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Derksen V, van der Helm-van Mil A, Huizinga T, Toes R, van der Woude D. SAT0109 The Number of Different Autoantibodies is Associated with Phenotypic Characteristics at Presentation in Patients with Rheumatoid Arthritis. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.5655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Markusse I, Meijs J, de Boer B, Bakker J, Schippers P, Schouffoer A, Ajmone Marsan N, Kroft L, Ninaber M, Huizinga T, de Vries-Bouwstra J. FRI0469 The Additive Value of Nailfold Videocapillaroscopy Patterns to Disease-Specific Autoantibodies in Discrimination of Patients with Systemic Sclerosis at Risk for Severe Organ Involvement. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.2752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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van Steenbergen HW, Raychaudhuri S, Rodríguez-Rodríguez L, Rantapää-Dahlqvist S, Berglin E, Toes REM, Huizinga TWJ, Fernández-Gutiérrez B, Gregersen PK, van der Helm-van Mil AHM. Association of valine and leucine at HLA-DRB1 position 11 with radiographic progression in rheumatoid arthritis, independent of the shared epitope alleles but not independent of anti-citrullinated protein antibodies. Arthritis Rheumatol 2015; 67:877-86. [PMID: 25580908 DOI: 10.1002/art.39018] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2014] [Accepted: 12/30/2014] [Indexed: 01/29/2023]
Abstract
OBJECTIVE For decades it has been known that the HLA-DRB1 shared epitope (SE) alleles are associated with an increased risk of development and progression of rheumatoid arthritis (RA). Recently, the following variations in the peptide-binding grooves of HLA molecules that predispose to RA development have been identified: Val and Leu at HLA-DRB1 position 11, Asp at HLA-B position 9, and Phe at HLA-DPB1 position 9. This study was undertaken to investigate whether these variants are also associated with radiographic progression in RA, independent of SE and anti-citrullinated protein antibody (ACPA) status. METHODS A total of 4,911 radiograph sets from 1,878 RA patients included in the Leiden Early Arthritis Clinic (The Netherlands), Umeå (Sweden), Hospital Clinico San Carlos-Rheumatoid Arthritis (Spain), and National Data Bank for Rheumatic Diseases (US) cohorts were studied. HLA was imputed using single-nucleotide polymorphism data from an Immunochip, and the amino acids listed above were tested in relation to radiographic progression per cohort using an additive model. Results from the 4 cohorts were combined in inverse-variance weighted meta-analyses using a fixed-effects model. Analyses were conditioned on SE and ACPA status. RESULTS Val and Leu at HLA-DRB1 position 11 were associated with more radiographic progression (meta-analysis P = 5.11 × 10(-7)); this effect was independent of SE status (meta-analysis P = 0.022) but not independent of ACPA status. Phe at HLA-DPB1 position 9 was associated with more severe radiographic progression (meta-analysis P = 0.024), though not independent of SE status. Asp at HLA-B position 9 was not associated with radiographic progression. CONCLUSION Val and Leu at HLA-DRB1 position 11 conferred a risk of a higher rate of radiographic progression independent of SE status but not independent of ACPA status. These findings support the relevance of these amino acids at position 11.
