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1. Early infection risk in patients with systemic lupus erythematosus treated with rituximab or belimumab from the British Isles Lupus Assessment Group Biologics Register (BILAG-BR): a prospective longitudinal study

Author

Abernethy, Rikki, Ahmad, Yasmeen, Akil, Mohamed, Bartram, Sarah, Batley, Mike, Bharadwaj, Anurag, Bruce, Ian, Carlucci, Francesco, Chan, Antoni, Dasgupta, Bhaskar, D'Cruz, David, De Lord, Denise, Dyke, Bernard, Edwards, Christopher, Erb, Nicola, Farrell, Adrian, Gayed, Mary, Gendi, Nagui, Gompels, Luke, Gordon, Caroline, Gordon, Patrick, Griffiths, Bridget, Gullick, Nicola, Gunwardena, Harsha, Haigh, Richard, Hamdulay, Shahir, Haque, Sahena, Hutchinson, David, Isenberg, David, Jayne, David, Jeffery, Rachel, Kapur, Deepti, Kaul, Arvind, King, Jon, Knights, Sally, Korendowych, Ellie, Lanyon, Peter, Mahindrakar, Madhu, Marks, Jonathan, McCann, Liza, McLaren, Zoe, Mediwake, Rapti, Menon, Ajit, Mewar, Devesh, Min, Steven Young, Nair, Jagdish, O'Riordan, Edmond, Pyne, Dev, Rahmeh, Fouz, Regan, Marian, Reynolds, John, Rhodes, Ben, Rhys-Dillon, Ceril, Robson, Joanna C, Shaffu, Shireen, Sheeran, T, Skeoch, Sarah, Sood, Bhrigu Raj, Stratton, Richard, Teh, Lee-Suan, Vermaak, Erin, Vital, Ed, Waller, Rosemary, Watts, Richard, Wijeyekoon, Jananath, Yee, Chee-Seng, Yong, Cee Yi, Youssef, Hazem, Yusuf, Abid, Zoma, Asad, Rodziewicz, Mia, Dyball, Sarah, Lunt, Mark, McDonald, Stephen, Sutton, Emily, Parker, Ben, and Bruce, Ian N

Published
2023
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2. Valuing Health Gain from Composite Response Endpoints for Multisystem Diseases

Author

Bruce, Ian, Payne, Katherine, Lunt, Mark, Peek, Niels, Geifman, Nophar, Gavan, Sean, Armitt, Gillian, Doherty, Patrick, Prattley, Jennifer, Azadbakht, Narges, Papazian, Angela, Le Sueur, Helen, Farrelly, Carmen, Richardson, Clare, Shabbir, Zunnaira, Hewitt, Lauren, McHugh, Neil, Gordon, Caroline, Reynolds, John, Young, Stephen, Jayne, David, Farewell, Vern, Su, Li, Pickering, Matthew, Lightstone, Elizabeth, Gilmore, Alyssa, Botto, Marina, Vyse, Timothy, Morris, David Lester, D’Cruz, David, Vital, Edward, Wittmann, Miriam, Emery, Paul, Beresford, Michael, Hedrich, Christian, Midgley, Angela, Gritzfeld, Jenna, Ehrenstein, Michael, Isenberg, David, Parvaz, Mariea, Dunnage, Jane, Batchelor, Jane, Holland, Elaine, Upsall, Pauline, Youssef, Hazem, McCann, Liza, Mediwake, Rapti, Bharadwaj, Anurag, Vital, Ed, Kapur, Deepti, Chee-Seng Yee, Prof, Griffiths, Bridget, Yusuf, Abid, Zoma, Asad, Vermaak, Erin, Carlucci, Francesco, Watts, Richard, Gordon, Patrick, Shaffu, Shireen, Wijeyekoon, Jananath, McLaren, Zoe, Ahmad, Yasmeen, Batley, Mike, Gompels, Luke, Sheeran, T., Yi Yong, Cee, Jeffery, Rachel, Hamdulay, Shahir, Rahmeh, Fouz, Young Min, Steven, Rhodes, Ben, De Lord, Denise, Lanyon, Peter, Chan, Antoni, Teh, Lee-Suan, Marks, Jonathan, Hutchinson, David, Regan, Marian, Haigh, Richard, Stratton, Richard, Rhys-Dillon, Ceril, Akil, Mohamed, Mewar, Devesh, Skeoch, Sarah, Erb, Nicola, O’Riordan, Edmond, Bartram, Sarah, Gayed, Mary, Dasgupta, Bhaskar, Gunwardena, Harsha, Pyne, Dev, Kaul, Arvind, Mahindrakar, Madhu, Raj Sood, Bhrigu, Gullick, Nicola, Edwards, Christopher, Joanna C Robson, King, Jon, Farrell, Adrian, Haque, Sahena, Knights, Sally, Gavan, Sean P., and Bruce, Ian N.

Published
2023
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3. Contribution of rare and predicted pathogenic gene variants to childhood-onset lupus: a large, genetic panel analysis of British and French cohorts

Author

Campion, Dominique, Dartigues, Jean-Francois, Deleuze, Jean-François, Genin, Emmanuelle, Lambert, Jean-Charles, Redon, Richard, Allain-Launay, Emma, Bader-Meunier, Brigitte, Belot, Alexandre, Bouayed, Kenza, Burtey, Stephane, Carbasse, Aurélia, Decramer, Stéphane, Despert, Véronique, Fain, Olivier, Fischbach, Michel, Flodrops, Hugues, Galeotti, Caroline, Hachulla, Eric, Hatchuel, Yves, Kleinmann, Jean-Francois, Kone-Paut, Isabelle, Lanteri, Aurélia, Lemelle, Irène, Maillard, Hélène, Maurier, François, Meinzer, Ulrich, Melki, Isabelle, Morell-Dubois, Sandrine, Pagnier, Anne, Piram, Maryam, Ranchin, Bruno, Reumaux, Héloise, Samaille, Charlotte, Sibilia, Jean, Weill, Olivia, Al-Abadi, Eslam, Armon, Kate, Bailey, Kathryn, Beresford, Michael, Brennan, Mary, Ciurtin, Coziana, Gardner-Medwin, Janet, Haslam, Kirsty, Hawley, Daniel, Leahy, Alice, Leone, Valentina, Mewar, Devesh, Moots, Rob, Pilkington, Clarissa, Ramanan, Athimalaipet, Rangaraj, Satyapal, Ratcliffe, Annie, Riley, Philip, Sen, Ethan, Sridhar, Arani, Wilkinson, Nick, Wood, Fiona, Rice, Gillian I, Omarjee, Sulliman Ommar, Rouchon, Quentin, Smith, Eve M D, Moreews, Marion, Tusseau, Maud, Frachette, Cécile, Bournhonesque, Raphael, Thielens, Nicole, Gaboriaud, Christine, Rouvet, Isabelle, Chopin, Emilie, Hoshino, Akihiro, Latour, Sylvain, Cimaz, Rolando, Romagnani, Paula, Malcus, Christophe, Fabien, Nicole, Sarda, Marie-Nathalie, Kassai, Behrouz, Lega, Jean-Christophe, Abou-Jaoude, Pauline, Bruce, Ian N, Simonet, Thomas, Bardel, Claire, Rollat-Farnier, Pierre Antoine, Viel, Sebastien, O'Sullivan, James, Walzer, Thierry, Mathieu, Anne-Laure, Marenne, Gaelle, Ludwig, Thomas, Ellingford, Jamie, Briggs, Tracy A, Beresford, Michael W, and Crow, Yanick J

Published
2020
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5. Symptom-based stratification of patients with primary Sjögren's syndrome: multi-dimensional characterisation of international observational cohorts and reanalyses of randomised clinical trials

