 (13.3)N/APresence of EAMs (n/N [%])4/44 (9.1)27/687 (3.9)65/693 (9.4)2/33 (6.1%)Fulfillment of CASPAR (n/N [%])N/A391/687 (56.9)100/100 (100)N/ATherapy class (n [%]):*TNFi66 (79.5)478 (69.6)651 (67.3)104 (80.0)IL-17i11 (13.3)106 (15.4)191 (19.9)21 (16.2)IL-12/23i6 (7.2)33 (4.8)124 (12.9)5 (3.9)PDE4i48 (7.0)Other22 (3.2)Failure to achieve MDA within 6 months of starting therapy (n/N [%])**18/21 (87.5)184/246 (74.8)391/571 (68.1)30/43 (69.8)Failure to achieve DAPSA ≤14 within 6 months of starting therapy (n/N [%])**N/A74/110 (67.3)201/365 (55.1)3/3 (100.0)*Patients may be taking >1 advanced therapy, **Not all patients had assessments of disease activity.ConclusionPreliminary data show approximately three quarters of Canadians with PsA failed to achieve MDA or LDA within 6 months of initiating an advanced therapy. Disease duration is a possible explanation for not achieving MDA or LDA; better therapeutic approaches are needed to achieve these outcomes in patients with PsA.AcknowledgementsThe authors wish to thank Dr. Steve Ramkissoon, for supporting the statistical analysis of the IPART registry. Medical writing and statistical support (funded by Abbvie) were provided by John Howell and Hong Chen, respectively, from McDougall Scientific. Financial support for the study was provided by AbbVie. AbbVie participated in the design of the study, interpretation of data, review, and approval of this publication. All authors contributed to the development of the publication and maintained control over the final content.Disclosure of InterestsDenis Choquette Speakers bureau: Amgen, Abbvie, CIHR, Novartis, Pfizer, Fresenius-Kabi, Eli Lilly, Sandoz, Tevapharm, Consultant of: Amgen, Abbvie, CIHR, Novartis, Pfizer, Fresenius-Kabi, Eli Lilly, Sandoz, Tevapharm, Grant/research support from: Rhumadata is supported through grants and research contracts from Amgen, Abbvie, CIHR, Novartis, Pfizer, Fresenius-Kabi, Eli Lilly, Sandoz, Tevapharm., Vinod Chandran Consultant of: AbbVie, Amgen, BMS, Eli Lilly, Janssen, Novartis, UCB, Pfizer, Employee of: Spouse is an employee of AstraZeneca, Marie-Claude Laliberté Shareholder of: AbbVie Corp., Employee of: AbbVie Corp., Pierre-André Fournier Shareholder of: AbbVie Corp., Employee of: AbbVie Corp., Tanya Girard Shareholder of: AbbVie Corp., Employee of: AbbVie Corp., Mitchell Sutton: None declared, Dafna D Gladman Consultant of: AbbVie, Amgen, BMS, Galapagos, Gilead, Eli Lilly, Janssen Novartis, Pfizer, UCB, Grant/research support from: AbbVie, Amgen, Eli Lilly, Janssen, Novartis, Pfizer, UCB
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Colaco K, Piguet V, Chandran V, Harvey P, Gladman DD, Eder L. OP0030 ASSOCIATION OF TRADITIONAL AND DISEASE-RELATED RISK FACTORS WITH CARDIOVASCULAR EVENTS IN PATIENTS WITH PSORIATIC ARTHRITIS AND PSORIASIS. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.2993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundPatients with psoriatic arthritis and psoriasis, collectively termed psoriatic disease (PsD), have an increased risk for cardiovascular (CV) disease.ObjectivesWe aimed to identify traditional CV risk factors and PsD-related risk factors associated with CV events.MethodsPatients from a longitudinal PsD cohort without a prior history of CV events were included. Detailed information on demographics, comorbidities including traditional cardiovascular risk factors, medications and disease activity is collected according to a standard protocol. The study outcome included any of the following CV events occurring within the first 10 years of patients’ initial clinic visit: angina, myocardial infarction, congestive heart failure, transient ischemic attack, cerebrovascular accident, revascularization procedures and CV death. A total of 10 traditional CV risk factors and 15 PsD-related risk factors were assessed. The association of each risk factor with incident CVEs were analyzed separately using Cox proportional hazards regression models with time-dependent covariates, adjusted for age and sex.ResultsA total of 1,376 patients with PsD, followed between 1978 and 2020, were analyzed (mean age 48.3 ± 12.9 years, 46.8% female). During the follow-up period, 102 (7.4%) patients developed incident CV events. In Cox regression models adjusted for age and sex, age (Hazard Ratio (HR) 1.08, 95% Confidence Interval (CI) 1.06, 1.10), diabetes (HR 1.88, 95% CI 1.17, 3.02), systolic blood pressure (HR 1.02, 95% CI 1.01, 1.03), body mass index (BMI) (HR 1.04, 95% CI 1.01, 1.08), triglycerides (HR 1.24, 95% CI 1.07, 1.43), treatment for hypertension (HR 1.70, 95% CI 1.13, 2.56), and use of lipid-lowering medications (HR 1.70, 95% CI 1.13, 2.56) were among the traditional CV risk factors associated with increased CV risk. Among the PsD-related risk factors, psoriasis area and severity index (PASI) (HR 1.05, 95% CI 1.02, 1.08), erythrocyte sedimentation rate (ESR) (HR 1.02, 95% CI 1.01, 1.02), number of tender joints (HR 1.03, 95% CI 1.01, 1.05), number of swollen joints (HR 1.06, 95% CI 1.01, 1.12), health assessment questionnaire (HAQ) score (HR 1.63, 95% CI 1.23, 2.17), and daily use of non-steroidal anti-inflammatory drugs (NSAIDs) (HR 1.72, 95% CI 1.16, 2.55) were associated with increased CV risk. Use of biologic medications (HR 0.63, 95% CI 0.40, 1.00) was not found to be significantly protective against CV events.ConclusionIn patients with PsD, we identified six PsD-related risk factors that were significantly associated with incident CV events. These risk factors may be useful for the development of a PsD-specific CV risk prediction score that uses routine clinical assessments in combination with PsD-related biomarkers.References[1]Eder L, Wu Y, Chandran V, et al. Incidence and predictors for cardiovascular events in patients with psoriatic arthritis. Ann Rheum Dis 2016;75(9):1680-6.AcknowledgementsKeith Colaco is supported by the Enid Walker Estate, Women’s College Research Institute, and Arthritis Society (TGP-19-0446). Lihi Eder is supported by a Young Investigator Award from the Arthritis Society (YIA-16-394) and an Early Researcher Award from the Ontario Ministry of Science and Innovation. The Psoriatic Disease Program has been supported by a grant from the Krembil Foundation.Disclosure of InterestsNone declared.
