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Rheumatoid Arthritis: HELP
Articles by Dr. Paul Emery
Based on 352 articles published since 2009
(Why 352 articles?)
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Between 2009 and 2019, P. Emery wrote the following 352 articles about Arthritis, Rheumatoid.
 
+ Citations + Abstracts
Pages: 1 · 2 · 3 · 4 · 5 · 6 · 7 · 8 · 9 · 10 · 11 · 12 · 13 · 14 · 15
1 Guideline 2016 update of the EULAR recommendations for the management of early arthritis. 2017

Combe, Bernard / Landewe, Robert / Daien, Claire I / Hua, Charlotte / Aletaha, Daniel / Álvaro-Gracia, Jose María / Bakkers, Margôt / Brodin, Nina / Burmester, Gerd R / Codreanu, Catalin / Conway, Richard / Dougados, Maxime / Emery, Paul / Ferraccioli, Gianfranco / Fonseca, Joao / Raza, Karim / Silva-Fernández, Lucía / Smolen, Josef S / Skingle, Diana / Szekanecz, Zoltan / Kvien, Tore K / van der Helm-van Mil, Annette / van Vollenhoven, Ronald. ·Rheumatology Department, Lapeyronie Hospital, Montpellier University, UMR 5535, Montpellier, France. · Department of Clinical Immunology & Rheumatology, Amsterdam Rheumatology Center, Amsterdam and Zuyderland Medical Centre, Heerlen, The Netherlands. · Division of Rheumatology, Department of Medicine 3, Medical University of Vienna, Vienna, Austria. · Biological Therapies Unit, Servicio de Reumatología. Hospital Universitario de la Princesa, IIS-IP, Madrid, Spain. · EULAR Standing Committee of People with Arthritis/Rheumatism in Europe (PARE), Zurich, Switzerland. · Division of Physiotherapy, Department of Neurobiology Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden. · Department of Orthopaedics, Danderyd Hospital, Stockholm, Sweden. · Department of Rheumatology and Clinical Immunology, Charité-University Medicine Berlin, Berlin, Germany. · Department of Rheumatology, Center for Rheumatic Diseases, University of Medicine and Pharmacy, Bucharest, Romania. · Department of Rheumatology, Centre for Arthritis and Rheumatic Diseases, St Vincent's University Hospital, Dublin Academic Medical Centre, Dublin, Ireland. · Medicine Faculty, APHP, Rheumatology B Department, Paris Descartes University, Cochin Hospital, Paris, France. · Leeds NIHR Musculoskeletal Biomedical Research Unit, LTHT, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK. · Fondazione Policlinico Gemelli Academic Hospital, Catholic University School of Medicine, Rome, Italy. · Rheumatology Department, Hospital de Santa Maria, Lisbon Academic Medical Centre, Lisbon. · Instituto de Medicina Molecular, Faculdade de Medicina Universidade de Lisboa, Portugal. · Rheumatology Research Group, Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK. · Sandwell and West Birmingham Hospitals NHS Trust, Birmingham, UK. · Rheumatology Department, Complexo Hospitalario Universitario de Ferrol, A Coruña, Spain. · Faculty of Medicine, Department of Rheumatology, University of Debrecen, Debrecen, Hungary. · Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway. · Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands. · Department of Rheumatology, Erasmus Medical Center, Rotterdam, The Netherlands. · Department of Clinical Immunology & Rheumatology, Academic Medical Center, Amsterdam, The Netherlands. ·Ann Rheum Dis · Pubmed #27979873.

ABSTRACT: OBJECTIVES: Since the 2007 recommendations for the management of early arthritis have been presented, considerable research has been published in the field of early arthritis, mandating an update of the 2007 European League Against Rheumatism (EULAR) recommendations for management of early arthritis. METHODS: In accordance with the 2014 EULAR Standardised Operating Procedures, the expert committee pursued an approach that was based on evidence in the literature and on expert opinion. The committee involved 20 rheumatologists, 2 patients and 1 healthcare professional representing 12 European countries. The group defined the focus of the expert committee and target population, formulated a definition of 'management' and selected the research questions. A systematic literature research (SLR) was performed by two fellows with the help of a skilled librarian. A set of draft recommendations was proposed on the basis of the research questions and the results of the SLR. For each recommendation, the categories of evidence were identified, the strength of recommendations was derived and the level of agreement was determined through a voting process. RESULTS: The updated recommendations comprise 3 overarching principles and 12 recommendations for managing early arthritis. The selected statements involve the recognition of arthritis, referral, diagnosis, prognostication, treatment (information, education, pharmacological and non-pharmacological interventions), monitoring and strategy. Eighteen items were identified as relevant for future research. CONCLUSIONS: These recommendations provide rheumatologists, general practitioners, healthcare professionals, patients and other stakeholders with an updated EULAR consensus on the entire management of early arthritis.

2 Guideline EULAR recommendations for the management of rheumatoid arthritis with synthetic and biological disease-modifying antirheumatic drugs: 2013 update. 2014

Smolen, Josef S / Landewé, Robert / Breedveld, Ferdinand C / Buch, Maya / Burmester, Gerd / Dougados, Maxime / Emery, Paul / Gaujoux-Viala, Cécile / Gossec, Laure / Nam, Jackie / Ramiro, Sofia / Winthrop, Kevin / de Wit, Maarten / Aletaha, Daniel / Betteridge, Neil / Bijlsma, Johannes W J / Boers, Maarten / Buttgereit, Frank / Combe, Bernard / Cutolo, Maurizio / Damjanov, Nemanja / Hazes, Johanna M W / Kouloumas, Marios / Kvien, Tore K / Mariette, Xavier / Pavelka, Karel / van Riel, Piet L C M / Rubbert-Roth, Andrea / Scholte-Voshaar, Marieke / Scott, David L / Sokka-Isler, Tuulikki / Wong, John B / van der Heijde, Désirée. ·Division of Rheumatology, Department of Medicine 3, Medical University of Vienna, , Vienna, Austria. ·Ann Rheum Dis · Pubmed #24161836.