Author

Devauchelle-Pensec, Valerie, Dieude, Philippe, Dubost, Jean Jacques, Fauchais, Anne-Laure, Goeb, Vincent, Hachulla, Eric, Larroche, Claire, Le Guern, Véronique, Morel, Jacques, Perdriger, Aleth, Puéchal, Xavier, Rist, Stephanie, Sen, Damien, Sibilia, Jean, Vittecoq, Olivier, Benessiano, Joelle, Tubiana, Sarah, Inamo, Karine, Gaete, Stanie, Batouche, Djilali, Molinari, Domitille, Randrianandrasana, Mickael, Pane, Isabelle, Abbe, Adeline, Baron, Gabriel, Ravaud, Philippe, Gottenberg, Jacques-Eric, Saraux, Alain, Devauchelle-Pensec, Valérie, Hayem, Gilles, Hatron, Pierre, Sene, Damien, Zarnitsky, Charles, Furlan, Valérie, Perrodeau, Elodie, Seror, Raphaele, Mariette, Xavier, Brown, S, Navarro, N Coy, Pitzalis, C, Emery, P, Pavitt, S, Gray, J, Hulme, C, Hall, F, Busch, R, Smith, P, Dawson, L, Bombardieri, M, Ng, W-F, Pease, C, Price, E, Sutcliffe, N, Woods, C, Ruddock, S, Everett, C, Reynolds, C, Skinner, E, Poveda-Gallego, A, Rout, J, Macleod, I, Rauz, S, Bowman, S, Ng, Wan-Fai, Bowman, Simon J, Griffiths, Bridget, Hall, Frances, Bacaba, Elalaine C, Frankland, Helen, Moots, Robert, Chadravarty, Kuntal, Lamabadusuriya, Shamin, Bombardieri, Michele, Pitzalis, Constantino, Sutcliffe, Nurhan, Breston, Celia, Gendi, Nagui, Culfear, Karen, Riddell, Claire, Hamburger, John, Richards, Andrea, Rauz, Saaeh, Brailsford, Sue, Dasgin, Joanne, Logan, Joanne, Mulherin, Diarmuid, Andrews, Jacqueline, Emery, Pau, McManus, Alison, Pease, Colin, Pickles, David, Booth, Alison, Regan, Marian, Kin, Jon King, Holt, Amanda, Dimitroulas, Theodoros, Kadiki, Lucy, Kaur, Daljit, Kitas, George, Khan, Abdul, Cosier, Tracey, Panthakalam, Mintrim, Kell, Lloyd, Mark, Moore, Lisa, Gordon, Esther, Lawson, Cathy, Gupta, Monica, Hunter, John, Stirton, Lesley, Ortiz, Gill, Price, Elizabeth, Pelger, Suzannah, Gorman, Claire, Hans, Balinder, Clunie, Gavin, Lane, Suzanne, Rose, Ginny, Cuckow, Sue, Batley, Michael, Einosas, Ruby, Knight, Susan, Symmons, Deborah, Jones, Beverley, Carr, Andrew, Edgar, Suzanne, Figuereido, Francisco, Foggo, Heather, Lendrem, Dennis, Macleod, Iain, Mitchell, Sheryl, Downie, Christine, Tarn, Jessica, Locke, James, Al-Ali, Shereen, Legg, Sarah, Mirza, Kamran, Hargreaves, Ben, Hetherington, Laura, Jones, Adrian, Lanyon, Peter, Muir, Alice, White, Paula, Young-Min, Steven, Pugmire, Susan, Vadivelu, Saravanan, Cooper, Annie, Watkins, Marianne, Field, Anne, Kaye, Stephen, Mewar, Devesh, Medcalf, Patricia, Tomlinson, Pamela, Whiteside, Debbie, McHugh, Neil, Pauling, John, James, Julie, Dowden, Andrea, Akil, Mohammed, McDermott, Jayne, Godia, Olivia, Coady, David, Kidd, Elizabeth, Palmer, Lynne, Li, Charles, Bartrum, Sarah, Mead, De, Dasgupta, Bhaskar, Katsande, Victoria, Long, Pamela, Vermaak, Erin, Turner, Janet, Chandra, Usha, MacKay, Kirsten, Fedele, Stefano, Ferenkeh-Koroma, Ada, Giles, Ian, Isenberg, David, MaConnell, Helena, Ahwiren, Nyarko, Porter, Stephen, Allcoa, Paul, McLaren, John, Tarn, Jessica R, Howard-Tripp, Nadia, Lendrem, Dennis W, Skelton, Andrew J, James, Katherine, McMeekin, Peter, Hackett, Katie L, Lendrem, B Clare, Casement, John, Pease, Colin T, Emery, Paul, Pitzalis, Costantino, Saravanan, Vadivelu, Johnsen, Svein J A, Norheim, Katrine B, Omdal, Roald, Stocken, Deborah, Everett, Colin, Fernandez, Catherine, and Isaacs, John D

Published
2019
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6. Studies on autoantigens in rheumatoid arthritis

Author

Mewar, Devesh

Subjects
616, Phage
Abstract

This thesis describes the use of phage display for the isolation of autoantigens in rheumatoid arthritis. The potential of the technology is demonstrated by the isolation of an autoantigen, eukaryotic translation elongation factor 1a1 (eEF 1 (x 1)) from a fibroblast cDNA library using rounds of selective enrichment with IgG from RA patients. Subsequently in order to isolate joint-specific antigens a phage-displayed cDNA library from rheumatoid pannus was generated and screened with analogous procedures. From the clones isolated, putative candidate autoantigens were identified. The presence of anti- eEF 1a1 autoantibodies in approximately 20% of patients with RA was confirmed and extended in larger panels of sera, and the finding of anti-eEF la1 shown to be relatively specific for RA. In contrast autoantibodies to the activation-induced negative regulator of T cells, CTLA-4 were not found in contrast to a previous report. The relevance of these findings for the use of antibodies in the diagnosis and prediction of disease characteristics in RA are discussed.

Published
2003

7. The stool microbiome in patients with psoriatic arthritis is altered but, unlike the skin microbiome, does not change following treatment: evidence for an underlying inflammatory drive from the intestine.

Author

Castelino, Madhura, primary, Ijaz, Umer Zeeshan, additional, Tutino, Mauro, additional, McDonald, Elizabeth, additional, Fragoulis, George, additional, Ho, Pauline, additional, Mewar, Devesh, additional, Chelliah, Gladston, additional, McBain, Andrew, additional, O'Neill, Catherine, additional, Siebert, Stefan, additional, Barton, Anne, additional, and Milling, Simon, additional

Published
2023
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8. Early infection risk in patients with systemic lupus erythematosus treated with rituximab or belimumab from the British Isles Lupus Assessment Group Biologics Register (BILAG-BR): a prospective longitudinal study

Author

Rodziewicz, Mia, primary, Dyball, Sarah, additional, Lunt, Mark, additional, McDonald, Stephen, additional, Sutton, Emily, additional, Parker, Ben, additional, Bruce, Ian N, additional, Abernethy, Rikki, additional, Ahmad, Yasmeen, additional, Akil, Mohamed, additional, Bartram, Sarah, additional, Batley, Mike, additional, Bharadwaj, Anurag, additional, Bruce, Ian, additional, Carlucci, Francesco, additional, Chan, Antoni, additional, Dasgupta, Bhaskar, additional, D'Cruz, David, additional, De Lord, Denise, additional, Dyke, Bernard, additional, Edwards, Christopher, additional, Erb, Nicola, additional, Farrell, Adrian, additional, Gayed, Mary, additional, Gendi, Nagui, additional, Gompels, Luke, additional, Gordon, Caroline, additional, Gordon, Patrick, additional, Griffiths, Bridget, additional, Gullick, Nicola, additional, Gunwardena, Harsha, additional, Haigh, Richard, additional, Hamdulay, Shahir, additional, Haque, Sahena, additional, Hutchinson, David, additional, Isenberg, David, additional, Jayne, David, additional, Jeffery, Rachel, additional, Kapur, Deepti, additional, Kaul, Arvind, additional, King, Jon, additional, Knights, Sally, additional, Korendowych, Ellie, additional, Lanyon, Peter, additional, Mahindrakar, Madhu, additional, Marks, Jonathan, additional, McCann, Liza, additional, McLaren, Zoe, additional, Mediwake, Rapti, additional, Menon, Ajit, additional, Mewar, Devesh, additional, Min, Steven Young, additional, Nair, Jagdish, additional, O'Riordan, Edmond, additional, Pyne, Dev, additional, Rahmeh, Fouz, additional, Regan, Marian, additional, Reynolds, John, additional, Rhodes, Ben, additional, Rhys-Dillon, Ceril, additional, Robson, Joanna C, additional, Shaffu, Shireen, additional, Sheeran, T, additional, Skeoch, Sarah, additional, Sood, Bhrigu Raj, additional, Stratton, Richard, additional, Teh, Lee-Suan, additional, Vermaak, Erin, additional, Vital, Ed, additional, Waller, Rosemary, additional, Watts, Richard, additional, Wijeyekoon, Jananath, additional, Yee, Chee-Seng, additional, Yong, Cee Yi, additional, Youssef, Hazem, additional, Yusuf, Abid, additional, and Zoma, Asad, additional

Published
2023
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10. Physical activity but not sedentary activity is reduced in primary Sjögren’s syndrome

Author

Ng, Wan-Fai, Miller, Ariana, Bowman, Simon J., Price, Elizabeth J., Kitas, George D., Pease, Colin, Emery, Paul, Lanyon, Peter, Hunter, John, Gupta, Monica, Giles, Ian, Isenberg, David, McLaren, John, Regan, Marian, Cooper, Annie, Young-Min, Steven A., McHugh, Neil, Vadivelu, Saravanan, Moots, Robert J., Coady, David, MacKay, Kirsten, Dasgupta, Bhaskar, Sutcliffe, Nurhan, Bombardieri, Michele, Pitzalis, Costantino, Griffiths, Bridget, Mitchell, Sheryl, Miyamoto, Samira Tatiyama, Trenell, Michael, Hall, Frances, Bacabac, Elalaine C., Moots, Robert, Chakravarty, Kuntal, Lamabadusuriya, Shamin, Bombardieri, Michele, Pitzalis, Constantino, Sutcliffe, Nurhan, Gendi, Nagui, Adeniba, Rashidat, Hamburger, John, Richards, Andrea, Rauz, Saaeha, Brailsford, Sue, Logan, Joanne, Mulherin, Diarmuid, Andrews, Jacqueline, Emery, Paul, McManus, Alison, Pease, Colin, Booth, Alison, Regan, Marian, Dimitroulas, Theodoros, Kadiki, Lucy, Kaur, Daljit, Kitas, George, Lloyd, Mark, Moore, Lisa, Gordon, Esther, Lawson, Cathy, Gupta, Monica, Hunter, John, Stirton, Lesley, Ortiz, Gill, Price, Elizabeth, Clunie, Gavin, Rose, Ginny, Cuckow, Sue, Knight, Susan, Symmons, Deborah, Jones, Beverley, Al-Ali, Shereen, Carr, Andrew, Collins, Katherine, Corbett, Ian, Downie, Christine, Edgar, Suzanne, Carrozzo, Marco, Figuereido, Francisco, Foggo, Heather, James, Katherine, Lendrem, Dennis, Macleod, Iain, Mawson, Philip, Mitchell, Sheryl, Natasari, Andini, Stocks, Philip, Tarn, Jessica, Jones, Adrian, Lanyon, Peter, Muir, Alice, White, Paula, Young-Min, Steven, Pugmire, Susan, Vadivelu, Saravanan, Cooper, Annie, Watkins, Marianne, Field, Anne, Kaye, Stephen, Mewar, Devesh, Medcalf, Patricia, Tomlinson, Pamela, Whiteside, Debbie, McHugh, Neil, Pauling, John, James, Julie, Olaitan, Nike, Akil, Mohammed, McDermott, Jayne, Godia, Olivia, Coady, David, Kidd, Elizabeth, Palmer, Lynne, Dasgupta, Bhaskar, Katsande, Victoria, Long, Pamela, Li, Charles, Chandra, Usha, MacKay, Kirsten, Fedele, Stefano, Ferenkeh-Koroma, Ada, Giles, Ian, Isenberg, David, Maconnell, Helena, Porter, Stephen, Allcoat, Paul, McLaren, John, and on behalf of the UK Primary Sjögren’s Syndrome Registry

