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Spinal Diseases: HELP
Articles by Neil John McHugh
Based on 63 articles published since 2008
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Between 2008 and 2019, N. McHugh wrote the following 63 articles about Spinal Diseases.
 
+ Citations + Abstracts
Pages: 1 · 2 · 3
1 Guideline Group for Research and Assessment of Psoriasis and Psoriatic Arthritis 2015 Treatment Recommendations for Psoriatic Arthritis. 2016

Coates, Laura C / Kavanaugh, Arthur / Mease, Philip J / Soriano, Enrique R / Laura Acosta-Felquer, Maria / Armstrong, April W / Bautista-Molano, Wilson / Boehncke, Wolf-Henning / Campbell, Willemina / Cauli, Alberto / Espinoza, Luis R / FitzGerald, Oliver / Gladman, Dafna D / Gottlieb, Alice / Helliwell, Philip S / Husni, M Elaine / Love, Thorvardur J / Lubrano, Ennio / McHugh, Neil / Nash, Peter / Ogdie, Alexis / Orbai, Ana-Maria / Parkinson, Andrew / O'Sullivan, Denis / Rosen, Cheryl F / Schwartzman, Sergio / Siegel, Evan L / Toloza, Sergio / Tuong, William / Ritchlin, Christopher T. ·Leeds Institute of Rheumatic and Musculoskeletal Medicine and University of Leeds, Leeds, UK. · University of California at San Diego. · Swedish Medical Center and University of Washington School of Medicine, Seattle, Washington. · Hospital Italiano de Buenos Aires, Buenos Aires, Argentina. · University of Southern California, Keck School of Medicine, Los Angeles. · Hospital Militar Central and Universidad Militar Nueva Grenada, Bogotá, Colombia. · Geneva University Hospital, Geneva, Switzerland. · Toronto Western Hospital, Toronto, Ontario, Canada. · University of Cagliari, Monserrato Campus, Cagliari, Italy. · Louisiana State University Health Sciences Center, New Orleans. · St. Vincent's University Hospital, The Conway Institute for Biomolecular Research, and University College Dublin, Dublin, Ireland. · University of Toronto and Toronto Western Research Institute, Toronto, Ontario, Canada. · Tufts Medical Center, Boston, Massachusetts. · Leeds Institute of Rheumatic and Musculoskeletal Medicine and University of Leeds, Leeds, UK, and Bradford Hospitals NHS Foundation Trust, Bradford, UK. · Cleveland Clinic Foundation, Cleveland, Ohio. · University of Iceland and Landspitali University Hospital, Reykjavik, Iceland. · University of Molise, Campobasso, Italy. · Royal National Hospital for Rheumatic Diseases, Bath, UK. · University of Queensland, Brisbane, Queensland, Australia. · University of Pennsylvania, Philadelphia. · Johns Hopkins University School of Medicine, Baltimore, Maryland. · Chapel Allerton Hospital, Leeds, UK. · St. Vincent's University Hospital, Dublin, Ireland. · Toronto Western Hospital and University of Toronto, Toronto, Ontario, Canada. · Hospital for Special Surgery, New York, New York. · Arthritis and Rheumatism Associates, Rockville, Maryland. · Ministry of Health, San Fernando del Valle de Catamarca, Argentina. · University of California, Davis. · University of Rochester Medical Center, Rochester, New York. ·Arthritis Rheumatol · Pubmed #26749174.

ABSTRACT: OBJECTIVE: To update the 2009 Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA) treatment recommendations for the spectrum of manifestations affecting patients with psoriatic arthritis (PsA). METHODS: GRAPPA rheumatologists, dermatologists, and PsA patients drafted overarching principles for the management of PsA, based on consensus achieved at face-to-face meetings and via online surveys. We conducted literature reviews regarding treatment for the key domains of PsA (arthritis, spondylitis, enthesitis, dactylitis, skin disease, and nail disease) and convened a new group to identify pertinent comorbidities and their effect on treatment. Finally, we drafted treatment recommendations for each of the clinical manifestations and assessed the level of agreement for the overarching principles and treatment recommendations among GRAPPA members, using an online questionnaire. RESULTS: Six overarching principles had ≥80% agreement among both health care professionals (n = 135) and patient research partners (n = 10). We developed treatment recommendations and a schema incorporating these principles for arthritis, spondylitis, enthesitis, dactylitis, skin disease, nail disease, and comorbidities in the setting of PsA, using the Grading of Recommendations, Assessment, Development and Evaluation process. Agreement of >80% was reached for approval of the individual recommendations and the overall schema. CONCLUSION: We present overarching principles and updated treatment recommendations for the key manifestations of PsA, including related comorbidities, based on a literature review and consensus of GRAPPA members (rheumatologists, dermatologists, other health care providers, and patient research partners). Further updates are anticipated as the therapeutic landscape in PsA evolves.

2 Guideline The 2012 BSR and BHPR guideline for the treatment of psoriatic arthritis with biologics. 2013

Coates, Laura C / Tillett, William / Chandler, David / Helliwell, Philip S / Korendowych, Eleanor / Kyle, Stuart / McInnes, Iain B / Oliver, Susan / Ormerod, Anthony / Smith, Catherine / Symmons, Deborah / Waldron, Nicola / McHugh, Neil J / Anonymous440765. ·Royal National Hospital for Rheumatic Diseases, Upper Borough Walls, Bath BA1 1RL, UK. neil.mchugh@rnhrd.nhs.uk. ·Rheumatology (Oxford) · Pubmed #23887065.

ABSTRACT: -- No abstract --

3 Guideline European League Against Rheumatism recommendations for the management of psoriatic arthritis with pharmacological therapies. 2012

Gossec, L / Smolen, J S / Gaujoux-Viala, C / Ash, Z / Marzo-Ortega, H / van der Heijde, D / FitzGerald, O / Aletaha, D / Balint, P / Boumpas, D / Braun, J / Breedveld, F C / Burmester, G / Cañete, J D / de Wit, M / Dagfinrud, H / de Vlam, K / Dougados, M / Helliwell, P / Kavanaugh, A / Kvien, T K / Landewé, R / Luger, T / Maccarone, M / McGonagle, D / McHugh, N / McInnes, I B / Ritchlin, C / Sieper, J / Tak, P P / Valesini, G / Vencovsky, J / Winthrop, K L / Zink, A / Emery, P / Anonymous2420706. ·Paris Descartes University, Paris, France. laure.gossec@cch.aphp.fr ·Ann Rheum Dis · Pubmed #21953336.

ABSTRACT: BACKGROUND: Psoriatic arthritis (PsA) is a clinically heterogeneous disease. Clear consensual treatment guidance focused on the musculoskeletal manifestations of PsA would be advantageous. The authors present European League Against Rheumatism (EULAR) recommendations for the treatment of PsA with systemic or local (non-topical) symptomatic and disease-modifying antirheumatic drugs (DMARD). METHODS: The recommendations are based on evidence from systematic literature reviews performed for non-steroidal anti-inflammatory drugs (NSAID), glucocorticoids, synthetic DMARD and biological DMARD. This evidence was discussed, summarised and recommendations were formulated by a task force comprising 35 representatives, and providing levels of evidence, strength of recommendations and levels of agreement. RESULTS: Ten recommendations were developed for treatment from NSAID through synthetic DMARD to biological agents, accounting for articular and extra-articular manifestations of PsA. Five overarching principles and a research agenda were defined. CONCLUSION: These recommendations are intended to provide rheumatologists, patients and other stakeholders with a consensus on the pharmacological treatment of PsA and strategies to reach optimal outcomes, based on combining evidence and expert opinion. The research agenda informs directions within EULAR and other communities interested in PsA.