ABSTRACT: In this article, the 2010 European League against Rheumatism (EULAR) recommendations for the management of rheumatoid arthritis (RA) with synthetic and biological disease-modifying antirheumatic drugs (sDMARDs and bDMARDs, respectively) have been updated. The 2013 update has been developed by an international task force, which based its decisions mostly on evidence from three systematic literature reviews (one each on sDMARDs, including glucocorticoids, bDMARDs and safety aspects of DMARD therapy); treatment strategies were also covered by the searches. The evidence presented was discussed and summarised by the experts in the course of a consensus finding and voting process. Levels of evidence and grades of recommendations were derived and levels of agreement (strengths of recommendations) were determined. Fourteen recommendations were developed (instead of 15 in 2010). Some of the 2010 recommendations were deleted, and others were amended or split. The recommendations cover general aspects, such as attainment of remission or low disease activity using a treat-to-target approach, and the need for shared decision-making between rheumatologists and patients. The more specific items relate to starting DMARD therapy using a conventional sDMARD (csDMARD) strategy in combination with glucocorticoids, followed by the addition of a bDMARD or another csDMARD strategy (after stratification by presence or absence of adverse risk factors) if the treatment target is not reached within 6 months (or improvement not seen at 3 months). Tumour necrosis factor inhibitors (adalimumab, certolizumab pegol, etanercept, golimumab, infliximab, biosimilars), abatacept, tocilizumab and, under certain circumstances, rituximab are essentially considered to have similar efficacy and safety. If the first bDMARD strategy fails, any other bDMARD may be used. The recommendations also address tofacitinib as a targeted sDMARD (tsDMARD), which is recommended, where licensed, after use of at least one bDMARD. Biosimilars are also addressed. These recommendations are intended to inform rheumatologists, patients, national rheumatology societies and other stakeholders about EULAR's most recent consensus on the management of RA with sDMARDs, glucocorticoids and bDMARDs. They are based on evidence and expert opinion and intended to improve outcome in patients with RA.

3 Guideline Recommendations for an update of 2003 European regulatory requirements for registration of drugs to be used in the treatment of RA. 2011

Smolen, Josef S / Boers, Maarten / Abadie, Eric C / Breedveld, Ferdinand C / Emery, Paul / Bardin, Thomas / Goel, Niti / Ethgen, Dominique J / Avouac, Bernard P / Dere, Willard H / Durez, Patrick / Matucci-Cerinic, Marco / Flamion, Bruno / Laslop, Andrea / Lekkerkerker, Frits J / Miossec, Pierre / Mitlak, Bruce H / Ormarsdóttir, Sif / Paolozzi, Laurence / Rao, Ravi / Reiter, Susan / Tsouderos, Yannis / Reginster, Jean-Yves / Anonymous1740681. ·Hietzing Hospital, Vienna, Austria. ·Curr Med Res Opin · Pubmed #21142618.

ABSTRACT: Since 2003, the European Medicines Agency (EMA) document, 'Points to consider on clinical investigation of medicinal products other than NSAIDs (nonsteroidal anti-inflammatory drugs) for the treatment of rheumatoid arthritis' has provided guidance for the clinical development of both biologic and non-biologic disease-modifying antirheumatic drugs (DMARDs). In the last few years, several new products have been developed or are in development for the treatment of RA, which offer significant efficacy with regard to disease control, including prevention of structural damage and disability. Concurrently, novel insights have been gained with respect to the assessment of disease activity, joint damage and disability. New treatment strategies have been established which relate to early therapy, tight control and rapid switching of medication. Accordingly, several new EULAR/ACR recommendations have been or are being developed. Several important additions and changes are needed in the 2003 guidance to incorporate the current scientific knowledge into clinical trial design for the development of future products. Under the auspices of the Group for the Respect of Ethics and Excellence in Science (GREES), a group of experts in the field of RA and clinical trial design met to provide a consensus recommendation for an update to the 2003 EMA guidance document.

4 Guideline Treating rheumatoid arthritis to target: recommendations of an international task force. 2010

Smolen, Josef S / Aletaha, Daniel / Bijlsma, Johannes W J / Breedveld, Ferdinand C / Boumpas, Dimitrios / Burmester, Gerd / Combe, Bernard / Cutolo, Maurizio / de Wit, Maarten / Dougados, Maxime / Emery, Paul / Gibofsky, Alan / Gomez-Reino, Juan Jesus / Haraoui, Boulos / Kalden, Joachim / Keystone, Edward C / Kvien, Tore K / McInnes, Iain / Martin-Mola, Emilio / Montecucco, Carlomaurizio / Schoels, Monika / van der Heijde, Désirée / Anonymous5440652. ·Department of Internal Medicine 3, Division of Rheumatology, Medical University of Vienna,Waehringer Guertel 18-20, Vienna, Austria. josef.smolen@wienkav.at ·Ann Rheum Dis · Pubmed #20215140.

ABSTRACT: BACKGROUND: Aiming at therapeutic targets has reduced the risk of organ failure in many diseases such as diabetes or hypertension. Such targets have not been defined for rheumatoid arthritis (RA). OBJECTIVE: /st> To develop recommendations for achieving optimal therapeutic outcomes in RA. METHODS: A task force of rheumatologists and a patient developed a set of recommendations on the basis of evidence derived from a systematic literature review and expert opinion; these were subsequently discussed, amended and voted upon by >60 experts from various regions of the world in a Delphi-like procedure. Levels of evidence, strength of recommendations and levels of agreement were derived. RESULTS: The treat-to-target activity resulted in 10 recommendations. The treatment aim was defined as remission with low disease activity being an alternative goal in patients with long-standing disease. Regular follow-up (every 1-3 months during active disease) with appropriate therapeutic adaptation to reach the desired state within 3 to a maximum of 6 months was recommended. Follow-up examinations ought to employ composite measures of disease activity which include joint counts. Additional items provide further details for particular aspects of the disease. Levels of agreement were very high for many of these recommendations (> or =9/10). CONCLUSION: The 10 recommendations are supposed to inform patients, rheumatologists and other stakeholders about strategies to reach optimal outcomes of RA based on evidence and expert opinion.