Published
2017
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13. Neuropsychiatric involvement in juvenile-onset systemic lupus erythematosus: Data from the UK Juvenile-onset systemic lupus erythematosus cohort study

Author

Giani, Teresa, Smith, Eve MD, Al-Abadi, Eslam, Armon, Kate, Bailey, Kathryn, Ciurtin, Coziana, Davidson, Joyce, Gardner-Medwin, Janet, Haslam, Kirsty, Hawley, Dan P, Leahy, Alice, Leone, Valentina, McErlane, Flora, Mewar, Devesh, Modgil, Gita, Moots, Robert, Pilkington, Clarissa, Pregnolato, Francesca, Ramanan, Athimalaipet V, Rangaraj, Satyapal, Riley, Phil, Sridhar, Arani, Wilkinson, Nick, Cimaz, Rolando, Beresford, Michael W, Hedrich, Christian M, and Study, On Behalf Of The UK JSLE Cohort

Subjects
Systemic lupus erythematosus, pediatric, juvenile, peripheral nervous system, neuropsychiatric, Papers, central nervous system
Abstract

Funder: Versus Arthritis UK, Funder: LUPUS UK; FundRef: https://doi.org/10.13039/501100018817, Introduction: Juvenile-onset systemic lupus erythematosus (JSLE) is a rare autoimmune/inflammatory disease with significant morbidity and mortality. Neuropsychiatric (NP) involvement is a severe complication, encompassing a heterogeneous range of neurological and psychiatric manifestations. Methods: Demographic, clinical, and laboratory features of NP-SLE were assessed in participants of the UK JSLE Cohort Study, and compared to patients in the same cohort without NP manifestations. Results: A total of 428 JSLE patients were included in this study, 25% of which exhibited NP features, half of them at first visit. Most common neurological symptoms among NP-JSLE patients included headaches (78.5%), mood disorders (48.6%), cognitive impairment (42%), anxiety (23.3%), seizures (19.6%), movement disorders (17.7%), and cerebrovascular disease (14.9%). Peripheral nervous system involvement was recorded in 7% of NP-SLE patients. NP-JSLE patients more frequently exhibited thrombocytopenia (

Published
2021
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16. sj-pdf-1-lup-10.1177_0961203320984251 - Supplemental material for Clinical and laboratory phenotypes in juvenile-onset Systemic Lupus Erythematosus across ethnicities in the UK

Author

Massias, Joseph S, Eve MD Smith, Eslam Al-Abadi, Armon, Kate, Bailey, Kathryn, Coziana Ciurtin, Davidson, Joyce, Gardner-Medwin, Janet, Haslam, Kirsty, Hawley, Dan P, Leahy, Alice, Leone, Valentina, McErlane, Flora, Mewar, Devesh, Modgil, Gita, Moots, Robert, Pilkington, Clarissa, Athimalaipet V Ramanan, Satyapal Rangaraj, Riley, Phil, Arani Sridhar, Wilkinson, Nick, Beresford, Michael W, and Hedrich, Christian M

Subjects
111702 Aged Health Care, FOS: Health sciences
Abstract

Supplemental material, sj-pdf-1-lup-10.1177_0961203320984251 for Clinical and laboratory phenotypes in juvenile-onset Systemic Lupus Erythematosus across ethnicities in the UK by Joseph S Massias, Eve MD Smith, Eslam Al-Abadi, Kate Armon, Kathryn Bailey, Coziana Ciurtin, Joyce Davidson, Janet Gardner-Medwin, Kirsty Haslam, Dan P Hawley, Alice Leahy, Valentina Leone, Flora McErlane, Devesh Mewar, Gita Modgil, Robert Moots, Clarissa Pilkington, Athimalaipet V Ramanan, Satyapal Rangaraj, Phil Riley, Arani Sridhar, Nick Wilkinson, Michael W Beresford and Christian M Hedrich in Lupus

Published
2021
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17. Limited sensitivity and specificity of the ACR/EULAR-2019 classification criteria for SLE in JSLE?—observations from the UK JSLE Cohort Study

Author

Smith, Eve M D, primary, Rasul, Sajida, additional, Ciurtin, Coziana, additional, Al-Abadi, Eslam, additional, Armon, Kate, additional, Bailey, Kathryn, additional, Brennan, Mary, additional, Gardner-Medwin, Janet, additional, Haslam, Kirsty, additional, Hawley, Daniel P, additional, Lane, Steven, additional, Leahy, Alice, additional, Leone, Valentina, additional, Malik, Gulshan, additional, Mewar, Devesh , additional, Moots, Robert, additional, Pilkington, Clarissa, additional, Ramanan, Athimalaipet V, additional, Rangaraj, Satyapal , additional, Ratcliffe, Annie, additional, Riley, Phil, additional, Sen, Ethan, additional, Sridhar, Arani, additional, Wilkinson, Nick , additional, Beresford, Michael W, additional, McCann, Liza J, additional, and Hedrich, Christian M, additional

Published
2021
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18. Clinical and laboratory phenotypes in juvenile-onset Systemic Lupus Erythematosus across ethnicities in the UK

Author

Massias, Joseph S, primary, Smith, Eve MD, additional, Al-Abadi, Eslam, additional, Armon, Kate, additional, Bailey, Kathryn, additional, Ciurtin, Coziana, additional, Davidson, Joyce, additional, Gardner-Medwin, Janet, additional, Haslam, Kirsty, additional, Hawley, Dan P, additional, Leahy, Alice, additional, Leone, Valentina, additional, McErlane, Flora, additional, Mewar, Devesh, additional, Modgil, Gita, additional, Moots, Robert, additional, Pilkington, Clarissa, additional, Ramanan, Athimalaipet V, additional, Rangaraj, Satyapal, additional, Riley, Phil, additional, Sridhar, Arani, additional, Wilkinson, Nick, additional, Beresford, Michael W, additional, and Hedrich, Christian M, additional

Published
2021
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21. Symptom-based stratification of patients with primary Sjögren's syndrome: multi-dimensional characterisation of international observational cohorts and reanalyses of randomised clinical trials

Author

Tarn, Jessica R, Howard-Tripp, Nadia, Lendrem, Dennis W, Mariette, Xavier, Saraux, Alain, Devauchelle-Pensec, Valerie, Seror, Raphaele, Skelton, Andrew J, James, Katherine, McMeekin, Peter, Al-Ali, Shereen, Hackett, Kate, Lendrem, B Clare, Hargreaves, Ben, Casement, John, Mitchell, Sheryl, Bowman, Simon J, Price, Elizabeth, Pease, Colin T, Emery, Paul, Lanyon, Peter, Hunter, John, Gupta, Monica, Bombardieri, Michele, Sutcliffe, Nurhan, Pitzalis, Costantino, McLaren, John, Cooper, Annie, Regan, Marian, Giles, Ian, Isenberg, David, Saravanan, Vadivelu, Coady, David, Dasgupta, Bhaskar, McHugh, Neil, Young-Min, Steven, Moots, Robert, Gendi, Nagui, Akil, Mohammed, Griffiths, Bridget, Johnsen, Svein J A, Norheim, Katrine B, Omdal, Roald, Stocken, Deborah, Everett, Colin, Fernandez, Catherine, Isaacs, John D, Gottenberg, Jacques-Eric, Ng, Wan-Fai, Dieude, Philippe, Dubost, Jean Jacques, Fauchais, Anne-Laure, Goeb, Vincent, Hachulla, Eric, Larroche, Claire, Le Guern, Véronique, Morel, Jacques, Perdriger, Aleth, Puéchal, Xavier, Rist, Stephanie, Sen, Damien, Sibilia, Jean, Vittecoq, Olivier, Benessiano, Joelle, Tubiana, Sarah, Inamo, Karine, Gaete, Stanie, Batouche, Djilali, Molinari, Domitille, Randrianandrasana, Mickael, Pane, Isabelle, Abbe, Adeline, Baron, Gabriel, Ravaud, Philippe, Dubost, Jean-Jacques, Rist, Stéphanie, Devauchelle-Pensec, Valérie, Hayem, Gilles, Hatron, Pierre, Sene, Damien, Zarnitsky, Charles, Furlan, Valérie, Perrodeau, Elodie, Brown, S, Navarro, N Coy, Pitzalis, C, Emery, P, Pavitt, S, Gray, J, Hulme, C, Hall, F, Busch, R, Smith, P, Dawson, L, Bombardieri, M, Ng, W-F, Pease, C, Price, E, Sutcliffe, N, Woods, C, Ruddock, S, Everett, C, Reynolds, C, Skinner, E, Poveda-Gallego, A, Rout, J, Macleod, I, Rauz, S, Bowman, S, Hall, Frances, Bacaba, Elalaine C, Frankland, Helen, Chadravarty, Kuntal, Lamabadusuriya, Shamin, Pitzalis, Constantino, Breston, Celia, Culfear, Karen, Riddell, Claire, Hamburger, John, Richards, Andrea, Rauz, Saaeh, Brailsford, Sue, Dasgin, Joanne, Logan, Joanne, Mulherin, Diarmuid, Andrews, Jacqueline, Emery, Pau, McManus, Alison, Pease, Colin, Pickles, David, Booth, Alison, Kin, Jon King, Holt, Amanda, Dimitroulas, Theodoros, Kadiki, Lucy, Kaur, Daljit, Kitas, George, Khan, Abdul, Cosier, Tracey, Panthakalam, Mintrim, Kell, Lloyd, Mark, Moore, Lisa, Gordon, Esther, Lawson, Cathy, Stirton, Lesley, Ortiz, Gill, Pelger, Suzannah, Gorman, Claire, Hans, Balinder, Clunie, Gavin, Lane, Suzanne, Rose, Ginny, Cuckow, Sue, Batley, Michael, Einosas, Ruby, Knight, Susan, Symmons, Deborah, Jones, Beverley, Carr, Andrew, Edgar, Suzanne, Figuereido, Francisco, Foggo, Heather, Lendrem, Dennis, Macleod, Iain, Downie, Christine, Tarn, Jessica, Locke, James, Legg, Sarah, Mirza, Kamran, Hetherington, Laura, Jones, Adrian, Muir, Alice, White, Paula, Pugmire, Susan, Vadivelu, Saravanan, Watkins, Marianne, Field, Anne, Kaye, Stephen, Mewar, Devesh, Medcalf, Patricia, Tomlinson, Pamela, Whiteside, Debbie, Pauling, John, James, Julie, Dowden, Andrea, McDermott, Jayne, Godia, Olivia, Kidd, Elizabeth, Palmer, Lynne, Li, Charles, Bartrum, Sarah, Mead, De, Katsande, Victoria, Long, Pamela, Vermaak, Erin, Turner, Janet, Chandra, Usha, MacKay, Kirsten, Fedele, Stefano, Ferenkeh-Koroma, Ada, MaConnell, Helena, Ahwiren, Nyarko, Porter, Stephen, and Allcoa, Paul

