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Supplemental material, sj-docx-1-tab-10.1177_1759720X221149965 for Association between baseline cardiovascular risk and incidence rates of major adverse cardiovascular events and malignancies in patients with psoriatic arthritis and psoriasis receiving tofacitinib by Lars E. Kristensen, Bruce Strober, Denis Poddubnyy, Ying-Ying Leung, Hyejin Jo, Kenneth Kwok, Ivana Vranic, Dona L. Fleishaker, Lara Fallon, Arne Yndestad and Dafna D. Gladman in Therapeutic Advances in Musculoskeletal Disease

Additional file 1. STAR Trial Registration Data.

Additional file 2. STAR Trial SPIRIT Checklist.

Supplemental material, sj-docx-1-tab-10.1177_1759720X211057975 for Axial Involvement in Psoriatic Arthritis cohort (AXIS): the protocol of a joint project of the Assessment of SpondyloArthritis international Society (ASAS) and the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA) by Denis Poddubnyy, Xenofon Baraliakos, Filip Van den Bosch, J��rgen Braun, Laura C. Coates, Vinod Chandran, Torsten Diekhoff, Floris A. van Gaalen, Lianne S. Gensler, Niti Goel, Alice B. Gottlieb, D��sir��e van der Heijde, Philip S. Helliwell, Kay Geert A. Hermann, Deepak Jadon, Robert G. Lambert, Walter P. Maksymowych, Philip Mease, Peter Nash, Fabian Proft, Mikhail Protopopov, Joachim Sieper, Murat Torgutalp and Dafna D. Gladman in Therapeutic Advances in Musculoskeletal Disease

Supplemental material, sj-docx-2-tab-10.1177_1759720X211057975 for Axial Involvement in Psoriatic Arthritis cohort (AXIS): the protocol of a joint project of the Assessment of SpondyloArthritis international Society (ASAS) and the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA) by Denis Poddubnyy, Xenofon Baraliakos, Filip Van den Bosch, J��rgen Braun, Laura C. Coates, Vinod Chandran, Torsten Diekhoff, Floris A. van Gaalen, Lianne S. Gensler, Niti Goel, Alice B. Gottlieb, D��sir��e van der Heijde, Philip S. Helliwell, Kay Geert A. Hermann, Deepak Jadon, Robert G. Lambert, Walter P. Maksymowych, Philip Mease, Peter Nash, Fabian Proft, Mikhail Protopopov, Joachim Sieper, Murat Torgutalp and Dafna D. Gladman in Therapeutic Advances in Musculoskeletal Disease

Supplemental material, Table S1, for Assessment of the Toronto Psoriatic Arthritis Screen 2 as a Screening Tool for Psoriasis by Jennifer H. Taylor, Maneka Deo, Mitchell Sutton, Vinod Chandran, Sutha Shanmugarajah, Daniel Pereira, Dafna D. Gladman and Cheryl F. Rosen in Journal of Cutaneous Medicine & Surgery

Additional file 1 : Table S1. PROs included in the analysis. Table listing PROs and their descriptions included in the analysis of ScoreMDA and PASDAS.

Supplemental material, Supplementary Material 1, for Assessment of the Toronto Psoriatic Arthritis Screen 2 as a Screening Tool for Psoriasis by Jennifer H. Taylor, Maneka Deo, Mitchell Sutton, Vinod Chandran, Sutha Shanmugarajah, Daniel Pereira, Dafna D. Gladman and Cheryl F. Rosen in Journal of Cutaneous Medicine & Surgery

Supplemental material, sj-docx-2-tab-10.1177_1759720X211057975 for Axial Involvement in Psoriatic Arthritis cohort (AXIS): the protocol of a joint project of the Assessment of SpondyloArthritis international Society (ASAS) and the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA) by Denis Poddubnyy, Xenofon Baraliakos, Filip Van den Bosch, J��rgen Braun, Laura C. Coates, Vinod Chandran, Torsten Diekhoff, Floris A. van Gaalen, Lianne S. Gensler, Niti Goel, Alice B. Gottlieb, D��sir��e van der Heijde, Philip S. Helliwell, Kay Geert A. Hermann, Deepak Jadon, Robert G. Lambert, Walter P. Maksymowych, Philip Mease, Peter Nash, Fabian Proft, Mikhail Protopopov, Joachim Sieper, Murat Torgutalp and Dafna D. Gladman in Therapeutic Advances in Musculoskeletal Disease