5 Editorial Individuals at risk of rheumatoid arthritis - The evolving story. 2017

Emery, Paul / Mankia, Kulveer / Nam, Jackie L. ·Leeds Biomedical Research Centre, LTHT, United Kingdom; Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, United Kingdom. Electronic address: p.emery@leeds.ac.uk. · Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, United Kingdom. · Leeds Biomedical Research Centre, LTHT, United Kingdom. ·Best Pract Res Clin Rheumatol · Pubmed #29221593.

ABSTRACT: -- No abstract --

6 Editorial Introduction: the future of rheumatoid arthritis management. 2016

Emery, Paul. ·Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Chapel Allerton Hospital, Chapeltown Road, Leeds, LS7 4SA, NIHR Leeds Musculoskeletal Biomedical Research Unit, Leeds Teaching Hospitals NHS Trust, Leeds, UK. ·Curr Opin Rheumatol · Pubmed #26945336.

ABSTRACT: -- No abstract --

7 Editorial Suboptimal management of rheumatoid arthritis in the Middle East and Africa: could the EULAR recommendations be the start of a solution? 2013

El Zorkany, Bassel / Alwahshi, Humaid A / Hammoudeh, Mohamed / Al Emadi, Samar / Benitha, Romela / Al Awadhi, Adel / Bouajina, Elyes / Laatar, Ahmed / El Badawy, Samir / Al Badi, Marzooq / Al-Maini, Mustafa / Al Saleh, Jamal / Alswailem, Ramiz / Ally, Mahmood Moosa Tar Mahomed / Batha, Wafaa / Djoudi, Hachemi / El Garf, Ayman / El Hadidi, Khaled / El Marzouqi, Mohamed / Hadidi, Musa / Maharaj, Ajesh Basantharan / Masri, Abdel Fattah / Mofti, Ayman / Nahar, Ibrahim / Pettipher, Clive Allan / Spargo, Catherine Elizabeth / Emery, Paul. · ·Clin Rheumatol · Pubmed #23274756.

ABSTRACT: Although the prevalence of RA in the Middle East and Africa is comparable with that in other parts of the world, evidence indicates that its management in this region is suboptimal for a variety of reasons, including misconceptions and misunderstandings about the disease's prevalence and severity in the region, compounded by the lack of local epidemiological and health-economic data around the disease; the perception that RA is a low priority compared with other more prevalent conditions; delayed diagnosis, referral and treatment; and a lack of a region-specific, evidence-based management approach. In the absence of such an approach, the EULAR treatment recommendations may provide a useful starting point for the creation of guidelines to suit local circumstances. However, although agreement with the EULAR recommendations is high, many barriers prevent their implementation in clinical practise, including lack of timely referral to rheumatologists; suboptimal use of synthetic DMARDs; poor access to biologics; lack of awareness of the burden of RA among healthcare professionals, patients and payers; and lack of appropriate staffing levels.To optimise the management of RA in the Middle East and Africa, will require a multi-pronged approach from a diverse group of stakeholders-including local, national and regional societies, such as the African League of Associations in Rheumatology and International League of Associations for Rheumatology, and service providers-to collect data on the epidemiology and burden of the disease; to increase awareness of RA and its burden among healthcare professionals, payers and patients through various educational programmes; to encourage early referral and optimise use of DMARDs by promoting the EULAR treatment recommendations; to encourage the development of locally applicable guidelines based on the EULAR treatment recommendations; and to facilitate access to drugs and the healthcare professionals who can prescribe and monitor them.

8 Editorial Remission in inflammatory arthritis: a new immunological target. 2011

Saleem, Benazir / Walsh, Ceara A E / Emery, Paul. · ·Immunotherapy · Pubmed #21463185.

ABSTRACT: -- No abstract --

9 Editorial Updating the 2003 European regulatory requirements for registering disease-modifying drugs to be used in the treatment of rheumatoid arthritis. 2011

Smolen, Josef S / Boers, Maarten / Abadie, Eric C / Breedveld, Ferdinand C / Emery, Paul / Bardin, Thomas / Goel, Niti / Ethgen, Dominique J / Avouac, Bernard P / Durez, Patrick / Flamion, Bruno / Laslop, Andrea / Miossec, Pierre / Reiter, Susanne / Reginster, Jean-Yves / Anonymous890684. · ·Rheumatology (Oxford) · Pubmed #21242246.

ABSTRACT: -- No abstract --

10 Editorial 2010 ACR-EULAR classification criteria for rheumatoid arthritis. 2010

Villeneuve, Edith / Nam, Jackie / Emery, Paul. · ·Rev Bras Reumatol · Pubmed #21125184.

ABSTRACT: -- No abstract --

11 Editorial The American College of Rheumatology/European League Against Rheumatism criteria for the classification of rheumatoid arthritis: a game changer. 2010

Cohen, Stanley / Emery, Paul. · ·Arthritis Rheum · Pubmed #20872597.

ABSTRACT: -- No abstract --

12 Editorial Delay in receiving rheumatology care leads to long-term harm. 2010

Bykerk, Vivian / Emery, Paul. · ·Arthritis Rheum · Pubmed #20722032.

ABSTRACT: -- No abstract --

13 Editorial The American College of Rheumatology/European League Against Rheumatism Criteria for the classification of rheumatoid arthritis: a game changer. 2010

Cohen, Stanley / Emery, Paul. · ·Ann Rheum Dis · Pubmed #20699239.