Subjects
medicine.medical_specialty, business.industry, Immunology, Hydroxychloroquine, Placebo, Article, Rheumatology, B700, Clinical trial, B900, Internal medicine, Cohort, Immunology and Allergy, Medicine, Observational study, Rituximab, business, Depression (differential diagnoses), medicine.drug
Abstract

Summary Background Heterogeneity is a major obstacle to developing effective treatments for patients with primary Sjogren's syndrome. We aimed to develop a robust method for stratification, exploiting heterogeneity in patient-reported symptoms, and to relate these differences to pathobiology and therapeutic response. Methods We did hierarchical cluster analysis using five common symptoms associated with primary Sjogren's syndrome (pain, fatigue, dryness, anxiety, and depression), followed by multinomial logistic regression to identify subgroups in the UK Primary Sjogren's Syndrome Registry (UKPSSR). We assessed clinical and biological differences between these subgroups, including transcriptional differences in peripheral blood. Patients from two independent validation cohorts in Norway and France were used to confirm patient stratification. Data from two phase 3 clinical trials were similarly stratified to assess the differences between subgroups in treatment response to hydroxychloroquine and rituximab. Findings In the UKPSSR cohort (n=608), we identified four subgroups: Low symptom burden (LSB), high symptom burden (HSB), dryness dominant with fatigue (DDF), and pain dominant with fatigue (PDF). Significant differences in peripheral blood lymphocyte counts, anti-SSA and anti-SSB antibody positivity, as well as serum IgG, κ-free light chain, β2-microglobulin, and CXCL13 concentrations were observed between these subgroups, along with differentially expressed transcriptomic modules in peripheral blood. Similar findings were observed in the independent validation cohorts (n=396). Reanalysis of trial data stratifying patients into these subgroups suggested a treatment effect with hydroxychloroquine in the HSB subgroup and with rituximab in the DDF subgroup compared with placebo. Interpretation Stratification on the basis of patient-reported symptoms of patients with primary Sjogren's syndrome revealed distinct pathobiological endotypes with distinct responses to immunomodulatory treatments. Our data have important implications for clinical management, trial design, and therapeutic development. Similar stratification approaches might be useful for patients with other chronic immune-mediated diseases. Funding UK Medical Research Council, British Sjogren's Syndrome Association, French Ministry of Health, Arthritis Research UK, Foundation for Research in Rheumatology. Video Abstract Download : Download video (77MB) Symptom-based stratification of patients with Sjogren's syndrome

Published
2019

23. Contribution of rare and predicted pathogenic gene variants to childhood-onset lupus: a large, genetic panel analysis of British and French cohorts

Author

Belot, Alexandre, primary, Rice, Gillian I, additional, Omarjee, Sulliman Ommar, additional, Rouchon, Quentin, additional, Smith, Eve M D, additional, Moreews, Marion, additional, Tusseau, Maud, additional, Frachette, Cécile, additional, Bournhonesque, Raphael, additional, Thielens, Nicole, additional, Gaboriaud, Christine, additional, Rouvet, Isabelle, additional, Chopin, Emilie, additional, Hoshino, Akihiro, additional, Latour, Sylvain, additional, Ranchin, Bruno, additional, Cimaz, Rolando, additional, Romagnani, Paula, additional, Malcus, Christophe, additional, Fabien, Nicole, additional, Sarda, Marie-Nathalie, additional, Kassai, Behrouz, additional, Lega, Jean-Christophe, additional, Decramer, Stéphane, additional, Abou-Jaoude, Pauline, additional, Bruce, Ian N, additional, Simonet, Thomas, additional, Bardel, Claire, additional, Rollat-Farnier, Pierre Antoine, additional, Viel, Sebastien, additional, Reumaux, Héloise, additional, O'Sullivan, James, additional, Walzer, Thierry, additional, Mathieu, Anne-Laure, additional, Marenne, Gaelle, additional, Ludwig, Thomas, additional, Genin, Emmanuelle, additional, Ellingford, Jamie, additional, Bader-Meunier, Brigitte, additional, Briggs, Tracy A, additional, Beresford, Michael W, additional, Crow, Yanick J, additional, Campion, Dominique, additional, Dartigues, Jean-Francois, additional, Deleuze, Jean-François, additional, Lambert, Jean-Charles, additional, Redon, Richard, additional, Allain-Launay, Emma, additional, Belot, Alexandre, additional, Bouayed, Kenza, additional, Burtey, Stephane, additional, Carbasse, Aurélia, additional, Despert, Véronique, additional, Fain, Olivier, additional, Fischbach, Michel, additional, Flodrops, Hugues, additional, Galeotti, Caroline, additional, Hachulla, Eric, additional, Hatchuel, Yves, additional, Kleinmann, Jean-Francois, additional, Kone-Paut, Isabelle, additional, Lanteri, Aurélia, additional, Lemelle, Irène, additional, Maillard, Hélène, additional, Maurier, François, additional, Meinzer, Ulrich, additional, Melki, Isabelle, additional, Morell-Dubois, Sandrine, additional, Pagnier, Anne, additional, Piram, Maryam, additional, Samaille, Charlotte, additional, Sibilia, Jean, additional, Weill, Olivia, additional, Al-Abadi, Eslam, additional, Armon, Kate, additional, Bailey, Kathryn, additional, Beresford, Michael, additional, Brennan, Mary, additional, Ciurtin, Coziana, additional, Gardner-Medwin, Janet, additional, Haslam, Kirsty, additional, Hawley, Daniel, additional, Leahy, Alice, additional, Leone, Valentina, additional, Mewar, Devesh, additional, Moots, Rob, additional, Pilkington, Clarissa, additional, Ramanan, Athimalaipet, additional, Rangaraj, Satyapal, additional, Ratcliffe, Annie, additional, Riley, Philip, additional, Sen, Ethan, additional, Sridhar, Arani, additional, Wilkinson, Nick, additional, and Wood, Fiona, additional

Published
2020
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25. BHPR research: qualitative1. Complex reasoning determines patients' perception of outcome following foot surgery in rheumatoid arhtritis

