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Spinal Diseases: HELP
Articles by Cheryl F. Rosen
Based on 28 articles published since 2008
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Between 2008 and 2019, Cheryl F. Rosen wrote the following 28 articles about Spinal Diseases.
 
+ Citations + Abstracts
Pages: 1 · 2
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 Article Genetic signature to provide robust risk assessment of psoriatic arthritis development in psoriasis patients. 2018

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

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

3 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.

4 Article Addressing comorbidities in psoriatic disease. 2018

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

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

5 Article Treating Psoriasis and Psoriatic Arthritis: Position Paper on Applying the Treat-to-target Concept to Canadian Daily Practice. 2017

Gladman, Dafna D / Poulin, Yves / Adams, Karen / Bourcier, Marc / Barac, Snezana / Barber, Kirk / Chandran, Vinod / Dutz, Jan / Flanagan, Cathy / Gooderham, Melinda J / Gulliver, Wayne P / Ho, Vincent C / Hong, Chih-Ho / Karsh, Jacob / Khraishi, Majed M / Lynde, Charles W / Papp, Kim A / Rahman, Proton / Rohekar, Sherry / Rosen, Cheryl F / Russell, Anthony S / Vender, Ronald B / Yeung, Jensen / Ziouzina, Olga / Zummer, Michel. ·From the University of Toronto, Toronto, Ontario; Université Laval, Quebec, Quebec; Queen's University, Kingston; University of Ottawa, Ottawa; Western University, London; Dermatrials Research, Inc., Hamilton, Ontario; Université de Montréal, Montreal; Université de Sherbrooke, Sherbrooke, Quebec; The Winnipeg Clinic, Winnipeg, Manitoba; University of Calgary, Calgary; University of Alberta, Edmonton, Alberta; University of British Columbia, Vancouver, British Columbia; Memorial University of Newfoundland, St. John's, Newfoundland, Canada. dafna.gladman@utoronto.ca. · D.D. Gladman, MD, FRCPC, Professor of Medicine, University of Toronto; Y. Poulin, MD, Université Laval; K. Adams, MD, Université Laval; M. Bourcier, MD, Université de Sherbrooke; S. Barac, MD, The Winnipeg Clinic; K. Barber, MD, University of Calgary; V. Chandran, MBBS, MD, DM, PhD, University of Toronto; J. Dutz, MD, University of British Columbia; C. Flanagan, MD, University of British Columbia; M.J. Gooderham, MD, Queen's University; W.P. Gulliver, MD, Memorial University of Newfoundland; V.C. Ho, MD, University of British Columbia; C.H. Hong, MD, University of British Columbia; J. Karsh, MD, University of Ottawa; M.M. Khraishi, MBBCH, Memorial University of Newfoundland; C.W. Lynde, MD, University of Toronto; K.A. Papp, MD, PhD, University of Toronto; P. Rahman, MD, Memorial University of Newfoundland; S. Rohekar, MD, Western University; C.F. Rosen, MD, University of Toronto; A.S. Russell, MD, University of Alberta; R.B. Vender, MD, Dermatrials Research, Inc.; J. Yeung, MD, University of Toronto; O. Ziouzina, MD, University of Calgary; M. Zummer, MD, Université de Montréal. dafna.gladman@utoronto.ca. · From the University of Toronto, Toronto, Ontario; Université Laval, Quebec, Quebec; Queen's University, Kingston; University of Ottawa, Ottawa; Western University, London; Dermatrials Research, Inc., Hamilton, Ontario; Université de Montréal, Montreal; Université de Sherbrooke, Sherbrooke, Quebec; The Winnipeg Clinic, Winnipeg, Manitoba; University of Calgary, Calgary; University of Alberta, Edmonton, Alberta; University of British Columbia, Vancouver, British Columbia; Memorial University of Newfoundland, St. John's, Newfoundland, Canada. · D.D. Gladman, MD, FRCPC, Professor of Medicine, University of Toronto; Y. Poulin, MD, Université Laval; K. Adams, MD, Université Laval; M. Bourcier, MD, Université de Sherbrooke; S. Barac, MD, The Winnipeg Clinic; K. Barber, MD, University of Calgary; V. Chandran, MBBS, MD, DM, PhD, University of Toronto; J. Dutz, MD, University of British Columbia; C. Flanagan, MD, University of British Columbia; M.J. Gooderham, MD, Queen's University; W.P. Gulliver, MD, Memorial University of Newfoundland; V.C. Ho, MD, University of British Columbia; C.H. Hong, MD, University of British Columbia; J. Karsh, MD, University of Ottawa; M.M. Khraishi, MBBCH, Memorial University of Newfoundland; C.W. Lynde, MD, University of Toronto; K.A. Papp, MD, PhD, University of Toronto; P. Rahman, MD, Memorial University of Newfoundland; S. Rohekar, MD, Western University; C.F. Rosen, MD, University of Toronto; A.S. Russell, MD, University of Alberta; R.B. Vender, MD, Dermatrials Research, Inc.; J. Yeung, MD, University of Toronto; O. Ziouzina, MD, University of Calgary; M. Zummer, MD, Université de Montréal. ·J Rheumatol · Pubmed #28604347.

ABSTRACT: OBJECTIVE: To develop preliminary treat-to-target (T2T) recommendations for psoriasis and psoriatic arthritis (PsA) for Canadian daily practice. METHODS: A task force composed of expert Canadian dermatologists and rheumatologists performed a needs assessment among Canadian clinicians treating these diseases as well as an extensive literature search on the outcome measures used in clinical trials and practice. RESULTS: Based on results from the needs assessment and literature search, the task force established 5 overarching principles and developed 8 preliminary T2T recommendations. CONCLUSION: The proposed recommendations should improve management of psoriasis and PsA in Canadian daily practice. However, these recommendations must be further validated in a real-world observational study to ensure that their use leads to better longterm outcomes.

6 Article Psoriasis and Psoriatic Arthritis Clinics Multicenter Advancement Network Consortium (PPACMAN) Survey: Benefits and Challenges of Combined Rheumatology-dermatology Clinics. 2017

