Search

Your search keyword '"Lyddell C"' showing total 2 results
Start Over Author "Lyddell C" Publication Year Range Last 10 years
2 results on '"Lyddell C"'

1. Overweight, Obesity, and the Likelihood of Achieving Sustained Remission in Early Rheumatoid Arthritis: Results From a Multicenter Prospective Cohort Study

Author

Schulman, Elizabeth, Bartlett, Susan J., Schieir, Orit, Andersen, Kathleen M., Boire, Gilles, Pope, Janet E., Hitchon, Carol, Jamal, Shahin, Thorne, J. Carter, Tin, Diane, Keystone, Edward C., Haraoui, Boulos, Goodman, Susan M., Bykerk, Vivian P., Ahluwalia, V., Akhavan, P., Barra, L., Barber, C., Barnabe, C., Baron, M., Bessette, L., Bykerk, V., Colmegna, I., Fallavollita, S., Haaland, D., Hazlewood, G., Joshi, R., Kuriya, B., Larche, M., Lyddell, C., Nair, B., Penney, C., Rubin, L., Tremblay, J. L., Villeneuve, E., and Zummer, M.

Abstract

Obesity is implicated in rheumatoid arthritis (RA) development, severity, outcomes, and treatment response. We estimated the independent effects of overweight and obesity on ability to achieve sustained remission (sREM) in the 3 years following RA diagnosis. Data were from the Canadian Early Arthritis Cohort, a multicenter observational trial of early RA patients treated by rheumatologists using guideline‐based care. sREM was defined as Disease Activity Score in 28 joints (DAS28) <2.6 for 2 consecutive visits. Patients were stratified by body mass index (BMI) as healthy (18.5–24.9 kg/m2), overweight (25–29.9 kg/m2), and obese (≥30 kg/m2). Cox regression was used to estimate the effect of the BMI category on the probability of achieving sREM over the first 3 years, controlling for age, sex, race, education, RA duration, smoking status, comorbidities, baseline DAS28, Health Assessment Questionnaire disability index, C‐reactive protein level, and initial treatment. Of 982 patients, 315 (32%) had a healthy BMI, 343 (35%) were overweight, and 324 (33%) were obese; 355 (36%) achieved sREM within 3 years. Initial treatment did not differ by BMI category. Compared to healthy BMI, overweight patients (hazard ratio [HR] 0.75 [95% confidence interval (95% CI) 0.58–0.98]) and obese patients (HR 0.53 [95% CI 0.39–0.71]) were significantly less likely to achieve sREM. Rates of overweight and obesity were high (69%) in this early RA cohort. Overweight patients were 25% less likely, and obese patients were 47% less likely, to achieve sREM in the first 3 years, despite similar initial disease‐modifying antirheumatic drug treatment and subsequent biologic use. This is the largest study demonstrating the negative impact of excess weight on RA disease activity and supports a call to action to better identify and address this risk in RA patients.

Published
2018
Full Text
View/download PDF

2. Hydroxychloroquine is a safe and effective steroid-sparing agent for immune checkpoint inhibitor-induced inflammatory arthritis.

Author

Roberts J, Smylie M, Walker J, Basappa NS, Chu Q, Kolinsky M, Lyddell C, and Ye C

Subjects
Adult, Aged, Aged, 80 and over, Alberta, Arthritis, Rheumatoid chemically induced, CTLA-4 Antigen immunology, Female, Humans, Male, Middle Aged, Neoplasms drug therapy, Programmed Cell Death 1 Receptor immunology, Retrospective Studies, Tertiary Care Centers, Treatment Outcome, Antibodies, Monoclonal adverse effects, Antirheumatic Agents therapeutic use, Arthritis, Rheumatoid drug therapy, Hydroxychloroquine therapeutic use, Immunotherapy adverse effects
Abstract

Immunotherapy for cancer treatment continues to evolve, and immune checkpoints have proven successful therapeutic targets. With success has come the challenge of managing the commonly associated immune-related toxicities. Arthralgias and arthritis are a common immune-related adverse event (IrAE), well described in the literature (Pardoll Nat Rev Cancer 12:252-264, 2012; Diesendruck and Benhar Drug Resist Updat 30:39-47, 2017; Cappelli et al. Arthritis Care Res 69:1751-1763, 2017; Brahmer et al. J Clin Oncol 36:1714-1768, 2018; Smith and Bass (2017). The optimal management of immune checkpoint inhibitor (ICI)-induced arthritis remains unclear. We describe the first series using hydroxychloroquine as a first-line disease-modifying antirheumatic drug (DMARD) for patients without pre-existing autoimmune disease, who developed arthritis secondary to ICI's. This was a single-center retrospective observational study reporting all patients evaluated by rheumatologists affiliated with the University of Alberta, a large tertiary health care center in Northern Alberta, Canada, deemed to have inflammatory arthritis (IA) following ICIs. We identified 11 patients, without pre-existing autoimmune disease, who developed IA following ICIs. Most patients presented with a symmetrical polyarthritis with both large and small joint involvement. All patients were treated according to the outlined treatment protocol with hydroxychloroquine as a first-line steroid-sparing agent: either as monotherapy or in combination with tapering doses of systemic corticosteroids (3) or intra-articular steroid injections (6). One patient required the addition of methotrexate to control symptoms and none required biologic therapy. There were no reported adverse effects from hydroxychloroquine. Inflammatory arthritis is an important complication of ICIs leading to significant impact on patient quality of life. In our experience, in patients without pre-existing autoimmune disease, hydroxychloroquine is an effective first-line therapy for IA secondary to ICI therapy.

Published
2019
Full Text
View/download PDF

Catalog

Books, media, physical & digital resources
See catalog results