Supplemental Material, PsAID12_Supplement for Evidence for Psoriatic Arthritis Impact of Disease (PsAID12) as Core Instrument to Measure Health-Related Quality of Life in Psoriatic Arthritis: A Systematic Review of Psychometric Properties by Richard Holland, Pil Højgaard, William Tillett, Laure Gossec, Maarten de Wit, Robin Christensen, Neil McHugh, Dafna D. Gladman, Philip Mease, Oliver FitzGerald, Beverly Shea, Peter Tugwell, Dorcas Beaton, Ana-Maria Orbai and GRAPPA-OMERACT PsA Working Group in Journal of Psoriasis and Psoriatic Arthritis

Supplemental Material, Appendix_4_Study_Selection_Process for 2018 American College of Rheumatology/National Psoriasis Foundation Guideline for the Treatment of Psoriatic Arthritis by Jasvinder A. Singh, Gordon Guyatt, Alexis Ogdie, Dafna D. Gladman, Chad Deal, Atul Deodhar, Maureen Dubreuil, Jonathan Dunham, M. Elaine Husni, Sarah Kenny, Jennifer Kwan-Morley, Janice Lin, Paula Marchetta, Philip J. Mease, Joseph F. Merola, Julie Miner, Christopher T. Ritchlin, Bernadette Siaton, Benjamin J. Smith, Abby S. Van Voorhees, Anna Helena Jonsson, Amit Aakash Shah, Nancy Sullivan, Marat Turgunbaev, Laura C. Coates, Alice Gottlieb, Marina Magrey, W. Benjamin Nowell, Ana-Maria Orbai, Soumya M. Reddy, Jose U. Scher, Evan Siegel, Michael Siegel, Jessica A. Walsh, Amy S. Turner, and James Reston in Journal of Psoriasis and Psoriatic Arthritis

Supplemental Material, Singh_ART40726_Supplementary_Appendix_1_Methods for 2018 American College of Rheumatology/National Psoriasis Foundation Guideline for the Treatment of Psoriatic Arthritis by Jasvinder A. Singh, Gordon Guyatt, Alexis Ogdie, Dafna D. Gladman, Chad Deal, Atul Deodhar, Maureen Dubreuil, Jonathan Dunham, M. Elaine Husni, Sarah Kenny, Jennifer Kwan-Morley, Janice Lin, Paula Marchetta, Philip J. Mease, Joseph F. Merola, Julie Miner, Christopher T. Ritchlin, Bernadette Siaton, Benjamin J. Smith, Abby S. Van Voorhees, Anna Helena Jonsson, Amit Aakash Shah, Nancy Sullivan, Marat Turgunbaev, Laura C. Coates, Alice Gottlieb, Marina Magrey, W. Benjamin Nowell, Ana-Maria Orbai, Soumya M. Reddy, Jose U. Scher, Evan Siegel, Michael Siegel, Jessica A. Walsh, Amy S. Turner, and James Reston in Journal of Psoriasis and Psoriatic Arthritis

Supplemental Material, Appendixs5_revised for 2018 American College of Rheumatology/National Psoriasis Foundation Guideline for the Treatment of Psoriatic Arthritis by Jasvinder A. Singh, Gordon Guyatt, Alexis Ogdie, Dafna D. Gladman, Chad Deal, Atul Deodhar, Maureen Dubreuil, Jonathan Dunham, M. Elaine Husni, Sarah Kenny, Jennifer Kwan-Morley, Janice Lin, Paula Marchetta, Philip J. Mease, Joseph F. Merola, Julie Miner, Christopher T. Ritchlin, Bernadette Siaton, Benjamin J. Smith, Abby S. Van Voorhees, Anna Helena Jonsson, Amit Aakash Shah, Nancy Sullivan, Marat Turgunbaev, Laura C. Coates, Alice Gottlieb, Marina Magrey, W. Benjamin Nowell, Ana-Maria Orbai, Soumya M. Reddy, Jose U. Scher, Evan Siegel, Michael Siegel, Jessica A. Walsh, Amy S. Turner, and James Reston in Journal of Psoriasis and Psoriatic Arthritis