Okhovat, Jean-Phillip / Ogdie, Alexis / Reddy, Soumya M / Rosen, Cheryl F / Scher, Jose U / Merola, Joseph F. ·From the Beth Israel Deaconess Medical Center, Harvard Medical School; Harvard T.H. Chan School of Public Health; Department of Dermatology and Medicine, Division of Rheumatology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts; Medicine and Epidemiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; New York University School of Medicine, New York, New York, USA; Department of Medicine, Toronto Western Hospital, University of Toronto, Toronto, Ontario, Canada. · J. Okhovat, MD, MPH, Resident, Beth Israel Deaconess Medical Center, Harvard Medical School, and Harvard T.H. Chan School of Public Health; A. Ogdie, MD, MSCE, Assistant Professor of Medicine and Epidemiology, Perelman School of Medicine, University of Pennsylvania; S.M. Reddy, MD, Assistant Professor of Medicine, New York University School of Medicine; C.F. Rosen, MD, FRCPC, Professor, Department of Medicine, Toronto Western Hospital, University of Toronto; J.U. Scher, MD, Assistant Professor of Medicine, New York University School of Medicine; J.F. Merola, MD, MMSc, Assistant Professor of Dermatology, Department of Dermatology and Medicine, Division of Rheumatology, Brigham and Women's Hospital, Harvard Medical School. · From the Beth Israel Deaconess Medical Center, Harvard Medical School; Harvard T.H. Chan School of Public Health; Department of Dermatology and Medicine, Division of Rheumatology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts; Medicine and Epidemiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; New York University School of Medicine, New York, New York, USA; Department of Medicine, Toronto Western Hospital, University of Toronto, Toronto, Ontario, Canada. jfmerola@bwh.harvard.edu. · J. Okhovat, MD, MPH, Resident, Beth Israel Deaconess Medical Center, Harvard Medical School, and Harvard T.H. Chan School of Public Health; A. Ogdie, MD, MSCE, Assistant Professor of Medicine and Epidemiology, Perelman School of Medicine, University of Pennsylvania; S.M. Reddy, MD, Assistant Professor of Medicine, New York University School of Medicine; C.F. Rosen, MD, FRCPC, Professor, Department of Medicine, Toronto Western Hospital, University of Toronto; J.U. Scher, MD, Assistant Professor of Medicine, New York University School of Medicine; J.F. Merola, MD, MMSc, Assistant Professor of Dermatology, Department of Dermatology and Medicine, Division of Rheumatology, Brigham and Women's Hospital, Harvard Medical School. jfmerola@bwh.harvard.edu. ·J Rheumatol · Pubmed #28461529.

ABSTRACT: Optimal management of patients with both psoriasis and psoriatic arthritis (PsA) necessitates collaboration among dermatologists and rheumatologists. In this manuscript, we discuss challenges and opportunities for dual care models for patients with psoriasis and PsA and the results of a survey of combined clinics based in North America.

7 Article Proceedings of the GRAPPA 2016 Retreat. 2017

Jadon, Deepak R / Gladman, Dafna D / Mease, Philip J / FitzGerald, Oliver / Chandran, Vinod / Goel, Niti / Rosen, Cheryl F / Maksymowych, Walter P / Ritchlin, Christopher T / Ogdie, Alexis / Coates, Laura C / Cauli, Alberto / Soriano, Enrique R / Husni, M Elaine / Campbell, Willemina / Azevedo, Valderilio F / Callis Duffin, Kristina / Armstrong, April W / Gottlieb, Alice B / Kavanaugh, Arthur / Garg, Amit / Helliwell, Philip S. ·From the Rheumatology Research Unit, Cambridge University Hospitals UK National Health Service (NHS) Foundation Trust, Cambridge; UK National Institute for Health Research Clinical Lecturer, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds; Bradford Hospitals NHS Foundation Trust, Bradford, UK; Department of Medicine, Division of Rheumatology, University of Toronto, Toronto Western Hospital, Krembil Research Institute; Division of Dermatology, Toronto Western Hospital, University of Toronto, Ontario; University of Alberta, Edmonton, Alberta, Canada; Rheumatology Research, Swedish Medical Center and University of Washington School of Medicine, Seattle, Washington; Advisory Services, QuintilesIMS, Denver, Colorado; Duke University School of Medicine, Durham, North Carolina; Division of Allergy, Immunology, and Rheumatology, University of Rochester Medical Center, Rochester; New York Medical College, Valhalla; Hofstra Northwell School of Medicine, New Hyde Park, New York, New York; Medicine and Epidemiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; Cleveland Clinic, Cleveland, Ohio; University of Utah, Salt Lake City, Utah; University of Southern California, Los Angeles; University of California at San Diego, San Diego, California, USA; Newman Clinical Research Professor, Department of Rheumatology, St. Vincent's University Hospital; Conway Institute for Biomolecular Research, University College Dublin, Dublin, Ireland; Division of Rheumatology, University of Cagliari, Cagliari, Italy, Sección Reumatología, Servicio de Clínica Médica, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina; Federal University of Paraná, Curitiba, Brazil. · D.R. Jadon, MBBCh, MRCP, PhD, Director, Rheumatology Research Unit, Cambridge University Hospitals NHS Foundation Trust; D.D. Gladman, MD, FRCPC, Professor of Medicine, University of Toronto, and Senior Scientist, Krembil Research Institute, Toronto Western Hospital; P.J. Mease, MD, Rheumatology Research, Swedish Medical Center and University of Washington School of Medicine; O. FitzGerald, MD, FRCPI, FRCP( UK), Newman Clinical Research Professor, Department of Rheumatology, St. Vincent's University Hospital, and Conway Institute for Biomolecular Research, University College Dublin; V. Chandran, MBBS, MD, DM, PhD, Department of Medicine, Division of Rheumatology, University of Toronto, Toronto Western Hospital, Krembil Research Institute; N. Goel, MD, Patient Research Partner, Vice President, Advisory Services, QuintilesIMS, and Adjunct Assistant Professor, Duke University School of Medicine; C.F. Rosen, MD, FRCPC, Division of Dermatology, Toronto Western Hospital, University of Toronto; W.P. Maksymowych, MD, FRCP(C), Professor of Medicine, University of Alberta; C.T. Ritchlin, MD, MPH, Professor of Medicine, Division of Allergy, Immunology, and Rheumatology, University of Rochester Medical Center; A. Ogdie, MD, Assistant Professor of Medicine and Epidemiology, Perelman School of Medicine, University of Pennsylvania; L.C. Coates, MBChB, PhD, UK National Institute for Health Research Clinical Lecturer, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds; A. Cauli, MD, PhD, Division of Rheumatology, University of Cagliari; E.R. Soriano, MD, MSC, Sección Reumatología, Servicio de Clínica Médica, Hospital Italiano de Buenos Aires; M.E. Husni, MD, MPH, Cleveland Clinic; W. Campbell, BEd LLB, Patient Research Partner, Toronto Western Hospital; V.F. Azevedo, MD, PhD, Adjunct Professor of Rheumatology, Federal University of Paraná; K. Callis Duffin, MD, University of Utah; A.W. Armstrong, MD, MPH, University of Southern California; A.B. Gottlieb, MD, PhD, Professor of Dermatology, New York Medical College; A. Kavanaugh, MD, Professor of Medicine, University of California at San Diego; A. Garg, MD, Hofstra Northwell School of Medicine; P.S. Helliwell, DM, PhD, FRCP, University of Leeds, and Bradford Hospitals NHS Foundation Trust. · From the Rheumatology Research Unit, Cambridge University Hospitals UK National Health Service (NHS) Foundation Trust, Cambridge; UK National Institute for Health Research Clinical Lecturer, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds; Bradford Hospitals NHS Foundation Trust, Bradford, UK; Department of Medicine, Division of Rheumatology, University of Toronto, Toronto Western Hospital, Krembil Research Institute; Division of Dermatology, Toronto Western Hospital, University of Toronto, Ontario; University of Alberta, Edmonton, Alberta, Canada; Rheumatology Research, Swedish Medical Center and University of Washington School of Medicine, Seattle, Washington; Advisory Services, QuintilesIMS, Denver, Colorado; Duke University School of Medicine, Durham, North Carolina; Division of Allergy, Immunology, and Rheumatology, University of Rochester Medical Center, Rochester; New York Medical College, Valhalla; Hofstra Northwell School of Medicine, New Hyde Park, New York, New York; Medicine and Epidemiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; Cleveland Clinic, Cleveland, Ohio; University of Utah, Salt Lake City, Utah; University of Southern California, Los Angeles; University of California at San Diego, San Diego, California, USA; Newman Clinical Research Professor, Department of Rheumatology, St. Vincent's University Hospital; Conway Institute for Biomolecular Research, University College Dublin, Dublin, Ireland; Division of Rheumatology, University of Cagliari, Cagliari, Italy, Sección Reumatología, Servicio de Clínica Médica, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina; Federal University of Paraná, Curitiba, Brazil. p.helliwell@leeds.ac.uk. · D.R. Jadon, MBBCh, MRCP, PhD, Director, Rheumatology Research Unit, Cambridge University Hospitals NHS Foundation Trust; D.D. Gladman, MD, FRCPC, Professor of Medicine, University of Toronto, and Senior Scientist, Krembil Research Institute, Toronto Western Hospital; P.J. Mease, MD, Rheumatology Research, Swedish Medical Center and University of Washington School of Medicine; O. FitzGerald, MD, FRCPI, FRCP( UK), Newman Clinical Research Professor, Department of Rheumatology, St. Vincent's University Hospital, and Conway Institute for Biomolecular Research, University College Dublin; V. Chandran, MBBS, MD, DM, PhD, Department of Medicine, Division of Rheumatology, University of Toronto, Toronto Western Hospital, Krembil Research Institute; N. Goel, MD, Patient Research Partner, Vice President, Advisory Services, QuintilesIMS, and Adjunct Assistant Professor, Duke University School of Medicine; C.F. Rosen, MD, FRCPC, Division of Dermatology, Toronto Western Hospital, University of Toronto; W.P. Maksymowych, MD, FRCP(C), Professor of Medicine, University of Alberta; C.T. Ritchlin, MD, MPH, Professor of Medicine, Division of Allergy, Immunology, and Rheumatology, University of Rochester Medical Center; A. Ogdie, MD, Assistant Professor of Medicine and Epidemiology, Perelman School of Medicine, University of Pennsylvania; L.C. Coates, MBChB, PhD, UK National Institute for Health Research Clinical Lecturer, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds; A. Cauli, MD, PhD, Division of Rheumatology, University of Cagliari; E.R. Soriano, MD, MSC, Sección Reumatología, Servicio de Clínica Médica, Hospital Italiano de Buenos Aires; M.E. Husni, MD, MPH, Cleveland Clinic; W. Campbell, BEd LLB, Patient Research Partner, Toronto Western Hospital; V.F. Azevedo, MD, PhD, Adjunct Professor of Rheumatology, Federal University of Paraná; K. Callis Duffin, MD, University of Utah; A.W. Armstrong, MD, MPH, University of Southern California; A.B. Gottlieb, MD, PhD, Professor of Dermatology, New York Medical College; A. Kavanaugh, MD, Professor of Medicine, University of California at San Diego; A. Garg, MD, Hofstra Northwell School of Medicine; P.S. Helliwell, DM, PhD, FRCP, University of Leeds, and Bradford Hospitals NHS Foundation Trust. p.helliwell@leeds.ac.uk. ·J Rheumatol · Pubmed #28461522.

