Day Four Poster Session Roundup: Part 1

Dozens of posters were presented under the RA umbrella during the morning of day 4 at the American College of Rheumatology/Association of Rheumatology Health Professionals 2009 Annual Scientific Sessions. Among the highlights were the following:

Rheumatoid Arthritis: Human Etiology and Pathogenesis I

Genetic Variation at the IRF7/PHRF1 Locus Is Associated with Autoantibody Profile and Serum Interferon Alpha Activity in Lupus Patients Authors: Salloum R, Franek B, Kariuki S, et al. Purpose: "Interferon alpha (IFN-α) is a heritable risk factor for systemic lupus erythematosus (SLE), Studies have implicated genetic variation near interferon regulatory factor 7 (IRF7) in SLE susceptibility. SLE-associated autoantibodies can stimulate IFN-α production through the Toll-like receptor/IRF7 pathway. We hypothesized that variants of IRF7 may cause risk of SLE by increasing IFN-α production, and that autoantibodies may be important to this phenomenon."

Results: Researchers found that the data gathered in this study suggest that "IRF7/PHRF1 variants cooperate with SLE-associated autoantibodies to result in higher serum IFN-α, providing a biologic relevance for this locus at the protein level in SLE in vivo."

The Association of the Defects in ER Stress-Induced Autophagic Reaction and Apoptotic Cell Death of T Lymphocytes in Systemic Lupus Erythematosus Authors: Lee E, Hee, Yun J, Hong YK, et al. Purpose: To define "the roles of endoplasmic reticulum (ER) stress-induced autophagic reaction of T lymphocytes in patients with SLE."

Results: The authors of this study found that "ER stress-induced autophagic reaction was decreased in T lymphocytes of patients with SLE compared to healthy controls," and that "ER stress-induced autophagic reaction was decreased and associated with survival of T lymphocytes in SLE." These findings suggest "that defects in autophagic reaction of T lymphocytes are involved in the pathogenesis of SLE."

ACR/ARHP Annual Scientific Meeting: Rheumatoid Arthritis Clinical Aspects: Treatment Response - Biologics

Do Men and Women with Rheumatoid Arthritis Respond Differently to Treatment? Authors: Feng JY, Louis J, Paulus H, et al. Purpose: To examine "gender differences in treatment responses in rheumatoid arthritis (RA) patients."

Results: Researchers examined "gender differences in RA in two unique, real-world prospective observational cohorts, each with patients from approximately 350 rheumatology practices across the US, as part of the RA DMARD Intervention and Utilization Study." Their results demonstrated that, in RA, "significant differences in disease manifestations relating to function and pain are observed between men and women," and that "it is uncertain whether the observed trend toward differences in treatment response between men and women, at 6 months, is influenced by gender, disease state, or both."

Rheumatoid Arthritis: Insights, Strategies and Expectations-Global Results of the RAISE Patient Needs Survey Authors: McInnes IB Purpose: To "reveal the perceptions of RA patients on their disease and therapy."

Results: Researchers developed a questionnaire with input from 53 rheumatologists from 8 European countries and Canada and proceeded with interviewing a total of 586 patients, approximately 30 biologic naïve and 35 on anti-TNF therapy from each of 9 countries (mean age at the onset of RA symptoms was 41 years). This large patient survey provided "key insights into how RA patients live with their disease and how therapy has impacted them," and the data revealed "that biologic therapy has had significant impact on improving patients' lives."However, researchers also noted that "all patients reported some level of continuing symptoms and current pain indicating unmet clinical need."

ACR/ARHP Annual Scientific Meeting: Rheumatoid Arthritis Clinical Aspects: Treatment Response - Non-Biologics

Meta-Analysis of Tight Control Strategies in Rheumatoid Arthritis: Protocolized Treatment Has Additional Value with Respect to the Clinical Outcome Authors: Schipper LG, van Hulst LTC, Hulscher MEJL Purpose: "Randomized controlled trials show that tight control in Rheumatoid Arthritis (RA) is effective. Several ways for tight control have been studied, varying from 'monitoring with using a treatment protocol' to 'monitoring without applying a treatment protocol'. Whether these approaches differ in terms of clinical efficacy is not clear yet. Therefore, the efficacy of monitoring with protocolized treatment adjustments was compared to the efficacy of monitoring without protocolized treatment adjustments."

Results: Researchers found that, "in the treatment of RA, a tight control approach is more effective if monitoring is combined with protocolized treatment adjustments compared to tight control consisting of monitoring alone. Therefore, in tight control of RA, monitoring should be followed by protocolized treatment adjustments to accomplish the largest difference."