Pick Topic
Review Topic
List Experts
Examine Expert
Save Expert
  Site Guide ··   
Psoriasis: HELP
Articles by Vinod Chandran
Based on 126 articles published since 2008
||||

Between 2008 and 2019, V. Chandran wrote the following 126 articles about Psoriasis.
 
+ Citations + Abstracts
Pages: 1 · 2 · 3 · 4 · 5 · 6
1 Editorial Which is worse in psoriasis - skin or joints? 2015

Sharma, Aman / Danda, Debashish / Chandran, Vinod. ·Department of Internal Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh. ·Int J Rheum Dis · Pubmed #25823417.

ABSTRACT: -- No abstract --

2 Editorial Epidemiology of psoriatic arthritis. 2009

Chandran, Vinod. · ·J Rheumatol · Pubmed #19208553.

ABSTRACT: -- No abstract --

3 Review Role of Methotrexate in the Management of Psoriatic Arthritis. 2018

Elmamoun, Musaab / Chandran, Vinod. ·Department of Medicine, Division of Rheumatology, University of Toronto, Toronto, ON, Canada. · Centre for Prognosis Studies in the Rheumatic Diseases, Krembil Research Institute, Toronto Western Hospital, University Health Network, 1E 416, 399 Bathurst Street, Toronto, ON, M5T 2S8, Canada. · Department of Medicine, Division of Rheumatology, University of Toronto, Toronto, ON, Canada. vinod.chandran@uhnresearch.ca. · Centre for Prognosis Studies in the Rheumatic Diseases, Krembil Research Institute, Toronto Western Hospital, University Health Network, 1E 416, 399 Bathurst Street, Toronto, ON, M5T 2S8, Canada. vinod.chandran@uhnresearch.ca. · Department of Laboratory Medicine and Pathobiology & Institute of Medical Science, University of Toronto, Toronto, ON, Canada. vinod.chandran@uhnresearch.ca. ·Drugs · Pubmed #29616495.

ABSTRACT: Methotrexate is known to be safe and efficacious in the management of rheumatoid arthritis and psoriasis and thus has been used for the management of psoriatic arthritis despite a lack of evidence to support efficacy in psoriatic arthritis from randomized controlled trials. Although the largest randomized trial to date did not support its use as a disease-modifying therapy, observational studies have supported its role, and current treatment recommendations approve of its use as a first-line agent for the management of psoriatic arthritis with predominant peripheral arthritis. The first treat-to-target study in psoriatic arthritis, comparing tight control with standard care, has shown the efficacy of methotrexate as monotherapy in the first 12 weeks. This trial demonstrated the effectiveness of methotrexate with improvement in peripheral arthritis, skin and nail disease, enthesitis, and dactylitis over the course of 12 weeks. There is conflicting evidence about the role of combination (concomitant methotrexate and anti-tumor necrosis factor) therapy. However, drug survival and immunogenicity of certain anti-tumor necrosis factors seem to be better when used in combination with methotrexate. This report reviews the available evidence on the efficacy and effectiveness of methotrexate in psoriatic arthritis and its role in treating psoriatic arthritis to target, as well as in combination with biologic agents. Ideally, randomized placebo-controlled clinical trials evaluating methotrexate (using subcutaneous route of delivery) would provide much-needed clarity on the role of methotrexate in the management of psoriatic arthritis; however, issues around using a placebo in patients with active psoriatic arthritis may render such a trial unfeasible.

4 Review Treatment of psoriatic arthritis with traditional DMARD's and novel therapies: approaches and recommendations. 2017

Maharaj, Ajesh B / Chandran, Vinod. ·a Department of Internal Medicine, Prince Mshiyeni Memorial Hospital, Nelson R Mandela School of Medicine , University of KwaZulu-Natal , Durban , South Africa. · b Department of Clinical Immunology and Rheumatology, Academic Medical Center , University of Amsterdam , Amsterdam , The Netherlands. · c Psoriatic Arthritis Program, Centre for Prognosis Studies in the Rheumatic Diseases, Krembil Research Institute , University Health Network , Toronto , Canada. · d Division of Rheumatology, Department of Medicine , University of Toronto , Toronto , Canada. · e Department of Laboratory Medicine and Pathobiology , University of Toronto , Toronto , Canada. · f Institute of Medical Science , University of Toronto, Toronto Western Hospital , Toronto , Canada. ·Expert Rev Clin Immunol · Pubmed #27826996.

ABSTRACT: INTRODUCTION: Recent advances in the therapeutics of psoriatic arthritis (PsA) have provided more options to clinicians managing PsA. The purpose of this review is to update the reader on treatment options for PsA using conventional synthetic disease modifying agents (csDMARDs) and novel therapies including tumour necrosis factor alpha inhibitors, interleukin 12/23 inhibitor (ustekinumab), the interleukin 17 antagonists including secukinumab, brodalumab, ixekizumab, and the phosphodiesterase-4 inhibitor, apremilast. Areas covered: We reviewed published articles on the treatment of PsA. Our main sources of data included treatment recommendations, registry studies, systematic literature reviews, major randomised controlled trials for more recently approved drugs, and abstracts from the American College of Rheumatology and EULAR meetings. Expert commentary: An overview of the evidence for the use of various pharmacotherapeutic agents for treatment of this heterogeneous disease was compiled. Treatment options for the various domains of PsA are also discussed.