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Ajeganova S, van Steenbergen HW, van Nies JAB, Burgers LE, Huizinga TWJ, van der Helm-van Mil AHM. Disease-modifying antirheumatic drug-free sustained remission in rheumatoid arthritis: an increasingly achievable outcome with subsidence of disease symptoms. Ann Rheum Dis 2015; 75:867-73. [DOI: 10.1136/annrheumdis-2014-207080] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2014] [Accepted: 04/23/2015] [Indexed: 11/03/2022]
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van den Bosch WB, Mangnus L, Reijnierse M, Huizinga TWJ, van der Helm-van Mil AHM. The diagnostic accuracy of the squeeze test to identify arthritis: a cross-sectional cohort study. Ann Rheum Dis 2015; 74:1886-9. [DOI: 10.1136/annrheumdis-2014-207202] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2014] [Accepted: 04/05/2015] [Indexed: 11/04/2022]
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Shi J, van Steenbergen HW, van Nies JAB, van der Helm-van Mil AHM, Huizinga TWJ, Toes REM, Trouw LA. A7.4 The specificity of anti-carbamylated protein antibodies for rheumatoid arthritis in a setting of early arthritis. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-207259.174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Kerkman PF, Fabre E, van der Voort EH, Germar KL, Baeten DL, Huizinga TWJ, Toes REM, Scherer HU. A1.25 Visualisation and characterisation of citrullinated antigen-specific B cells from peripheral blood of patients with rheumatoid arthritis. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-207259.25] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Abstract
The care of patients with rheumatoid arthritis (RA) has been revolutionized since the 1990s. Strict monitoring and disease control based on measurement of signs and symptoms towards a target of low disease activity have improved outcome of patients enormously. As a result of treatment strategies based upon individualized measurement of disease activity, the clinical view of RA has changed from a destructive autoimmune disease (with a median joint damage of >10 Sharp units per year) to a condition in which significant damage can be prevented in the majority of patients. Moreover, a large number of targeted therapies (tumour necrosis factor, IL6, CD80/CD86 and CD20 inhibitors) have become available to better treat the underlying disease process. However, identification of the underlying pathways that drive the disease process in an individual patient has been relatively unsuccessful, implying that no predictive factors have been identified to guide the choice of a specific treatment. Distinct subsets of RA patients have been identified, based on the presence or absence of anticitrullinated protein antibodies (ACPAs). These two subsets are associated with different environmental and genetic risk factors, histology and disease outcome (a more destructive disease course with more persistent joint inflammation is observed when ACPAs are present). Therefore, it is recommended that treatment should be guided towards a more consistently low level of disease activity in the presence of ACPAs than in the absence of the antibodies.
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Meijs J, Pors D, Vliet Vlieland TPM, Huizinga TWJ, Schouffoer AA. Translation, cross-cultural adaptation, and validation of the UCLA Scleroderma Clinical Trial Consortium Gastrointestinal Tract Instrument (SCTC GIT) 2.0 into Dutch. Clin Exp Rheumatol 2014; 32:S-41-8. [PMID: 24984228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2013] [Accepted: 12/05/2013] [Indexed: 06/03/2023]
Abstract
OBJECTIVES To translate and adapt the University of California, Los Angeles Scleroderma Clinical Trial Consortium Gastrointestinal Tract Instrument 2.0 (UCLA SCTC GIT 2.0) into Dutch and validate it among Dutch systemic sclerosis (SSc) patients. METHODS First, the UCLA SCTC GIT 2.0 questionnaire was translated and adapted according to international guidelines. The resulting Dutch GIT 2.0 was, in combination with the SSc Health Assessment Questionnaire (SHAQ) and Short Form-36 (SF-36) administered to SSc patients participating in a standardised medical assessment. Moreover, all previous clinical examinations and confirmed medical diagnoses related to GIT were extracted from the medical records. Internal consistency was determined by calculating Cronbach's alpha. To determine the reliability, the questionnaire was re-administered with an interval of two weeks to a subgroup of patients and the intraclass-correlation coefficient (ICC) was computed. Spearman correlation coefficients between GIT scores, SF-36 and SHAQ were computed. GIT scores were compared among patients with and without previous gastrointestinal examinations and/or diagnoses. RESULTS Eighty-nine patients with a mean age of 53.6 (SD 12) years, and predominantly female (76%) were included. The median total GIT score was 0.17 (Cronbach's alpha 0.921). The test-retest reliability of the total GIT score was good (n=27; ICC 0.749). Overall, the GIT total scores correlated significantly with the SHAQ visual analogue scale intestinal complaints and the SF-36. Significant differences between GIT total and subscale scores of patients with and without previous gastrointestinal examinations and diagnoses were present. CONCLUSIONS The Dutch GIT 2.0 questionnaire showed good internal consistency, construct validity and test-retest reliability.