ABSTRACT: -- No abstract --

14 Review Palindromic rheumatism as part of the rheumatoid arthritis continuum. 2019

Mankia, Kulveer / Emery, Paul. ·Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK. · NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals NHS Trust, Chapel Allerton Hospital, Leeds, UK. · Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK. p.emery@leeds.ac.uk. · NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals NHS Trust, Chapel Allerton Hospital, Leeds, UK. p.emery@leeds.ac.uk. ·Nat Rev Rheumatol · Pubmed #31595059.

ABSTRACT: Palindromic rheumatism is a distinctive syndrome that has a long-recognized association with rheumatoid arthritis (RA). Palindromic rheumatism is characterized by intermittent flares of pain, erythema and swelling in and around the joints, which are typically severe and unpredictable. The observation that most patients with palindromic rheumatism have RA-related autoantibodies and that many eventually develop RA has led to palindromic rheumatism often being viewed as a relapsing-remitting variant of RA. However, the clinical and imaging phenotypes of palindromic rheumatism suggest important distinctions from RA and imply underlying mechanistic differences between the two conditions. Furthermore, the pattern of inflammation seen in palindromic rheumatism has interesting parallels with that seen in other groups of symptomatic individuals at risk of developing RA. In this Review, we explore the concept of palindromic rheumatism as part of the RA continuum and propose an updated disease paradigm for this unique syndrome.

15 Review Imaging in rheumatoid arthritis, psoriatic arthritis, axial spondyloarthritis, and osteoarthritis: An international viewpoint on the current knowledge and future research priorities. 2019

Baraliakos, Xenofon / Conaghan, Philip G / D'Agostino, Maria-Antonietta / Maksymowych, Walter / Naredo, Esperanza / Ostergaard, Mikkel / Schett, Georg / Emery, Paul. ·Rheumazentrum Ruhrgebiet Herne, Ruhr-University Bochum, Bochum, Germany. · Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK. · NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals NHS Trust, Leeds, UK. · Department of Rheumatology, APHP, Ambroise Paré Hospital, Boulogne-Billancourt, France. · INSERM U1173, Laboratoire d'Excellence INFLAMEX, UFR Simone Veil, Versailles-Saint-Quentin University, Saint-Quentin en Yvelines, France. · Division of Rheumatology, University of Alberta School of Medicine and Dentistry, Alberta, Canada. · Department of Rheumatology, Joint and Bone Research Unit, Hospital Universities Fundación Jiménez Díaz and Autonomy University, Madrid, Spain. · Copenhagen Center for Arthritis Research (COPECARE), Center for Rheumatology and Spine Diseases, Rigshospitalet, Glostrup, Denmark. · Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark. · Department of Internal Medicine 3-Rheumatology and Immunology, Friedrich-Alexander-University Erlangen-Nurnberg, Erlangen, Germany. ·Eur J Rheumatol · Pubmed #30451654.

ABSTRACT: Imaging is increasingly used in the routine management of rheumatic diseases as well as in the clinical trials of these disorders. This viewpoint, authored by a group of international imaging experts following two meetings dedicated to imaging in rheumatology, reports a consensus about the current knowledge and addresses where further research should be focused based on the views of the international imaging experts and discussion of the evidence with attending imaging practitioners. The goal was to maximize the potential of imaging to improve the clinical management of four rheumatic diseases. These rheumatic diseases include rheumatoid arthritis, psoriatic arthritis, axial spondyloarthritis, and osteoarthritis.

16 Review Genome-wide association study of response to methotrexate in early rheumatoid arthritis patients. 2018

Taylor, John C / Bongartz, Tim / Massey, Jonathan / Mifsud, Borbala / Spiliopoulou, Athina / Scott, Ian C / Wang, Jianmei / Morgan, Michael / Plant, Darren / Colombo, Marco / Orchard, Peter / Twigg, Sarah / McInnes, Iain B / Porter, Duncan / Freeston, Jane E / Nam, Jackie L / Cordell, Heather J / Isaacs, John D / Strathdee, Jenna L / Arnett, Donna / de Hair, Maria J H / Tak, Paul P / Aslibekyan, Stella / van Vollenhoven, Ronald F / Padyukov, Leonid / Bridges, S Louis / Pitzalis, Costantino / Cope, Andrew P / Verstappen, Suzanne M M / Emery, Paul / Barnes, Michael R / Agakov, Felix / McKeigue, Paul / Mushiroda, Taisei / Kubo, Michiaki / Weinshilboum, Richard / Barton, Anne / Morgan, Ann W / Barrett, Jennifer H / Anonymous8581104 / Anonymous8591104 / Anonymous8601104. ·Leeds Institute of Cancer and Pathology, University of Leeds, and NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals NHS Trust, Leeds, UK. · Vanderbilt University, Nashville, TN, USA. · Arthritis Research UK Centre for Genetics and Genomics, Division of Musculoskeletal and Dermatological Sciences, School of Biological Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, The University of Manchester, Manchester, UK. · NIHR Manchester BRC, Central Manchester Foundation Trust, Manchester, UK. · Clinical Pharmacology, William Harvey Research Institute, Queen Mary University, London, UK. · Centre for Population Health Sciences, Usher Institute, University of Edinburgh Old Medical School, Teviot Place, Edinburgh, UK. · Pharmatics Ltd., 9, Little France Road, Edinburgh, UK. · Research Institute for Primary Care and Health Sciences, Primary Care Sciences, Keele University and Department of Rheumatology, Haywood Hospital, High Lane, Burslem, Staffordshire, UK. · Department of Medical and Molecular Genetics, King's College London, London, UK. · Roche Products, Welwyn Garden City, UK. · Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals NHS Trust, Leeds, UK. · Wellcome Trust Sanger Institute, Genome Campus, Hinxton, Cambridge, UK. · Institute of Infection, Immunity and Inflammation, University of Glasgow, Glasgow, UK. · Institute of Genetic Medicine, Newcastle University, Newcastle, UK. · Musculoskeletal Research Group, Institute of Cellular Medicine, Newcastle University and NIHR Newcastle Biomedical Research Centre in Ageing and Long Term Conditions, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK. · University of Kentucky College of Public Health, Lexington, KY, 40536, USA. · University Medical Center Utrecht, Utrecht, The Netherlands. · Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands. · GlaxoSmithKline, Stevenage, UK. · Cambridge University, Cambridge, UK. · Ghent University, Ghent, Belgium. · Division of Clinical Immunology and Rheumatology, University of Alabama at Birmingham, Birmingham, AL, USA. · Rheumatology Unit, Department of Medicine Solna, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden. · Barts and The London School of Medicine & Dentistry, William Harvey Research Institute, Queen Mary University, London, UK. · Academic Department of Rheumatology, Faculty of Life Sciences and Medicine, King's College London, London, UK. · RIKEN Center for Integrative Medical Sciences, Tokyo, Japan. · Mayo Clinic, Rochester, MN, USA. · Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals NHS Trust, Leeds, UK. a.w.morgan@leeds.ac.uk. ·Pharmacogenomics J · Pubmed #29795407.