Supplemental Material, Appendix_2_Panel,_Teams_Involved for 2018 American College of Rheumatology/National Psoriasis Foundation Guideline for the Treatment of Psoriatic Arthritis by Jasvinder A. Singh, Gordon Guyatt, Alexis Ogdie, Dafna D. Gladman, Chad Deal, Atul Deodhar, Maureen Dubreuil, Jonathan Dunham, M. Elaine Husni, Sarah Kenny, Jennifer Kwan-Morley, Janice Lin, Paula Marchetta, Philip J. Mease, Joseph F. Merola, Julie Miner, Christopher T. Ritchlin, Bernadette Siaton, Benjamin J. Smith, Abby S. Van Voorhees, Anna Helena Jonsson, Amit Aakash Shah, Nancy Sullivan, Marat Turgunbaev, Laura C. Coates, Alice Gottlieb, Marina Magrey, W. Benjamin Nowell, Ana-Maria Orbai, Soumya M. Reddy, Jose U. Scher, Evan Siegel, Michael Siegel, Jessica A. Walsh, Amy S. Turner, and James Reston in Journal of Psoriasis and Psoriatic Arthritis

Supplemental Material, Appendix_6_Strong_Recommendations.docx for 2018 American College of Rheumatology/National Psoriasis Foundation Guideline for the Treatment of Psoriatic Arthritis by Jasvinder A. Singh, Gordon Guyatt, Alexis Ogdie, Dafna D. Gladman, Chad Deal, Atul Deodhar, Maureen Dubreuil, Jonathan Dunham, M. Elaine Husni, Sarah Kenny, Jennifer Kwan-Morley, Janice Lin, Paula Marchetta, Philip J. Mease, Joseph F. Merola, Julie Miner, Christopher T. Ritchlin, Bernadette Siaton, Benjamin J. Smith, Abby S. Van Voorhees, Anna Helena Jonsson, Amit Aakash Shah, Nancy Sullivan, Marat Turgunbaev, Laura C. Coates, Alice Gottlieb, Marina Magrey, W. Benjamin Nowell, Ana-Maria Orbai, Soumya M. Reddy, Jose U. Scher, Evan Siegel, Michael Siegel, Jessica A. Walsh, Amy S. Turner, and James Reston in Journal of Psoriasis and Psoriatic Arthritis

Supplemental Material, Appendix_1_Methods for 2018 American College of Rheumatology/National Psoriasis Foundation Guideline for the Treatment of Psoriatic Arthritis by Jasvinder A. Singh, Gordon Guyatt, Alexis Ogdie, Dafna D. Gladman, Chad Deal, Atul Deodhar, Maureen Dubreuil, Jonathan Dunham, M. Elaine Husni, Sarah Kenny, Jennifer Kwan-Morley, Janice Lin, Paula Marchetta, Philip J. Mease, Joseph F. Merola, Julie Miner, Christopher T. Ritchlin, Bernadette Siaton, Benjamin J. Smith, Abby S. Van Voorhees, Anna Helena Jonsson, Amit Aakash Shah, Nancy Sullivan, Marat Turgunbaev, Laura C. Coates, Alice Gottlieb, Marina Magrey, W. Benjamin Nowell, Ana-Maria Orbai, Soumya M. Reddy, Jose U. Scher, Evan Siegel, Michael Siegel, Jessica A. Walsh, Amy S. Turner, and James Reston in Journal of Psoriasis and Psoriatic Arthritis