4 Guideline Treatment recommendations for psoriatic arthritis. 2009

Ritchlin, C T / Kavanaugh, A / Gladman, D D / Mease, P J / Helliwell, P / Boehncke, W-H / de Vlam, K / Fiorentino, D / Fitzgerald, O / Gottlieb, A B / McHugh, N J / Nash, P / Qureshi, A A / Soriano, E R / Taylor, W J / Anonymous6760613. ·Clinical Immunology Research Center, University of Rochester Medical Center, 601 Elmwood Avenue, Box 695, Rochester, New York 14642, USA. christopher_ritchlin@urmc.rochester.edu ·Ann Rheum Dis · Pubmed #18952643.

ABSTRACT: OBJECTIVE: To develop comprehensive recommendations for the treatment of the various clinical manifestations of psoriatic arthritis (PsA) based on evidence obtained from a systematic review of the literature and from consensus opinion. METHODS: Formal literature reviews of treatment for the most significant discrete clinical manifestations of PsA (skin and nails, peripheral arthritis, axial disease, dactylitis and enthesitis) were performed and published by members of the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA). Treatment recommendations were drafted for each of the clinical manifestations by rheumatologists, dermatologists and PsA patients based on the literature reviews and consensus opinion. The level of agreement for the individual treatment recommendations among GRAPPA members was assessed with an online questionnaire. RESULTS: Treatment recommendations were developed for peripheral arthritis, axial disease, psoriasis, nail disease, dactylitis and enthesitis in the setting of PsA. In rotal, 19 recommendations were drafted, and over 80% agreement was obtained on 16 of them. In addition, a grid that factors disease severity into each of the different disease manifestations was developed to help the clinician with treatment decisions for the individual patient from an evidenced-based perspective. CONCLUSIONS: Treatment recommendations for the cardinal physical manifestations of PsA were developed based on a literature review and consensus between rheumatologists and dermatologists. In addition, a grid was established to assist in therapeutic reasoning and decision making for individual patients. It is anticipated that periodic updates will take place using this framework as new data become available.

5 Review Replication of a distinct psoriatic arthritis risk variant at the IL23R locus. 2016

Budu-Aggrey, Ashley / Bowes, John / Loehr, Sabine / Uebe, Steffen / Zervou, Maria I / Helliwell, Philip / Ryan, Anthony W / Kane, David / Korendowych, Eleanor / Giardina, Emiliano / Packham, Jonathan / McManus, Ross / FitzGerald, Oliver / McHugh, Neil / Behrens, Frank / Burkhardt, Harald / Huffmeier, Ulrike / Ho, Pauline / Martin, Javier / Castañeda, Santos / Goulielmos, George / Reis, Andre / Barton, Anne. ·Arthritis Research UK Centre for Genetics and Genomics, Centre for Musculoskeletal Research, The University of Manchester, UK NIHR Manchester Musculoskeletal Biomedical Research Unit, Central Manchester Foundation Trust and University of Manchester, Manchester Academy of Health Sciences, Manchester, UK. · Arthritis Research UK Centre for Genetics and Genomics, Centre for Musculoskeletal Research, The University of Manchester, UK. · Institute of Human Genetics, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany. · Laboratory of Molecular Medicine and Human Genetics, Department of Internal Medicine, University of Crete, Heraklion, Greece. · NIHR-Leeds Musculoskeletal Biomedical Research Unit Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK. · Department of Clinical Medicine, Institute of Molecular Medicine, Trinity College Dublin, Dublin, Ireland. · Department of Rheumatology, Adelaide and Meath Hospital and Trinity College Dublin, Ireland. · Royal National Hospital for Rheumatic Diseases and Department Pharmacy and Pharmacology, University of Bath, Bath, UK. · Department of Biomedicine and Prevention, University of Rome 'Tor Vergata' and Laboratory of Molecular Genetics UILDM, Fondazione Santa Lucia IRCCS, Rome, Italy. · Rheumatology Department, Haywood Hospital, Health Services Research Unit, Institute of Science and Technology in Medicine, Keele University, Stoke on Trent, UK. · Department of Rheumatology, St. Vincent's University Hospital, UCD School of Medicine and Medical Sciences and Conway Institute of Biomolecular and Biomedical Research, University College Dublin, Dublin, Ireland. · Division of Rheumatology and Fraunhofer IME-Project-Group Translational Medicine and Pharmacology, Goethe University, Frankfurt, Germany. · Arthritis Research UK Centre for Genetics and Genomics, Centre for Musculoskeletal Research, The University of Manchester, UK The Kellgren Centre for Rheumatology, Central Manchester Foundation Trust, NIHR Manchester Biomedical Research Centre, Manchester, UK. · CSIC, Instituto de Parasitologia y Biomedicina Lopez-Neyra, Granada, Spain. · Department of Rheumatology, Hospital La Princesa, IIS-IPrincesa, Madrid, Spain. · Arthritis Research UK Centre for Genetics and Genomics, Centre for Musculoskeletal Research, The University of Manchester, UK NIHR Manchester Musculoskeletal Biomedical Research Unit, Central Manchester Foundation Trust and University of Manchester, Manchester Academy of Health Sciences, Manchester, UK The Kellgren Centre for Rheumatology, Central Manchester Foundation Trust, NIHR Manchester Biomedical Research Centre, Manchester, UK. ·Ann Rheum Dis · Pubmed #27016051.

ABSTRACT: -- No abstract --

6 Review Early Psoriatic Arthritis. 2015

McHugh, Neil John. ·Department of Pharmacy and Pharmacology, University of Bath, Claverton Down, Bath BA2 7AY, UK. Electronic address: prsnjm@bath.ac.uk. ·Rheum Dis Clin North Am · Pubmed #26476222.

ABSTRACT: Skin psoriasis is a major risk factor for the development of psoriatic arthritis. Recent studies have shown that delayed diagnosis is associated with long-term adverse outcomes. Screening questionnaires have revealed a potential burden of undiagnosed disease. Lifestyle factors and genetic and soluble biomarkers have come under scrutiny as risk factors. Imaging modalities may have an important role in detecting early change. With more effective treatments, it may be possible to prevent significant joint damage and associated disability. However, the precise nature of accurate and cost-effective screening strategies remains to be determined.