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Waddington JC, Coleman O, Mease PJ, Chandran V, O'Sullivan D, FitzGerald O, Pennington SR. Basic Science Session 1. Biomarkers for Psoriatic Arthritis Treatment Response and Joint Damage Progression: An Update on 2 Industry-GRAPPA Projects. J Rheumatol 2022; 49:13-15. [PMID: 35365582 DOI: 10.3899/jrheum.211320] [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] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/07/2021] [Indexed: 11/22/2022]
Abstract
The Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA) has identified several priority areas for biomarker development, including biomarkers to predict at baseline which patients may progress to develop joint damage and whether a patient will respond to a specific targeted therapy. Two industry-GRAPPA projects were initiated in 2020 on these biomarker research areas: (1) the Pfizer-GRAPPA project, focused on biomarkers of treatment response to tofacitinib in the Oral Psoriatic Arthritis TriaL program; and (2) the Lilly-GRAPPA project, focused on biomarkers of damage in the ixekizumab SPIRIT-P1 randomized controlled trial. Preliminary results from these 2 projects were presented by the GRAPPA team, with both studies showing promising initial results. Data from these studies will be published when the studies have been completed. Large-scale validation studies are required and are under discussion.
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Affiliation(s)
- James C Waddington
- As part of the supplement series GRAPPA 2021, this report was reviewed internally and approved by the Guest Editors for integrity, accuracy, and consistency with scientific and ethical standards. Industry-GRAPPA projects were funded by Pfizer and Eli Lilly. J.C. Waddington, MBiolSci, PhD, O. Coleman, PhD, Atturos Ltd., Conway Institute of Biomolecular and Biomedical Research, University College Dublin, Dublin, Ireland; P.J. Mease, MD, MACR, Rheumatology Research, Swedish Medical Center/Providence St. Joseph Health, Washington, and University of Washington School of Medicine, Seattle, Washington, USA; V. Chandran, MBBS, MD, DM, PhD, Department of Medicine, Division of Rheumatology, University of Toronto, Toronto, and Krembil Research Institute, Toronto Western Hospital, Toronto, Ontario, Canada; D. O'Sullivan, BE, GRAPPA Patient Research Partner, Our Lady's Hospice & Care Services, Rheumatic & Musculoskeletal Disease Unit, Dublin, Ireland; O. FitzGerald, MD, FRCPI, FRCP, Consultant Rheumatologist and Newman Clinical Research Professor, S.R. Pennington, PhD, School of Medicine, Conway Institute for Biomolecular and Biomedical Research, University College Dublin, Dublin, Ireland. PJM has received research grants, consultation fees, and speaker honoraria from AbbVie, Amgen, Boehringer Ingelheim, BMS, Eli Lilly, Galapagos, Gilead, GSK, Janssen, Merck, Novartis, Pfizer, Sun Pharma, and UCB. VC has received consulting fees and/or speaking fees and/or honoraria from AbbVie, Amgen, BMS, Celgene, Eli Lilly, Janssen, Novartis, Pfizer, and UCB; his spouse is an employee of AstraZeneca and a former employee of Eli Lilly. OF has received research grants and/or consulting fees from AbbVie, Amgen, BMS, Celgene, Eli Lilly, Janssen, Novartis, Pfizer, and UCB. JCW, OC, DO, and SRP report no conflicts of interest. This paper does not require institutional review board approval. Address correspondence to Prof. S.R. Pennington, School of Medicine, Conway Institute of Biomolecular and Biomedical Research, University College Dublin, Belfield, Dublin 4, Ireland. . Accepted for publication December 7, 2021
| | - Orla Coleman
- As part of the supplement series GRAPPA 2021, this report was reviewed internally and approved by the Guest Editors for integrity, accuracy, and consistency with scientific and ethical standards. Industry-GRAPPA projects were funded by Pfizer and Eli Lilly. J.C. Waddington, MBiolSci, PhD, O. Coleman, PhD, Atturos Ltd., Conway Institute of Biomolecular and Biomedical Research, University College Dublin, Dublin, Ireland; P.J. Mease, MD, MACR, Rheumatology Research, Swedish Medical Center/Providence St. Joseph Health, Washington, and University of Washington School of Medicine, Seattle, Washington, USA; V. Chandran, MBBS, MD, DM, PhD, Department of Medicine, Division of Rheumatology, University of Toronto, Toronto, and Krembil Research Institute, Toronto Western Hospital, Toronto, Ontario, Canada; D. O'Sullivan, BE, GRAPPA Patient Research Partner, Our Lady's Hospice & Care Services, Rheumatic & Musculoskeletal Disease Unit, Dublin, Ireland; O. FitzGerald, MD, FRCPI, FRCP, Consultant Rheumatologist and Newman Clinical Research Professor, S.R. Pennington, PhD, School of Medicine, Conway Institute for Biomolecular and Biomedical Research, University College Dublin, Dublin, Ireland. PJM has received research grants, consultation fees, and speaker honoraria from AbbVie, Amgen, Boehringer Ingelheim, BMS, Eli Lilly, Galapagos, Gilead, GSK, Janssen, Merck, Novartis, Pfizer, Sun Pharma, and UCB. VC has received consulting fees and/or speaking fees and/or honoraria from AbbVie, Amgen, BMS, Celgene, Eli Lilly, Janssen, Novartis, Pfizer, and UCB; his spouse is an employee of AstraZeneca and a former employee of Eli Lilly. OF has received research grants and/or consulting fees from AbbVie, Amgen, BMS, Celgene, Eli Lilly, Janssen, Novartis, Pfizer, and UCB. JCW, OC, DO, and SRP report no conflicts of interest. This paper does not require institutional review board approval. Address correspondence to Prof. S.R. Pennington, School of Medicine, Conway Institute of Biomolecular and Biomedical Research, University College Dublin, Belfield, Dublin 4, Ireland. . Accepted for publication December 7, 2021