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de Lange-Brokaar BJE, Ioan-Facsinay A, Yusuf E, Visser AW, Kroon HM, Andersen SN, Herb-van Toorn L, van Osch GJVM, Zuurmond AM, Stojanovic-Susulic V, Bloem JL, Nelissen RGHH, Huizinga TWJ, Kloppenburg M. Degree of synovitis on MRI by comprehensive whole knee semi-quantitative scoring method correlates with histologic and macroscopic features of synovial tissue inflammation in knee osteoarthritis. Osteoarthritis Cartilage 2014; 22:1606-13. [PMID: 24365722 DOI: 10.1016/j.joca.2013.12.013] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2013] [Revised: 11/25/2013] [Accepted: 12/10/2013] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To evaluate the association between synovitis on contrast enhanced (CE) MRI with microscopic and macroscopic features of synovial tissue inflammation. METHOD Forty-one patients (mean age 60 years, 61% women) with symptomatic radiographic knee OA were studied: twenty underwent arthroscopy (macroscopic features were scored (0-4), synovial biopsies obtained), twenty-one underwent arthroplasty (synovial tissues were collected). After haematoxylin and eosin staining, the lining cell layer, synovial stroma and inflammatory infiltrate of synovial tissues were scored (0-3). T1-weighted CE-MRI's (3 T) were used to semi-quantitatively score synovitis at 11 sites (0-22) according to Guermazi et al. Spearman's rank correlations were calculated. RESULTS The mean (SD) MRI synovitis score was 8.0 (3.7) and the total histology grade was 2.5 (1.6). Median (range) scores of macroscopic features were 2 (1-3) for neovascularization, 1 (0-3) for hyperplasia, 2 (0-4) for villi and 2 (0-3) for fibrin deposits. The MRI synovitis score was significantly correlated with total histology grade [r = 0.6], as well as with lining cell layer [r = 0.4], stroma [r = 0.3] and inflammatory infiltrate [r = 0.5] grades. Moreover, MRI synovitis score was also significantly correlated with macroscopic neovascularization [r = 0.6], hyperplasia [r = 0.6] and villi [r = 0.6], but not with fibrin [r = 0.3]. CONCLUSION Synovitis severity on CE-MRI assessed by a new whole knee scoring system by Guermazi et al. is a valid, non-invasive method to determine synovitis as it is significantly correlated with both macroscopic and microscopic features of synovitis in knee OA patients.
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Liu R, Kwok WY, Vliet Vlieland TPM, Kroon HM, Meulenbelt I, Houwing-Duistermaat JJ, Rosendaal FR, Huizinga TWJ, Kloppenburg M. Mortality in osteoarthritis patients. Scand J Rheumatol 2014; 44:70-3. [PMID: 25179456 DOI: 10.3109/03009742.2014.922213] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVES To investigate whether all-cause mortality and deaths due to cardiovascular disease are increased in patients who have consulted primary or secondary health care with symptoms and signs of osteoarthritis (OA). METHOD This study included 383 patients with symptomatic OA at multiple sites from the Genetics ARthrosis and Progression (GARP) study (mean age 60 years, 82% women, 3693 person-years of follow-up) and 459 patients with primary hand, knee, or hip OA from the Osteoarthritis Care Clinic (OCC) study (mean age 61 years, 88% women, 1890 person-years of follow-up). Standardized mortality ratios (SMRs) with 95% confidence intervals (CIs) were calculated for all-cause mortality and causes of deaths in comparison to the general population. Cox proportional hazard ratios (HRs) with 95% CIs were used to associate baseline characteristics with all-cause mortality. RESULTS In the GARP study, 26 patients died whereas 48 deaths were expected (SMR 0.54, 95% CI 0.37-0.79). The SMR was 0.47 (95% CI 0.29-0.76) in women and 0.73 (95% CI 0.39-1.35) in men. Similar results were found in the OCC study (SMR 0.45, 95% CI 0.25-0.82). Malignancy and cardiovascular disease were the main causes of deaths in GARP. Male sex (HR 3.04, 95% CI 1.38-6.69), increasing age (HR 1.10, 95% CI 1.05-1.16), and self-reported cancer (HR 8.29, 95% CI 3.12-22.03) were associated with increased mortality in GARP. CONCLUSIONS Patients consulting health care for their OA are not at higher risk of death than the general population. These results suggest that the management of OA patients may not need to focus specifically on the treatment of cardiovascular risk factors and comorbidities.
