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Yates M, Clark A, Watts R, Macgregor A, Mackie S. FRI0198 OCULAR MORBIDITY IN PATIENTS WITH PMR AND GCA IN THE UK - A CPRD STUDY. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.4402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:Visual loss is the most serious consequences of a diagnosis of polymyalgia rheumatic (PMR) and giant cell arteritis (GCA). To date, information on the occurrence of eye disease in GCA has been based almost exclusively on small hospital-based patient series. Furthermore the lack of control group for these studies results in a lack of relative risk estimates for visual loss.There are no accurate data on the prevalence and nature of eye complications among patients in the community. Patients with GCA may be exclusively managed in the primary care setting without referral for either temporal artery biopsy or ophthalmic department examination. Currently the incidence and prevalence of eye complications within this group are unknown.Objectives:Examine the absolute rate and relative risk of ocular morbidity, in a longitudinal community setting, in patients with PMR and or GCA including visual loss, AOIN including optic atrophy, cataract and glaucoma identified from Read codes in the (Clinical Practice Research Datalink) CPRD dataset.Methods:Construction of a disease cohort of incident diagnoses of PMR and GCA from patients in the CPRD matched to controls on age, sex (+/- 2 years) and practice location. Diagnosis were identified by CPRD researchers of those individuals between January 1997 to December 2015, with a minimum age at diagnosis of 50 years. Those with both a diagnosis of PMR and GCA were analysed in the GCA group. The outcomes of ocular morbidity included Read codes for severe visual impairment (multiple codes covered: blindness, severe visual impairment, registered partially sighted, issue of certificate of visual impairment, examination findings of 4/60 or worse), anterior ischaemic optic neuropathy (including codes of optic neuropathy and atrophy but not codes of glaucomatous atrophy), cataract, cataract extraction and glaucoma. Statistically modelling with Cox proportional hazards was used to generate hazard ratios for ocular morbidity taking account of censorship through death and moving out of area.Results:We identified 30,714 individuals with PMR (20,270 women; 66%) with a mean age at diagnosis of 72.9 year (sd 9.1) and 6,104 with GCA (4,309 women; 70.6%) with a mean age of 72.1 years (sd 9.4). Of those diagnosed with GCA 1,669 were also diagnosed with PMR. Using Read codes for severe visual impairment and blindness 5.9% of patients with GCA and 2.7% with PMR had this complication compared with 1.6% of the matched controls. The hazard ratio for the various ocular morbidities and by cases of PMR or GCA are shown in the table below:Ocular morbidityPMR HR (95% CI) p valueGCA HR (95% CI) p valueSevere visual impairment1.76 (1.60, 1.94) p=<0.0013.55 (3.10, 4.08) p=<0.001Anterior ischaemic optic atrophy3.37 (2.15, 5.31) p=<0.00136.33 (25.19, 52.39) p=<0.001Cataract2.18 (2.04, 2.32) p=<0.0012.48 (2.22, 2.78) p=<0.001Cataract operation2.11 (1.97, 2.25) p=<0.0012.41 (2.13, 2.72) p=<0.001Glaucoma2.10 (1.91, 2.32) p=<0.0012.50 (2.10, 2.97) p=<0.001Conclusion:These community-based national data on risk of ocular morbidity in PMR and GCA show for the first time the risk of various ocular morbidities are increased for both groups. In addition this are the first estimates of relative risk compared to an age and sex matched population. These data are crucial for providing information to patients about their relative risk of ocular morbidity following a diagnosis of PMR or GCA.Acknowledgments:We would like to thank Dr Helen Strongman at the CPRD for carrying out patient searchers. We thank Dr Ferran Espuny Pujol for completion of the linkage request for dates of death.Disclosure of Interests:Max Yates: None declared, Allan Clark: None declared, Richard Watts: None declared, Alex MacGregor: None declared, Sarah Mackie Grant/research support from: Roche (attendance of EULAR 2019; co-applicant on research grant), Consultant of: Sanofi, Roche/Chugai (monies paid to my institution not to me)