| | - Philip J Mease
- As part of the supplement series GRAPPA 2021, this report was reviewed internally and approved by the Guest Editors for integrity, accuracy, and consistency with scientific and ethical standards. Industry-GRAPPA projects were funded by Pfizer and Eli Lilly. J.C. Waddington, MBiolSci, PhD, O. Coleman, PhD, Atturos Ltd., Conway Institute of Biomolecular and Biomedical Research, University College Dublin, Dublin, Ireland; P.J. Mease, MD, MACR, Rheumatology Research, Swedish Medical Center/Providence St. Joseph Health, Washington, and University of Washington School of Medicine, Seattle, Washington, USA; V. Chandran, MBBS, MD, DM, PhD, Department of Medicine, Division of Rheumatology, University of Toronto, Toronto, and Krembil Research Institute, Toronto Western Hospital, Toronto, Ontario, Canada; D. O'Sullivan, BE, GRAPPA Patient Research Partner, Our Lady's Hospice & Care Services, Rheumatic & Musculoskeletal Disease Unit, Dublin, Ireland; O. FitzGerald, MD, FRCPI, FRCP, Consultant Rheumatologist and Newman Clinical Research Professor, S.R. Pennington, PhD, School of Medicine, Conway Institute for Biomolecular and Biomedical Research, University College Dublin, Dublin, Ireland. PJM has received research grants, consultation fees, and speaker honoraria from AbbVie, Amgen, Boehringer Ingelheim, BMS, Eli Lilly, Galapagos, Gilead, GSK, Janssen, Merck, Novartis, Pfizer, Sun Pharma, and UCB. VC has received consulting fees and/or speaking fees and/or honoraria from AbbVie, Amgen, BMS, Celgene, Eli Lilly, Janssen, Novartis, Pfizer, and UCB; his spouse is an employee of AstraZeneca and a former employee of Eli Lilly. OF has received research grants and/or consulting fees from AbbVie, Amgen, BMS, Celgene, Eli Lilly, Janssen, Novartis, Pfizer, and UCB. JCW, OC, DO, and SRP report no conflicts of interest. This paper does not require institutional review board approval. Address correspondence to Prof. S.R. Pennington, School of Medicine, Conway Institute of Biomolecular and Biomedical Research, University College Dublin, Belfield, Dublin 4, Ireland. . Accepted for publication December 7, 2021
| | - Vinod Chandran
- As part of the supplement series GRAPPA 2021, this report was reviewed internally and approved by the Guest Editors for integrity, accuracy, and consistency with scientific and ethical standards. Industry-GRAPPA projects were funded by Pfizer and Eli Lilly. J.C. Waddington, MBiolSci, PhD, O. Coleman, PhD, Atturos Ltd., Conway Institute of Biomolecular and Biomedical Research, University College Dublin, Dublin, Ireland; P.J. Mease, MD, MACR, Rheumatology Research, Swedish Medical Center/Providence St. Joseph Health, Washington, and University of Washington School of Medicine, Seattle, Washington, USA; V. Chandran, MBBS, MD, DM, PhD, Department of Medicine, Division of Rheumatology, University of Toronto, Toronto, and Krembil Research Institute, Toronto Western Hospital, Toronto, Ontario, Canada; D. O'Sullivan, BE, GRAPPA Patient Research Partner, Our Lady's Hospice & Care Services, Rheumatic & Musculoskeletal Disease Unit, Dublin, Ireland; O. FitzGerald, MD, FRCPI, FRCP, Consultant Rheumatologist and Newman Clinical Research Professor, S.R. Pennington, PhD, School of Medicine, Conway Institute for Biomolecular and Biomedical Research, University College Dublin, Dublin, Ireland. PJM has received research grants, consultation fees, and speaker honoraria from AbbVie, Amgen, Boehringer Ingelheim, BMS, Eli Lilly, Galapagos, Gilead, GSK, Janssen, Merck, Novartis, Pfizer, Sun Pharma, and UCB. VC has received consulting fees and/or speaking fees and/or honoraria from AbbVie, Amgen, BMS, Celgene, Eli Lilly, Janssen, Novartis, Pfizer, and UCB; his spouse is an employee of AstraZeneca and a former employee of Eli Lilly. OF has received research grants and/or consulting fees from AbbVie, Amgen, BMS, Celgene, Eli Lilly, Janssen, Novartis, Pfizer, and UCB. JCW, OC, DO, and SRP report no conflicts of interest. This paper does not require institutional review board approval. Address correspondence to Prof. S.R. Pennington, School of Medicine, Conway Institute of Biomolecular and Biomedical Research, University College Dublin, Belfield, Dublin 4, Ireland. . Accepted for publication December 7, 2021
| | - Denis O'Sullivan
- As part of the supplement series GRAPPA 2021, this report was reviewed internally and approved by the Guest Editors for integrity, accuracy, and consistency with scientific and ethical standards. Industry-GRAPPA projects were funded by Pfizer and Eli Lilly. J.C. Waddington, MBiolSci, PhD, O. Coleman, PhD, Atturos Ltd., Conway Institute of Biomolecular and Biomedical Research, University College Dublin, Dublin, Ireland; P.J. Mease, MD, MACR, Rheumatology Research, Swedish Medical Center/Providence St. Joseph Health, Washington, and University of Washington School of Medicine, Seattle, Washington, USA; V. Chandran, MBBS, MD, DM, PhD, Department of Medicine, Division of Rheumatology, University of Toronto, Toronto, and Krembil Research Institute, Toronto Western Hospital, Toronto, Ontario, Canada; D. O'Sullivan, BE, GRAPPA Patient Research Partner, Our Lady's Hospice & Care Services, Rheumatic & Musculoskeletal Disease Unit, Dublin, Ireland; O. FitzGerald, MD, FRCPI, FRCP, Consultant Rheumatologist and Newman Clinical Research Professor, S.R. Pennington, PhD, School of Medicine, Conway Institute for Biomolecular and Biomedical Research, University College Dublin, Dublin, Ireland. PJM has received research grants, consultation fees, and speaker honoraria from AbbVie, Amgen, Boehringer Ingelheim, BMS, Eli Lilly, Galapagos, Gilead, GSK, Janssen, Merck, Novartis, Pfizer, Sun Pharma, and UCB. VC has received consulting fees and/or speaking fees and/or honoraria from AbbVie, Amgen, BMS, Celgene, Eli Lilly, Janssen, Novartis, Pfizer, and UCB; his spouse is an employee of AstraZeneca and a former employee of Eli Lilly. OF has received research grants and/or consulting fees from AbbVie, Amgen, BMS, Celgene, Eli Lilly, Janssen, Novartis, Pfizer, and UCB. JCW, OC, DO, and SRP report no conflicts of interest. This paper does not require institutional review board approval. Address correspondence to Prof. S.R. Pennington, School of Medicine, Conway Institute of Biomolecular and Biomedical Research, University College Dublin, Belfield, Dublin 4, Ireland. . Accepted for publication December 7, 2021