ABSTRACT: In advance of its 2016 annual meeting, members of the steering committee of the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA) convened for a strategic planning meeting. The purpose of this advance meeting was to review the work of GRAPPA since its inception in 2003, ascertain and review the current priorities of the group, and devise a strategy for proceeding. The key accomplishments of GRAPPA to date, priorities and objectives for the next 5 years, and goals and opportunities for the GRAPPA committees were discussed. GRAPPA has a responsibility and commitment to patients, its members, and partners to innovate, inspire, and improve knowledge and the ability to care for people with psoriasis and psoriatic arthritis.

8 Article The Association Between Obesity and Clinical Features of Psoriatic Arthritis: A Case-control Study. 2017

Eder, Lihi / Abji, Fatima / Rosen, Cheryl F / Chandran, Vinod / Gladman, Dafna D. ·From the Division of Rheumatology, Women's College Research Institute, Women's College Hospital; Department of Medicine, University of Toronto; Centre for Prognosis Studies in the Rheumatic Diseases, Toronto Western Hospital; Division of Dermatology, Toronto Western Hospital, Toronto, Ontario, Canada. lihi.eder@wchospital.ca. · L. Eder, MD, PhD, Division of Rheumatology, Women's College Research Institute, Women's College Hospital, and Department of Medicine, University of Toronto; F. Abji, MSc, Centre for Prognosis Studies in the Rheumatic Diseases, Toronto Western Hospital; C.F. Rosen, MD, FRCPC, Division of Dermatology, Toronto Western Hospital; V. Chandran, MD, DM, PhD, Department of Medicine, University of Toronto, and Centre for Prognosis Studies in the Rheumatic Diseases, Toronto Western Hospital; D.D. Gladman, MD, FRCPC, Department of Medicine, University of Toronto, and Centre for Prognosis Studies in the Rheumatic Diseases, Toronto Western Hospital. lihi.eder@wchospital.ca. · From the Division of Rheumatology, Women's College Research Institute, Women's College Hospital; Department of Medicine, University of Toronto; Centre for Prognosis Studies in the Rheumatic Diseases, Toronto Western Hospital; Division of Dermatology, Toronto Western Hospital, Toronto, Ontario, Canada. · L. Eder, MD, PhD, Division of Rheumatology, Women's College Research Institute, Women's College Hospital, and Department of Medicine, University of Toronto; F. Abji, MSc, Centre for Prognosis Studies in the Rheumatic Diseases, Toronto Western Hospital; C.F. Rosen, MD, FRCPC, Division of Dermatology, Toronto Western Hospital; V. Chandran, MD, DM, PhD, Department of Medicine, University of Toronto, and Centre for Prognosis Studies in the Rheumatic Diseases, Toronto Western Hospital; D.D. Gladman, MD, FRCPC, Department of Medicine, University of Toronto, and Centre for Prognosis Studies in the Rheumatic Diseases, Toronto Western Hospital. ·J Rheumatol · Pubmed #28202737.

ABSTRACT: OBJECTIVE: To assess whether obesity is associated with distinct psoriatic arthritis (PsA) features and whether it interacts with PsA HLA susceptibility alleles. METHODS: Patients with early PsA were compared with patients with psoriasis without arthritis (PsC). The primary predictor was the body mass index (BMI) at the first visit to the clinic. The clinical features across 3 BMI groups were compared by linear trend test and Cochrane-Armitage trend test. The interaction between BMI and HLA risk alleles for psoriatic disease (HLA-B*27, B*3901, B*3801, B*0801, B*4402, B*4403, and C*0602) were assessed using logistic regression analysis. RESULTS: There were 314 patients with early PsA, and 498 patients with PsC were analyzed. Obesity was more frequent in patients with PsA compared with PsC (OR 1.77; p = 0.002). Higher BMI was associated with older age at onset of PsA (p < 0.0001) and psoriasis (p = 0.009). The frequency of HLA-B*27 was higher in patients with normal weight compared with those with higher BMI (p = 0.002). A significant interaction was found for the combined effect of HLA-B*27 and obesity in logistic regression analysis (p = 0.036). In patients who were HLA-B*27-negative, the association between obesity and PsA was statistically significant (OR 2.39; p < 0.001), but obesity was less frequent in patients with PsA who were HLA-B*27-positive. CONCLUSION: Obesity is linked with late-onset psoriasis and PsA, while normal weight is associated with the presence of the HLA-B*27 allele and an earlier onset of the disease. These results highlight the differential risk factors that may drive the inflammatory process in psoriatic disease.

