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Littlejohn G, Anbumurali N, O'Sullivan C, Smith T, Tymms K, Bird P, Nicholls D, Griffiths H. Optimising patient outcomes: temporal trends in remission rates of rheumatoid arthritis patients in the Australian OPAL dataset between 2009 and 2022. Clin Rheumatol 2024:10.1007/s10067-024-06967-8. [PMID: 38634966 DOI: 10.1007/s10067-024-06967-8] [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: 10/31/2023] [Revised: 03/11/2024] [Accepted: 04/11/2024] [Indexed: 04/19/2024]
Abstract
OBJECTIVE To describe the trends in remission rates among RA patients in the OPAL dataset, spanning from 2009 to 2022, and provide insights into the effectiveness of evolving RA management approaches in real-world clinical settings. METHODS Patients with a physician diagnosis of RA and at least 3 visits between 1 January 2009 and December 2022 were identified in the OPAL dataset, an aggregated collection of data extracted from the electronic medical records of patients managed by 117 Australian rheumatologists. Demographics, disease history, prescribed medications and proportions of patients in Disease Activity Score 28-joint count C-reactive protein (DAS28CRP)) categories (remission, low disease activity (LDA), moderate disease activity (MDA) and high disease activity (HDA)) were described. RESULTS A large population (n = 48,388) of eligible patients with RA were identified in the OPAL dataset. A consistent and substantial improvement in DAS28CRP remission rates were found in (i) all patients, (ii) patients managed on conventional synthetic disease-modifying antirheumatic drugs (csDMARD) and (iii) patients treated with biological or targeted synthetic (b/ts)DMARD therapy, increasing from approximately 50% in 2009 to over 70% by 2022. The increase in DAS28CRP remission was accompanied by reduced proportions of patients in MDA and HDA states. CONCLUSION This study highlights a consistent improvement in disease activity and rising remission rates among Australian RA patients within the OPAL dataset, offering the potential for enhanced patient outcomes and reduced disease burden.
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Affiliation(s)
- Geoffrey Littlejohn
- OPAL Rheumatology Ltd, Sydney, NSW, Australia.
- Monash University, Clayton, VIC, Australia.
- Suite H, Monash Medical Centre, Clayton, VIC, 3168, Australia.
| | | | | | - Tegan Smith
- OPAL Rheumatology Ltd, Sydney, NSW, Australia
| | - Kathleen Tymms
- OPAL Rheumatology Ltd, Sydney, NSW, Australia
- Canberra Rheumatology, Canberra, ACT, Australia
| | - Paul Bird
- OPAL Rheumatology Ltd, Sydney, NSW, Australia
- University of New South Wales, Kensington, Australia
- Emeritus Research, Botany, NSW, Australia
| | - David Nicholls
- OPAL Rheumatology Ltd, Sydney, NSW, Australia
- Coast Joint Care and University of The Sunshine Coast, Maroochydore, QLD, Australia
| | - Hedley Griffiths
- OPAL Rheumatology Ltd, Sydney, NSW, Australia
- Barwon Rheumatology, Geelong, VIC, Australia
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Gaussen J, Trott DJ, Spiers Z, Jenkins C, Griffiths H. Sporadic bovine encephalopathy caused by Chlamydia pecorum secondary to bovine viral diarrhoea virus infection in calves in South Australia. Aust Vet J 2024; 102:80-86. [PMID: 38148529 DOI: 10.1111/avj.13307] [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: 08/30/2023] [Accepted: 11/19/2023] [Indexed: 12/28/2023]
Abstract
BACKGROUND Despite bovine viral diarrhoea virus and Chlamydia pecorum being important endemic diseases of cattle, there are limited reports of theirco-occurrence. CASE REPORT Several 12-18-week-old, weaned Hereford calves presented with ill-thriftiness and neurological signs on a mixed cattle and sheep farm in South Australia in July 2021. Immune suppression resulting from transient infection with bovine viral diarrhoea virus (BVDV) is implicated in predisposing to infection with Chlamydia pecorum, the causative agent of sporadic bovine encephalopathy (SBE). Chlamydia spp. are difficult to culture in vitro or definitively identify based on current standard molecular based tests. In this case, diagnosis was confirmed by immunohistochemistry. CONCLUSION To the authors' knowledge, this case report is the first to document BVDV transient infection occurring in conjunction with SBE. Given the current high prevalence of BVDV on Australian farms, such co-infections may have significant future clinical relevance. This case also highlights the need for appropriate tests, such as immunohistochemistry to demonstrate the causative organism in histological lesions and thus reduce the occurrence of false negative diagnosis.
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Affiliation(s)
- J Gaussen
- Thrive Agri Services, Hamilton, Victoria, 3300, Australia
| | - D J Trott
- Davies Livestock Research Centre, University of Adelaide, Roseworthy, South Australia, 5371, Australia
| | - Z Spiers
- Elizabeth Macarthur Agricultural Institute, NSW Department of Primary Industries, Menangle, New South Wales, 2568, Australia
| | - C Jenkins
- Elizabeth Macarthur Agricultural Institute, NSW Department of Primary Industries, Menangle, New South Wales, 2568, Australia
| | - H Griffiths
- Davies Livestock Research Centre, University of Adelaide, Roseworthy, South Australia, 5371, Australia
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Deakin CT, Littlejohn GO, Griffiths H, Ciciriello S, O'Sullivan C, Smith T, Youssef P, Bird P. Comparative effectiveness of etanercept originator and biosimilar for treating rheumatoid arthritis: implications for cost-savings. Intern Med J 2023. [PMID: 38009675 DOI: 10.1111/imj.16296] [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: 10/03/2023] [Accepted: 11/06/2023] [Indexed: 11/29/2023]
Abstract
BACKGROUND AND AIMS This study aimed to assess the comparative effectiveness of the etanercept (ETN) originator (Enbrel) and ETN biosimilar SB4 (Brenzys) as first-line treatment in patients with rheumatoid arthritis (RA), while also exploring the potential cost-savings associated with this approach in Australia. METHODS Clinical data were obtained from the Optimising Patient outcomes in rheumatoLogy Australian real-world data set. Adult patients with RA who had initiated treatment with the ETN originator or biosimilar as their first-recorded biologic or targeted synthetic disease-modifying antirheumatic drug between 1 April 2017 and 31 December 2020 were included. Treatment persistence was analysed using survival analysis. Cost-savings were estimated based on data reported by the Australian National Prescribing Service MedicineWise. RESULTS Propensity score matching followed by inverse probability of treatment weighting selected patients taking originator (n = 209) or biosimilar (n = 141) with similar baseline characteristics and eliminated small differences in baseline disease activity. The median time for 50% of the patients to stop treatment was 19.4 months (95% confidence interval [CI], 14.7-36.4 months) for the originator and 22.4 months (95% CI, 15.0-33.1 months) for the biosimilar (P = 0.95). As a result of pricing policies established by the Australian Government, introduction of the ETN biosimilar would have resulted in a cost-savings of over AU$9.5 million for 1 year of treatment for the patients reported in this study. CONCLUSION Treatment persistence using either ETN originator or biosimilar was similar. The cost of all brands of ETN markedly reduced upon listing of the ETN biosimilar, resulting in significant savings for the Australian Government.
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Affiliation(s)
- Claire T Deakin
- OPAL Rheumatology Ltd, Sydney, New South Wales, Australia
- Centre for Adolescent Rheumatology at University College London, University College London Hospitals and Great Ormond Street Hospital, London, UK
- National Institute of Health Research Biomedical Centre at Great Ormond Street Hospital, London, UK
| | - Geoffrey O Littlejohn
- OPAL Rheumatology Ltd, Sydney, New South Wales, Australia
- Department of Medicine, Monash University, Melbourne, Victoria, Australia
| | - Hedley Griffiths
- OPAL Rheumatology Ltd, Sydney, New South Wales, Australia
- Barwon Rheumatology Service, Geelong, Victoria, Australia
| | - Sabina Ciciriello
- OPAL Rheumatology Ltd, Sydney, New South Wales, Australia
- Royal Melbourne Hospital, Melbourne, Victoria, Australia
| | | | - Tegan Smith
- OPAL Rheumatology Ltd, Sydney, New South Wales, Australia
| | - Peter Youssef
- OPAL Rheumatology Ltd, Sydney, New South Wales, Australia
- University of Sydney, Sydney, New South Wales, Australia
- Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
| | - Paul Bird
- OPAL Rheumatology Ltd, Sydney, New South Wales, Australia
- Department of Medicine, University of New South Wales, Sydney, New South Wales, Australia
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Wahid NW, Deutsch P, Amlani A, Gupta KK, Griffiths H, Ahmad I. Bedside open tracheostomy in COVID-19 patients - a safe and swift approach. Med Oral Patol Oral Cir Bucal 2023:26326. [PMID: 37992143 DOI: 10.4317/medoral.26326] [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] [Received: 08/30/2023] [Accepted: 10/09/2023] [Indexed: 11/24/2023] Open
Abstract
BACKGROUND Tracheostomy can be performed as an open surgical procedure, percutaneous, or hybrid and forms an important step in the management of patients infected with coronavirus disease 2019 (COVID-19) requiring weaning from mechanical ventilation. The purpose of this article is to share our experience to performing bedside surgical tracheostomy in COVID-19 patients in a safe and effective manner, whilst minimising the risk of viral transmission, to optimise patient outcomes and reduce risk to healthcare professionals. MATERIAL AND METHODS As recommended by ENT UK, we prospectively established a COVID Airway Team within the ENT department at Birmingham Heartlands Hospital, consisting of four head and neck consultant surgeons to perform either open-bedside, open-theatre or percutaneous tracheostomy in COVID-19 patients. A specific stepwise method for bedside open surgical tracheostomy was based on ENT UK and British Laryngological Society recommendations. RESULTS Thirty patients underwent tracheostomy during the study period (14 bedside-open, 5 open-theatre, 11 percutaneous). Mean duration of mechanical intubation prior to bedside-open tracheostomy was 14.5 days. The average time for open-bedside tracheostomy was 9 minutes compared to 31 minutes for open-theatre. There were no significant tracheostomy related complications with bedside-open tracheostomy. No healthcare professional involved reported acute COVID-19 infection. CONCLUSIONS We describe our effective, safe and swift approach to bedside open tracheostomy during the COVID-19 pandemic. Our experience demonstrated a short mean procedural time, with no tracheostomy-related complications and no reported viral transmission amongst the healthcare members involved.
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Affiliation(s)
- N-W Wahid
- Birmingham Heartlands Hospital B9 5SS, Bordesley Green East Birmingham, United Kingdom
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Deakin CT, De Stavola BL, Littlejohn G, Griffiths H, Ciciriello S, Youssef P, Mathers D, Bird P, Smith T, O'Sullivan C, Freeman T, Segelov D, Hoffman D, Seaman SR. Comparative Effectiveness of Adalimumab vs Tofacitinib in Patients With Rheumatoid Arthritis in Australia. JAMA Netw Open 2023; 6:e2320851. [PMID: 37382956 DOI: 10.1001/jamanetworkopen.2023.20851] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/30/2023] Open
Abstract
Importance There is a need for observational studies to supplement evidence from clinical trials, and the target trial emulation (TTE) framework can help avoid biases that can be introduced when treatments are compared crudely using observational data by applying design principles for randomized clinical trials. Adalimumab (ADA) and tofacitinib (TOF) were shown to be equivalent in patients with rheumatoid arthritis (RA) in a randomized clinical trial, but to our knowledge, these drugs have not been compared head-to-head using routinely collected clinical data and the TTE framework. Objective To emulate a randomized clinical trial comparing ADA vs TOF in patients with RA who were new users of a biologic or targeted synthetic disease-modifying antirheumatic drug (b/tsDMARD). Design, Setting, and Participants This comparative effectiveness study emulating a randomized clinical trial of ADA vs TOF included Australian adults aged 18 years or older with RA in the Optimising Patient Outcomes in Australian Rheumatology (OPAL) data set. Patients were included if they initiated ADA or TOF between October 1, 2015, and April 1, 2021; were new b/tsDMARD users; and had at least 1 component of the disease activity score in 28 joints using C-reactive protein (DAS28-CRP) recorded at baseline or during follow-up. Intervention Treatment with either ADA (40 mg every 14 days) or TOF (10 mg daily). Main Outcomes and Measures The main outcome was the estimated average treatment effect, defined as the difference in mean DAS28-CRP among patients receiving TOF compared with those receiving ADA at 3 and 9 months after initiating treatment. Missing DAS28-CRP data were multiply imputed. Stable balancing weights were used to account for nonrandomized treatment assignment. Results A total of 842 patients were identified, including 569 treated with ADA (387 [68.0%] female; median age, 56 years [IQR, 47-66 years]) and 273 treated with TOF (201 [73.6%] female; median age, 59 years [IQR, 51-68 years]). After applying stable balancing weights, mean DAS28-CRP in the ADA group was 5.3 (95% CI, 5.2-5.4) at baseline, 2.6 (95% CI, 2.5-2.7) at 3 months, and 2.3 (95% CI, 2.2-2.4) at 9 months; in the TOF group, it was 5.3 (95% CI, 5.2-5.4) at baseline, 2.4 (95% CI, 2.2-2.5) at 3 months, and 2.3 (95% CI, 2.1-2.4) at 9 months. The estimated average treatment effect was -0.2 (95% CI, -0.4 to -0.03; P = .02) at 3 months and -0.03 (95% CI, -0.2 to 0.1; P = .60) at 9 months. Conclusions and Relevance In this study, there was a modest but statistically significant reduction in DAS28-CRP at 3 months for patients receiving TOF compared with those receiving ADA and no difference between treatment groups at 9 months. Three months of treatment with either drug led to clinically relevant average reductions in mean DAS28-CRP, consistent with remission.
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Affiliation(s)
- Claire T Deakin
- OPAL Rheumatology Ltd, Sydney, New South Wales, Australia
- Centre for Adolescent Rheumatology Versus Arthritis at University College London, University College London Hospitals, Great Ormond Street Hospital and University College London, London, United Kingdom
- National Institute of Health Research Biomedical Centre at Great Ormond Street Hospital, London, United Kingdom
| | - Bianca L De Stavola
- Population, Policy and Practice Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, London, United Kingdom
| | - Geoffrey Littlejohn
- OPAL Rheumatology Ltd, Sydney, New South Wales, Australia
- Department of Medicine, Monash University, Clayton, Victoria, Australia
| | - Hedley Griffiths
- OPAL Rheumatology Ltd, Sydney, New South Wales, Australia
- Barwon Rheumatology Service, Geelong, Victoria, Australia
| | - Sabina Ciciriello
- OPAL Rheumatology Ltd, Sydney, New South Wales, Australia
- Royal Melbourne Hospital, Melbourne, Victoria, Australia
| | - Peter Youssef
- OPAL Rheumatology Ltd, Sydney, New South Wales, Australia
- Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
- University of Sydney, Sydney, New South Wales, Australia
| | - David Mathers
- OPAL Rheumatology Ltd, Sydney, New South Wales, Australia
- Georgetown Arthritis, Newcastle, New South Wales, Australia
| | - Paul Bird
- OPAL Rheumatology Ltd, Sydney, New South Wales, Australia
- University of New South Wales, Kensington, New South Wales, Australia
| | - Tegan Smith
- OPAL Rheumatology Ltd, Sydney, New South Wales, Australia
| | | | - Tim Freeman
- Software for Specialists Pty Ltd, Sydney, New South Wales, Australia
| | - Dana Segelov
- Software for Specialists Pty Ltd, Sydney, New South Wales, Australia
| | - David Hoffman
- Software for Specialists Pty Ltd, Sydney, New South Wales, Australia
| | - Shaun R Seaman
- MRC Biostatistics Unit, University of Cambridge, Cambridge, United Kingdom
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Tymms K, O'Sullivan C, Smith T, Littlejohn G, Freeman T, Hoffman D, Segelov D, Griffiths H, Ciciriello S, Youssef P, Mathers D, Deakin CT. A novel electronic patient-reported outcome delivery system to implement health-related quality of life measures in routine clinical care: An analysis of 5 years of experience. Front Digit Health 2023; 4:1074931. [PMID: 36698650 PMCID: PMC9869675 DOI: 10.3389/fdgth.2022.1074931] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Accepted: 12/13/2022] [Indexed: 01/11/2023] Open
Abstract
Objective To develop a simple and secure technological solution to incorporate electronic patient-reported outcomes (ePROs) into routine clinical care. Methods A novel ePRO questionnaire delivery system was developed by Software for Specialists (S4S) in partnership with OPAL Rheumatology Australia. Validated questionnaires were sent from the electronic medical record (EMR) (Audit4) of patients with rheumatoid arthritis (RA), psoriatic arthritis (PsA), ankylosing spondylitis (AS), lupus or giant cell arteritis (GCA) and delivered to the patient's email address or completed in the clinic waiting room using a smart device (in-practice). Completed questionnaires were encrypted and returned to the patient's Audit4. Deidentified clinical data was extracted and aggregated across all sites. Data collected between April 2016-Dec 2020 were analysed descriptively. Results Between April 2016 to Dec 2020, 221,352 Functional Assessment of Chronic Illness Therapy Fatigue (FACIT-F), Patient Health Questionnaire-2 (PHQ-2) and/or HealthCare Resource Utilization (HCRU) questionnaires were sent from 39 of 42 contributing clinics (93%). 85% of questionnaires were delivered via email and 15% in-practice. Overall, 85% of patients completed at least one questionnaire, and of all questionnaires sent, 73% were completed. Females were more likely to engage with the questionnaires than males (87% vs. 81%), and older patients were slightly more likely to complete all questionnaires delivered. Conclusions The novel Audit4 ePRO delivery system is an effective tool for incorporating PROs into routine clinical care. The data generated provides a unique opportunity to understand the full burden of disease for patients in the real-world setting and the impact of interventions.
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Affiliation(s)
| | | | | | - Geoffrey Littlejohn
- OPAL Rheumatology, Sydney, NSW, Australia,Monash University, Clayton, VIC, Australia
| | - Tim Freeman
- Software4Specialists Pty Ltd, Sydney, NSW, Australia
| | - David Hoffman
- Software4Specialists Pty Ltd, Sydney, NSW, Australia
| | - Dana Segelov
- Software4Specialists Pty Ltd, Sydney, NSW, Australia
| | - Hedley Griffiths
- OPAL Rheumatology, Sydney, NSW, Australia,Barwon Rheumatology Service, Geelong, VIC, Australia
| | - Sabina Ciciriello
- OPAL Rheumatology, Sydney, NSW, Australia,Royal Melbourne Hospital, Parkville, VIC, Australia
| | - Peter Youssef
- OPAL Rheumatology, Sydney, NSW, Australia,University of Sydney, Sydney, NSW, Australia,Royal Prince Alfred, Camperdown, NSW, Australia
| | - David Mathers
- OPAL Rheumatology, Sydney, NSW, Australia,Georgetown Arthritis, Newcastle, NSW, Australia
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Alten R, Rauch C, Chartier M, Nurmohamed MT, Connolly S, Buch MH, Peichl P, Mariette X, Patel Y, Marsal S, Caporali R, Griffiths H, Sanmartí R, Bannert B, Elbez Y, Lozenski K. POS0512 ANTI-CITRULLINATED PROTEIN ANTIBODY SEROSTATUS DETERMINES 2-YEAR RETENTION OF IV AND SC ABATACEPT IN PATIENTS WITH RA IN A REAL-WORLD SETTING. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.878] [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
BackgroundA treat-to-target approach for RA management is recommended.1,2 However, up to half of patients discontinue DMARD treatment within 18 months.2 Predictive biomarkers, such as anti-citrullinated protein antibodies (ACPAs) and RF, may be useful to stratify patients to the most appropriate treatment. ACTION (AbataCepT In rOutiNe clinical practice; NCT02109666) and ASCORE (Abatacept SubCutaneOus in Routine Clinical PracticE; NCT02090556) were 2-year, international, observational, prospective, multicenter studies of IV and SC abatacept, respectively, for the treatment of RA in routine clinical practice.3,4 Higher retention has been previously reported in patients with double ACPA/RF seropositive RA compared with double ACPA/RF seronegative RA.3,4ObjectivesTo assess the independent effect of ACPA or RF single seropositivity on abatacept retention in patients with RA receiving abatacept in a post hoc analysis of ACTION and ASCORE.MethodsThis post hoc analysis included patients aged ≥ 18 years, with active moderate-to-severe RA (ACR/EULAR 2010 criteria) who initiated IV (body weight–adjusted dosing) or SC (125 mg once weekly) abatacept.3,4 Patients were stratified by baseline ACPA/RF status: ACPA+/RF− (ACPA+ only), ACPA/RF double positive (+/+), ACPA−/RF+ (RF+ only), and ACPA/RF double negative (−/−). Abatacept retention rate at 2 years was estimated by Kaplan–Meier (KM) analysis.ResultsPatients with ACPA/RF serostatus data from the ACTION and ASCORE studies (N = 1679 and N = 1748, respectively) were evaluated. Baseline demographic and disease characteristics were similar across studies and serostatus groups (Table 1). In patients with ACPA+ only RA, abatacept retention rates were similar to the +/+ group and greater than the RF+ only and −/− groups (Figure 1). In ASCORE (Figure 1A), retention rates were significantly higher in ACPA+ only and +/+ groups when compared with the −/− group. In contrast, retention rates for patients with RF+ only RA were not significantly different vs −/− patients. Results were similar in ACTION, although the higher retention in the ACPA+ group did not reach statistical significance (Figure 1B).Table 1.Baseline demographics and disease characteristics by ACPA/RF status for the ASCORE and ACTION studiesASCORE+/+RF+ onlyACPA+ only−/−(n = 1079)(n = 142)(n = 184)(n = 343)Age, years57.1 (12.8)58.2 (11.8)57.4 (13.5)57.8 (13.9)DAS28 (CRP)4.7 (1.2)4.6 (1.1)4.4 (1.0)4.8 (1.2)CDAI26.6 (12.5)25.8 (12.0)23.6 (10.9)28.2 (13.2)SDAI28.1 (13.0)27.2 (12.4)24.4 (10.8)29.7 (13.9)ACTION+/+RF+ onlyACPA+ only−/−(n = 1028)(n = 161)(n = 98)(n = 392)Age, years58.2 (12.0)58.4 (13.4)58.5 (14.0)57.0 (13.3)DAS28 (CRP)4.9 (1.1)5.0 (1.1)4.9 (1.0)5.0 (1.1)CDAI28.7 (12.2)29.2 (12.4)28.7 (11.5)30.1 (12.9)SDAI30.4 (13.1)31.2 (13.4)29.8 (11.5)31.7 (13.4)Data are mean (SD). Patients with missing data for baseline ACPA/RF status are excluded.ConclusionIn this post hoc analysis of the real-world ACTION and ASCORE studies, ACPA positivity was associated with an increased likelihood of retention over 2 years. Patients with ACPA+ only RA were equally as likely to be retained on abatacept as patients with ACPA/RF double positivity. In contrast, patients with RF+ only RA were less likely to be retained on abatacept over 2 years. These findings suggest that ACPA positivity played a more important role than RF positivity in abatacept retention. The higher retention seen in patients with ACPA+ only vs RF+ only disease demonstrates the key role of ACPA in RA and supports the importance of precision medicine in treating patients.References[1]Fraenkel L, et al. Arthritis Care Res (Hoboken) 2021;73:924–39.[2]Smolen JS, et al. Ann Rheum Dis 2020;79:685–99.[3]Alten R, et al. Clin Rheumatol 2019;38:1413–24.[4]Alten R, et al. Ann Rheum Dis 2021;80(suppl 1):OP0180.AcknowledgementsThis study was sponsored by Bristol Myers Squibb. Medical writing and editorial assistance was provided by Fiona Boswell, PhD, of Caudex, and was funded by Bristol Myers Squibb. Study management provided by Syneos (CRO).Disclosure of InterestsRieke Alten Speakers bureau: AbbVie, Bristol Myers Squibb, Celltrion, Galapagos, Gilead, Janssen, Lilly, Novartis, Pfizer, Roche, Paid instructor for: AbbVie, Bristol Myers Squibb, Celltrion, Galapagos, Gilead, Janssen, Lilly, Novartis, Pfizer, Roche, Consultant of: AbbVie, Bristol Myers Squibb, Celltrion, Galapagos, Gilead, Janssen, Lilly, Novartis, Pfizer, Roche, Grant/research support from: AbbVie, Bristol Myers Squibb, Celltrion, Galapagos, Gilead, Janssen, Lilly, Novartis, Pfizer, Roche, Christiane Rauch Shareholder of: Bristol Myers Squibb, Employee of: Bristol Myers Squibb, Melanie Chartier Shareholder of: Bristol Myers Squibb, Employee of: Bristol Myers Squibb, M.T. Nurmohamed Speakers bureau: AbbVie, Bristol Myers Squibb, Eli Lilly, Janssen, Pfizer, Consultant of: AbbVie, Bristol Myers Squibb, Eli Lilly, Janssen, Pfizer, Grant/research support from: AbbVie, Amgen, Bristol Myers Squibb, Eli Lilly, Galapagos, Janssen, MSD, Pfizer, Sean Connolly Shareholder of: Bristol Myers Squibb, Employee of: Bristol Myers Squibb, Maya H Buch Speakers bureau: AbbVie, Consultant of: AbbVie, Galapagos, Gilead, Pfizer, Grant/research support from: Gilead, Pfizer, UCB, Peter Peichl Speakers bureau: GlaxoSmithKline, Janssen, Xavier Mariette Consultant of: Bristol Myers Squibb, Galapagos, GlaxoSmithKline, Janssen, Novartis, Pfizer, Sanofi, UCB, Yusuf Patel: None declared, Sara Marsal Speakers bureau: Bristol Myers Squibb, Lilly, MSD, Novartis - Sandoz, Pfizer, Roche, Consultant of: AbbVie, Galapagos, Pfizer, Sanofi; IMIDomics (executive role), Grant/research support from: AbbVie, Bristol Myers Squibb, Galapagos, Janssen, Lilly, MSD, Novartis - Sandoz, Pfizer, Roche, Sanofi, UCB, Roberto Caporali Speakers bureau: AbbVie, Amgen, Bristol Myers Squibb, Celltrion, Fresenius-Kabi, Galapagos, Janssen, Lilly, MSD, Novartis, Pfizer, Roche, Sandoz, UCB, Consultant of: AbbVie, Amgen, Bristol Myers Squibb, Celltrion, Galapagos, Janssen, Lilly, MSD, Novartis, Pfizer, Sandoz, UCB, Hedley Griffiths Consultant of: Amgen, Raimón Sanmartí Speakers bureau: AbbVie, Bristol Myers Squibb, Lilly, MSD, Pfizer, Roche, Sanofi, Grant/research support from: AbbVie, Bristol Myers Squibb, MSD, Pfizer, Roche, Bettina Bannert Speakers bureau: Novartis Pharma Schweiz AG, Yedid Elbez Consultant of: Bristol Myers Squibb, Employee of: Signifience, Karissa Lozenski Shareholder of: Bristol Myers Squibb, Employee of: Bristol Myers Squibb.