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van den Berg R, van der Heijde D, Landewé R, van Lambalgen K, Huizinga T. The METEOR initiative: the way forward for optimal, worldwide data integration to improve care for RA patients. Clin Exp Rheumatol 2014; 32:S-135-40. [PMID: 25365103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2014] [Accepted: 09/10/2014] [Indexed: 06/04/2023]
Abstract
OBJECTIVES The METEOR (Measurement of Efficacy of Treatment in the 'Era of Outcome' in Rheumatology) initiative aims at improving care for RA patients by assisting rheumatologists in strict monitoring and tight control of disease activity. The state of the art of the METEOR initiative, the technical organisation of the database and future perspectives are described. METHODS RA patients are followed in the daily practice setting; (follow-up) visits are registered via the tool or upload facility. The METEOR tool is an easy-to-use, stand-alone, web-based program free available to rheumatologists worldwide. The upload facility is developed to meet the wish of many local registries to upload their data into the METEOR database to benefit from benchmark and research facilities without giving up their own registries. Rheumatologists will always have access to full patient details of their own patients. Yet, patient identifying data are stored in an encrypted manner in the METEOR database in order to provide full patient anonymity to all other users. RESULTS While the tool can be used without IT involvement, the upload facility requires IT support. The incorporation of local registries into the METEOR database is time consuming, requires endeavours as well as technical support of both the local registries and the METEOR organisation, however, the combination of the tool and the upload facility has enabled the successful creation of a strong research database with real life data of 35,000 RA patients with more than 140,000 visits from all over the world! CONCLUSIONS The METEOR database offers the unique opportunity to study daily practice care as well as dedicated research questions in worldwide real life setting. Moreover, the METEOR's collective experience can be accessed by those who think about initiating patient registries for all sorts of purposes. Consequently, these well-designed registries may help in treating RA patients even more successfully in future.
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Huizinga TWJ, Conaghan PG, Martin-Mola E, Schett G, Amital H, Xavier RM, Troum O, Aassi M, Bernasconi C, Dougados M. Clinical and radiographic outcomes at 2 years and the effect of tocilizumab discontinuation following sustained remission in the second and third year of the ACT-RAY study. Ann Rheum Dis 2014; 74:35-43. [PMID: 25169728 PMCID: PMC4283697 DOI: 10.1136/annrheumdis-2014-205752] [Citation(s) in RCA: 83] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Objective To assess the efficacy and safety of tocilizumab (TCZ) plus methotrexate/placebo (MTX/PBO) over 2 years and the course of disease activity in patients who discontinued TCZ due to sustained remission. Methods ACT-RAY was a double-blind 3-year trial. Patients with active rheumatoid arthritis despite MTX were randomised to add TCZ to ongoing MTX (add-on strategy) or switch to TCZ plus PBO (switch strategy). Using a treat-to-target approach, open-label conventional synthetic disease-modifying antirheumatic drugs (csDMARDs), other than MTX, were added from week 24 if Disease Activity Score in 28 joints based on erythrocyte sedimentation rate (DAS28-ESR) >3.2. Between weeks 52 and 104, patients in sustained clinical remission (DAS28-ESR <2.6 at two consecutive visits 12 weeks apart) discontinued TCZ and were assessed every 4 weeks for 1 year. If sustained remission was maintained, added csDMARDs, then MTX/PBO, were discontinued. Results Of the 556 randomised patients, 76% completed year 2. Of patients entering year 2, 50.4% discontinued TCZ after achieving sustained remission and 5.9% achieved drug-free remission. Most patients who discontinued TCZ (84.0%) had a subsequent flare, but responded well to TCZ reintroduction. Despite many patients temporarily stopping TCZ, radiographic progression was minimal, with differences favouring add-on treatment. Rates of serious adverse events and serious infections per 100 patient-years were 12.2 and 4.4 in add-on and 15.0 and 3.7 in switch patients. In patients with normal baseline values, alanine aminotransferase elevations >3×upper limit of normal were more frequent in add-on (14.3%) versus switch patients (5.4%). Conclusions Treat-to-target strategies could be successfully implemented with TCZ to achieve sustained remission, after which TCZ was stopped. Biologic-free remission was maintained for about 3 months, but most patients eventually flared. TCZ restart led to rapid improvement. Trial registration number NCT00810199.