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Yates M, Welikala R, Rudnicka A, Peto T, MacGregor AJ, Khawaja A, Watts R, Broadway D, Hayat S, Luben R, Barman S, Owen C, Khaw KT, Foster P. Retinal vasculometric characteristics and their associations with polymyalgia rheumatica and giant cell arteritis in a prospective cohort: EPIC-Norfolk Eye Study. Ann Rheum Dis 2020; 79:547-549. [PMID: 31784452 DOI: 10.1136/annrheumdis-2019-216078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Revised: 11/15/2019] [Accepted: 11/21/2019] [Indexed: 11/04/2022]
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Hinchcliff E, Roszik J, Yemelyanova A, Yates M, Hwu P, Jazaeri A. Immune response changes in HPV-related vulvar malignancy. Gynecol Oncol 2019. [DOI: 10.1016/j.ygyno.2019.04.155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Hinchcliff E, Paquette C, Roszik J, Kelting S, Stoler M, Mok S, Yeung T, Zhang Q, Yates M, Peng W, Hwu P, Jazaeri A. Lymphocyte-specific protein tyrosine kinase expression predicts survival in ovarian high-grade serous carcinoma. Gynecol Oncol 2019. [DOI: 10.1016/j.ygyno.2019.04.153] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Tsigarides J, MacGregor ADM, Dainty JR, Chipping JR, Verstappen SMM, Yates M. 215 Predictors of resilience in severe rheumatoid arthritis: an analysis of data from the Norfolk Arthritis Register. Rheumatology (Oxford) 2019. [DOI: 10.1093/rheumatology/kez107.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Wong KY, Yates M, Lim CSE, Gaffney K. 259 Changing trends in TNF inhibitor prescribing for axial spondyloarthritis: the influence of National Institute for Health and Care Excellence guidance. Rheumatology (Oxford) 2019. [DOI: 10.1093/rheumatology/kez107.075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Sayers E, Dainty JR, Yates M, Verstappen SM, Chipping J, Carding SR, Luben RN, Khaw KT, Wareham NJ, MacGregor AJ. O14 Pro-inflammatory diets are associated with increased C-reactive protein and subsequent rheumatoid arthritis in the European Investigation of Cancer: Norfolk Arthritis Register cohort. Rheumatology (Oxford) 2019. [DOI: 10.1093/rheumatology/kez105.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Yates M, Owen CE, Muller S, Graham K, Neill L, Twohig H, Boers M, Pujades-Rodriguez MDM, Goodman S, Cheah JTL, Dejaco C, Mukhtyar C, Nielsen BD, Robson J, Simon LS, Shae B, Mackie SL, Hill C. 217 Results of a patient survey on feasibility and face validity of outcome measures for intended use in future studies enrolling participants with polymyalgia rheumatica. Rheumatology (Oxford) 2019. [DOI: 10.1093/rheumatology/kez107.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Owen CE, Yates M, Twohig H, Muller S, Neill LM, Harrison E, Shea B, Simon LS, Hill CL, Mackie SL. Toward a Core Outcome Measurement Set for Polymyalgia Rheumatica: Report from the OMERACT 2018 Special Interest Group. J Rheumatol 2019; 46:1360-1364. [DOI: 10.3899/jrheum.181050] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/17/2019] [Indexed: 01/19/2023]
Abstract
Objective.To report the progress of the Outcome Measures in Rheumatology (OMERACT) Polymyalgia Rheumatica (PMR) Working Group in selecting candidate instruments for a core outcome measurement set.Methods.A systematic literature review identified outcomes measured and instruments used in PMR studies, and a respondent survey and raw data analysis assessed their domain match and feasibility.Results.Candidate instruments were identified for pain [visual analog scale/numerical rating scale (VAS/NRS)], stiffness (VAS/NRS and duration), and physical function (Health Assessment Questionnaire–Disability Index/modified Health Assessment Questionnaire). Domain match and feasibility assessments were favorable; however, validation in PMR was lacking.Conclusion.Further assessment of candidate instruments is required prior to recommending a PMR core outcome measurement set.