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Alten R, Rauch C, Chartier M, Nurmohamed MT, Connolly S, Buch MH, Peichl P, Mariette X, Patel Y, Marsal S, Caporali R, Griffiths H, Sanmartí R, Bannert B, Elbez Y, Lozenski K. POS0107 ACPA POSITIVITY DETERMINES REMISSION IN PATIENTS WITH RA TREATED WITH IV AND SC ABATACEPT: A POST HOC ANALYSIS OF THE REAL-WORLD OBSERVATIONAL ACTION AND ASCORE STUDIES. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.887] [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 goal of treatment for RA is achieving low disease activity and/or remission1,2; however, disease course and management can be complicated by additional factors that may be influenced by serostatus. Anti-citrullinated protein antibodies (ACPAs) and RF contribute to a more severe RA disease pattern3 and may be useful in predicting response to treatment.4 ACTION (AbataCepT In rOutiNe clinical practice; NCT02109666) and ASCORE (Abatacept SubCutaneOus in Routine Clinical PracticE; NCT02090556) were 2-year, international, observational, prospective, multicenter studies of IV and SC abatacept, respectively, for the treatment of RA in routine clinical practice.4,5 Previous analyses have shown that ACPA/RF double-positive serostatus was associated with better treatment outcomes compared with ACPA/RF double-negative serostatus.4–6ObjectivesTo assess the independent effect of ACPA or RF single seropositivity among patients with RA on achieving remission after treatment with abatacept for 2 years, and to compare outcomes among patients with single versus double serostatus.MethodsThis post hoc analysis included patients from ACTION and ASCORE who initiated IV (body weight–adjusted dosing) or SC abatacept (125 mg once weekly), respectively. Patients were stratified by baseline ACPA/RF status: ACPA+/RF− (ACPA+ only), ACPA/RF double positive (+/+), ACPA−/RF+ (RF+ only), and ACPA/RF double negative (−/−). DAS28 (CRP) and CDAI remission rates (defined as < 2.6 and 0–2.8, respectively) at 2 years for patients who were ACPA+ or RF+ only at baseline were assessed and compared with those who were +/+ and −/−. Patients with missing baseline ACPA/RF status were excluded. Last observation carried forward efficacy analyses were used to impute missing values.ResultsThis analysis included 1679 patients from ACTION (ACPA+ only, n = 98; +/+, n = 1028; RF+ only, n = 161; and −/−, n = 392) and 1748 patients from ASCORE (ACPA+ only, n = 184; +/+, n = 1079; RF+ only, n = 142; and −/−, n = 343). Across studies and serogroups, baseline demographics and disease characteristics were similar (data not shown). In both ACTION and ASCORE, a higher proportion of patients who were only ACPA+ achieved DAS28 (CRP) and CDAI remission at 2 years compared with patients who were only RF+ (Figure 1). Additionally, a similar proportion of patients who were only ACPA+ achieved DAS28 (CRP) and CDAI remission at 2 years compared with patients who were +/+. In contrast, a lower proportion of patients who were only RF+ achieved DAS28 (CRP) and CDAI remission at 2 years compared with patients who were +/+.ConclusionIn this post hoc analysis of real-world data from ACTION and ASCORE, ACPA positivity was associated with an increased likelihood of achieving DAS28 (CRP) and CDAI remission at 2 years. Patients who were ACPA+ only were as likely to achieve remission as +/+ patients, suggesting that RF serostatus had less influence than ACPA serostatus on remission status at 2 years. In line with this, patients who were RF+ only were less likely to achieve remission at 2 years. This is the first large, real-world study to show that ACPA positivity plays a more important role than RF positivity in achieving remission whilst on abatacept. These results highlight the importance of assessing baseline ACPA status when considering treatment options for patients with RA.References[1]Smolen JS, et al. Ann Rheum Dis 2020;79:685–99.[2]Fraenkel L, et al. Arthritis Care Res (Hoboken) 2021;73:924–39.[3]Katchamart, W, et al. Rheumatol Int 2015;35:1693–9.[4]Alten R, et al. Ann Rheum Dis 2021;80(suppl 1):OP0180.[5]Alten R, et al. Clin Rheumatol 2019;38:1413–24.[6]Alten R, et al. RMD Open 2017;3:e000345.AcknowledgementsThis study was sponsored by Bristol Myers Squibb. Medical writing and editorial assistance was provided by Rachel Rankin, PhD, of Caudex, and was funded by Bristol Myers Squibb. Study management provided by Syneos (CRO).Disclosure of InterestsRieke Alten Speakers bureau: AbbVie, Bristol Myers Squibb, Celltrion, Galapagos, Gilead, Janssen, Lilly, Novartis, Pfizer, Roche, Paid instructor for: AbbVie, Bristol Myers Squibb, Celltrion, Galapagos, Gilead, Janssen, Lilly, Novartis, Pfizer, Roche, Consultant of: AbbVie, Bristol Myers Squibb, Celltrion, Galapagos, Gilead, Janssen, Lilly, Novartis, Pfizer, Roche, Grant/research support from: AbbVie, Bristol Myers Squibb, Celltrion, Galapagos, Gilead, Janssen, Lilly, Novartis, Pfizer, Roche, Christiane Rauch Shareholder of: Bristol Myers Squibb, Employee of: Bristol Myers Squibb, Melanie Chartier Shareholder of: Bristol Myers Squibb, Employee of: Bristol Myers Squibb, M.T. Nurmohamed Speakers bureau: AbbVie, Bristol Myers Squibb, Eli Lilly, Janssen, Pfizer, Consultant of: AbbVie, Bristol Myers Squibb, Eli Lilly, Janssen, Pfizer, Grant/research support from: AbbVie, Amgen, Bristol Myers Squibb, Eli Lilly, Galapagos, Janssen, MSD, Pfizer, Sean Connolly Shareholder of: Bristol Myers Squibb, Employee of: Bristol Myers Squibb, Maya H Buch Speakers bureau: AbbVie, Consultant of: AbbVie, Galapagos, Gilead, Pfizer, Grant/research support from: Gilead, Pfizer, UCB, Peter Peichl Speakers bureau: Janssen, GlaxoSmithKline, Xavier Mariette Consultant of: Bristol Myers Squibb, Galapagos, GlaxoSmithKline, Janssen, Novartis, Pfizer, Sanofi, UCB, Yusuf Patel: None declared, Sara Marsal Speakers bureau: Bristol Myers Squibb, Lilly, MSD, Novartis - Sandoz, Pfizer, Roche, Consultant of: AbbVie, Galapagos, Pfizer, Sanofi; IMIDomics (executive role), Grant/research support from: AbbVie, Bristol Myers Squibb, Galapagos, Janssen, Lilly, MSD, Novartis - Sandoz, Pfizer, Roche, Sanofi, UCB, Roberto Caporali Speakers bureau: AbbVie, Amgen, Bristol Myers Squibb, Celltrion, Fresenius-Kabi, Galapagos, Janssen, Lilly, MSD, Novartis, Pfizer, Roche, Sandoz, UCB, Consultant of: AbbVie, Amgen, Bristol Myers Squibb, Celltrion, Galapagos, Janssen, Lilly, MSD, Novartis, Pfizer, Sandoz, UCB, Hedley Griffiths Consultant of: Amgen, Raimón Sanmartí Speakers bureau: AbbVie, Bristol Myers Squibb, Lilly, MSD, Pfizer, Roche, Sanofi, Grant/research support from: AbbVie, Bristol Myers Squibb, MSD, Pfizer, Roche, Bettina Bannert: None declared, Yedid Elbez Consultant of: Bristol Myers Squibb, Employee of: Signifience, Karissa Lozenski Shareholder of: Bristol Myers Squibb, Employee of: Bristol Myers Squibb
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Deakin C, De Stavola B, Littlejohn G, Griffiths H, Ciciriello S, Youssef P, Mathers D, Bird P, Smith T, Osullivan C, Freeman T, Segelov D, Hoffman D, Seaman S. POS0691 EMULATING A TARGET TRIAL OF ADALIMUMAB VERSUS TOFACITINIB IN PATIENTS WITH RHEUMATOID ARTHRITIS: A COMPARATIVE EFFECTIVENESS ANALYSIS USING THE OPAL REAL-WORLD DATASET. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.2515] [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
BackgroundThere is increasing recognition of the complementary role for real-world evidence (RWE) in health care and regulatory decision-making (1). However, careful analysis is required when drugs are compared using observational data to account for differences between treatment groups. Electronic medical records (EMR) are an important source of real-world data (RWD), but outcomes are often recorded incompletely.We emulated a target trial of adalimumab (ADA) versus tofacitinib (TOF) in patients with rheumatoid arthritis (RA) using the OPAL dataset to illustrate the application of methodologies to address the challenges of non-random treatment assignment and incomplete data. The OPAL dataset is derived from EMR of 112 community-based rheumatologists around Australia, where practitioners have discretion to prescribe whichever b/tsDMARD they consider most clinically appropriate.ObjectivesTo estimate the average treatment effect (ATE) of TOF compared to ADA at 3 and 9 months, defined as the difference in mean disease activity score (DAS28CRP), in patients with RA who are new users of a b/tsDMARD. This is equivalent to aiming to estimate the intention-to-treat effect in a randomised controlled trial.MethodsOPAL patients diagnosed with RA were included if they initiated ADA or TOF between 1 October 2015 and 1 April 2021, were new b/tsDMARD users (no prior recorded b/tsDMARD, at least 6 months of prior csDMARD treatment), and had at least 1 component of DAS28CRP recorded at baseline or during follow-up. Data were also extracted on baseline characteristics. Baseline characteristics were DAS28CRP, patient demographics, regional location, disease duration, prescriber characteristics (including gender, experience), prior recorded comorbidities, and prior and concomitant treatment with csDMARDs and oral corticosteroids.We used random forest multiple imputation to impute missing baseline and follow-up DAS28CRP components (2). Stable balancing weights (SBW) were then used to balance the treatment groups in terms of their baseline characteristics, including DAS28CRP (3). For each imputed dataset, the ATE at 3 months was estimated as the difference between the mean outcome in the two treatment groups after balancing (i.e. weighting) the sample, and then these estimates were averaged across the 10 imputed datasets. The ATE at 9 months was estimated similarly. The whole procedure was subsequently performed in 1000 bootstrap samples to estimate a 95% confidence interval (CI) for the ATEs using the percentile method (4).Results842 patients were identified including n=569 treated with ADA and n=273 treated with TOF. After applying the SBW, the maximum difference between the mean of each baseline characteristic in the ADA and TOF groups was less than 0.03% of the corresponding standard deviation in the whole sample, indicating reasonable balance was achieved in this complex dataset. After weighting, mean DAS28CRP reduced from 5.3 at baseline (both ADA and TOF groups) to 2.6 and 2.3 at 3 and 9 months for ADA, and 2.4 and 2.3 at 3 and 9 months for TOF.The estimated ATE was -0.22 (95% CI -0.36, -0.03; p=0.02) at 3 months, indicating a modest but significant reduction in disease activity for patients on TOF. The estimated ATE was -0.03 (95% CI -0.19, 0.1; p=0.56) at 9 months, indicating no difference between groups.ConclusionDAS28CRP was significantly lower at 3 months for patients treated with TOF compared to ADA. However, 3 months of treatment with either drug led to substantive average reductions in mean DAS28CRP, consistent with remission. There was no difference between drugs at 9 months. Future work will estimate a per-protocol effect.References[1]Arlett et al. Clin Pharmacol Ther 2022;111(1):21–3.[2]van Buuren and Groothuis-Oudshoorn J Stat Softw 201145(3):1–67[3]Zubizarreta J Am Stat Assoc 2015;110(511):910–22[4]Bartlett and Hughes Stat Methods Med Res 2020;29(12):3533–46AcknowledgementsThe authors acknowledge the members of OPAL Rheumatology Ltd and their patients for providing clinical data for this study, and Software4Specialists Pty Ltd for providing the Audit4 platform.Disclosure of InterestsClaire Deakin: None declared, Bianca De Stavola: None declared, Geoff Littlejohn Consultant of: Abbvie, Janssen, Bristol Myers Squibb, Gilead, Eli Lilly, and MSD, Hedley Griffiths Consultant of: AbbVie and Eli Lilly, Sabina Ciciriello: None declared, Peter Youssef Speakers bureau: AbbVie, Novartis, Eli Lilly, David Mathers: None declared, Paul Bird Speakers bureau: Abbvie, Janssen, Bristol Myers Squibb, Pfizer, Novartis, Gilead, Eli Lilly, Consultant of: Abbvie, Janssen, Bristol Myers Squibb, Pfizer, Novartis, Gilead, Eli Lilly, Imaging consulting for Synarc and Boston Imaging Core Lab., Tegan Smith: None declared, Catherine OSullivan: None declared, Tim Freeman: None declared, Dana Segelov: None declared, David Hoffman: None declared, Shaun Seaman: None declared
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Leadbetter J, Griffiths H. Dr. Griffiths et al reply. J Rheumatol 2022; 49:1075. [PMID: 35569833 DOI: 10.3899/jrheum.220120] [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: 11/22/2022]
Abstract
We thank Dr Schou for her insightful comments.1 The interpretation of data from an observational study such as this is complex, and the conclusions are by necessity less robust than in a randomized controlled trial.
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Affiliation(s)
- Jo Leadbetter
- WriteSource Medical, Lane Cove; OPAL Rheumatology Ltd, Sydney; Barwon Rheumatology Service, Geelong, Australia. The published study, "Persistence to Biologic Therapy Among Patients With Ankylosing Spondylitis: An Observational Study Using the OPAL Dataset" received financial assistance from Janssen-Cilag Pty Ltd, Australia. The study was conducted independently by OPAL with review and input on the study start up documents (protocol and statistical analysis plan) as well as review and input into final manuscript by Janssen staff member M. Acar. The authors declare no conflicts of interest relevant to this article. Address correspondence to Dr. H. Griffiths, Barwon Rheumatology Service, 156 Bellerine Street, Geelong, 3220 VIC, Australia.
| | - Hedley Griffiths
- WriteSource Medical, Lane Cove; OPAL Rheumatology Ltd, Sydney; Barwon Rheumatology Service, Geelong, Australia. The published study, "Persistence to Biologic Therapy Among Patients With Ankylosing Spondylitis: An Observational Study Using the OPAL Dataset" received financial assistance from Janssen-Cilag Pty Ltd, Australia. The study was conducted independently by OPAL with review and input on the study start up documents (protocol and statistical analysis plan) as well as review and input into final manuscript by Janssen staff member M. Acar. The authors declare no conflicts of interest relevant to this article. Address correspondence to Dr. H. Griffiths, Barwon Rheumatology Service, 156 Bellerine Street, Geelong, 3220 VIC, Australia.
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Alten R, Mariette X, Flipo RM, Caporali R, Buch MH, Patel Y, Marsal S, Sanmartí R, Nurmohamed MT, Griffiths H, Peichl P, Bannert B, Chartier M, Connolly SE, Lozenski K, Rauch C. Retention of subcutaneous abatacept for the treatment of rheumatoid arthritis: real-world results from the ASCORE study: an international 2-year observational study. Clin Rheumatol 2022; 41:2361-2373. [PMID: 35536413 PMCID: PMC9287226 DOI: 10.1007/s10067-022-06176-1] [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] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 04/01/2022] [Accepted: 04/09/2022] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To evaluate retention, efficacy, and safety of subcutaneous (SC) abatacept over 2 years in patients with moderate-to-severe RA in the Abatacept SubCutaneOus in Routine clinical practicE (ASCORE) study. METHODS Patients with RA who initiated SC abatacept 125 mg once weekly were enrolled in the international, observational, prospective multicentre ASCORE study into biologic-naïve or ≥ 1 prior biologic failure cohorts. PRIMARY ENDPOINT abatacept retention rate at 2 years. Secondary endpoints: proportion of patients with good/moderate EULAR response rates based on DAS28 (ESR), low disease activity and/or remission according to DAS28 (ESR; ≤ 3.2/ < 2.6), SDAI (≤ 11/ ≤ 3.3), CDAI (≤ 10/ ≤ 2.8), and Boolean criteria. Retention rate by baseline serostatus was evaluated post hoc. RESULTS Overall, 47% of patients remained on abatacept for 2 years, irrespective of treatment line. Higher abatacept retention rates were associated with lower prior biologic exposure. Generally, clinical outcomes showed that the proportion of patients with low disease activity/remission was higher in biologic-naïve patients (vs biologic-failure) and similar in those with 1 and ≥ 2 prior biologic failures. In patients on treatment at 2 years, good/moderate EULAR response rates of ~ 80% were consistently noted irrespective of prior biologic exposure. Across treatment lines, retention was greater in patients with seropositive (vs seronegative) RA. Patients with rheumatoid factor/anti-citrullinated protein antibody single-positive RA who were bio-naïve had higher retention than patients who were bio-experienced. CONCLUSIONS In the ASCORE study, SC abatacept retention was 47% at 2 years with good clinical outcomes and was well-tolerated in the real-world setting. Abatacept retention and clinical response rates were higher in patients who received abatacept as an earlier- versus later-line biologic drug treatment and in those with seropositive RA. TRIAL REGISTRATION ClinicalTrials.gov, NCT02090556.
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Affiliation(s)
- Rieke Alten
- Schlosspark-Klinik, University Medicine Berlin, Heubnerweg 2, 14059, Berlin, Germany.
| | - Xavier Mariette
- Université Paris-Saclay, AP-HP, Hospital Bicêtre, INSERM UMR1184, Le Kremlin Bicêtre, France
| | | | | | - Maya H Buch
- University of Leeds, Leeds, UK
- University of Manchester and NIHR Manchester Biomedical Research Centre, Manchester, UK
| | - Yusuf Patel
- Hull University Teaching Hospitals NHS Trust, Hull, UK
| | - Sara Marsal
- Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | | | - Michael T Nurmohamed
- ARC Amsterdam University Hospitals - VU University Medical & Reade, Amsterdam, Netherlands
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Griffiths H, Doraiswami M. P.90 Idiopathic transverse myelitis - an anaesthetic conundrum on labour ward. Int J Obstet Anesth 2022. [DOI: 10.1016/j.ijoa.2022.103386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Griffiths H, Das D. P.83 COL4A1 mutation - the new kid on the block. Int J Obstet Anesth 2022. [PMCID: PMC9060826 DOI: 10.1016/j.ijoa.2022.103379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Griffiths H, Rubino A, Parmar J. Impact of Surgical Approach for Lung Transplantation on Clinical Outcomes Regarding Patient Recovery. J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Tymms K, Butcher BE, Sletten TL, Smith T, O'Sullivan C, Littlejohn G, Sadler R, Tronnberg R, Griffiths H. Prevalence of sleep disturbance and the association between poor disease control in people with ankylosing spondylitis within the Australian clinical setting (ASLEEP study): a real-world observational study using the OPAL dataset. Clin Rheumatol 2021; 41:1105-1114. [PMID: 34825268 PMCID: PMC8913462 DOI: 10.1007/s10067-021-05953-8] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Revised: 09/27/2021] [Accepted: 09/30/2021] [Indexed: 11/08/2022]
Abstract
Introduction Sleep disturbance and fatigue are commonly reported in ankylosing spondylitis (AS) but specific prevalence and the relationship to disease control are unknown. Method This retrospective non-interventional observational study of data from the OPAL dataset included patients with AS (ICD code M45, M45.0 or M08.1), aged 18 to 95 years and had completed ≥ 1 sleep questionnaire between 1 January 2019 and 30 September 2020. The prevalence of insomnia and obstructive sleep apnoea were assessed using the Insomnia Severity Index (ISI) and Multivariate Apnoea Prediction Index (MAPI), respectively. Propensity score (PS) matching based on sex, age and symptom duration increased comparability between patients administered tumour necrosis factor inhibitors (TNFi) and interleukin 17A inhibitors (IL-17Ai). Results Four hundred ninety-five patients were included. The mean ISI total score in the overall population was 8.6 ± 6.2. Self-reported moderate or severe clinical insomnia was present in 16% and 3.2% of patients, respectively. The mean MAPI score was 0.4 ± 0.3, self-reported apnoea was identified in 31.5% of patients and the mean FACIT-Fatigue score was 36.1 ± 10.7. In the PS matched population, the only treatment-related difference was the mean MAPI score (IL-17Ai 0.4 ± 0.3 and TNFi 0.3 ± 0.2, p = 0.046). Those with poor disease control (BASDAI ≥ 4) were more likely (odds ratio [OR] 7.29, 95% CI 2.37 to 22.46, p = 0.001) to have a greater severity of insomnia symptoms than those with good disease control. Conclusion In this real-world AS cohort, poor disease control was associated with sleep disturbance. Little difference in sleep disturbance was observed between biologic TNFi and IL-17Ai treatment. Key Points | • Sleep disturbance and fatigue are common in patients with ankylosing spondylitis. • In our real-world cohort, self-reported apnoea was reported in one-third of patients; and one in five patients reported moderate to severe insomnia. • Those with poor disease control were more likely to experience greater sleep disturbance than those with good disease control. |
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Affiliation(s)
- Kathleen Tymms
- OPAL Rheumatology Ltd, Sydney, NSW, Australia. .,Canberra Rheumatology, 9/40 Marcus Clarke St, Canberra, ACT, 2601, Australia.
| | - Belinda E Butcher
- University of New South Wales, Kensington, NSW, Australia.,WriteSource Medical Pty Ltd, Lane Cove, NSW, Australia
| | - Tracey L Sletten
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, VIC, Australia
| | - Tegan Smith
- OPAL Rheumatology Ltd, Sydney, NSW, Australia
| | | | - Geoffrey Littlejohn
- OPAL Rheumatology Ltd, Sydney, NSW, Australia.,Department of Medicine, Monash University, Clayton, VIC, Australia
| | - Ricky Sadler
- Novartis Pharmaceuticals Australia Pty Ltd, Macquarie Park, NSW, Australia
| | - Rebecca Tronnberg
- Novartis Pharmaceuticals Australia Pty Ltd, Macquarie Park, NSW, Australia
| | - Hedley Griffiths
- OPAL Rheumatology Ltd, Sydney, NSW, Australia.,Barwon Rheumatology Service, Geelong, VIC, Australia
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Bird P, Littlejohn G, Butcher B, Smith T, O'Sullivan C, Witcombe D, Griffiths H. Real-world evaluation of effectiveness, persistence, and usage patterns of monotherapy and combination therapy tofacitinib in treatment of rheumatoid arthritis in Australia. Clin Rheumatol 2021; 41:53-62. [PMID: 34370130 PMCID: PMC8724080 DOI: 10.1007/s10067-021-05853-x] [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] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 06/24/2021] [Accepted: 06/29/2021] [Indexed: 01/05/2023]
Abstract
Objective This study aimed to describe the real-world effectiveness and treatment persistence among patients with rheumatoid arthritis treated with monotherapy and combination therapy tofacitinib and biologic disease-modifying antirheumatic drugs (bDMARDs). Methods This was a post hoc analysis of a retrospective, non-interventional study that extracted data for patients treated with tofacitinib or bDMARDs from the Australian OPAL dataset between March 2015 and September 2018. Monotherapy tofacitinib and bDMARDs and combination therapy tofactinib and bDMARDs were propensity score matched and treatment effectiveness and persistence of the groups were evaluated. Results In the bDMARD and tofacitinib monotherapy and combination therapy matched populations there were 1300 bDMARD initiators (n = 564 monotherapy) and 650 tofacitinib initiators (n = 282 monotherapy). In the bDMARD and tofacitinib monotherapy matched groups, 62.9% and 66.7% were in DAS-28 CRP disease remission after 18 months of treatment, respectively. In the combination therapy bDMARD and tofacitinib groups, 50% and 58.9% were in DAS-28 CRP disease remission after 18 months, respectively. The median treatment persistence was similar between the monotherapy bDMARD and tofacitinib treatment groups (36.7 months (95% CI 27.4 to “not reached’) and 34.2 months (95%CI 30.3 to “not reached”) respectively) as well as the combination therapy bDMARD and tofacitinib groups (32.2 months (95% CI 25.7 to 34.4) and 32.7 months (95%CI 28.7 to “not reached”, respectively). Conclusions Patients receiving combination therapy with tofacitinib or bDMARDs had higher disease activity scores at index than patients receiving monotherapy. Monotherapy with tofacitinib or bDMARDs, and combination therapy with tofacitinib or bDMARDs demonstrated similar treatment effectiveness and persistence, respectively.
Key Points • This study provides real-world evidence regarding effectiveness, treatment persistence, and treatment patterns, among patients with rheumatoid arthritis (RA) treated with monotherapy or combination therapy tofacitinib. • The study suggests that monotherapy and combination therapy tofacitinib is an effective intervention in RA with persistence and effectiveness comparable to bDMARDs. |
Supplementary Information The online version contains supplementary material available at 10.1007/s10067-021-05853-x.
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Affiliation(s)
- Paul Bird
- University of New South Wales, Kensington, New South Wales, Australia
| | - Geoffrey Littlejohn
- OPAL Rheumatology Ltd, Sydney, New South Wales, Australia.,Monash University, Clayton, Victoria, Australia
| | - Belinda Butcher
- University of New South Wales, Kensington, New South Wales, Australia.,WriteSource Medical Pty Ltd, Lane Cove, New South Wales, Australia
| | - Tegan Smith
- OPAL Rheumatology Ltd, Sydney, New South Wales, Australia
| | | | | | - Hedley Griffiths
- OPAL Rheumatology Ltd, Sydney, New South Wales, Australia.,Barwon Rheumatology Service, Geelong, Victoria, Australia
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Griffiths H, Smith T, Mack C, Leadbetter J, Butcher B, Acar M, Ciciriello S. Persistence to Biologic Therapy among Patients with Spondyloarthritis: An Observational Study using the OPAL Dataset. J Rheumatol 2021; 49:150-156. [PMID: 34334362 DOI: 10.3899/jrheum.201551] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/22/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVE To describe the treatment response and persistence to biologic DMARD (bDMARD) therapy in patients with ankylosing spondylitis (AS) in a real-world Australian cohort. METHODS This was a retrospective, non-interventional cohort study that extracted data for patients with AS from the Optimising Patient outcomes in Australian rheumatology (OPAL) dataset for the period Aug-2006 to Sep-2019. Patients were classified as either bDMARD initiators if they commenced a bDMARD during the sampling window, or bDMARD naïve if they did not. Results were summarised descriptively. Treatment persistence was calculated using Kaplan-Meier methods. Differences in treatment persistence were explored using log-rank tests. RESULTS 5048 patients with AS were identified. 2597 patients initiated bDMARDs and 2451 remained bDMARD naïve throughout the study window. Treatment with first, second and third line bDMARDs significantly reduced disease activity. Median persistence on first line bDMARDs was 96 months (95% CI 85 to 109), declining to 19 months (95% CI 16 to 22) in second line, and 14 months (95% CI 11 to 18) in third line therapy. Median persistence was longest for the golimumab treated group in all lines of therapy and shortest for the etanercept group. Differences in persistence rates according to the time-period that bDMARDs were prescribed (pre-and post-2012) were also seen for etanercept and adalimumab. CONCLUSION In this cohort all bDMARDs effectively reduced disease activity. Patients remained on their first bDMARD longer than subsequent agents. Median persistence was longest for the golimumab treated group in all lines of therapy and shortest for the etanercept group.
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Affiliation(s)
- Hedley Griffiths
- OPAL Rheumatology Ltd, Sydney, NSW, Australia; Barwon Rheumatology Service, Geelong, VIC, Australia; Coast Joint Care, Maroochydore, QLD, Australia; WriteSource Medical, Lane Cove, NSW, Australia; University of New South Wales, Kensington, NSW, Australia; Janssen-Cilag, Macquarie Park, NSW, Australia; Royal Melbourne Hospital, Parkville, VIC, Australia. Funding: This study received financial assistance from Janssen-Cilag Pty Ltd, Australia. The study was conducted independently by OPAL with review and input on the study start up documents (protocol and statistical analysis plan) as well as review and input into final manuscript by Janssen staff member M. Acar. Conflicts of interest: A.M. is an employee of Janssen-Cilag Pty Ltd. Australia Data statement: The OPAL dataset collects information from individual clinicians' servers during routine clinical consultations. Clinicians contributing data to OPAL use purpose-built worksheets in Audit4 software (Software4Specialists, Australia), and this software serves as the patient's medical record. Data de-identified for patient, clinic, and clinician were exported from each of the OPAL member's local server, and aggregated across all sites. Each clinician retains their patient records. Patient and Public Involvement: The research activities of OPAL Rheumatology Ltd are based on a patient opt-out arrangement. This report is based on data captured for routine clinical care and does not require additional informed consent to be obtained from patients. We thank patients for providing their clinical data for research purposes. Address correspondence to Hedley Griffiths, Barwon Rheumatology Service, 156 Bellerine Street, Geelong 3220 VIC, Australia.
| | - Tegan Smith
- OPAL Rheumatology Ltd, Sydney, NSW, Australia; Barwon Rheumatology Service, Geelong, VIC, Australia; Coast Joint Care, Maroochydore, QLD, Australia; WriteSource Medical, Lane Cove, NSW, Australia; University of New South Wales, Kensington, NSW, Australia; Janssen-Cilag, Macquarie Park, NSW, Australia; Royal Melbourne Hospital, Parkville, VIC, Australia. Funding: This study received financial assistance from Janssen-Cilag Pty Ltd, Australia. The study was conducted independently by OPAL with review and input on the study start up documents (protocol and statistical analysis plan) as well as review and input into final manuscript by Janssen staff member M. Acar. Conflicts of interest: A.M. is an employee of Janssen-Cilag Pty Ltd. Australia Data statement: The OPAL dataset collects information from individual clinicians' servers during routine clinical consultations. Clinicians contributing data to OPAL use purpose-built worksheets in Audit4 software (Software4Specialists, Australia), and this software serves as the patient's medical record. Data de-identified for patient, clinic, and clinician were exported from each of the OPAL member's local server, and aggregated across all sites. Each clinician retains their patient records. Patient and Public Involvement: The research activities of OPAL Rheumatology Ltd are based on a patient opt-out arrangement. This report is based on data captured for routine clinical care and does not require additional informed consent to be obtained from patients. We thank patients for providing their clinical data for research purposes. Address correspondence to Hedley Griffiths, Barwon Rheumatology Service, 156 Bellerine Street, Geelong 3220 VIC, Australia.
| | - Christopher Mack
- OPAL Rheumatology Ltd, Sydney, NSW, Australia; Barwon Rheumatology Service, Geelong, VIC, Australia; Coast Joint Care, Maroochydore, QLD, Australia; WriteSource Medical, Lane Cove, NSW, Australia; University of New South Wales, Kensington, NSW, Australia; Janssen-Cilag, Macquarie Park, NSW, Australia; Royal Melbourne Hospital, Parkville, VIC, Australia. Funding: This study received financial assistance from Janssen-Cilag Pty Ltd, Australia. The study was conducted independently by OPAL with review and input on the study start up documents (protocol and statistical analysis plan) as well as review and input into final manuscript by Janssen staff member M. Acar. Conflicts of interest: A.M. is an employee of Janssen-Cilag Pty Ltd. Australia Data statement: The OPAL dataset collects information from individual clinicians' servers during routine clinical consultations. Clinicians contributing data to OPAL use purpose-built worksheets in Audit4 software (Software4Specialists, Australia), and this software serves as the patient's medical record. Data de-identified for patient, clinic, and clinician were exported from each of the OPAL member's local server, and aggregated across all sites. Each clinician retains their patient records. Patient and Public Involvement: The research activities of OPAL Rheumatology Ltd are based on a patient opt-out arrangement. This report is based on data captured for routine clinical care and does not require additional informed consent to be obtained from patients. We thank patients for providing their clinical data for research purposes. Address correspondence to Hedley Griffiths, Barwon Rheumatology Service, 156 Bellerine Street, Geelong 3220 VIC, Australia.
| | - Jo Leadbetter
- OPAL Rheumatology Ltd, Sydney, NSW, Australia; Barwon Rheumatology Service, Geelong, VIC, Australia; Coast Joint Care, Maroochydore, QLD, Australia; WriteSource Medical, Lane Cove, NSW, Australia; University of New South Wales, Kensington, NSW, Australia; Janssen-Cilag, Macquarie Park, NSW, Australia; Royal Melbourne Hospital, Parkville, VIC, Australia. Funding: This study received financial assistance from Janssen-Cilag Pty Ltd, Australia. The study was conducted independently by OPAL with review and input on the study start up documents (protocol and statistical analysis plan) as well as review and input into final manuscript by Janssen staff member M. Acar. Conflicts of interest: A.M. is an employee of Janssen-Cilag Pty Ltd. Australia Data statement: The OPAL dataset collects information from individual clinicians' servers during routine clinical consultations. Clinicians contributing data to OPAL use purpose-built worksheets in Audit4 software (Software4Specialists, Australia), and this software serves as the patient's medical record. Data de-identified for patient, clinic, and clinician were exported from each of the OPAL member's local server, and aggregated across all sites. Each clinician retains their patient records. Patient and Public Involvement: The research activities of OPAL Rheumatology Ltd are based on a patient opt-out arrangement. This report is based on data captured for routine clinical care and does not require additional informed consent to be obtained from patients. We thank patients for providing their clinical data for research purposes. Address correspondence to Hedley Griffiths, Barwon Rheumatology Service, 156 Bellerine Street, Geelong 3220 VIC, Australia.