| | - Oliver FitzGerald
- As part of the supplement series GRAPPA 2021, this report was reviewed internally and approved by the Guest Editors for integrity, accuracy, and consistency with scientific and ethical standards. Industry-GRAPPA projects were funded by Pfizer and Eli Lilly. J.C. Waddington, MBiolSci, PhD, O. Coleman, PhD, Atturos Ltd., Conway Institute of Biomolecular and Biomedical Research, University College Dublin, Dublin, Ireland; P.J. Mease, MD, MACR, Rheumatology Research, Swedish Medical Center/Providence St. Joseph Health, Washington, and University of Washington School of Medicine, Seattle, Washington, USA; V. Chandran, MBBS, MD, DM, PhD, Department of Medicine, Division of Rheumatology, University of Toronto, Toronto, and Krembil Research Institute, Toronto Western Hospital, Toronto, Ontario, Canada; D. O'Sullivan, BE, GRAPPA Patient Research Partner, Our Lady's Hospice & Care Services, Rheumatic & Musculoskeletal Disease Unit, Dublin, Ireland; O. FitzGerald, MD, FRCPI, FRCP, Consultant Rheumatologist and Newman Clinical Research Professor, S.R. Pennington, PhD, School of Medicine, Conway Institute for Biomolecular and Biomedical Research, University College Dublin, Dublin, Ireland. PJM has received research grants, consultation fees, and speaker honoraria from AbbVie, Amgen, Boehringer Ingelheim, BMS, Eli Lilly, Galapagos, Gilead, GSK, Janssen, Merck, Novartis, Pfizer, Sun Pharma, and UCB. VC has received consulting fees and/or speaking fees and/or honoraria from AbbVie, Amgen, BMS, Celgene, Eli Lilly, Janssen, Novartis, Pfizer, and UCB; his spouse is an employee of AstraZeneca and a former employee of Eli Lilly. OF has received research grants and/or consulting fees from AbbVie, Amgen, BMS, Celgene, Eli Lilly, Janssen, Novartis, Pfizer, and UCB. JCW, OC, DO, and SRP report no conflicts of interest. This paper does not require institutional review board approval. Address correspondence to Prof. S.R. Pennington, School of Medicine, Conway Institute of Biomolecular and Biomedical Research, University College Dublin, Belfield, Dublin 4, Ireland. . Accepted for publication December 7, 2021
| | - Stephen R Pennington
- As part of the supplement series GRAPPA 2021, this report was reviewed internally and approved by the Guest Editors for integrity, accuracy, and consistency with scientific and ethical standards. Industry-GRAPPA projects were funded by Pfizer and Eli Lilly. J.C. Waddington, MBiolSci, PhD, O. Coleman, PhD, Atturos Ltd., Conway Institute of Biomolecular and Biomedical Research, University College Dublin, Dublin, Ireland; P.J. Mease, MD, MACR, Rheumatology Research, Swedish Medical Center/Providence St. Joseph Health, Washington, and University of Washington School of Medicine, Seattle, Washington, USA; V. Chandran, MBBS, MD, DM, PhD, Department of Medicine, Division of Rheumatology, University of Toronto, Toronto, and Krembil Research Institute, Toronto Western Hospital, Toronto, Ontario, Canada; D. O'Sullivan, BE, GRAPPA Patient Research Partner, Our Lady's Hospice & Care Services, Rheumatic & Musculoskeletal Disease Unit, Dublin, Ireland; O. FitzGerald, MD, FRCPI, FRCP, Consultant Rheumatologist and Newman Clinical Research Professor, S.R. Pennington, PhD, School of Medicine, Conway Institute for Biomolecular and Biomedical Research, University College Dublin, Dublin, Ireland. PJM has received research grants, consultation fees, and speaker honoraria from AbbVie, Amgen, Boehringer Ingelheim, BMS, Eli Lilly, Galapagos, Gilead, GSK, Janssen, Merck, Novartis, Pfizer, Sun Pharma, and UCB. VC has received consulting fees and/or speaking fees and/or honoraria from AbbVie, Amgen, BMS, Celgene, Eli Lilly, Janssen, Novartis, Pfizer, and UCB; his spouse is an employee of AstraZeneca and a former employee of Eli Lilly. OF has received research grants and/or consulting fees from AbbVie, Amgen, BMS, Celgene, Eli Lilly, Janssen, Novartis, Pfizer, and UCB. JCW, OC, DO, and SRP report no conflicts of interest. This paper does not require institutional review board approval. Address correspondence to Prof. S.R. Pennington, School of Medicine, Conway Institute of Biomolecular and Biomedical Research, University College Dublin, Belfield, Dublin 4, Ireland. . Accepted for publication December 7, 2021
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Castillo RL, Yan D, Ashhurst AS, Elliott A, Angioni MM, Scher JU, Naik S, Neimann A, Byrne SN, Payne RJ, FitzGerald O, Pennington SR, Cauli A, Chandran V. GRAPPA 2020 Research Award Recipients. J Rheumatol 2022; 49:55-56. [DOI: 10.3899/jrheum.211335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/07/2021] [Indexed: 10/18/2022]
Abstract
At the 2021 Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA) annual meeting, a summary of the research conducted by the recipients of the 2020 GRAPPA Research Awards was presented by the awardees. The summary of the 4 presentations is provided here.