ABSTRACT: Methotrexate (MTX) monotherapy is a common first treatment for rheumatoid arthritis (RA), but many patients do not respond adequately. In order to identify genetic predictors of response, we have combined data from two consortia to carry out a genome-wide study of response to MTX in 1424 early RA patients of European ancestry. Clinical endpoints were change from baseline to 6 months after starting treatment in swollen 28-joint count, tender 28-joint count, C-reactive protein and the overall 3-component disease activity score (DAS28). No single nucleotide polymorphism (SNP) reached genome-wide statistical significance for any outcome measure. The strongest evidence for association was with rs168201 in NRG3 (p = 10

17 Review Lipid profile and effect of statin treatment in pooled phase II and phase III baricitinib studies. 2018

Taylor, Peter C / Kremer, Joel M / Emery, Paul / Zuckerman, Steven H / Ruotolo, Giacomo / Zhong, Jinglin / Chen, Lei / Witt, Sarah / Saifan, Chadi / Kurzawa, Monika / Otvos, James D / Connelly, Margery A / Macias, William L / Schlichting, Douglas E / Rooney, Terence P / de Bono, Stephanie / McInnes, Iain B. ·Botnar Research Centre, Nuffield Department ofOrthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK. · Center for Rheumatology, Albany Medical College, Albany, New York, USA. · Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK. · Eli Lilly and Company, Indianapolis, Indiana, USA. · IQVIA, Morrisville, North Carolina, USA. · Laboratory Corporation of America Holdings (LabCorp), Morrisville, North Carolina, USA. · Institute of Infection, Immunity and Inflammation, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK. ·Ann Rheum Dis · Pubmed #29463520.

ABSTRACT: OBJECTIVES: Lipid profiles are altered by active disease in patients with rheumatoid arthritis (RA) and may be further modified by treatment with Janus kinase inhibitors and other disease-modifying antirheumatic drugs. METHODS: Lipid data were analysed from phase II and III studies of 4 mg (n=997) and 2 mg (n=479) oral baricitinib administered once daily in patients with moderate-to-severe active RA. Lipoprotein particle size and number and GlycA were evaluated with nuclear magnetic resonance in one phase III study. The effect of statin therapy on lipid levels was evaluated in patients on statins at baseline and in patients who initiated statins during the study. RESULTS: Treatment with baricitinib was associated with increased levels of total cholesterol, low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C) and triglycerides, but no significant change in LDL-C:HDL-C ratio. Lipid levels plateaued after 12 weeks of treatment. Baricitinib treatment increased large LDL and decreased small, dense LDL particle numbers and GlycA. Lipid changes from baseline were not significantly different between baseline statin users and non-users. In patients who initiated statin therapy during the study, LDL-C, triglycerides (baricitinib 4 mg only) and apolipoprotein B decreased to pre-baricitinib levels; HDL-C and apolipoprotein A-I levels remained elevated. CONCLUSIONS: Baricitinib was associated with increased LDL-C, HDL-C and triglyceride levels, but did not alter the LDL-C:HDL-C ratio. Evaluation of cardiovascular event rates during long-term treatment is warranted to further characterise these findings and their possible clinical implications. TRIAL REGISTRATION NUMBER: NCT00902486, NCT01469013, NCT01185353, NCT01721044, NCT01721057, NCT01711359, NCT01710358, NCT01885078.

18 Review Rheumatoid arthritis. 2018

Smolen, Josef S / Aletaha, Daniel / Barton, Anne / Burmester, Gerd R / Emery, Paul / Firestein, Gary S / Kavanaugh, Arthur / McInnes, Iain B / Solomon, Daniel H / Strand, Vibeke / Yamamoto, Kazuhiko. ·Division of Rheumatology, Department of Medicine 3, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria. · Arthritis Research UK Centre for Genetics and Genomics and NIHR Manchester Biomedical Research Centre, Manchester Academic Health Sciences Centre, The University of Manchester and Central Manchester Foundation Trust, Manchester, UK. · Department of Rheumatology and Clinical Immunology, Charité - Universitätsmedizin Berlin, Berlin, Germany. · Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Chapel Allerton Hospital, Leeds, UK. · NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals NHS Trust, Leeds, UK. · Division of Rheumatology, Allergy and Immunology, University of California-San Diego School of Medicine, La Jolla, CA, USA. · Institute of Infection Immunity and Inflammation, University of Glasgow, Glasgow, UK. · Division of Rheumatology, Brigham and Women's Hospital, Boston, MA, USA. · Division of Immunology and Rheumatology, Stanford University, Palo Alto, CA, USA. · Laboratory for Autoimmune Diseases, RIKEN Center for Integrative Medical Sciences, Yokohama, Japan. ·Nat Rev Dis Primers · Pubmed #29417936.