| | - Belinda Butcher
- OPAL Rheumatology Ltd, Sydney, NSW, Australia; Barwon Rheumatology Service, Geelong, VIC, Australia; Coast Joint Care, Maroochydore, QLD, Australia; WriteSource Medical, Lane Cove, NSW, Australia; University of New South Wales, Kensington, NSW, Australia; Janssen-Cilag, Macquarie Park, NSW, Australia; Royal Melbourne Hospital, Parkville, VIC, Australia. Funding: This study received financial assistance from Janssen-Cilag Pty Ltd, Australia. The study was conducted independently by OPAL with review and input on the study start up documents (protocol and statistical analysis plan) as well as review and input into final manuscript by Janssen staff member M. Acar. Conflicts of interest: A.M. is an employee of Janssen-Cilag Pty Ltd. Australia Data statement: The OPAL dataset collects information from individual clinicians' servers during routine clinical consultations. Clinicians contributing data to OPAL use purpose-built worksheets in Audit4 software (Software4Specialists, Australia), and this software serves as the patient's medical record. Data de-identified for patient, clinic, and clinician were exported from each of the OPAL member's local server, and aggregated across all sites. Each clinician retains their patient records. Patient and Public Involvement: The research activities of OPAL Rheumatology Ltd are based on a patient opt-out arrangement. This report is based on data captured for routine clinical care and does not require additional informed consent to be obtained from patients. We thank patients for providing their clinical data for research purposes. Address correspondence to Hedley Griffiths, Barwon Rheumatology Service, 156 Bellerine Street, Geelong 3220 VIC, Australia.
| | - Mustafa Acar
- OPAL Rheumatology Ltd, Sydney, NSW, Australia; Barwon Rheumatology Service, Geelong, VIC, Australia; Coast Joint Care, Maroochydore, QLD, Australia; WriteSource Medical, Lane Cove, NSW, Australia; University of New South Wales, Kensington, NSW, Australia; Janssen-Cilag, Macquarie Park, NSW, Australia; Royal Melbourne Hospital, Parkville, VIC, Australia. Funding: This study received financial assistance from Janssen-Cilag Pty Ltd, Australia. The study was conducted independently by OPAL with review and input on the study start up documents (protocol and statistical analysis plan) as well as review and input into final manuscript by Janssen staff member M. Acar. Conflicts of interest: A.M. is an employee of Janssen-Cilag Pty Ltd. Australia Data statement: The OPAL dataset collects information from individual clinicians' servers during routine clinical consultations. Clinicians contributing data to OPAL use purpose-built worksheets in Audit4 software (Software4Specialists, Australia), and this software serves as the patient's medical record. Data de-identified for patient, clinic, and clinician were exported from each of the OPAL member's local server, and aggregated across all sites. Each clinician retains their patient records. Patient and Public Involvement: The research activities of OPAL Rheumatology Ltd are based on a patient opt-out arrangement. This report is based on data captured for routine clinical care and does not require additional informed consent to be obtained from patients. We thank patients for providing their clinical data for research purposes. Address correspondence to Hedley Griffiths, Barwon Rheumatology Service, 156 Bellerine Street, Geelong 3220 VIC, Australia.
| | - Sabina Ciciriello
- OPAL Rheumatology Ltd, Sydney, NSW, Australia; Barwon Rheumatology Service, Geelong, VIC, Australia; Coast Joint Care, Maroochydore, QLD, Australia; WriteSource Medical, Lane Cove, NSW, Australia; University of New South Wales, Kensington, NSW, Australia; Janssen-Cilag, Macquarie Park, NSW, Australia; Royal Melbourne Hospital, Parkville, VIC, Australia. Funding: This study received financial assistance from Janssen-Cilag Pty Ltd, Australia. The study was conducted independently by OPAL with review and input on the study start up documents (protocol and statistical analysis plan) as well as review and input into final manuscript by Janssen staff member M. Acar. Conflicts of interest: A.M. is an employee of Janssen-Cilag Pty Ltd. Australia Data statement: The OPAL dataset collects information from individual clinicians' servers during routine clinical consultations. Clinicians contributing data to OPAL use purpose-built worksheets in Audit4 software (Software4Specialists, Australia), and this software serves as the patient's medical record. Data de-identified for patient, clinic, and clinician were exported from each of the OPAL member's local server, and aggregated across all sites. Each clinician retains their patient records. Patient and Public Involvement: The research activities of OPAL Rheumatology Ltd are based on a patient opt-out arrangement. This report is based on data captured for routine clinical care and does not require additional informed consent to be obtained from patients. We thank patients for providing their clinical data for research purposes. Address correspondence to Hedley Griffiths, Barwon Rheumatology Service, 156 Bellerine Street, Geelong 3220 VIC, Australia.
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McMahon O, Hallam TM, Patel S, Harris CL, Menny A, Zelek WM, Widjajahakim R, Java A, Cox TE, Tzoumas N, Steel DHW, Shuttleworth VG, Smith-Jackson K, Brocklebank V, Griffiths H, Cree AJ, Atkinson JP, Lotery AJ, Bubeck D, Morgan BP, Marchbank KJ, Seddon JM, Kavanagh D. The rare C9 P167S risk variant for age-related macular degeneration increases polymerization of the terminal component of the complement cascade. Hum Mol Genet 2021; 30:1188-1199. [PMID: 33783477 PMCID: PMC8212764 DOI: 10.1093/hmg/ddab086] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Revised: 03/21/2021] [Accepted: 03/22/2021] [Indexed: 12/25/2022] Open
Abstract
Age-related macular degeneration (AMD) is a complex neurodegenerative eye disease with behavioral and genetic etiology and is the leading cause of irreversible vision loss among elderly Caucasians. Functionally significant genetic variants in the alternative pathway of complement have been strongly linked to disease. More recently, a rare variant in the terminal pathway of complement has been associated with increased risk, Complement component 9 (C9) P167S. To assess the functional consequence of this variant, C9 levels were measured in two independent cohorts of AMD patients. In both cohorts, it was demonstrated that the P167S variant was associated with low C9 plasma levels. Further analysis showed that patients with advanced AMD had elevated sC5b-9 compared to those with non-advanced AMD, although this was not associated with the P167S polymorphism. Electron microscopy of membrane attack complexes (MACs) generated using recombinantly produced wild type or P167S C9 demonstrated identical MAC ring structures. In functional assays, the P167S variant displayed a higher propensity to polymerize and a small increase in its ability to induce hemolysis of sheep erythrocytes when added to C9-depleted serum. The demonstration that this C9 P167S AMD risk polymorphism displays increased polymerization and functional activity provides a rationale for the gene therapy trials of sCD59 to inhibit the terminal pathway of complement in AMD that are underway.
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Affiliation(s)
- O McMahon
- Complement Therapeutics Research Group, Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, NE2 4HH, UK
- National Renal Complement Therapeutics Centre, Royal Victoria Infirmary, Newcastle upon Tyne, NE1 4LP, UK
| | - T M Hallam
- Complement Therapeutics Research Group, Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, NE2 4HH, UK
- National Renal Complement Therapeutics Centre, Royal Victoria Infirmary, Newcastle upon Tyne, NE1 4LP, UK
| | - S Patel
- Department of Ophthalmology and Visual Sciences, University of Massachusetts Medical School, Worcester, MA 01655, USA
| | - C L Harris
- Complement Therapeutics Research Group, Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, NE2 4HH, UK
- National Renal Complement Therapeutics Centre, Royal Victoria Infirmary, Newcastle upon Tyne, NE1 4LP, UK
| | - A Menny
- Department of Life Sciences, Sir Ernst Chain Building, Imperial College London, London SW7 2AZ, UK
| | - W M Zelek
- Division of Infection and Immunity, School of Medicine, Systems Immunity Research Institute, Cardiff University, Heath Park, Cardiff CF14 4XN, UK
| | - R Widjajahakim
- Department of Ophthalmology and Visual Sciences, University of Massachusetts Medical School, Worcester, MA 01655, USA
| | - A Java
- Divisions of Nephrology and Rheumatology, Department of Medicine, Washington University, St Louis, MO 63110, USA
| | - T E Cox
- Complement Therapeutics Research Group, Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, NE2 4HH, UK
- National Renal Complement Therapeutics Centre, Royal Victoria Infirmary, Newcastle upon Tyne, NE1 4LP, UK
| | - N Tzoumas
- Biosciences Institute, Newcastle University, Newcastle upon Tyne, NE1 3BZ, UK
| | - D H W Steel
- Biosciences Institute, Newcastle University, Newcastle upon Tyne, NE1 3BZ, UK
| | - V G Shuttleworth
- Complement Therapeutics Research Group, Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, NE2 4HH, UK
- National Renal Complement Therapeutics Centre, Royal Victoria Infirmary, Newcastle upon Tyne, NE1 4LP, UK
| | - K Smith-Jackson
- Complement Therapeutics Research Group, Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, NE2 4HH, UK
- National Renal Complement Therapeutics Centre, Royal Victoria Infirmary, Newcastle upon Tyne, NE1 4LP, UK
| | - V Brocklebank
- Complement Therapeutics Research Group, Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, NE2 4HH, UK
- National Renal Complement Therapeutics Centre, Royal Victoria Infirmary, Newcastle upon Tyne, NE1 4LP, UK
| | - H Griffiths
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton SO16 6YD, UK
| | - A J Cree
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton SO16 6YD, UK
| | - J P Atkinson
- Divisions of Nephrology and Rheumatology, Department of Medicine, Washington University, St Louis, MO 63110, USA
| | - A J Lotery
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton SO16 6YD, UK
| | - D Bubeck
- Department of Life Sciences, Sir Ernst Chain Building, Imperial College London, London SW7 2AZ, UK
| | - B P Morgan
- Division of Infection and Immunity, School of Medicine, Systems Immunity Research Institute, Cardiff University, Heath Park, Cardiff CF14 4XN, UK
| | - K J Marchbank
- Complement Therapeutics Research Group, Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, NE2 4HH, UK
- National Renal Complement Therapeutics Centre, Royal Victoria Infirmary, Newcastle upon Tyne, NE1 4LP, UK
| | - J M Seddon
- Department of Ophthalmology and Visual Sciences, University of Massachusetts Medical School, Worcester, MA 01655, USA
| | - D Kavanagh
- Complement Therapeutics Research Group, Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, NE2 4HH, UK
- National Renal Complement Therapeutics Centre, Royal Victoria Infirmary, Newcastle upon Tyne, NE1 4LP, UK
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Tymms K, Butcher B, Sletten T, Smith T, Osullivan C, Littlejohn G, Sadler R, Tronnberg R, Griffiths H. POS0906 PREVALENCE OF SLEEP DISTURBANCE IN PATIENTS WITH ANKYLOSING SPONDYLITIS WITHIN THE AUSTRALIAN CLINICAL SETTING (ASLEEP STUDY): A REAL-WORLD OBSERVATIONAL STUDY USING THE OPAL DATASET. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.578] [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
Background:Sleep disorders are more prevalent in patients with ankylosing spondylitis (AS) compared to the general population. Sleep disturbance in AS, in addition to pain and fatigue, can lead to impaired physical function and reduced quality of life.Objectives:The primary objective was to determine the prevalence of sleep disturbance in patients with AS in a real-world Australian cohort using the Insomnia Severity Index (ISI) and Multivariate Apnoea Prediction Index (MAPI). ISI score of ≥ 15 is considered clinical insomnia. MAPI values below 0.05 are suggestive of clinical apnoea.Methods:Routinely collected, de-identified clinical data were sourced from the OPAL dataset. Patients aged between 18 and 95 years with a diagnosis of AS and who had completed at least one ISI or MAPI questionnaire between Jan-2019 and Sept-2020 were included. ISI and MAPI questionnaires were emailed to patients using OPAL’s electronic patient reported outcome (ePRO) delivery method or completed in the clinic using a smart device and returned to the patient’s file using a QR code. Disease activity was assessed using BASDAI collected at the same time as the sleep questionnaires. Age, sex and duration of symptoms were used to propensity match patients in the Il-17ai and TNFi group in a 1:2 ratio.Results:495 of the 5,323 patients identified with AS completed a questionnaire and were included in the analysis (n=395 TNFi, n=48 Il-17ai (secukinumab), n=52 other therapies). 142 were included in the propensity score matched population (n = 94 TNFi, and n = 48 Il-17ai). In the overall population the mean (SD) age was 48.3 (13.6), 55.4% were males, the mean (SD) BMI was 30.1 (19.6) at the index date and 4.8% reported depression. 51.7% had an optimal disease control (BASDAI <4). The mean (SD) ISI score was 8.6 (6.2). 48.1% reported no clinical significant insomnia, 32.7% reported subthreshold insomnia, 16% reported clinical insomnia (moderate severity) and 3.2% reported clinical insomnia (severe). The mean (SD) MAPI score was 0.4 (0.3). 292 patients (59.0%) had low risk of clinical apnoea, 134 patients (27.1%) had high risk of clinical apnoea and 69 patients 13.9% had not completed the MAPI questionnaire. In the propensity scored matched population, the TNFi and Il-17ai groups had mean (SD) ISI scores of 9.1 (6.6) and 8.9 (5.9) at index, respectively (p = 0.83) and mean (SD) MAPI scores of 0.3 (0.2) and 0.4 (0.3) at index, respectively (p=0.046), however a higher percentage of overweight and obese patients were identified in the Il-17ai treatment group. Ordered logistic regression analysis of the relationship between demographics and ISI in the matched population found that patients with BASDAI ≥4 were seven times more likely to experience greater sleep disturbance (OR 7.29, 95%CI 2.37 to 22.46, p=0.001) than those with BASDAI <4.Conclusion:In this real-world AS cohort, poor disease control was associated with sleep disturbance, despite bDMARD therapy. Little difference was observed between TNFi and Il-17ai treatment. Screening for sleep disturbance and fatigue in routine clinical care may provide a more holistic view of the burden of this disease.Table 1.Patient characteristics and outcome scores in the propensity
score matched population at index.TNFi (n=94)Il-17ai (n=48)p valueBMI category Underweight2 (2%)1 (2%)0.094 Normal weight33 (35%)8 (17%) Overweight24 (26%)16 (33%) Obese27 (29%)21 (44%) Missing8 (9%)2 (4%)Duration of treatment (months), mean (SD)61.0 (156.7)23.7 (20.1)0.18BASDAI <443 (46%)23 (48%)0.89BASDAI > 416 (17%)8 (17%)Missing35 (37%)17 (35%)ISI score, mean (SD)9.1 (6.6)8.9 (5.9)0.83ISI category (n (%)0.83 No clinically significant insomnia44 (57%)24 (50%) Subthreshold insomnia30 (32%)15 (31%) Clinical insomnia (moderate)15 (16%)8 (17%) Clinical insomnia (severe)5 (5%)1 (2%)MAPI score, mean (SD)0.3 (0.2)0.4 (0.3)0.046MAPI, high apnoea risk Yes17 (18%)16 (33%)0.051 No62 (66%)26 (54%) Missing15 (16%)6 (12%)Acknowledgements:The authors acknowledge the members of OPAL Rheumatology Ltd and their patients for providing clinical data for this study, and Software4Specialists Pty Ltd for providing the Audit4 platform. We acknowledge WriteSource Medical Pty Ltd for providing statistical services. Funding for this study was provided by Novartis.Disclosure of Interests:Kathleen Tymms: None declared, Belinda Butcher: None declared, Tracey Sletten: None declared, Tegan Smith: None declared, Catherine OSullivan: None declared, Geoff Littlejohn Consultant of: AbbVie, Bristol Myers Squibb, Eli Lilly, Gilead, Novartis, Pfizer, Janssen, Sandoz, Sanofi and Seqirus., Ricky Sadler Employee of: Current employee of Novartis, Rebecca Tronnberg Employee of: Current employee of Novartis, Hedley Griffiths Consultant of: AbbVie, Gilead, Novartis and Lilly.
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Deakin C, Littlejohn G, Griffiths H, Smith T, Osullivan C, Bird P. POS0619 MODELLING OF DISEASE ACTIVITY IN PATIENTS WITH INFLAMMATORY ARTHROPATHIES TREATED WITH ETANERCEPT ORIGINATOR OR BIOSIMILAR AS FIRST-LINE BIOLOGIC IN AN AUSTRALIAN REAL-WORLD DATASET. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.2265] [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
Background:The availability of biosimilars as non-proprietary versions of established biologic disease-modifying anti-rheumatic drugs (bDMARDs) is enabling greater access for patients with rheumatic diseases to effective medications at a lower cost. Since April 2017 both the originator and a biosimilar for etanercept (trade names Enbrel and Brenzys, respectively) have been available for use in Australia.Objectives:[1]To model effectiveness of etanercept originator or biosimilar in reducing Disease Activity Score 28-joint count C reactive protein (DAS28CRP) in patients with rheumatoid arthritis (RA), psoriatic arthritis (PsA) or ankylosing spondylitis (AS) treated with either drug as first-line bDMARD[2]To describe persistence on etanercept originator or biosimilar as first-line bDMARD in patients with RA, PsA or ASMethods:Clinical data were obtained from the Optimising Patient outcomes in Australian rheumatoLogy (OPAL) dataset, derived from electronic medical records. Eligible patients with RA, PsA or AS who initiated etanercept originator (n=856) or biosimilar (n=477) as first-line bDMARD between 1 April 2017 and 31 December 2020 were identified. Propensity score matching was performed to select patients on originator (n=230) or biosimilar (n=136) with similar characteristics in terms of diagnosis, disease duration, joint count, age, sex and concomitant medications. Data on clinical outcomes were recorded at 3 months after baseline, and then at 6-monthly intervals. Outcomes data that were missing at a recorded visit were imputed.Effectiveness of the originator, relative to the biosimilar, for reducing DAS28CRP over time was modelled in the matched population using linear mixed models with both random intercepts and slopes to allow for individual heterogeneity, and weighting of individuals by inverse probability of treatment weights to ensure comparability between treatment groups. Time was modelled as a combination of linear, quadratic and cubic continuous variables.Persistence on the originator or biosimilar was analysed using survival analysis (log-rank test).Results:Reduction in DAS28CRP was associated with both time and etanercept originator treatment (Table 1). The conditional R-squared for the model was 0.31. The average predicted DAS28CRP at baseline, 3 months, 6 months, 9 months and 12 months were 4.0 and 4.4, 3.1 and 3.4, 2.6 and 2.8, 2.3 and 2.6, and 2.2 and 2.4 for the originator and biosimilar, respectively, indicating a clinically meaningful effect of time for patients on either drug and an additional modest improvement for patients on the originator.Median time to 50% of patients stopping treatment was 25.5 months for the originator and 24.1 months for the biosimilar (p=0.53). An adverse event was the reason for discontinuing treatment in 33 patients (14.5%) on the originator and 18 patients (12.9%) on the biosimilar.Conclusion:Analysis using a large national real-world dataset showed treatment with either the etanercept originator or the biosimilar was associated with a reduction in DAS28CRP over time, with the originator being associated with a further modest reduction in DAS28CRP that was not clinically significant. Persistence on treatment was not different between the two drugs.Table 1.Respondent characteristics.Fixed EffectEstimate95% Confidence Intervalp-valueTime (linear)0.900.89, 0.911.5e-63Time (quadratic)1.011.00, 1.011.3e-33Time (cubic)1.001.00, 1.007.1e-23Originator0.910.86, 0.960.0013Acknowledgements:The authors acknowledge the members of OPAL Rheumatology Ltd and their patients for providing clinical data for this study, and Software4Specialists Pty Ltd for providing the Audit4 platform.Supported in part by a research grant from Investigator-Initiated Studies Program of Merck & Co Inc, Kenilworth, NJ, USA. The opinions expressed in this paper are those of the authors and do not necessarily represent those of Merck & Co Inc, Kenilworth, NJ, USA.Disclosure of Interests:Claire Deakin: None declared, Geoff Littlejohn Consultant of: Over the last 5 years Geoffrey Littlejohn has received educational grants and consulting fees from AbbVie, Bristol Myers Squibb, Eli Lilly, Gilead, Novartis, Pfizer, Janssen, Sandoz, Sanofi and Seqirus., Hedley Griffiths Consultant of: AbbVie, Gilead, Novartis and Lilly., Tegan Smith: None declared, Catherine OSullivan: None declared, Paul Bird Speakers bureau: Eli Lilly, abbvie, pfizer, BMS, UCB, Gilead, Novartis
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Tymms K, Smith T, Deakin C, Freeman T, Hoffman D, Segelov D, Griffiths H, Ciciriello S, Youssef P, Mathers D, Osullivan C, Littlejohn G. POS1461-HPR THE DEVELOPMENT OF A NOVEL EPRO DELIVERY SYSTEM TO MEASURE PATIENT QUALITY OF LIFE IN ROUTINE CLINICAL CARE: AN ANALYSIS OF 5 YEARS OF EXPERIENCE. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.2253] [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
Background:Registry studies and clinical trials are increasingly incorporating patient reported outcomes (PROs) to measure the full burden of disease and better measure the efficacy and value of medicines; however, the burden of paper-based surveys, time constraints, and privacy concerns impede the widespread use of PROs in routine clinical care.Objectives:To develop a simple and secure technological solution to incorporate validated PROs into routine clinical care for patients with rheumatic diseases, and to assess the patient response to functional assessment of chronic illness therapy fatigue (FACIT-F), patient health questionnaire-2 (PHQ-2), and healthcare resource utilization (HCRU) questionnaires delivered using this ePRO method.Methods:A novel ePRO questionnaire delivery system was developed by Software4Specialists in partnership with OPAL Rheumatology. Validated PRO questionnaires were sent from the patient’s electronic medical record (Audit4, Software4Specialists) and delivered to the patient’s email address at time intervals specified by the rheumatologist (defaults to quarterly) or completed in the clinic waiting room prior to the consultation using a tablet or the patient’s smart phone (in-practice). Completed questionnaires were encrypted and returned directly to the patient’s Audit4 electronic medical record held on the clinician’s server for review at the next clinical consultation. The link to the PRO questionnaire expired within 28 days if the questionnaire was not completed, and the questionnaires were automatically cancelled if 2 consecutive links expired. This technology was made available to up to 111 rheumatologists located in 42 clinics in 6 states/territories in Australia, and the use of this technology to furnish the clinical consultation was voluntary for clinicians and patients. Deidentified clinical data was extracted from the servers of participating rheumatologists and aggregated across all sites.1 Data collected between April 2016-Dec 2020 was analysed descriptively.Results:Between April 2016-Dec 2020, 99,505 FACIT-F, PHQ-2 and HCRU questionnaires have been delivered to 5,784 patients from 39 of 42 contributing clinics (93%). 85% of questionnaires were delivered via email and 15% in-practice. Overall, 85% of patients completed at least one questionnaire, and of all questionnaires sent, 73% were completed. These rates have remained consistent over time. The completion rates were higher when questionnaires were delivered to patients in-practice compared to email (96% vs 69%). Females were more likely to engage with the questionnaires than males (87% vs 81%), and older patients were slightly more likely to complete all questionnaires delivered. 69% of questionnaires sent via email were completed on the day they were delivered and 94% were completed within 7 days. The median (IQR) number of questionnaires completed per patient was 3 (1,7) and the median (IQR) time since the first questionnaire was completed was 13 months (5,26).Conclusion:The novel Audit4 ePRO delivery system is an effective tool for incorporating PROs into routine clinical care to capture data directly from the patient on the impact of their condition on their quality of life. The data generated provides a unique opportunity to understand the full burden of disease for patients in the real-world setting and the impact of interventions.References:[1]Littlejohn GO, Tymms KE, Smith T, Griffiths HT. Using big data from real-world Australian rheumatology encounters to enhance clinical care and research. Clin Exp Rheum 2020:38(5): 874 -880.Acknowledgements:The authors acknowledge the members of OPAL Rheumatology Ltd and their patients for providing clinical data for this study, and Software4Specialists Pty Ltd for providing the Audit4 platform.Disclosure of Interests:Kathleen Tymms: None declared, Tegan Smith: None declared, Claire Deakin: None declared, Tim Freeman: None declared, David Hoffman: None declared, Dana Segelov: None declared, Hedley Griffiths Consultant of: AbbVie, Gilead, Novartis and Lilly., Sabina Ciciriello: None declared, Peter Youssef: None declared, David Mathers: None declared, Catherine OSullivan: None declared, Geoff Littlejohn Consultant of: Over the last 5 years Geoffrey Littlejohn has received educational grants and consulting fees from AbbVie, Bristol Myers Squibb, Eli Lilly, Gilead, Novartis, Pfizer, Janssen, Sandoz, Sanofi and Seqirus
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Ciciriello S, Smith T, Osullivan C, Tymms K, Youssef P, Mathers D, Deakin C, Griffiths H, Littlejohn G. POS0223 PATTERNS OF JANUS KINASE INHIBITOR CYCLING FOR THE MANAGEMENT OF RHEUMATOID ARTHRITIS IN REAL-WORLD CLINICAL PRACTICE: AN ANALYSIS OF THE OPAL DATASET. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.2256] [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
Background:There are currently eleven biologic and targeted synthetic (b/ts)DMARDs acting via five different modes of action available for the treatment of RA in Australia. The cost of b/tsDMARDs is subsidized by government for patients that have active RA despite six months of combination csDMARD therapy. Once a patient is eligible, the clinician can prescribe the b/tsDMARD they deem to be the most clinically appropriate for the patient. In Oct 2015 the first JAK inhibitor (JAKi) became available in Australia (tofacitinib, TOF), baricitinib (BARI) became available in Sept 2018, and upadacitinib (UPA) in May 2020. Each of these oral tsDMARDs possess different selectivity profiles towards different members of the JAK family (JAK1–3 and Tyk2).Objectives:The aim of this analysis was to determine the patterns of JAKi cycling in real-world practice in Australia.Methods:Deidentified clinical data were sourced from the OPAL dataset, which is collected in a custom-built electronic medical record during the routine consultation1. Data from patients >18 years with RA who commenced a b/tsDMARD between Jan-2007 and Dec-2020 were included in the analysis. A visual analytics software program was used to display data on medication initiation and cessation dates, and reasons for stopping tsDMARDs, which is recorded in the medical record at the time of the decision.Results:At Dec 2020, 28% of the 52,190 patients with RA in the OPAL dataset were prescribed b/tsDMARDs. Of these patients, 3,850 (26.3%) were currently prescribed a JAKi with 51.4% receiving TOF, 29.2% BARI and 19.4% UPA. In 2020, JAKi initiations accounted for 48.8% of all initiations and 30.7% of 1st line initiations; an increase of 6.1% and 3.5% from 2019, respectively. The percentage of patients switching from a first line JAKi to a second line JAKi rather than an agent with another mode of action increased from 33.1% in 2019 to 42.6% in 2020. This is despite 26.2% in 2019 and 45.8% in 2020 of the patients switching to another JAKi citing lack of efficacy as the reason for JAKi discontinuation. In the period between May 2020, when a third JAKi (UPA) become available, and Dec 2020, the majority of patients switching from first line TOF or BARI to another JAKI switched to UPA (69.4% and 83.9%, respectively), whilst 30.6% of first line TOF patients switched to BARI (30.6%), and 16.1% of first line BARI patients switched to TOF in second line. The majority of patients switching from second line TOF or BARI to a third line JAKi switched to UPA (73% and 96%, respectively), with 27% of second line TOF patients switching to BARI and a very low number moving from second line BARI to TOF (4%). JAKi choice after a third line TOF or BARI was almost exclusively UPA (86.2% and 95.5%, respectively).Conclusion:There has been significant and sustained uptake of JAKi for the management of RA in Australia and JAKi cycling is increasingly common in routine clinical care. Clinical outcomes and persistence following JAKi cycling requires further investigation.References:[1]Littlejohn GO, Tymms KE, Smith T, Griffiths HT. Using big data from real-world Australian rheumatology encounters to enhance clinical care and research. Clin Exp Rheumatol. Sep-Oct 2020;38(5):874-880.Figure 1.Patterns of JAKi cycling for the management of rheumatoid arthritis in first, second and third line switching.Acknowledgements:The authors acknowledge the members of OPAL Rheumatology Ltd and their patients for providing clinical data for this study, and Software4Specialists Pty Ltd for providing the Audit4 platformDisclosure of Interests:Sabina Ciciriello: None declared, Tegan Smith: None declared, Catherine OSullivan: None declared, Kathleen Tymms: None declared, Peter Youssef: None declared, David Mathers: None declared, Claire Deakin: None declared, Hedley Griffiths Consultant of: AbbVie, Gilead, Novartis and Lilly., Geoff Littlejohn Speakers bureau: Over the last 5 years Geoffrey Littlejohn has received educational grants and consulting fees from AbbVie, Bristol Myers Squibb, Eli Lilly, Gilead, Novartis, Pfizer, Janssen, Sandoz, Sanofi and Seqirus.