9 Article The Development of Psoriatic Arthritis in Patients With Psoriasis Is Preceded by a Period of Nonspecific Musculoskeletal Symptoms: A Prospective Cohort Study. 2017

Eder, Lihi / Polachek, Ari / Rosen, Cheryl F / Chandran, Vinod / Cook, Richard / Gladman, Dafna D. ·Women's College Hospital and University of Toronto, Toronto, Ontario, Canada. · University Health Network, Toronto, Ontario, Canada. · University of Toronto and University Health Network, Toronto, Ontario, Canada. · University of Waterloo, Waterloo, Ontario, Canada. ·Arthritis Rheumatol · Pubmed #27792862.

ABSTRACT: OBJECTIVE: To assess whether the presence of nonspecific musculoskeletal symptoms, their degree, and change over time predict the development of psoriatic arthritis (PsA) in a prospective cohort of psoriasis patients without arthritis at baseline. METHODS: This prospective cohort study involved patients with psoriasis who were assessed at baseline to exclude the presence of clinical PsA. The study participants were reassessed annually to determine if they had developed PsA. The presence of musculoskeletal symptoms and the patients' assessments of pain, fatigue, stiffness, physical function, and psychological distress were recorded at each visit. Cox proportional hazards models were used to assess what symptoms predicted the development of PsA. RESULTS: A total of 57 of 410 psoriasis patients developed PsA. At baseline, the presence of arthralgia in women (hazard ratio [HR] 2.59, P = 0.02), heel pain (HR 4.18, P = 0.02), high fatigue score (HR 2.36, P = 0.007), and high stiffness score (HR 2.03, P = 0.045) predicted subsequent development of PsA. In addition, an increase from baseline in fatigue score (HR 1.27, P = 0.001), pain score (HR 1.34, P < 0.001), and stiffness score (HR 1.21, P = 0.03), and a worsening in physical function score (HR 0.96, P = 0.04) predicted the development of PsA. CONCLUSION: A preclinical phase exists in patients with PsA prior to the diagnosis of the disease. This phase is characterized by nonspecific musculoskeletal symptoms, including joint pain, fatigue, and stiffness.

10 Article The Incidence and Risk Factors for Psoriatic Arthritis in Patients With Psoriasis: A Prospective Cohort Study. 2016

Eder, Lihi / Haddad, Amir / Rosen, Cheryl F / Lee, Ker-Ai / Chandran, Vinod / Cook, Richard / Gladman, Dafna D. ·Toronto Western Hospital, Toronto, Ontario, Canada. · University of Waterloo, Waterloo, Ontario, Canada. ·Arthritis Rheumatol · Pubmed #26555117.

ABSTRACT: OBJECTIVE: To estimate the incidence of psoriatic arthritis (PsA) in patients with psoriasis, and to identify risk factors for its development. METHODS: The study was designed as a prospective cohort study involving psoriasis patients who did not have a diagnosis of arthritis at the time of study enrollment. Information was collected about lifestyle habits, comorbidities, psoriasis activity, and medications. Patients who developed inflammatory arthritis or spondylitis were classified as having PsA if they fulfilled the criteria of the Classification of Psoriatic Arthritis Study group. The annual incidence of PsA was estimated using an event per person-years analysis. Cox proportional hazards models, involving fixed and time-dependent explanatory variables, were fitted to obtain estimates of the relative risk (RR) of the onset of PsA, determined in multivariate models stratified by sex and controlled for age at onset of psoriasis. RESULTS: The data obtained from the 464 patients who were followed up for 8 years were analyzed. A total of 51 patients developed PsA during the 8 years since enrollment. The annual incidence rate of PsA was 2.7 cases (95% confidence interval 2.1-3.6) per 100 psoriasis patients. The following baseline variables were associated with the development of PsA in multivariate analysis: severe psoriasis (RR 5.4, P = 0.006), low level of education (university/college versus high school incomplete RR 0.22, P = 0.005; high school graduate versus high school incomplete RR 0.30, P = 0.049), and use of retinoid medications (RR 3.4, P = 0.02). In multivariate models with time-dependent variables, psoriatic nail pitting (RR 2.5, P = 0.002) and uveitis (RR 31.5, P = 0.0002) were associated with the development of PsA. CONCLUSION: The incidence of PsA in patients with psoriasis is higher than previously reported. A severe psoriasis phenotype, presence of nail pitting, low level of education, and uveitis are predictive of the development of PsA in patients with psoriasis.

11 Article Validation of the Toronto Psoriatic Arthritis Screen Version 2 (ToPAS 2). 2015

Tom, Brian D M / Chandran, Vinod / Farewell, Vernon T / Rosen, Cheryl F / Gladman, Dafna D. ·From the MRC Biostatistics Unit, UK Institute of Public Health, Cambridge, UK; the Psoriatic Arthritis Program, Centre for Prognosis Studies in the Rheumatic Diseases, Toronto Western Hospital; Division of Dermatology, Toronto Western Hospital, University of Toronto, Toronto, Ontario, Canada.B.D. Tom, PhD, MRC Biostatistics Unit, UK Institute of Public Health; V. Chandran, MBBS, MD, DM, PhD, Psoriatic Arthritis Program, Centre for Prognosis Studies in the Rheumatic Diseases, Toronto Western Hospital; V.T. Farewell, PhD, MRC Biostatistics Unit, UK Institute of Public Health; C.F. Rosen, MD, FRCPC, Division of Dermatology, Toronto Western Hospital, University of Toronto; D.D. Gladman, MD, FRCPC, Psoriatic Arthritis Program, Centre for Prognosis Studies in the Rheumatic Diseases, Toronto Western Hospital. ·J Rheumatol · Pubmed #25834198.

ABSTRACT: OBJECTIVE: We previously developed and performed an initial validation of a screening questionnaire, the Toronto Psoriatic Arthritis Screen (ToPAS), for psoriatic arthritis (PsA). In our original analysis, we found that the index constructed appeared to discriminate well between those with a confirmed diagnosis of PsA and those without PsA in various clinical settings. However, it was suggested that ToPAS would benefit from additional refinement to the questions and the scoring system, because items pertaining to axial involvement were not included in our original index. Subsequently, a second version of ToPAS was developed, ToPAS 2, which incorporated the suggested refinements. We aimed to validate ToPAS 2 as a screening instrument for PsA. METHODS: ToPAS 2 was administered to 3 "diagnostic" groups of individuals - patients with PsA, patients with psoriasis, and healthy controls, and the data collected were analyzed. RESULTS: It was found that the new version of ToPAS, ToPAS 2, again performed well, with the axial domain now featuring in the new scoring system. The constructed index, ToPAS2_cap, had an overall area under the receiver-operation curve of 0.910, with overall values of sensitivity and specificity, at a cutpoint of 8 (or 7), of 87.2% (92.0%) and 82.7% (77.2%), respectively. CONCLUSION: ToPAS 2 shows much promise as a screening instrument for identifying PsA both in people with psoriasis and in individuals from the general population. Its performance against other proposed screening instruments for PsA should be evaluated in other clinics and for other study designs.