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Colaco K, Lee KA, Akhtari S, Winer R, Welsh P, Sattar N, McInnes IB, Chandran V, Harvey P, Cook RJ, Gladman DD, Piguet V, Eder L. Association of Cardiac Biomarkers With Cardiovascular Outcomes in Patients With Psoriatic Arthritis and Psoriasis: A Longitudinal Cohort Study. Arthritis Rheumatol 2022; 74:1184-1192. [PMID: 35261189 PMCID: PMC9545279 DOI: 10.1002/art.42079] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Revised: 12/08/2021] [Accepted: 01/25/2022] [Indexed: 11/20/2022]
Abstract
Objective In patients with psoriatic disease (PsD), we determined whether cardiac troponin I (cTnI) and N‐terminal pro–brain natriuretic peptide (NT‐proBNP) were associated with carotid plaque burden and the development of cardiovascular events independent of the Framingham Risk Score (FRS). Methods Among 1,000 patients with PsD, carotid total plaque area (TPA) was measured in 358 participants at baseline. Cardiac troponin I and NT‐proBNP were measured using automated clinical assays. The association between cardiac biomarkers and carotid atherosclerosis was assessed by multivariable regression after adjusting for cardiovascular risk factors. Improvement in the prediction of cardiovascular events beyond the FRS was tested using measures of risk discrimination and reclassification. Results In univariate analyses, cTnI (β coefficient 0.52 [95% confidence interval (95% CI) 0.3, 0.74], P < 0.001) and NT‐proBNP (β coefficient 0.24 [95% CI 0.1, 0.39], P < 0.001) were associated with TPA. After adjusting for cardiovascular risk factors, the association remained statistically significant for cTnI (adjusted β coefficient 0.21 [95% CI 0, 0.41], P = 0.047) but not for NT‐proBNP (P = 0.21). Among the 1,000 patients with PsD assessed for cardiovascular risk prediction, 64 patients had incident cardiovascular events. When comparing a base model (with the FRS alone) to expanded models (with the FRS plus cardiac biomarkers), there was no improvement in predictive performance. Conclusion In patients with PsD, cTnI may reflect the burden of atherosclerosis, independent of traditional cardiovascular risk factors. Cardiac troponin I and NT‐proBNP are associated with incident cardiovascular events independent of the FRS, but further study of their role in cardiovascular risk stratification is warranted.
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Affiliation(s)
- Keith Colaco
- Women's College Hospital, University of Toronto, and University Health Network, Toronto, Ontario, Canada
| | - Ker-Ai Lee
- University of Waterloo, Waterloo, Ontario, Canada
| | - Shadi Akhtari
- Women's College Hospital and University of Toronto, Toronto, Ontario, Canada
| | - Raz Winer
- Rambam Health Care Campus, Haifa, Israel
| | | | | | | | - Vinod Chandran
- University of Toronto and University Health Network Toronto, Ontario, Canada
| | - Paula Harvey
- Women's College Hospital and University of Toronto, Toronto, Ontario, Canada
| | | | - Dafna D Gladman
- University of Toronto and University Health Network Toronto, Ontario, Canada
| | - Vincent Piguet
- Women's College Hospital and University of Toronto, Toronto, Ontario, Canada
| | - Lihi Eder
- Women's College Hospital and University of Toronto, Toronto, Ontario, Canada
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Eder L, Li Q, Rahmati S, Rahman P, Jurisica I, Chandran V. Defining imaging sub-phenotypes of psoriatic arthritis: integrative analysis of imaging data and gene expression in a PsA patient cohort. Rheumatology (Oxford) 2022; 61:4952-4961. [PMID: 35157043 PMCID: PMC9707284 DOI: 10.1093/rheumatology/keac078] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 09/29/2021] [Revised: 01/07/2022] [Indexed: 01/11/2023] Open
Abstract
OBJECTIVES To define imaging sub-phenotypes in patients with PsA; determine their association with whole blood gene expression and identify biological pathways characterizing the sub-phenotypes. METHODS Fifty-five patients with PsA ready to initiate treatment for active disease were prospectively recruited. We performed musculoskeletal ultrasound assessment of the extent of inflammation in the following domains: synovitis, peritenonitis, tenosynovitis and enthesitis. Peripheral whole blood was profiled with RNAseq, and gene expression data were obtained. First, unsupervised cluster analysis was performed to define imaging sub-phenotypes that reflected the predominant tissue involved. Subsequently, principal component analysis was used to determine the association between imaging-defined sub-phenotypes and peripheral blood gene expression profile. Pathway enrichment analysis was performed to identify underlying mechanisms that characterize individual sub-phenotypes. RESULTS Cluster analysis revealed three imaging sub-phenotypes: (i) synovitis predominant [n = 31 (56%)]; (ii) enthesitis predominant [n = 13 (24%)]; (iii) peritenonitis predominant [n = 11 (20%)]. The peritenonitis-predominant sub-phenotype had the most severe clinical joint involvement, whereas the enthesitis-predominant sub-phenotype had the highest tender entheseal count. Unsupervised clustering of gene expression data identified three sub-phenotypes that partially overlapped with the imaging sub-phenotypes suggesting biological and clinical relevance of these sub-phenotypes. We therefore characterized enriched differential pathways, which included: immune system (innate system, B cells and neutrophil degranulation), complement system, platelet activation and coagulation function. CONCLUSIONS We identified three sub-phenotypes based on the predominant tissue involved in patients with active PsA. Distinct biological pathways may underlie these imaging sub-phenotypes seen in PsA, suggesting their biological and clinical importance.