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Alten R, Mariette X, Flipo RM, Caporali R, Buch MH, Patel Y, Marsal S, Nurmohamed MT, Griffiths H, Peichl P, Bannert B, Forster A, Chartier M, Elbez Y, Rauch C, Lozenski K, Khaychuk V. POS0447 PHYSICAL FUNCTION IN PATIENTS WITH RA, STRATIFIED BY SEROSTATUS AND TREATMENT LINE, FOLLOWING SC ABATACEPT: POST HOC ANALYSIS OF AN OBSERVATIONAL, 2-YEAR STUDY CONDUCTED IN ROUTINE CLINICAL PRACTICE (ASCORE). Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.903] [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
Background:RA is characterised by the production of autoantibodies, including RF and anti-citrullinated protein antibodies (ACPAs).1 Seropositive disease is associated with poorer prognosis in patients with RA,2 and response to different treatments has been shown to vary based on ACPA status.3 ASCORE (Abatacept SubCutaneOus in Routine Clinical PracticE; NCT02090556) was a 2-year, observational, prospective, multicentre study of SC abatacept for the treatment of RA.4Objectives:This post hoc analysis of the ASCORE study evaluated patient-reported outcomes, assessed using HAQ-DI, by RF/ACPA serostatus and treatment line over 24 months of treatment with abatacept.Methods:Eligible patients, aged ≥18 years, with active moderate-to-severe RA (ACR/EULAR 2010 criteria) who were IV abatacept-naive and initiated SC abatacept 125 mg once weekly, were enrolled into two cohorts: biologic (b)DMARD-naive patients and those with ≥1 prior bDMARD treatment failure. This post hoc analysis assessed mean change from baseline in HAQ-DI score at 6, 12, 18 and 24 months in response to treatment with abatacept stratified by baseline serostatus (RF/ACPA double positive [+/+]; RF/ACPA single positive [+/−; RF+/ACPA– or RF–/ACPA+] or RF/ACPA double negative [–/–]) and by line of therapy (all patients, patients receiving abatacept as a first-line bDMARD or as a ≥ second-line bDMARD [data not shown], and those receiving abatacept following 1 [data not shown] or ≥2 prior bDMARDs). Estimates of mean difference with 95% CIs between patients with different serostatus were calculated using a t-test for all patients and within different lines of therapy.Results:Among 2892 eligible patients in ASCORE, 1748 patients with RF/ACPA status available at baseline were included in this analysis (1079 +/+, 326 +/– and 343 –/–). Of these, 791 patients received abatacept as a first-line bDMARD therapy and 957 as a ≥ second-line bDMARD therapy (505 patients had received ≥2 prior bDMARDs). Among all patients, mean change from baseline in HAQ-DI score at 6 months was greater for patients with +/+ RA (mean difference [95% CI]: –0.2 [–0.3, –0.0]; p=0.0068) or +/– RA (mean difference [95% CI]: –0.2 [–0.3, –0.0]; p=0.0315) versus those with –/– RA at baseline (Figure 1). Similarly, mean change (95% CI) in HAQ-DI score at 6 months was greater for patients with +/+ RA versus –/– RA among those receiving abatacept as first-line therapy (–0.2 [–0.4, –0.0]; p=0.0407) or following treatment with ≥2 bDMARDs (–0.3 [–0.5, –0.0]; p=0.0265) (Figure 1). Among patients treated with abatacept following ≥2 prior bDMARDs, mean change in HAQ-DI score was higher among patients with +/– RA versus –/– RA at 18 months (data not shown) and 24 months (Figure 1). No other significant differences were observed by serostatus or line of therapy at any other time points.Conclusion:Patients with RA who were RF+/ACPA+ at baseline showed an enhanced initial response to abatacept compared with those who were RF–/ACPA–. Over 24 months of treatment in this real-world setting, abatacept was equally effective as a first- or ≥ second-line therapy.References:[1]Scott DL, et al. Lancet 2010;376:1094–1108.[2]Hecht C, et al. Ann Rheum Dis 2015;74:2151–2156.[3]Harrold LR, et al. J Rheumatol 2018;45:32–39.[4]Alten R, et al. Ann Rheum Dis 2019;78(suppl 2):A1639.Acknowledgements:Professional medical writing and editorial assistance was provided by Fiona Boswell, PhD, at Caudex and was funded by Bristol Myers Squibb. This study was funded by Bristol Myers Squibb.Disclosure of Interests:Rieke Alten Speakers bureau: AbbVie, Bristol Myers Squibb, Gilead, Janssen, Lilly, Pfizer, Consultant of: AbbVie, Bristol Myers Squibb, Gilead, Janssen, Lilly, Pfizer, Grant/research support from: AbbVie, Bristol Myers Squibb, Gilead, Janssen, Lilly, Pfizer, Xavier Mariette Consultant of: Bristol Myers Squibb, Galapagos, Gilead, GlaxoSmithKline, Janssen, Pfizer, UCB, Rene-Marc Flipo Speakers bureau: AbbVie, Bristol Myers Squibb, Janssen, Lilly, Medac, Merck Sharp & Dohme, Novartis, Pfizer, Roche-Chugai, Grant/research support from: Amgen, Janssen, Novartis, Pfizer, Roberto Caporali Speakers bureau: AbbVie, Amgen, Bristol Myers Squibb, Celltrion, Fresenius Kabi, Galapagos, Gilead, Lilly, Merck Sharp & Dohme, Pfizer, Roche, Samsung Bioepis, Sanofi, UCB, Consultant of: Galapagos, Gilead, Janssen, Lilly, Merck Sharp & Dohme, Maya H Buch Speakers bureau: AbbVie, Consultant of: AbbVie, Eli Lilly, Gilead, Merck Serono, Pfizer, Roche, Sanofi, Grant/research support from: Gilead, Pfizer, Roche, UCB, Yusuf Patel: None declared, Sara Marsal Speakers bureau: Bristol Myers Squibb, Celgene, Pfizer, Roche, Sanofi, UCB, Consultant of: AbbVie, Bristol Myers Squibb, Celgene, Galapagos, Merck Sharp & Dohme, Pfizer, Roche, Sanofi, UCB, Grant/research support from: AbbVie, Bristol Myers Squibb, Celgene, Janssen, Merck Sharp & Dohme, Novartis, Pfizer, Roche, Sanofi, UCB, M.T. Nurmohamed Speakers bureau: AbbVie, Bristol Myers Squibb, Eli Lilly, Roche, Sanofi, Consultant of: AbbVie, Celgene, Celltrion, Eli Lilly, Janssen, Grant/research support from: AbbVie, Bristol Myers Squibb, Celgene, Eli Lilly, Janssen, Merck Sharp & Dohme, Mundipharma, Novartis, Pfizer, Roche, Sanofi, Hedley Griffiths Consultant of: AbbVie, Gilead, Janssen, Novartis, Peter Peichl: None declared, Bettina Bannert: None declared, Adrian Forster: None declared, Melanie Chartier Shareholder of: Bristol Myers Squibb, Employee of: Bristol Myers Squibb, Yedid Elbez Consultant of: Bristol Myers Squibb, Christiane Rauch Shareholder of: Bristol Myers Squibb, Employee of: Bristol Myers Squibb, Karissa Lozenski Shareholder of: Bristol Myers Squibb, Employee of: Bristol Myers Squibb, Vadim Khaychuk Shareholder of: Bristol Myers Squibb, Employee of: Bristol Myers Squibb
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Alten R, Mariette X, Flipo RM, Caporali R, Buch MH, Patel Y, Sanmartí R, Marsal S, Nurmohamed MT, Griffiths H, Peichl P, Bannert B, Forster A, Chartier M, Connolly S, Elbez Y, Rauch C, Khaychuk V, Lozenski K. OP0180 IMPACT OF RF AND ANTI-CITRULLINATED PROTEIN ANTIBODY SEROSTATUS ON 2-YEAR RETENTION OF ABATACEPT IN PATIENTS WITH RA. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.932] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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
Background:Up to 50% of patients with RA discontinue DMARD treatment within 18 months.1 However, up to 20% of patients who fail multiple treatments may have a good treatment response to another therapy.1 Predictive biomarkers, such as RF and anti-citrullinated protein antibodies (ACPAs), may be useful to stratify patients with RA to the most appropriate treatment.1 ASCORE (Abatacept SubCutaneOus in Routine Clinical PracticE; NCT02090556) was a 2-year, observational, prospective, multicentre study of SC abatacept for the treatment of RA in routine clinical practice.2Objectives:To determine if RF/ACPA serostatus and treatment line impact abatacept retention in patients with RA in a post hoc analysis of ASCORE.Methods:Eligible patients, aged ≥18 years, with active moderate-to-severe RA (ACR/EULAR 2010 criteria) who were IV abatacept-naive and initiated SC abatacept 125 mg once weekly, were enrolled into two cohorts: biologic (b)DMARD-naive patients and those with ≥1 prior bDMARD treatment failure. This post hoc analysis assessed abatacept retention rate at 2 years in a subset of patients with RF/ACPA serostatus data (n=1748) from the ASCORE study (N=2892; as observed). Baseline (BL) serostatus groups examined by treatment line were: RF/ACPA double positive (+/+) RA, RF/ACPA single positive (RF+/ACPA– or RF–/ACPA+) RA (data not shown) and RF/ACPA double negative (–/–) RA. Last observation carried forward (LOCF) analyses were used to assess change from BL and measures of disease remission (DAS28 [CRP] <2.6, CDAI ≤2.8, and SDAI ≤3.3) in patients with +/+ RA versus –/– RA.Results:BL demographic and disease characteristics were similar across serostatus groups and treatment lines (Table 1). Mean age was 57.1 and 57.8 years for +/+ RA and –/– RA, respectively. Mean DAS28 (CRP) was 4.7 and 4.8 for +/+ RA and –/– RA, respectively. In patients with +/+ RA, abatacept retention was greater when given as first-line treatment (57% vs 48% when given as ≥ second-line) (Figure 1). Retention was similar in patients with –/– RA regardless of treatment line. After 2 years, mean (SE) change from BL (LOCF) in DAS28 (CRP) was –1.41 (0.06) and –0.97 (0.09) for patients with +/+ and –/– RA, respectively. For patients with +/+ RA, mean (SE) change from BL in DAS28 (CRP) was –1.62 (0.08) for those in whom abatacept was first-line and –1.19 (0.08) for those in whom abatacept was ≥ second-line. For patients with –/– RA, mean (SE) change from BL in DAS28 (CRP) was –1.03 (0.13) for those in whom abatacept was first-line and –0.93 (0.12) for those in whom abatacept was ≥ second-line. Remission rates (LOCF) were significantly (p<0.0001) higher in patients with +/+ RA vs –/– RA respectively: DAS28 (CRP) 38.4% (n=393) versus 19.3% (n=62); CDAI 50.6% (n=513) versus 33.0% (n=107); and SDAI 49.5% (n=497) versus 32.5% (n=102).Table 1.BL demographics and disease characteristics by RF/ACPA status+/+ RA(n=1079)–/– RA(n=343)First-line (n=511)≥ second-line (n=568)First-line(n=140)≥ second-line(n=203)Age57.1 (13.4)57.1 (12.2)59.5 (14.7)56.6 (13.2)DAS28 (CRP)4.7 (1.2)4.7 (1.2)4.8 (1.1)4.8 (1.2)CDAI26.6 (12.5)26.6 (12.4)27.7 (12.5)28.6 (13.8)SDAI28.1 (13.1)28.1 (12.9)29.1 (12.9)30.2 (14.7)Data are mean (SD). Patients with missing data for BL RF/ACPA status are excluded.ACPA=anti-citrullinated protein antibody; BL=baseline.Conclusion:In this real-world analysis, patients with +/+ RA treated with first-line abatacept had higher retention than patients receiving abatacept as a ≥ second-line therapy. Remission rates on abatacept were higher in patients with +/+ RA versus –/– RA. These results support early treatment with abatacept and highlight the importance of further evaluating precision medicine approaches in RA.References:[1]Smolen JS, et al. Ann Rheum Dis 2020;79:685–699.[2]Alten R, et al. Ann Rheum Dis 2019;78(suppl 2):A1639.Acknowledgements:Professional medical writing and editorial assistance was provided by Lindsay Craik at Caudex and was funded by Bristol Myers Squibb. This study was funded by Bristol Myers Squibb.Disclosure of Interests:Rieke Alten Speakers bureau: AbbVie, Bristol Myers Squibb, Gilead, Janssen, Lilly, Pfizer, Consultant of: AbbVie, Bristol Myers Squibb, Gilead, Janssen, Lilly, Pfizer, Grant/research support from: AbbVie, Bristol Myers Squibb, Gilead, Janssen, Lilly, Pfizer, Xavier Mariette Consultant of: Bristol Myers Squibb, Galapagos, Gilead, GlaxoSmithKline, Janssen, Pfizer, UCB, Rene-Marc Flipo Speakers bureau: AbbVie, Bristol Myers Squibb, Janssen, Lilly, Medac, Merck Sharp & Dohme, Novartis, Pfizer, Roche-Chugai, Grant/research support from: Amgen, Janssen, Novartis, Pfizer, Roberto Caporali Speakers bureau: AbbVie, Amgen, Bristol Myers Squibb, Celltrion, Fresenius Kabi, Galapagos, Gilead, Lilly, Merck Sharp & Dohme, Pfizer, Roche, Samsung Bioepis, Sanofi, UCB, Consultant of: Galapagos, Gilead, Janssen, Lilly, Merck Sharp & Dohme, Maya H Buch Speakers bureau: AbbVie, Consultant of: AbbVie, Eli Lilly, Gilead, Merck Serono, Pfizer, Roche, Sanofi, Grant/research support from: Gilead, Pfizer, Roche, UCB, Yusuf Patel: None declared, Raimón Sanmartí Speakers bureau: AbbVie, Bristol Myers Squibb, Gebro, Janssen, Lilly, Merck Sharp & Dohme, Pfizer, Roche, Sanofi, Consultant of: AbbVie, Bristol Myers Squibb, Gebro, Lilly, Merck Sharp & Dohme, Pfizer, Roche, Sanofi, Grant/research support from: Bristol Myers Squibb, Merck Sharp & Dohme, Pfizer, Sara Marsal Speakers bureau: Bristol Myers Squibb, Celgene, Pfizer, Roche, Sanofi, UCB, Consultant of: AbbVie, Bristol Myers Squibb, Celgene, Galapagos, Merck Sharp & Dohme, Pfizer, Roche, Sanofi, UCB, Grant/research support from: AbbVie, Bristol Myers Squibb, Celgene, Janssen, Merck Sharp & Dohme, Novartis, Pfizer, Roche, Sanofi, UCB, M.T. Nurmohamed Speakers bureau: AbbVie, Bristol Myers Squibb, Eli Lilly, Roche, Sanofi, Consultant of: AbbVie, Celgene, Celltrion, Eli Lilly, Janssen, Grant/research support from: AbbVie, Bristol Myers Squibb, Celgene, Eli Lilly, Janssen, Merck Sharp & Dohme, Mundipharma, Novartis, Pfizer, Roche, Sanofi, Hedley Griffiths Consultant of: AbbVie, Gilead, Janssen, Novartis, Peter Peichl: None declared, Bettina Bannert: None declared, Adrian Forster: None declared, Melanie Chartier Shareholder of: Bristol Myers Squibb, Employee of: Bristol Myers Squibb, Sean Connolly Shareholder of: Bristol Myers Squibb, Employee of: Bristol Myers Squibb, Yedid Elbez Consultant of: Bristol Myers Squibb, Christiane Rauch Shareholder of: Bristol Myers Squibb, Employee of: Bristol Myers Squibb, Vadim Khaychuk Shareholder of: Bristol Myers Squibb, Employee of: Bristol Myers Squibb, Karissa Lozenski Shareholder of: Bristol Myers Squibb, Employee of: Bristol Myers Squibb
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Alten R, Mariette X, Flipo RM, Caporali R, Buch MH, Patel Y, Sanmartí R, Marsal S, Nurmohamed MT, Griffiths H, Peichl P, Bannert B, Forster A, Chartier M, Elbez Y, Rauch C, Lozenski K, Khaychuk V. POS0599 DISEASE ACTIVITY IN PATIENTS WITH RA BY SEROSTATUS AND TREATMENT LINE, FOLLOWING TREATMENT WITH ABATACEPT: RESULTS FROM AN INTERNATIONAL OBSERVATIONAL STUDY. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.928] [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
Background:RF and anti-citrullinated protein antibodies (ACPAs) are associated with a severe and aggressive disease course in patients with RA.1 Abatacept is a selective co-stimulation modulator for the treatment of RA.2 ASCORE (Abatacept SubCutaneOus in Routine Clinical PracticE; NCT02090556) was a 2-year, observational, prospective, multicentre study of SC abatacept for the treatment of RA in routine clinical practice.3Objectives:To determine if serostatus and treatment line impacted disease activity in patients enrolled in the ASCORE study.Methods:Eligible patients, aged ≥18 years, with active moderate-to-severe RA (ACR/EULAR 2010 criteria) who were IV abatacept-naive and initiated SC abatacept 125 mg once weekly, were enrolled into two cohorts: biologic (b)DMARD-naive patients and those with ≥1 prior bDMARD treatment failure. This post hoc analysis assessed the mean change in disease activity (CDAI, SDAI and DAS28 [ESR]) from baseline (BL) at 6, 12, 18 and 24 months in response to treatment with abatacept. Patients were stratified by BL serostatus (all patients, RF/ACPA double positive [+/+] RA; RF/ACPA single positive [+/–; RF+/ACPA– or RF–/ACPA+] RA and RF/ACPA double negative [–/–] RA) and by line of therapy (all patients, patients receiving abatacept as a first-line or ≥ second-line therapy and those receiving abatacept following 1 or ≥2 prior bDMARDs). Overall patient data, as well as data for patients who were +/– or those who had 1 or ≥2 previous bDMARDs, are not shown. Estimates of mean difference are from t-test.Results:Among 2892 eligible patients in ASCORE, 1748 patients with RF/ACPA status available at BL were included in this analysis (1079 +/+ RA, 326 +/− RA and 343 −/− RA). After 6 months, patients with +/+ RA on first-line abatacept therapy had better improvements in CDAI and SDAI scores from BL than patients on ≥ second-line abatacept therapy (mean difference [95% CI]: –3.4 [–5.6, –1.1]; p=0.0032 and –3.9 [–6.5, –1.3]; p=0.0035, respectively); better improvements in SDAI were also seen after 12 months (mean difference [95% CI]: –3.5 [–6.5, –0.5]; p=0.0207). Changes in CDAI and SDAI scores were comparable after 18 and 24 months. At 6 and 12 months, patients with +/+ RA on first-line therapy had better improvements from BL in DAS28 (ESR) than those on ≥ second-line therapy (mean differences [95% CI]: –0.5 [–0.8, –0.2]; p=0.0002 and –0.4 [–0.7, –0.0]; p=0.0317, respectively); changes were comparable at 18 and 24 months (Figure 1). For patients on ≥ second-line therapy, at 18 months those with +/+ RA had better improvements from BL in DAS28 (ESR) than those with –/– RA (mean difference [95% CI]: –0.7 [–1.2, –0.1]; p=0.0232). For patients not stratified by line of therapy, changes in DAS28 (ESR) were comparable between the +/+ and –/– RA subgroups over time, with the exception of 6 months where patients with –/– RA had better improvements from BL compared with patients with +/+ RA (mean difference [95% CI]: –0.3 [–0.6, –0.0]; p=0.0495).Conclusion:In this real-world, post hoc analysis, patients with +/+ RA who received abatacept as a first-line therapy had greater early improvements in disease activity compared with patients who received abatacept as a ≥ second-line therapy. Improvements in disease activity at 24 months were comparable between patients who were +/+ and those who were –/–. Larger studies are needed to further corroborate these findings.References:[1]Katchamart W, et al. Rheumatol Int 2015;35:1693–1699.[2]Malmström V, et al. Nat Rev Immunol 2017;17:60–75.[3]Alten R, et al. Ann Rheum Dis 2019;78(Suppl 2):A1639.Acknowledgements:Professional medical writing and editorial assistance was provided by Rachel Rankin, PhD, at Caudex and was funded by Bristol Myers Squibb. This study was funded by Bristol Myers Squibb.Disclosure of Interests:Rieke Alten Speakers bureau: AbbVie, Bristol Myers Squibb, Gilead, Janssen, Lilly, Pfizer, Consultant of: AbbVie, Bristol Myers Squibb, Gilead, Janssen, Lilly, Pfizer, Grant/research support from: AbbVie, Bristol Myers Squibb, Gilead, Janssen, Lilly, Pfizer, Xavier Mariette Consultant of: Bristol Myers Squibb, Galapagos, Gilead, GlaxoSmithKline, Janssen, Pfizer, UCB, Rene-Marc Flipo Speakers bureau: AbbVie, Bristol Myers Squibb, Janssen, Lilly, Medac, Merck Sharp & Dohme, Novartis, Pfizer, Roche-Chugai, Grant/research support from: Amgen, Janssen, Novartis, Pfizer, Roberto Caporali Speakers bureau: AbbVie, Amgen, Bristol Myers Squibb, Celltrion, Fresenius Kabi, Galapagos, Gilead, Lilly, Merck Sharp & Dohme, Pfizer, Roche, Samsung Bioepis, Sanofi, UCB, Consultant of: Galapagos, Gilead, Janssen, Lilly, Merck Sharp & Dohme, Maya H Buch Speakers bureau: AbbVie, Consultant of: AbbVie, Eli Lilly, Gilead, Merck Serono, Pfizer, Roche, Sanofi, Grant/research support from: Gilead, Pfizer, Roche, UCB, Yusuf Patel: None declared, Raimón Sanmartí Speakers bureau: AbbVie, Bristol Myers Squibb, Gebro, Janssen, Lilly, Merck Sharp & Dohme, Pfizer, Roche, Sanofi, Consultant of: AbbVie, Bristol Myers Squibb, Gebro, Lilly, Merck Sharp & Dohme, Pfizer, Roche, Sanofi, Grant/research support from: Bristol Myers Squibb, Merck Sharp & Dohme, Pfizer, Sara Marsal Speakers bureau: Bristol Myers Squibb, Celgene, Pfizer, Roche, Sanofi, UCB, Consultant of: AbbVie, Bristol Myers Squibb, Celgene, Galapagos, Merck Sharp & Dohme, Pfizer, Roche, Sanofi, UCB, Grant/research support from: AbbVie, Bristol Myers Squibb, Celgene, Janssen, Merck Sharp & Dohme, Novartis, Pfizer, Roche, Sanofi, UCB, M.T. Nurmohamed Speakers bureau: AbbVie, Bristol Myers Squibb, Eli Lilly, Roche, Sanofi, Consultant of: AbbVie, Celgene, Celltrion, Eli Lilly, Janssen, Grant/research support from: AbbVie, Bristol Myers Squibb, Celgene, Eli Lilly, Janssen, Merck Sharp & Dohme, Mundipharma, Novartis, Pfizer, Roche, Sanofi, Hedley Griffiths Consultant of: AbbVie, Gilead, Janssen, Novartis, Peter Peichl: None declared, Bettina Bannert: None declared, Adrian Forster: None declared, Melanie Chartier Shareholder of: Bristol Myers Squibb, Employee of: Bristol Myers Squibb, Yedid Elbez Consultant of: Bristol Myers Squibb, Christiane Rauch Shareholder of: Bristol Myers Squibb, Employee of: Bristol Myers Squibb, Karissa Lozenski Shareholder of: Bristol Myers Squibb, Employee of: Bristol Myers Squibb, Vadim Khaychuk Shareholder of: Bristol Myers Squibb, Employee of: Bristol Myers Squibb
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Alten R, Mariette X, Flipo RM, Caporali R, Buch MH, Patel Y, Sanmartí R, Marsal S, Nurmohamed MT, Griffiths H, Peichl P, Bannert B, Forster A, Chartier M, Elbez Y, Rauch C, Khaychuk V, Lozenski K. AB0207 ANALYSIS OF ABATACEPT TREATMENT RETENTION AND EFFICACY ACCORDING TO DISEASE DURATION AND TREATMENT LINE IN A REAL-WORLD SETTING. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.955] [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
Background:Longer disease duration and greater number of prior DMARDs have been associated with lower treatment efficacy in patients with RA.1 Abatacept is a biologic (b)DMARD for treatment of moderate-to-severe RA and is available in SC formulation, which may offer convenience benefits with efficacy similar to IV administration.2 ASCORE (Abatacept SubCutaneOus in Routine Clinical PracticE; NCT02090556) was a 2-year, observational, prospective, multicentre study of SC abatacept for treatment of RA in routine clinical practice.3Objectives:This post hoc analysis was conducted to determine if retention and efficacy of abatacept were impacted by disease duration and/or treatment line.Methods:Eligible patients, aged ≥18 years, with active moderate-to-severe RA (ACR/EULAR 2010 criteria) who were IV abatacept-naive and initiated SC abatacept 125 mg once weekly, were enrolled into two cohorts: bDMARD-naive patients and those with ≥1 prior bDMARD treatment failure. This post hoc analysis evaluated abatacept retention using Kaplan-Meier estimates, as well as disease activity scores (DAS28 [ESR]), CDAI and SDAI in patients with disease duration of ≤2, 3–5, 6–10 or >10 years, and in patients taking abatacept as first-line or ≥ second-line treatment.Results:Table 1 shows baseline (BL) characteristics. Mean age increased with disease duration; other characteristics were comparable across groups. Retention proportions (95% CIs) at Month 24 were 0.50 (0.4, 0.5), 0.47 (0.4, 0.5), 0.51 (0.5, 0.5) and 0.46 (0.4, 0.5) in the ≤2, 3–5, 6–10 and >10 years’ duration groups, respectively. Proportion of patients (95% CI) with ≤2 years’ duration retaining treatment at Month 24 were 0.51 (0.4, 0.6) among those using abatacept as first-line treatment and 0.44 (0.3, 0.6) among those using abatacept as a ≥ second-line treatment (Figure 1). Proportions (95% CI) at Month 24 were 0.51 (0.5, 0.6), 0.57 (0.5, 0.6) and 0.52 (0.5, 0.6) in first-line patients and 0.43 (0.4, 0.5), 0.48 (0.4, 0.5) and 0.44 (0.4, 0.5) in ≥ second-line patients in the 3–5, 6–10 and >10 years’ duration groups, respectively. Mean (SE) changes from BL in DAS28 (ESR) at Month 24 were –2.12 (0.205), –1.86 (0.151), –2.07 (0.140) and –2.05 (0.115) in the ≤2, 3–5, 6–10 and >10 years’ duration groups, respectively; respective mean (SE) changes in CDAI were –18.74 (1.604), –15.60 (1.099), –18.50 (1.038) and –17.68 (0.850); and respective mean (SE) changes in SDAI were –19.10 (1.873), –15.72 (1.345), –19.54 (1.103) and –17.07 (0.939).Conclusion:In this post hoc analysis of the real-world ASCORE trial, patients with RA receiving abatacept in clinical practice as first-line therapy had better retention versus those receiving it as a ≥ second-line treatment, regardless of disease duration at BL. Retention rates were similar across disease duration subgroups. Improvements in disease activity were seen in all duration subgroups, without consistently greater or lesser improvement seen with longer disease duration.References:[1]Aletaha D, et al. Ann Rheum Dis 2019;78:1609–1615.[2]Genovese MC, et al. Arthritis Rheumatol 2011;63:2854–2864.[3]Alten R, et al. Ann Rheum Dis 2019;78(suppl 2):A1639.Table 1.BL characteristics (n=2872)RA disease duration, years≤2(n=338)3–5(n=655)6–10(n=686)>10(n=1193)Age, years n3386556861193 Mean (SD)55.2 (12.8)55.6 (12.7)56.9 (13.0)59.9 (12.2)Weight, kg n3276296651150 Mean (SD)75.3 (18.1)76.4 (19.0)74.7 (17.4)72.9 (16.0)DAS28 (ESR) n247439441743 Mean (SD)5.2 (1.3)4.9 (1.3)5 (1.2)5.1 (1.3)DAS28 (CRP) n267460467799 Mean (SD)4.7 (1.2)4.6 (1.2)4.7 (1.1)4.7 (1.2)CDAI n269477474805 Mean (SD)26.9 (12.7)25.3 (12.2)26.8 (12.4)26.6 (12.2)SDAI n255448445749 Mean (SD)28.3 (13.3)26.8 (12.9)27.9 (12.6)28.0 (12.7)RF status, n (%) RF+159 (47.0)342 (52.2)345 (50.3)597 (50.0) RF–103 (30.5)152 (23.2)158 (23.0)215 (18.0)Anti-CCP status, n (%) Anti-CCP+165 (48.8)332 (50.7)333 (48.5)516 (43.3) Anti-CCP–89 (26.3)126 (19.2)137 (20.0)175 (14.7)Patients with missing duration of disease are excluded.CCP=cyclic citrullinated peptide.Acknowledgements:Professional medical writing and editorial assistance was provided by Rob Coover, MPH, at Caudex and was funded by Bristol Myers Squibb. This study was funded by Bristol Myers Squibb.Disclosure of Interests:Rieke Alten Speakers bureau: AbbVie, Bristol Myers Squibb, Gilead, Janssen, Lilly, Pfizer, Consultant of: AbbVie, Bristol Myers Squibb, Gilead, Janssen, Lilly, Pfizer, Grant/research support from: AbbVie, Bristol Myers Squibb, Gilead, Janssen, Lilly, Pfizer, Xavier Mariette Consultant of: Bristol Myers Squibb, Galapagos, Gilead, GlaxoSmithKline, Janssen, Pfizer, UCB, Rene-Marc Flipo Speakers bureau: AbbVie, Bristol Myers Squibb, Janssen, Lilly, Medac, Merck Sharp & Dohme, Novartis, Pfizer, Roche-Chugai, Grant/research support from: Amgen, Janssen, Novartis, Pfizer, Roberto Caporali Speakers bureau: AbbVie, Amgen, Bristol Myers Squibb, Celltrion, Fresenius Kabi, Galapagos, Gilead, Lilly, Merck Sharp & Dohme, Pfizer, Roche, Samsung Bioepis, Sanofi, UCB, Consultant of: Galapagos, Gilead, Janssen, Lilly, Merck Sharp & Dohme, Maya H Buch Speakers bureau: AbbVie, Consultant of: AbbVie, Eli Lilly, Gilead, Merck Serono, Pfizer, Roche, Sanofi, Grant/research support from: Gilead, Pfizer, Roche, UCB, Yusuf Patel: None declared, Raimón Sanmartí Speakers bureau: AbbVie, Bristol Myers Squibb, Gebro, Janssen, Lilly, Merck Sharp & Dohme, Pfizer, Roche, Sanofi, Consultant of: AbbVie, Bristol Myers Squibb, Gebro, Lilly, Merck Sharp & Dohme, Pfizer, Roche, Sanofi, Grant/research support from: Bristol Myers Squibb, Merck Sharp & Dohme, Pfizer, Sara Marsal Speakers bureau: Bristol Myers Squibb, Celgene, Pfizer, Roche, Sanofi, UCB, Consultant of: AbbVie, Bristol Myers Squibb, Celgene, Galapagos, Merck Sharp & Dohme, Pfizer, Roche, Sanofi, UCB, Grant/research support from: AbbVie, Bristol Myers Squibb, Celgene, Janssen, Merck Sharp & Dohme, Novartis, Pfizer, Roche, Sanofi, UCB, M.T. Nurmohamed Speakers bureau: AbbVie, Bristol Myers Squibb, Eli Lilly, Roche, Sanofi, Consultant of: AbbVie, Celgene, Celltrion, Eli Lilly, Janssen, Grant/research support from: AbbVie, Bristol Myers Squibb, Celgene, Eli Lilly, Janssen, Merck Sharp & Dohme, Mundipharma, Novartis, Pfizer, Roche, Sanofi, Hedley Griffiths Consultant of: AbbVie, Gilead, Janssen, Novartis, Peter Peichl: None declared, Bettina Bannert: None declared, Adrian Forster: None declared, Melanie Chartier Shareholder of: Bristol Myers Squibb, Employee of: Bristol Myers Squibb, Yedid Elbez Consultant of: Bristol Myers Squibb, Christiane Rauch Shareholder of: Bristol Myers Squibb, Employee of: Bristol Myers Squibb, Vadim Khaychuk Shareholder of: Bristol Myers Squibb, Employee of: Bristol Myers Squibb, Karissa Lozenski Shareholder of: Bristol Myers Squibb, Employee of: Bristol Myers Squibb
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Jukes C, Bjerre A, Codina C, Griffiths H. Measurement of ductions and fields of binocular single vision (BSV): orthoptic practice in the UK and Ireland. Strabismus 2021; 29:95-101. [PMID: 33904348 DOI: 10.1080/09273972.2021.1914679] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
To evaluate the current clinical practice of quantifying ductions and fields of BSV in the UK and Ireland using an online questionnaire. An anonymous online questionnaire with twenty-one questions was distributed in February 2019 via the British and Irish Orthoptic Society (BIOS) members' newsletter. Objectives were to investigate: methods used, frequency of assessment, limiting factors and opinions of importance. Informed consent was gained to include the responses in the study. The data was analyzed using descriptive statistics and Wilcoxon Signed Ranks Testing. The questionnaire was completed by 105 orthoptists. The methods reported to quantify ductions and fields of BSV respectively were: Goldmann (33% and 34%), Aimark (22 and 23%), Lister (7%), Octopus (5 and 4%), Thomson ocular motility analyzer (2 and 3%), Binocular vision analyzer (2%) and no method reported (30% and 32%). The frequency of measuring ductions and fields of BSV per week (median 1-2) was significantly less than the number of patients seen with limited ocular motility per week (median 6-9). The main reasons for never or rarely measuring ductions or fields of BSV were not enough time, no method available and only on selected patients. Respondents indicated that they would measure ductions and fields of BSV more frequently if a quicker portable method was available (median 3-5 times per week). Most agreed that measurements of ductions and fields of BSV are important (89 and 95% respectively). There is no standardized method of quantitively measuring ductions or fields of BSV, with almost a third of respondents not measuring either. Although most orthoptists agreed these measurements are important, they are infrequently performed. The main factors limiting these assessments are insufficient time and lack of a testing method. If a faster portable device was available, orthoptists would measure ductions and fields of BSV more frequently.