12 Article Depression and anxiety in psoriatic disease: prevalence and associated factors. 2014

McDonough, Emily / Ayearst, Renise / Eder, Lihi / Chandran, Vinod / Rosen, Cheryl F / Thavaneswaran, Arane / Gladman, Dafna D. ·From the Psoriatic Arthritis Program, Centre for Prognosis Studies in the Rheumatic Diseases, University Health Network, Toronto Western Hospital; Division of Dermatology, Toronto Western Hospital, and Department of Medicine, University of Toronto, Toronto, Ontario, Canada. ·J Rheumatol · Pubmed #24692521.

ABSTRACT: OBJECTIVE: (1) To determine the prevalence of depression and anxiety in patients with psoriatic arthritis (PsA) and to identify associated demographic and disease-related factors. (2) To determine whether there is a difference in the prevalence of depression and anxiety between patients with PsA and those with psoriasis without PsA (PsC). METHODS: Consecutive patients attending PsA and dermatology clinics were assessed for depression and anxiety using the Hospital Anxiety and Depression Scale. Patients underwent a clinical assessment according to a standard protocol and completed questionnaires assessing their health and quality of life. T tests, ANOVA, and univariate and multivariate models were used to compare depression and anxiety prevalence between patient cohorts and to determine factors associated with depression and anxiety. RESULTS: We assessed 306 patients with PsA and 135 with PsC. There were significantly more men in the PsA group (61.4% vs 48% with PsC) and they were more likely to be unemployed. The prevalence of both anxiety and depression was higher in patients with PsA (36.6% and 22.2%, respectively) compared to those with PsC (24.4% and 9.6%; p = 0.012, 0.002). Depression and/or anxiety were associated with unemployment, female sex, and higher actively inflamed joint count as well as disability, pain, and fatigue. In the multivariate reduced model, employment was protective for depression (OR 0.36) and a 1-unit increase on the fatigue severity scale was associated with an increased risk of depression (OR 1.5). CONCLUSION: The rate of depression and anxiety is significantly higher in patients with PsA than in those with PsC. Depression and anxiety are associated with disease-related factors.

13 Article Is the MAdrid Sonographic Enthesitis Index useful for differentiating psoriatic arthritis from psoriasis alone and healthy controls? 2014

Eder, Lihi / Jayakar, Jai / Thavaneswaran, Arane / Haddad, Amir / Chandran, Vinod / Salonen, David / Rosen, Cheryl F / Gladman, Dafna D. ·From the Psoriatic Arthritis Program, Centre for Prognosis Studies in the Rheumatic Diseases, Toronto Western Hospital, Toronto; Western University, London; Division of Rheumatology, Department of Medicine, University of Toronto; Department of Medical Imaging, University of Toronto; Musculoskeletal Imaging, Mount Sinai Hospital; Department of Medical Imaging, University of Toronto; Division of Dermatology, Toronto Western Hospital and University Health Network Hospitals; Centre for Prognosis Studies in the Rheumatic Diseases, Toronto Western Hospital, University of Toronto Psoriatic Arthritis Clinic, Toronto, Ontario, Canada. ·J Rheumatol · Pubmed #24488414.

ABSTRACT: OBJECTIVE: To assess the usefulness of the MAdrid Sonographic Enthesitis Index (MASEI) in classifying patients as having psoriatic arthritis (PsA) and comparing entheseal abnormalities between patients with PsA, psoriasis alone (PsC), and healthy controls (HC). METHODS: Patients with PsC were assessed to exclude inflammatory arthritis. The MASEI scoring system was used to quantify the extent of ultrasonographic (US) entheseal abnormalities. The total MASEI score was categorized into items that reflected inflammatory abnormalities (MASEI-inflammatory) and chronic damage (MASEI-damage). Nonparametric tests were used to compare MASEI scores across the groups. A cutoff point of MASEI ≥ 20 was used to calculate the sensitivity and specificity of the MASEI to classify patients as having PsA. RESULTS: Patients with PsA (n = 50), PsC (n = 66), and HC (n = 60) were assessed. Total MASEI scores were higher in patients with PsA than in those with PsC, and both those groups were higher than HC (p < 0.0001). MASEI-inflammatory showed a similar trend (p < 0.0001). MASEI-damage was higher in patients with PsA compared to both patients with PsC and HC (p < 0.0001); however, no difference was observed between patients with PsC and HC. No significant difference in MASEI scores was found across the 3 groups in patients with a body mass index > 30. The sensitivity of the MASEI score to correctly classify patients as having PsA was 30% and the specificity was 95% when compared to HC and 89% when compared to PsC. CONCLUSION: The severity of US entheseal abnormalities is highest in patients with PsA followed by PsC and is lowest in healthy controls. MASEI can specifically classify patients as having PsA.

14 Article Serum adipokines in patients with psoriatic arthritis and psoriasis alone and their correlation with disease activity. 2013

Eder, Lihi / Jayakar, Jai / Pollock, Remy / Pellett, Fawnda / Thavaneswaran, Arane / Chandran, Vinod / Rosen, Cheryl F / Gladman, Dafna D. ·Centre for Prognosis Studies in the Rheumatic Diseases, Toronto Western Hospital, , Toronto, Ontario, Canada. ·Ann Rheum Dis · Pubmed #23243196.

ABSTRACT: OBJECTIVE: To compare the prevalence of metabolic syndrome (MetS) and the levels of related biomarkers in patients with psoriatic arthritis (PsA) and psoriasis without arthritis (PsC). METHODS: This study compared patients with PsA and patients with PsC. The presence of MetS was determined. Serum levels of insulin, adiponectin and leptin were measured. The homeostasis model assessment for insulin resistance (HOMA-IR) was calculated. HOMA-IR, adiponectin and leptin were log-transformed. Continuous variables were compared using the t test and the χ(2) test was used for discrete variables. Multivariate regression models were used to investigate the association of MetS and adiponectin with PsA compared to PsC after adjusting for potential confounding variables. RESULTS: 203 PsA and 155 PsC patients were analysed. The prevalence of MetS was higher in PsA patients compared to those with PsC. However, this did not reach statistical significance (36.5% vs 27.1%, p=0.056). The levels of adipokines were significantly higher in PsA compared to PsC: adiponectin (8.8±5.2 vs 7.4±4.5 log (µg/ml), p=0.009) and leptin in women (3.1±0.8 vs 2.8±0.8, log (ng/ml), p=0.04). HOMA-IR was also higher in PsA (0.97±0.63 vs 0.68±0.81, p<0.001). No difference was observed in leptin levels in men. In multivariate regression analysis, PsA (p=0.04) and the psoriasis area and severity index score (p=0.02) were associated with MetS. Adiponectin was significantly associated with PsA (p=0.005), the use of anti-tumour necrosis factor α therapy (p=0.03) and active joint count (p=0.001). CONCLUSIONS: MetS and related adipokines correlated with an increased burden of skin and joint inflammation.