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Affiliation(s)
- Lihi Eder
- Correspondence to: Lihi Eder, Women’s College Research Institute, Room 6326, Women’s College Hospital, 76 Grenville Street, Toronto, Ontario M5S 1B2, Canada. E-mail:
| | - Quan Li
- Princess Margaret Cancer Centre, University Health Network, University of Toronto
| | - Sara Rahmati
- Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, Toronto, ON
| | - Proton Rahman
- Rheumatology Division, Department of Medicine, Memorial University, St. John’s, NL
| | - Igor Jurisica
- Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, Toronto, ON,Departments of Medical Biophysics and Computer Science, Faculty of Dentistry University of Toronto, ON, Canada,Institute of Neuroimmunology, Slovak Academy of Sciences, Bratislava, Slovakia
| | - Vinod Chandran
- Rheumatology Division, Department of Medicine,Institute of Medical Science,Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, Toronto, ON,Rheumatology Division, Department of Medicine, Memorial University, St. John’s, NL,Department of Laboratory Medicine and Pathobiology, University of Toronto, ON, Canada
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Koussiouris J, Chandran V. Autoantibodies in Psoriatic Disease. J Appl Lab Med 2022; 7:281-293. [PMID: 34996072 DOI: 10.1093/jalm/jfab120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2021] [Accepted: 09/13/2021] [Indexed: 11/14/2022]
Abstract
BACKGROUND Psoriasis (Ps) is an inflammatory skin disease affecting over 8 million people in the USA and Canada. Approximately a quarter of patients with Ps have an inflammatory arthritis termed psoriatic arthritis (PsA). Psoriatic disease encompassing both Ps and PsA is regarded as an immune-mediated inflammatory disease, exhibiting both autoimmune and autoinflammatory features. Innate immune cell activation promotes inflammation and the cellular infiltrate in inflamed tissue is predominantly lymphocytic. CONTENT A narrative review of the current literature on the presence and clinical significance of autoantibodies found in psoriatic disease are presented. The frequency of several autoantibodies in Ps and PsA patients as well as their association with disease diagnosis, disease activity, and treatment response are reviewed. SUMMARY Despite historically described as a rheumatoid factor negative (seronegative) disease, an array of autoantibodies has been identified in patients with psoriatic disease. Many of the autoantibodies reviewed are elevated in Ps and PsA patients and are associated with disease activity, treatment response, and cardiovascular disease risk. The identification of autoantibodies in Ps and PsA patients points to an autoimmune component potentially playing a role in psoriatic disease; however, additional evidence is needed to determine the clinical utility of these autoantibodies and their contribution to disease pathogenesis.
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Affiliation(s)
- John Koussiouris
- Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, Toronto, Ontario, Canada
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada
| | - Vinod Chandran
- Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, Toronto, Ontario, Canada
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada
- Division of Rheumatology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
- Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada
- Department of Medicine, Memorial University, St. John's, Newfoundland and Labrador, Canada
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Pratheeksha ., Chandran V, Rao GM, Rao D. Correlation of CA 19-9 with HbA1c in prediabetic and diabetic groups. Biomedicine (Taipei) 2021. [DOI: 10.51248/.v41i4.909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Introduction and Aim: Carbohydrate antigen19-9 (CA 19-9) is a marker of pancreatic cancer. In diabetics, pancreatic beta cell dysfunction can lead to elevated serum CA19-9 level. This study was designed for estimation of CA19-9 in diabetes and its correlation with glucose levels and glycosylated hemoglobin.
Materials and Methods: The includes diabetic, pre diabetic with no history of malignancies and healthy normal subjects (n=50 each). Ca19-9 was estimated using ELISA, HbA1c by D10-Biorad variant turbo and the Lipid profile in Roche COBAs 6000 auto analyzer. Statistical analysis was done by Statistical Package for Social Sciences software version17 (SPSS 17). P <0.05 was considered significant.
Results: Serum CA19-9 level was high in diabetics compared to normal, (p=0.38) however it was decreased in pre diabetic group (P=0.06). There was significant difference in comparison of CA19-9 levels between pre diabetic and diabetics(p=0.001). A significant increase in triglycerides was observed both in diabetics (p<0.01) and pre-diabetics(p=0.04). There was a significant positive correlation of CA19-9 with TC/HDL (p=0.022) and non-HDL(p) in control group.
Conclusion: CA19-9 levels can be influenced by glycemic status, hence assessment of pancreatic cancer in diabetic patients must be interpreted carefully in consideration with CA19-9 levels. CA19-9 level was decreased in prediabetics when compared to normal and diabetics. This is a novel finding, the cause for which must ascertained, and this will open further avenues for research.