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van Steenbergen HW, Rantapää-Dahlqvist S, van Nies JAB, Berglin E, Huizinga TWJ, Gregersen PK, van der Helm-van Mil AHM. Does a genetic variant in FOXO3A predict a milder course of rheumatoid arthritis? Arthritis Rheumatol 2014; 66:1678-81. [PMID: 24574309 DOI: 10.1002/art.38405] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Diamantopoulos A, Finckh A, Huizinga T, Sungher DK, Sawyer L, Neto D, Dejonckheere F. Tocilizumab in the treatment of rheumatoid arthritis: a cost-effectiveness analysis in the UK. PHARMACOECONOMICS 2014; 32:775-87. [PMID: 24854959 PMCID: PMC4113684 DOI: 10.1007/s40273-014-0165-7] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
BACKGROUND Since receiving a positive recommendation in England, Wales and Scotland, tocilizumab (TCZ) is one of the options available to clinicians for the treatment of rheumatoid arthritis (RA) patients in the UK. OBJECTIVE The objective of this study was to evaluate the cost effectiveness of adding TCZ to the current treatment sequence of RA patients from a UK payer's perspective over a patient lifetime horizon. METHODS An individual sampling model was developed to synthesise all clinical and economic inputs. Two scenarios were explored separately: patients contraindicated to methotrexate (MTX) and those MTX tolerant. For each scenario, the analysis compared three strategies. The standard of care (SoC) strategy included a sequence of the most commonly prescribed biologics; the other two comparator strategies considered the addition of TCZ to SoC at first line and second line. Patient characteristics were representative of UK patients. Treatment efficacy and quality-of-life evidence were synthesised from clinical trials and secondary sources. An analysis of a patient registry informed the model parameters regarding treatment discontinuation. The safety profile of all treatments in a given strategy was based on a network meta-analysis and literature review. Resource utilisation, treatment acquisition, administration, monitoring and adverse event treatment costs were considered. All costs reflect 2012 prices. Uncertainty in model parameters was explored by one-way and probabilistic sensitivity analysis. RESULTS In the MTX-contraindicated population, if TCZ was added to the SoC in first line, the estimated incremental cost-effectiveness ratio (ICER) was £7,300 per quality-adjusted life-year (QALY) gained; if added in second line, the estimated ICER was £11,400 per QALY. In the MTX-tolerant population, the estimated costs and QALYs of the TCZ strategy were similar to those of the SoC strategy. Sensitivity analysis showed that parameters that affect the treatment cost (such as patient weight) can have a noticeable impact on the overall cost-effectiveness results. The majority of the other sensitivity analyses resulted in modest changes to the ICER. CONCLUSION For the treatment of RA in MTX-tolerant and contraindicated patients, the addition of TCZ to the SoC was estimated to be a cost-effective strategy.
