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2. Using a Discrete-Choice Experiment in a Decision Aid to Nudge Patients Towards Value-Concordant Treatment Choices in Rheumatoid Arthritis: A Proof-of-Concept Study

Author

Hazlewood GS, Marshall DA, Barber CEH, Li LC, Barnabe C, Bykerk V, Tugwell P, Hull PM, and Bansback N

Subjects
conjoint analysis, decision tool, value concordance, methotrexate, Medicine (General), R5-920
Abstract

Glen S Hazlewood,1– 3 Deborah A Marshall,1– 3 Claire EH Barber,1– 3 Linda C Li,3 Cheryl Barnabe,1– 3 Vivian Bykerk,4,5 Peter Tugwell,6 Pauline M Hull,7 Nick Bansback3,8 1Departments of Medicine and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Canada; 2McCaig Institute of Bone and Joint Health, University of Calgary, Calgary, Canada; 3Arthritis Research Canada, Vancouver, BC, Canada; 4Weill Cornell Medical College, Cornell University, New York, NY, USA; 5Department of Rheumatology, Hospital for Special Surgery, New York, NY, USA; 6Department of Medicine, Department of Epidemiology and Community Medicine, Canada Research Chair, University of Ottawa, Institute of Population Health, Ottawa, Canada; 7University of Calgary, Calgary, Canada; 8Faculty of Medicine, School of Population and Public Health, University of British Columbia, Vancouver, CanadaCorrespondence: Glen S HazlewoodDepartments of Medicine and Community Health Sciences, University of Calgary, 3280 Hospital Drive NW, 3AA10, Calgary AB T2N 4Z6, CanadaTel +1 403 220-5903Fax +1 403 210-3899Email gshazlew@ucalgary.caPurpose: To evaluate, in a proof-of-concept study, a decision aid that incorporates hypothetical choices in the form of a discrete-choice experiment (DCE), to help patients with early rheumatoid arthritis (RA) understand their values and nudge them towards a value-centric decision between methotrexate and triple therapy (a combination of methotrexate, sulphasalazine and hydroxychloroquine).Patients and Methods: In the decision aid, patients completed a series of 6 DCE choice tasks. Based on the patient’s pattern of responses, we calculated his/her probability of choosing each treatment, using data from a prior DCE. Following pilot testing, we conducted a cross-sectional study to determine the agreement between the predicted and final stated preference, as a measure of value concordance. Secondary outcomes including time to completion and usability were also evaluated.Results: Pilot testing was completed with 10 patients and adjustments were made. We then recruited 29 patients to complete the survey: median age 57, 55% female. The patients were all taking treatment and had well-controlled disease. The predicted treatment agreed with the final treatment chosen by the patient 21/29 times (72%), similar to the expected agreement from the mean of the predicted probabilities (68%). Triple therapy was the predicted treatment 24/29 times (83%) and chosen 20/29 (69%) times. Half of the patients (51%) agreed that completing the choice questions helped them to understand their preferences (38% neutral, 10% disagreed). The tool took an average of 15 minutes to complete, and median usability scores were 55 (system usability scale) indicating “OK” usability.Conclusion: Using a DCE as a value-clarification task within a decision aid is feasible, with promising potential to help nudge patients towards a value-centric decision. Usability testing suggests further modifications are needed prior to implementation, perhaps by having the DCE exercises as an “add-on” to a simpler decision aid.Keywords: conjoint analysis, decision tool, value concordance, methotrexate

Published
2020

5. Evidence for clonal propagation in natural isolates of Plasmodium falciparum from Venezuela.

Author

Urdaneta, L, Lal, A, Barnabe, C, Oury, B, Goldman, I, Ayala, FJ, and Tibayrenc, M

Subjects
Animals, Plasmodium falciparum, Random Amplified Polymorphic DNA Technique, Seasons, Phylogeny, Genotype, Linkage Disequilibrium, Polymorphism, Genetic, Venezuela
Abstract