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Poddubnyy D, Baraliakos X, Van den Bosch F, Braun J, Coates LC, Chandran V, Diekhoff T, van Gaalen FA, Gensler LS, Goel N, Gottlieb AB, van der Heijde D, Helliwell PS, Hermann KGA, Jadon D, Lambert RG, Maksymowych WP, Mease P, Nash P, Proft F, Protopopov M, Sieper J, Torgutalp M, Gladman DD. Axial Involvement in Psoriatic Arthritis cohort (AXIS): the protocol of a joint project of the Assessment of SpondyloArthritis international Society (ASAS) and the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA). Ther Adv Musculoskelet Dis 2021; 13:1759720X211057975. [PMID: 34987619 PMCID: PMC8721378 DOI: 10.1177/1759720x211057975] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Accepted: 10/14/2021] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND Involvement of the axial skeleton (sacroiliac joints and spine) is a relatively frequent manifestation associated with psoriatic skin disease, mostly along with involvement of peripheral musculoskeletal structures (peripheral arthritis, enthesitis, dactylitis), which are referred to as psoriatic arthritis (PsA). Data suggest that up to 30% of patients with psoriasis have PsA. Depending on the definition used, the prevalence of axial involvement varies from 25% to 70% of patients with PsA. However, there are currently no widely accepted criteria for axial involvement in PsA.Objective: The overarching aim of the Axial Involvement in Psoriatic Arthritis (AXIS) study is to systematically evaluate clinical and imaging manifestations indicative of axial involvement in patients with PsA and to develop classification criteria and a unified nomenclature for axial involvement in PsA that would allow defining a homogeneous subgroup of patients for research. DESIGN Prospective, multicenter, multinational, cross-sectional study. METHODS AND ANALYSES In this multicenter, multinational, cross-sectional study, eligible patients [adult patients diagnosed with PsA and fulfilling Classification Criteria for Psoriatic Arthritis (CASPAR) with musculoskeletal symptom duration of ⩽10 years not treated with biological or targeted synthetic disease-modifying anti-rheumatic drugs] will be recruited prospectively. They will undergo study-related clinical and imaging examinations. Imaging will include radiography and magnetic resonance imaging examinations of sacroiliac joints and spine. Local investigators will evaluate for the presence of axial involvement based on clinical and imaging information which will represent the primary outcome of the study. In addition, imaging will undergo evaluation by central review. Finally, the central clinical committee will determine the presence of axial involvement based on all available information. ETHICS The study will be performed according to the ethical principles of the Declaration of Helsinki and International Council for Harmonisation Good Clinical Practice guidelines. The study protocol will be approved by the individual Independent Ethics Committee / Institutional Review Board of participating centers. Written informed consent will be obtained from all included patients.Registration: ClinicalTrials.gov ID: NCT04434885.
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Affiliation(s)
- Denis Poddubnyy
- Department of Gastroenterology, Infectious Diseases and Rheumatology (including Nutrition Medicine), Charité – Universitätsmedizin Berlin, Campus Benjamin Franklin, Hindenburgdamm 30, 12203 Berlin, Germany
| | | | - Filip Van den Bosch
- Department of Internal Medicine and Pediatrics, Ghent University, VIB Center for Inflammation Research, Ghent, Belgium
| | - Jürgen Braun
- Rheumazentrum Ruhrgebiet Herne, Ruhr-University Bochum, Bochum, Germany
| | - Laura C. Coates
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Vinod Chandran
- Division of Rheumatology, Department of Medicine, University of Toronto, Schroeder Arthritis Institute, Krembil Research Institute, Toronto Western Hospital, Toronto, ON, Canada
| | - Torsten Diekhoff
- Department of Radiology, Charité – Universitätsmedizin Berlin, Berlin, Germany
| | - Floris A. van Gaalen
- Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands
| | - Lianne S. Gensler
- Division of Rheumatology, Department of Medicine, University of California San Francisco, San Francisco, CA, USA
| | - Niti Goel
- Patient Research Partner; Abcuro, Inc., Newton, MA, USA; Division of Rheumatology, Department of Medicine, Duke University School of Medicine, Durham, NC, USA
| | - Alice B. Gottlieb
- Department of Dermatology, Mount Sinai-Beth Israel Hospital, Icahn School of Medicine, New York, NY, USA
| | | | - Philip S. Helliwell
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Chapel Allerton Hospital, Leeds, UK
| | | | - Deepak Jadon
- Department of Medicine, University of Cambridge, Cambridge, UK
| | - Robert G. Lambert
- Department of Radiology and Diagnostic Imaging, University of Alberta, Edmonton, AB, Canada; Medical Imaging Consultants, Edmonton, AB, Canada
| | - Walter P. Maksymowych
- Department of Medicine, University of Alberta, Edmonton, AB, Canada; CARE Arthritis, Edmonton, AB, Canada
| | - Philip Mease
- Division of Rheumatology Research, Swedish Medical Center/Providence St. Joseph Health and University of Washington School of Medicine, Seattle, WA, USA
| | - Peter Nash
- School of Medicine, Griffith University, Brisbane, QLD, Australia
| | - Fabian Proft
- Department of Gastroenterology, Infectious Diseases and Rheumatology (including Nutrition Medicine), Charité – Universitätsmedizin Berlin, Berlin, Germany
| | - Mikhail Protopopov
- Department of Gastroenterology, Infectious Diseases and Rheumatology (including Nutrition Medicine), Charité – Universitätsmedizin Berlin, Berlin, Germany
| | - Joachim Sieper
- Department of Gastroenterology, Infectious Diseases and Rheumatology (including Nutrition Medicine), Charité – Universitätsmedizin Berlin, Berlin, Germany
| | - Murat Torgutalp
- Department of Gastroenterology, Infectious Diseases and Rheumatology (including Nutrition Medicine), Charité – Universitätsmedizin Berlin, Berlin, Germany
| | - Dafna D. Gladman
- Division of Rheumatology, Department of Medicine, University of Toronto, Schroeder Arthritis Institute, Krembil Research Institute, Toronto Western Hospital, Toronto, ON, Canada
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Abji F, Rasti M, Gómez-Aristizábal A, Muytjens C, Saifeddine M, Mihara K, Motahhari M, Gandhi R, Viswanathan S, Hollenberg MD, Oikonomopoulou K, Chandran V. Corrigendum: Proteinase-Mediated Macrophage Signaling in Psoriatic Arthritis. Front Immunol 2021; 12:814072. [PMID: 34975926 PMCID: PMC8715513 DOI: 10.3389/fimmu.2021.814072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Accepted: 11/18/2021] [Indexed: 11/14/2022] Open
Affiliation(s)
- Fatima Abji
- Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, Toronto, ON, Canada
| | - Mozhgan Rasti
- Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, Toronto, ON, Canada
| | | | - Carla Muytjens
- Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, Toronto, ON, Canada