7 Review Enhanced Patient Involvement and the Need to Revise the Core Set - Report from the Psoriatic Arthritis Working Group at OMERACT 2014. 2015

Tillett, William / Eder, Lihi / Goel, Niti / De Wit, Maarten / Gladman, Dafna D / FitzGerald, Oliver / Campbell, Willemina / Helliwell, Philip S / Gossec, Laure / Orbai, Ana-Maria / Ogdie, Alexis / Strand, Vibeke / McHugh, Neil J / Mease, Philip J. ·From the Royal National Hospital for Rheumatic Diseases, Bath, UK; Toronto Western Hospital; Psoriatic Arthritis Program, University Health Network, Toronto Western Research Institute, Toronto, Ontario, Canada; St. Vincent's University Hospital, Dublin, Ireland; Quintiles; Duke University School of Medicine; Durham, North Carolina, USA; Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds; Chapel Allerton Hospital, Leeds, UK; Sorbonne Universités, Université Pierre et Marie Curie-Paris 6 (UPMC Univ Paris 6), Institut Pierre Louis d'Epidémiologie et de Santé Publique; AP-HP, Pitié Salpêtrière Hospital, Department of Rheumatology, Paris, France; Johns Hopkins University School of Medicine, Division of Rheumatology, Baltimore, Maryland; Division of Immunology/Rheumatology, Stanford University School of Medicine, Portola Valley, California, USA; University of Bath, Bath, UK; Swedish Medical Center, University of Washington, Seattle, Washington; Hospital of the University of Pennsylvania (HUP), Philadelphia, Pennsylvania, USA.W. Tillett, MB, ChB, BSc, MRCP, PhD, Research Fellow, Royal National Hospital for Rheumatic Diseases; L. Eder, MD, PhD, Postdoctoral Research Fellow, Toronto Western Hospital; M. de Wit, PhD, OMERACT Patient Research Partner, The Netherlands; D.D. Gladman, MD, FRCPC, Director, Psoriatic Arthritis Program, University Health Network, Senior Scientist, Toronto Western Research Institute; O. FitzGerald, MD, FRCPI, FRCP( UK), Consultant Rheumatologist and Newman Clinical Research Professor, St. Vincent's University Hospital; N. Goel, MD, OMERACT Patient Research Partner, Quintiles, and Duke University School of Medicine; W. Campbell, BEd, LLB, OMERACT Patient Research Partner; P.S. Helliwell, DM, PhD, FRCP, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Chapel Allerton Hospital; L. Gossec, MD, PhD, Sorbonne Universités, UPMC Univ Paris 6, Institut Pierre Louis d'Epidémiologie et de Sant ·J Rheumatol · Pubmed #25934828.

ABSTRACT: OBJECTIVE: To discuss the need for revision of the "core set" of domains to be included for assessment in psoriatic arthritis (PsA) randomized controlled trials and longitudinal observational studies, review work undertaken since the 2012 meeting of Outcome Measures for Rheumatology 11 (OMERACT 11) to include patient perspectives in this revision, and reassess proposed composite measures in the context of new research data and the OMERACT Filter 2.0 framework. METHODS: The OMERACT 12 (2014) PsA working group presented work completed over the last 2 years to incorporate patient involvement in PsA outcomes research, review the endorsed PsA core set based on the patient perspective as well as new research findings, and further develop PsA responder indices. Breakout groups then discussed 2 topics: (1) the need to revise the PsA core set, and opportunities to add, move, or merge existing domains to improve existing redundancy; and (2) how to incorporate the core set in a composite index. Breakout groups fed back to the working group before participant voting. RESULTS: Meeting participants endorsed the need to revise the PsA core set according to the OMERACT Filter 2.0 framework (100%), and the inclusion of disease impact (94%) and fatigue (72%) in the inner circle. Breakout group feedback suggested the core set revision was an opportunity to consolidate pathophysiologic aspects such as arthritis, enthesitis, dactylitis, spondylitis as "inflammatory musculoskeletal disease," and nail and skin psoriasis as "psoriasis activity." CONCLUSION: Future work will focus on updating the PsA core set and development of responder indices with ongoing, meaningful involvement of patient research partners.

8 Review Serum soluble bone turnover biomarkers in psoriatic arthritis and psoriatic spondyloarthropathy. 2015

Jadon, Deepak R / Nightingale, Alison L / McHugh, Neil J / Lindsay, Mark A / Korendowych, Eleanor / Sengupta, Raj. ·From the Royal National Hospital for Rheumatic Diseases, and the University of Bath, Bath, UK.D.R. Jadon, MRCP, Research Fellow, Rheumatology; E. Korendowych, FRCP, Consultant Rheumatologist; R. Sengupta, FRCP, Consultant Rheumatologist, Royal National Hospital for Rheumatic Diseases; A.L. Nightingale, PhD, Research Fellow; M.A. Lindsay, PhD, Professor, Pharmacy and Pharmacology, University of Bath; N.J. McHugh, FRCP, Consultant Rheumatologist, Royal National Hospital for Rheumatic Diseases, and the University of Bath. ·J Rheumatol · Pubmed #25362660.

ABSTRACT: Because psoriatic arthritis (PsA) is an inflammatory disease of joints, serum soluble biomarkers specific for chronic joint and bone inflammation may predict future disease severity and response to therapy, thereby informing stratified medicine approaches. The objectives of our systematic review were to determine whether serum soluble bone and cartilage turnover biomarkers are (1) associated with PsA or psoriatic spondyloarthropathy; and (2) associated with disease activity, disease severity, or clinical phenotype. Ten studies met eligibility criteria. Matrix metalloproteinase (MMP)-3, Dickkopf (DKK)-1, macrophage colony-stimulating factor (M-CSF), crosslinked telopeptide of collagen-1, and tumor necrosis factor-related apoptosis-inducing ligand were associated with PsA, with equivocal results for osteoprotegerin (OPG) and bone alkaline phosphatase (ALP). MMP-3, DKK-1, M-CSF, CPII:C2C (ratio of cartilage degradation vs byproduct formation), and possibly OPG were associated with PsA independently of psoriasis. C1-2C (a neoepitope released when type 2 cartilage is degraded by collagenases) was associated with both tender and swollen joint counts, and bone morphogenetic protein-4 with patient global assessment of disease, pain score, and the Bath Ankylosing Spondylitis Disease Activity Index. Bone ALP was associated with disease activity. M-CSF and receptor activator of nuclear factor-κB ligand were associated with several plain radiographic features. No studies have investigated biomarker associations specifically with axial PsA.

9 Review Tumour necrosis factor inhibitor monotherapy vs combination with MTX in the treatment of PsA: a systematic review of the literature. 2015

Behrens, Frank / Cañete, Juan D / Olivieri, Ignazio / van Kuijk, Arno W / McHugh, Neil / Combe, Bernard. ·CIRI/Division of Rheumatology and Fraunhofer Institute IME, Translational Medicine and Pharmacology, Goethe University, Frankfurt/Main, Germany, Arthritis Unit, Rheumatology Department, Hospital Clinic and IDIBAPS, Barcelona, Spain, Rheumatology Department of Lucania, San Carlo Hospital of Potenza and Madonna delle Grazie Hospital of Matera, Italy, Rheumatology Department, Reade/Jan van Breemen Research Institute, Amsterdam, The Netherlands, Rheumatology Department, Royal National Hospital for Rheumatic Diseases, Bath, UK and Departement de Rhumatologie Hôpital Lapeyronie-Université Montpellier I, UMR 5535, Montpellier, France behrens@ciri-clinical.de. · CIRI/Division of Rheumatology and Fraunhofer Institute IME, Translational Medicine and Pharmacology, Goethe University, Frankfurt/Main, Germany, Arthritis Unit, Rheumatology Department, Hospital Clinic and IDIBAPS, Barcelona, Spain, Rheumatology Department of Lucania, San Carlo Hospital of Potenza and Madonna delle Grazie Hospital of Matera, Italy, Rheumatology Department, Reade/Jan van Breemen Research Institute, Amsterdam, The Netherlands, Rheumatology Department, Royal National Hospital for Rheumatic Diseases, Bath, UK and Departement de Rhumatologie Hôpital Lapeyronie-Université Montpellier I, UMR 5535, Montpellier, France. ·Rheumatology (Oxford) · Pubmed #25349441.