We have analyzed 75 isolates of Plasmodium falciparum, collected in Venezuela during both the dry (November) and rainy (May-July) seasons, with a range of genetic markers including antigen genes and 14 random amplified polymorphic DNA (RAPD) primers. Thirteen P. falciparum stocks from Kenya and four other Plasmodium species are included in the analysis for comparison. Cross-hybridization shows that the 14 RAPD primers reveal 14 separate regions of the parasite's genome. The P. falciparum isolates are a monophyletic clade, significantly different from the other Plasmodium species. We identify three RAPD characters that could be useful as "tags" for rapid species identification. The Venezuelan genotypes fall into two discrete genetic subdivisions associated with either the dry or the rainy season; the isolates collected in the rainy season exhibit greater genetic diversity. There is significant linkage disequilibrium in each seasonal subsample and in the full sample. In contrast, no linkage disequilibrium is detected in the African sample. These results support the hypothesis that the population structure of P. falciparum in Venezuela, but not in Africa, is predominantly clonal. However, the impact of genetic recombination on Venezuelan P. falciparum seems higher than in parasitic species with long-term clonal evolution like Trypanosoma cruzi, the agent of Chagas' disease. The genetic structure of the Venezuelan samples is similar to that of Escherichia coli, a bacterium that propagates clonally, with occasional genetic recombination.

Published
2001

8. POS0111 MORE METICULOUSLY FOLLOWING TREAT-TO-TARGET IN RA DOES NOT LEAD TO LESS RADIOGRAPHIC PROGRESSION: A LONGITUDINAL ANALYSIS IN BIODAM

Author

Ramiro, S., primary, Landewé, R. B. M., additional, Van der Heijde, D., additional, Sepriano, A., additional, Fitzgerald, O., additional, Østergaard, M., additional, Homik, J., additional, Elkayam, O., additional, Thorne, C., additional, Larché, M., additional, Ferraccioli, G., additional, Backhaus, M., additional, Boire, G., additional, Combe, B., additional, Schaeverbeke, T., additional, Saraux, A., additional, Dougados, M., additional, Rossini, M., additional, Govoni, M., additional, Sinigaglia, L., additional, Cantagrel, A., additional, Allaart, C., additional, Barnabe, C., additional, Bingham, C., additional, Van Schaardenburg, D., additional, Hammer, H. B., additional, Dadashova, R., additional, Hutchings, E., additional, Paschke, J., additional, and Maksymowych, W. P., additional

Published
2022
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9. Contributors

Author

Anderson, Tavis K., Arenas, Miguel, Ayouba, Ahidjo, Barnabé, C., Beshir, Khalid B., Beveridge, Ian, Binyang, Achille, Biron, David G., Brenière, S.F., Cambau, Emmanuelle, Cancino-Muñoz, Irving, Castro-Nallar, Eduardo, Challagundla, Lavanya, Chilton, Neil B., Cochran, G., Cohan, Frederick M., Davidson, Josiah Levi, Delaporte, Eric, Dorn, P.L., Droit, Arnaud, D'arc, Mirela, Dujardin, Jean-Pierre, Etang, Josiane, Etienne, Lucie, García-González, Neris, Gasser, Robin B., Geddes-McAlister, Jennifer, Gibson, Wendy, Gonzalo-Asensio, Jesús, González-Candelas, Fernando, Gostinčar, Cene, Gunde-Cimerman, Nina, Guyeux, Christophe, Hanage, William P., Harpending, H., Holzmuller, Philippe, Houldcroft, Charlotte J., Hu, Ben, Izenour, Katie, Kamel, Mohamed, Kaur, Simerdeep, Kelly, Brenyn, Kopac, Sarah, Kumar, Virendra, La, Kevin, Lewis, Michael D., Liu, Yu-Tsueng, Mbakop, Lili Ranaise, McClure, JoAnn, Medina, Rafael A., Miles, Michael A., Missé, Dorothée, Mokrousov, Igor, Morand, Serge, Munds, Rachel A., Nedelkov, Dobrin, Nelson, Martha I., Nwane, Philippe, Panzera, F., Pardos, Elena Campos, Peeters, Martine, Pita, S., Polley, Spencer D., Pérez-Losada, Marcos, Qiu, Xueting, Refrégier, Guislaine, Robinson, D. Ashley, Roux-Dalvai, Florence, Sahal, Muhammed Rabiu, Sanjuán, Rafael, Senelle, Gaetan, Senghore, Madikay, Seral, Juan Calvet, Shi, Zhengli, Sironi, Manuela, Sola, Christophe, Solano, Philippe, Sánchez-Busó, Leonor, Sutherland, Colin J., Tibayrenc, Michel, van Belkum, Alex, Van Regenmortel, Marc H.V., Verma, Mohit S., Vernet, Guy, Waleckx, E., Wang, Lin-Fa, Wang, Jiangshan, Wille, Michelle, Yeo, Matthew, Zhang, Kunyan, and Zohdy, Sarah

Published
2024
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11. High-Resolution Peripheral Quantitative Computed Tomography for Bone Evaluation in Inflammatory Rheumatic Disease.