Author

Backhouse, Michael R., Vinall, Karen A., Redmond, Anthony, Helliwell, Philip, Keenan, Anne-Maree, Dale, Rebecca M., Thomas, Amanda, Aronson, Diane, Turner-Cobb, Julie, Sengupta, Raj, France, Brisa, Hill, Ingrid, Flurey, Caroline A., Morris, Marianne, Pollock, Jon, Hughes, Rod, Richards, Pam, Hewlett, Sarah, Ryan, Sarah, Lille, Kate, Adams, Jo, Haq, Inam, McArthur, Margaret, Goodacre, Lynne, Birt, Linda, Wilson, Oonagh, Kirwan, John, Dures, Emma, Quest, Enid, Rajak, Rizwan, Thomas, Tasmin, Lawson, Tom, Petford, Sharon, Hale, Elizabeth, Kitas, George D., Gooberman-Hill, Rachael, Jinks, Clare, Dziedzic, Krysia, Bouças, Sofia Barbosa, Hislop, Kelly, Rhodes, Carol, Ali, Fizzah, Ong, Bie Nio, White, Derrick, Hensor, Elizabeth, Ferguson, Anna M., Douiri, Abdel, Scott, David L., Lempp, Heidi, Halls, Serena, Law, Rebecca-Jane, Jones, Jeremy, Markland, David, Maddison, Peter, Thom, Jeanette, Thom, Jeanette M., Breslin, Anne, Kraus, Alexandra, Gordhan, Chandrika, Dennis, Sean, Connor, John, Chowdhary, Bhavani, Lottay, Neena, Juneja, Parmjit, Bacon, Paul A., Isaacs, David, Jack, James, Keller, Majella, Tibble, Jeremy, Hammond, Alison, Gill, Rachel, Tyson, Sarah, Tennant, Alan, Nordenskiold, Ulla, Pease, Emily E., Pease, Colin T., Trehane, Anne, Rahmeh, Fouz, Cornell, Patricia, Westlake, Sarah L., Rose, Katy, Alber, Catherine Fouad, Watson, Liam, Stratton, Richard, Lazarus, Mark, McNeilly, Natasha E., Waterfield, Jackie, Hurley, Mike, Greenwood, James, Clayton, Ann M., Lynch, Michael, Clewes, Adrian, Dawson, Julie, Abernethy, Veronica, Griffiths, Ann E., Chamberlain, Victoria A., McLoughlin, YokeMei, Campbell, Sophie, Hayes, Janita, Moffat, Claire, McKenna, Frank, Shah, Preeti, Williams, Ann, Rhys-Dillon, Ceril, Goodfellow, Rhian, Martin, James C., Bari, Farhan, Hughes, Gwenan, Thomas, Eleri, Baker, Sarah, Collins, David, Price, Elizabeth, Williamson, Lyn, Dunkley, Lisa, Youll, Matthew J., Rodziewicz, Mia, Reynolds, John A., Berry, Jacqueline, Pavey, Chee, Hyrich, Kimme, Gorodkin, Rachel, Wilkinson, Kate, Bruce, Ian, Barton, Anne, Silman, Alan, Ho, Pauline, Cornell, Tricia, Richards, Selwyn, Holmes, A., Parker, S., Smith, H., Briggs, N., Arthanari, S., Nisar, M., Thwaites, Catharine, Kamath, Sanjeet, Price, Shyra, Robinson, Sandra M., Walker, David, Coop, Hazel, Al-Allaf, Wahab, Charleton, Rebecca C., Griffiths, Bridget, Edwards, Elizabeth A., Partlett, Rosamund, Martin, Keith, Tarzi, Mike, Panthakalam, Sathianathan, Freeman, Tanya, Ainley, Louise, Turner, Michael, Hughes, Lyndsay, Russell, Bridget, Jenkins, Suzanne, Done, John, Young, Adam, Jones, Tadeusz, Gaywood, Ian C., Pande, Ira, Pradère, Marie-Josèphe, Bhaduri, Mahua, Smith, Angela, Cook, Haley, Abraham, Sonya, Ngcozana, Tanaka, Denton, Christopher P., Parker, Louise, Black, Carol M., Ong, Voon, Thompson, Nicola, White, Catherine, Duddy, Martin, Jobanputra, Paresh, Bacon, Pauline, Smith, Jacqueline, Richardson, Ann, Giancola, Giorgio, Soh, Vicky, Spencer, Simon, Greenhalgh, Ann, Hanson, Mark, De Lord, Denise, Lloyd, Mark, Wong, Henna, Wren, Damian, Grover, Bob, Hall, John, Neville, Cai, Alton, Peter, Kelly, Stephen, Bombardieri, Michele, Humby, Fran, Ng, Nora, Di Cicco, Maria, Hands, Rebecca, Epis, Oscar, Filer, Andrew, Buckley, Christopher, McInnes, Iain, Taylor, Peter, Pitzalis, Costantino, Freeston, Jane, Conaghan, Philip, Grainger, Andrew, O'Connor, Philip J., Evans, Rob, Emery, Paul, Hodgson, Richard, Fleischmann, Roy, Han, Chenglong, van der Heijde, Desiree, Xu, Weichun, Hsia, Elizabeth, Kavanaugh, Arthur, Gladman, Dafna, Chattopadhyay, Chandrabhusan, Beutler, Anna, Zayat, Ahmed S., Ellegard, Karen, Terslev, Lene, Wakefield, Richard J., Ciurtin, Coziana, Leandro, Maria, Dey, Dzifa, Nandagudi, Anupama, Giles, Ian, Shipley, Mike, Morris, Vanessa, Ioannou, John, Ehrenstein, Michael, Sen, Debajit, Chan, Marian, Quinlan, Tim M., Brophy, Richard, Mewar, Devesh, Patel, Dipti, Wilby, M. J., Pellegrini, Vincent, Eyes, Brian, Crooks, Daniel, Anderson, Marina, Ball, Elisabeth, McKeeman, Helen, Burns, James, Yau, Wing Hoi, Moore, Owen, Foo, Joanne, Benson, Claire, Patterson, Chris, Wright, Gary, Taggart, Allister, Drew, Sarah, Tanner, Lorraine, Sanyal, Kaushik, Bourke, Brian E., Alston, Claire, Baqai, Charlotte, Chard, Michael, Sandhu, Virinderjit, Jordan, Kelsey, Munns, Catherine, Zouita, Louisa, Shattles, Warren, Davies, Ursula, Makadsi, Raad, Griffith, Sian, Kiely, Patrick D., Dimofte, Ionela, Dabu, Mihaela, Dabu, Bogdan, Dobarro, David, Schreiber, Benjamin E., Warrell, Clare, Handler, Clive, Coghlan, Gerry, Denton, Chris, Ishorari, Jasmine, Bunn, Chris, Beynon, Huw, George Malal, Joby J., Boton-Maggs, Ben, Leung, Alexander, Farewell, Daniel, Choy, Ernest, Gullick, Nicola J., Choy, Ernest H., Wincup, Chris, Fisher, Ben, Charles, Peter, Pollard, Louise C., Kirkham, Bruce W., Ma, Margaret H., Ramanujan, Saroja, Cavet, Guy, Haney, Doug, Kingsley, Gabrielle H., Scott, David, Cope, Andrew, Singh, Animesh, Wilson, Jo, Isaacs, Anthony, Wing, Charlotte, McLaughlin, Maeve, Penn, Henry, Genovese, Mark C., Sebba, Anthony, Rubbert-Roth, Andrea, Scali, Juan, Zilberstein, Moshe, Thompson, Liz, Van Vollenhoven, Ronald, De Benedetti, Fabrizio, Brunner, Hermine, Allen, Roger, Brown, Diane, Chaitow, Jeffrey, Pardeo, Manuela, Espada, Graciela, Flato, Berit, Horneff, Gerd, Devlin, Clare, Kenwright, Andrew, Schneider, Rayfel, Woo, Patricia, Martini, Alberto, Lovell, Daniel, Ruperto, Nicola, John, Holly, Hale, Elizabeth D., Treharne, Gareth J., Carroll, Douglas, Mercer, Louise, Low, Audrey, Galloway, James, Watson, Kath, Lunt, Mark, Symmons, Deborah, Davies, Rebecca, Dixon, William, Balarajah, Sharmili, Sandhu, Amrita, Ariyo, Mercy, Rankin, Elizabeth, Sandoo, Aamer, van Zanten, Jet J. Veldhuijzen, Toms, Tracey E., Smith, Jacqueline P., Malik, Saadia, Toberty, Elizabeth, Thalayasingam, Nishanthi, Hamilton, Jennifer, Kelly, Clive, Puntis, Daniel, Saravanan, Vadivelu, Rynne, Martin, Heycock, Carol, Winter, Richard, Wardle, Phil, Toms, Tracey, Cadman, Susan, Nightingale, Peter, Kitas, George, Alhusain, Awal Z., Verstappen, Suzanne M., Mirjafari, Hoda, Charlton-Menys, Valentine, Bunn, Diane, Durrington, Paul, Cooney, Jennifer K., Moore, Jonathan P., Lemmey, Andrew, Jones, Jeremy G., Maddison, Peter J., Ahmad, Yasmeen A., Ahmed, Tazeen J., Leone, Francesca, Browne, Hannah K., Wig, Surabhi, Chevance, Aurelie, Moore, Tonia, Manning, Joanne, Vail, Andy, Herrick, Ariane L., Derrett-Smith, Emma, Hoyles, Rachel, Moinzadeh, Pia, Chighizola, Cecilia, Khan, Korsa, Abraham, David, Warrell, Clare E., Sykes, Rebecca, Muir, Lindsay, Ennis, Holly, Shiwen, Xu, Thompson, Katherine, Liu, Shangxi, Leask, Andrew, Abraham, David J., Strickland, Gemma, Pauling, John, Betteridge, Zoe, Dunphy, Juliet, Owen, Pat, McHugh, Neil, Abignano, Giuseppina, Cuomo, Giovanna, Buch, Maya H., Rosenberg, William M., Valentini, Gabriele, Del Galdo, Francesco, Jenkins, Jessica, Pauling, John D., Howell, Kevin, Nihtyanova, Svetlana, Fonseca, Carmen, Malaviya, Anshuman P., Hadjinicolaou, Andreas V., Nisar, Muhammad K., Ruddlesden, Michael, Furlong, Anita, Baker, Sharon, Hall, Frances C., Raut-Roy, Dominique, Peluso, Rosario, Dario Di Minno, M. N., Iervolino, Salvatore, Costa, Luisa, Atteno, Mariangela, Lofrano, Mariana, Soscia, Ernesto, Castiglione, Fabiana, Foglia, Francesca, Scarpa, Raffaele, Wallis, Dinny, Dougados, Maxime, Keystone, Edward, Heckaman, Michele, Mease, Philip, Landewé, Robert, Nguyen, Dianne, Winfield, Rachel A., Dyke, Claire, Clemence, Mark, Mackay, Kirsten, Haywood, Kirstie L., Packham, Jon, Jordan, Kelvin P., Davies, Helen, Brophy, Sinead, Irvine, Elizabeth, Cooksey, Roxanne, Dennis, Michael S., Siebert, Stefan, Ibrahim, Fowzia, Krueger, Gerald, Gathany, Tim, Mudivarthy, Surekha, Mack, Michael, Tandon, Neeta, Sieper, Joachim, Braun, Jürgen, van der Heijde, Désirée, Isaacs, John, Dahmen, Georg, Wollenhaupt, Jürgen, Schulze-Koops, Hendrik, Gsteiger, Sandro, Bertolino, Arthur, Hueber, Wolfgang, Tak, Paul P., Cohen, Carla J., Karaderi, Tugce, Pointon, Jennifer J., Wordsworth, Bryan P., Keidel, Sarah, Farrar, Claire, Appleton, Louise H., Adshead, Rebecca, Tahir, Hasan, Greenwood, Mandy, Donnelly, Simon P., Wajed, Julekha, and Kirkham, Bruce