15 Article The burden of carotid artery plaques is higher in patients with psoriatic arthritis compared with those with psoriasis alone. 2013

Eder, Lihi / Jayakar, Jai / Shanmugarajah, Sutha / Thavaneswaran, Arane / Pereira, Daniel / Chandran, Vinod / Rosen, Cheryl F / Gladman, Dafna D. ·Department of Rheumatology, Centre for Prognosis Studies in the Rheumatic Diseases, Toronto Western Hospital, University of Toronto Psoriatic Arthritis Program, Toronto, Ontario, Canada. ·Ann Rheum Dis · Pubmed #22736087.

ABSTRACT: AIM: To compare the extent of atherosclerosis in patients with psoriatic arthritis (PsA) and patients with cutaneous psoriasis without arthritis (PsC). METHODS: In this cross-sectional study the authors compared patients with PsA with PsC patients. Psoriasis patients underwent a rheumatological assessment to exclude inflammatory arthritis. Ultrasonographic measurements of carotid total plaque area (TPA) and carotid intima-media thickness (cIMT) were performed. t Test was used to compare the imaging findings between the two groups. Multivariate linear regression analysis was used to assess the association between disease status and imaging findings after adjusting for potential confounders. RESULTS: Overall, 125 PsA and 114 PsC patients were compared. There were no significant differences in age, gender or cardiovascular risk factors between the two groups. Patients with PsA exhibited greater TPA than did PsC patients (TPA (square root of area in mm(2)) 3.33±3.34 vs 2.43±2.72, p=0.03). This difference remained statistically significant in the multivariate regression analysis after adjusting for potential confounders (p=0.03). The difference in cIMT between the groups did not achieve statistical significance (p=0.09). The following disease-related variables were associated with increase in TPA in multivariate regression analysis among PsA patients: duration of PsA (p=0.04), highest Psoriasis Area and Severity Index recorded in the first 3 years of follow-up (p=0.02) and erythrocyte sedimentation rate (p=0.005). CONCLUSIONS: PsA patients suffer from more severe subclinical atherosclerosis compared with patients with PsC. This difference is independent of traditional cardiovascular risk factors and correlates with PsA disease duration, more severe skin disease and increased inflammatory markers.

16 Article Exploring priority research areas in psoriasis and psoriatic arthritis from dermatologists' perspective: a report from the GRAPPA 2011 annual meeting. 2012

Armstrong, April W / Callis Duffin, Kristina / Garg, Amit / Gelfand, Joel M / Gottlieb, Alice B / Krueger, Gerald G / Qureshi, Abrar A / Rosen, Cheryl F. ·Department of Dermatology, University of California Davis, Sacramento, California 95816, USA. aprilarmstrong@post.harvard.edu ·J Rheumatol · Pubmed #23118289.

ABSTRACT: At the 2011 annual meeting of the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA) in Naples, Italy, the GRAPPA dermatology members led discussions on priority research areas in psoriasis and psoriatic arthritis (PsA). These discussions centered on 3 primary areas: evaluation of PsA screening tools, updates on psoriasis comorbidities, and new developments in genetics and comparative effectiveness research. Introductory presentations were followed by engaging panel discussions and audience interaction. The members agreed that screening tools are highly valuable in early detection of PsA among dermatology patients and that efforts are necessary to develop tools suitable for adoption in clinical practice. Members also agreed that a collaborative investigation to evaluate the effect of psoriasis treatments on cardiovascular comorbidities would be highly informative. Finally, the members supported continued efforts to explore the genetic basis of psoriasis and more studies focused on comparative effectiveness of existing treatments.

17 Article Differential human leucocyte allele association between psoriasis and psoriatic arthritis: a family-based association study. 2012

Eder, Lihi / Chandran, Vinod / Pellett, Fawnda / Shanmugarajah, Sutha / Rosen, Cheryl F / Bull, Shelley B / Gladman, Dafna D. ·Center for Prognosis Studies in the Rheumatic Diseases,Toronto Western Hospital, University of Toronto Psoriatic Arthritis Clinic, Toronto, Canada. ·Ann Rheum Dis · Pubmed #22586163.

ABSTRACT: OBJECTIVE: A recent population-based study identified several HLA alleles as conferring a risk for psoriatic arthritis (PsA) among patients with psoriasis. The authors aimed to confirm these results using a family-based association study. METHODS: PsA probands, psoriasis probands and their first-degree family members were included. All participants were evaluated for the presence of psoriasis and inflammatory arthritis. HLA-B and -C genotyping was performed. The family-based association test was used to test for differences between PsA and psoriasis patients in transmission of candidate alleles from parents to offspring. RESULTS: A total of 178 PsA and 30 psoriasis probands and 561 first degree family members were analysed. The following HLA alleles were over-transmitted to PsA compared with psoriasis: HLA-C*12 (p=0.005), HLA-B*38 (p=0.04), HLA-B*39 (p=0.03), HLA-B*27 (p=0.002). CONCLUSIONS: HLA-B*27, HLA-B*38, HLA-B*39 and HLA-C*12 alleles are potential PsA-specific genetic markers among patients with psoriasis.

18 Article Patients with psoriatic arthritis have worse quality of life than those with psoriasis alone. 2012

Rosen, Cheryl F / Mussani, Farheen / Chandran, Vinod / Eder, Lihi / Thavaneswaran, Arane / Gladman, Dafna D. ·Toronto Western Hospital,Toronto, ON M5T 2S8, Canada. ·Rheumatology (Oxford) · Pubmed #22157469.

ABSTRACT: OBJECTIVE: PsA is an inflammatory arthritis present in ∼30% of people with psoriasis (PsC). Both conditions have a significant impact on quality of life (QoL). Our objective was to test the hypothesis that people with PsA have poorer QoL than patients with PsC because of the added burden of arthritis, age and comorbidities. METHODS: Consecutive patients with PsA (CASPAR criteria) and PsC were approached to participate in this study. Patients with PsC were examined by a rheumatologist using a standardized protocol to exclude PsA. Patients completed the HAQ, Medical Outcome Study 36-item Short Form Health Survey, Dermatology Life Quality Index (DLQI), EuroQoL 5 domains (EQ-5D) and Fatigue Severity Scale (FSS). Mean scores were compared and multivariate analyses were conducted to compare the QoL measures between the two patient groups. RESULTS: Two hundred and one patients with PsC and 201 patients with PsA were studied. A significant decrease in QoL for patients with PsA compared with those with PsC was identified by all questionnaires except for the DLQI. This skin-specific questionnaire revealed a lower QoL in patients with PsC. Multivariate analyses for each QoL measure confirmed the results of these analyses. After adjusting for age, sex, duration of PsC, comorbidities, DMARDs and biologic therapy, HAQ and DLQI were independently associated with PsA in a logistic regression. CONCLUSION: Patients with PsA have a poorer QoL compared with those with PsC as measured by all questionnaires except the DLQI.