Author

Klose-Jensen, R, Tse, JJ, Keller, KK, Barnabe, C, Burghardt, AJ, Finzel, S, Tam, L-S, Hauge, E-M, Stok, KS, Manske, SL, Klose-Jensen, R, Tse, JJ, Keller, KK, Barnabe, C, Burghardt, AJ, Finzel, S, Tam, L-S, Hauge, E-M, Stok, KS, and Manske, SL

Abstract

High resolution peripheral quantitative computed tomography (HR-pQCT) is a 3-dimensional imaging modality with superior sensitivity for bone changes and abnormalities. Recent advances have led to increased use of HR-pQCT in inflammatory arthritis to report quantitative volumetric measures of bone density, microstructure, local anabolic (e.g., osteophytes, enthesiophytes) and catabolic (e.g., erosions) bone changes and joint space width. These features may be useful for monitoring disease progression, response to therapy, and are responsive to differentiating between those with inflammatory arthritis conditions and healthy controls. We reviewed 69 publications utilizing HR-pQCT imaging of the metacarpophalangeal (MCP) and/or wrist joints to investigate arthritis conditions. Erosions are a marker of early inflammatory arthritis progression, and recent work has focused on improvement and application of techniques to sensitively identify erosions, as well as quantifying erosion volume changes longitudinally using manual, semi-automated and automated methods. As a research tool, HR-pQCT may be used to detect treatment effects through changes in erosion volume in as little as 3 months. Studies with 1-year follow-up have demonstrated progression or repair of erosions depending on the treatment strategy applied. HR-pQCT presents several advantages. Combined with advances in image processing and image registration, individual changes can be monitored with high sensitivity and reliability. Thus, a major strength of HR-pQCT is its applicability in instances where subtle changes are anticipated, such as early erosive progression in the presence of subclinical inflammation. HR-pQCT imaging results could ultimately impact decision making to uptake aggressive treatment strategies and prevent progression of joint damage. There are several potential areas where HR-pQCT evaluation of inflammatory arthritis still requires development. As a highly sensitive imaging technique, one of th

Published
2020

12. Consensus approach for 3D joint space width of metacarpophalangeal joints of rheumatoid arthritis patients using high-resolution peripheral quantitative computed tomography

Author

Stok, KS, Burghardt, AJ, Boutroy, S, Peters, MPH, Manske, SL, Stadelmann, V, Vilayphiou, N, van den Bergh, JP, Geusens, P, Li, X, Marotte, H, van Rietbergen, B, Boyd, SK, Barnabe, C, Stok, KS, Burghardt, AJ, Boutroy, S, Peters, MPH, Manske, SL, Stadelmann, V, Vilayphiou, N, van den Bergh, JP, Geusens, P, Li, X, Marotte, H, van Rietbergen, B, Boyd, SK, and Barnabe, C

Abstract

Background: Joint space assessment for rheumatoid arthritis (RA) by ordinal conventional radiographic scales is susceptible to floor and ceiling effects. High-resolution peripheral quantitative computed tomography (HR-pQCT) provides superior resolution, and may detect earlier changes. The goal of this work was to compare existing 3D methods to calculate joint space width (JSW) metrics in human metacarpophalangeal (MCP) joints with HR-pQCT and reach consensus for future studies. Using the consensus method, we established reproducibility with repositioning as well as feasibility for use in second-generation HR-pQCT scanners. Methods: Three published JSW methods were compared using datasets from individuals with RA from three research centers. A SPECTRA consensus method was developed to take advantage of strengths of the individual methods. Using the SPECTRA method, reproducibility after repositioning was tested and agreement between scanner generations was also established. Results: When comparing existing JSW methods, excellent agreement was shown for JSW minimum and mean (ICC 0.987–0.996) but not maximum and volume (ICC 0.000–0.897). Differences were identified as variations in volume definitions and algorithmic differences that generated high sensitivity to boundary conditions. The SPECTRA consensus method reduced this sensitivity, demonstrating good scan-rescan reliability (ICC >0.911) except for minimum JSW (ICC 0.656). There was strong agreement between results from first- and second-generation HR-pQCT (ICC >0.833). Conclusions: The SPECTRA consensus method combines unique strengths of three independently-developed algorithms and leverages underlying software updates to provide a mature analysis to measure 3D JSW. This method is robust with respect to repositioning and scanner generations, suggesting its suitability for detecting change.