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Affiliation(s)
- Catherine Jukes
- Orthoptic Department, Blackpool Teaching Hospital, Blackpool.,Division of Ophthalmology and Orthoptics, University of Sheffield, Sheffield
| | - A Bjerre
- Division of Ophthalmology and Orthoptics, University of Sheffield, Sheffield
| | - C Codina
- Division of Ophthalmology and Orthoptics, University of Sheffield, Sheffield
| | - H Griffiths
- Division of Ophthalmology and Orthoptics, University of Sheffield, Sheffield
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Aw J, Griffiths H, Zochling J, Lanzafame A, Jordan A. Usability of the Certolizumab Pegol Auto-Injection Device in Australian Patients with Chronic Rheumatic Diseases: Results from a Market Research Study. Patient Prefer Adherence 2021; 15:1469-1476. [PMID: 34234420 PMCID: PMC8254605 DOI: 10.2147/ppa.s310086] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Accepted: 05/01/2021] [Indexed: 11/23/2022] Open
Abstract
PURPOSE To determine the usability of the ergonomically designed certolizumab pegol pre-filled pen (CZP PFP) in Australian patients with active ankylosing spondylitis, active psoriatic arthritis or moderate-to-severe rheumatoid arthritis. PATIENTS AND METHODS CZP-naive patients were recruited from six clinical centers in Australia between November 2018 and May 2019. Patients and healthcare professionals (HCPs) reviewed training materials and completed pre-injection surveys; patients then self-administered ≥1 injection with the CZP PFP during each of three visits. Patients and HCPs then completed post-injection surveys. Some survey questions were adapted from the self-injection assessment questionnaire (SIAQv2.0). RESULTS Seventy patients participated (65 completed 3 visits); 33 were biologic-experienced. All patients agreed that training materials were informative; 94% found them easy to understand. Pre-injection, 89% of patients reported little or no anxiety about having injections; 67% (79% in biologic-experienced) were very confident about self-injecting the correct dose with the PFP. Ninety percent of patients were satisfied/very satisfied with their first experience with the CZP PFP; those with pre-injection anxiety reported lower satisfaction (43% vs 79% "very satisfied"). Confidence and satisfaction increased as visits progressed (for Visit 3 vs Visit 2: 69% vs 56% "very convenient"; 75% vs 67% "very confident"; 71% vs 57% "very satisfied"). All HCPs were confident in their patients' competence to self-inject and thought all patients had overall positive experiences. CONCLUSION Australian patients with chronic rheumatic disease reported high levels of confidence and satisfaction following initial use of the CZP PFP. The availability of devices with patient-centered design innovations may help overcome barriers to self-injection for improved adherence/outcomes.
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Affiliation(s)
- Juan Aw
- Peninsula Rheumatology, Langwarrin, VIC, Australia
| | | | | | | | - Andrew Jordan
- BJC Health, Parramatta, NSW, Australia
- Correspondence: Andrew Jordan BJC Health, Level 1, 17-21 Hunter St, Parramatta, NSW, 2150, AustraliaTel +61 1300 252 698Fax +61 02 9890 7655 Email
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McLean KA, Ahmed WUR, Akhbari M, Claireaux HA, English C, Frost J, Henshall DE, Khan M, Kwek I, Nicola M, Rehman S, Varghese S, Drake TM, Bell S, Nepogodiev D, McLean KA, Drake TM, Glasbey JC, Borakati A, Drake TM, Kamarajah S, McLean KA, Bath MF, Claireaux HA, Gundogan B, Mohan M, Deekonda P, Kong C, Joyce H, Mcnamee L, Woin E, Burke J, Khatri C, Fitzgerald JE, Harrison EM, Bhangu A, Nepogodiev D, Arulkumaran N, Bell S, Duthie F, Hughes J, Pinkney TD, Prowle J, Richards T, Thomas M, Dynes K, Patel M, Patel P, Wigley C, Suresh R, Shaw A, Klimach S, Jull P, Evans D, Preece R, Ibrahim I, Manikavasagar V, Smith R, Brown FS, Deekonda P, Teo R, Sim DPY, Borakati A, Logan AE, Barai I, Amin H, Suresh S, Sethi R, Bolton W, Corbridge O, Horne L, Attalla M, Morley R, Robinson C, Hoskins T, McAllister R, Lee S, Dennis Y, Nixon G, Heywood E, Wilson H, Ng L, Samaraweera S, Mills A, Doherty C, Woin E, Belchos J, Phan V, Chouari T, Gardner T, Goergen N, Hayes JDB, MacLeod CS, McCormack R, McKinley A, McKinstry S, Milligan W, Ooi L, Rafiq NM, Sammut T, Sinclair E, Smith M, Baker C, Boulton APR, Collins J, Copley HC, Fearnhead N, Fox H, Mah T, McKenna J, Naruka V, Nigam N, Nourallah B, Perera S, Qureshi A, Saggar S, Sun L, Wang X, Yang DD, Caroll P, Doyle C, Elangovan S, Falamarzi A, Perai KG, Greenan E, Jain D, Lang-Orsini M, Lim S, O'Byrne L, Ridgway P, Van der Laan S, Wong J, Arthur J, Barclay J, Bradley P, Edwin C, Finch E, Hayashi E, Hopkins M, Kelly D, Kelly M, McCartan N, Ormrod A, Pakenham A, Hayward J, Hitchen C, Kishore A, Martins T, Philomen J, Rao R, Rickards C, Burns N, Copeland M, Durand C, Dyal A, Ghaffar A, Gidwani A, Grant M, Gribbon C, Gruhn A, Leer M, Ahmad K, Beattie G, Beatty M, Campbell G, Donaldson G, Graham S, Holmes D, Kanabar S, Liu H, McCann C, Stewart R, Vara S, Ajibola-Taylor O, Andah EJE, Ani C, Cabdi NMO, Ito G, Jones M, Komoriyama A, Patel P, Titu L, Basra M, Gallogly P, Harinath G, Leong SH, Pradhan A, Siddiqui I, Zaat S, Ali A, Galea M, Looi WL, Ng JCK, Atkin G, Azizi A, Cargill Z, China Z, Elliot J, Jebakumar R, Lam J, Mudalige G, Onyerindu C, Renju M, Babu VS, Hussain M, Joji N, Lovett B, Mownah H, Ali B, Cresswell B, Dhillon AK, Dupaguntla YS, Hungwe C, Lowe-Zinola JD, Tsang JCH, Bevan K, Cardus C, Duggal A, Hossain S, McHugh M, Scott M, Chan F, Evans R, Gurung E, Haughey B, Jacob-Ramsdale B, Kerr M, Lee J, McCann E, O'Boyle K, Reid N, Hayat F, Hodgson S, Johnston R, Jones W, Khan M, Linn T, Long S, Seetharam P, Shaman S, Smart B, Anilkumar A, Davies J, Griffith J, Hughes B, Islam Y, Kidanu D, Mushaini N, Qamar I, Robinson H, Schramm M, Tan CY, Apperley H, Billyard C, Blazeby JM, Cannon SP, Carse S, Göpfert A, Loizidou A, Parkin J, Sanders E, Sharma S, Slade G, Telfer R, Huppatz IW, Worley E, Chandramoorthy L, Friend C, Harris L, Jain P, Karim MJ, Killington K, McGillicuddy J, Rafferty C, Rahunathan N, Rayne T, Varathan Y, Verma N, Zanichelli D, Arneill M, Brown F, Campbell B, Crozier L, Henry J, McCusker C, Prabakaran P, Wilson R, Asif U, Connor M, Dindyal S, Math N, Pagarkar A, Saleem H, Seth I, Sharma S, Standfield N, Swartbol T, Adamson R, Choi JE, El Tokhy O, Ho W, Javaid NR, Kelly M, Mehdi AS, Menon D, Plumptre I, Sturrock S, Turner J, Warren O, Crane E, Ferris B, Gadsby C, Smallwood J, Vipond M, Wilson V, Amarnath T, Doshi A, Gregory C, Kandiah K, Powell B, Spoor H, Toh C, Vizor R, Common M, Dunleavy K, Harris S, Luo C, Mesbah Z, Kumar AP, Redmond A, Skulsky S, Walsh T, Daly D, Deery L, Epanomeritakis E, Harty M, Kane D, Khan K, Mackey R, McConville J, McGinnity K, Nixon G, Ang A, Kee JY, Leung E, Norman S, Palaniappan SV, Sarathy PP, Yeoh T, Frost J, Hazeldine P, Jones L, Karbowiak M, Macdonald C, Mutarambirwa A, Omotade A, Runkel M, Ryan G, Sawers N, Searle C, Suresh S, Vig S, Ahmad A, McGartland R, Sim R, Song A, Wayman J, Brown R, Chang LH, Concannon K, Crilly C, Arnold TJ, Burgin A, Cadden F, Choy CH, Coleman M, Lim D, Luk J, Mahankali-Rao P, Prudence-Taylor AJ, Ramakrishnan D, Russell J, Fawole A, Gohil J, Green B, Hussain A, McMenamin L, McMenamin L, Tang M, Azmi F, Benchetrit S, Cope T, Haque A, Harlinska A, Holdsworth R, Ivo T, Martin J, Nisar T, Patel A, Sasapu K, Trevett J, Vernet G, Aamir A, Bird C, Durham-Hall A, Gibson W, Hartley J, May N, Maynard V, Johnson S, Wood CM, O'Brien M, Orbell J, Stringfellow TD, Tenters F, Tresidder S, Cheung W, Grant A, Tod N, Bews-Hair M, Lim ZH, Lim SW, Vella-Baldacchino M, Auckburally S, Chopada A, Easdon S, Goodson R, McCurdie F, Narouz M, Radford A, Rea E, Taylor O, Yu T, Alfa-Wali M, Amani L, Auluck I, Bruce P, Emberton J, Kumar R, Lagzouli N, Mehta A, Murtaza A, Raja M, Dennahy IS, Frew K, Given A, He YY, Karim MA, MacDonald E, McDonald E, McVinnie D, Ng SK, Pettit A, Sim DPY, Berthaume-Hawkins SD, Charnley R, Fenton K, Jones D, Murphy C, Ng JQ, Reehal R, Robinson H, Seraj SS, Shang E, Tonks A, White P, Yeo A, Chong P, Gabriel R, Patel N, Richardson E, Symons L, Aubrey-Jones D, Dawood S, Dobrzynska M, Faulkner S, Griffiths H, Mahmood F, Patel P, Perry M, Power A, Simpson R, Ali A, Brobbey P, Burrows A, Elder P, Ganyani R, Horseman C, Hurst P, Mann H, Marimuthu K, McBride S, Pilsworth E, Powers N, Stanier P, Innes R, Kersey T, Kopczynska M, Langasco N, Patel N, Rajagopal R, Atkins B, Beasley W, Lim ZC, Gill A, Ang HL, Williams H, Yogeswara T, Carter R, Fam M, Fong J, Latter J, Long M, Mackinnon S, McKenzie C, Osmanska J, Raghuvir V, Shafi A, Tsang K, Walker L, Bountra K, Coldicutt O, Fletcher D, Hudson S, Iqbal S, Bernal TL, Martin JWB, Moss-Lawton F, Smallwood J, Vipond M, Cardwell A, Edgerton K, Laws J, Rai A, Robinson K, Waite K, Ward J, Youssef H, Knight C, Koo PY, Lazarou A, Stanger S, Thorn C, Triniman MC, Botha A, Boyles L, Cumming S, Deepak S, Ezzat A, Fowler AJ, Gwozdz AM, Hussain SF, Khan S, Li H, Morrell BL, Neville J, Nitiahpapand R, Pickering O, Sagoo H, Sharma E, Welsh K, Denley S, Khan S, Agarwal M, Al-Saadi N, Bhambra R, Gupta A, Jawad ZAR, Jiao LR, Khan K, Mahir G, Singagireson S, Thoms BL, Tseu B, Wei R, Yang N, Britton N, Leinhardt D, Mahfooz M, Palkhi A, Price M, Sheikh S, Barker M, Bowley D, Cant M, Datta U, Farooqi M, Lee A, Morley G, Amin MN, Parry A, Patel S, Strang S, Yoganayagam N, Adlan A, Chandramoorthy S, Choudhary Y, Das K, Feldman M, France B, Grace R, Puddy H, Soor P, Ali M, Dhillon P, Faraj A, Gerard L, Glover M, Imran H, Kim S, Patrick Y, Peto J, Prabhudesai A, Smith R, Tang A, Vadgama N, Dhaliwal R, Ecclestone T, Harris A, Ong D, Patel D, Philp C, Stewart E, Wang L, Wong E, Xu Y, Ashaye T, Fozard T, Galloway F, Kaptanis S, Mistry P, Nguyen T, Olagbaiye F, Osman M, Philip Z, Rembacken R, Tayeh S, Theodoropoulou K, Herman A, Lau J, Saha A, Trotter M, Adeleye O, Cave D, Gunwa T, Magalhães J, Makwana S, Mason R, Parish M, Regan H, Renwick P, Roberts G, Salekin D, Sivakumar C, Tariq A, Liew I, McDade A, Stewart D, Hague M, Hudson-Peacock N, Jackson CES, James F, Pitt J, Walker EY, Aftab R, Ang JJ, Anwar S, Battle J, Budd E, Chui J, Crook H, Davies P, Easby S, Hackney E, Ho B, Imam SZ, Rammell J, Andrews H, Perry C, Schinle P, Ahmed P, Aquilina T, Balai E, Church M, Cumber E, Curtis A, Davies G, Dennis Y, Dumann E, Greenhalgh S, Kim P, King S, Metcalfe KHM, Passby L, Redgrave N, Soonawalla Z, Waters S, Zornoza A, Gulzar I, Hole J, Hull K, Ishaq H, Karaj J, Kelkar A, Love E, Patel S, Thakrar D, Vine M, Waterman A, Dib NP, Francis N, Hanson M, Ingleton R, Sadanand KS, Sukirthan N, Arnell S, Ball M, Bassam N, Beghal G, Chang A, Dawe V, George A, Huq T, Hussain A, Ikram B, Kanapeckaite L, Khan M, Ramjas D, Rushd A, Sait S, Serry M, Yardimci E, Capella S, Chenciner L, Episkopos C, Karam E, McCarthy C, Moore-Kelly W, Watson N, Ahluwalia V, Barnfield J, Ben-Gal O, Bloom I, Gharatya A, Khodatars K, Merchant N, Moonan A, Moore M, Patel K, Spiers H, Sundaram K, Turner J, Bath MF, Black J, Chadwick H, Huisman L, Ingram H, Khan S, Martin L, Metcalfe M, Sangal P, Seehra J, Thatcher A, Venturini S, Whitcroft I, Afzal Z, Brown S, Gani A, Gomaa A, Hussein N, Oh SY, Pazhaniappan N, Sharkey E, Sivagnanasithiyar T, Williams C, Yeung J, Cruddas L, Gurjar S, Pau A, Prakash R, Randhawa R, Chen L, Eiben I, Naylor M, Osei-Bordom D, Trenear R, Bannard-Smith J, Griffiths N, Patel BY, Saeed F, Abdikadir H, Bennett M, Church R, Clements SE, Court J, Delvi A, Hubert J, Macdonald B, Mansour F, Patel RR, Perris R, Small S, Betts A, Brown N, Chong A, Croitoru C, Grey A, Hickland P, Ho C, Hollington D, McKie L, Nelson AR, Stewart H, Eiben P, Nedham M, Ali I, Brown T, Cumming S, Hunt C, Joyner C, McAlinden C, Roberts J, Rogers D, Thachettu A, Tyson N, Vaughan R, Verma N, Yasin T, Andrew K, Bhamra N, Leong S, Mistry R, Noble H, Rashed F, Walker NR, Watson L, Worsfold M, Yarham E, Abdikadir H, Arshad A, Barmayehvar B, Cato L, Chan-lam N, Do V, Leong A, Sheikh Z, Zheleniakova T, Coppel J, Hussain ST, Mahmood R, Nourzaie R, Prowle J, Sheik-Ali S, Thomas A, Alagappan A, Ashour R, Bains H, Diamond J, Gordon J, Ibrahim B, Khalil M, Mittapalli D, Neo YN, Patil P, Peck FS, Reza N, Swan I, Whyte M, Chaudhry S, Hernon J, Khawar H, O'Brien J, Pullinger M, Rothnie K, Ujjal S, Bhatte S, Curtis J, Green S, Mayer A, Watkinson G, Chapple K, Hawthorne T, Khaliq M, Majkowski L, Malik TAM, Mclauchlan K, En BNW, Parton S, Robinson SD, Saat MI, Shurovi BN, Varatharasasingam K, Ward AE, Behranwala K, Bertelli M, Cohen J, Duff F, Fafemi O, Gupta R, Manimaran M, Mayhew J, Peprah D, Wong MHY, Farmer N, Houghton C, Kandhari N, Khan K, Ladha D, Mayes J, McLennan F, Panahi P, Seehra H, Agrawal R, Ahmed I, Ali S, Birkinshaw F, Choudhry M, Gokani S, Harrogate S, Jamal S, Nawrozzadeh F, Swaray A, Szczap A, Warusavitarne J, Abdalla M, Asemota N, Cullum R, Hartley M, Maxwell-Armstrong C, Mulvenna C, Phillips J, Yule A, Ahmed L, Clement KD, Craig N, Elseedawy E, Gorman D, Kane L, Livie J, Livie V, Moss E, Naasan A, Ravi F, Shields P, Zhu Y, Archer M, Cobley H, Dennis R, Downes C, Guevel B, Lamptey E, Murray H, Radhakrishnan A, Saravanabavan S, Sardar M, Shaw C, Tilliridou V, Wright R, Ye W, Alturki N, Helliwell R, Jones E, Kelly D, Lambotharan S, Scott K, Sivakumar R, Victor L, Boraluwe-Rallage H, Froggatt P, Haynes S, Hung YMA, Keyte A, Matthews L, Evans E, Haray P, John I, Mathivanan A, Morgan L, Oji O, Okorocha C, Rutherford A, Spiers H, Stageman N, Tsui A, Whitham R, Amoah-Arko A, Cecil E, Dietrich A, Fitzpatrick H, Guy C, Hair J, Hilton J, Jawad L, McAleer E, Taylor Z, Yap J, Akhbari M, Debnath D, Dhir T, Elbuzidi M, Elsaddig M, Glace S, Khawaja H, Koshy R, Lal K, Lobo L, McDermott A, Meredith J, Qamar MA, Vaidya A, Acquaah F, Barfi L, Carter N, Gnanappiragasam D, Ji C, Kaminski F, Lawday S, Mackay K, Sulaiman SK, Webb R, Ananthavarathan P, Dalal F, Farrar E, Hashemi R, Hossain M, Jiang J, Kiandee M, Lex J, Mason L, Matthews JH, McGeorge E, Modhwadia S, Pinkney T, Radotra A, Rickard L, Rodman L, Sales A, Tan KL, Bachi A, Bajwa DS, Battle J, Brown LR, Butler A, Calciu A, Davies E, Gardner I, Girdlestone T, Ikogho O, Keelan G, O'Loughlin P, Tam J, Elias J, Ngaage M, Thompson J, Bristow S, Brock E, Davis H, Pantelidou M, Sathiyakeerthy A, Singh K, Chaudhry A, Dickson G, Glen P, Gregoriou K, Hamid H, Mclean A, Mehtaji P, Neophytou G, Potts S, Belgaid DR, Burke J, Durno J, Ghailan N, Hanson M, Henshaw V, Nazir UR, Omar I, Riley BJ, Roberts J, Smart G, Van Winsen K, Bhatti A, Chan M, D'Auria M, Green S, Keshvala C, Li H, Maxwell-Armstrong C, Michaelidou M, Simmonds L, Smith C, Wimalathasan A, Abbas J, Cairns C, Chin YR, Connelly A, Moug S, Nair A, Svolkinas D, Coe P, Subar D, Wang H, Zaver V, Brayley J, Cookson P, Cunningham L, Gaukroger A, Ho M, Hough A, King J, O'Hagan D, Widdison A, Brown R, Brown B, Chavan A, Francis S, Hare L, Lund J, Malone N, Mavi B, McIlwaine A, Rangarajan S, Abuhussein N, Campbell HS, Daniels J, Fitzgerald I, Mansfield S, Pendrill A, Robertson D, Smart YW, Teng T, Yates J, Belgaumkar A, Katira A, Kossoff J, Kukran S, Laing C, Mathew B, Mohamed T, Myers S, Novell R, Phillips BL, Thomas M, Turlejski T, Turner S, Varcada M, Warren L, Wynell-Mayow W, Church R, Linley-Adams L, Osborn G, Saunders M, Spencer R, Srikanthan M, Tailor S, Tullett A, Ali M, Al-Masri S, Carr G, Ebhogiaye O, Heng S, Manivannan S, Manley J, McMillan LE, Peat C, Phillips B, Thomas S, Whewell H, Williams G, Bienias A, Cope EA, Courquin GR, Day L, Garner C, Gimson A, Harris C, Markham K, Moore T, Nadin T, Phillips C, Subratty SM, Brown K, Dada J, Durbacz M, Filipescu T, Harrison E, Kennedy ED, Khoo E, Kremel D, Lyell I, Pronin S, Tummon R, Ventre C, Walls L, Wootton E, Akhtar A, Davies E, El-Sawy D, Farooq M, Gaddah M, Griffiths H, Katsaiti I, Khadem N, Leong K, Williams I, Chean CS, Chudek D, Desai H, Ellerby N, Hammad A, Malla S, Murphy B, Oshin O, Popova P, Rana S, Ward T, Abbott TEF, Akpenyi O, Edozie F, El Matary R, English W, Jeyabaladevan S, Morgan C, Naidu V, Nicholls K, Peroos S, Prowle J, Sansome S, Torrance HD, Townsend D, Brecher J, Fung H, Kazmi Z, Outlaw P, Pursnani K, Ramanujam N, Razaq A, Sattar M, Sukumar S, Tan TSE, Chohan K, Dhuna S, Haq T, Kirby S, Lacy-Colson J, Logan P, Malik Q, McCann J, Mughal Z, Sadiq S, Sharif I, Shingles C, Simon A, Burnage S, Chan SSN, Craig ARJ, Duffield J, Dutta A, Eastwood M, Iqbal F, Mahmood F, Mahmood W, Patel C, Qadeer A, Robinson A, Rotundo A, Schade A, Slade RD, De Freitas M, Kinnersley H, McDowell E, Moens-Lecumberri S, Ramsden J, Rockall T, Wiffen L, Wright S, Bruce C, Francois V, Hamdan K, Limb C, Lunt AJ, Manley L, Marks M, Phillips CFE, Agnew CJF, Barr CJ, Benons N, Hart SJ, Kandage D, Krysztopik R, Mahalingam P, Mock J, Rajendran S, Stoddart MT, Clements B, Gillespie H, Lee S, McDougall R, Murray C, O'Loane R, Periketi S, Tan S, Amoah R, Bhudia R, Dudley B, Gilbert A, Griffiths B, Khan H, McKigney N, Roberts B, Samuel R, Seelarbokus A, Stubbing-Moore A, Thompson G, Williams P, Ahmed N, Akhtar R, Chandler E, Chappelow I, Gil H, Gower T, Kale A, Lingam G, Rutler L, Sellahewa C, Sheikh A, Stringer H, Taylor R, Aglan H, Ashraf MR, Choo S, Das E, Epstein J, Gentry R, Mills D, Poolovadoo Y, Ward N, Bull K, Cole A, Hack J, Khawari S, Lake C, Mandishona T, Perry R, Sleight S, Sultan S, Thornton T, Williams S, Arif T, Castle A, Chauhan P, Chesner R, Eilon T, Kamarajah S, Kambasha C, Lock L, Loka T, Mohammad F, Motahariasl S, Roper L, Sadhra SS, Sheikh A, Toma T, Wadood Q, Yip J, Ainger E, Busti S, Cunliffe L, Flamini T, Gaffing S, Moorcroft C, Peter M, Simpson L, Stokes E, Stott G, Wilson J, York J, Yousaf A, Borakati A, Brown M, Goaman A, Hodgson B, Ijeomah A, Iroegbu U, Kaur G, Lowe C, Mahmood S, Sattar Z, Sen P, Szuman A, Abbas N, Al-Ausi M, Anto N, Bhome R, Eccles L, Elliott J, Hughes EJ, Jones A, Karunatilleke AS, Knight JS, Manson CCF, Mekhail I, Michaels L, Noton TM, Okenyi E, Reeves T, Yasin IH, Banfield DA, Harris R, Lim D, Mason-Apps C, Roe T, Sandhu J, Shafiq N, Stickler E, Tam JP, Williams LM, Ainsworth P, Boualbanat Y, Doull C, Egan E, Evans L, Hassanin K, Ninkovic-Hall G, Odunlami W, Shergill M, Traish M, Cummings D, Kershaw S, Ong J, Reid F, Toellner H, Alwandi A, Amer M, George D, Haynes K, Hughes K, Peakall L, Premakumar Y, Punjabi N, Ramwell A, Sawkins H, Ashwood J, Baker A, Baron C, Bhide I, Blake E, De Cates C, Esmail R, Hosamuddin H, Kapp J, Nguru N, Raja M, Thomson F, Ahmed H, Aishwarya G, Al-Huneidi R, Ali S, Aziz R, Burke D, Clarke B, Kausar A, Maskill D, Mecia L, Myers L, Smith ACD, Walker G, Wroe N, Donohoe C, Gibbons D, Jordan P, Keogh C, Kiely A, Lalor P, McCrohan M, Powell C, Foley MP, Reynolds J, Silke E, Thorpe O, Kong JTH, White C, Ali Q, Dalrymple J, Ge Y, Khan H, Luo RS, Paine H, Paraskeva B, Parker L, Pillai K, Salciccioli J, Selvadurai S, Sonagara V, Springford LR, Tan L, Appleton S, Leadholm N, Zhang Y, Ahern D, Cotter M, Cremen S, Durrigan T, Flack V, Hrvacic N, Jones H, Jong B, Keane K, O'Connell PR, O'sullivan J, Pek G, Shirazi S, Barker C, Brown A, Carr W, Chen Y, Guillotte C, Harte J, Kokayi A, Lau K, McFarlane S, Morrison S, Broad J, Kenefick N, Makanji D, Printz V, Saito R, Thomas O, Breen H, Kirk S, Kong CH, O'Kane A, Eddama M, Engledow A, Freeman SK, Frost A, Goh C, Lee G, Poonawala R, Suri A, Taribagil P, Brown H, Christie S, Dean S, Gravell R, Haywood E, Holt F, Pilsworth E, Rabiu R, Roscoe HW, Shergill S, Sriram A, Sureshkumar A, Tan LC, Tanna A, Vakharia A, Bhullar S, Brannick S, Dunne E, Frere M, Kerin M, Kumar KM, Pratumsuwan T, Quek R, Salman M, Van Den Berg N, Wong C, Ahluwalia J, Bagga R, Borg CM, Calabria C, Draper A, Farwana M, Joyce H, Khan A, Mazza M, Pankin G, Sait MS, Sandhu N, Virani N, Wong J, Woodhams K, Croghan N, Ghag S, Hogg G, Ismail O, John N, Nadeem K, Naqi M, Noe SM, Sharma A, Tan S, Begum F, Best R, Collishaw A, Glasbey J, Golding D, Gwilym B, Harrison P, Jackman T, Lewis N, Luk YL, Porter T, Potluri S, Stechman M, Tate S, Thomas D, Walford B, Auld F, Bleakley A, Johnston S, Jones C, Khaw J, Milne S, O'Neill S, Singh KKR, Smith R, Swan A, Thorley N, Yalamarthi S, Yin ZD, Ali A, Balian V, Bana R, Clark K, Livesey C, McLachlan G, Mohammad M, Pranesh N, Richards C, Ross F, Sajid M, Brooke M, Francombe J, Gresly J, Hutchinson S, Kerrigan K, Matthews E, Nur S, Parsons L, Sandhu A, Vyas M, White F, Zulkifli A, Zuzarte L, Al-Mousawi A, Arya J, Azam S, Yahaya AA, Gill K, Hallan R, Hathaway C, Leptidis I, McDonagh L, Mitrasinovic S, Mushtaq N, Pang N, Peiris GB, Rinkoff S, Chan L, Christopher E, Farhan-Alanie MMH, Gonzalez-Ciscar A, Graham CJ, Lim H, McLean KA, Paterson HM, Rogers A, Roy C, Rutherford D, Smith F, Zubikarai G, Al-Khudairi R, Bamford M, Chang M, Cheng J, Hedley C, Joseph R, Mitchell B, Perera S, Rothwell L, Siddiqui A, Smith J, Taylor K, Wright OW, Baryan HK, Boyd G, Conchie H, Cox L, Davies J, Gardner S, Hill N, Krishna K, Lakin F, Scotcher S, Alberts J, Asad M, Barraclough J, Campbell A, Marshall D, Wakeford W, Cronbach P, D'Souza F, Gammeri E, Houlton J, Hall M, Kethees A, Patel R, Perera M, Prowle J, Shaid M, Webb E, Beattie S, Chadwick M, El-Taji O, Haddad S, Mann M, Patel M, Popat K, Rimmer L, Riyat H, Smith H, Anandarajah C, Cipparrone M, Desai K, Gao C, Goh ET, Howlader M, Jeffreys N, Karmarkar A, Mathew G, Mukhtar H, Ozcan E, Renukanthan A, Sarens N, Sinha C, Woolley A, Bogle R, Komolafe O, Loo F, Waugh D, Zeng R, Crewe A, Mathias J, Mills A, Owen A, Prior A, Saunders I, Baker A, Crilly L, McKeon J, Ubhi HK, Adeogun A, Carr R, Davison C, Devalia S, Hayat A, Karsan RB, Osborne C, Scott K, Weegenaar C, Wijeyaratne M, Babatunde F, Barnor-Ahiaku E, Beattie G, Chitsabesan P, Dixon O, Hall N, Ilenkovan N, Mackrell T, Nithianandasivam N, Orr J, Palazzo F, Saad M, Sandland-Taylor L, Sherlock J, Ashdown T, Chandler S, Garsaa T, Lloyd J, Loh SY, Ng S, Perkins C, Powell-Chandler A, Smith F, Underhill R. Perioperative intravenous contrast administration and the incidence of acute kidney injury after major gastrointestinal surgery: prospective, multicentre cohort study. Br J Surg 2020; 107:1023-1032. [PMID: 32026470 DOI: 10.1002/bjs.11453] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Revised: 09/21/2019] [Accepted: 11/08/2019] [Indexed: 01/14/2023]
Abstract
BACKGROUND This study aimed to determine the impact of preoperative exposure to intravenous contrast for CT and the risk of developing postoperative acute kidney injury (AKI) in patients undergoing major gastrointestinal surgery. METHODS This prospective, multicentre cohort study included adults undergoing gastrointestinal resection, stoma reversal or liver resection. Both elective and emergency procedures were included. Preoperative exposure to intravenous contrast was defined as exposure to contrast administered for the purposes of CT up to 7 days before surgery. The primary endpoint was the rate of AKI within 7 days. Propensity score-matched models were adjusted for patient, disease and operative variables. In a sensitivity analysis, a propensity score-matched model explored the association between preoperative exposure to contrast and AKI in the first 48 h after surgery. RESULTS A total of 5378 patients were included across 173 centres. Overall, 1249 patients (23·2 per cent) received intravenous contrast. The overall rate of AKI within 7 days of surgery was 13·4 per cent (718 of 5378). In the propensity score-matched model, preoperative exposure to contrast was not associated with AKI within 7 days (odds ratio (OR) 0·95, 95 per cent c.i. 0·73 to 1·21; P = 0·669). The sensitivity analysis showed no association between preoperative contrast administration and AKI within 48 h after operation (OR 1·09, 0·84 to 1·41; P = 0·498). CONCLUSION There was no association between preoperative intravenous contrast administered for CT up to 7 days before surgery and postoperative AKI. Risk of contrast-induced nephropathy should not be used as a reason to avoid contrast-enhanced CT.