Supplemental Material, Singh_ART40726_Supplementary_Appendix_4_Study_Selection_Process for 2018 American College of Rheumatology/National Psoriasis Foundation Guideline for the Treatment of Psoriatic Arthritis by Jasvinder A. Singh, Gordon Guyatt, Alexis Ogdie, Dafna D. Gladman, Chad Deal, Atul Deodhar, Maureen Dubreuil, Jonathan Dunham, M. Elaine Husni, Sarah Kenny, Jennifer Kwan-Morley, Janice Lin, Paula Marchetta, Philip J. Mease, Joseph F. Merola, Julie Miner, Christopher T. Ritchlin, Bernadette Siaton, Benjamin J. Smith, Abby S. Van Voorhees, Anna Helena Jonsson, Amit Aakash Shah, Nancy Sullivan, Marat Turgunbaev, Laura C. Coates, Alice Gottlieb, Marina Magrey, W. Benjamin Nowell, Ana-Maria Orbai, Soumya M. Reddy, Jose U. Scher, Evan Siegel, Michael Siegel, Jessica A. Walsh, Amy S. Turner, and James Reston in Journal of Psoriasis and Psoriatic Arthritis

Supplemental Material, Appendix_3_PsA_Search_Strategies for 2018 American College of Rheumatology/National Psoriasis Foundation Guideline for the Treatment of Psoriatic Arthritis by Jasvinder A. Singh, Gordon Guyatt, Alexis Ogdie, Dafna D. Gladman, Chad Deal, Atul Deodhar, Maureen Dubreuil, Jonathan Dunham, M. Elaine Husni, Sarah Kenny, Jennifer Kwan-Morley, Janice Lin, Paula Marchetta, Philip J. Mease, Joseph F. Merola, Julie Miner, Christopher T. Ritchlin, Bernadette Siaton, Benjamin J. Smith, Abby S. Van Voorhees, Anna Helena Jonsson, Amit Aakash Shah, Nancy Sullivan, Marat Turgunbaev, Laura C. Coates, Alice Gottlieb, Marina Magrey, W. Benjamin Nowell, Ana-Maria Orbai, Soumya M. Reddy, Jose U. Scher, Evan Siegel, Michael Siegel, Jessica A. Walsh, Amy S. Turner, and James Reston in Journal of Psoriasis and Psoriatic Arthritis

Supplemental Material, Singh_ART40726_Supplementary_Appendix_2_Panel,_Teams_Involved for 2018 American College of Rheumatology/National Psoriasis Foundation Guideline for the Treatment of Psoriatic Arthritis by Jasvinder A. Singh, Gordon Guyatt, Alexis Ogdie, Dafna D. Gladman, Chad Deal, Atul Deodhar, Maureen Dubreuil, Jonathan Dunham, M. Elaine Husni, Sarah Kenny, Jennifer Kwan-Morley, Janice Lin, Paula Marchetta, Philip J. Mease, Joseph F. Merola, Julie Miner, Christopher T. Ritchlin, Bernadette Siaton, Benjamin J. Smith, Abby S. Van Voorhees, Anna Helena Jonsson, Amit Aakash Shah, Nancy Sullivan, Marat Turgunbaev, Laura C. Coates, Alice Gottlieb, Marina Magrey, W. Benjamin Nowell, Ana-Maria Orbai, Soumya M. Reddy, Jose U. Scher, Evan Siegel, Michael Siegel, Jessica A. Walsh, Amy S. Turner, and James Reston in Journal of Psoriasis and Psoriatic Arthritis

Supplemental Material, Singh_ART40726_Supplementary_Appendix_3_PsA_Search_Strategies for 2018 American College of Rheumatology/National Psoriasis Foundation Guideline for the Treatment of Psoriatic Arthritis by Jasvinder A. Singh, Gordon Guyatt, Alexis Ogdie, Dafna D. Gladman, Chad Deal, Atul Deodhar, Maureen Dubreuil, Jonathan Dunham, M. Elaine Husni, Sarah Kenny, Jennifer Kwan-Morley, Janice Lin, Paula Marchetta, Philip J. Mease, Joseph F. Merola, Julie Miner, Christopher T. Ritchlin, Bernadette Siaton, Benjamin J. Smith, Abby S. Van Voorhees, Anna Helena Jonsson, Amit Aakash Shah, Nancy Sullivan, Marat Turgunbaev, Laura C. Coates, Alice Gottlieb, Marina Magrey, W. Benjamin Nowell, Ana-Maria Orbai, Soumya M. Reddy, Jose U. Scher, Evan Siegel, Michael Siegel, Jessica A. Walsh, Amy S. Turner, and James Reston in Journal of Psoriasis and Psoriatic Arthritis