5 Review Assessing disease activity in psoriasis and psoriatic arthritis: impact on management and therapy. 2016

Chandran, Vinod / Maharaj, Ajesh B. ·a Department of Medicine, and Department of Laboratory Medicine and Pathobiology , University of Toronto , Toronto , Ontario , Canada. · b Institute of Medical Science , University of Toronto , Toronto , Ontario , Canada. · c Krembil Research Institute , University Health Network , Toronto , Ontario , Canada. · d Department of Internal Medicine , Prince Mshiyeni Memorial Hospital, Nelson R Mandela School of Medicine, University of Kwazulu-Natal , Durban , South Africa. · e Department of Clinical Immunology and Rheumatology, Academic Medical Center , University of Amsterdam , Amsterdam , The Netherlands. ·Expert Rev Clin Immunol · Pubmed #26807494.

ABSTRACT: The management of psoriatic arthritis (PsA) and psoriasis has undergone major advancements over the last decade. This has been made possible, in part, due to the introduction of new therapies for their management, as well as global collaboration in the development of outcome measures and "treat- to- target" paradigms. In this review article, we discuss how disease activity is measured and the outcome measures that have been recently developed for the management of PsA. The importance of assessing the individual domains as well as global assessments both from the physician and patient perspective, and the development of composite measures are discussed. The newer PsA specific measures are expected to be more commonly used in clinical trials as well as clinical practice.

6 Review Psoriatic Arthritis Mutilans: Clinical and Radiographic Criteria. A Systematic Review. 2015

Haddad, Amir / Johnson, Sindhu R / Somaily, Mansour / Fazelzad, Rouhi / Kron, Amie T / Chau, Cathy / Chandran, Vinod. ·From the University of Toronto Psoriatic Arthritis Clinic, and Division of Rheumatology, Toronto Western Hospital; Institute of Health Policy, Management and Evaluation, and Division of Rheumatology, Department of Medicine, University of Toronto; University Health Network, Toronto, Ontario, Canada.A. Haddad, MD, University of Toronto Psoriatic Arthritis Clinic, Toronto Western Hospital; S.R. Johnson, MD, PhD, Division of Rheumatology, Toronto Western Hospital, and Institute of Health Policy, Management and Evaluation, and Division of Rheumatology, Department of Medicine, University of Toronto; M. Somaily, MD, University of Toronto Psoriatic Arthritis Clinic, Toronto Western Hospital; R. Fazelzad, BSc, MISt, University Health Network; A.T. Kron, BSc (Honors); C. Chau, BMath, CIM, Division of Rheumatology, Toronto Western Hospital; V. Chandran, MBBS, MD, DM, PhD, University of Toronto Psoriatic Arthritis Clinic, and Division of Rheumatology, Toronto Western Hospital, and Division of Rheumatology, Department of Medicine, University of Toronto. ·J Rheumatol · Pubmed #26077409.

ABSTRACT: OBJECTIVE: Research on psoriatic arthritis mutilans (PAM), the most severe form of psoriatic arthritis, is impeded by the lack of an accepted classification criteria. We performed a systematic review of the literature to identify and synthesize clinical and radiographic features associated with the definition of PAM. METHODS: A systematic literature search limited to human studies was conducted without language restriction. Abstracts were independently screened by 2 investigators and studies that reported information on patients with PAM were included. A standardized form was used to independently collect clinical and radiographic items defining PAM, patient's demographics, disease characteristics, and outcomes. RESULTS: There were 8570 citations searched to identify 112 articles for full review and 58 articles for data abstraction. We identified 8 definitions of PAM that were used in 283 subjects with a mean age ± SD at diagnosis of PsA of 33.9 ± 8.2 years. Disease manifestations (prevalence) included dactylitis (29-64%), enthesitis (29-32%), axial disease (14-27%), and nail lesions (47%). PAM definitions include 1 (n = 2 studies) or more (n = 14 studies) joints involving interphalangeal, metacarpophalangeal, or metatarsophalangeal joints. The most prevalent PAM clinical features were digital telescoping (34%), digital shortening (33%), and flail joints (22%). The most prevalent PAM radiographic items were bone resorption (41%), pencil-in-cup change (16%), total joint erosions (14%), ankylosis (21%), and subluxation (7%). CONCLUSION: We have identified 8 definitions of PAM, and synthesized the clinical and radiographic items that are important for the classification of PAM. We have established the groundwork for future development classification criteria for PAM.

7 Review What have we learned about genetic susceptibility in psoriasis and psoriatic arthritis? 2015

Eder, Lihi / Chandran, Vinod / Gladman, Dafna D. ·Centre for Prognosis Studies in the Rheumatic Diseases, Toronto Western Hospital, Toronto, Ontario, Canada. ·Curr Opin Rheumatol · Pubmed #25415529.

ABSTRACT: PURPOSE OF REVIEW: To review recent evidence for genetic susceptibility in psoriasis and psoriatic arthritis. RECENT FINDINGS: Psoriasis and psoriatic arthritis (PsA) have substantive genetic determinants as indicated by their high family aggregation. Psoriasis and PsA share several susceptibility genes; however, other genes, mostly within the major histocompatibility complex (MHC) region, confer an independent risk for PsA. The human leukocyte antigen-C0602 allele confers the highest risk for psoriasis whereas several human leukocyte antigen-B alleles were identified as 'PsA-specific' genes. Fine mapping of the MHC suggests that glutamine at position 45 is an important susceptibility factor for PsA. Additional genes outside of the MHC region were identified as psoriasis susceptibility genes. These genes belong to several proinflammatory pathways and skin barrier mechanisms that play a role in the pathogenesis of psoriatic disease. SUMMARY: The MHC remains the major susceptibility locus for psoriatic disease. Future studies using next-generation sequencing technologies may reveal novel rare susceptibility genes for this disease.