ABSTRACT: Rheumatoid arthritis (RA) is a chronic, inflammatory, autoimmune disease that primarily affects the joints and is associated with autoantibodies that target various molecules including modified self-epitopes. The identification of novel autoantibodies has improved diagnostic accuracy, and newly developed classification criteria facilitate the recognition and study of the disease early in its course. New clinical assessment tools are able to better characterize disease activity states, which are correlated with progression of damage and disability, and permit improved follow-up. In addition, better understanding of the pathogenesis of RA through recognition of key cells and cytokines has led to the development of targeted disease-modifying antirheumatic drugs. Altogether, the improved understanding of the pathogenetic processes involved, rational use of established drugs and development of new drugs and reliable assessment tools have drastically altered the lives of individuals with RA over the past 2 decades. Current strategies strive for early referral, early diagnosis and early start of effective therapy aimed at remission or, at the least, low disease activity, with rapid adaptation of treatment if this target is not reached. This treat-to-target approach prevents progression of joint damage and optimizes physical functioning, work and social participation. In this Primer, we discuss the epidemiology, pathophysiology, diagnosis and management of RA.

19 Review The RA-MAP Consortium: a working model for academia-industry collaboration. 2018

Cope, Andrew P / Barnes, Michael R / Belson, Alexandra / Binks, Michael / Brockbank, Sarah / Bonachela-Capdevila, Francisco / Carini, Claudio / Fisher, Benjamin A / Goodyear, Carl S / Emery, Paul / Ehrenstein, Michael R / Gozzard, Neil / Harris, Ray / Hollis, Sally / Keidel, Sarah / Levesque, Marc / Lindholm, Catharina / McDermott, Michael F / McInnes, Iain B / Mela, Christopher M / Parker, Gerry / Read, Simon / Pedersen, Ayako Wakatsuki / Ponchel, Frederique / Porter, Duncan / Rao, Ravi / Rowe, Anthony / Schulz-Knappe, Peter / Sleeman, Matthew A / Symmons, Deborah / Taylor, Peter C / Tom, Brian / Tsuji, Wayne / Verbeeck, Denny / Isaacs, John D / Anonymous3411515. ·Centre for Inflammation Biology and Cancer Immunology, School of Immunology and Microbial Sciences, Faculty of Life Sciences and Medicine, King's College London, Great Maze Pond, London, SE1 1UL, UK. · Queen Mary University of London, UK. · GlaxoSmithKline. · Newcastle University, UK. · Janssen. · Pfizer. · University of Birmingham, UK. · University of Glasgow, UK. · University of Leeds, UK. · University College London, UK. · UCB Pharma. · Elsai. · AstraZeneca. · Abbvie. · Roche. · Grunenthal. · Protagen AG. · MedImmune. · University of Manchester, UK. · University of Oxford, UK. · University of Cambridge, UK. · Amgen. ·Nat Rev Rheumatol · Pubmed #29213124.

ABSTRACT: Collaboration can be challenging; nevertheless, the emerging successes of large, multi-partner, multi-national cooperatives and research networks in the biomedical sector have sustained the appetite of academics and industry partners for developing and fostering new research consortia. This model has percolated down to national funding agencies across the globe, leading to funding for projects that aim to realise the true potential of genomic medicine in the 21st century and to reap the rewards of 'big data'. In this Perspectives article, the experiences of the RA-MAP consortium, a group of more than 140 individuals affiliated with 21 academic and industry organizations that are focused on making genomic medicine in rheumatoid arthritis a reality are described. The challenges of multi-partner collaboration in the UK are highlighted and wide-ranging solutions are offered that might benefit large research consortia around the world.

20 Review Diagnostic test accuracy of ultrasound for synovitis in rheumatoid arthritis: systematic review and meta-analysis. 2018

Takase-Minegishi, Kaoru / Horita, Nobuyuki / Kobayashi, Kouji / Yoshimi, Ryusuke / Kirino, Yohei / Ohno, Shigeru / Kaneko, Takeshi / Nakajima, Hideaki / Wakefield, Richard J / Emery, Paul. ·Center for Rheumatic Diseases, Yokohama City University Medical Center. · Department of Pulmonology. · Department of Stem Cell and Immune Regulation, Yokohama City University Graduate School of Medicine, Yokohama, Japan. · Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds NIHR Leeds Musculoskeletal Biomedical Research Unit, Leeds Teaching Hospitals NHS Trust, Leeds, UK. ·Rheumatology (Oxford) · Pubmed #28340066.

ABSTRACT: Objective: To evaluate diagnostic test accuracy of US compared with MRI for the detection of synovitis in RA patients. Methods: A systematic literature search was performed in the PubMed, EMBASE, Cochrane Library and Web of Science Core Collection databases. Studies evaluating the diagnostic test accuracy of US for synovitis detected by MRI as the reference standard for wrist, MCP, PIP and knee joints were included. To assess the overall accuracy, we calculated the diagnostic odds ratio using a DerSimonian-Laird random effects model and the area under the curve (AUC) for the hierarchical summary receiver operating characteristics using Holling's proportional hazards models. The summary estimate of the sensitivity and specificity were obtained using the bivariate model. Results: Fourteen of 601 identified articles were included in the review. The diagnostic odds ratio was 11.6 (95% CI 5.6, 24; I2 = 0%), 28 (95% CI 12, 66; I2 = 11%), 23 (95% CI 6.5, 84; I2 = 19%) and 5.3 (95% CI 0.60, 48; I2 = 0%) and the AUC was 0.81, 0.91, 0.91 and 0.61 for wrist, MCP, PIP and knee joints, respectively. The summary estimates of sensitivity and specificity were 0.73 (95% CI 0.51, 0.87)/0.78 (95% CI 0.46, 0.94), 0.64 (95% CI 0.43, 0.81)/0.93 (95% CI 0.88, 0.97), 0.71 (95% CI 0.33, 0.93)/0.94 (95% CI 0.89, 0.97) and 0.91 (95% CI 0.56, 0.99)/0.60 (95% CI 0.20, 0.90) for wrist, MCP, PIP and knee joints, respectively. Conclusion: US is a valid and reproducible technique for detecting synovitis in the wrist and finger joints. It may be considered for routine use as part of the standard diagnostic tools in RA.