Published
2020

16. LO43: First Nations emergency care visits in Alberta: Descriptive results of a retrospective cohort study

Author

McLane, P., primary, Barnabe, C., additional, Holroyd, B., additional, Colquhoun, A., additional, Bill, L., additional, Fitzpatrick, K., additional, Rittenbach, K., additional, Healy, C., additional, Bull, H., additional, Crawler, M., additional, Firth, L., additional, Jacobs, T., additional, Twin, D., additional, and Rosychuk, R., additional

Published
2020
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17. The SPECTRA Collaboration OMERACT Special Interest Group: Current Research and Future Directions

Author

Stok, K.S., Finzel, S., Burghardt, A.J., Conaghan, P.G., Barnabe, C., Boyd, S.K., Martin, L., Barr, S.G., Feehan, L., Van Veenendaal, M., Cheung, A., Yeung, R., Schett, G., Tzaribachev, N., Engelke, K., Li, X., Pedoia, V., Jiang, Y., Troy, K., Baker, J., Van Den Bergh, J., Geusens, P., van Rietbergen, B., Willems, P.C., de Jong, J., Marotte, H., Chapurlat, R., and Orthopaedic Biomechanics

Subjects
0301 basic medicine, Pathology, Radiography, Rheumatology/trends, Rheumatic Diseases/diagnostic imaging, Radiographic computed tomography, Severity of Illness Index, METACARPOPHALANGEAL JOINT, Metacarpophalangeal Joint/diagnostic imaging, 0302 clinical medicine, STRENGTH, Immunology and Allergy, Medicine, Quantitative computed tomography, Tomography, Reliability (statistics), medicine.diagnostic_test, OMERACT, PERIARTICULAR BONE, X-Ray Computed, Systematic review, Metacarpophalangeal joint, HR-PQCT, Disease Progression, Omeract, musculoskeletal diseases, medicine.medical_specialty, Immunology, 3-D imaging, 03 medical and health sciences, Rheumatology, Rheumatic Diseases, Criterion validity, Humans, Medical physics, Rheumatoid arthritis, 030203 arthritis & rheumatology, EROSIONS, business.industry, QUANTITATIVE COMPUTED-TOMOGRAPHY, Reproducibility of Results, Special Interest Group, JOINT SPACE WIDTH, METACARPOPHALANGEAL, RHEUMATOID-ARTHRITIS, Clinical trial, 030104 developmental biology, PSORIATIC-ARTHRITIS, Observational study, MICROSTRUCTURE, Tomography, X-Ray Computed, business
Abstract

Objective.High-resolution peripheral quantitative computed tomography (HR-pQCT) has the potential to improve radiographic progression determination in clinical trials and longitudinal observational studies. The goal of this work was to describe the current state of research presented at Outcome Measures in Rheumatology (OMERACT) 2016 and ensuing future directions outlined during discussion among attendees.Methods.At OMERACT 2016, SPECTRA (Study grouP for xtrEme-Computed Tomography in Rheumatoid Arthritis) introduced efforts to (1) validate the HR-pQCT according to OMERACT guidelines, focusing on rheumatoid arthritis (RA), and (2) find alternatives for automated joint space width (JSW) analysis. The Special Interest Group (SIG) was presented to patient research partners, physicians/researchers, and SIG leaders followed by a 40-min discussion on future directions.Results.A consensus definition for RA erosion using HR-pQCT was demonstrated through a systematic literature review and a Delphi exercise. Histopathology and perfusion studies were presented that analyzed the true characteristics of cortical breaks in HR-pQCT images, and to provide criterion validity. Results indicate that readers were able to discriminate between erosion and small vascular channels. Moderate reliability (ICC 0.206–0.871) of direct erosion size measures was shown, which improved (> 0.9) only when experienced readers were considered. Quantification of erosion size was presented for scoring, direct measurement, and volumetric approaches, as well as a reliability exercise for direct measurement. Three methods for JSW measurement were compared, all indicating excellent reproducibility with differences at the extremes (i.e., near-zero and joint edge thickness).Conclusion.Initial reports on HR-pQCT are promising; however, to consider its use in clinical trials and longitudinal observational studies, it is imperative to assess the responsiveness of erosion measurement quantification.