8 Review Unusual cause of limited elbow movement in a patient with psoriatic arthritis. 2014

Maharaj, Ajesh B / Chandran, Vinod. ·Division of Clinical Immunology and Rheumatology, Academic Medical Center/University of Amsterdam, Amsterdam, the Netherlands, and Prince Mshiyeni Memorial Hospital, Department of Internal Medicine, Nelson R. Mandela School of Medicine, University of KwaZulu Natal, Durban, South Africa; maharaja30@ukzn.ac.za. · Division of Rheumatology, University of Toronto, Staff Physician, Division of Rheumatology, Toronto Western Hospital, Toronto, Ontario, Canada. ·J Rheumatol · Pubmed #25452180.

ABSTRACT: -- No abstract --

9 Review Biomarkers in psoriatic arthritis: recent progress. 2014

Chandran, Vinod / Scher, Jose U. ·Department of Medicine, Division of Rheumatology, University of Toronto, Toronto, Ontario, Canada, vchandra@uhnresearch.ca. ·Curr Rheumatol Rep · Pubmed #25218735.

ABSTRACT: Psoriatic arthritis (PsA) is an inflammatory arthritis associated with psoriasis. About a quarter of patients with psoriasis of the skin will develop PsA, although it is currently challenging-if not impossible-to determine a priori which individuals will progress. Identification of biomarkers for screening, disease activity, joint damage, treatment response and comorbidities are therefore perceived as important clinical needs in the field. Over the last few years, several lines of investigation have advanced our knowledge of new markers for PsA and its outcomes, including genomic, proteomic, cellular and tissue studies. Imaging studies utilizing ultrasonography have been applied to better understand the natural history of the disease. Novel biomarkers, such as soluble proteins and microbiomics, are also being described. Although no biomarker has yet been validated for use in clinical practice, discovery studies are in progress and validation cohorts are being designed. In this report, we review the latest progress in biomarker research in PsA and its potential implications in pathogenesis, diagnosis and therapy.

10 Review Qualifying unmet needs and improving standards of care in psoriatic arthritis. 2014

Helliwell, Philip / Coates, Laura / Chandran, Vinod / Gladman, Dafna / de Wit, Maarten / FitzGerald, Oliver / Kavanaugh, Arthur / Strand, Vibeke / Mease, Philip J / Boehncke, Wolf-Henning / Langley, Richard G / Lubrano, Ennio / Maccarone, Mara / Schulze-Koops, Hendrik / Miceli-Richard, Corinne / Queiro, Ruben. ·Leeds Institute of Molecular Medicine, University of Leeds, Leeds, UK. ·Arthritis Care Res (Hoboken) · Pubmed #25047391.

ABSTRACT: -- No abstract --

11 Review Investigational drugs for treating psoriatic arthritis. 2014

Sheane, Barry J / Chandran, Vinod. ·University of Toronto Psoriatic Arthritis Clinic, Centre for Prognosis Studies in the Rheumatic Diseases, University Health Network, Toronto Western Hospital , 1E 416, 399 Bathurst Street, Toronto, Ontario, M5T 2S8 , Canada +1 416 603 5192 ; +1 416 603 9387 ; vchandra@uhnresearch.ca. ·Expert Opin Investig Drugs · Pubmed #24758276.

ABSTRACT: INTRODUCTION: Psoriatic arthritis (PsA) is an inflammatory arthritis occurring in up to 30% of patients with psoriasis and can lead to progressive joint damage and disability. The emergence of 'biological' treatments, typified by the TNF inhibitors, has significantly advanced treatment of psoriatic disease over the last two decades and has led to an expanding field of drugs designed to target specific pathways identified in the pathogenesis of the disease. AREAS COVERED: This review article describes current knowledge pertaining to genetic susceptibility and that gleaned from animal models. It discusses putative drug targets and drugs in development, up to Phase II, while acknowledging that many of these drugs are being investigated in rheumatoid arthritis and psoriasis rather than PsA alone. EXPERT OPINION: Ongoing trials of some of these drugs, such as the JAK inhibitors, appear particularly promising, while the evolution of dual-targeting therapies affords the aspiration of enhanced efficacy, safety and remission. Paramount to the future of drug discovery and development is the affordability of these agents to the healthcare purchaser as well as their accessibility to the patient.

12 Review Arthritis mutilans. 2013

Haddad, Amir / Chandran, Vinod. ·Division of Rheumatology, Department of Medicine, University of Toronto, Toronto, Canada. ·Curr Rheumatol Rep · Pubmed #23430715.

ABSTRACT: Arthritis mutilans is described as the most severe form of psoriatic arthritis. It is characterized by digital shortening associated with severe osteolysis of peripheral joints. Research on arthritis mutilans has been impeded by lack of an accepted case definition. Here we describe the definitions used to date, epidemiology, clinical and radiological features, and clues to pathogenesis of arthritis mutilans. An initiative by the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA) to develop a consensus definition is described. The purpose of the GRAPPA initiative is to assist studies identifying clinical predictors and biomarkers for arthritis mutilans, so that patients at risk are identified early and appropriate therapeutic intervention is instituted to prevent joint destruction and preserve quality of life and function.

13 Review The genetics of psoriasis and psoriatic arthritis. 2013

Chandran, Vinod. ·Division of Rheumatology, Department of Medicine, University of Toronto, and Centre for Prognosis Studies in the Rheumatic Diseases, Toronto Western Hospital, Toronto, ON, Canada. vchandra@uhnresearch.ca ·Clin Rev Allergy Immunol · Pubmed #22274791.