ABSTRACT: OBJECTIVES: The aim of this study was to review the available evidence on TNF inhibitor monotherapy vs combination therapy with MTX in PsA. METHODS: A literature search was conducted up to and including October 2013 for randomized controlled trials (RCTs) and observational studies comparing TNF inhibitor monotherapy vs combination therapy with MTX in patients with PsA. Key information was extracted from the abstracts and/or full text of the articles retrieved. RESULTS: Eleven published articles and three conference abstracts were retrieved, reporting on six RCTs of four TNF inhibitors. Most RCTs found no differences in efficacy for peripheral arthritis between patients treated with or without MTX. However, the studies were not powered to answer this question. Some data suggest that concomitant MTX may reduce the progression of structural damage. No significant differences in other outcomes have been reported. Data on TNF inhibitor monotherapy vs MTX combination therapy were reported from six registries. Three registries reported that the use of concomitant MTX did not affect the efficacy of TNF inhibitor therapy. Data from three European Union registries suggest that TNF inhibitor (especially mAbs) drug survival is superior in patients taking concomitant MTX, while one Canadian registry reported no difference. CONCLUSION: Available evidence on the efficacy and safety of TNF inhibitor monotherapy vs add-on MTX therapy shows little or no improvement with combination therapy, although the use of concomitant MTX appears to prolong TNF inhibitor drug survival of mAb TNF inhibitors. Registries and observational studies have the potential to fill some of the knowledge gaps in this area.

10 Review Drug therapies for peripheral joint disease in psoriatic arthritis: a systematic review. 2014

Acosta Felquer, Maria Laura / Coates, Laura C / Soriano, Enrique R / Ranza, Roberto / Espinoza, Luis R / Helliwell, Philip S / FitzGerald, Oliver / McHugh, Neil / Roussou, Euthalia / Mease, Philip J. ·From the Sección Reumatología, Servicio de Clínica Médica, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina; Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK; Sección Reumatología, Servicio de Clínica Médica, Hospital Italiano de Buenos Aires; Academic Unit of Rheumatology, Universidade Federal de Uberlândia, Uberlândia, MG, Brazil; Section of Rheumatology, Louisiana State University Health Sciences Center, New Orleans, Louisiana, USA; Academic Unit of Musculoskeletal Disease, Chapel Allerton Hospital, Leeds, UK; Department of Rheumatology, St. Vincent's University Hospital and Conway Institute for Biomolecular Research, University College, Dublin, Ireland; Department of Pharmacy and Pharmacology, University of Bath, Bath, UK; Barking Havering and Redbridge University Hospitals, NHS Trust; and Queens Mary's University of London, London, UK; and Swedish Medical Center, University of Washington School of Medicine, Seattle, Washington, USA.M.L. Acosta Felquer, MD, Sección Reumatología, Servicio de Clínica Médica, Hospital Italiano de Buenos Aires; L.C. Coates, MRCP, PhD, NIHR Clinical Lecturer, Leeds Institute; E.R. Soriano, MD, MSC, Jefe Sección Reumatología, Servicio de Clínica Médica, Hospital Italiano de Buenos Aires; R. Ranza, MD, Academic Unit of Rheumatology, Universidade Federal de Uberlândia; L.R. Espinoza, MD, Section of Rheumatology, Louisiana State University Health Sciences Center; P.S. Helliwell, DM, PhD, Academic Unit of Musculoskeletal Disease, Chapel Allerton Hospital; O. FitzGerald, MD, Department of Rheumatology, St. Vincent's University Hospital and Conway Institute for Biomolecular Research, University College; N. McHugh, FRCP, MD, Department of Pharmacy and Pharmacology, University of Bath; E. Roussou, MD, Consultant Rheumatologist, Barking Havering and Redbridge University Hospitals, NHS Trust and Clinical Senior Lecturer, Queens Mary's University of London; P.J. Mease, MD, Rhe ·J Rheumatol · Pubmed #25362711.

ABSTRACT: In 2009, GRAPPA published their first evidence-based recommendations for the treatment of psoriasis and psoriatic arthritis (PsA). Since then, new information has been published and drugs developed. We summarize evidence for the efficacy of available treatments for peripheral joint involvement in PsA. We performed a systematic review of current literature on the efficacy of different therapies, management, and therapeutic strategies for peripheral arthritis involvement in PsA, in order to provide information for the development of the new GRAPPA treatment recommendations.

11 Review Patient involvement in outcome measures for psoriatic arthritis. 2014

Tillett, William / Adebajo, Ade / Brooke, Mel / Campbell, Willemina / Coates, Laura C / FitzGerald, Oliver / Gossec, Laure / Helliwell, Philip / Hewlett, Sarah / James, Jana / Minnock, Patricia / Reast, Aisling / O'Sullivan, Dennis / de Wit, Maarten / McHugh, Neil. ·Royal National Hospital for Rheumatic Diseases, Upper Borough Walls, Bath, BA11RL, UK, w.tillett@nhs.net. ·Curr Rheumatol Rep · Pubmed #24623563.

ABSTRACT: Psoriatic arthritis (PsA) is a heterogeneous inflammatory arthritis with a varied clinical phenotype. There has been considerable international collaboration over recent years to develop and prioritise appropriate disease domains and outcome measures to capture all aspects of this complex disease. It has been recognised that patient-reported measures and physician assessments are complementary and, when used together, allow an improved reflection of disease burden. Taking this concept one step further, the experience in rheumatoid arthritis has demonstrated benefits of incorporating the patient perspective in the development of outcome measures. We report a systematic review demonstrating (1) that there has been little incorporation of the patient perspective in the development of outcome measures and domains in PsA, (2) the proceedings from the preliminary patient involvement in outcome measures for PsA (PIOMPSA) meetings, and (3) a proposed roadmap for improving patient involvement.

12 Review Development of a disease activity and responder index for psoriatic arthritis--report of the Psoriatic Arthritis Module at OMERACT 11. 2014

Coates, Laura C / FitzGerald, Oliver / Mease, Philip J / Gladman, Dafna D / Strand, Vibeke / Goel, Niti / Campbell, Ina / Krueger, Gerald / McHugh, Neil J / Helliwell, Philip S. ·From the Division of Rheumatic and Musculoskeletal Disease, University of Leeds, UK; Department of Rheumatology, St. Vincent's University Hospital and Conway Institute, University College Dublin, Dublin, Ireland; Seattle Rheumatology Associates, Swedish Medical Center, University of Washington School of Medicine, Seattle, Washington, USA; Division of Rheumatology, Department of Medicine, University of Toronto, Centre for Prognosis Studies in the Rheumatic Diseases, Toronto Western Hospital, Toronto, Ontario, Canada; Division of Immunology/Rheumatology, Stanford University, Palo Alto, California; Division of Rheumatology, Department of Medicine, Duke University Medical Center, Durham, and General Medicine Therapeutic Delivery Unit, Quintiles, Morrisville, North Carolina; Department of Dermatology, University of Utah, Salt Lake City, Utah, USA; Royal National Hospital for Rheumatic Diseases and University of Bath, Bath, UK. ·J Rheumatol · Pubmed #24488420.