19 Article The association between smoking and the development of psoriatic arthritis among psoriasis patients. 2012

Eder, Lihi / Shanmugarajah, Sutha / Thavaneswaran, Arane / Chandran, Vinod / Rosen, Cheryl F / Cook, Richard J / Gladman, Dafna D. ·Psoriatic Arthritis Clinic, Centre for Prognosis Studies in the Rheumatic Diseases, Toronto Western Hospital, University of Toronto, ON, Canada. ·Ann Rheum Dis · Pubmed #21953342.

ABSTRACT: AIM: To investigate the association between smoking and psoriatic arthritis (PsA) among patients with psoriasis and its interaction with the HLA-C*06 allele. METHODS: In this exploratory case-control study, smoking status was determined at the time of the diagnosis of arthritis for PsA patients and at their first study visit for psoriasis patients, when they were confirmed not to have PsA. The proportions of patients exposed to smoking were compared in patients with PsA to those with psoriasis alone. A logistic regression model was constructed to test the independent association of smoking and PsA after adjusting for potential confounders. The statistical interaction between HLA-C*06 and smoking was tested through a regression model. RESULTS: The proportions of current and past smokers were higher in the psoriasis group compared with the PsA group (30.2% vs 23.4% and 26.7% vs 22.3%, p=0.001, respectively). On multivariate analysis being a current smoker versus a lifetime non-smoker remained inversely associated with PsA (OR 0.57, p=0.002), while past smoker versus lifetime non-smoker status was no longer significant. In a subgroup analysis, smoking remained inversely associated with PsA only among patients who were HLA-C*06 negative. Regression analysis revealed that the interaction between smoking status (ever smoked vs lifetime non-smoker) and HLA-C*06 was statistically significant (p=0.01). CONCLUSION: Smoking may be inversely associated with PsA among psoriasis patients. This association is not present among HLA-C*06-positive individuals.

20 Article Human leucocyte antigen risk alleles for psoriatic arthritis among patients with psoriasis. 2012

Eder, Lihi / Chandran, Vinod / Pellet, Fawnda / Shanmugarajah, Sutha / Rosen, Cheryl F / Bull, Shelley B / Gladman, Dafna D. ·Centre for Prognosis Studies in Rheumatic Diseases, Toronto Western Hospital, Toronto, Canada. ·Ann Rheum Dis · Pubmed #21900282.

ABSTRACT: METHODS: 712 adult patients with PsA, 335 adult patients with PsC and 713 healthy controls were genotyped for HLA-A, HLA-B, HLA-C, HLA-DR and HLA-DQ alleles. Differences in allelic distributions for each of the HLA loci were compared using a likelihood ratio test. Logistic regression analysis of multiple loci was performed to account for linkage disequilibrium. Haplotype information was inferred using the expectation-maximisation algorithm (given HLA-C and HLA-B genotypes) and analysed similarly. RESULTS: The following HLA alleles were found to be significantly associated with patients with PsA compared to patients with PsC in multivariate regression analysis: B*08 (OR 1.61, p=0.009), B*27 (OR 5.17, p<0.0001), B*38 (OR 1.65, p=0.026) and C*06 (OR 0.58, p=0.0002). HLA-B*27, HLA-B*38 and HLA-C*06 frequencies were also significantly higher in patients with PsA than in healthy controls (B*27: OR 3.05, p<0.0001; B*38: OR 5.9, p<0.0001; HLA-C*06: OR 1.71, p<0.0001). The following haplotypes were independently associated with PsA compared to PsC: HLA-B*18-C*07 (OR 10.1, p=0.004), HLA-B*27-C*01 (OR 41.1, p<0.0001), HLA-B*27-C*02 (OR 19.9, p<0.0001), HLA-B*38-C*12 (OR 2.9, p=0.01), HLA-B*08-C*07 (OR 2.6, p=0.004) and HLA-B*57-C*06 (OR 0.5, p=0.03). CONCLUSIONS: Certain HLA-B and HLA-C alleles confer susceptibility to PsA among patients with psoriasis and may be used to identify patients with PsC who may develop PsA.

21 Article Seasonal variation in vitamin D levels in psoriatic arthritis patients from different latitudes and its association with clinical outcomes. 2011

Touma, Zahi / Eder, Lihi / Zisman, Devy / Feld, Joy / Chandran, Vinod / Rosen, Cheryl F / Shen, Hua / Cook, Richard J / Gladman, Dafna D. ·Centre for Prognosis Studiesin the Rheumatic Diseases, Toronto, Ontario, Canada. ·Arthritis Care Res (Hoboken) · Pubmed #22121512.

ABSTRACT: Objective. Vitamin D insufficiency appears to be a pandemic problem and is more common in inhabitants of high latitude compared to low latitude areas. We aimed to determine the prevalence of vitamin D deficiency/insufficiency in patients with psoriatic arthritis (PsA), its seasonal and geographic variation, and the possible association with demographics and disease activity.Methods. This study was conducted in a northern geographic area and in a subtropical region from March 2009 to August 2009. Most subjects were assessed in both winter and summer. Demographics, clinical data, skin photo type, and serum 25-hydroxyvitamin D (25[OH]D) levels were determined. Multivariate linear and logistic mixed models were used to assess the relationship with serum 25(OH)D levels.Results. In total, 302 PsA patients were enrolled. Two hundred fifty-eight patients were evaluated during the winter,while 214 patients were evaluated during the summer. 25(OH)D levels in winter and summer were adequate (north: 41.3%winter and 41.4% summer, south: 42.1% winter and 35.1% summer), insufficient (north: 55.7% winter and 58.6% summer,south: 50.9% winter and 62.2% summer), and deficient (north: 3% winter and 0% summer, south: 7% winter and 2.7%summer) among patients. There was no association between 25(OH)D levels, geographic and seasonal interaction, race,employment status, and skin photo type or disease activity in both seasons. No association between disease activity in summer and vitamin D levels in winter could be found.Conclusion. A high prevalence of vitamin D insufficiency among PsA patients was found. There was no seasonal variation in 25(OH)D levels among PsA patients in the southern and northern sites. No association could be established between disease activity and vitamin D level.

22 Article Cardiovascular and other comorbidities in patients with psoriatic arthritis: a comparison with patients with psoriasis. 2011

Husted, Janice A / Thavaneswaran, Arane / Chandran, Vinod / Eder, Lihi / Rosen, Cheryl F / Cook, Richard J / Gladman, Dafna D. ·University of Waterloo, Waterloo, Ontario, Canada. ·Arthritis Care Res (Hoboken) · Pubmed #21905258.