ABSTRACT: Genetic epidemiological studies have demonstrated a significant genetic basis to both psoriasis and psoriatic arthritis (PsA). Although candidate gene association studies had identified genes for disease susceptibility, recent genome-wide association studies have demonstrated robust associations both within and outside the major histocompatibility region on chromosome 6p. The susceptibility genes identified include HLA-C, IL13, IL4, TNFAIP3, IL23A, IL23R, IL28RA, REL, IFIH1, ERAP, TRAF3IP2, NFKBIA, TYK2, ZNF313, NOS2, FBXL19 and NFKBIA in subjects of European ethnicity and HLA-C, IL12B, LCE3D, ERAP1, TNIP1, PTTG1, CSMD1, GJB2, SERPINB8 and ZNF816A in subjects of Chinese ethnicity. These associations provide us with a model for the pathogenesis of psoriasis involving skin barrier function, innate and adaptive immunity. Gene-gene and gene-environmental interaction effects have also been demonstrated. However, loci identified to date do not fully account for the high heritability of psoriasis and PsA, and therefore many genetic as well as environmental factors and interaction effects remain to be determined. This article reviews the current status of genetic studies in psoriasis and PsA.

14 Review Review of clinical registries of psoriatic arthritis: lessons learned?: value for the future? 2011

Gladman, Dafna D / Chandran, Vinod. ·Toronto Western Research Institute, Psoriatic Arthritis Program, University Health Network, University of Toronto, Ontario, Canada. dafna.gladman@utoronto.ca ·Curr Rheumatol Rep · Pubmed #21494786.

ABSTRACT: Psoriatic arthritis (PsA), an inflammatory musculoskeletal disease associated with psoriasis, is a complex disease in terms of its clinical presentation, etiology, and pathogenesis. Musculoskeletal presentations include peripheral arthritis, spondylitis, enthesitis, and dactylitis. To learn about the course of and prognosis for such a complex disease, it is important to observe patients longitudinally so that all aspects of the disease are recognized. Several registries have been developed to evaluate the course of and prognosis for patients with PsA. Based on such registries, it has been shown that PsA is more severe than previously thought, and that progression of joint damage is related to joint inflammation. Such registries also have been used to determine genetic factors in PsA and to identify biomarkers for both susceptibility and expression of the disease. Drug registries also have been developed to document response to new therapies as well as the long-term adverse effects resulting from such therapies. It is hoped that an international effort currently on the way will further enhance the contribution of PsA patient registries to address the etiology, pathogenesis, and outcome of this complex disease.

15 Review Observational cohort studies: lessons learnt from the University of Toronto Psoriatic Arthritis Program. 2011

Gladman, Dafna D / Chandran, Vinod. ·Psoriatic Arthritis Program, Centre for Prognosis Studies in the Rheumatic Diseases, Toronto Western Hospital, Toronto, ON M5T 2S8, Canada. dafna.gladman@utoronto.ca ·Rheumatology (Oxford) · Pubmed #20693260.

ABSTRACT: Observational cohorts have emerged as important resources to study course and prognosis of chronic disease, and also facilitate phenotype definition for genetic studies. We describe the development and accomplishments of the PsA cohort at the University of Toronto as an example of an observational cohort that has allowed the description of disease manifestations, course and prognosis of PsA. We also describe the development of an international collaboration based on this cohort, which will further be used to study the incidence, prevalence and predictive factors for the development of PsA among patients with psoriasis.

16 Review Update on the genetics of spondyloarthritis--ankylosing spondylitis and psoriatic arthritis. 2010

Chandran, Vinod / Rahman, Proton. ·University of Toronto, Toronto, ON, Canada. ·Best Pract Res Clin Rheumatol · Pubmed #21035081.

ABSTRACT: Spondyloarthritis refers to a group of inflammatory rheumatic diseases that share common clinical and genetic characteristics. Due to the rapid advances in technology and computational genetics, there is now an increasing list of well-validated genes in spondyloarthritis. The newest genetic associations are of modest magnitude and have been identified as a result of analysing thousands of samples, using genome-wide association scans or targeted candidate-gene association studies. In this article, we will highlight the genes associated with spondyloarthritis, with an emphasis on the recent candidate genes that have been identified in ankylosing spondylitis and psoriatic arthritis. If applicable, we will also discuss their potential relevance to the clinical rheumatologist.

17 Review Update on biomarkers in psoriatic arthritis. 2010

Chandran, Vinod / Gladman, Dafna D. ·Division of Rheumatology, Department of Medicine, University of Toronto, Centre for Prognosis Studies in Rheumatic Diseases, Toronto Western Hospital, 399 Bathurst Street, 1E-410B, Toronto, Ontario M5T 2S8, Canada. ·Curr Rheumatol Rep · Pubmed #20437120.

ABSTRACT: Biomarkers in psoriatic arthritis (PsA) may serve as surrogate end points for disease outcome and can provide insights into disease susceptibility and natural history. Biomarkers could relate to diagnosis, pathogenesis, prognosis, therapeutic response, and comorbidities. The "felt need" is, however, in the development of biomarkers for the presence of PsA in patients with psoriasis, as well as that for joint damage. During the past few years, many studies related to PsA biomarkers have been conducted. These studies are reviewed here. C-reactive protein, matrix metalloproteinase-3, and circulating osteoclast precursors show promise. An international goal-directed study to determine biomarkers for joint damage in PsA is now under way through a collaborative effort of GRAPPA (the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis) and OMERACT (Outcome Measures for Rheumatology Clinical Trials).

18 Review Geoepidemiology and environmental factors of psoriasis and psoriatic arthritis. 2010

Chandran, Vinod / Raychaudhuri, Siba P. ·Division of Rheumatology, Toronto Western Hospital, University of Toronto, Canada. ·J Autoimmun · Pubmed #20034760.