ABSTRACT: This module reflected work within the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA) to develop and validate composite disease activity measures in psoriatic arthritis (PsA). At the Outcome Measures in Rheumatology (OMERACT) 8 Meeting, a core set of domains to be assessed in randomized controlled trials (RCT) and longitudinal observational studies of PsA was agreed upon. At OMERACT 10, 5 proposed composite responder definitions for PsA were reviewed and discussed, including new data from the GRACE (GRAppa Composite Exercise) study. At OMERACT 11, ongoing retrospective analyses of RCT data using the 3 proposed measures (Composite Psoriatic Disease Activity Index, Psoriatic Arthritis Disease Activity Score, and Arithmetic Mean of the Desirability Function) were discussed in detail. There was agreement that developing composite outcome measures for use in RCT and longitudinal observational studies in PsA was important. Concerns were expressed regarding development of a single measure that encompassed diverse domains, such as joint counts, quality of life (QOL), and disability measures. It was emphasized that the use of any composite measure should include the ability to differentiate between activity in individual domains, such as enthesitis or psoriasis, such that the effect of each could be assessed independently. It was also agreed that patients would be systematically involved in further development and refinement of composite measures. Future plans include qualitative work with patients to explore their experience of disease activity and statistical modeling to explore how each of the proposed measures will perform in different disease subgroups.

13 Review Mortality and causes of death in psoriatic arthritis. 2012

Arumugam, Ramani / McHugh, Neil J. ·Rheumatology Department, Royal National Hospital for Rheumatic Diseases, Bath, UK. ·J Rheumatol Suppl · Pubmed #22751588.

ABSTRACT: OBJECTIVE: To evaluate the mortality associated with psoriatic arthritis (PsA) and causes of death. METHODS: Data were evaluated from several published studies identified by a literature search. A standardized mortality ratio was documented when available, as were causes of death derived from clinical databases, death certificates, and mortality databases. In some studies, mortality data was stratified by sex, age, and calendar year with time trend analysis. RESULTS: There were variable reports of increased mortality in PsA that may be explained by factors such as pattern of referral, the severity of arthritis and/or skin psoriasis, and treatment exposure. There appears to be a greater incidence of cardiovascular death in psoriatic disease, although further studies are needed to separate the effect of skin psoriasis from arthritis. CONCLUSION: PsA is not a mild disease and mortality may be increased in more severe disease. Although cardiovascular risk is more substantiated in severe psoriasis than in arthritis, it would be remiss not to evaluate the cardiovascular risk profile in all patients with psoriatic disease. It is important to treat patients with PsA early and aggressively to prevent disease severity that may influence longevity.

14 Review Treatment algorithms for early psoriatic arthritis: do they depend on disease phenotype? 2012

Tillett, William / McHugh, Neil. ·Royal National Hospital for Rheumatic Diseases, Upper Borough Walls, Bath, BA11RL, England, UK. william.tillett@rnhrd.nhs.uk ·Curr Rheumatol Rep · Pubmed #22644331.

ABSTRACT: Psoriatic arthritis is a distinct inflammatory arthritis associated with psoriasis and characterized by a broad clinical phenotype. Associated with skin disease, patients may have differing patterns of peripheral joint disease, spondyloarthritis, enthesitis, dactylitis, and nail disease with overlap and transition between phenotypes. Research over the past decade has resulted in a wealth of data to guide management, and several treatment algorithms have recently been published with varying emphasis on disease phenotype. This review discusses the incorporation of phenotype in the treatment of early disease, with extended discussion of current research and new concepts in disease measurement that will impact the development of future algorithms.

15 Review Work disability in psoriatic arthritis: a systematic review. 2012

Tillett, William / de-Vries, Corinne / McHugh, Neil J. ·Department of Rheumatology, Royal National Hospital for Rheumatic Diseases, Upper Borough Walls, Bath BA11RL, UK. w.tillett@nhs.net ·Rheumatology (Oxford) · Pubmed #21752872.

ABSTRACT: OBJECTIVE: Work disability (WD) is an important functional outcome measure in arthritis. There is a large body of information on WD in rheumatic diseases such as RA and AS; however, until now factors that influence WD in PsA have not been systematically reviewed. Our objective was to perform a systematic and critical review of the current literature on WD and its measurement in PsA. METHODS: A systematic literature search was conducted using Medline, Embase and Cochrane databases. The search strategy was supplemented by a manual search of cited articles. All original English language publications in the form of meta-analyses, randomized controlled trials (RCTs), observational studies and publications in abstract form were included. A quality assessment was made of the articles published in full form. RESULTS: Nineteen publications (nine in abstract form) were identified. There is intermediate quality evidence that levels of unemployment (20-50%) and WD (16-39%) are high and associated with longer disease duration, worse physical function, high joint count, low educational level, female gender, erosive disease and manual work. There is sparse low-quality evidence that WD is worse in those with PsA than psoriasis alone. CONCLUSIONS: Disability at work in those with PsA is high; however, data on its associations are limited by the small number of reports and heterogeneity of data collected. Future work should focus on the validation of WD data collection tools for use in PsA.

16 Review Traditional schemes for treatment of psoriatic arthritis. 2009

McHugh, Neil J. ·Royal National Hospital for Rheumatic Diseases, Bath, BA1 1RL, UK. neil.mchugh@rnhrd.nhs.uk ·J Rheumatol Suppl · Pubmed #19661541.

ABSTRACT: Prior to the availability of biologic agents such as anti-tumor necrosis factor (TNF), traditional treatment schemes for psoriatic arthritis were not extensively evaluated. While it appears that the newer forms of treatment are more effective, conventional agents still need to be scrutinized with similar methodology and will still have a role in those patients with less progressive disease, in combination with biologic agents, and in patients where biologics are not tolerated or have failed.

17 Clinical Trial Effectiveness of adalimumab in treating patients with active psoriatic arthritis and predictors of good clinical responses for arthritis, skin and nail lesions. 2010

Van den Bosch, F / Manger, B / Goupille, P / McHugh, N / Rødevand, E / Holck, P / van Vollenhoven, R F / Leirisalo-Repo, M / Fitzgerald, O / Kron, M / Frank, M / Kary, S / Kupper, H. ·University Hospital Gent, Belgium. filip.vandenbosch@ugent.be ·Ann Rheum Dis · Pubmed #19815494.