Abstract

Background: Foot surgery is common in patients with RA but research into surgical outcomes is limited and conceptually flawed as current outcome measures lack face validity: to date no one has asked patients what is important to them. This study aimed to determine which factors are important to patients when evaluating the success of foot surgery in RA Methods: Semi structured interviews of RA patients who had undergone foot surgery were conducted and transcribed verbatim. Thematic analysis of interviews was conducted to explore issues that were important to patients. Results: 11 RA patients (9 ♂, mean age 59, dis dur = 22yrs, mean of 3 yrs post op) with mixed experiences of foot surgery were interviewed. Patients interpreted outcome in respect to a multitude of factors, frequently positive change in one aspect contrasted with negative opinions about another. Overall, four major themes emerged. Function: Functional ability & participation in valued activities were very important to patients. Walking ability was a key concern but patients interpreted levels of activity in light of other aspects of their disease, reflecting on change in functional ability more than overall level. Positive feelings of improved mobility were often moderated by negative self perception ("I mean, I still walk like a waddling duck”). Appearance: Appearance was important to almost all patients but perhaps the most complex theme of all. Physical appearance, foot shape, and footwear were closely interlinked, yet patients saw these as distinct separate concepts. Patients need to legitimize these feelings was clear and they frequently entered into a defensive repertoire ("it's not cosmetic surgery; it's something that's more important than that, you know?”). Clinician opinion: Surgeons' post operative evaluation of the procedure was very influential. The impact of this appraisal continued to affect patients' lasting impression irrespective of how the outcome compared to their initial goals ("when he'd done it ... he said that hasn't worked as good as he'd wanted to ... but the pain has gone”). Pain: Whilst pain was important to almost all patients, it appeared to be less important than the other themes. Pain was predominately raised when it influenced other themes, such as function; many still felt the need to legitimize their foot pain in order for health professionals to take it seriously ("in the end I went to my GP because it had happened a few times and I went to an orthopaedic surgeon who was quite dismissive of it, it was like what are you complaining about”). Conclusions: Patients interpret the outcome of foot surgery using a multitude of interrelated factors, particularly functional ability, appearance and surgeons' appraisal of the procedure. While pain was often noted, this appeared less important than other factors in the overall outcome of the surgery. Future research into foot surgery should incorporate the complexity of how patients determine their outcome Disclosure statement: All authors have declared no conflicts of interest

Published
2017

30. Mixed‐Methods Study Identifying Key Intervention Targets to Improve Participation in Daily Living Activities in Primary Sjögren's Syndrome Patients

Author

Hackett, Katie L., Deane, Katherine H. O., Newton, Julia L., Deary, Vincent, Bowman, Simon J., Rapley, Tim, Ng, Wan‐Fai, Brailsford, Sue, Dasgin, Joanne, Dimitroulas, Theodoros, Kadiki, Lucy, Kaur, Daljit, Kitas, George, Gordon, Esther, Lawson, Cathy, Ortiz, Gill, Price, Elizabeth, Pegler, Suzannah, Clunie, Gavin, Lane, Suzanne, Rose, Ginny, Cuckow, Sue, Griffiths, Bridget, Mitchell, Sheryl, Downie, Christine, Legg, Sarah, Pugmire, Susan, Vadivelu, Saravanan, Field, Anne, Kaye, Stephen, Mewar, Devesh, Medcalf, Patricia, Tomlinson, Pamela, Whiteside, Debbie, McHugh, Neil, Pauling, John, James, Julie, Dowden, Andrea, Coady, David, Kidd, Elizabeth, Palmer, Lynne, Dasgupta, Bhaskar, Katsande, Victoria, Long, Pamela, Godia, Olivia, Chandra, Usha, and MacKay, Kirsten

Abstract

Functional ability and participation in life situations are compromised in many primary Sjögren's syndrome (SS) patients. This study aimed to identify the key barriers and priorities to participation in daily living activities, in order to develop potential future interventions. Group concept mapping, a semiquantitative, mixed‐methods approach was used to identify and structure ideas from UKprimary SSpatients, adult household members living with a primary SSpatient, and health care professionals. Brainstorming generated ideas, which were summarized into a final set of statements. Participants individually arranged these statements into themes and rated each statement for importance. Multidimensional scaling and hierarchical cluster analysis were applied to sorted and rated data to produce visual representations of the ideas (concept maps), enabling identification of agreed priority areas for interventions. A total of 121 patients, 43 adult household members, and 67 health care professionals took part. In sum, 463 ideas were distilled down to 94 statements. These statements were grouped into 7 clusters: Patient Empowerment, Symptoms, Wellbeing, Access and Coordination of Health Care, Knowledge and Support, Public Awareness and Support, and Friends and Family. Patient Empowerment and Symptoms were rated as priority conceptual themes. Important statements within priority clusters indicate patients should be taken seriously and supported to self‐manage symptoms of oral and ocular dryness, fatigue, pain, and poor sleep. Our data highlighted the fact that in addition to managing primary SSsymptoms, interventions aiming to improve patient empowerment, general wellbeing, access to health care, patient education, and social support are important to facilitate improved participation in daily living activities.

Published
2018
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31. To the Editor

Author

Owen, Manon E., primary, Beare, Nicholas A. V., additional, Pearce, Ian A., additional, and Mewar, Devesh, additional

Published
2012
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32. Subjective and Objective Measures of Dryness Symptoms in Primary Sjögren's Syndrome: Capturing the Discrepancy

Author

Bezzina, Oriana M., Gallagher, Peter, Mitchell, Sheryl, Bowman, Simon J., Griffiths, Bridget, Hindmarsh, Victoria, Hargreaves, Ben, Price, Elizabeth J., Pease, Colin T., Emery, Paul, Lanyon, Peter, Bombardieri, Michele, Sutcliffe, Nurhan, Pitzalis, Costantino, Hunter, John, Gupta, Monica, McLaren, John, Cooper, Anne M., Regan, Marian, Giles, Ian P., Isenberg, David A., Saravanan, Vadivelu, Coady, David, Dasgupta, Bhaskar, McHugh, Neil J., Young‐Min, Steven A., Moots, Robert J., Gendi, Nagui, Akil, Mohammed, MacKay, Kirsten, Ng, W. Fai, Robinson, Lucy J., Bacabac, Elalaine C, Moots, Robert, Chakravarty, Kuntal, Lamabadusuriya, Shamin, Pitzalis, Constantino, Adeniba, Rashidat, Hamburger, John, Richards, Andrea, Rauz, Saaeha, Brailsford, Sue, Logan, Joanne, Mulherin, Diarmuid, Andrews, Jacqueline, McManus, Alison, Pease, Colin, Booth, Alison, Dimitroulas, Theodoros, Kadiki, Lucy, Kaur, Daljit, Kitas, George, Lloyd, Mark, Moore, Lisa, Gordon, Esther, Lawson, Cathy, Stirton, Lesley, Ortiz, Gill, Price, Elizabeth, Clunie, Gavin, Rose, Ginny, Cuckow, Sue, Knight, Susan, Symmons, Deborah, Jones, Beverley, Al‐Ali, Shereen, Carr, Andrew, Collins, Katherine, Corbett, Ian, Downie, Christine, Edgar, Suzanne, Carrozzo, Marco, Figuereido, Francisco, Foggo, Heather, Humphreys, Claire, James, Katherine, Lendrem, Dennis, Locke, James, Macleod, Iain, Mawson, Philip, Stocks, Philip, Tarn, Jessica, Jones, Adrian, Muir, Alice, White, Paula, Young‐Min, Steven, Pugmire, Susan, Vadivelu, Saravanan, Cooper, Annie, Watkins, Marianne, Field, Anne, Kaye, Stephen, Mewar, Devesh, Medcalf, Patricia, Tomlinson, Pamela, Whiteside, Debbie, McHugh, Neil, Pauling, John, James, Julie, Olaitan, Nike, McDermott, Jayne, Godia, Olivia, Kidd, Elizabeth, Palmer, Lynne, Katsande, Victoria, Long, Pamela, Li, Charles, Chandra, Usha, Fedele, Stefano, Ferenkeh‐Koroma, Ada, Giles, Ian, Isenberg, David, Maconnell, Helena, Porter, Stephen, and Allcoat, Paul

Abstract

To develop a novel method for capturing the discrepancy between objective tests and subjective dryness symptoms (a sensitivity scale) and to explore predictors of dryness sensitivity. Archive data from the UKPrimary Sjögren's Syndrome Registry (n = 688) were used. Patients were classified on a scale from −5 (stoical) to +5 (sensitive) depending on the degree of discrepancy between their objective and subjective symptoms classes. Sensitivity scores were correlated with demographic variables, disease‐related factors, and symptoms of pain, fatigue, anxiety, and depression. Patients were on average relatively stoical for both types of dryness symptoms (mean ± SDocular dryness −0.42 ± 2.2 and −1.24 ± 1.6 oral dryness). Twenty‐seven percent of patients were classified as sensitive to ocular dryness and 9% to oral dryness. Hierarchical regression analyses identified the strongest predictor of ocular dryness sensitivity to be self‐reported pain and that of oral dryness sensitivity to be self‐reported fatigue. Ocular and oral dryness sensitivity can be classified on a continuous scale. The 2 symptom types are predicted by different variables. A large number of factors remain to be explored that may impact symptom sensitivity in primary Sjögrenʼs syndrome, and the proposed method could be used to identify relatively sensitive and stoical patients for future studies.