ABSTRACT: Psoriasis and Psoriatic Arthritis (PsA) are chronic inflammatory diseases that have a major impact on health. The prevalence and incidence estimates of these two closely related diseases show ethnic and geographic variations, being generally more common in the colder north than in the tropics. In Europe the prevalence of psoriasis varies anywhere from 0.6 to 6.5%. In the USA, the estimated prevalence of diagnosed psoriasis is 3.15%. The prevalence in Africa varies depending on geographic location, being lowest in West Africa. Psoriasis is less prevalent in China and Japan than in Europe, and is entirely absent in natives of the Andean region of South America. There are fewer reports on the incidence of psoriasis, but a recent study from Rochester, USA showed an increasing trend over the last 2 decades. The prevalence of PsA also shows similar variation, being highest in people of European descent and lowest in the Japanese. Although, study methodology and case definition may explain some of the variations, genetic and environmental factors are important. Genetic epidemiologic studies have shown that both diseases have a strong genetic component. The strongest association is with HLA-Cw*06. Associations with a number of genes including IL12B and IL23R have recently been confirmed. Environmental risk factors including streptococcal pharyngitis, stressful life events, low humidity, drugs, HIV infection, trauma, smoking and obesity have been associated with psoriasis and PsA. Here we have reviewed the current literature on the epidemiology and genetics of psoriasis and PsA.

19 Review Genetics of psoriasis and psoriatic arthritis: update and future direction. 2008

Duffin, Kristina Callis / Chandran, Vinod / Gladman, Dafna D / Krueger, Gerald G / Elder, James T / Rahman, Proton. ·Department of Dermatology, University of Utah, Salt Lake City, Utah, USA. ·J Rheumatol · Pubmed #18609743.

ABSTRACT: Psoriasis and psoriatic arthritis (PsA) both have substantive genetic determinants. Numerous candidate regions and genes have now been replicated in disease susceptibility, and to a lesser extent in disease expression, in both disease entities. Intensive efforts are now under way or are being planned to perform genome-wide association scans (GWAS) in psoriasis and PsA. A major determinant of success for GWAS is likely to be accumulation of multiple large well-phenotyped cohorts, sophisticated data management, and verification of the findings. At the 2007 Annual Meeting of the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA), members of the GRAPPA genetics committee presented a discussion of the genetics of psoriasis and PsA, including future trends. This article is a summary of that presentation and a review of the literature.

20 Article The association between occupational-related mechanical stress and radiographic damage in psoriatic arthritis. 2019

Zhou, WanLi / Chandran, Vinod / Cook, Richard / Gladman, Dafna D / Eder, Lihi. ·Department of Medicine, University of Toronto, Toronto, ON, Canada. · Department of Medicine, University of Toronto, Toronto, ON, Canada; Centre for Prognosis Studies in the Rheumatic Diseases, Toronto Western Hospital, Toronto, Ontario, Canada. · Department of Statistics and Actuarial Science, University of Waterloo, Waterloo, Ontario, Canada. · Department of Medicine, University of Toronto, Toronto, ON, Canada; Women's College Research Institute, Women's College Hospital, Toronto, Ontario, Canada. Electronic address: lihi.eder@wchospital.ca. ·Semin Arthritis Rheum · Pubmed #30057322.

ABSTRACT: OBJECTIVE: To assess the association between occupational-related mechanical factors and the severity of radiographic peripheral and axial joint damage in patients with longstanding Psoriatic Arthritis (PsA). METHODS: Patients with longstanding PsA (disease duration≥10 years) were identified from a prospective longitudinal cohort. Using an occupation history questionnaire, patients were asked to report all paid employments since the age of 18. The key predictor variables included various occupational-related mechanical exposures. A job classification database was used to rate the level of exposure to various occupational physical activities. The outcomes were the extent of radiographic damage in the peripheral and axial joints, as measured by the modified Steinbrocker score (mSS), and the modified Stokes Ankylosing Spondylitis Spine Score (mSASSS). The association between the predictors and outcome variables was assessed by negative binomial regression models after adjusting for potential confounding variables. RESULTS: A total of 307 eligible patients were analyzed. In the multivariable analysis, exposure to prolonged repetitive hand movements (exp CONCLUSION: High level of occupation-related mechanical stress is associated with increased radiographic peripheral joint damage among patients with longstanding PsA. This finding supports the potential role of micro-trauma in the pathogenesis of PsA.

21 Article Genetic signature to provide robust risk assessment of psoriatic arthritis development in psoriasis patients. 2018