Supplemental Material, Singh_ART40726_Supplementary_Appendix_5_Evidence_Report for 2018 American College of Rheumatology/National Psoriasis Foundation Guideline for the Treatment of Psoriatic Arthritis by Jasvinder A. Singh, Gordon Guyatt, Alexis Ogdie, Dafna D. Gladman, Chad Deal, Atul Deodhar, Maureen Dubreuil, Jonathan Dunham, M. Elaine Husni, Sarah Kenny, Jennifer Kwan-Morley, Janice Lin, Paula Marchetta, Philip J. Mease, Joseph F. Merola, Julie Miner, Christopher T. Ritchlin, Bernadette Siaton, Benjamin J. Smith, Abby S. Van Voorhees, Anna Helena Jonsson, Amit Aakash Shah, Nancy Sullivan, Marat Turgunbaev, Laura C. Coates, Alice Gottlieb, Marina Magrey, W. Benjamin Nowell, Ana-Maria Orbai, Soumya M. Reddy, Jose U. Scher, Evan Siegel, Michael Siegel, Jessica A. Walsh, Amy S. Turner, and James Reston in Journal of Psoriasis and Psoriatic Arthritis

Systemic lupus erythematosus (SLE) is an autoimmune disease with marked gender and ethnic disparities. We report a large transancestral association study of SLE using Immunochip genotype data from 27,574 individuals of European (EA), African (AA) and Hispanic Amerindian (HA) ancestry. We identify 58 distinct non-HLA regions in EA, 9 in AA and 16 in HA (∼50% of these regions have multiple independent associations); these include 24 novel SLE regions (P

OBJECTIVE: To examine the frequency, characteristics, and outcome of mood disorders, as well as clinical and autoantibody associations, in a multiethnic/racial, prospective inception cohort of patients with systemic lupus erythematosus (SLE). METHODS: Patients were assessed annually for mood disorders (4 types, according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition) and 18 other neuropsychiatric events. Global disease activity scores (SLE Disease Activity Index 2000 [SLEDAI-2K]), damage scores (Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index [SDI]), and Short Form 36 subscales, mental and physical component summary scores were collected. Time to event, linear and ordinal regressions, and multi-state models were used as appropriate. RESULTS: Among the 1,827 patients with SLE, 88.9% were female, and 48.9% were Caucasian. The mean ± SD age of the patients was 35.1 ± 13.3 years, disease duration was 5.6 ± 4.8 months, and the length of followup was 4.7 ± 3.5 years. During the course of the study, 863 (47.2%) of the 1,827 patients had 1,627 neuropsychiatric events. Mood disorders occurred in 232 (12.7%) of 1,827 patients, and 98 (38.3%) of 256 mood disorder events were attributed to SLE. The estimated cumulative incidence of any mood disorder after 10 years was 17.7% (95% confidence interval 15.1, 20.2%). A greater risk of mood disorder was associated with concurrent neuropsychiatric events (P ≤ 0.01), and a lower risk was associated with Asian race/ethnicity (P = 0.01) and treatment with immunosuppressive drugs (P = 0.003). Mood disorders were associated with lower mental health and mental component summary scores but not with the SLEDAI-2K, SDI, or lupus autoantibodies. Among the 232 patients with depression, 168 (72.4%) were treated with antidepressants. One hundred twenty-six (49.2%) of 256 mood disorders resolved in 117 (50.4%) of 232 patients. CONCLUSION: Mood disorders, the second most frequent neuropsychiatric event in patients with SLE, have a negative impact on health-related quality of life and improve over time. The lack of association with global SLE disease activity, cumulative organ damage, and lupus autoantibodies emphasizes the multifactorial etiology of mood disorders and a role for non-lupus-specific therapies.