21 Review The initiation of autoimmunity at epithelial surfaces: a focus on rheumatoid arthritis and systemic lupus erythematosus. 2017

Pentony, Peta / Duquenne, Laurence / Dutton, Katherine / Mankia, Kulveer / Gul, Hanna / Vital, Edward / Emery, Paul. ·Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, LS7 4SA, U.K. ·Discov Med · Pubmed #29278672.

ABSTRACT: It is well established that the autoantibodies that characterize both rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE) are present systemically years before patients develop disease. In both these autoimmune rheumatic diseases, evidence is growing that local autoimmune processes occur at epithelial surfaces potentially initiating localized autoimmunity. For RA, these are mucosal surfaces including the oral mucosa, lung, and gut. At the oral mucosa and lung, risk factors such as periodontal disease and smoking may contribute to autoimmunity by driving the local generation of citrullinated autoantigens. For SLE, the skin may be integral in pathogenesis. It is proposed that defective clearance of apoptotic debris leads to initial innate immune responses preceding autoimmunity. Many tissues may be implicated but the frequency of skin disease, even without autoantibodies, and the role of UV light as a trigger suggest that keratinocytes may be a key site of initiation. In both diseases, a local break in immune tolerance could lead to systemic autoimmunity, and, in the gut, bacterial organisms that colonize the intestine may influence the localized gut immune response through T-cells and promote the development of systemic autoimmunity. In this review, we discuss the evidence for localized epithelial autoimmunity in those at risk of RA and SLE and early disease. Localized autoimmunity at the oral mucosa, lung, gut, and skin will be considered as potential initiating sites of ARD-related autoimmunity.

22 Review What can palindromic rheumatism tell us? 2017

Mankia, Kulveer / Emery, Paul. ·Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Chapel Allerton Hospital, Chapeltown Road, Leeds, LS7 4SA, UK; NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals NHS Trust, Leeds, UK. Electronic address: k.s.mankia@leeds.ac.uk. · Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Chapel Allerton Hospital, Chapeltown Road, Leeds, LS7 4SA, UK; NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals NHS Trust, Leeds, UK. Electronic address: p.emery@leeds.ac.uk. ·Best Pract Res Clin Rheumatol · Pubmed #29221602.

ABSTRACT: Palindromic rheumatism (PR) is a syndrome characterised by recurrent, self-resolving inflammatory attacks in and around the joints. An association between PR and rheumatoid arthritis (RA) has long been postulated; a significant proportion of PR patients eventually develop RA and the majority also have anti-CCP antibodies. Therefore, PR is often considered a prodrome of RA. However, the clinical and imaging phenotype of PR has several important distinctions from RA. This suggests that despite the similarities, distinct disease mechanisms are at play. Given the paucity of evidence-based therapy in PR, a better understanding of these mechanisms will be important for refined and targeted therapeutic approaches for this important condition.

23 Review Periodontal disease and periodontal bacteria as triggers for rheumatoid arthritis. 2017

Cheng, Zijian / Meade, Josephine / Mankia, Kulveer / Emery, Paul / Devine, Deirdre A. ·Division of Oral Biology, School of Dentistry, University of Leeds, UK. · Leeds Musculoskeletal Biomedical Research Unit, School of Medicine, University of Leeds, UK. · Division of Oral Biology, School of Dentistry, University of Leeds, UK. Electronic address: d.a.devine@leeds.ac.uk. ·Best Pract Res Clin Rheumatol · Pubmed #29221594.

ABSTRACT: There is an epidemiological association between periodontitis and rheumatoid arthritis (RA), which is hypothesised to lead to enhanced generation of RA-related autoantibodies that can be detected years before the onset of RA symptoms. Periodontitis is a common dysbiotic disease; tissue damage occurs because the immune system fails to limit both the resident microbial community and the associated local immune response. Certain periodontal bacteria, including Porphyromonas gingivalis and Aggregatibacter actinomycetemcomitans, may contribute to RA autoantibody production through direct post-translational modification of proteins or, indirectly, by influencing neutrophil-mediated neo-epitope generation. Oral bacteria that invade the blood may also contribute to chronic inflammatory responses and generation of autoantibodies. The putative association between periodontitis and the development of RA raises the potential of finding novel predictive markers of disease and disease progression and for periodontitis treatment to be included in the future as an adjunct to conventional RA immunotherapy or as part of a preventive strategy.

24 Review Down-titration of biologics for the treatment of rheumatoid arthritis: a systematic literature review. 2017

Lau, Chak Sing / Gibofsky, Allan / Damjanov, Nemanja / Lula, Sadiq / Marshall, Lisa / Jones, Heather / Emery, Paul. ·Division of Rheumatology and Clinical Immunology, The University of Hong Kong, Pok Fu Lam, Hong Kong. CSLau@hku.hk. · Hospital for Special Surgery and Weill Cornell Medicine, New York, NY, USA. · Belgrade University School of Medicine, Belgrade, Serbia. · Envision Pharma Group, Market Access Solutions, London, UK. · Medical Affairs, Pfizer, Collegeville, PA, USA. · Leeds Institute of Molecular Medicine, University of Leeds, Leeds, UK. ·Rheumatol Int · Pubmed #28852832.