ABSTRACT: OBJECTIVES: To evaluate the effectiveness of adalimumab in patients with psoriatic arthritis (PsA) and identify predictors of good clinical response for joint and skin lesions. METHODS: Patients received adalimumab 40 mg every other week in addition to standard therapy in this prospective, 12-week, open-label, uncontrolled study. Four definitions of good clinical response were used: > or =50% improvement in American College of Rheumatology response criteria (ACR50), good response according to European League Against Rheumatism (EULAR) guidelines, a > or =3-grade improvement in Physician Global Assessment of psoriasis (PGA) and a > or =50% improvement in the Nail Psoriasis Severity Index (NAPSI). Response predictors were determined by logistic regression with backward elimination (selection level was 5%). RESULTS: Of 442 patients, 94% completed 12 weeks of treatment. At week 12, 74%, 51% and 32% of the patients had achieved ACR20, 50 and 70, respectively; 87% and 61% experienced moderate and good responses according to EULAR criteria, respectively. The percentage of patients with PGA results of "clear/almost clear" increased from 34% (baseline) to 68%. The mean NAPSI score was reduced by 44%. No new safety signals were detected. A lower Health Assessment Questionnaire Disability Index (HAQ-DI) score, greater pain assessment, male sex and absence of systemic glucocorticoid therapy were strongly associated with achievement of ACR50 and good response according to EULAR criteria. In addition, greater C-reactive protein concentration and polyarthritis predicted ACR50, and non-involvement of large joints predicted a good response according to EULAR criteria. CONCLUSIONS: Adalimumab was effective in patients with PsA. Lower impairment of physical function, greater pain, male sex and no systemic treatment with glucocorticoids were factors that increased the chance of achieving a good clinical response.

18 Article Group for Research and Assessment of Psoriasis and Psoriatic Arthritis/Outcome Measures in Rheumatology Consensus-Based Recommendations and Research Agenda for Use of Composite Measures and Treatment Targets in Psoriatic Arthritis. 2018

Coates, Laura C / FitzGerald, Oliver / Merola, Joseph F / Smolen, Josef / van Mens, Leonieke J J / Bertheussen, Heidi / Boehncke, Wolf-Henning / Callis Duffin, Kristina / Campbell, Willemina / de Wit, Maarten / Gladman, Dafna / Gottlieb, Alice / James, Jana / Kavanaugh, Arthur / Kristensen, Lars Erik / Kvien, Tore K / Luger, Thomas / McHugh, Neil / Mease, Philip / Nash, Peter / Ogdie, Alexis / Rosen, Cheryl F / Strand, Vibeke / Tillett, William / Veale, Douglas J / Helliwell, Philip S. ·University of Leeds, Leeds, UK, and University of Oxford, Oxford, UK. · St. Vincent's University Hospital and University College Dublin, Dublin, Ireland. · Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts. · Medical University of Vienna, Vienna, Austria. · Academic Medical Center/University of Amsterdam, Amsterdam, The Netherlands. · Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA) , Oslo, Norway, and People with Arthritis/Rheumatism in Europe, Zurich, Switzerland. · Geneva University Hospital and Geneva University, Geneva, Switzerland. · University of Utah, Salt Lake City. · GRAPPA and Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada. · VU University Medical Centre and EMGO+ Research Institute, Amsterdam, The Netherlands. · University of Toronto and Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada. · New York Medical College, Valhalla, New York. · GRAPPA, Bath, UK. · University of California at San Diego. · Copenhagen University Hospital, Copenhagen, Denmark. · Diakonhjemmet Hospital, Oslo, Norway. · University Hospital Münster, Münster, Germany. · University of Bath, Bath, UK. · St. Joseph Health System, University of Washington, Seattle. · University of Queensland, Brisbane, Queensland, Australia. · University of Pennsylvania, Philadelphia. · Stanford University, Palo Alto, California. · Royal National Hospital for Rheumatic Diseases and University of Bath, Bath, UK. · University of Leeds, Leeds, UK. ·Arthritis Rheumatol · Pubmed #29193765.

ABSTRACT: OBJECTIVE: A meeting was convened by the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA) and Outcome Measures in Rheumatology (OMERACT) to further the development of consensus among physicians and patients regarding composite disease activity measures and targets in psoriatic arthritis (PsA). METHODS: Prior to the meeting, physicians and patients completed surveys on outcome measures. A consensus meeting of 26 rheumatologists, dermatologists, and patient research partners reviewed evidence on composite measures and potential treatment targets plus results of the surveys. The meeting consisted of plenary presentations, breakout sessions, and group discussions. International experts including members of GRAPPA and OMERACT were invited to the meeting, including the developers of all of the measures discussed. After discussions, participants voted on proposals for use, and consensus was established in a second survey. RESULTS: Survey results from 128 health care professionals and 139 patients were analyzed alongside a systematic literature review summarizing evidence. A weighted vote was cast for composite measures. For randomized controlled trials, the most popular measures were the PsA disease activity score (40 votes) and the GRAPPA composite index (28 votes). For clinical practice, the most popular measures were an average of scores on 3 visual analog scales (45 votes) and the disease activity in PsA score (26 votes). After discussion, there was no consensus on a composite measure. The group agreed that several composite measures could be used and that future studies should allow further validation and comparison. The group unanimously agreed that remission should be the ideal target, with minimal disease activity (MDA)/low disease activity as a feasible alternative. The target should include assessment of musculoskeletal disease, skin disease, and health-related quality of life. The group recommended a treatment target of very low disease activity (VLDA) or MDA. CONCLUSION: Consensus was not reached on a continuous measure of disease activity. In the interim, the group recommended several composites. Consensus was reached on a treatment target of VLDA/MDA. An extensive research agenda was composed and recommends that data on all PsA clinical domains be collected in ongoing studies.

19 Article Validation of the Psoriatic Arthritis Impact of Disease (PsAID) Questionnaire and its potential as a single-item outcome measure in clinical practice. 2018

Holland, Richard / Tillett, William / Korendowych, Eleanor / Cavill, Charlotte / Waldron, Nicola / Brooke, Melanie / McHugh, Neil J. ·Royal National Hospital for Rheumatic Diseases, Royal United Hospitals, Bath, UK. · RPAH Medical Centre, Newtown, Sydney, NSW, Australia. · Department of Pharmacy and Pharmacology, University of Bath, Bath, UK. ·Ann Rheum Dis · Pubmed #29146740.

ABSTRACT: OBJECTIVES: The Psoriatic Arthritis Impact of Disease (PsAID) Questionnaire is a recently developed patient-reported outcome measure (PROM) of disease impact in psoriatic arthritis (PsA). We set out to assess the validity in an independent cohort of patients, estimate the minimally important difference for improvement and explore the potential of individual components of the PsAID in clinical practice. METHODS: Data were collected prospectively for a single-centre cohort of patients with PsA. Construct validity was assessed by Spearman correlation with other PROMs and reliability by intraclass correlation coefficient (ICC) at 1 week. Sensitivity to change at 3 months was determined by the standardised response mean (SRM) in those patients with active disease requiring a change in treatment. RESULTS: A total of 129 patients (mean ±SD age 52.1±13.3, 57% women, disease duration 10.2±8 years) completed the baseline questionnaires and assessments. The mean baseline PsAID12 score was 3.92±2.26 with an ICC of 0.91 (95%CI 0.87 to 0.94). The SE of measurement was 0.51 and the minimal detectable change was 1.41. There was strong correlation (r≥0.70) with most of the PROMs studied and moderate correlation with clinical outcomes (r=0.40-0.57). The SRM of the PsAID12 was 0.74 (95%CI 0.45 to 0.97). There was strong correlation with individual PsAID items and their corresponding PROM questionnaires (r≥0.67). CONCLUSION: The PsAID is a reliable, feasible and discriminative measure in patients with PsA. The good responsiveness of the PsAID and strong correlation of individual items with other PROMS represent an opportunity to reduce questionnaire burden for patients in studies and clinical practice.