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Yates M, Kotecha J, Watts RA, Luben R, Khaw KT, MacGregor AJ. Incidence of inflammatory polyarthritis in polymyalgia rheumatica: a population-based cohort study. Ann Rheum Dis 2018; 78:704-705. [PMID: 30366946 DOI: 10.1136/annrheumdis-2018-214386] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Revised: 10/10/2018] [Accepted: 10/13/2018] [Indexed: 11/03/2022]
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Yates M, Luben R, Hayat S, Mackie SL, Watts RA, Khaw KT, MacGregor AJ. 088 Cardiovascular risk factors are associated with the onset of polymyalgia rheumatica (PMR) and giant cell arteritis (GCA) in a prospective cohort: EPIC-Norfolk study. Rheumatology (Oxford) 2018. [DOI: 10.1093/rheumatology/key075.312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Yates M, Watts R, Bajema I, Cid M, Crestani B, Hauser T, Hellmich B, Holle J, Laudien M, Little MA, Luqmani RA, Mahr A, Merkel P, Mills J, Mooney J, Segelmark M, Tesar V, Westman KWA, Vaglio A, Yalçındağ N, Jayne DR, Mukhtyar C. Validation of the EULAR/ERA-EDTA recommendations for the management of ANCA-associated vasculitis by disease content experts. RMD Open 2017; 3:e000449. [PMID: 28955487 PMCID: PMC5604609 DOI: 10.1136/rmdopen-2017-000449] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2017] [Revised: 03/14/2017] [Accepted: 03/21/2017] [Indexed: 11/29/2022] Open
Abstract
The European League Against Rheumatism recommendations for the management of antineutrophil cytoplasmic antibody-associated vasculitis have been recently published. Unique to recommendation development, they were also voted on by members of a learned society. This paper explores the wider validity of the recommendations among people who self-identify as clinicians caring for patients with vasculitis. In addition to the task force, a learned society (European Vasculitis Society—EUVAS) was invited, through online survey, to rate independently the strength of evidence of each recommendation to obtain an indication of the agreement among the final target audience and ultimate end-users of the recommendations. The survey took place in June 2015. Of the 158 EUVAS members surveyed, there were 88 responses (55.7%). There was a large degree of agreement in the voting patterns between EUVAS survey participants and task force members. Notable exceptions were lower grades for the recommendation of the use of rituximab for remission induction in patients with eosinophilic granulomatosis with polyangiitis and for methotrexate and mycophenolate mofetil as remission maintenance agents in patients with granulomatosis with polyangiitis/microscopic polyangiitis by EUVAS members. These results are encouraging and suggest that the voting patterns of the task force are representative of the wider vasculitis community. We recommend future recommendations adopt this approach for data/expert-based treatment guidelines, especially for multisystem diseases.