Published
2017
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34. Independent associations of anti-cyclic citrullinated peptide antibodies and rheumatoid factor with radiographic severity of rheumatoid arthritis

Author

Mewar, Devesh, Coote, Annabel, Moore, David J, Marinou, Ioanna, Keyworth, Jodie, Dickson, Marion C, Montgomery, Doug S, Binks, Michael H, and Wilson, Anthony G

Subjects
musculoskeletal diseases, Male, Gene Dosage, Enzyme-Linked Immunosorbent Assay, Middle Aged, Peptides, Cyclic, Severity of Illness Index, Antibodies, Arthritis, Rheumatoid, Cohort Studies, Epitopes, Cross-Sectional Studies, Rheumatoid Factor, Humans, Female, skin and connective tissue diseases, Arthrography, Alleles, Research Article
Abstract

Several recent publications have established a strong association between anti-cyclic citrullinated peptide antibody (anti-CCP)-positive rheumatoid arthritis (RA) and carriage of shared epitope (SE) alleles. Although anti-CCP have also been associated with more severe RA, the issue of whether this is independent of rheumatoid factor (RF) has not been addressed. To identify associations between RF, anti-CCP, SE status and radiological damage, we studied a large cross-sectional cohort with longstanding RA. Individuals (n = 872) enrolled in the study all fulfilled the American College of Rheumatology criteria for RA, had a minimum disease duration of 3 years, and at least one definite radiographic erosion was present in hands or feet. Radiographs were scored blind at study entry by a single musculoskeletal radiologist using a modified Larsen's score. Anti-CCP and RF levels were determined using enzyme-linked immunosorbent assay, and DRB1 typing was performed using polymerase chain reaction based methodology. Both anti-CCP and RF levels were strongly associated with radiographic severity (P < 0.0001). In subgroups stratified for both anti-CCP and RF status, evidence of independent associations of both antibodies with radiographic outcome was found (P < 0.0001). An association of SE alleles with radiographic severity was present only in RF-negative individuals. Anti-CCP positivity was associated with SE status with evidence of a gene-dose effect, most markedly in RF-negative individuals (P < 0.01). Anti-CCP and RF status are independent severity factors for RA, with SE alleles playing at most a secondary role. Our data support the view that previously described associations between SE and radiological severity, especially in RF-negative patients, may be indirect and due to an association with anti-CCP.

Published
2006

35. BHPR research: qualitative1. Complex reasoning determines patients' perception of outcome following foot surgery in rheumatoid arhtritis