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Littlejohn G, Smith T, Tymms K, Youssef P, Cooley H, Ciciriello S, Mathers D, Griffiths H. THU0209 UPTAKE OF JANUS KINASE INHIBITORS FOR MANAGEMENT OF RHEUMATOID ARTHRITIS IN AUSTRALIA. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.5055] [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
Background:JAK inhibitors (JAKi) are oral tsDMARDs with a different mode of action (MOA) to both oral cs- and parenteral bDMARDs. In Australia the cost of b/tsDMARDs for treatment of RA is subsidized if the patient has documented high levels of clinical/laboratory disease activity and has not responded to a pre-specified combination of csDMARDs, including MTX. Once eligible for subsidy the clinician can prescribe the b/tsDMARD deemed most clinically appropriate.Objectives:To determine the patterns of use and reasons for initiation and discontinuation of JAKi in real-world rheumatology practice in Australia.Methods:Deidentified clinical data were sourced from the OPAL dataset, which is collected in a custom-built electronic medical record at the time of the consultation1by 94 rheumatologists in Australia, representing one third of Australian clinical rheumatologists. Data from patients >18 years with a diagnosis of RA who commenced a b/tsDMARD between Jan-2007 and Sept-2019 were included in the analysis. Tableau®was used to display data on medication initiation and cessation dates, and reasons for starting and stopping b/tsDMARDs, which is recorded at the time of the decision.Results:At Sept 2019, there were 45,317 patients with RA in the data set, with 27% prescribed b/tsDMARDs. Of patients currently on treatment at Sept 2019, 53% were receiving a TNFi and 21% a JAKi, with the remainder receiving tocilizumab, abatacept or rituximab. Of patients who commenced their current treatment after JAKi’s become available in Sept 2015, 46% were treated with a TNFi, and 32% were treated with a JAKi. Tofacitinib (TOF) has been the most prescribed b/tsDMARD since Sept 2015 with 22% of all initiations; however, since baricitinib (BARI) became available in Sept 2018, it has taken over as the preferred JAKi with 24% of new initiations compared to 14% for TOF. From Sept 2018-Sept 2019 etanercept and adalimumab were the most commonly prescribed agents in first line, followed by TOF then BARI; however, BARI was the most prescribed agent in lines 2-6+ (figure 1). The main clinician-listed reason for choice of TOF was MOA in 54%, efficacy compared with alternatives in 30%, mode of administration in 7%, efficacy as monotherapy in 7%, and safety in 1%. BARI was chosen for MOA in 35%, efficacy compared with alternatives in 38%, mode of administration in 12%, efficacy as monotherapy in 12%, and safety in 1%. The main reasons for stopping TOF were lack of efficacy (34%), better alternative (25%) and adverse reaction (13%); those for BARI were lack of efficacy (35%) and adverse reaction (25%) which is consistent with the rates observed in the first 12-months of clinical experience with TOF, and better alternative (12%). Patient non-adherence was listed in 1% and 2% of cessations for TOF and BARI, respectively. 45% of patients discontinuing a JAKi in first line switched to a TNFi in second line, and 40% switched to another JAKi, citing lack of efficacy, adverse reaction, and better alternative as the reason for switching.Figure 1.Rank of new initiations by line of therapy (Sept 2018-Sept 2019)Conclusion:There has been significant and sustained uptake of JAKi for the management of RA in Australia. MOA and perceived efficacy rate much higher than mode of administration for clinicians when selecting a JAKi. Clinical outcomes and persistence following JAKi cycling requires further investigation.References:Littlejohn GO, Tymms KE, Smith T, Griffiths HT. Using big data from real-world Australian rheumatology encounters to enhance clinical care and research. Clin Exp Rheum Nov 2019Disclosure of Interests:None declared
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Bird P, Littlejohn G, Butcher B, Smith T, da Fonseca Pereira C, Witcombe D, Griffiths H. Real-world evaluation of effectiveness, persistence, and usage patterns of tofacitinib in treatment of rheumatoid arthritis in Australia. Clin Rheumatol 2020; 39:2545-2551. [PMID: 32157469 DOI: 10.1007/s10067-020-05021-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [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: 12/15/2019] [Revised: 02/20/2020] [Accepted: 02/28/2020] [Indexed: 12/20/2022]
Abstract
INTRODUCTION The aim of this study was to describe the real-world evidence for effectiveness, treatment persistence, and treatment patterns among patients in the community with rheumatoid arthritis treated with the JAK inhibitor tofacitinib. METHODS This was a retrospective, non-interventional cohort study that extracted data for new users of tofacitinib or biologic disease-modifying antirheumatic drugs (bDMARDs) from the Australian Optimizing Patient outcomes in Australian RheumatoLogy (OPAL) dataset between March 2015 and September 2018. Patients were propensity score matched at a 1:2 tofacitinib to bDMARD ratio based on age, sex, and selected baseline treatment combinations. Treatment effectiveness was evaluated using disease status measures. Treatment persistence was calculated and the percentage of patients receiving monotherapy or combination therapy at treatment initiation was evaluated. RESULTS Data from 2810 patients were extracted and 1950 patients were included in the matched population (1300 bDMARD initiators and 650 tofacitinib initiators). Patients were predominantly aged 55 to 74 years (57.8%) and female (81.2%). After 18 months of treatment, 52.4% and 57.8% of patients had achieved disease activity score (DAS) remission in the bDMARD and tofacitinib groups, respectively. The median treatment persistence for tofacitinib was similar to that for bDMARDs: 34.2 months (95% CI 32.2 to not reached) and 33.8 months (95% CI 28.8 to 40.4), respectively. In the overall population, more patients were prescribed tofacitinib as monotherapy (43.4%) compared with bDMARD monotherapy (33.4%). CONCLUSIONS Tofacitinib demonstrated treatment effectiveness and persistence similar to bDMARDs. Overall, there was a trend for more use of tofacitinib as monotherapy than bDMARDs. Key Points • This study provides real-world evidence regarding effectiveness, treatment persistence, and treatment patterns, among patients with rheumatoid arthritis (RA) in the community being treated with tofacitinib. • The study suggests that tofacitinib is an effective and enduring intervention in RA with tofacitinib persistence and effectiveness comparable to bDMARDs.
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Affiliation(s)
- Paul Bird
- OPAL Rheumatology Ltd, Sydney, New South Wales, Australia.,University of New South Wales, Kensington, New South Wales, Australia
| | - Geoffrey Littlejohn
- OPAL Rheumatology Ltd, Sydney, New South Wales, Australia.,Monash University, Clayton, Victoria, Australia
| | - Belinda Butcher
- University of New South Wales, Kensington, New South Wales, Australia. .,WriteSource Medical Pty Ltd, Lane Cove, New South Wales, Australia.
| | - Tegan Smith
- OPAL Rheumatology Ltd, Sydney, New South Wales, Australia
| | | | | | - Hedley Griffiths
- OPAL Rheumatology Ltd, Sydney, New South Wales, Australia.,Barwon Rheumatology Service, Geelong, Victoria, Australia
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Youssef P, Marcal B, Button P, Truman M, Bird P, Griffiths H, Roberts L, Tymms K, Littlejohn G. Reasons for Biologic and Targeted Synthetic Disease-modifying Antirheumatic Drug Cessation and Persistence of Second-line Treatment in a Rheumatoid Arthritis Dataset. J Rheumatol 2019; 47:1174-1181. [PMID: 31787605 DOI: 10.3899/jrheum.190535] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [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: 11/20/2019] [Indexed: 12/11/2022]
Abstract
OBJECTIVE To provide real-world evidence about the reasons why Australian rheumatologists cease biologic (b) and targeted synthetic (ts) disease-modifying antirheumatic drugs (DMARD) when treating patients with rheumatoid arthritis (RA), and to assess (1) the primary failure rate for first-line treatment, and (2) the persistence on second-line treatments in patients who stopped first-line tumor necrosis factor inhibitors (TNFi). METHODS This is a multicenter retrospective, noninterventional study of patients with RA enrolled in the Australian Optimising Patient outcome in Australian RheumatoLogy (OPAL) dataset with a start date of b/tsDMARD between August 1, 2010, and June 30, 2017. Primary failure was defined as stopping treatment within 6 months of treatment initiation. RESULTS Data from 7740 patients were analyzed; 6914 patients received first-line b/tsDMARD. First-line treatment was stopped in 3383 (49%) patients; 1263 (37%) were classified as primary failures. The most common reason was "lack of efficacy" (947/2656, 36%). Of the patients who stopped first-line TNFi, 43% (1111/2560) received second-line TNFi, which resulted in the shortest median time to stopping second-line treatment (11 months, 95% CI 9-12) compared with non-TNFi. The longest second-line median treatment duration after first-line TNFi was for patients receiving rituximab (39 months, 95% CI 27-74). CONCLUSION A large proportion of patients who stopped first-line TNFi therapy received another TNFi despite evidence for longer treatment persistence on second-line b/tsDMARD with a different mode of action. Lack of efficacy was recorded as the most common reason for making a switch in first-line treatment of patients with RA.
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Affiliation(s)
- Peter Youssef
- From the Royal Prince Alfred Hospital, Camperdown; University of Sydney, Sydney; Roche Products Pty Ltd., Sydney; OzBiostat Pty Ltd., Sydney; University of New South Wales, Sydney; Barwon Rheumatology Service, Geelong; Monash Rheumatology, Clayton; Canberra Rheumatology, Canberra; Monash University, Clayton, Australia. .,P. Youssef, MD, Professor, Royal Prince Alfred Hospital, and University of Sydney; B. Marcal, BPharm, Roche Products Pty Ltd.; P. Button, MSc, OzBiostat Pty Ltd.; M. Truman, MSc, OzBiostat Pty Ltd.; P. Bird, MD, PhD, Grad Dip MRI, University of New South Wales; H. Griffiths, MD, Barwon Rheumatology Service; L. Roberts, MD, PhD, Associate Professor, Monash Rheumatology; K. Tymms, MD, Associate Professor, Canberra Rheumatology; G. Littlejohn, MD, Professor, Monash University.
| | - Bruno Marcal
- From the Royal Prince Alfred Hospital, Camperdown; University of Sydney, Sydney; Roche Products Pty Ltd., Sydney; OzBiostat Pty Ltd., Sydney; University of New South Wales, Sydney; Barwon Rheumatology Service, Geelong; Monash Rheumatology, Clayton; Canberra Rheumatology, Canberra; Monash University, Clayton, Australia.,P. Youssef, MD, Professor, Royal Prince Alfred Hospital, and University of Sydney; B. Marcal, BPharm, Roche Products Pty Ltd.; P. Button, MSc, OzBiostat Pty Ltd.; M. Truman, MSc, OzBiostat Pty Ltd.; P. Bird, MD, PhD, Grad Dip MRI, University of New South Wales; H. Griffiths, MD, Barwon Rheumatology Service; L. Roberts, MD, PhD, Associate Professor, Monash Rheumatology; K. Tymms, MD, Associate Professor, Canberra Rheumatology; G. Littlejohn, MD, Professor, Monash University
| | - Peter Button
- From the Royal Prince Alfred Hospital, Camperdown; University of Sydney, Sydney; Roche Products Pty Ltd., Sydney; OzBiostat Pty Ltd., Sydney; University of New South Wales, Sydney; Barwon Rheumatology Service, Geelong; Monash Rheumatology, Clayton; Canberra Rheumatology, Canberra; Monash University, Clayton, Australia.,P. Youssef, MD, Professor, Royal Prince Alfred Hospital, and University of Sydney; B. Marcal, BPharm, Roche Products Pty Ltd.; P. Button, MSc, OzBiostat Pty Ltd.; M. Truman, MSc, OzBiostat Pty Ltd.; P. Bird, MD, PhD, Grad Dip MRI, University of New South Wales; H. Griffiths, MD, Barwon Rheumatology Service; L. Roberts, MD, PhD, Associate Professor, Monash Rheumatology; K. Tymms, MD, Associate Professor, Canberra Rheumatology; G. Littlejohn, MD, Professor, Monash University
| | - Matt Truman
- From the Royal Prince Alfred Hospital, Camperdown; University of Sydney, Sydney; Roche Products Pty Ltd., Sydney; OzBiostat Pty Ltd., Sydney; University of New South Wales, Sydney; Barwon Rheumatology Service, Geelong; Monash Rheumatology, Clayton; Canberra Rheumatology, Canberra; Monash University, Clayton, Australia.,P. Youssef, MD, Professor, Royal Prince Alfred Hospital, and University of Sydney; B. Marcal, BPharm, Roche Products Pty Ltd.; P. Button, MSc, OzBiostat Pty Ltd.; M. Truman, MSc, OzBiostat Pty Ltd.; P. Bird, MD, PhD, Grad Dip MRI, University of New South Wales; H. Griffiths, MD, Barwon Rheumatology Service; L. Roberts, MD, PhD, Associate Professor, Monash Rheumatology; K. Tymms, MD, Associate Professor, Canberra Rheumatology; G. Littlejohn, MD, Professor, Monash University
| | - Paul Bird
- From the Royal Prince Alfred Hospital, Camperdown; University of Sydney, Sydney; Roche Products Pty Ltd., Sydney; OzBiostat Pty Ltd., Sydney; University of New South Wales, Sydney; Barwon Rheumatology Service, Geelong; Monash Rheumatology, Clayton; Canberra Rheumatology, Canberra; Monash University, Clayton, Australia.,P. Youssef, MD, Professor, Royal Prince Alfred Hospital, and University of Sydney; B. Marcal, BPharm, Roche Products Pty Ltd.; P. Button, MSc, OzBiostat Pty Ltd.; M. Truman, MSc, OzBiostat Pty Ltd.; P. Bird, MD, PhD, Grad Dip MRI, University of New South Wales; H. Griffiths, MD, Barwon Rheumatology Service; L. Roberts, MD, PhD, Associate Professor, Monash Rheumatology; K. Tymms, MD, Associate Professor, Canberra Rheumatology; G. Littlejohn, MD, Professor, Monash University
| | - Hedley Griffiths
- From the Royal Prince Alfred Hospital, Camperdown; University of Sydney, Sydney; Roche Products Pty Ltd., Sydney; OzBiostat Pty Ltd., Sydney; University of New South Wales, Sydney; Barwon Rheumatology Service, Geelong; Monash Rheumatology, Clayton; Canberra Rheumatology, Canberra; Monash University, Clayton, Australia.,P. Youssef, MD, Professor, Royal Prince Alfred Hospital, and University of Sydney; B. Marcal, BPharm, Roche Products Pty Ltd.; P. Button, MSc, OzBiostat Pty Ltd.; M. Truman, MSc, OzBiostat Pty Ltd.; P. Bird, MD, PhD, Grad Dip MRI, University of New South Wales; H. Griffiths, MD, Barwon Rheumatology Service; L. Roberts, MD, PhD, Associate Professor, Monash Rheumatology; K. Tymms, MD, Associate Professor, Canberra Rheumatology; G. Littlejohn, MD, Professor, Monash University
| | - Lynden Roberts
- From the Royal Prince Alfred Hospital, Camperdown; University of Sydney, Sydney; Roche Products Pty Ltd., Sydney; OzBiostat Pty Ltd., Sydney; University of New South Wales, Sydney; Barwon Rheumatology Service, Geelong; Monash Rheumatology, Clayton; Canberra Rheumatology, Canberra; Monash University, Clayton, Australia.,P. Youssef, MD, Professor, Royal Prince Alfred Hospital, and University of Sydney; B. Marcal, BPharm, Roche Products Pty Ltd.; P. Button, MSc, OzBiostat Pty Ltd.; M. Truman, MSc, OzBiostat Pty Ltd.; P. Bird, MD, PhD, Grad Dip MRI, University of New South Wales; H. Griffiths, MD, Barwon Rheumatology Service; L. Roberts, MD, PhD, Associate Professor, Monash Rheumatology; K. Tymms, MD, Associate Professor, Canberra Rheumatology; G. Littlejohn, MD, Professor, Monash University
| | - Kathleen Tymms
- From the Royal Prince Alfred Hospital, Camperdown; University of Sydney, Sydney; Roche Products Pty Ltd., Sydney; OzBiostat Pty Ltd., Sydney; University of New South Wales, Sydney; Barwon Rheumatology Service, Geelong; Monash Rheumatology, Clayton; Canberra Rheumatology, Canberra; Monash University, Clayton, Australia.,P. Youssef, MD, Professor, Royal Prince Alfred Hospital, and University of Sydney; B. Marcal, BPharm, Roche Products Pty Ltd.; P. Button, MSc, OzBiostat Pty Ltd.; M. Truman, MSc, OzBiostat Pty Ltd.; P. Bird, MD, PhD, Grad Dip MRI, University of New South Wales; H. Griffiths, MD, Barwon Rheumatology Service; L. Roberts, MD, PhD, Associate Professor, Monash Rheumatology; K. Tymms, MD, Associate Professor, Canberra Rheumatology; G. Littlejohn, MD, Professor, Monash University
| | - Geoff Littlejohn
- From the Royal Prince Alfred Hospital, Camperdown; University of Sydney, Sydney; Roche Products Pty Ltd., Sydney; OzBiostat Pty Ltd., Sydney; University of New South Wales, Sydney; Barwon Rheumatology Service, Geelong; Monash Rheumatology, Clayton; Canberra Rheumatology, Canberra; Monash University, Clayton, Australia.,P. Youssef, MD, Professor, Royal Prince Alfred Hospital, and University of Sydney; B. Marcal, BPharm, Roche Products Pty Ltd.; P. Button, MSc, OzBiostat Pty Ltd.; M. Truman, MSc, OzBiostat Pty Ltd.; P. Bird, MD, PhD, Grad Dip MRI, University of New South Wales; H. Griffiths, MD, Barwon Rheumatology Service; L. Roberts, MD, PhD, Associate Professor, Monash Rheumatology; K. Tymms, MD, Associate Professor, Canberra Rheumatology; G. Littlejohn, MD, Professor, Monash University
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Kampf G, Jung M, Suchomel M, Saliou P, Griffiths H, Vos MC. Prion disease and recommended procedures for flexible endoscope reprocessing - a review of policies worldwide and proposal for a simplified approach. J Hosp Infect 2019; 104:92-110. [PMID: 31408691 DOI: 10.1016/j.jhin.2019.08.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [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: 07/14/2019] [Accepted: 08/05/2019] [Indexed: 10/26/2022]
Abstract
Several guidelines recommend specific treatments for endoscopes, procedures of quarantine for endoscopes, or additional treatments for the endoscope washer disinfector (EWD) in suspected or confirmed cases of Creutzfeldt-Jakob disease (CJD) or variant CJD (vCJD) but vary in many details. This study therefore reviewed guidelines on reprocessing flexible endoscopes after use in patients with suspected or confirmed prion disease. In addition, a literature search was performed in Medline on prion, CJD, vCJD, chemical inactivation, transmission healthcare, epidemiology healthcare, concentration tissue human and endoscope. Thus far, no case of CJD or vCJD transmitted by flexible endoscope has been reported. In animals it has been shown that oral uptake of 0.1-5 g of bovine spongiform encephalopathy (BSE)-infected brain homogenate is necessary for transmission. The maximum prion concentration in other tissues (e.g., terminal ileum) is at least 100-fold lower. Automated cleaning of endoscopes alone results in very low total residual protein ≤5.6 mg per duodenoscopes. Recommendations vary between countries, sometimes with additional cleaning, use of alkaline cleaners, no use of cleaners with fixative properties, use of disinfectants without fixative properties or single-use disinfectants. Sodium hydroxide (1 M) and sodium hypochlorite (10,000 and 25,000 mg/L) are very effective in preventing transmission via contaminated wires implanted into animal brains, but their relevance for endoscopes is questionable. Based on circumstantial evidence, it is proposed to consider validated reprocessing as appropriate in the case of delayed suspected prion disease when immediate bedside cleaning, routine use of alkaline cleaners, no fixative agents anywhere prior to disinfection and single use brushes and cleaning solutions can be assured.
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Affiliation(s)
- G Kampf
- University Medicine Greifswald, Institute for Hygiene and Environmental Medicine, Greifswald, Germany.
| | - M Jung
- University Hospital Frankfurt, Medical Department 1, Endoscopy, Frankfurt, Germany
| | - M Suchomel
- Medical University of Vienna, Institute for Hygiene and Applied Immunology, Vienna, Austria
| | - P Saliou
- Brest Teaching Hospital, Infection Control Unit, Brest, France
| | - H Griffiths
- Brecon War Memorial Hospital, Brecon, Powys, UK
| | - M C Vos
- Erasmus University Medical Center, Department of Medical Microbiology and Infectious Diseases, Rotterdam, The Netherlands; ESCMID Study Group on Nosocomial Infections
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Perju-Dumbrava L, Islam F, Makonahalli R, McLean C, Griffiths H, Malhotra A. 051 Overlapping syndrome of giant cell arteritis and ANCA-associated vasculitis complicated by severe axonal neuropathy: a case report. J Neurol Psychiatry 2019. [DOI: 10.1136/jnnp-2019-anzan.45] [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
CaseA 61-year- old woman presented with what was thought to be a refractory, temporal artery biopsy-proven giant cell arteritis (GCA). After 4 months of therapy she was unable to get the prednisolone dose below 40 mg/day, so weekly subcutaneous Tocilizumab was introduced but with minimal response after 8 weeks. She was then admitted to hospital with a severe rapidly progressive length dependent sensorimotor peripheral neuropathy. Nerve conduction studies showed predominantly an axonal neuropathy with multiple pseudo-conduction blocks.Sural nerve and gastrocnemius biopsies revealed a necrotising vasculitis with numerous giant cells and active axonal degeneration. She proved to be ANCA-PR3 positive, without other systemic manifestations. ANCA-associated vasculitic neuropathy was diagnosed and she was treated with two 1g Rituximab infusions, 2 weeks apart.On follow-up after a month, she had regained some strength but still required a wheelchair for mobility. Further Rituximab infusion after 6 months is planned; prednisolone had been successfully weaned to 10 mg/day.ConclusionPeripheral nerve involvement, which is relatively common in ANCA-associated vasculitis, has also been reported in 14% of GCA cases. But ANCA-PR3 positivity is rare in biopsy-proven GGA, with only a handful of well-documented cases.Heightened suspicion of an alternative diagnosis in the face of an unusual clinical course (lack of steroid response and appearance of small vessel vasculitic symptoms for what is accepted to be a large vessel vasculitis) is critical and our experience highlights the important fact that a diagnosis of one of these disorders does not preclude the subsequent diagnosis of the other.