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MESH Headings
- Anti-Inflammatory Agents/administration & dosage
- Anti-Inflammatory Agents/adverse effects
- Anti-Inflammatory Agents/economics
- Anti-Inflammatory Agents/therapeutic use
- Antibodies, Monoclonal, Humanized/administration & dosage
- Antibodies, Monoclonal, Humanized/adverse effects
- Antibodies, Monoclonal, Humanized/economics
- Antibodies, Monoclonal, Humanized/therapeutic use
- Arthritis, Rheumatoid/drug therapy
- Arthritis, Rheumatoid/economics
- Arthritis, Rheumatoid/immunology
- Contraindications
- Cost-Benefit Analysis
- Drug Costs
- Drug Therapy, Combination
- Humans
- Interleukin-6/antagonists & inhibitors
- Methotrexate
- Models, Economic
- Quality of Life
- Surveys and Questionnaires
- Treatment Outcome
- United Kingdom
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Krabben A, Stomp W, van Nies JAB, Huizinga TWJ, van der Heijde D, Bloem JL, Reijnierse M, van der Helm-van Mil AHM. MRI-detected subclinical joint inflammation is associated with radiographic progression. Ann Rheum Dis 2014; 73:2034-7. [DOI: 10.1136/annrheumdis-2014-205208] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Reinards THCM, Albers HM, Brinkman DMC, Kamphuis SSM, van Rossum MAJ, Girschick HJ, Wouters C, Hoppenreijs EPAH, Saurenmann RK, Hinks A, Ellis JA, Bakker E, Verduijn W, Slagboom P, Huizinga TWJ, Toes REM, Houwing-Duistermaat JJ, ten Cate R, Schilham MW. CD226 (DNAM-1) is associated with susceptibility to juvenile idiopathic arthritis. Ann Rheum Dis 2014; 74:2193-8. [PMID: 25057181 DOI: 10.1136/annrheumdis-2013-205138] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2013] [Accepted: 07/11/2014] [Indexed: 01/08/2023]
Abstract
OBJECTIVES Juvenile idiopathic arthritis (JIA) is considered a complex genetic autoimmune disease. We investigated the association of genetic variants previously implicated in JIA, autoimmunity and/or immunoregulation, with susceptibility to JIA. METHODS A genetic association study was performed in 639 JIA patients and 1613 healthy controls of northwest European descent. Ninety-three single nucleotide polymorphisms (SNP) were genotyped in a candidate gene approach. Results of the entire JIA patient group (all subtypes) were compared with results obtained, alternatively, with a clinically homogeneous patient group including only oligoarticular and rheumatoid factor (RF) negative polyarticular JIA patients (n=493). Meta-analyses were performed for all SNPs that have been typed in other Caucasian JIA cohorts before. RESULTS SNPs in or near PTPN22, VTCN1, the IL2-IL21 region, ANKRD55 and TNFA were confirmed to be associated with JIA (p<0.05), strengthening the evidence for involvement of these genes in JIA. In the majority of these replicated SNPs, effect sizes were larger when analysing a homogeneous patient cohort than when analysing all subtypes. We identified two novel associations with oligoarticular and RF-negative polyarticular JIA: CD226 rs763361 (OR 1.30, 95% CI 1.12 to 1.51, p=0.0006) and CD28 rs1980422 (OR 1.29, 95% CI 1.07 to 1.55, p=0.008). Meta-analyses including reported studies confirmed the association of both SNPs with susceptibility to JIA (OR 1.16, p=0.001 and OR 1.18, p=0.001, for rs763361 and rs1980422, respectively). CONCLUSIONS The CD226 gene has been identified as novel association with JIA, and a SNP near CD28 as a suggestive association. Both genes are probable candidate risk factors, since they are involved in costimulation of T cells.
