Author Interviews, Orthopedics, Rheumatology / 18.06.2018 Interview with: Samuel Hawley | Research Assistant (NIHR PhD Project) | Pharmaco- and Device Epidemiology Group | Centre for Statistics in Medicine | NDORMS | University of Oxford What is the background for this study? What are the main findings? Response: The aim was to disentangle some of the potential reasons for the recent decline in joint replacement rates among rheumatoid arthritis (RA) patients in the developed world. The main findings from our UK patient-level analysis indicated that joint replacement rates were not significantly different for users of TNF inhibitors versus the patients who remained only on conventional synthetic DMARDS, however we did find that TNF inhibitor use amongst older RA patients was associated with a 40% reduction in hip replacement rates. (more…)
Author Interviews, Biomarkers, Rheumatology / 16.06.2018 Interview with: Dr. Lisa van Baarsen PhD Principal Investigator at the Amsterdam Rheumatology and Immunology Cente Academic Medical Center the Netherlands What is the background for this study? What are the main findings? Response: The discovery that autoantibodies can be present years before the onset of clinical symptoms of rheumatoid arthritis (RA) enables us to study autoantibody positive individuals who are at risk of developing RA. In patients with established disease the target tissue of RA, the synovial joints, is characterized by cellular infiltration and inflammation. Moreover, successful therapy decreases this synovial inflammation. In the past, our department already showed (PMID: 21177292; PMID: 24574210) that in autoantibody positive at risk individuals there is no overt cellular infiltration present in the synovium. In the current study we performed a so called discovery-based approach to investigate at a genome-wide gene expression level (using microarrays) whether the synovium is altered at a molecular level before onset of rheumatoid arthritis. Our molecular and microscopic studies on synovial biopsies obtained from autoantibody positive individuals indeed revealed interesting differences between those at risk individuals who developed disease after follow up and those who did not. (more…)
Author Interviews, Rheumatology / 16.06.2018 Interview with: Maarten Boers, MSc, MD, PhD Professor of Clinical Epidemiology Department of Epidemiology and Biostatistics VU University Medical Center--F wing MedFac Amsterdam, Netherlands What is the background for this study? What are the main findings? Response: Mortality in rheumatoid arthritis is increased. Recent (short-term) studies suggest the situation is improving, but in studies with long (>10-year) follow up the increased mortality persists. We have been following a trial cohort of rheumatoid arthritis patients treated right from the beginning of disease (the COBRA trial) for 23 years and now, for the first time, show normal mortality compared to the general population. (more…)