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Thomas C, Stevens R, West L, Oliver E, Pang J, Griffiths H. Performance evaluation of the VITROS® TSH3* assay on the VITROS® 5600/XT7600 integrated and VITROS® 3600 and ECI/ECIQ immunodiagnostic systems. Clin Chim Acta 2019. [DOI: 10.1016/j.cca.2019.03.699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Deodhar A, Gensler LS, Sieper J, Clark M, Calderon C, Wang Y, Zhou Y, Leu JH, Campbell K, Sweet K, Harrison DD, Hsia EC, Heijde D, Ariel F, Asnal CA, Berman A, Citera G, Rodriguez G, Savio VG, Bird P, Griffiths H, Nicholls D, Rischmueller M, Zochling J, De Vlam K, Malaise M, Toukap AN, Van den Bosch F, Vanhoof J, Bonfiglioli R, Keiserman M, Scotton AS, Xavier R, Ximenes AC, Atanasov A, Goranov I, Kazmin I, Licheva RN, Nikolov N, Oparanov B, Stoilov R, Bessette L, Rodrigues J, Bortilik L, Dokoupilova E, Dvoarak Z, Galatikova D, Nemec P, Podrazilova L, Simkova G, Stejfova Z, Moravcova R, Vitek P, Cantagrel A, Baillet A, Banneville B, Combe B, Breban M, Nguyen M, Goupille P, Braun J, Everding A, Kekow J, Koenig R, Rubbert‐Roth A, Witte T, Bartha A, Drescher E, Kerekes K, Kovacs A, Pulai J, Rojkovich B, Szanto S, Toth E, Avila H, Torre IG, Irazoque F, Maradiaga M, Pacheco C, Brzosko M, Dudek A, Jeka S, Krogulec M, Kwiatkowska B, Wiland P, Wojciechowski R, Zielinska A, Santos H, Bugrova O, Christyakov V, Gorbunov V, Ilivanova E, Zemerova E, Kamalova R, Kameneva T, Macievskaya G, Marusenko I, Maslyansky A, Myasoedova S, Myasoutova L, Nemtsov B, Nesmeyanova O, Plaksina T, Pokrovskaya T, Polyakova S, Rebrov A, Savina L, Smakotina S, Stanislav M, Ukhanova O, Vinogradova I, Zonova E, Baek HJ, Kim T, Lee C, Lee S, Lee S, Lee S, Park S, Song Y, Suh C, Ramos JA, Blanco FJ, Collantes E, Diaz MC, Vivar MLG, Gratacos J, Juanola X, Chen D, Chen H, Chen K, Chen Y, Chiu Y, Luo S, Tsai S, Tseng J, Wei C, Weng M, Abrahamovych O, Reshotko D, Golovchenko O, Hospodarsky I, Iaremenko O, Levchenko O, Dudnyk O, Garmish O, Grishyna O, Protsenko G, Rekalov D, Smiyan S, Stanislavchuk M, Trypilka S, Tseluyko V, Turianytsia S, Vasylets V, Virstyuk N, Kleban Y, Ciurtin C, Gaffney K, Gunasekera W, Mackay K, Packham J, Sengupta R, Tahir H, Aelion J, Bennett R, Deodhar A, Gonzalez‐Paoli J, Griffin RM, Grisanti M, Mallepalli J, Peters E, Schechtman J, Singhal A. Three Multicenter, Randomized, Double‐Blind, Placebo‐Controlled Studies Evaluating the Efficacy and Safety of Ustekinumab in Axial Spondyloarthritis. Arthritis Rheumatol 2018; 71:258-270. [DOI: 10.1002/art.40728] [Citation(s) in RCA: 173] [Impact Index Per Article: 28.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2018] [Accepted: 09/13/2018] [Indexed: 12/12/2022]
Affiliation(s)
| | | | | | - Michael Clark
- Janssen Research & Development, LLC Spring House Pennsylvania
| | - Cesar Calderon
- Janssen Research & Development, LLC Spring House Pennsylvania
| | - Yuhua Wang
- Janssen Research & Development, LLC Spring House Pennsylvania
| | - Yiying Zhou
- Janssen Research & Development, LLC Spring House Pennsylvania
| | - Jocelyn H. Leu
- Janssen Research & Development, LLC Spring House Pennsylvania
| | - Kim Campbell
- Janssen Research & Development, LLC Spring House Pennsylvania
| | - Kristen Sweet
- Janssen Research & Development, LLC Spring House Pennsylvania
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Nicholls D, Barrett R, Button P, Truman M, Bird P, Roberts L, Tymms K, Littlejohn G, Griffiths H. Effectiveness of biologics in Australian patients with rheumatoid arthritis: a large observational study: REAL. Intern Med J 2018; 48:1185-1192. [PMID: 29968400 DOI: 10.1111/imj.14028] [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: 12/21/2017] [Revised: 05/17/2018] [Accepted: 06/23/2018] [Indexed: 11/28/2022]
Abstract
BACKGROUND The comparative effectiveness of biologic treatment regimens in a real world Australian population is unknown. AIM To assess the effectiveness of biological disease-modifying anti-rheumatic drugs (bDMARD) as monotherapy or in combination with methotrexate and/or other conventional DMARD (cDMARD) for the treatment of rheumatoid arthritis (RA). METHODS A retrospective, non-interventional study was conducted that investigated the use of bDMARD in adult patients with RA in routine clinical practice. Data were extracted from the Optimising Patient Outcomes in Australian Rheumatology - Quality Use of Medicines Initiative database. Real-world effectiveness was measured using the 28-joint disease activity score (DAS28) and clinical disease activity index (CDAI) by treatment group at baseline, weeks 12 and 24. RESULTS A total of 2970 patients was included with a median (min-max) age of 60.0 (19.0-94.0) years and median (min-max) duration of RA before first bDMARD treatment of 6.0 (0.2-58.3) years. A total of 1177 patients received more than one bDMARD during the analysis period of 1 January 1997 to 15 August 2015. Patients had 4922 treatment 'episodes' (defined as a cycle of continuous individual bDMARD prescribing in a single patient). Patients received a mean (SD) of 1.7 (1.0) episodes of treatment with median (min-max) treatment duration of 0.7 (0-11.8) years; median treatment duration was higher with the first treatment episode. bDMARD were most commonly initiated in combination with methotrexate (73.9% of episodes) and least commonly as monotherapy (9.9% of episodes). Median (min-max) baseline DAS28 decreased from 5.3 (0-8.7) with the first bDMARD to 3.7 (0-8.8) with the second. Median baseline CDAI similarly decreased. CONCLUSIONS Patients tended to persist longer on their first bDMARD treatment. bDMARD as monotherapy or in combination appear to be accepted treatment strategies in the real world.
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Affiliation(s)
- Dave Nicholls
- University of the Sunshine Coast and Coast Joint Care, Rheumatology Research Unit, Maroochydore, Queensland, Australia
| | - Rina Barrett
- Roche Products Pty Limited, Medical Affairs, Sydney, New South Wales, Australia
| | - Peter Button
- Roche Products Pty Limited, Medical Affairs, Sydney, New South Wales, Australia
| | - Matt Truman
- Roche Products Pty Limited, Medical Affairs, Sydney, New South Wales, Australia
| | - Paul Bird
- University of New South Wales and Combined Rheumatology Practice, Sydney, New South Wales, Australia
| | - Lynden Roberts
- Monash University, Monash Rheumatology, Melbourne, Victoria, Australia
| | - Kathleen Tymms
- Canberra Rheumatology, Canberra, Australian Capital Territory, Australia
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Biersma EM, Jackson JA, Bracegirdle TJ, Griffiths H, Linse K, Convey P. Low genetic variation between South American and Antarctic populations of the bank-forming moss Chorisodontium aciphyllum (Dicranaceae). Polar Biol 2018. [DOI: 10.1007/s00300-017-2221-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Egea J, Fabregat I, Frapart YM, Ghezzi P, Görlach A, Kietzmann T, Kubaichuk K, Knaus UG, Lopez MG, Olaso-Gonzalez G, Petry A, Schulz R, Vina J, Winyard P, Abbas K, Ademowo OS, Afonso CB, Andreadou I, Antelmann H, Antunes F, Aslan M, Bachschmid MM, Barbosa RM, Belousov V, Berndt C, Bernlohr D, Bertrán E, Bindoli A, Bottari SP, Brito PM, Carrara G, Casas AI, Chatzi A, Chondrogianni N, Conrad M, Cooke MS, Costa JG, Cuadrado A, My-Chan Dang P, De Smet B, Debelec-Butuner B, Dias IHK, Dunn JD, Edson AJ, El Assar M, El-Benna J, Ferdinandy P, Fernandes AS, Fladmark KE, Förstermann U, Giniatullin R, Giricz Z, Görbe A, Griffiths H, Hampl V, Hanf A, Herget J, Hernansanz-Agustín P, Hillion M, Huang J, Ilikay S, Jansen-Dürr P, Jaquet V, Joles JA, Kalyanaraman B, Kaminskyy D, Karbaschi M, Kleanthous M, Klotz LO, Korac B, Korkmaz KS, Koziel R, Kračun D, Krause KH, Křen V, Krieg T, Laranjinha J, Lazou A, Li H, Martínez-Ruiz A, Matsui R, McBean GJ, Meredith SP, Messens J, Miguel V, Mikhed Y, Milisav I, Milković L, Miranda-Vizuete A, Mojović M, Monsalve M, Mouthuy PA, Mulvey J, Münzel T, Muzykantov V, Nguyen ITN, Oelze M, Oliveira NG, Palmeira CM, Papaevgeniou N, Pavićević A, Pedre B, Peyrot F, Phylactides M, Pircalabioru GG, Pitt AR, Poulsen HE, Prieto I, Rigobello MP, Robledinos-Antón N, Rodríguez-Mañas L, Rolo AP, Rousset F, Ruskovska T, Saraiva N, Sasson S, Schröder K, Semen K, Seredenina T, Shakirzyanova A, Smith GL, Soldati T, Sousa BC, Spickett CM, Stancic A, Stasia MJ, Steinbrenner H, Stepanić V, Steven S, Tokatlidis K, Tuncay E, Turan B, Ursini F, Vacek J, Vajnerova O, Valentová K, Van Breusegem F, Varisli L, Veal EA, Yalçın AS, Yelisyeyeva O, Žarković N, Zatloukalová M, Zielonka J, Touyz RM, Papapetropoulos A, Grune T, Lamas S, Schmidt HHHW, Di Lisa F, Daiber A. Corrigendum to "European contribution to the study of ROS: A summary of the findings and prospects for the future from the COST action BM1203 (EU-ROS)" [Redox Biol. 13 (2017) 94-162]. Redox Biol 2017; 14:694-696. [PMID: 29107648 PMCID: PMC5975209 DOI: 10.1016/j.redox.2017.10.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [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: 11/17/2022] Open
Affiliation(s)
- J Egea
- Institute Teofilo Hernando, Department of Pharmacology, School of Medicine, Univerisdad Autonoma de Madrid, Spain
| | - I Fabregat
- Bellvitge Biomedical Research Institute (IDIBELL) and University of Barcelona (UB), L'Hospitalet, Barcelona, Spain
| | - Y M Frapart
- LCBPT, UMR 8601 CNRS - Paris Descartes University, Sorbonne Paris Cité, Paris, France
| | - P Ghezzi
- Brighton & Sussex Medical School, Brighton, UK
| | - A Görlach
- Experimental and Molecular Pediatric Cardiology, German Heart Center Munich at the Technical University Munich, Munich, Germany; DZHK (German Centre for Cardiovascular Research), partner site Munich Heart Alliance, Munich, Germany
| | - T Kietzmann
- Faculty of Biochemistry and Molecular Medicine, and Biocenter Oulu, University of Oulu, Oulu, Finland
| | - K Kubaichuk
- Faculty of Biochemistry and Molecular Medicine, and Biocenter Oulu, University of Oulu, Oulu, Finland
| | - U G Knaus
- Conway Institute, School of Medicine, University College Dublin, Dublin, Ireland
| | - M G Lopez
- Institute Teofilo Hernando, Department of Pharmacology, School of Medicine, Univerisdad Autonoma de Madrid, Spain
| | | | - A Petry
- Experimental and Molecular Pediatric Cardiology, German Heart Center Munich at the Technical University Munich, Munich, Germany
| | - R Schulz
- Institute of Physiology, JLU Giessen, Giessen, Germany
| | - J Vina
- Department of Physiology, University of Valencia, Spain
| | - P Winyard
- University of Exeter Medical School, St Luke's Campus, Exeter EX1 2LU, UK
| | - K Abbas
- LCBPT, UMR 8601 CNRS - Paris Descartes University, Sorbonne Paris Cité, Paris, France
| | - O S Ademowo
- Life & Health Sciences and Aston Research Centre for Healthy Ageing, Aston University, Aston Triangle, Birmingham B4 7ET, UK
| | - C B Afonso
- School of Life & Health Sciences, Aston University, Aston Triangle, Birmingham B47ET, UK
| | - I Andreadou
- Laboratory of Pharmacology, Faculty of Pharmacy, National and Kapodistrian University of Athens, Greece
| | - H Antelmann
- Institute for Biology-Microbiology, Freie Universität Berlin, Berlin, Germany
| | - F Antunes
- Departamento de Química e Bioquímica and Centro de Química e Bioquímica, Faculdade de Ciências, Portugal
| | - M Aslan
- Department of Medical Biochemistry, Faculty of Medicine, Akdeniz University, Antalya, Turkey
| | - M M Bachschmid
- Vascular Biology Section & Whitaker Cardiovascular Institute, Boston University School of Medicine, Boston, MA, USA
| | - R M Barbosa
- Center for Neurosciences and Cell Biology, University of Coimbra and Faculty of Pharmacy, University of Coimbra, Coimbra, Portugal
| | - V Belousov
- Molecular technologies laboratory, Shemyakin-Ovchinnikov Institute of Bioorganic Chemistry, Miklukho-Maklaya 16/10, Moscow 117997, Russia
| | - C Berndt
- Department of Neurology, Medical Faculty, Heinrich-Heine University, Düsseldorf, Germany
| | - D Bernlohr
- Department of Biochemistry, Molecular Biology and Biophysics, University of Minnesota - Twin Cities, USA
| | - E Bertrán
- Bellvitge Biomedical Research Institute (IDIBELL) and University of Barcelona (UB), L'Hospitalet, Barcelona, Spain
| | - A Bindoli
- Institute of Neuroscience (CNR), Padova, Italy
| | - S P Bottari
- GETI, Institute for Advanced Biosciences, INSERM U1029, CNRS UMR 5309, Grenoble-Alpes University and Radio-analysis Laboratory, CHU de Grenoble, Grenoble, France
| | - P M Brito
- Research Institute for Medicines (iMed.ULisboa), Faculty of Pharmacy, Universidade de Lisboa, Lisboa, Portugal; Faculdade de Ciências da Saúde, Universidade da Beira Interior, Covilhã, Portugal
| | - G Carrara
- Department of Pathology, University of Cambridge, Cambridge, UK
| | - A I Casas
- Department of Pharmacology & Personalized Medicine, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, The Netherlands
| | - A Chatzi
- Institute of Molecular Cell and Systems Biology, College of Medical Veterinary and Life Sciences, University of Glasgow, University Avenue, Glasgow, UK
| | - N Chondrogianni
- National Hellenic Research Foundation, Institute of Biology, Medicinal Chemistry and Biotechnology, 48 Vas. Constantinou Ave., 116 35 Athens, Greece
| | - M Conrad
- Helmholtz Center Munich, Institute of Developmental Genetics, Neuherberg, Germany
| | - M S Cooke
- Helmholtz Center Munich, Institute of Developmental Genetics, Neuherberg, Germany
| | - J G Costa
- Research Institute for Medicines (iMed.ULisboa), Faculty of Pharmacy, Universidade de Lisboa, Lisboa, Portugal; CBIOS, Universidade Lusófona Research Center for Biosciences & Health Technologies, Lisboa, Portugal
| | - A Cuadrado
- Instituto de Investigaciones Biomédicas "Alberto Sols" UAM-CSIC, Instituto de Investigación Sanitaria La Paz (IdiPaz), Department of Biochemistry, Faculty of Medicine, Autonomous University of Madrid, Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain
| | - P My-Chan Dang
- Université Paris Diderot, Sorbonne Paris Cité, INSERM-U1149, CNRS-ERL8252, Centre de Recherche sur l'Inflammation, Laboratoire d'Excellence Inflamex, Faculté de Médecine Xavier Bichat, Paris, France
| | - B De Smet
- Department of Plant Systems Biology, VIB, 9052 Ghent, Belgium; Structural Biology Research Center, VIB, 1050 Brussels, Belgium; Department of Biomedical Sciences and CNR Institute of Neuroscience, University of Padova, Padova, Italy; Pharmahungary Group, Szeged, Hungary
| | - B Debelec-Butuner
- Department of Pharmaceutical Biotechnology, Faculty of Pharmacy, Ege University, Bornova, Izmir 35100, Turkey
| | - I H K Dias
- Life & Health Sciences and Aston Research Centre for Healthy Ageing, Aston University, Aston Triangle, Birmingham B4 7ET, UK
| | - J D Dunn
- Department of Biochemistry, Science II, University of Geneva, 30 quai Ernest-Ansermet, 1211 Geneva-4, Switzerland
| | - A J Edson
- Department of Molecular Biology, University of Bergen, Bergen, Norway
| | - M El Assar
- Fundación para la Investigación Biomédica del Hospital Universitario de Getafe, Getafe, Spain
| | - J El-Benna
- Université Paris Diderot, Sorbonne Paris Cité, INSERM-U1149, CNRS-ERL8252, Centre de Recherche sur l'Inflammation, Laboratoire d'Excellence Inflamex, Faculté de Médecine Xavier Bichat, Paris, France
| | - P Ferdinandy
- Department of Pharmacology and Pharmacotherapy, Medical Faculty, Semmelweis University, Budapest, Hungary; Pharmahungary Group, Szeged, Hungary
| | - A S Fernandes
- CBIOS, Universidade Lusófona Research Center for Biosciences & Health Technologies, Lisboa, Portugal
| | - K E Fladmark
- Department of Molecular Biology, University of Bergen, Bergen, Norway
| | - U Förstermann
- Department of Pharmacology, Johannes Gutenberg University Medical Center, Mainz, Germany
| | - R Giniatullin
- A.I. Virtanen Institute for Molecular Sciences, University of Eastern Finland, Kuopio, Finland
| | - Z Giricz
- Department of Pharmacology and Pharmacotherapy, Medical Faculty, Semmelweis University, Budapest, Hungary; Pharmahungary Group, Szeged, Hungary
| | - A Görbe
- Department of Pharmacology and Pharmacotherapy, Medical Faculty, Semmelweis University, Budapest, Hungary; Pharmahungary Group, Szeged, Hungary
| | - H Griffiths
- Life & Health Sciences and Aston Research Centre for Healthy Ageing, Aston University, Aston Triangle, Birmingham B4 7ET, UK; Faculty of Health and Medical Sciences, University of Surrey, Guildford GU2 7XH, UK
| | - V Hampl
- Department of Physiology, 2nd Faculty of Medicine, Charles University, Prague, Czech Republic
| | - A Hanf
- Molecular Cardiology, Center for Cardiology, Cardiology 1, University Medical Center Mainz, Mainz, Germany
| | - J Herget
- Department of Physiology, 2nd Faculty of Medicine, Charles University, Prague, Czech Republic
| | - P Hernansanz-Agustín
- Servicio de Immunología, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IIS-IP), Madrid, Spain; Departamento de Bioquímica, Facultad de Medicina, Universidad Autónoma de Madrid (UAM) and Instituto de Investigaciones Biomédicas Alberto Sols, Madrid, Spain
| | - M Hillion
- Institute for Biology-Microbiology, Freie Universität Berlin, Berlin, Germany
| | - J Huang
- Department of Plant Systems Biology, VIB, 9052 Ghent, Belgium; Structural Biology Research Center, VIB, 1050 Brussels, Belgium; Department of Plant Biotechnology and Bioinformatics, Ghent University, 9052 Ghent, Belgium; Brussels Center for Redox Biology, Structural Biology Brussels, Vrije Universiteit Brussel, 1050 Brussels, Belgium
| | - S Ilikay
- Harran University, Arts and Science Faculty, Department of Biology, Cancer Biology Lab, Osmanbey Campus, Sanliurfa, Turkey
| | - P Jansen-Dürr
- Institute for Biomedical Aging Research, University of Innsbruck, Innsbruck, Austria
| | - V Jaquet
- Dept. of Pathology and Immunology, Centre Médical Universitaire, Geneva, Switzerland
| | - J A Joles
- Department of Nephrology & Hypertension, University Medical Center Utrecht, The Netherlands
| | | | - D Kaminskyy
- Danylo Halytsky Lviv National Medical University, Lviv, Ukraine
| | - M Karbaschi
- Oxidative Stress Group, Dept. Environmental & Occupational Health, Florida International University, Miami, FL 33199, USA
| | - M Kleanthous
- Molecular Genetics Thalassaemia Department, The Cyprus Institute of Neurology and Genetics, Nicosia, Cyprus
| | - L O Klotz
- Institute of Nutrition, Department of Nutrigenomics, Friedrich Schiller University, Jena, Germany
| | - B Korac
- University of Belgrade, Institute for Biological Research "Sinisa Stankovic" and Faculty of Biology, Belgrade, Serbia
| | - K S Korkmaz
- Department of Bioengineering, Cancer Biology Laboratory, Faculty of Engineering, Ege University, Bornova, 35100 Izmir, Turkey
| | - R Koziel
- Institute for Biomedical Aging Research, University of Innsbruck, Innsbruck, Austria
| | - D Kračun
- Experimental and Molecular Pediatric Cardiology, German Heart Center Munich at the Technical University Munich, Munich, Germany
| | - K H Krause
- Dept. of Pathology and Immunology, Centre Médical Universitaire, Geneva, Switzerland
| | - V Křen
- Institute of Microbiology, Laboratory of Biotransformation, Czech Academy of Sciences, Videnska 1083, CZ-142 20 Prague, Czech Republic
| | - T Krieg
- Department of Medicine, University of Cambridge, UK
| | - J Laranjinha
- Center for Neurosciences and Cell Biology, University of Coimbra and Faculty of Pharmacy, University of Coimbra, Coimbra, Portugal
| | - A Lazou
- School of Biology, Aristotle University of Thessaloniki, Thessaloniki 54124, Greece
| | - H Li
- Department of Pharmacology, Johannes Gutenberg University Medical Center, Mainz, Germany
| | - A Martínez-Ruiz
- Servicio de Immunología, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IIS-IP), Madrid, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain
| | - R Matsui
- Vascular Biology Section & Whitaker Cardiovascular Institute, Boston University School of Medicine, Boston, MA, USA
| | - G J McBean
- School of Biomolecular and Biomedical Science, Conway Institute, University College Dublin, Dublin, Ireland
| | - S P Meredith
- School of Life & Health Sciences, Aston University, Aston Triangle, Birmingham B47ET, UK
| | - J Messens
- Structural Biology Research Center, VIB, 1050 Brussels, Belgium; Brussels Center for Redox Biology, Structural Biology Brussels, Vrije Universiteit Brussel, 1050 Brussels, Belgium
| | - V Miguel
- Centro de Biología Molecular "Severo Ochoa" (CSIC-UAM), Madrid, Spain
| | - Y Mikhed
- Molecular Cardiology, Center for Cardiology, Cardiology 1, University Medical Center Mainz, Mainz, Germany
| | - I Milisav
- University of Ljubljana, Faculty of Medicine, Institute of Pathophysiology and Faculty of Health Sciences, Ljubljana, Slovenia
| | - L Milković
- Ruđer Bošković Institute, Division of Molecular Medicine, Zagreb, Croatia
| | - A Miranda-Vizuete
- Instituto de Biomedicina de Sevilla, Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Sevilla, Spain
| | - M Mojović
- University of Belgrade, Faculty of Physical Chemistry, Studentski trg 12-16, 11000 Belgrade, Serbia
| | - M Monsalve
- Instituto de Investigaciones Biomédicas "Alberto Sols" (CSIC-UAM), Madrid, Spain
| | - P A Mouthuy
- Laboratory for Oxidative Stress, Rudjer Boskovic Institute, Bijenicka 54, 10000 Zagreb, Croatia
| | - J Mulvey
- Department of Medicine, University of Cambridge, UK
| | - T Münzel
- Molecular Cardiology, Center for Cardiology, Cardiology 1, University Medical Center Mainz, Mainz, Germany
| | - V Muzykantov
- Department of Pharmacology, Center for Targeted Therapeutics & Translational Nanomedicine, ITMAT/CTSA Translational Research Center University of Pennsylvania The Perelman School of Medicine, Philadelphia, PA, USA
| | - I T N Nguyen
- Department of Nephrology & Hypertension, University Medical Center Utrecht, The Netherlands
| | - M Oelze
- Molecular Cardiology, Center for Cardiology, Cardiology 1, University Medical Center Mainz, Mainz, Germany
| | - N G Oliveira
- Research Institute for Medicines (iMed.ULisboa), Faculty of Pharmacy, Universidade de Lisboa, Lisboa, Portugal
| | - C M Palmeira
- Center for Neurosciences & Cell Biology of the University of Coimbra, Coimbra, Portugal; Department of Life Sciences of the Faculty of Sciences & Technology of the University of Coimbra, Coimbra, Portugal
| | - N Papaevgeniou
- National Hellenic Research Foundation, Institute of Biology, Medicinal Chemistry and Biotechnology, 48 Vas. Constantinou Ave., 116 35 Athens, Greece
| | - A Pavićević
- University of Belgrade, Faculty of Physical Chemistry, Studentski trg 12-16, 11000 Belgrade, Serbia
| | - B Pedre
- Structural Biology Research Center, VIB, 1050 Brussels, Belgium; Brussels Center for Redox Biology, Structural Biology Brussels, Vrije Universiteit Brussel, 1050 Brussels, Belgium
| | - F Peyrot
- LCBPT, UMR 8601 CNRS - Paris Descartes University, Sorbonne Paris Cité, Paris, France; ESPE of Paris, Paris Sorbonne University, Paris, France
| | - M Phylactides
- Molecular Genetics Thalassaemia Department, The Cyprus Institute of Neurology and Genetics, Nicosia, Cyprus
| | - G G Pircalabioru
- The Research Institute of University of Bucharest, Bucharest, Romania
| | - A R Pitt
- School of Life & Health Sciences, Aston University, Aston Triangle, Birmingham B47ET, UK
| | - H E Poulsen
- Laboratory of Clinical Pharmacology, Rigshospitalet, University Hospital Copenhagen, Denmark; Department of Clinical Pharmacology, Bispebjerg Frederiksberg Hospital, University Hospital Copenhagen, Denmark; Department Q7642, Rigshospitalet, Blegdamsvej 9, DK-2100 Copenhagen, Denmark
| | - I Prieto
- Instituto de Investigaciones Biomédicas "Alberto Sols" (CSIC-UAM), Madrid, Spain
| | - M P Rigobello
- Department of Biomedical Sciences, University of Padova, via Ugo Bassi 58/b, 35131 Padova, Italy
| | - N Robledinos-Antón
- Instituto de Investigaciones Biomédicas "Alberto Sols" UAM-CSIC, Instituto de Investigación Sanitaria La Paz (IdiPaz), Department of Biochemistry, Faculty of Medicine, Autonomous University of Madrid, Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain
| | - L Rodríguez-Mañas
- Fundación para la Investigación Biomédica del Hospital Universitario de Getafe, Getafe, Spain; Servicio de Geriatría, Hospital Universitario de Getafe, Getafe, Spain
| | - A P Rolo
- Center for Neurosciences & Cell Biology of the University of Coimbra, Coimbra, Portugal; Department of Life Sciences of the Faculty of Sciences & Technology of the University of Coimbra, Coimbra, Portugal
| | - F Rousset
- Dept. of Pathology and Immunology, Centre Médical Universitaire, Geneva, Switzerland
| | - T Ruskovska
- Faculty of Medical Sciences, Goce Delcev University, Stip, Republic of Macedonia
| | - N Saraiva
- CBIOS, Universidade Lusófona Research Center for Biosciences & Health Technologies, Lisboa, Portugal
| | - S Sasson
- Institute for Drug Research, Section of Pharmacology, Diabetes Research Unit, The Hebrew University Faculty of Medicine, Jerusalem, Israel
| | - K Schröder
- Institute for Cardiovascular Physiology, Goethe-University, Frankfurt, Germany; DZHK (German Centre for Cardiovascular Research), partner site Rhine-Main, Mainz, Germany
| | - K Semen
- Danylo Halytsky Lviv National Medical University, Lviv, Ukraine
| | - T Seredenina
- Dept. of Pathology and Immunology, Centre Médical Universitaire, Geneva, Switzerland
| | - A Shakirzyanova
- A.I. Virtanen Institute for Molecular Sciences, University of Eastern Finland, Kuopio, Finland
| | - G L Smith
- Department of Pathology, University of Cambridge, Cambridge, UK
| | - T Soldati
- Department of Biochemistry, Science II, University of Geneva, 30 quai Ernest-Ansermet, 1211 Geneva-4, Switzerland
| | - B C Sousa
- School of Life & Health Sciences, Aston University, Aston Triangle, Birmingham B47ET, UK
| | - C M Spickett
- Life & Health Sciences and Aston Research Centre for Healthy Ageing, Aston University, Aston Triangle, Birmingham B4 7ET, UK
| | - A Stancic
- University of Belgrade, Institute for Biological Research "Sinisa Stankovic" and Faculty of Biology, Belgrade, Serbia
| | - M J Stasia
- Université Grenoble Alpes, CNRS, Grenoble INP, CHU Grenoble Alpes, TIMC-IMAG, F38000 Grenoble, France; CDiReC, Pôle Biologie, CHU de Grenoble, Grenoble F-38043, France
| | - H Steinbrenner
- Institute of Nutrition, Department of Nutrigenomics, Friedrich Schiller University, Jena, Germany
| | - V Stepanić
- Ruđer Bošković Institute, Division of Molecular Medicine, Zagreb, Croatia
| | - S Steven
- Molecular Cardiology, Center for Cardiology, Cardiology 1, University Medical Center Mainz, Mainz, Germany
| | - K Tokatlidis
- Institute of Molecular Cell and Systems Biology, College of Medical Veterinary and Life Sciences, University of Glasgow, University Avenue, Glasgow, UK
| | - E Tuncay
- Department of Biophysics, Ankara University, Faculty of Medicine, 06100 Ankara, Turkey
| | - B Turan
- Department of Biophysics, Ankara University, Faculty of Medicine, 06100 Ankara, Turkey
| | - F Ursini
- Department of Molecular Medicine, University of Padova, Padova, Italy
| | - J Vacek
- Department of Medical Chemistry and Biochemistry, Faculty of Medicine and Dentistry, Palacký University, Hnevotinska 3, Olomouc 77515, Czech Republic
| | - O Vajnerova
- Department of Physiology, 2nd Faculty of Medicine, Charles University, Prague, Czech Republic
| | - K Valentová
- Institute of Microbiology, Laboratory of Biotransformation, Czech Academy of Sciences, Videnska 1083, CZ-142 20 Prague, Czech Republic
| | - F Van Breusegem
- Department of Plant Systems Biology, VIB, 9052 Ghent, Belgium; Department of Plant Biotechnology and Bioinformatics, Ghent University, 9052 Ghent, Belgium
| | - L Varisli
- Harran University, Arts and Science Faculty, Department of Biology, Cancer Biology Lab, Osmanbey Campus, Sanliurfa, Turkey
| | - E A Veal
- Institute for Cell and Molecular Biosciences, and Institute for Ageing, Newcastle University, Framlington Place, Newcastle upon Tyne, UK
| | - A S Yalçın
- Department of Biochemistry, School of Medicine, Marmara University, Istanbul, Turkey
| | - O Yelisyeyeva
- Danylo Halytsky Lviv National Medical University, Lviv, Ukraine
| | - N Žarković
- Laboratory for Oxidative Stress, Rudjer Boskovic Institute, Bijenicka 54, 10000 Zagreb, Croatia
| | - M Zatloukalová
- Department of Medical Chemistry and Biochemistry, Faculty of Medicine and Dentistry, Palacký University, Hnevotinska 3, Olomouc 77515, Czech Republic
| | - J Zielonka
- Medical College of Wisconsin, Milwaukee, USA
| | - R M Touyz
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, UK
| | - A Papapetropoulos
- Laboratoty of Pharmacology, Faculty of Pharmacy, National and Kapodistrian University of Athens, Greece
| | - T Grune
- German Institute of Human Nutrition, Department of Toxicology, Arthur-Scheunert-Allee 114-116, 14558 Nuthetal, Germany
| | - S Lamas
- Centro de Biología Molecular "Severo Ochoa" (CSIC-UAM), Madrid, Spain
| | - H H H W Schmidt
- Department of Pharmacology & Personalized Medicine, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, The Netherlands
| | - F Di Lisa
- Department of Biomedical Sciences and CNR Institute of Neuroscience, University of Padova, Padova, Italy.
| | - A Daiber
- Molecular Cardiology, Center for Cardiology, Cardiology 1, University Medical Center Mainz, Mainz, Germany; DZHK (German Centre for Cardiovascular Research), partner site Rhine-Main, Mainz, Germany.