ABSTRACT: OBJECTIVE: To determine whether the presence of psoriatic arthritis (PsA) is associated with greater comorbidity, in particular cardiovascular morbidity, compared to psoriasis without arthritis. METHODS: Six hundred eleven patients with PsA were recruited from the University of Toronto Psoriatic Arthritis Clinic and 449 psoriasis without arthritis patients were recruited from the University of Toronto Psoriasis Cohort. The clinical database was used to identify the prevalence of cardiovascular and other comorbidities in both PsA and psoriasis without arthritis patients. Univariate and multivariate logistic regression analyses were conducted to estimate odds ratios (ORs), comparing the odds of ever having a given comorbid disease in PsA patients with those in psoriasis without arthritis patients. Covariates included age, sex, education, smoking status, severity and duration of psoriasis, medication status, and other comorbidities. RESULTS: The prevalence of hypertension, obesity, hyperlipidemia, type 2 diabetes mellitus, and at least 1 cardiovascular event in PsA patients was 37.1%, 30.0%, 20.7%, 12.0%, and 8.2%, respectively. This was significantly higher than in psoriasis without arthritis patients, with unadjusted ORs ranging from 1.54 to 2.59. In the multivariate analyses, hypertension remained significantly elevated (adjusted OR 2.17). PsA was also significantly associated with infections not treated with antibiotics (presumably viral), neurologic conditions, gastrointestinal disorders, and liver disease (adjusted ORs 2.83, 4.76, 21.53, and 7.74, respectively). Infections treated with antibiotics and depression/anxiety were relatively common in PsA, with a prevalence of 30.5% and 20.7%, respectively. However, this was not significantly different from psoriasis without arthritis after multivariate adjustments. CONCLUSION: The results suggest that inflammatory joint disease may play a role in both cardiovascular and noncardiovascular morbidity in PsA.

23 Article IL13 gene polymorphism is a marker for psoriatic arthritis among psoriasis patients. 2011

Eder, Lihi / Chandran, Vinod / Pellett, Fawnda / Pollock, Remy / Shanmugarajah, Sutha / Rosen, Cheryl F / Rahman, Proton / Gladman, Dafna D. ·Centre for Prognosis Studies in the Rheumatic Diseases, University of Toronto Psoriatic Arthritis Clinic, Toronto Western Hospital, Toronto, Ontario, Canada. ·Ann Rheum Dis · Pubmed #21613309.

ABSTRACT: AIM: To study the association between smoking and IL13 gene polymorphisms with psoriatic arthritis (PsA) and psoriasis. METHODS: The authors genotyped three groups of Caucasians: those with PsA, those with psoriasis without arthritis (PsC) and healthy controls for the rs20541 and rs848 IL13 single nucleotide polymorphisms (SNPs). An additional SNP, rs1800925, was genotyped only in the PsA and PsC groups. The differences in allelic distributions were compared by χ(2) test. The prevalence of smoking was compared between people with PsA and those with PsC. The combined effect of genotype and smoking was tested by comparing the frequencies of different combinations of rs1800925 genotype and smoking status in PsA and PsC. RESULTS: 555 PsA patients, 342 PsC patients and 217 healthy controls were included in the study. Smoking was less prevalent in patients with PsA compared with PsC (47.4% vs 59.4%, p<0.0006). rs20541*G and rs848*C alleles were associated with PsA compared with controls (OR 1.64, p=0.0005, OR 1.61, p=0.0007 respectively). The association between these alleles and PsC compared with controls was only of borderline significance (OR 1.33, p=0.06, OR 1.26, p=0.11 respectively). Two major alleles, rs1800925*C (OR 1.28, p=0.045) and rs848*C (OR 1.30, p=0.047) were increased in PsA compared with PsC. The combination of non-smoking and the genotype rs1800925*CC was associated with increased susceptibility to PsA compared with PsC. Among smokers, rs1800925*CC was not associated with PsA compared with PsC. CONCLUSIONS: IL13 gene polymorphism is associated with increased susceptibility to PsA in psoriasis patients.

24 Article Association between environmental factors and onset of psoriatic arthritis in patients with psoriasis. 2011

Eder, Lihi / Law, Tamryn / Chandran, Vinod / Shanmugarajah, Sutha / Shen, Hua / Rosen, Cheryl F / Cook, Richard J / Gladman, Dafna D. ·Toronto Western Hospital, 399 Bathurst Street, Toronto, Ontario, Canada. ·Arthritis Care Res (Hoboken) · Pubmed #21560259.

ABSTRACT: OBJECTIVE: To investigate the association between potential environmental exposures and the development of psoriatic arthritis (PsA) in patients with psoriasis. METHODS: In this case-control study, the cases were patients with recent-onset PsA. The controls were psoriasis patients without arthritis. The occurrence of the following environmental exposures was recorded through a standardized questionnaire: smoking, alcohol consumption, infections, injuries, physically demanding occupational tasks, stressful life events, vaccinations, and female hormonal exposures. The association between each exposure to environmental events and disease status was assessed through logistic regression after adjustment for age, sex, education level, and duration and severity of psoriasis. RESULTS: There were 159 subjects in each group. The following exposures remained significantly associated with PsA following multivariate logistic regression: lifting cumulative loads of at least 100 pounds/hour (odds ratio [OR] 2.8, 95% confidence interval [95% CI] 1.51-5.05), infections that required antibiotics (OR 1.7, 95% CI 1.00-2.77), smoking (OR 0.6, 95% CI 0.36-0.89), and injuries (OR 2.1, 95% CI 1.11-4.01). The results were not appreciably changed with the inclusion of each of these factors in a single regression model; however, the level of significance for injuries had become borderline. No association was found between PsA and alcohol consumption, vaccination, stressful life events, and female hormonal exposures. CONCLUSION: Lifting heavy loads and infections that required antibiotics were associated with the occurrence of arthritis among patients with psoriasis. There was an inverse association between smoking and PsA. Further studies are necessary to determine whether these and other environmental factors are moderated by predisposing genetic factors.

25 Article Incidence of arthritis in a prospective cohort of psoriasis patients. 2011

Eder, Lihi / Chandran, Vinod / Shen, Hua / Cook, Richard J / Shanmugarajah, Sutha / Rosen, Cheryl F / Gladman, Dafna D. ·University of Toronto Psoriatic Arthritis Clinic, Centre for Prognosis Studies in the Rheumatic Diseases 1E-410B, Toronto Western Hospital, 399 Bathurst Street, Toronto, Ontario, Canada M5T 2S8. ·Arthritis Care Res (Hoboken) · Pubmed #21452273.

ABSTRACT: OBJECTIVE: Epidemiologic studies about the incidence of psoriatic arthritis (PsA) are limited to a few population-based studies. There are limited data regarding the incidence of PsA in patients with psoriasis. We aimed to determine the incidence of PsA among a prospective cohort of psoriasis patients. METHODS: The setting is a prospective longitudinal cohort study of psoriasis patients without arthritis. The patients are assessed annually by a rheumatologist in order to detect the onset of arthritis. We summarize the results of 4 years of followup and report the cumulative incidence of PsA from the time of entry to the study that was estimated using an event per person-years analysis and a nonparametric analysis. RESULTS: Three hundred thirteen psoriasis patients that had at least 1 year of followup were included in the analysis. The annual incidence rate was found to be 1.87 (95% confidence interval 0.71-3.03) PsA cases per 100 psoriasis patients. CONCLUSION: The incidence rate of PsA in patients with psoriasis may be higher than previously reported, particularly among patients with moderate to severe psoriasis.

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