ABSTRACT: Biologic therapies have improved the management of rheumatoid arthritis (RA) and the treat-to-target approach has resulted in many patients achieving remission. In the current treatment landscape, clinicians have begun considering dose reduction/tapering for their patients. Rheumatology guidelines in Asia, Europe, and the United States include down-titration of biologics but admit that the level of evidence is moderate. We conducted a systematic literature review to assess the published studies that evaluate down-titration of biologics in RA. The published literature was searched for studies that down-titrated the following biologics: abatacept, adalimumab, certolizumab, etanercept, golimumab, infliximab, rituximab, and tocilizumab. Eligible studies included randomized controlled trials (RCTs), non-RCTs, observational, and pharmacoeconomic studies. The outcomes of interest were (1) efficacy and health-related quality of life, (2) disease flares, and (3) impact on cost. Eleven full-text publications were identified; only three were RCTs. Study results suggest that dosing down may be an option in many patients who have achieved remission or low disease activity. However, some patients are likely to experience a disease flare. Across the studies, the definition of disease flare and the down-titration criteria were inconsistent, making it difficult to conclude which patients may be appropriate and when to attempt down-titration. Studies have evaluated the practice of dosing down biologic therapy in patients with RA; however, a relatively small number of RCTs have been published. Although down-titration may be an option for some patients in LDA or remission, additional RCTs are needed to provide guidance on this practice.

25 Review Synovial tissue research: a state-of-the-art review. 2017

Orr, Carl / Vieira-Sousa, Elsa / Boyle, David L / Buch, Maya H / Buckley, Christopher D / Cañete, Juan D / Catrina, Anca I / Choy, Ernest H S / Emery, Paul / Fearon, Ursula / Filer, Andrew / Gerlag, Danielle / Humby, Frances / Isaacs, John D / Just, Søren A / Lauwerys, Bernard R / Le Goff, Benoit / Manzo, Antonio / McGarry, Trudy / McInnes, Iain B / Najm, Aurélie / Pitzalis, Constantino / Pratt, Arthur / Smith, Malcolm / Tak, Paul P / Thurlings, Rogier / Fonseca, João E / Veale, Douglas J / Tas, Sander W. ·Centre for Arthritis and Rheumatic Disease, University College Dublin, Dublin Academic Medical Centre, St. Vincent's University Hospital, Elm Park, Dublin 4, Ireland. · Instituto de Medicina Molecular, Faculdade de Medicina da Universidade de Lisboa, Av. Prof. Egas Moniz, 1649-035, Lisbon, Portugal. · University of California San Diego School of Medicine, 9500 Gilman Drive, La Jolla, California 92093, USA. · Leeds Musculoskeletal Biomedical Research Unit, University of Leeds, Chapel Allerton Hospital, Chapeltown Road, Leeds LS7 4SA, UK. · Rheumatology Research Group, University of Birmingham, Edgbaston, Birmingham, West Midlands B15 2TT, UK. · Arthritis Unit, Rheumatology Department, Hospital Clínic, IDIBAPS, Villarroel, 170, 08036 Barcelona, Spain. · Rheumatology Unit, Department of Medicine (Solna), Karolinska Institute and Karolinska University Hospital, 171 76 Stockholm, Sweden. · Cardiff University School of Medicine, Institute of Infection and Immunity, 1 st Floor, Tenovus Building, Heath Park, Cardiff CF14 4XN, UK. · Department of Molecular Rheumatology, Trinity College Dublin, University of Dublin, College Green, Dublin 2, Ireland. · Department of Clinical Immunology &Rheumatology, Amsterdam Rheumatology and Immunology Centre, Academic Medical Centre, University of Amsterdam, Room F4-105, POBox 22700, 1100 DE, Amsterdam, Netherlands. · Clinical Unit Cambridge, GlaxoSmithKline, Cambridge, UK. · Centre for Experimental Medicine and Rheumatology, John Vane Science Centre, William Harvey Research Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, Charterhouse Square, London EC1M 6BQ, UK. · Institute of Cellular Medicine, Faculty of Medical Sciences, Newcastle University, Framlington Place, Newcastle upon Tyne, NE2 4HH, UK. · Department of Medicine, Svendborg Hospital, Odense University Hospital, Valdemarsgade 53, 5700 Svendborg, Denmark. · Université catholique de Louvain and Department of Rheumatology, Cliniques Universitaires Saint-Luc, Avenue Hippocrate 10, 1200 Bruxelles, Belgium. · Rheumatology Unit, Nantes University Hospital, Hôtel-Dieu, 1, place Alexis-Ricordeau, 44093 Nantes cedex 1, France. · Rheumatology and Translational Immunology Research Laboratories (LaRIT), Division of Rheumatology, IRCCS Policlinico San Matteo Foundation/University of Pavia, P.le Golgi 19, 27100 Pavia, Italy. · Institute of Infection, Immunity and Inflammation, College of Medicine, Veterinary and Life Sciences University of Glasgow, 120 University Avenue, Glasgow G12 8TA, UK. · Rheumatology, Flinders University, GPO Box 2100, Adelaide 5001, South Australia, Australia. · GlaxoSmithKline, Cambridge, UK. · Institute for Molecular Life Sciences, RadboudUMC, Theodoor Craanenlaan 11, Nijmegen 6525 GA, Netherlands. ·Nat Rev Rheumatol · Pubmed #28701760.

ABSTRACT: The synovium is the major target tissue of inflammatory arthritides such as rheumatoid arthritis. The study of synovial tissue has advanced considerably throughout the past few decades from arthroplasty and blind needle biopsy to the use of arthroscopic and ultrasonographic technologies that enable easier visualization and improve the reliability of synovial biopsies. Rapid progress has been made in using synovial tissue to study disease pathogenesis, to stratify patients, to discover biomarkers and novel targets, and to validate therapies, and this progress has been facilitated by increasingly diverse and sophisticated analytical and technological approaches. In this Review, we describe these approaches, and summarize how their use in synovial tissue research has improved our understanding of rheumatoid arthritis and identified candidate biomarkers that could be used in disease diagnosis and stratification, as well as in predicting disease course and treatment response.

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