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Cordy H, Rouch K, Govier A, Adams O, Griffiths H, Singh S, Star L, Crossley L, Nicholls H, Datta D. Clinical outcomes from a tier three weight management service. ATHEROSCLEROSIS SUPP 2017. [DOI: 10.1016/j.atherosclerosissup.2017.08.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Tymms K, Kelly A, Bird P, Griffiths H, de Jager J, Littlejohn G, Louw S, Roberts L, Youssef P, Zochling J, Nichols D. Psoriatic arthritis treatment regimens, therapy duration and reasons for cessation in the biologics era: a multi-centre Australian study. Int J Rheum Dis 2017; 21:510-516. [PMID: 28730757 DOI: 10.1111/1756-185x.13127] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [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: 11/27/2022]
Abstract
AIM To describe the treatment regimens, duration of therapy and reasons for disease-modifying antirheumatic drug (DMARD) cessation in a large psoriatic arthritis (PsA) cohort. METHODS A retrospective non-interventional multi-centre study using Audit4 electronic medical records, with de-identified, routinely collected clinical data from rheumatology practices in the OPAL consortium (Optimising Patient outcomes in Australian rheumatoLogy) during November 2015. Baseline characteristics, type and duration of conventional and biologic DMARDs (cDMARD and bDMARD, respectively), disease activity (Disease Activity Score of 28 joints C-reactive protein [DAS28-CRP]), and reasons for treatment cessation were recorded. RESULTS A total of 3422 rheumatologist-diagnosed PsA patients were included: 60% female, mean age 54 years and disease duration 10 years. Of patients with treatment recorded (n = 2948), 46% were on cDMARD monotherapy, 19% bDMARD monotherapy, 13% combination bDMARD and cDMARDs, 11% combination cDMARDs and 10% no DMARDs. Of those with DAS28-CRP results (n = 494), the highest mean DAS28-CRP was 3.32 on combination cDMARDs, and the lowest was 2.19 on bDMARD monotherapy. Median duration on cDMARD monotherapy was 33.5 months (n = 2232), on bDMARD monotherapy 110.1 months (n = 751), on combination bDMARD and cDMARDs 68.5 months (n = 559). The most common reasons for cessation of cDMARD monotherapy was adverse reactions (41%), for bDMARD monotherapy lack of efficacy (26%), and for combination bDMARD and cDMARDs treatment completed or no longer required (37%). CONCLUSION Most PsA patients were prescribed DMARD therapies with a large proportion receiving cDMARDs. Patients on combination cDMARD therapies had the highest DAS28-CRP results. Adverse reactions were the most common reason for cessation of cDMARD monotherapy, whereas for bDMARD monotherapy it was lack of efficacy.
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Affiliation(s)
- Kathleen Tymms
- Canberra Rheumatology, Canberra, Australian Capital Territory, Australia.,Rheumatology Department, Canberra Hospital, Canberra, Australian Capital Territory, Australia
| | - Ayano Kelly
- Canberra Rheumatology, Canberra, Australian Capital Territory, Australia.,Rheumatology Department, Canberra Hospital, Canberra, Australian Capital Territory, Australia
| | - Paul Bird
- Combined Rheumatology Practice, Sydney, New South Wales, Australia
| | | | | | - Geoff Littlejohn
- Monash Rheumatology and Monash University, Melbourne, Victoria, Australia
| | - Sandra Louw
- McCloud Consulting Group, Sydney, New South Wales, Australia
| | | | - Peter Youssef
- Susan Street Medical Centre, Sydney, New South Wales, Australia
| | | | - Dave Nichols
- Coast Joint Care, Maroochydore, Queensland, Australia.,University of Queensland, Brisbane, Queensland, Australia
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Biersma EM, Jackson JA, Hyvönen J, Koskinen S, Linse K, Griffiths H, Convey P. Global biogeographic patterns in bipolar moss species. R Soc Open Sci 2017; 4:170147. [PMID: 28791139 PMCID: PMC5541534 DOI: 10.1098/rsos.170147] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/21/2017] [Accepted: 06/08/2017] [Indexed: 05/20/2023]
Abstract
A bipolar disjunction is an extreme, yet common, biogeographic pattern in non-vascular plants, yet its underlying mechanisms (vicariance or long-distance dispersal), origin and timing remain poorly understood. Here, combining a large-scale population dataset and multiple dating analyses, we examine the biogeography of four bipolar Polytrichales mosses, common to the Holarctic (temperate and polar Northern Hemisphere regions) and the Antarctic region (Antarctic, sub-Antarctic, southern South America) and other Southern Hemisphere (SH) regions. Our data reveal contrasting patterns, for three species were of Holarctic origin, with subsequent dispersal to the SH, while one, currently a particularly common species in the Holarctic (Polytrichum juniperinum), diversified in the Antarctic region and from here colonized both the Holarctic and other SH regions. Our findings suggest long-distance dispersal as the driver of bipolar disjunctions. We find such inter-hemispheric dispersals are rare, occurring on multi-million-year timescales. High-altitude tropical populations did not act as trans-equatorial 'stepping-stones', but rather were derived from later dispersal events. All arrivals to the Antarctic region occurred well before the Last Glacial Maximum and previous glaciations, suggesting that, despite the harsh climate during these past glacial maxima, plants have had a much longer presence in this southern region than previously thought.
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Affiliation(s)
- E. M. Biersma
- Department of Plant Sciences, University of Cambridge, Downing Street, Cambridge CB2 3EA, UK
- British Antarctic Survey, Natural Environment Research Council, High Cross, Madingley Road, Cambridge CB3 0ET, UK
| | - J. A. Jackson
- British Antarctic Survey, Natural Environment Research Council, High Cross, Madingley Road, Cambridge CB3 0ET, UK
| | - J. Hyvönen
- Finnish Museum of Natural History (Botany) and Viikki Plant Science Centre, Department of Biosciences, University of Helsinki, PO Box 7, Helsinki FIN-00014, Finland
| | - S. Koskinen
- Department of Biochemistry, University of Turku, Turku, 20014, Finland
| | - K. Linse
- British Antarctic Survey, Natural Environment Research Council, High Cross, Madingley Road, Cambridge CB3 0ET, UK
| | - H. Griffiths
- Department of Plant Sciences, University of Cambridge, Downing Street, Cambridge CB2 3EA, UK
| | - P. Convey
- British Antarctic Survey, Natural Environment Research Council, High Cross, Madingley Road, Cambridge CB3 0ET, UK
- National Antarctic Research Center, Institute of Graduate Studies, University of Malaya, 50603 Kuala Lumpur, Malaysia
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Bird P, Nicholls D, Barrett R, de Jager J, Griffiths H, Roberts L, Tymms K, McCloud P, Littlejohn G. Longitudinal study of clinical prognostic factors in patients with early rheumatoid arthritis: the PREDICT study. Int J Rheum Dis 2017; 20:460-468. [PMID: 28205333 DOI: 10.1111/1756-185x.13036] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [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: 01/23/2023]
Abstract
AIM To assess the association between baseline clinical prognostic factors and subsequent Disease Activity Score of 28 joints (DAS28) remission in early rheumatoid arthritis (RA). METHODS Data were collected using point of care clinical software from participating rheumatology centres. Patients aged 18 years or over whose date of clinical onset of RA was within the previous 12-24 months, who had at least 6 months of follow-up data and a DAS28-ESR (erythrocyte sedimentation rate) score recorded between 12 and 24 months from first being seen for RA were included. Data collected included baseline demographics, mode of disease onset, pattern of joint involvement at onset, smoking status, DAS28, rheumatoid factor (RF), anti-citrullinated peptide antibodies (ACPA), time from symptom onset to presentation and disease activity at baseline. Univariate and multivariate logistic regression of DAS28-ESR remission between 12 and 24 months after first assessment were performed. RESULTS Data from 1017 patients were analyzed: 70% female; mean age 60 years (SD: 14.7); 70% RF-positive, 58% ACPA-positive. The strongest age and sex adjusted baseline predictors of DAS28-ESR remission at 12-24 months were remission at baseline (odds ratio [OR]: 4.49, 95% CI: 2.17-9.29, P < 0.001), being male (OR: 2.42, 95% CI: 1.46-4.01, P < 0.001), abstaining from alcohol (P < 0.001) and being lower weight (OR: 0.98, 95% CI: 0.97-1.00, P = 0.015). There was no statistically significant association between joint onset patterns, mode of onset, RF, ACPA or smoking status. CONCLUSION In this observational study, patients with early RA at risk of not achieving remission include those with high disease activity at baseline, women, those who drink alcohol and those with higher body weight.
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Affiliation(s)
- Paul Bird
- University of New South Wales and Combined Rheumatology Practice, Kogarah, New South Wales, Australia
| | - Dave Nicholls
- Coast Joint Care, Maroochydore, Queensland, Australia
| | - Rina Barrett
- Roche Products, Pty. Limited, Sydney, New South Wales, Australia
| | | | | | | | - Kathleen Tymms
- Canberra Rheumatology, Canberra, Australian Capital Territory, Australia
| | - Philip McCloud
- McCloud Consulting Group, Sydney, New South Wales, Australia
| | - Geoffrey Littlejohn
- Monash Medical Centre, Melbourne, Victoria, Australia.,Monash University, Melbourne, Victoria, Australia
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Vialet-Chabrand S, Matthews JSA, Brendel O, Blatt MR, Wang Y, Hills A, Griffiths H, Rogers S, Lawson T. Modelling water use efficiency in a dynamic environment: An example using Arabidopsis thaliana. Plant Sci 2016; 251:65-74. [PMID: 27593464 PMCID: PMC5038844 DOI: 10.1016/j.plantsci.2016.06.016] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/19/2016] [Revised: 06/13/2016] [Accepted: 06/22/2016] [Indexed: 05/21/2023]
Abstract
Intrinsic water use efficiency (Wi), the ratio of net CO2 assimilation (A) over stomatal conductance to water vapour (gs), is a complex trait used to assess plant performance. Improving Wi could lead in theory to higher productivity or reduced water usage by the plant, but the physiological traits for improvement and their combined effects on Wi have not been clearly identified. Under fluctuating light intensity, the temporal response of gs is an order of magnitude slower than A, which results in rapid variations in Wi. Compared to traditional approaches, our new model scales stoma behaviour at the leaf level to predict gs and A during a diurnal period, reproducing natural fluctuations of light intensity, in order to dissect Wi into traits of interest. The results confirmed the importance of stomatal density and photosynthetic capacity on Wi but also revealed the importance of incomplete stomatal closure under dark conditions as well as stomatal sensitivity to light intensity. The observed continuous decrease of A and gs over the diurnal period was successfully described by negative feedback of the accumulation of photosynthetic products. Investigation into the impact of leaf anatomy on temporal responses of A, gs and Wi revealed that a high density of stomata produces the most rapid response of gs but may result in lower Wi.
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Affiliation(s)
- S Vialet-Chabrand
- School of Biological Sciences, University of Essex, Colchester, CO4 3SQ, UK
| | - J S A Matthews
- School of Biological Sciences, University of Essex, Colchester, CO4 3SQ, UK
| | - O Brendel
- EEF, INRA, Université de Lorraine, F-54280 Champenoux, France
| | - M R Blatt
- Laboratory of Plant Physiology and Biophysics, University of Glasgow, Bower Building, Glasgow G12 8QQ, UK
| | - Y Wang
- Laboratory of Plant Physiology and Biophysics, University of Glasgow, Bower Building, Glasgow G12 8QQ, UK
| | - A Hills
- Laboratory of Plant Physiology and Biophysics, University of Glasgow, Bower Building, Glasgow G12 8QQ, UK
| | - H Griffiths
- Plant Sciences, University of Cambridge, Downing Street, Cambridge CB2 3EA, UK
| | - S Rogers
- Computing Science, University of Glasgow, Alwyn Williams Building, Glasgow G12 8QQ, UK
| | - T Lawson
- School of Biological Sciences, University of Essex, Colchester, CO4 3SQ, UK.
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Nicholls D, Nakayama A, Griffiths H, Littlejohn G, Bird P, Roberts L, de Jager J, Zochling J, Richter S, Louw S, Tymms K. THU0436 A Retrospective Non-Interventional Multi-Centre Study Evaluating Treatment Regimens Used in Psoriatic Arthritis Patients in Australia- The PSA Real Study. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.2099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Bird P, Peterfy C, DiCarlo J, Joshua F, Hall S, Griffiths H, Youssef P, Barrett R, Button P. AB0368 AC-Cute: An Open-Label Study To Evaluate Non-Progression of Structural Joint Damage in Patients with Moderate To Severe Active Rheumatoid Arthritis Treated with Subcutaneous Tocilizumab. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.3780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Nicholls D, Griffiths H, Barrett R, Button P, Truman M, Bird P, Roberts L, Tymms K, Littlejohn G. AB0344 A Retrospective Non-Interventional Study on The Use of Biologics in The Treatment of Australian Patients with Rheumatoid Arthritis-The Real Study. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.4470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Littlejohn G, Roberts L, Bird P, de Jager J, Griffiths H, Nicholls D, Young J, Zochling J, Tymms KE. Patients with Rheumatoid Arthritis in the Australian OPAL Cohort Show Significant Improvement in Disease Activity over 5 Years: A Multicenter Observational Study. J Rheumatol 2015; 42:1603-9. [DOI: 10.3899/jrheum.141575] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/29/2015] [Indexed: 11/22/2022]
Abstract
Objective.To evaluate disease activity trends in a large cohort of Australian patients with rheumatoid arthritis (RA) from 2009 to 2014.Methods.This is a multicenter, cross-sectional, noninterventional study of patients with RA treated in Australia. Patients with RA treated at participating OPAL (Optimising Patient outcome in Australian RheumatoLogy) clinics were included in the study. Data, deidentified by patient, clinic, and clinician, were identified using a purpose-written electronic medical record. Patient demographics, disease onset, medications, and disease measures were analyzed. The Disease Activity Score at 28 joints (DAS28) was used to classify patients into the disease activity states of remission: low disease activity, moderate disease activity (MDA), and high disease activity. Choice of therapy was at the discretion of the treating clinician.Results.At the time of analysis, the database contained 15,679 patients with RA, 8998 of whom fulfilled the inclusion criteria. Mean age was 63.2 years, mean disease duration was 13.8 years, and the majority were women (72.4%). A total of 37,274 individual DAS28-erythrocyte sedimentation rate scores were recorded for the 8998 patients. The frequency of remission increased significantly from 36.7% in 2009 to 53.5% in 2014 (p < 0.001), and that of MDA decreased from 33% (2009) to 22.2% (2014). The use of biologic disease-modifying antirheumatic drugs for the patients in remission increased from 17% in 2009 to 36.9% in 2014.Conclusion.Contemporary management of RA in Australia shows improvements in disease activity toward the target of remission over a 5-year period.
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Goirigolzarri Artaza J, Gallego Delgado M, Jaimes Castellanos C, Cavero Gibanel M, Pastrana Ledesma M, Alonso Pulpon L, Gonzalez Mirelis J, Al Ansi RZ, Sokolovic S, Cerin G, Szychta W, Popa BA, Botezatu D, Benea D, Manganiello S, Corlan A, Jabour A, Igual Munoz B, Osaca Asensi J, Andres La Huerta A, Maceira Gonzalez A, Estornell Erill J, Cano Perez O, Sancho-Tello M, Alonso Fernandez P, Sepulveda Sanchez P, Montero Argudo A, Palombo C, Morizzo C, Baluci M, Kozakova M, Panajotu A, Karady J, Szeplaki G, Horvath T, Tarnoki D, Jermendy A, Geller L, Merkely B, Maurovich-Horvat P, Moustafa S, Mookadam F, Youssef M, Zuhairy H, Connelly M, Prieur T, Alvarez N, Ashikhmin Y, Drapkina O, Boutsikou M, Demerouti E, Leontiadis E, Petrou E, Karatasakis G, Kozakova M, Morizzo C, Bianchi V, Marchi B, Federico G, Palombo C, Chatzistamatiou E, Moustakas G, Memo G, Konstantinidis D, Mpampatzeva Vagena I, Manakos K, Traxanas K, Vergi N, Feretou A, Kallikazaros I, Goto M, Uejima T, Itatani K, Pedrizzetti G, Mada R, Daraban A, Duchenne J, Voigt J, Chiu DYY, Green D, Johnstone L, Sinha S, Kalra P, Abidin N, Sikora-Frac M, Zaborska B, Maciejewski P, Bednarz B, Budaj A, Nemes A, Sasi V, Gavaller H, Kalapos A, Domsik P, Katona A, Szucsborus T, Ungi T, Forster T, Ungi I, Pluchinotta F, Arcidiacono C, Saracino A, Carminati M, Bussadori C, Dahlslett T, Karlsen S, Grenne B, Sjoli B, Bendz B, Skulstad H, Smiseth O, Edvardsen T, Brunvand H, Vereckei A, Szelenyi Z, Szenasi G, Santoro C, Galderisi M, Niglio T, Santoro M, Stabile E, Rapacciuolo A, Spinelli L, De Simone G, Esposito G, Trimarco B, Hubert S, Jacquier A, Fromonot J, Resseguier C, Tessier A, Guieu R, Renard S, Haentjiens J, Lavoute C, Habib G, Menting ME, Koopman L, Mcghie J, Rebel B, Gnanam D, Helbing W, Van Den Bosch A, Roos-Hesselink J, Shiino K, Yamada A, Sugimoto K, Takada K, Takakuwa Y, Miyagi M, Iwase M, Ozaki Y, Hayashi T, Itatani K, Inuzuka R, Shindo T, Hirata Y, Shimizu N, Miyaji K, Henri C, Dulgheru R, Magne J, Kou S, Davin L, Nchimi A, Oury C, Pierard L, Lancellotti P, Kovalyova O, Honchar O, Tengku W, Ketaren A, Mingo Santos S, Monivas Palomero V, Restrepo Cordoba A, Rodriguez Gonzalez E, Goirigolzarri Artaza J, Sayago Silva I, Garcia Lunar I, Mitroi C, Cavero Gibanel M, Segovia Cubero J, Ryu S, Park J, Kim S, Choi J, Goh C, Byun Y, Choi J, Westholm C, Johnson J, Jernberg T, Winter R, Rio P, Moura Branco L, Galrinho A, Pinto Teixeira P, Viveiros Monteiro A, Portugal G, Pereira-Da-Silva T, Afonso Nogueira M, Abreu J, Cruz Ferreira R, Mazzone A, Botto N, Paradossi U, Chabane A, Francini M, Cerone E, Baroni M, Maffei S, Berti S, Ghattas A, Shantsila E, Griffiths H, Lip G, Galli E, Guirette Y, Daudin M, Auffret V, Mabo P, Donal E, Fabiani I, Conte L, Scatena C, Barletta V, Pratali S, De Martino A, Bortolotti U, Naccarato A, Di Bello V, Falanga G, Alati E, Di Giannuario G, Zito C, Cusma' Piccione M, Carerj S, Oreto G, Dattilo G, Alfieri O, La Canna G, Generati G, Bandera F, Pellegrino M, Alfonzetti E, Labate V, Guazzi M, Cengiz B, Sahin ST, Yurdakul S, Kahraman S, Bozkurt A, Aytekin S, Borges IP, Peixoto E, Peixoto R, Peixoto R, Marcolla V, Venkateshvaran A, Sola S, Dash PK, Thapa P, Manouras A, Winter R, Brodin L, Govind SC, Mizariene V, Verseckaite R, Bieseviciene M, Karaliute R, Jonkaitiene R, Vaskelyte J, Arzanauskiene R, Janenaite J, Jurkevicius R, Rosner S, Orban M, Nadjiri J, Lesevic H, Hadamitzky M, Sonne C, Manganaro R, Carerj S, Cusma-Piccione M, Caprino A, Boretti I, Todaro M, Falanga G, Oreto L, D'angelo M, Zito C, Le Tourneau T, Cueff C, Richardson M, Hossein-Foucher C, Fayad G, Roussel J, Trochu J, Vincentelli A, Cavalli G, Muraru D, Miglioranza M, Addetia K, Veronesi F, Cucchini U, Mihaila S, Tadic M, Lang R, Badano L, Polizzi V, Pino P, Luzi G, Bellavia D, Fiorilli R, Chialastri C, Madeo A, Malouf J, Buffa V, Musumeci F, Gripari P, Tamborini G, Bottari V, Maffessanti F, Carminati C, Muratori M, Vignati C, Bartorelli A, Alamanni F, Pepi M, Polymeros S, Dimopoulos A, Spargias K, Karatasakis G, Athanasopoulos G, Pavlides G, Dagres N, Vavouranakis E, Stefanadis C, Cokkinos D, Pradel S, Mohty D, Magne J, Darodes N, Lavergne D, Damy T, Beaufort C, Aboyans V, Jaccard A, Mzoughi K, Zairi I, Jabeur M, Ben Moussa F, Ben Chaabene A, Kamoun S, Mrabet K, Fennira S, Zargouni A, Kraiem S, Jovanova S, Arnaudova-Dezjulovic F, Correia CE, Cruz I, Marques N, Fernandes M, Bento D, Moreira D, Lopes L, Azevedo O, Keramida K, Kouris N, Kostopoulos V, Psarrou G, Giannaris V, Olympios C, Marketou M, Parthenakis F, Kalyva N, Pontikoglou C, Maragkoudakis S, Zacharis E, Patrianakos A, Roufas K, Papadaki H, Vardas P, Dominguez Rodriguez F, Monivas Palomero V, Mingo Santos S, Arribas Rivero B, Cuenca Parra S, Zegri Reiriz I, Vazquez Lopez-Ibor J, Garcia-Pavia P, Szulik M, Streb W, Wozniak A, Lenarczyk R, Sliwinska A, Kalarus Z, Kukulski T, Nemes A, Domsik P, Kalapos A, Forster T, Serra W, Lumetti F, Mozzani F, Del Sante G, Ariani A, Corros C, Colunga S, Garcia-Campos A, Diaz E, Martin M, Rodriguez-Suarez M, Leon V, Fidalgo A, Moris C, De La Hera J, Kylmala MM, Rosengard-Barlund M, Groop PH, Lommi J, Bruin De- Bon H, Bilt Van Der I, Wilde A, Brink Van Den R, Teske A, Rinkel G, Bouma B, Teixeira R, Monteiro R, Garcia J, Silva A, Graca M, Baptista R, Ribeiro M, Cardim N, Goncalves L, Duszanska A, Skoczylas I, Kukulski T, Polonski L, Kalarus Z, Choi JH, Park J, Ahn J, Lee J, Ryu S, Ahn J, Kim D, Lee H, Przewlocka-Kosmala M, Mlynarczyk J, Rojek A, Mysiak A, Kosmala W, Pellissier A, Larochelle E, Krsticevic L, Baron E, Le V, Roy A, Deragon A, Cote M, Garcia D, Tournoux F, Yiangou K, Azina C, Yiangou A, Zitti M, Ioannides M, Ricci F, Dipace G, Aquilani R, Radico F, Cicchitti V, Bianco F, Miniero E, Petrini F, De Caterina R, Gallina S, Jardim Prista Monteiro R, Teixeira R, Garcia J, Baptista R, Ribeiro M, Cardim N, Goncalves L, Chung H, Kim J, Joung B, Uhm J, Pak H, Lee M, Lee K, Ragab A, Abdelwahab A, Yazeed Y, El Naggar W, Spahiu K, Spahiu E, Doko A, Liesting C, Brugts J, Kofflard M, Kitzen J, Boersma E, Levin MD, Coppola C, Piscopo G, Rea D, Maurea C, Caronna A, Capasso I, Maurea N, Azevedo O, Tadeu I, Lourenco M, Portugues J, Pereira V, Lourenco A, Nesukay E, Kovalenko V, Cherniuk S, Danylenko O, Nemes A, Domsik P, Kalapos A, Lengyel C, Varkonyi T, Orosz A, Forster T, Castro M, Abecasis J, Dores H, Madeira S, Horta E, Ribeiras R, Canada M, Andrade M, Mendes M, Morosin M, Piazza R, Leonelli V, Leiballi E, Pecoraro R, Cinello M, Dell' Angela L, Cassin M, Sinagra G, Nicolosi G, Wierzbowska-Drabik K, Hamala P, Kasprzak J, O'driscoll J, Rossato C, Gargallo-Fernandez P, Araco M, Sharma S, Sharma R, Jakus N, Baricevic Z, Ljubas Macek J, Skoric B, Skorak I, Velagic V, Separovic Hanzevacki J, Milicic D, Cikes M, Deljanin Ilic M, Ilic S, Kocic G, Pavlovic R, Stoickov V, Ilic V, Nikolic L, Generati G, Bandera F, Pellegrino M, Alfonzetti E, Labate V, Guazzi M, Labate V, Bandera F, Generati G, Pellegrino M, Donghi V, Alfonzetti E, Guazzi M, Zakarkaite D, Kramena R, Aidietiene S, Janusauskas V, Rucinskas K, Samalavicius R, Norkiene I, Speciali G, Aidietis A, Kemaloglu Oz T, Ozpamuk Karadeniz F, Akyuz S, Unal Dayi S, Esen Zencirci A, Atasoy I, Osken A, Eren M, Fazendas PR, Caldeira D, Stuart B, Cruz I, Rocha Lopes L, Almeida AR, Sousa P, Joao I, Cotrim C, Pereira H, Fazendas PR, Caldeira D, Stuart B, Cruz I, Rocha Lopes L, Almeida AR, Joao I, Cotrim C, Pereira H, Sinem Cakal S, Elif Eroglu E, Baydar O, Beytullah Cakal B, Mehmet Vefik Yazicioglu M, Mustafa Bulut M, Cihan Dundar C, Kursat Tigen K, Birol Ozkan B, Ali Metin Esen A, Yagasaki H, Kawasaki M, Tanaka R, Minatoguchi S, Houle H, Warita S, Ono K, Noda T, Watanabe S, Minatoguchi S, Cho EJ, Park SJ, Lim HJ, Chang SA, Lee SC, Park SW, Cho EJ, Park SJ, Lim HJ, Chang SA, Lee SC, Park SW, Mornos C, Cozma D, Ionac A, Mornos A, Popescu I, Ionescu G, Pescariu S, Melzer L, Faeh-Gunz A, Seifert B, Attenhofer Jost CH, Storve S, Haugen B, Dalen H, Grue J, Samstad S, Torp H, Ferrarotti L, Maggi E, Piccinino C, Sola D, Pastore F, Marino P, Ranjbar S, Karvandi M, Hassantash S, Karvandi M, Ranjbar S, Tierens S, Remory I, Bala G, Gillis K, Hernot S, Droogmans S, Cosyns B, Lahoutte T, Tran N, Poelaert J, Al-Mallah M, Alsaileek A, Nour K, Celeng C, Horvath T, Kolossvary M, Karolyi M, Panajotu A, Kitslaar P, Merkely B, Maurovich Horvat P, Aguiar Rosa S, Ramos R, Marques H, Portugal G, Pereira Da Silva T, Rio P, Afonso Nogueira M, Viveiros Monteiro A, Figueiredo L, Cruz Ferreira R. Poster session 6. Eur Heart J Cardiovasc Imaging 2014; 15:ii235-ii264. [PMCID: PMC4453635 DOI: 10.1093/ehjci/jeu271] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/13/2023] Open
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Littlejohn G, Roberts L, Arnold M, Bird P, Burnet S, de Jager J, Griffiths H, Nicholls D, Scott J, Zochling J, Tymms KE. A multi-center, observational study shows high proportion of Australian rheumatoid arthritis patients have inadequate disease control. Int J Rheum Dis 2014; 16:532-8. [PMID: 24164840 DOI: 10.1111/1756-185x.12163] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [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: 01/09/2023]
Abstract
OBJECTIVES To evaluate the disease activity and current pharmacological interventions used to achieve remission in rheumatoid arthritis (RA) patients in Australia. METHODS Rheumatoid arthritis patients treated in participating Australian clinics were included in the study. Patient demographics, disease onset, medications and disease measures were analyzed. Data, de-identified to the patient, clinic and clinician were captured using an electronic clinical management program. The disease activity score (DAS28) was used to classify patients into the disease activity states of remission, low disease activity (LDA), moderate disease activity (MDA) and high disease activity (HDA). Choice of therapy was at the discretion of the treating clinician. RESULTS A total of 5686 patients, 72.9% female, 26.9% male, with mean age 61.1 (SD 13.6) years and mean disease duration of 11.5 (SD 10.5) years were analyzed. DAS28 ESR (erythrocyte sedimentation rate) scores were recorded for 2973 patients, with 41.6% in remission, 18.6% LDA, 31.6% MDA and 8.2% HDA. Of those in remission, 17% received a biological disease modifying anti-rheumatic drug (bDMARD), 73% methotrexate (MTX), 19% leflunomide (LEF) and 28% prednisolone. Of the patients with MDA, 20% received a bDMARD, 76% MTX, 24% LEF and 39% prednisolone. Of the patients in HDA, 27% received a bDMARD, 78% MTX, 31% LEF and 60% with prednisolone. CONCLUSIONS Cross-sectional assessment of this large cohort of Australian RA patients found a large proportion remain in moderate or high disease activity; suggesting a considerable evidence-practice gap. Improvement in disease control in this group may reduce future health burdens.
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