Published
2017
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25. An automated algorithm for the detection of cortical interruptions and its underlying loss of trabecular bone; a reproducibility study

Author

Peters, M, de Jong, J, Scharmga, A, van Tubergen, A, Geusens, P, Loeffen, D, Weijers, R, Boyd, SK, Barnabe, C, Stok, KS, van Rietbergen, B, van den Bergh, J, Peters, M, de Jong, J, Scharmga, A, van Tubergen, A, Geusens, P, Loeffen, D, Weijers, R, Boyd, SK, Barnabe, C, Stok, KS, van Rietbergen, B, and van den Bergh, J

Abstract

BACKGROUND: We developed a semi-automated algorithm that detects cortical interruptions in finger joints using high-resolution peripheral quantitative computed tomography (HR-pQCT), and extended it with trabecular void volume measurement. In this study we tested the reproducibility of the algorithm using scan/re-scan data. METHODS: Second and third metacarpophalangeal joints of 21 subjects (mean age 49 (SD 11) years, 17 early rheumatoid arthritis and 4 undifferentiated arthritis, all diagnosed < 1 year ago) were imaged twice by HR-pQCT on the same day with repositioning between scans. The images were analyzed twice by one operator (OP1) and once by an additional operator (OP2), who independently corrected the bone contours when necessary. The number, surface and volume of interruptions per joint were obtained. Intra- and inter-operator reliability and intra-operator reproducibility were determined by intra-class correlation coefficients (ICC). Intra-operator reproducibility errors were determined as the least significant change (LSCSD). RESULTS: Per joint, the mean number of interruptions was 3.1 (SD 3.6), mean interruption surface 4.2 (SD 7.2) mm2, and mean interruption volume 3.5 (SD 10.6) mm3 for OP1. Intra- and inter-operator reliability was excellent for the cortical interruption parameters (ICC ≥0.91), except good for the inter-operator reliability of the interruption surface (ICC = 0.70). The LSCSD per joint was 4.2 for the number of interruptions, 5.8 mm2 for interruption surface, and 3.2 mm3 for interruption volume. CONCLUSIONS: The algorithm was highly reproducible in the detection of cortical interruptions and their volume. Based on the LSC findings, the potential value of this algorithm for monitoring structural damage in the joints in early arthritis patients needs to be tested in clinical studies.

Published
2018

26. The effect of rheumatoid arthritis-associated autoantibodies on the incidence of cardiovascular events in a large inception cohort of early inflammatory arthritis

Author

Barra, Lillian J., Pope, Janet E., Hitchon, Carol, Boire, Gilles, Schieir, Orit, Lin, Daming, Thorne, Carter J., Tin, Diane, Keystone, Edward C., Haraoui, Boulos, Jamal, Shahin, Bykerk, Vivian P., Ahluwalia, V., Akhavan, P., Barra, L., Barber, C., Barnabe, C., Bartlett, S., Baron, M., Bessette, L., Boire, G., Bykerk, V., Colmegna, I., Fallavollita, S., and Haaland, D.

Subjects
Male, 0301 basic medicine, Canada, medicine.medical_specialty, Complications, Inflammatory arthritis, Arthritis, Kaplan-Meier Estimate, Peptides, Cyclic, Arthritis, Rheumatoid, 03 medical and health sciences, 0302 clinical medicine, Rheumatology, Rheumatoid Factor, Risk Factors, Internal medicine, medicine, Medicine and Health Sciences, Humans, Rheumatoid factor, Pharmacology (medical), Prospective Studies, Risk factor, Rheumatoid arthritis, Prospective cohort study, Autoantibodies, 030203 arthritis & rheumatology, Analysis of Variance, Proportional hazards model, business.industry, Incidence, Seropositive, Early Inflammatory Arthritis, Middle Aged, medicine.disease, ACPA, Cardiovascular disease, 030104 developmental biology, Cardiovascular Diseases, Antirheumatic Agents, Hypertension, Cohort, RF, Female, business
Abstract