20 Article Interval between onset of psoriasis and psoriatic arthritis comparing the UK Clinical Practice Research Datalink with a hospital-based cohort. 2017

Tillett, William / Charlton, Rachel / Nightingale, Alison / Snowball, Julia / Green, Amelia / Smith, Catherine / Shaddick, Gavin / McHugh, Neil. ·Department of Rheumatology, Royal National Hospital for Rheumatic Diseases. · Department of Pharmacy and Pharmacology. · Department of Mathematical Sciences, University of Bath, Bath. · St John's Institute of Dermatology, Guy's and St Thomas' NHS Foundation Trust, London. · Department of Mathematics, University of Exeter, Exeter, UK. ·Rheumatology (Oxford) · Pubmed #28968790.

ABSTRACT: Objectives: To describe the time interval between the onset of psoriasis and PsA in the UK primary care setting and compare with a large, well-classified secondary care cohort. Methods: Patients with PsA and/or psoriasis were identified in the UK Clinical Practice Research Datalink (CPRD). The secondary care cohort comprised patients from the Bath PsA longitudinal observational cohort study. For incident PsA patients in the CPRD who also had a record of psoriasis, the time interval between PsA diagnosis and first psoriasis record was calculated. Comparisons were made with the time interval between diagnoses in the Bath cohort. Results: There were 5272 eligible PsA patients in the CPRD and 815 in the Bath cohort. In both cohorts, the majority of patients (82.3 and 61.3%, respectively) had psoriasis before their PsA diagnosis or within the same calendar year (10.5 and 23.8%), with only a minority receiving their PsA diagnosis first (7.1 and 14.8%). Excluding those who presented with arthritis before psoriasis, the median time between diagnoses was 8 years [interquartile range (IQR) 2-15] in the CPRD and 7 years (IQR 0-20) in the Bath cohort. In the CPRD, 60.1 and 75.1% received their PsA diagnosis within 10 and 15 years of their psoriasis diagnosis, respectively; this was comparable with 57.2 and 67.7% in the Bath cohort. Conclusion: A similar distribution for the time interval between psoriasis and arthritis was observed in the CPRD and secondary care cohort. These data can inform screening strategies and support the validity of data from each cohort.

21 Article Serum bone-turnover biomarkers are associated with the occurrence of peripheral and axial arthritis in psoriatic disease: a prospective cross-sectional comparative study. 2017

Jadon, Deepak R / Sengupta, Raj / Nightingale, Alison / Lu, Hui / Dunphy, Juliet / Green, Amelia / Elder, James T / Nair, Rajan P / Korendowych, Eleanor / Lindsay, Mark A / McHugh, Neil J. ·Department of Rheumatology, Royal National Hospital for Rheumatic Diseases, Bath, UK. jadondr@yahoo.com. · Department of Rheumatology, Cambridge University Hospitals NHSFT, Cambridge, UK. jadondr@yahoo.com. · Department of Rheumatology, Royal National Hospital for Rheumatic Diseases, Bath, UK. · Department of Pharmacy & Pharmacology, University of Bath, Bath, UK. · Department of Dermatology, Ann Arbor Veterans Affairs Hospital, Ann Arbor, Michigan, USA. ·Arthritis Res Ther · Pubmed #28934972.

ABSTRACT: BACKGROUND: A recent systematic review identified four candidate serum-soluble bone-turnover biomarkers (dickkopf-1, Dkk-1; macrophage-colony stimulating factor, M-CSF; matrix metalloproteinase-3, MMP-3; osteoprotegerin, OPG) showing possible association with psoriatic arthritis (PsA). We aimed to: (i) confirm and determine if these four biomarkers are associated with PsA; (ii) differentiate psoriasis cases with and without arthritis; and (iii) differentiate PsA cases with and without axial arthritis. METHODS: A prospective cross-sectional comparative two-centre study recruited 200 patients with psoriasis without arthritis (PsC), 127 with PsA without axial arthritis (pPsA), 117 with PsA with axial arthritis (psoriatic spondyloarthritis, PsSpA), 157 with ankylosing spondylitis (AS) without psoriasis, and 50 matched healthy controls (HC). Serum biomarker concentrations were measured using ELISA. Multivariable regression and receiver operating characteristic analyses were performed. RESULTS: MMP-3 concentrations were significantly higher and M-CSF significantly lower in each arthritis disease group compared with HC (p ≤ 0.02). MMP-3 concentrations were significantly higher (adjusted odds ratio, OR CONCLUSIONS: MMP-3 and M-CSF are biomarkers for the presence of arthritis in psoriatic disease, and could therefore be used to screen for PsA in psoriasis cohorts. Dkk-1 and OPG are biomarkers of axial arthritis; they could therefore be used to screen for the presence of axial disease in PsA cases, and help differentiate PsSpA from AS. High concentrations of Dkk-1 in AS and PsSpA compared with HC, support previous reports that Dkk-1 is dysfunctional in the spondyloarthritides.

22 Article Cross-phenotype association mapping of the MHC identifies genetic variants that differentiate psoriatic arthritis from psoriasis. 2017

Bowes, John / Ashcroft, James / Dand, Nick / Jalali-Najafabadi, Farideh / Bellou, Eftychia / Ho, Pauline / Marzo-Ortega, Helena / Helliwell, Philip S / Feletar, Marie / Ryan, Anthony W / Kane, David J / Korendowych, Eleanor / Simpson, Michael A / Packham, Jonathan / McManus, Ross / Brown, Matthew A / Smith, Catherine H / Barker, Jonathan N / McHugh, Neil / FitzGerald, Oliver / Warren, Richard B / Barton, Anne. ·Arthritis Research UK Centre for Genetics and Genomics, Centre for Musculoskeletal Research, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK. · Division of Genetics and Molecular Medicine, King's College London, Guy's Hospital, London, UK. · NIHR Manchester Musculoskeletal Biomedical Research Unit, Manchester Academic Health Science Centre, Manchester, UK. · NIHR Leeds Musculoskeletal 12 Biomedical Research Unit, Leeds Teaching Hospitals Trust and Leeds Institute of Rheumatic and Musculoskeletal Disease, University of Leeds, Leeds, UK. · Department of Rheumatology, Emeritus Research, Melbourne, Victoria, Australia. · Department of Clinical Medicine, Trinity Translational Medicine Institute, Trinity College Dublin, Dublin, Ireland. · Adelaide and Meath Hospital and Trinity College Dublin, Dublin, Ireland. · Royal National Hospital for Rheumatic Diseases and Department Pharmacy and Pharmacology, University of Bath, Bath, UK. · Department of Rheumatology, St Vincent's University Hospital, UCD School of Medicine and Medical Sciences and Conway Institute of Biomolecular and Biomedical Research, University College Dublin, Dublin, Ireland. · Haywood Academic Rheumatology Centre, Institute of Applied Clinical Science, Keele University, Stoke on Trent, UK. · Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia. · St John's Institute of Dermatology, Guys and St Thomas' Foundation Trust, London, UK. · St John's Institute of Dermatology, Division of Genetics and Molecular Medicine, Faculty of Life Sciences and Medicine, King's College London, London, UK. · Dermatology Centre, Salford Royal NHS Foundation Trust, University of Manchester, Manchester, UK. ·Ann Rheum Dis · Pubmed #28821532.