| | - Mahmoud Saifeddine
- Department of Physiology & Pharmacology, University of Calgary Cumming School of Medicine, Calgary, AB, Canada
| | - Koichiro Mihara
- Department of Physiology & Pharmacology, University of Calgary Cumming School of Medicine, Calgary, AB, Canada
| | - Majid Motahhari
- Department of Physiology & Pharmacology, University of Calgary Cumming School of Medicine, Calgary, AB, Canada
| | - Rajiv Gandhi
- Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, Toronto, ON, Canada
- Division of Orthopaedic Surgery, Department of Surgery, Toronto Western Hospital, Toronto, ON, Canada
| | - Sowmya Viswanathan
- Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, Toronto, ON, Canada
- Institute of Biomedical Engineering, University of Toronto, Toronto, ON, Canada
- Division of Hematology, Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - Morley D. Hollenberg
- Department of Physiology & Pharmacology, University of Calgary Cumming School of Medicine, Calgary, AB, Canada
- Department of Medicine, University of Calgary Cumming School of Medicine, Calgary, AB, Canada
| | - Katerina Oikonomopoulou
- Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, Toronto, ON, Canada
- *Correspondence: Katerina Oikonomopoulou, ; Vinod Chandran,
| | - Vinod Chandran
- Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, Toronto, ON, Canada
- Division of Rheumatology, Department of Medicine, University of Toronto, Toronto, ON, Canada
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada
- Department of Medicine, Memorial University of Newfoundland, St. John’s, NL, Canada
- *Correspondence: Katerina Oikonomopoulou, ; Vinod Chandran,
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Murray S, Crowley J, Gooderham MJ, Kivitz A, Chandran V, Péloquin S, Doghramji PP, Freeman C, Lazure P. Healthcare Providers Face Numerous Challenges in Treating Patients with Psoriasis: Results from a Mixed-Methods Study. Journal of Psoriasis and Psoriatic Arthritis 2021. [DOI: 10.1177/24755303211062887] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Background The paradigm shift toward biologic medications in psoriasis care requires healthcare providers (HCPs) to become acquainted with mechanisms of action and safety profiles of these new treatments to confidently use them in practice. A better understanding of this paradigm shift is necessary to provide adequate education for HCPs in psoriasis care. Objectives This study assessed clinical practice gaps and challenges experienced by HCPs caring for patients with psoriasis. Methods A mixed-methods approach was used to identify practice gaps and clinical challenges of dermatologists, rheumatologists, primary care physicians, physician assistants, and nurse practitioners with various levels of clinical experience in academic and community-based settings. Qualitative and quantitative data were collected sequentially. Interviews were transcribed and thematically analyzed. Results A total of 380 psoriasis care providers in Canada and the US participated in this study. Analysis revealed challenges in establishing an accurate diagnosis of psoriasis (including screening for sub-type and distinguishing psoriasis from other skin conditions), selecting treatment (particularly regarding recently approved treatments), monitoring side effects, and collaborating with other HCPs involved in psoriasis care. Conclusion These findings highlight educational needs of HCPs involved in psoriasis care that could have repercussions on accurate and timely diagnosis of the condition, treatment initiation, side effect monitoring, and continuity of care. Findings provide a starting point for clinicians to reflect on their practice and for the improvement of continuing professional development interventions that would bridge these gaps.
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Affiliation(s)
| | - Jeffrey Crowley
- Bakersfield Dermatology and Skin Cancer Medical Group, Bakersfield, CA, USA
| | | | - Alan Kivitz
- Altoona Center for Clinical Research, Duncansville, PA, USA
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Taylor JH, Deo M, Sutton M, Chandran V, Shanmugarajah S, Pereira D, Gladman DD, Rosen CF. Assessment of the Toronto Psoriatic Arthritis Screen 2 as a Screening Tool for Psoriasis. J Cutan Med Surg 2021; 26:237-242. [PMID: 34841919 DOI: 10.1177/12034754211061085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Psoriasis is a chronic inflammatory disease affecting multiple organ systems and resulting in reduced quality of life for many patients. A screening tool would be useful, particularly in underserviced or research settings with limited access to dermatologists. The Toronto Psoriatic Arthritis Screen, version 2 (ToPAS 2) is a validated screening tool for psoriatic arthritis containing questions specific for psoriasis. OBJECTIVES To evaluate the performance of skin-specific questions from ToPAS 2 for the diagnosis of psoriasis. METHODS Participants aged >18 were recruited from Dermatology and Family Medicine clinics and completed the ToPAS 2 questionnaire prior to being examined by a dermatologist for psoriasis. Two scoring indexes were derived from the ToPAS 2 skin-related questions using backward selection regression models. Statistical analysis was performed using receiver operating characteristic (ROC) curves to measure their performances. RESULTS Two hundred and fifty eight participants were recruited. 32 (12%) were diagnosed with psoriasis by dermatologist assessment. Index 1 includes all 5 skin-related questions from ToPAS 2, while Index 2 includes three of the five questions. Both indexes demonstrate high specificity (82% to 92%), sensitivity (69% to 84%), and excellent negative predictive value (NPV) (>95%) for a diagnosis of psoriasis. The overall discriminatory power of these models is 0.823 (Index 1) and 0.875 (Index 2). CONCLUSIONS Skin-related questions from ToPAS 2 have discriminatory value in detecting psoriasis, specifically questions relating to a family history, a prior physician diagnosis of psoriasis or a rash consistent with images of plaque psoriasis. This study is a valuable step in developing a screening tool for psoriasis.
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Affiliation(s)
- Jennifer H Taylor
- 26625 Division of Dermatology, Department of Medicine, Toronto Western Hospital, ON, Canada
| | - Maneka Deo
- 26625 Division of Dermatology, Department of Medicine, Toronto Western Hospital, ON, Canada
| | - Mitchell Sutton
- 574808 Department of Rheumatology, Toronto Western Hospital, ON, Canada
| | - Vinod Chandran
- 574808 Department of Rheumatology, Toronto Western Hospital, ON, Canada
| | | | - Daniel Pereira
- 574808 Department of Rheumatology, Toronto Western Hospital, ON, Canada
| | - Dafna D Gladman
- 574808 Department of Rheumatology, Toronto Western Hospital, ON, Canada
| | - Cheryl F Rosen
- 26625 Division of Dermatology, Department of Medicine, Toronto Western Hospital, ON, Canada
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