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Akdemir G, Markusse I, Dirven L, van den Broek M, Molenaar E, Schouffoer A, Kerstens P, Lems W, Huizinga T, Allaart C. THU0257 Acpa-Negative RA Patients Benefit from Initial Combination Therapy with Early Clinical Improvement - A Sub-Analysis of the Best Study. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.2142] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Roeterink A, de Hooge M, vd Vijver J, vd Berg R, Dagfinrud H, Turina M, van Oosterhout M, Ramonda R, Huizinga T, vd Heijde D, van Gaalen F. THU0063 A Substantial Decrease in Work Productivity and Physical Health-Related Quality of Life in Patients with Chronic Back Pain in the Space-Cohort. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.1686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Bakker P, de Hooge M, van den Berg R, van Gaalen F, Reijnierse M, Huizinga T, van der Heijde D. FRI0125 Impact of Repeating Imaging of the Sacro-Iliac Joints over One Year on the Classification According the ASAS Axial SPA Criteria of Patients. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.1630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Abawi O, vd Berg R, vd Heijde D, de Hooge M, Bakker P, Reijnierse M, Huizinga T, van Gaalen F. FRI0122 Evaluation of the Two-Step Referral Strategy for Axial Spondyloarthritis in the Spondyloarthritis Caught Early Cohort. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.1901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Bakker P, van den Berg R, de Hooge M, van Gaalen F, Reijnierse M, Huizinga T, van der Heijde D. SAT0204 Do Bone Marrow Edema Lesions in the Sacroiliac Joint Change into Fatty Lesions over A 1-Year Period in Patients with Axial Spondyloarthritis or Possible Spondyloarthritis. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.4096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Shi J, van de Stadt L, Levarht N, Huizinga T, Hamann D, van Schaardenburg D, Toes R, Trouw L. FRI0013 Anti-Carbamylated Protein Antibodies (ANTI-CARP) Precede the Onset of Rheumatoid Arthritis. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.1192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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de Rooy DPC, Zhernakova A, Tsonaka R, Willemze A, Kurreeman BAS, Trynka G, van Toorn L, Toes REM, Huizinga TWJ, Houwing-Duistermaat JJ, Gregersen PK, van der Helm-van Mil AHM. A genetic variant in the region of MMP-9 is associated with serum levels and progression of joint damage in rheumatoid arthritis. Ann Rheum Dis 2014; 73:1163-9. [PMID: 23696630 DOI: 10.1136/annrheumdis-2013-203375] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
OBJECTIVES The severity of joint destruction is highly variable between rheumatoid arthritis (RA) patients. The majority of its heritability is still unexplained. Several autoimmune diseases share genetic risk variants that may also influence disease progression. We aimed to identify genetic risk factors for the severity of joint damage in RA by studying genetic susceptibility loci of several autoimmune diseases. METHODS In phase 1, 3143 sets of x-rays of 646 Dutch RA patients taken over 7 years (Sharp van der Heijde (SHS) scored) were studied. Genotyping was done by Immunochip. Associations of single-nucleotide polymorphisms (SNPs) with minor allele frequency (MAF) >0.01 and joint destruction were analysed. In phase 2, 686 North American RA patients with 926 SHS-scored x-rays over 15 years of follow-up were evaluated. In both phases multiple testing corrections were done for the number of uncorrelated SNPs; the thresholds for significance were p<1.1×10(-6) and p<0.0036. Matrix metalloproteinase 9 (MMP-9) levels were measured with ELISA in baseline serum samples. RESULTS In phase 1, 109 SNPs associated significantly with joint destruction (p<1.1×10(-6)). Of these, 76 were located in the HLA region; the 33 non-HLA variants were studied in phase 2. Here two variants were associated with the severity of joint destruction: rs451066 on chromosome 14 (p=0.002, MAF=0.20) and rs11908352 on chromosome 20 (p=0.002, MAF=0.21). Rs11908352 is located near the gene encoding MMP-9. Serum levels of MMP-9 were significantly associated with the rs11908352 genotypes (p=0.007). CONCLUSIONS These data indicate that two loci that confer risk to other autoimmune diseases also affect the severity of joint destruction in RA. Rs11908352 may influence joint destruction via MMP-9 production.
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Jiang X, Trouw L, van Wesemael T, Shi J, Bengtsson C, Kallberg H, Malmstrom V, Israelsson L, Hreggvidsdottir H, Verduyn W, Klareskog L, Alfredsson L, Huizinga T, Toes R, Lundberg K, Van Der Woude D. FRI0341 Anti-Carp Antibodies in Two Large Cohorts of Patients with Rheumatoid Arthritis and their Relationship to Genetic Risk Factors, Cigarette Smoking and Other Autoantibodies. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.4653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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