This article reviews recent advances in psoriatic arthritis (PsA) over the past several years with emphasis on early diagnosis, better understanding of pathogenesis, and new therapeutic approaches. Early diagnosis is important, since people who present late do not fare as well. There are a number of clinical, laboratory, and ultrasound features that can help identify patients destined to develop PsA, and several screening tools have been developed. It is recognized that genetic and epigenetic factors, as well as T cells and cytokines, play a role in the pathogenesis of PsA, and several targets have been identified for therapeutic interventions. New therapies have been developed and tested in PsA and have been found to be highly effective for both skin and joint manifestations of the disease. The expectation is that, in the future, PsA patients will be treated early and more aggressively and that there will not be significant progression of joint damage. Moreover, with effective treatment of the skin and joint disease and management of risk factors for the comorbidities, we can expect to reduce their occurrence and further reduce the excess mortality and reduced quality of life and function in these patients.

OBJECTIVE: To determine the frequency, characteristics, and outcomes of cerebrovascular events (CerVEs), as well as clinical and autoantibody associations in a multiethnic/racial inception cohort of patients with systemic lupus erythematosus (SLE). METHODS: A total of 1,826 patients were assessed annually for 19 neuropsychiatric (NP) events, including 5 types of CerVEs: 1) stroke, 2) transient ischemia, 3) chronic multifocal ischemia, 4) subarachnoid/intracranial hemorrhage, and 5) sinus thrombosis. Global disease activity (Systemic Lupus Erythematosus Disease [SLE] Activity Index 2000), damage scores (SLE International Collaborating Clinics/American College of Rheumatology Damage Index), and Short Form 36 (SF-36) scores were collected. Time to event, linear and logistic regressions, and multistate models were used as appropriate. RESULTS: CerVEs were the fourth most frequent NP event: 82 of 1,826 patients had 109 events; of these events, 103 were attributed to SLE, and 44 were identified at the time of enrollment. The predominant events were stroke (60 of 109 patients) and transient ischemia (28 of 109 patients). CerVEs were associated with other NP events attributed to SLE, non-SLE-attributed NP events, African ancestry (at US SLICC sites), and increased organ damage scores. Lupus anticoagulant increased the risk of first stroke and sinus thrombosis and transient ischemic attack. Physician assessment indicated resolution or improvement in the majority of patients, but patients reported sustained reduction in SF-36 summary and subscale scores following a CerVE. CONCLUSION: CerVEs, the fourth most frequent NP event in SLE, are usually attributable to lupus. In contrast to good physician-reported outcomes, patients reported a sustained reduction in health-related quality of life following a CerVE.

OBJECTIVE: To examine the frequency, characteristics, and outcome of mood disorders, as well as clinical and autoantibody associations, in a multiethnic/racial, prospective inception cohort of patients with systemic lupus erythematosus (SLE). METHODS: Patients were assessed annually for mood disorders (4 types, according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition) and 18 other neuropsychiatric events. Global disease activity scores (SLE Disease Activity Index 2000 [SLEDAI-2K]), damage scores (Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index [SDI]), and Short Form 36 subscales, mental and physical component summary scores were collected. Time to event, linear and ordinal regressions, and multi-state models were used as appropriate. RESULTS: Among the 1,827 patients with SLE, 88.9% were female, and 48.9% were Caucasian. The mean ± SD age of the patients was 35.1 ± 13.3 years, disease duration was 5.6 ± 4.8 months, and the length of followup was 4.7 ± 3.5 years. During the course of the study, 863 (47.2%) of the 1,827 patients had 1,627 neuropsychiatric events. Mood disorders occurred in 232 (12.7%) of 1,827 patients, and 98 (38.3%) of 256 mood disorder events were attributed to SLE. The estimated cumulative incidence of any mood disorder after 10 years was 17.7% (95% confidence interval 15.1, 20.2%). A greater risk of mood disorder was associated with concurrent neuropsychiatric events (P ≤ 0.01), and a lower risk was associated with Asian race/ethnicity (P = 0.01) and treatment with immunosuppressive drugs (P = 0.003). Mood disorders were associated with lower mental health and mental component summary scores but not with the SLEDAI-2K, SDI, or lupus autoantibodies. Among the 232 patients with depression, 168 (72.4%) were treated with antidepressants. One hundred twenty-six (49.2%) of 256 mood disorders resolved in 117 (50.4%) of 232 patients. CONCLUSION: Mood disorders, the second most frequent neuropsychiatric event in patients with SLE, have a negative impact on health-related quality of life and improve over time. The lack of association with global SLE disease activity, cumulative organ damage, and lupus autoantibodies emphasizes the multifactorial etiology of mood disorders and a role for non-lupus-specific therapies.