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Dottino J, Pakish J, Zhang Q, Jazaeri A, Soliman P, Schmandt R, Yates M, Lu K. Differential expression of immune response markers in the endometrium of obese and non-obese women. Gynecol Oncol 2017. [DOI: 10.1016/j.ygyno.2017.03.266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Dottino J, Pakish J, Chisholm G, Jazaeri A, Schmandt R, Mok S, Broaddus R, Yates M, Lu K. Is the immune microenvironment of microsatellite instable endometrial cancer altered in morbidly obese vs non-obese patients? Gynecol Oncol 2017. [DOI: 10.1016/j.ygyno.2017.03.249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Yates M, Chan C, Roach A, Lewis A, Flint J, Kay L, Dennison E, MacGregor AJ. 173. NATIONAL AUDIT OF BIOSIMILARS USE IN RHEUMATOLOGY DEPARTMENTS IN THE UNITED KINGDOM: RESULTS FROM THE BIOSIMILARS OBSERVATORY. Rheumatology (Oxford) 2017. [DOI: 10.1093/rheumatology/kex062.174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Pathak H, Cefai E, Yates M, Marshall T. 208. RITUXIMAB AND LATE-ONSET NEUTROPENIA: A RETROSPECTIVE ANALYSIS OF RITUXIMAB-TREATED ADULT RHEUMATOID ARTHRITIS PATIENTS IN A TEACHING HOSPITAL. Rheumatology (Oxford) 2017. [DOI: 10.1093/rheumatology/kex062.209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Steel L, Yates M, Hamilton L, Gaffney K. 106. IS THERE A SUSTAINED RESPONSE TO TUMOUR NECROSIS FACTOR INHIBITOR DOSE TAPERING IN ANKYLOSING SPONDYLITIS? Rheumatology (Oxford) 2017. [DOI: 10.1093/rheumatology/kex062.106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Fenn RK, Steel L, Yates M, Mukhtyar C. 188. ANTI-CITRULLINATED PROTEIN ANTIBODIES AND RHEUMATOID FACTOR EFFECT ON BONE EROSIONS IN A NORFOLK RHEUMATOID ARTHRITIS COHORT: IS BOTH RHEUMATOID FACTOR AND ANTI-CITRULLINATED PROTEIN ANTIBODY TESTING STILL NECESSARY? Rheumatology (Oxford) 2017. [DOI: 10.1093/rheumatology/kex062.189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Abstract
The vasculitides are a heterogeneous group of conditions typified by their ability to cause vessel inflammation with or without necrosis. They present with a wide variety of signs and symptoms and, if left untreated, carry a significant burden of mortality and morbidity. The antineutrophil cytoplasmic antibody (ANCA)-associated vasculitides (AAV) are three separate conditions - granulomatosis with polyangiitis (GPA; formerly known as Wegener's granulomatosis), microscopic polyangiitis (MPA), and eosinophilic granulomatosis with polyangiitis (EGPA; previously known as Churg-Strauss syndrome). This review examines recent developments in the pathogenesis and treatment of AAV, focusing on developments in treatment following the introduction of rituximab, in particular.
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Yates M, Jayne DR, Mukhtyar C. Response to: 'Renal biopsies should be performed whenever treatment strategies depend on renal involvement' by Chemouny et al. Ann Rheum Dis 2017; 76:e28. [PMID: 28122763 DOI: 10.1136/annrheumdis-2016-210962] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/03/2017] [Indexed: 11/04/2022]
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Yates M, Watts RA, Swords F, MacGregor AJ. Glucocorticoid withdrawal in polymyalgia rheumatica: the theory versus the practice. Clin Exp Rheumatol 2017; 35:1-2. [PMID: 28079505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2016] [Accepted: 10/26/2016] [Indexed: 06/06/2023]
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Yates M, MacGregor AJ, Robson J, Craven A, Merkel PA, Luqmani RA, Watts RA. The association of vascular risk factors with visual loss in giant cell arteritis. Rheumatology (Oxford) 2016; 56:524-528. [DOI: 10.1093/rheumatology/kew397] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2016] [Indexed: 11/13/2022] Open
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Dundas R, Yates M, Arffman M, Manderbacka K, Lumme S, Keskimäki I, Leyland AH. Trends in contributions to amenable mortality in Finland, Scotland and England, 1992-2013. Eur J Public Health 2016. [DOI: 10.1093/eurpub/ckw167.077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Yates M, Dundas R, Katikireddi SV, McKee M, Pell JP, Stuckler D, Leyland AH. The impact of health system reform on amenable mortality in England. Eur J Public Health 2016. [DOI: 10.1093/eurpub/ckw169.078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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