ABSTRACT: OBJECTIVES: Psoriatic arthritis (PsA) is a chronic inflammatory arthritis, with a strong heritable component, affecting patients with psoriasis. Here we attempt to identify genetic variants within the major histocompatibility complex (MHC) that differentiate patients with PsA from patients with cutaneous psoriasis alone (PsC). METHODS: 2808 patients with PsC, 1945 patients with PsA and 8920 population controls were genotyped. We imputed SNPs, amino acids and classical HLA alleles across the MHC and tested for association with PsA compared to population controls and the PsC patient group. In addition we investigated the impact of the age of disease onset on associations. RESULTS: HLA-C*06:02 was protective of PsA compared to PsC (p=9.57×10 CONCLUSIONS: By controlling for the age of psoriasis onset, we show, for the first time, that

23 Article A Multicenter Nominal Group Study to Rank Outcomes Important to Patients, and Their Representation in Existing Composite Outcome Measures for Psoriatic Arthritis. 2017

Tillett, William / Dures, Emma / Hewlett, Sarah / Helliwell, Philip S / FitzGerald, Oliver / Brooke, Melanie / James, Jana / Lord, Jane / Bowen, Clive / de Wit, Martin / Orbai, Ana-Maria / McHugh, Neil / Anonymous6980914. · ·J Rheumatol · Pubmed #28765241.

ABSTRACT: OBJECTIVE: To rank outcomes identified as important to patients with psoriatic arthritis (PsA) and examine their representation in existing composite measures. METHODS: Seven nominal group technique (NGT) meetings took place at 4 hospital sites. Two sorting rounds were conducted to generate a shortlist of outcomes followed by a group discussion and final ranking. In the final ranking round, patients were given 15 points each and asked to rank their top 5 outcomes from the shortlist. The totals were summed across the 7 NGT groups and were presented as a percentage of the maximum possible priority score. RESULTS: Thirty-one patients took part: 16 men and 15 women; the mean age was 54 years (range 24-77; SD 12.2), the mean disease duration was 10.3 years (range 1-40; SD 9.2), and mean Health Assessment Questionnaire was 1.15 (range 0-2.63; SD 0.7). The highest-ranked outcomes that patients wished to see from treatment were pain with 93 points (20.0%), fatigue 62 (13.3%), physical fitness 33 (7.1%), halting/slowing damage 32 (6.9%), and quality of life/well-being 29 (6.2%). Reviewing existing composite measures for PsA demonstrated that no single measure adequately identifies all these outcomes. CONCLUSION: Pain and fatigue were ranked as the outcomes most important to patients receiving treatment for PsA and are not well represented within existing composite measures. Future work will focus on validating composite measures modified to identify outcomes important to patients.

24 Article A rare coding allele in 2017

Budu-Aggrey, Ashley / Bowes, John / Stuart, Philip E / Zawistowski, Matthew / Tsoi, Lam C / Nair, Rajan / Jadon, Deepak Rohit / McHugh, Neil / Korendowych, Eleanor / Elder, James T / Barton, Anne / Raychaudhuri, Soumya. ·Arthritis Research UK Centre for Genetics and Genomics, Centre for Musculoskeletal Research, University of Manchester, Manchester, UK. · NIHR Manchester Musculoskeletal Biomedical Research Unit, Central Manchester Foundation Trust and University of Manchester, Manchester Academy of Health Sciences, Manchester, UK. · Department of Dermatology, University of Michigan, Ann Arbor, Michigan, USA. · Department of Biostatistics, Center for Statistical Genetics, University of Michigan, Ann Arbor, Michigan, USA. · Royal National Hospital for Rheumatic Diseases, University of Bath, Bath, UK. · Department of Rheumatology, Cambridge University Hospitals NHSFT, Cambridge, UK. · Department of Pharmacy and Parmacology, University of Bath, Bath, UK. · Ann Arbor Veterans Affairs Hospital, Ann Arbor, Michigan, USA. · Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA. · Program in Medical and Population Genetics, Broad Institute of MIT and Harvard, Cambridge, Massachusetts, USA. ·Ann Rheum Dis · Pubmed #28501801.

ABSTRACT: OBJECTIVES: Psoriatic arthritis (PsA) is an inflammatory arthritis associated with psoriasis. While many common risk alleles have been reported for association with PsA as well as psoriasis, few rare coding alleles have yet been identified. METHODS: To identify rare coding variation associated with PsA risk or protection, we genotyped 41 267 variants with the exome chip and investigated association within an initial cohort of 1980 PsA cases and 5913 controls. Genotype data for an independent cohort of 2234 PsA cases and 5708 controls was also made available, allowing for a meta-analysis to be performed with the discovery dataset. RESULTS: We identified an association with the rare variant rs35667974 (p=2.39x10 CONCLUSION: For the first time, we report a rare coding allele in

25 Article Important Treatment Outcomes for Patients with Psoriatic Arthritis: A Multisite Qualitative Study. 2017

Dures, Emma / Hewlett, Sarah / Lord, Jane / Bowen, Clive / McHugh, Neil / Anonymous1071283 / Tillett, William. ·University of the West of England, Bristol, UK. emma2.dures@uwe.ac.uk. · Academic Rheumatology, Bristol Royal Infirmary, Bristol, BS2 8HW, UK. emma2.dures@uwe.ac.uk. · University of the West of England, Bristol, UK. · University Hospitals Bristol, Bristol, UK. · The Psoriatic Arthritis Support Group (PsAZZ), Bath, UK. · University of Bath, Bath, UK. · Royal National Hospital for Rheumatic Diseases, Bath, UK. ·Patient · Pubmed #28229377.

ABSTRACT: BACKGROUND: Psoriatic arthritis (PsA) is a variable and complex inflammatory condition. Symptoms can compromise physical function, reduce quality of life, and accrue significant health costs. Commonly used patient-reported outcomes largely reflect the professionals' perspective, however it is not known whether they capture what is important to patients. OBJECTIVE: The aim of our study was to identify treatment outcomes important to patients with PsA. METHODS: Eight focus groups that were audio recorded, transcribed, anonymised and analysed using inductive thematic analysis were conducted at five hospital sites. The full data set was analysed by the lead researcher, and subsets analysed by three team members (including patient partners). RESULTS: Overall, 41 patients sampled for a range of phenotypes and domains of disease activity participated in the study: 20 males; mean age 58 years (range 28-75, standard deviation [SD] 11.4); mean disease duration 9 years (range 0.5-39, SD 8.3); and mean Health Assessment Questionnaire score of 1 (range 0.0-2.5, SD 0.7). Over 60 outcomes were identified and grouped into four themes: (i) symptom alleviation (e.g. pain, fatigue, itchy skin, swelling, and reducing variability); (ii) reduction of disease impact (e.g. tiredness and pain, mobility and dexterity, deteriorating physical fitness, negative emotional responses, and strained relationships and social interactions); (iii) improved prognosis (e.g. slowing down disease progression, maintaining independence, and enhancing quality of life); and (iv) minimisation of treatment harm and burden (e.g. nausea, long-term effects, and administration and monitoring of treatments). CONCLUSIONS: Outcomes from treatments that are important to patients, which relate to impacts from PsA and its treatment that range beyond those outcomes commonly measured, were identified. These patient perspectives need to be considered when evaluating treatments.

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