© The Author 2017. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. Objective. RA is associated with an increased risk of cardiovascular events (CVEs). The objective was to estimate independent effects of RA autoantibodies on the incident CVEs in patients with early RA. Methods. Patients were enrolled in the Canadian Early Inflammatory Arthritis Cohort, a prospective multicentre inception cohort. Incident CVEs, including acute coronary syndromes and cerebrovascular events, were self-reported by the patient and partially validated by medical chart review. Seropositive status was defined as either RF or ACPA positive. Multivariable Cox proportional hazards survival analysis was used to estimate the effects of seropositive status on incident CVEs, controlling for RA clinical variables and traditional cardiovascular risk factors. Results. A total of 2626 patients were included: the mean symptom duration at diagnosis was 6.3 months (S.D. 4.6), the mean age was 53 years (S.D. 15), 72% were female and 86% met classification criteria for RA. Forty-six incident CVEs occurred over 6483 person-years [incidence rate 7.1/1000 person-years (95% confidence interval 5.3, 9.4)]. The CVE rate did not differ in seropositive vs seronegative subjects and seropositivity was not associated with incident CVEs in multivariable Cox regression models. Baseline covariates independently associated with incident CVEs were older age, a history of hypertension and a longer duration of RA symptoms prior to diagnosis. Conclusion. The rate of CVEs early in the course of inflammatory arthritis was low; however, delays in the diagnosis of arthritis increased the rate of CVEs. Hypertension was the strongest independent risk factor for CVEs. Results support early aggressive management of RA disease activity and co-morbidities to prevent severe complications.

Published
2017

33. Is Treat-to-Target Really Working? a Longitudinal Analysis in Biodam

Author

Ramiro, S., Landewe, R.B.M., Heijde, D. van der, FitzGerald, O., Ostergaard, M., Homik, J., Elkayam, O., Thorne, J.C., Larche, M., Ferraccioli, G., Backhaus, M., Boire, G., Combe, B., Schaeverbeke, T., Saraux, A., Dougados, M., Adami, S., Govoni, M., Sinigaglia, L., Cantagrel, A.G., Allaart, C.F., Barnabe, C., Bingham, C.O., Tak, P.P., Schaardenburg, D. van, Hammer, H.B., Dadashova, R., Hutchings, E., Paschke, J., and Maksymowych, W.

Published
2015

34. Is Treat-To-Target Really Working?:A Longitudinal Analysis in Biodam

Author

Ramiro, S., Landewé, R., van der Heijde, D., Fitzgerald, O., Østergaard, M., Homik, J., Elkayam, O., Thorne, J. C., Larché, M., Ferraccioli, G., Backhaus, M., Boire, G., Combe, B., Schaeverbeke, T., Saraux, A., Dougados, M., Adami, S., Govoni, M., Sinigaglia, L., Cantagrel, A., Allaart, C. F., Barnabe, C., Bingham III, C. O., Tak, P. P., van Schaardenburg, D., Hammer, H. B., Dadashova, R., Hutchings, E., Paschke, J., Maksymowych, W. P., Ramiro, S., Landewé, R., van der Heijde, D., Fitzgerald, O., Østergaard, M., Homik, J., Elkayam, O., Thorne, J. C., Larché, M., Ferraccioli, G., Backhaus, M., Boire, G., Combe, B., Schaeverbeke, T., Saraux, A., Dougados, M., Adami, S., Govoni, M., Sinigaglia, L., Cantagrel, A., Allaart, C. F., Barnabe, C., Bingham III, C. O., Tak, P. P., van Schaardenburg, D., Hammer, H. B., Dadashova, R., Hutchings, E., Paschke, J., and Maksymowych, W. P.

Published
2016

36. Impact of Failure to Adhere to Treat-to-Target of Rheumatoid Arthritis in Real World Practice: Data from the International Rheumatoid Arthritis Biomarker Program

Author

Maksymowych, W.P., Ostergaard, M., Elkayam, O., Landewe, R., Homik, J., Thorne, C., Backhaus, M., Shaikh, S., Boire, G., Larche, M., Combe, B., Schaeverbeke, T., Saraux, A., Ferraccioli, G., Dougados, M., Barnabe, C., Govoni, M., Tak, P.P., Schaardenburg, D. van, Heijde, D. van der, Dadashova, R., Hutchings, E., Paschke, J., and FitzGerald, O.