BACKGROUND AND AIMS: We studied damage accrual and factors determining development and progression of damage in an international cohort of systemic lupus erythematosus (SLE) patients. METHODS: The Systemic Lupus International Collaborating Clinics (SLICC) Inception Cohort recruited patients within 15 months of developing four or more 1997 American College of Rheumatology (ACR) criteria for SLE; the SLICC/ACR damage index (SDI) was measured annually. We assessed relative rates of transition using maximum likelihood estimation in a multistate model. The Kaplan-Meier method estimated the probabilities for time to first increase in SDI score and Cox regression analysis was used to assess mortality. RESULTS: We recruited 1722 patients; mean (SD) age 35.0 (13.4) years at cohort entry. Patients with damage at enrolment were more likely to have further worsening of SDI (SDI 0 vs ≥1; p

OBJECTIVE: Little is known about the long-term costs of lupus nephritis (LN). The costs were compared between patients with and without LN using multistate modeling. METHODS: Patients from 32 centers in 11 countries were enrolled in the Systemic Lupus International Collaborating Clinics inception cohort within 15 months of diagnosis and provided annual data on renal function, hospitalizations, medications, dialysis, and selected procedures. LN was diagnosed by renal biopsy or the American College of Rheumatology classification criteria. Renal function was assessed annually using the estimated glomerular filtration rate (GFR) or estimated proteinuria. A multistate model was used to predict 10-year cumulative costs by multiplying annual costs associated with each renal state by the expected state duration. RESULTS: A total of 1,545 patients participated; 89.3% were women, the mean ± age at diagnosis was 35.2 ± 13.4 years, 49% were white, and the mean followup duration was 6.3 ± 3.3 years. LN developed in 39.4% of these patients by the end of followup. Ten-year cumulative costs were greater in those with LN and an estimated glomerular filtration rate (GFR) 60 ml/minute) or with LN and estimated proteinuria >3 gm/day ($84,040 versus $20,499 if no LN and estimated proteinuria

OBJECTIVE: To determine the frequency, clinical characteristics, associations, and outcomes of different types of peripheral nervous system (PNS) disease in a multiethnic/multiracial, prospective inception cohort of systemic lupus erythematosus (SLE) patients. METHODS: Patients were evaluated annually for 19 neuropsychiatric (NP) events including 7 types of PNS disease. SLE disease activity, organ damage, autoantibodies, and patient and physician assessment of outcome were measured. Time to event and linear regressions were used as appropriate. RESULTS: Of 1,827 SLE patients, 88.8% were female, and 48.8% were white. The mean ± SD age was 35.1 ± 13.3 years, disease duration at enrollment was 5.6 ± 4.2 months, and follow-up was 7.6 ± 4.6 years. There were 161 PNS events in 139 (7.6%) of 1,827 patients. The predominant events were peripheral neuropathy (66 of 161 [41.0%]), mononeuropathy (44 of 161 [27.3%]), and cranial neuropathy (39 of 161 [24.2%]), and the majority were attributed to SLE. Multivariate Cox regressions suggested longer time to resolution in patients with a history of neuropathy, older age at SLE diagnosis, higher SLE Disease Activity Index 2000 scores, and for peripheral neuropathy versus other neuropathies. Neuropathy was associated with significantly lower Short Form 36 (SF-36) physical and mental component summary scores versus no NP events. According to physician assessment, the majority of neuropathies resolved or improved over time, which was associated with improvements in SF-36 summary scores for peripheral neuropathy and mononeuropathy. CONCLUSION: PNS disease is an important component of total NPSLE and has a significant negative impact on health-related quality of life. The outcome is favorable for most patients, but our findings indicate that several factors are associated with longer time to resolution.