Patrick, Matthew T / Stuart, Philip E / Raja, Kalpana / Gudjonsson, Johann E / Tejasvi, Trilokraj / Yang, Jingjing / Chandran, Vinod / Das, Sayantan / Callis-Duffin, Kristina / Ellinghaus, Eva / Enerbäck, Charlotta / Esko, Tõnu / Franke, Andre / Kang, Hyun M / Krueger, Gerald G / Lim, Henry W / Rahman, Proton / Rosen, Cheryl F / Weidinger, Stephan / Weichenthal, Michael / Wen, Xiaoquan / Voorhees, John J / Abecasis, Gonçalo R / Gladman, Dafna D / Nair, Rajan P / Elder, James T / Tsoi, Lam C. ·Department of Dermatology, University of Michigan Medical School, Ann Arbor, 48109, MI, USA. · Morgridge Institute for Research, Madison, 53715, WI, USA. · Ann Arbor Veterans Affairs Hospital, Ann Arbor, 48105, MI, USA. · Department of Biostatistics, Center for Statistical Genetics, University of Michigan, Ann Arbor, 48109, MI, USA. · Department of Human Genetics, Emory University School of Medicine, Atlanta, 30322, GA, USA. · Department of Medicine, Division of Rheumatology, University of Toronto, Toronto, Ontario, M5G 2C4, Canada. · Centre for Prognosis Studies in the Rheumatic Diseases, Krembil Research Institute, University of Toronto, Toronto, Ontario, M5T 2S8, Canada. · Institute of Medical Science, University of Toronto, Toronto, Ontario, M5S 1A8, Canada. · Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, M5S 1A8, Canada. · Department of Dermatology, University of Utah, Salt Lake City, Utah, 84132, USA. · Institute of Clinical Molecular Biology, Christian-Albrechts-University of Kiel, Kiel, 24105, Germany. · Department of Dermatology, Linköping University, Linköping, SE-581 83, Sweden. · Estonian Genome Center, University of Tartu, Tartu, 51010, Estonia. · Broad Institute of MIT and Harvard, Cambridge, Massachusetts, 02142, USA. · Department of Dermatology, Henry Ford Hospital, Detroit, 48202, MI, USA. · Memorial University, St. John's, Newfoundland and Labrador, A1B 3X9, Canada. · Division of Dermatology, Toronto Western Hospital, University of Toronto, Toronto, M5G 2C4, Ontario, Canada. · Department of Dermatology, University Medical Center Schleswig-Holstein, Campus Kiel, Kiel, 24105, Germany. · Department of Dermatology, University of Michigan Medical School, Ann Arbor, 48109, MI, USA. alextsoi@med.umich.edu. · Department of Biostatistics, Center for Statistical Genetics, University of Michigan, Ann Arbor, 48109, MI, USA. alextsoi@med.umich.edu. · Department of Computational Medicine & Bioinformatics, University of Michigan, Ann Arbor, 4810, MI, USA. alextsoi@med.umich.edu. ·Nat Commun · Pubmed #30301895.

ABSTRACT: Psoriatic arthritis (PsA) is a complex chronic musculoskeletal condition that occurs in ~30% of psoriasis patients. Currently, no systematic strategy is available that utilizes the differences in genetic architecture between PsA and cutaneous-only psoriasis (PsC) to assess PsA risk before symptoms appear. Here, we introduce a computational pipeline for predicting PsA among psoriasis patients using data from six cohorts with >7000 genotyped PsA and PsC patients. We identify 9 new loci for psoriasis or its subtypes and achieve 0.82 area under the receiver operator curve in distinguishing PsA vs. PsC when using 200 genetic markers. Among the top 5% of our PsA prediction we achieve >90% precision with 100% specificity and 16% recall for predicting PsA among psoriatic patients, using conditional inference forest or shrinkage discriminant analysis. Combining statistical and machine-learning techniques, we show that the underlying genetic differences between psoriasis subtypes can be used for individualized subtype risk assessment.

22 Article Proceedings of the 2017 GRAPPA Collaborative Research Network Meeting. 2018

Jadon, Deepak R / Chandran, Vinod / Stober, Carmel / Ogdie, Alexis / Armstrong, April W / Callis Duffin, Kristina / Gladman, Dafna D / Helliwell, Philip S / O'Sullivan, Denis / de Wit, Maarten / FitzGerald, Oliver / Ritchlin, Christopher T. ·From the Rheumatology Research Unit, Cambridge University Hospitals UK National Health Service (NHS) Foundation Trust, Cambridge; University of Leeds, Leeds; Bradford Hospitals NHS Foundation Trust, Bradford, UK; Department of Medicine, Division of Rheumatology, University of Toronto, Toronto Western Hospital, Krembil Research Institute, Toronto, Ontario, Canada; Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; University of Southern California, Los Angeles, California; University of Utah, Salt Lake City, Utah; Division of Allergy, Immunology, and Rheumatology, University of Rochester Medical Center, Rochester, New York, USA; Our Lady's Hospice and Care Services; Newman Clinical Research Professor, Department of Rheumatology, St. Vincent's University Hospital and Conway Institute for Biomolecular Research, University College Dublin, Dublin, Ireland; Department of Medical Humanities, VU University Medical Centre, Amsterdam, the Netherlands. deepak.jadon@addenbrookes.nhs.uk. · D.R. Jadon, MBBCh, MRCP, PhD, Director of Rheumatology Research Unit, Cambridge University Hospitals NHS Foundation Trust; V. Chandran, MBBS, MD, DM, PhD, Department of Medicine, Division of Rheumatology, University of Toronto, Toronto Western Hospital, Krembil Research Institute; C. Stober, PhD, MBChB, MRCP, Consultant Rheumatologist, Cambridge University Hospitals NHS Foundation Trust; A. Ogdie, MD, Assistant Professor of Medicine and Epidemiology, Perelman School of Medicine, University of Pennsylvania; A.W. Armstrong, MD, MPH, University of Southern California; K. Callis Duffin, MD, University of Utah; D.D. Gladman, MD, FRCPC, Professor of Medicine, University of Toronto, and Senior Scientist, Krembil Research Institute, Toronto Western Hospital; P.S. Helliwell, DM, PhD, FRCP, University of Leeds, and Bradford Hospitals NHS Foundation Trust; D. O'Sullivan, BE, Patient Research Partner, Our Lady's Hospice and Care Services; M. de Wit, PhD, Patient Research Partner, Department of Medical Humanities, VU University Medical Centre; O. FitzGerald, MD, FRCPI, FRCP( UK), Newman Clinical Research Professor, Department of Rheumatology, St. Vincent's University Hospital and Conway Institute for Biomolecular Research, University College Dublin; C.T. Ritchlin, MD, MPH, Professor of Medicine, Division of Allergy, Immunology, and Rheumatology, University of Rochester Medical Center. deepak.jadon@addenbrookes.nhs.uk. · From the Rheumatology Research Unit, Cambridge University Hospitals UK National Health Service (NHS) Foundation Trust, Cambridge; University of Leeds, Leeds; Bradford Hospitals NHS Foundation Trust, Bradford, UK; Department of Medicine, Division of Rheumatology, University of Toronto, Toronto Western Hospital, Krembil Research Institute, Toronto, Ontario, Canada; Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; University of Southern California, Los Angeles, California; University of Utah, Salt Lake City, Utah; Division of Allergy, Immunology, and Rheumatology, University of Rochester Medical Center, Rochester, New York, USA; Our Lady's Hospice and Care Services; Newman Clinical Research Professor, Department of Rheumatology, St. Vincent's University Hospital and Conway Institute for Biomolecular Research, University College Dublin, Dublin, Ireland; Department of Medical Humanities, VU University Medical Centre, Amsterdam, the Netherlands. · D.R. Jadon, MBBCh, MRCP, PhD, Director of Rheumatology Research Unit, Cambridge University Hospitals NHS Foundation Trust; V. Chandran, MBBS, MD, DM, PhD, Department of Medicine, Division of Rheumatology, University of Toronto, Toronto Western Hospital, Krembil Research Institute; C. Stober, PhD, MBChB, MRCP, Consultant Rheumatologist, Cambridge University Hospitals NHS Foundation Trust; A. Ogdie, MD, Assistant Professor of Medicine and Epidemiology, Perelman School of Medicine, University of Pennsylvania; A.W. Armstrong, MD, MPH, University of Southern California; K. Callis Duffin, MD, University of Utah; D.D. Gladman, MD, FRCPC, Professor of Medicine, University of Toronto, and Senior Scientist, Krembil Research Institute, Toronto Western Hospital; P.S. Helliwell, DM, PhD, FRCP, University of Leeds, and Bradford Hospitals NHS Foundation Trust; D. O'Sullivan, BE, Patient Research Partner, Our Lady's Hospice and Care Services; M. de Wit, PhD, Patient Research Partner, Department of Medical Humanities, VU University Medical Centre; O. FitzGerald, MD, FRCPI, FRCP( UK), Newman Clinical Research Professor, Department of Rheumatology, St. Vincent's University Hospital and Conway Institute for Biomolecular Research, University College Dublin; C.T. Ritchlin, MD, MPH, Professor of Medicine, Division of Allergy, Immunology, and Rheumatology, University of Rochester Medical Center. ·J Rheumatol Suppl · Pubmed #29858357.