Published
2014

37. Systemic autoimmune rheumatic disease prevalence in Canada: updated analyses across 7 provinces

Author

Sasha Bernatsky, Hudson M, Christine A. Peschken, Hanly Jg, Christian A. Pineau, Paul R. Fortin, Mark D. Smith, Aviña-Zubieta Ja, O'Donnell S, Diane Lacaille, Lisa M. Lix, A E Clarke, Patrick Bélisle, Elizabeth M. Badley, Broten L, Edworthy Sm, Barnabe C, Louise Bergeron, L. Joseph, Sonia Jean, and Lawrence W. Svenson

Subjects
Adult, Male, Rural Population, medicine.medical_specialty, Pediatrics, Canada, Databases, Factual, Urban Population, Immunology, Population, Comorbidity, Age and sex, Latent class regression, Autoimmune Diseases, Age Distribution, Rheumatology, Internal medicine, Rheumatic Diseases, Prevalence, Immunology and Allergy, Medicine, Humans, Lupus Erythematosus, Systemic, Sex Distribution, education, Primary Sjögren Syndrome, Aged, education.field_of_study, Scleroderma, Systemic, business.industry, Rheumatic disease, Bayes Theorem, Dermatomyositis, Middle Aged, medicine.disease, Multiple data, Sjogren's Syndrome, Female, business, Demography
Abstract

Objective.To estimate systemic autoimmune rheumatic disease (SARD) prevalence across 7 Canadian provinces using population-based administrative data evaluating both regional variations and the effects of age and sex.Methods.Using provincial physician billing and hospitalization data, cases of SARD (systemic lupus erythematosus, scleroderma, primary Sjögren syndrome, polymyositis/dermatomyositis) were ascertained. Three case definitions (rheumatology billing, 2-code physician billing, and hospital diagnosis) were combined to derive a SARD prevalence estimate for each province, categorized by age, sex, and rural/urban status. A hierarchical Bayesian latent class regression model was fit to account for the imperfect sensitivity and specificity of each case definition. The model also provided sensitivity estimates of different case definition approaches.Results.Prevalence estimates for overall SARD ranged between 2 and 5 cases per 1000 residents across provinces. Similar demographic trends were evident across provinces, with greater prevalence in women and in persons over 45 years old. SARD prevalence in women over 45 was close to 1%. Overall sensitivity was poor, but estimates for each of the 3 case definitions improved within older populations and were slightly higher for men compared to women.Conclusion.Our results are consistent with previous estimates and other North American findings, and provide results from coast to coast, as well as useful information about the degree of regional and demographic variations that can be seen within a single country. Our work demonstrates the usefulness of using multiple data sources, adjusting for the error in each, and providing estimates of the sensitivity of different case definition approaches.

Published
2014

38. THU0067 Is Treat-To-Target Really Working? A Longitudinal Analysis in Biodam

Author

Ramiro, S., primary, Landewé, R., additional, van der Heijde, D., additional, FitzGerald, O., additional, Østergaard, M., additional, Homik, J., additional, Elkayam, O., additional, Thorne, J.C., additional, Larche, M., additional, Ferraccioli, G., additional, Backhaus, M., additional, Boire, G., additional, Combe, B., additional, Schaeverbeke, T., additional, Saraux, A., additional, Dougados, M., additional, Adami, S., additional, Govoni, M., additional, Sinigaglia, L., additional, Cantagrel, A., additional, Allaart, C.F., additional, Barnabe, C., additional, Bingham, C.O., additional, Tak, P.P., additional, van Schaardenburg, D., additional, Hammer, H.B., additional, Dadashova, R., additional, Hutchings, E., additional, Paschke, J., additional, and Maksymowych, W.P., additional

Published
2016
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42. FRI0249 Case Definition for Erosions Imaged with High Resolution Peripheral Quantitative Computed Tomography (HR-PQCT): an International Spectra Reliability Exercise-1 (RELEX-1)