Background/objectives The European League Against Rheumatism (EULAR)/American College of Rheumatology (ACR) 2019 classification criteria for systemic lupus erythematosus system showed high specificity, while attaining also high sensitivity. We hereby analysed the performance of the individual criteria items and their contribution to the overall performance of the criteria. Methods We combined the EULAR/ACR derivation and validation cohorts for a total of 1197 systemic lupus erythematosus (SLE) and n=1074 non-SLE patients with a variety of conditions mimicking SLE, such as other autoimmune diseases, and calculated the sensitivity and specificity for antinuclear antibodies (ANA) and the 23 specific criteria items. We also tested performance omitting the EULAR/ACR criteria attribution rule, which defines that items are only counted if not more likely explained by a cause other than SLE. Results Positive ANA, the new entry criterion, was 99.5% sensitive, but only 19.4% specific, against a non-SLE population that included other inflammatory rheumatic, infectious, malignant and metabolic diseases. The specific criteria items were highly variable in sensitivity (from 0.42% for delirium and 1.84% for psychosis to 75.6% for antibodies to double-stranded DNA), but their specificity was uniformly high, with low C3 or C4 (83.0%) and leucopenia Conclusions Changing the position of the highly sensitive, non-specific ANA to an entry criterion and the attribution rule resulted in a specificity of >80% for all items, explaining the higher overall specificity of the criteria set.

Funder: American College of Rheumatology Research and Education Foundation; FundRef: http://dx.doi.org/10.13039/100000960, Funder: National Institute of Arthritis and Musculoskeletal and Skin Diseases; FundRef: http://dx.doi.org/10.13039/100000069, Funder: European League Against Rheumatism; FundRef: http://dx.doi.org/10.13039/501100008741, OBJECTIVES: The European League Against Rheumatism (EULAR)/American College of Rheumatology (ACR) 2019 Classification Criteria for systemic lupus erythematosus (SLE) have been validated with high sensitivity and specificity. We evaluated the performance of the new criteria with regard to disease duration, sex and race/ethnicity, and compared its performance against the Systemic Lupus International Collaborating Clinics (SLICC) 2012 and ACR 1982/1997 criteria. METHODS: Twenty-one SLE centres from 16 countries submitted SLE cases and mimicking controls to form the validation cohort. The sensitivity and specificity of the EULAR/ACR 2019, SLICC 2012 and ACR 1982/1997 criteria were evaluated. RESULTS: The cohort consisted of female (n=1098), male (n=172), Asian (n=118), black (n=68), Hispanic (n=124) and white (n=941) patients; with an SLE duration of 1 to

Objective.Physician’s global assessment (PGA) of disease activity is a major determinant of therapeutic decision making. This study assesses the reliability of the PGA, measured by means of 0–100 mm visual analog scale (VAS), and the additional use of separate VAS scales for musculoskeletal (PhysMSK) and dermatologic (PhysSk) manifestations in patients with psoriatic arthritis (PsA).Methods.Sixteen centers from 8 countries enrolled 319 consecutive patients with PsA. PGA, PhysMSK, and PhysSk evaluation forms were administered at enrollment (W0) and after 1 week (W1). Detailed clinical data regarding musculoskeletal (MSK) manifestations, as well as dermatological assessment, were recorded.Results.Comparison of W0 and W1 scores showed no significant variation (intraclass correlation coefficients were PGA 0.87, PhysMSK 0.86, PhysSk 0.78), demonstrating the reliability of the instrument. PGA scores were dependent on PhysMSK and PhysSk (p < 0.0001) with a major effect of the MSK component (B = 0.69) compared to skin (B = 0.32). PhysMSK was correlated with the number of swollen joints, tender joints, and presence of dactylitis (p < 0.0001). PhysSk scores were correlated with the extent of skin psoriasis and by face, buttocks or intergluteal, and feet involvement (p < 0.0001). Finally, physician and patient assessments were compared showing frequent mismatch and a scattered dot plot: PGA versus patient’s global assessment (r = 0.36), PhysMSK versus patient MSK (r = 0.39), and PhysSk versus patient skin (r = 0.49).Conclusion.PGA assessed by means of VAS is a reliable tool to assess MSK and dermatological disease activity. PGA may diverge from patient self-evaluation. Because MSK and skin/nail disease activity may diverge, it is suggested that both PhysMSK and PhysSk are assessed.