Day Three Poster Session Roundup

Here we recap some of the highlights of today's poster session with a focus on rheumatoid arthritis.

Associated Factors for Falls and Fear of Falls in Japanese Patients with Rheumatoid ArthritisAuthors: Furuya T, Yamagiwa K, Ikai T, et al

Purpose: “To determine factors associated with falls in Japanese patients with rheumatoid arthritis (RA).”

Results: “HAQ disability score, tender joint counts, and VAS-general health were associated with both falls and fear of falling in Japanese patients with RA. Concomitant use of active vitamin D3 and methotrexate appeared to be related to falls in Japanese patients with RA.”

FCRL3 — 169CC is Associated with ACPA Positive RA and with Radiographic ProgressionAuthors: Maehlen M, Nordang G, Syversen S, et al

Purpose: Because “the Fc receptor-like 3 gene has been reported to be associated with RA in Japanese, Norwegian, and Dutch populations,” and examinations of other populations have produced conflicting results, researchers sought “to carry out an association study investigating the effect of FCRL-169T>C on anti-citrullinated protein antibody status and radiographic progression.”

Results: “A promoter polymorphism of FCRL3 was associated to bth ACPA and RF positive RA, which supports the proposed association with auto antibody production…In addition we found suggestive evidence that the FCRL3 — 169CC genotype influence disease severity by conferring increased radiographic progression.”

Tolerability of Nonselective NSAIDs and Celecoxib Among Patients with Gastroesophegeal Reflux Disease and OsteoarthritisAuthors: Cryer B, Luo X, Sands G, Mardekian J

Purpose: “In OA and RA, selective COX-2 NSAID use is typically associated with less dyspepsia than with nsNSAIDs,” however, “little is known about NSAID tolerance in patients with GERD.” Therefore, researchers “studied nsNSAID and celecoxib prescription patterns, including discontinuations, in OA/RA patients with concomitant GERD.”

Results: “In patients with GERD/OA or GERD/RA who require anti-inflammatory treatment, significantly fewer patients discontinued celecoxib when compared to those discontinuing nsNSAIDs.”

Effect of Blood Loss on Physical Functioning: Pooled Analysis of Patients with Osteoarthritis or Rheumatoid ArthritisAuthors: Strand V, Luo X, Cappelleri J, et al

Purpose: “To assess the effect of clinically significant blood loss on physical functioning and other aspects of health-related quality of life in patients with OA or RA.”

Results: “The median number of subjects with data across SF-36 domains was 9850. On average, most domain scores improved from baseline, improvements in physical functioning domains scores were lower in patients with Hgb decreases ≥ 2 g/dL compared with those with lesser changes in Hgb (from -1 to 1 g/dL). Differences between the two groups were statistically significant and clinically meaningful, defined by changes ≥ 5 points in domain scores in both female (P=0.02;6.3) and male (P=0.01; 6.8) subjects. In the subgroup of female subjects with baseline Hgb ≤15 g/dL (P=0.001, 12.6). Statistically significant and clinically meaningful group differences in improvements from baseline were also observed in role-physical domain scores among male subjects (P=0.01; 13.7). Differences between improvements in the other domain scores with respect to blood loss were neither statistically significant nor clinically meaningful.”

Variation in Rheumatoid Arthritis (RA) Susceptibility Genes Predicts Response to Anti-tumour Necrosis Factor Treatment in RA PatientsAuthors: Gibbons L, Tan R, Potter C, et al

Purpose: “To investigate single nucleotide polymorphisms mapping to confirmed RA susceptibility loci in response to anti-TNF treatment.”

Results: “Results suggest that the RA susceptibility genes CD225 and AFF3 influence response to anti-TNF treatment…Further work is needed to confirm or refute the STAT4 association…”

Health Literacy in Childhood ArthritisAuthors: Levey E, Ehrlich J, Wagner-Weiner L, Onel K

Purpose: “The degree to which parental health literacy affects outcomes for children with chronic disease is less certain” than that of health literacy and outcomes in adults. “Juvenile idiopathic Arthritis (JIA) presents an appropriate model to explore this relationship between parental literacy and child health outcome.”

Results: Researchers performed literacy assessments in an urban pediatric rheumatology center and “found significant baseline differences between parental literacy ability when analyzing demographic data. Further, there was a strong relationship between limited parental and child literacy. Finally, there was a large discrepancy in insurance types between the two literacy groups. Of concern, there was a lack of correlation between the ratings of parents with limited literacy on GA and the physician’s GA. Previous studies have suggested that children with private insurance do better than those without despite seeing the same physicians in the same office. This outcome gap may be explained in part by the disparity in health literacy between the two groups preventing understanding of disease severity. We plan to follow these patients over time to better understand effects of parent/child literacy on health outcomes.”

Assessment of the Adequacy of Conclusions in Superiority RCTs. The Example of 3 Rheumatic Diseases: Rheumatoid Arthritis, Spondyloarthropathics, and OsteoarthritisAuthors: Mathieu S, Giraudeau B, Soubrier M, Ravaud P

Purpose: “To assess the proportion, and to define the causes of, misleading conclusions in published randomized controlled trials (RCTs) assessing RA, OA, or SPA, and to determine whether conclusions were based on the primary outcome.”

Results: “This study found a proportion of 27% of misleading conclusions in the abstracts of a sample of RCTs assessing RA, OA, and SPA. Negative and clinically irrelevant results were risk factors of misleading conclusions.”

Does the Framingham Score Underestimate Cardiovascular Risk in Rheumatoid Arthritis?Authors: Crowson S, Myasoedova E, Roger V, et al

Purpose: Because patients with RA suffer from an excess burden of cardiovascular disease, and the Framingham risk score is often used to assess CV risk in the general population, researchers sought “to examine whether the Framingham risk score underestimates CV risk for RA patients.”

Results: “The Framingham risk score substantially underestimates CVD risk in RA patients of both genders, especially in older ages. In patients aged ≥ 75 years, the deficit in CV risk estimates was particularly large. This underscores the need for more accurate tools to predict the risk of CVD in RA patients.”

Frequency and Cost of Joint Replacement Surgery for Patients with Rheumatoid Arthritis: A Population-Based Study in CanadaAuthors: Dobson RL, Osenenko K, Szabo SM, et al

Purpose: “RA causes joint damage, often necessitating surgical joint replacement. Clinic- and hospital-based studies have estimated that 7-27% of patients with RA require total joint replacement surgery; however, variable follow-up periods and/or small sample sizes limit generalizability of these results. This study used a population-based database to estimate the frequency, timing, and cost of joint replacements for patients with RA.”

Results: “Joint replacement surgeries contribute substantially to the burden of RA. In this large, longitudinal, population-based study, almost 1 in 10 patients with RA required joint replacement surgery, with 25% of these surgeries occurring within the first 2 years after diagnosis. Early, appropriate treatment of RA may prevent joint damage and result in fewer or delayed joint surgeries.”