ABSTRACT: The Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA) Collaborative Research Network (CRN) is an endeavor that aims to address gaps in the knowledge of the etiopathogenesis and management of psoriatic disease by best using the large community of experienced investigators who are already collecting rich clinical phenotype data and biologic samples using validated techniques. Exemplar rheumatology and dermatology projects will inform strategies to implement the CRN, while input and funding from government organizations, charities, and industry will shape the CRN. The key immediate priorities to establish the CRN are discussed herein and include (1) strategies for building infrastructure to collect and store biosamples and associated clinical data, (2) best practices for sample collection and storage, (3) approaches to engage the GRAPPA community of investigators and industry to collaborate most effectively on shared priorities, and (4) agreement on a funding strategy. The following 4 CRN candidate flagship research areas were identified: (1) predictors of treatment response in psoriatic arthritis (PsA) and cutaneous psoriasis (PsC) to permit personalized and stratified medicine approaches; (2) predictors of structural damage and disease severity, linking with the existing PsA BioDAM project; (3) predictors of PsC progressing to PsA to enable earlier intervention and possibly halt progression to PsA; and (4) comorbidity prevalence and effect on clinical outcomes in psoriatic disease. The collaboration and momentum provided by a GRAPPA-CRN will offer more than the sum of its individual contributing centers. A CRN will permit high-quality research that can more effectively address questions pertinent to patients, clinicians, scientists, industry, and governments.

23 Article Patterns of peripheral joint involvement in psoriatic arthritis-Symmetric, ray and/or row? 2018

Chandran, Vinod / Stecher, Lynne / Farewell, Vern / Gladman, Dafna D. ·Departments of Medicine & Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada; Centre for Prognosis Studies in The Rheumatic Diseases, Krembil Research Institute, University Health Network, University of Toronto, Toronto, Ontario, Canada. · Institute of Medical Statistics and Epidemiology, Klinikum rechts der Isar, Technical University of Munich, Ismaninger Strasse 22, 81675 Munich, Germany. · MRC Biostatistics Unit, Institute of Public Health, University of Cambridge, Cambridge, United Kingdom. · Centre for Prognosis Studies in The Rheumatic Diseases, Krembil Research Institute, University Health Network, University of Toronto, Toronto, Ontario, Canada. Electronic address: dafna.gladman@utoronto.ca. ·Semin Arthritis Rheum · Pubmed #29724452.

ABSTRACT: OBJECTIVE: We sought to examine whether joint involvement in psoriatic arthritis (PsA) follows a symmetric, ray, and/or row pattern using longitudinal data. METHODS: Data on activity and clinical damage of the joints of the hands and feet were obtained from a PsA cohort. For each analysis (symmetry, ray or row) for each outcome (joint damage and activity) expected values for table cells under the null hypothesis that joints progress independently to damage or activity were calculated based on a logistic regression model with patient level random effects for the probability of involvement developing between clinic visits. To determine the consistency of observed with expected values, goodness-of-fit tests were performed. RESULTS: Data from 704 patients were available. The 511 (552) patients with no hand (foot) damage at clinic entry were used for analyses of hand (foot) damage. When considering joint damage, there was strong evidence against independence of joint involvement based on evident symmetric patterns. There was little suggestion of ray patterns of joint damage. There was considerable evidence for row pattern of involvement of joints. When considering joint activity, symmetric patterns were also evident but, unlike joint damage, there was evidence of ray patterns, most notably in the hands. There was also evidence for row pattern involvement. CONCLUSION: Patterns of peripheral joint involvement seen over time in PsA patients, demonstrate consistency with expected ray patterns of disease activity, especially in the hands, but there is also considerable evidence for symmetric and row patterns for both joint damage and activity.