Author

Barnabe, C., primary, Kraus, S., additional, Marotte, H., additional, Hauge, E.-M., additional, Scharmga, A., additional, Kocijan, R., additional, Töpfer, D., additional, Boutroy, S., additional, Keller, K.K., additional, de Jong, J., additional, Williams, J., additional, Stok, K.S., additional, and Finzel, S., additional

Published
2014
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43. THU0120 Is Early DMARD Use Associated with Less Joint Replacement Surgery? an Analysis of 5,199 Incident Rheumatoid Arthritis (RA) Patients

Author

Moura, C., primary, Abrahamowicz, M., additional, Beauchamp, M.-E., additional, Lacaille, D., additional, Wang, Y., additional, Bombardier, C., additional, Widdifield, J., additional, Hanly, J.G., additional, Boire, G., additional, Feldman, D., additional, Maksymowych, W., additional, Peschken, C., additional, Barnabe, C., additional, Edworthy, S., additional, Fortin, P.R., additional, Bessette, L., additional, Behlouli, H., additional, and Bernatsky, S., additional

Published
2014
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46. SAT0178 Rheumatoid Arthritis Erosion Detection and Measurement in Longitudinal Datasets Using High-Resolution Peripheral Quantitative Computed Tomography (HR-PQCT): Reliability Exercise-2 (RELEX-2)

Author

Barnabe, C., primary, Marotte, H., additional, Scharmga, A., additional, Kraus, S., additional, Burghardt, A., additional, Hauge, E.-M., additional, Boutroy, S., additional, Toepfer, D., additional, Engelke, K., additional, Kocijan, R., additional, de Jong, J., additional, Li, X., additional, Stok, K., additional, and Finzel, S., additional

Published
2014
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48. Overweight, Obesity, and the Likelihood of Achieving Sustained Remission in Early Rheumatoid Arthritis: Results From a Multicenter Prospective Cohort Study

Author

Schulman, Elizabeth, Bartlett, Susan J., Schieir, Orit, Andersen, Kathleen M., Boire, Gilles, Pope, Janet E., Hitchon, Carol, Jamal, Shahin, Thorne, J. Carter, Tin, Diane, Keystone, Edward C., Haraoui, Boulos, Goodman, Susan M., Bykerk, Vivian P., Ahluwalia, V., Akhavan, P., Barra, L., Barber, C., Barnabe, C., Baron, M., Bessette, L., Bykerk, V., Colmegna, I., Fallavollita, S., Haaland, D., Hazlewood, G., Joshi, R., Kuriya, B., Larche, M., Lyddell, C., Nair, B., Penney, C., Rubin, L., Tremblay, J. L., Villeneuve, E., and Zummer, M.

Abstract

Obesity is implicated in rheumatoid arthritis (RA) development, severity, outcomes, and treatment response. We estimated the independent effects of overweight and obesity on ability to achieve sustained remission (sREM) in the 3 years following RA diagnosis. Data were from the Canadian Early Arthritis Cohort, a multicenter observational trial of early RA patients treated by rheumatologists using guideline‐based care. sREM was defined as Disease Activity Score in 28 joints (DAS28) <2.6 for 2 consecutive visits. Patients were stratified by body mass index (BMI) as healthy (18.5–24.9 kg/m2), overweight (25–29.9 kg/m2), and obese (≥30 kg/m2). Cox regression was used to estimate the effect of the BMI category on the probability of achieving sREM over the first 3 years, controlling for age, sex, race, education, RA duration, smoking status, comorbidities, baseline DAS28, Health Assessment Questionnaire disability index, C‐reactive protein level, and initial treatment. Of 982 patients, 315 (32%) had a healthy BMI, 343 (35%) were overweight, and 324 (33%) were obese; 355 (36%) achieved sREM within 3 years. Initial treatment did not differ by BMI category. Compared to healthy BMI, overweight patients (hazard ratio [HR] 0.75 [95% confidence interval (95% CI) 0.58–0.98]) and obese patients (HR 0.53 [95% CI 0.39–0.71]) were significantly less likely to achieve sREM. Rates of overweight and obesity were high (69%) in this early RA cohort. Overweight patients were 25% less likely, and obese patients were 47% less likely, to achieve sREM in the first 3 years, despite similar initial disease‐modifying antirheumatic drug treatment and subsequent biologic use. This is the largest study demonstrating the negative impact of excess weight on RA disease activity and supports a call to action to better identify and address this risk in RA patients.

Published
2018
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