24 Article Addressing comorbidities in psoriatic disease. 2018

Patel, Priya / Rosen, Cheryl F / Chandran, Vinod / Ye, Yang Justine / Gladman, Dafna D. ·Centre for Prognosis Studies in the Rheumatic Diseases, Krembil Research Institute, University Health Network, Toronto, ON, Canada. · Division of Dermatology, Department of Medicine, Toronto Western Hospital, University of Toronto, Toronto, ON, Canada. · Departments of Medicine and Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Canada. · Institute of Medical Science, University of Toronto, Toronto, ON, Canada. · University of Toronto, Toronto, Canada. dafna.gladman@utoronto.ca. · Krembil Research Institute, Toronto, Canada. dafna.gladman@utoronto.ca. · Psoriatic Disease Program, University Health Network, Toronto, ON, Canada. dafna.gladman@utoronto.ca. · Centre for Prognosis Studies in the Rheumatic Diseases, Toronto Western Hospital, 399 Bathurst Street, 1E-410B, Toronto, Ontario, M5T 2S8, Canada. dafna.gladman@utoronto.ca. ·Rheumatol Int · Pubmed #29185085.

ABSTRACT: Psoriasis and PsA are associated with comorbidities including cardiovascular disease, obesity, metabolic syndrome and depression. The purpose of this study was to examine if patients recognize that they are being monitored for comorbidities associated with their condition, and to determine which physicians are managing these comorbidities. Patients with psoriasis without arthritis (PsC) and patients with PsA were recruited from the University of Toronto Psoriasis Cohort and Psoriatic Arthritis Clinic, respectively. A comorbidity questionnaire was developed through a literature review and patients completed the questionnaire at clinic visits or over the telephone. PsA patient responses were compared with information recorded by physicians at clinic visits. A total of 268 patients (103 PsC and 164 PsA) were included. Patients indicated having their blood pressure (96.3%), weight (94.4%), blood sugar (75%) and cholesterol (79.5%) levels checked, with PsA patients indicating being checked more frequently than PsC patients. PsA patients were most uncertain about whether their blood sugar and cholesterol levels were checked by physicians. The highest correlation between patient responses and physician records occurred for medications for diabetes, depression and hypercholesterolemia. Patients indicated their family physician were most responsible in monitoring the comorbidities. Overall, patients documented being moderately well screened for most comorbidities and were most unsure about having their blood sugar and cholesterol levels monitored. Patient education and records should be improved at clinic visits, as there are discrepancies between patient responses and physician records regarding the presence and treatment of comorbidities.

25 Article Th17 gene expression in psoriatic arthritis synovial fluid and peripheral blood compared to osteoarthritis and cutaneous psoriasis. 2018

Abji, Fatima / Pollock, Remy A / Liang, Kun / Chandran, Vinod / Gladman, Dafna D. ·University of Toronto Psoriatic Arthritis Program, Centre for Prognosis Studies in the Rheumatic Diseases, Toronto Western Research Institute, Toronto, Canada. · Department of Statistics and Actuarial Science, University of Waterloo, Canada. · Univ. of Toronto Psoriatic Arthritis Program, Ctre for Prognosis Studies in Rheumatic Diseases, Toronto Western Res. Inst.; Div. of Rheumatology, Dept. of Medicine; Dept. of Lab. Medicine & Pathobiology; Institute of Medical Science, Univ. Toronto, Canada. · University of Toronto Psoriatic Arthritis Program, Centre for Prognosis Studies in the Rheumatic Diseases, Toronto Western Research Institute; Division of Rheumatology, Dept. of Medicine; Institute of Medical Science, University of Toronto, Canada. ·Clin Exp Rheumatol · Pubmed #29148410.

ABSTRACT: OBJECTIVES: The IL-23/IL-17 axis is central to the pathogenesis of psoriatic arthritis (PsA). We aimed to identify Th17 signalling genes that are dysregulated in synovial fluid of PsA compared to osteoarthritis (OA) patients and to determine if differences in peripheral blood can distinguish PsA from psoriasis patients and controls. METHODS: Synovial fluid cells (SFCs) from 14 PsA and 9 OA patients were obtained and stored in TRIzol reagent. RNA was isolated by phenol-chloroform extraction and purified with RNeasy miniprep kits. Total RNA was extracted from PAXgene whole blood from 20 PsA, 20 psoriasis without arthritis (PsC) and 11 controls. Quantitative RT-PCR arrays were used to profile expression of 84 genes related to the Th17 regulatory network. Fold change differences were compared by Mann-Whitney U-test with false discovery rate (FDR) correction (FDR<0.05). RESULTS: In PsA compared to OA SFCs, a total of 33 genes were up-regulated and 27 genes were down-regulated. Signalling molecules (such as STAT3, FOXP3) were highly expressed in PsA SFCs, while cytokines (such as IL17F, IL6) were more predominant in OA SFCs after non-supervised hierarchal clustering. Nine genes (MMP3, CCL1, IL17C, CCL20, IL17F, IL3, CXCL5, IL6 and CX3CL1) had concordant expression in SFCs and in peripheral blood cells (PBCs) of PsA compared to PsC and/or controls. CONCLUSIONS: We identified expression differences in Th17 signalling genes in PsA compared to OA SFCs, with an elevation of signalling molecules and attenuation of cytokine expression in PsA. A subset of genes was concordant in PBCs; these may thus be potential biomarkers of PsA.

Next