Author

Backhouse, Michael R., Vinall, Karen A., Redmond, Anthony, Helliwell, Philip, Keenan, Anne-Maree, Dale, Rebecca M., Thomas, Amanda, Aronson, Diane, Turner-Cobb, Julie, Sengupta, Raj, France, Brisa, Hill, Ingrid, Flurey, Caroline A., Morris, Marianne, Pollock, Jon, Hughes, Rod, Richards, Pam, Hewlett, Sarah, Ryan, Sarah, Lille, Kate, Adams, Jo, Haq, Inam, McArthur, Margaret, Goodacre, Lynne, Birt, Linda, Wilson, Oonagh, Kirwan, John, Dures, Emma, Quest, Enid, Rajak, Rizwan, Thomas, Tasmin, Lawson, Tom, Petford, Sharon, Hale, Elizabeth, Kitas, George D., Gooberman-Hill, Rachael, Jinks, Clare, Dziedzic, Krysia, Bouças, Sofia Barbosa, Hislop, Kelly, Rhodes, Carol, Ali, Fizzah, Ong, Bie Nio, White, Derrick, Hensor, Elizabeth, Ferguson, Anna M., Douiri, Abdel, Scott, David L., Lempp, Heidi, Halls, Serena, Law, Rebecca-Jane, Jones, Jeremy, Markland, David, Maddison, Peter, Thom, Jeanette, Thom, Jeanette M., Breslin, Anne, Kraus, Alexandra, Gordhan, Chandrika, Dennis, Sean, Connor, John, Chowdhary, Bhavani, Lottay, Neena, Juneja, Parmjit, Bacon, Paul A., Isaacs, David, Jack, James, Keller, Majella, Tibble, Jeremy, Hammond, Alison, Gill, Rachel, Tyson, Sarah, Tennant, Alan, Nordenskiold, Ulla, Pease, Emily E., Pease, Colin T., Trehane, Anne, Rahmeh, Fouz, Cornell, Patricia, Westlake, Sarah L., Rose, Katy, Alber, Catherine Fouad, Watson, Liam, Stratton, Richard, Lazarus, Mark, McNeilly, Natasha E., Waterfield, Jackie, Hurley, Mike, Greenwood, James, Clayton, Ann M., Lynch, Michael, Clewes, Adrian, Dawson, Julie, Abernethy, Veronica, Griffiths, Ann E., Chamberlain, Victoria A., McLoughlin, YokeMei, Campbell, Sophie, Hayes, Janita, Moffat, Claire, McKenna, Frank, Shah, Preeti, Williams, Ann, Rhys-Dillon, Ceril, Goodfellow, Rhian, Martin, James C., Bari, Farhan, Hughes, Gwenan, Thomas, Eleri, Baker, Sarah, Collins, David, Price, Elizabeth, Williamson, Lyn, Dunkley, Lisa, Youll, Matthew J., Rodziewicz, Mia, Reynolds, John A., Berry, Jacqueline, Pavey, Chee, Hyrich, Kimme, Gorodkin, Rachel, Wilkinson, Kate, Bruce, Ian, Barton, Anne, Silman, Alan, Ho, Pauline, Cornell, Tricia, Richards, Selwyn, Holmes, A., Parker, S., Smith, H., Briggs, N., Arthanari, S., Nisar, M., Thwaites, Catharine, Kamath, Sanjeet, Price, Shyra, Robinson, Sandra M., Walker, David, Coop, Hazel, Al-Allaf, Wahab, Charleton, Rebecca C., Griffiths, Bridget, Edwards, Elizabeth A., Partlett, Rosamund, Martin, Keith, Tarzi, Mike, Panthakalam, Sathianathan, Freeman, Tanya, Ainley, Louise, Turner, Michael, Hughes, Lyndsay, Russell, Bridget, Jenkins, Suzanne, Done, John, Young, Adam, Jones, Tadeusz, Gaywood, Ian C., Pande, Ira, Pradère, Marie-Josèphe, Bhaduri, Mahua, Smith, Angela, Cook, Haley, Abraham, Sonya, Ngcozana, Tanaka, Denton, Christopher P., Parker, Louise, Black, Carol M., Ong, Voon, Thompson, Nicola, White, Catherine, Duddy, Martin, Jobanputra, Paresh, Bacon, Pauline, Smith, Jacqueline, Richardson, Ann, Giancola, Giorgio, Soh, Vicky, Spencer, Simon, Greenhalgh, Ann, Hanson, Mark, De Lord, Denise, Lloyd, Mark, Wong, Henna, Wren, Damian, Grover, Bob, Hall, John, Neville, Cai, Alton, Peter, Kelly, Stephen, Bombardieri, Michele, Humby, Fran, Ng, Nora, Di Cicco, Maria, Hands, Rebecca, Epis, Oscar, Filer, Andrew, Buckley, Christopher, McInnes, Iain, Taylor, Peter, Pitzalis, Costantino, Freeston, Jane, Conaghan, Philip, Grainger, Andrew, O'Connor, Philip J., Evans, Rob, Emery, Paul, Hodgson, Richard, Fleischmann, Roy, Han, Chenglong, van der Heijde, Desiree, Xu, Weichun, Hsia, Elizabeth, Kavanaugh, Arthur, Gladman, Dafna, Chattopadhyay, Chandrabhusan, Beutler, Anna, Zayat, Ahmed S., Ellegard, Karen, Terslev, Lene, Wakefield, Richard J., Ciurtin, Coziana, Leandro, Maria, Dey, Dzifa, Nandagudi, Anupama, Giles, Ian, Shipley, Mike, Morris, Vanessa, Ioannou, John, Ehrenstein, Michael, Sen, Debajit, Chan, Marian, Quinlan, Tim M., Brophy, Richard, Mewar, Devesh, Patel, Dipti, Wilby, M. J., Pellegrini, Vincent, Eyes, Brian, Crooks, Daniel, Anderson, Marina, Ball, Elisabeth, McKeeman, Helen, Burns, James, Yau, Wing Hoi, Moore, Owen, Foo, Joanne, Benson, Claire, Patterson, Chris, Wright, Gary, Taggart, Allister, Drew, Sarah, Tanner, Lorraine, Sanyal, Kaushik, Bourke, Brian E., Alston, Claire, Baqai, Charlotte, Chard, Michael, Sandhu, Virinderjit, Jordan, Kelsey, Munns, Catherine, Zouita, Louisa, Shattles, Warren, Davies, Ursula, Makadsi, Raad, Griffith, Sian, Kiely, Patrick D., Dimofte, Ionela, Dabu, Mihaela, Dabu, Bogdan, Dobarro, David, Schreiber, Benjamin E., Warrell, Clare, Handler, Clive, Coghlan, Gerry, Denton, Chris, Ishorari, Jasmine, Bunn, Chris, Beynon, Huw, George Malal, Joby J., Boton-Maggs, Ben, Leung, Alexander, Farewell, Daniel, Choy, Ernest, Gullick, Nicola J., Choy, Ernest H., Wincup, Chris, Fisher, Ben, Charles, Peter, Pollard, Louise C., Kirkham, Bruce W., Ma, Margaret H., Ramanujan, Saroja, Cavet, Guy, Haney, Doug, Kingsley, Gabrielle H., Scott, David, Cope, Andrew, Singh, Animesh, Wilson, Jo, Isaacs, Anthony, Wing, Charlotte, McLaughlin, Maeve, Penn, Henry, Genovese, Mark C., Sebba, Anthony, Rubbert-Roth, Andrea, Scali, Juan, Zilberstein, Moshe, Thompson, Liz, Van Vollenhoven, Ronald, De Benedetti, Fabrizio, Brunner, Hermine, Allen, Roger, Brown, Diane, Chaitow, Jeffrey, Pardeo, Manuela, Espada, Graciela, Flato, Berit, Horneff, Gerd, Devlin, Clare, Kenwright, Andrew, Schneider, Rayfel, Woo, Patricia, Martini, Alberto, Lovell, Daniel, Ruperto, Nicola, John, Holly, Hale, Elizabeth D., Treharne, Gareth J., Carroll, Douglas, Mercer, Louise, Low, Audrey, Galloway, James, Watson, Kath, Lunt, Mark, Symmons, Deborah, Davies, Rebecca, Dixon, William, Balarajah, Sharmili, Sandhu, Amrita, Ariyo, Mercy, Rankin, Elizabeth, Sandoo, Aamer, van Zanten, Jet J. Veldhuijzen, Toms, Tracey E., Smith, Jacqueline P., Malik, Saadia, Toberty, Elizabeth, Thalayasingam, Nishanthi, Hamilton, Jennifer, Kelly, Clive, Puntis, Daniel, Saravanan, Vadivelu, Rynne, Martin, Heycock, Carol, Winter, Richard, Wardle, Phil, Toms, Tracey, Cadman, Susan, Nightingale, Peter, Kitas, George, Alhusain, Awal Z., Verstappen, Suzanne M., Mirjafari, Hoda, Charlton-Menys, Valentine, Bunn, Diane, Durrington, Paul, Cooney, Jennifer K., Moore, Jonathan P., Lemmey, Andrew, Jones, Jeremy G., Maddison, Peter J., Ahmad, Yasmeen A., Ahmed, Tazeen J., Leone, Francesca, Browne, Hannah K., Wig, Surabhi, Chevance, Aurelie, Moore, Tonia, Manning, Joanne, Vail, Andy, Herrick, Ariane L., Derrett-Smith, Emma, Hoyles, Rachel, Moinzadeh, Pia, Chighizola, Cecilia, Khan, Korsa, Abraham, David, Warrell, Clare E., Sykes, Rebecca, Muir, Lindsay, Ennis, Holly, Shiwen, Xu, Thompson, Katherine, Liu, Shangxi, Leask, Andrew, Abraham, David J., Strickland, Gemma, Pauling, John, Betteridge, Zoe, Dunphy, Juliet, Owen, Pat, McHugh, Neil, Abignano, Giuseppina, Cuomo, Giovanna, Buch, Maya H., Rosenberg, William M., Valentini, Gabriele, Del Galdo, Francesco, Jenkins, Jessica, Pauling, John D., Howell, Kevin, Nihtyanova, Svetlana, Fonseca, Carmen, Malaviya, Anshuman P., Hadjinicolaou, Andreas V., Nisar, Muhammad K., Ruddlesden, Michael, Furlong, Anita, Baker, Sharon, Hall, Frances C., Raut-Roy, Dominique, Peluso, Rosario, Dario Di Minno, M. N., Iervolino, Salvatore, Costa, Luisa, Atteno, Mariangela, Lofrano, Mariana, Soscia, Ernesto, Castiglione, Fabiana, Foglia, Francesca, Scarpa, Raffaele, Wallis, Dinny, Dougados, Maxime, Keystone, Edward, Heckaman, Michele, Mease, Philip, Landewé, Robert, Nguyen, Dianne, Winfield, Rachel A., Dyke, Claire, Clemence, Mark, Mackay, Kirsten, Haywood, Kirstie L., Packham, Jon, Jordan, Kelvin P., Davies, Helen, Brophy, Sinead, Irvine, Elizabeth, Cooksey, Roxanne, Dennis, Michael S., Siebert, Stefan, Ibrahim, Fowzia, Krueger, Gerald, Gathany, Tim, Mudivarthy, Surekha, Mack, Michael, Tandon, Neeta, Sieper, Joachim, Braun, Jürgen, van der Heijde, Désirée, Isaacs, John, Dahmen, Georg, Wollenhaupt, Jürgen, Schulze-Koops, Hendrik, Gsteiger, Sandro, Bertolino, Arthur, Hueber, Wolfgang, Tak, Paul P., Cohen, Carla J., Karaderi, Tugce, Pointon, Jennifer J., Wordsworth, Bryan P., Keidel, Sarah, Farrar, Claire, Appleton, Louise H., Adshead, Rebecca, Tahir, Hasan, Greenwood, Mandy, Donnelly, Simon P., Wajed, Julekha, Kirkham, Bruce, Backhouse, Michael R., Vinall, Karen A., Redmond, Anthony, Helliwell, Philip, Keenan, Anne-Maree, Dale, Rebecca M., Thomas, Amanda, Aronson, Diane, Turner-Cobb, Julie, Sengupta, Raj, France, Brisa, Hill, Ingrid, Flurey, Caroline A., Morris, Marianne, Pollock, Jon, Hughes, Rod, Richards, Pam, Hewlett, Sarah, Ryan, Sarah, Lille, Kate, Adams, Jo, Haq, Inam, McArthur, Margaret, Goodacre, Lynne, Birt, Linda, Wilson, Oonagh, Kirwan, John, Dures, Emma, Quest, Enid, Rajak, Rizwan, Thomas, Tasmin, Lawson, Tom, Petford, Sharon, Hale, Elizabeth, Kitas, George D., Gooberman-Hill, Rachael, Jinks, Clare, Dziedzic, Krysia, Bouças, Sofia Barbosa, Hislop, Kelly, Rhodes, Carol, Ali, Fizzah, Ong, Bie Nio, White, Derrick, Hensor, Elizabeth, Ferguson, Anna M., Douiri, Abdel, Scott, David L., Lempp, Heidi, Halls, Serena, Law, Rebecca-Jane, Jones, Jeremy, Markland, David, Maddison, Peter, Thom, Jeanette, Thom, Jeanette M., Breslin, Anne, Kraus, Alexandra, Gordhan, Chandrika, Dennis, Sean, Connor, John, Chowdhary, Bhavani, Lottay, Neena, Juneja, Parmjit, Bacon, Paul A., Isaacs, David, Jack, James, Keller, Majella, Tibble, Jeremy, Hammond, Alison, Gill, Rachel, Tyson, Sarah, Tennant, Alan, Nordenskiold, Ulla, Pease, Emily E., Pease, Colin T., Trehane, Anne, Rahmeh, Fouz, Cornell, Patricia, Westlake, Sarah L., Rose, Katy, Alber, Catherine Fouad, Watson, Liam, Stratton, Richard, Lazarus, Mark, McNeilly, Natasha E., Waterfield, Jackie, Hurley, Mike, Greenwood, James, Clayton, Ann M., Lynch, Michael, Clewes, Adrian, Dawson, Julie, Abernethy, Veronica, Griffiths, Ann E., Chamberlain, Victoria A., McLoughlin, YokeMei, Campbell, Sophie, Hayes, Janita, Moffat, Claire, McKenna, Frank, Shah, Preeti, Williams, Ann, Rhys-Dillon, Ceril, Goodfellow, Rhian, Martin, James C., Bari, Farhan, Hughes, Gwenan, Thomas, Eleri, Baker, Sarah, Collins, David, Price, Elizabeth, Williamson, Lyn, Dunkley, Lisa, Youll, Matthew J., Rodziewicz, Mia, Reynolds, John A., Berry, Jacqueline, Pavey, Chee, Hyrich, Kimme, Gorodkin, Rachel, Wilkinson, Kate, Bruce, Ian, Barton, Anne, Silman, Alan, Ho, Pauline, Cornell, Tricia, Richards, Selwyn, Holmes, A., Parker, S., Smith, H., Briggs, N., Arthanari, S., Nisar, M., Thwaites, Catharine, Kamath, Sanjeet, Price, Shyra, Robinson, Sandra M., Walker, David, Coop, Hazel, Al-Allaf, Wahab, Charleton, Rebecca C., Griffiths, Bridget, Edwards, Elizabeth A., Partlett, Rosamund, Martin, Keith, Tarzi, Mike, Panthakalam, Sathianathan, Freeman, Tanya, Ainley, Louise, Turner, Michael, Hughes, Lyndsay, Russell, Bridget, Jenkins, Suzanne, Done, John, Young, Adam, Jones, Tadeusz, Gaywood, Ian C., Pande, Ira, Pradère, Marie-Josèphe, Bhaduri, Mahua, Smith, Angela, Cook, Haley, Abraham, Sonya, Ngcozana, Tanaka, Denton, Christopher P., Parker, Louise, Black, Carol M., Ong, Voon, Thompson, Nicola, White, Catherine, Duddy, Martin, Jobanputra, Paresh, Bacon, Pauline, Smith, Jacqueline, Richardson, Ann, Giancola, Giorgio, Soh, Vicky, Spencer, Simon, Greenhalgh, Ann, Hanson, Mark, De Lord, Denise, Lloyd, Mark, Wong, Henna, Wren, Damian, Grover, Bob, Hall, John, Neville, Cai, Alton, Peter, Kelly, Stephen, Bombardieri, Michele, Humby, Fran, Ng, Nora, Di Cicco, Maria, Hands, Rebecca, Epis, Oscar, Filer, Andrew, Buckley, Christopher, McInnes, Iain, Taylor, Peter, Pitzalis, Costantino, Freeston, Jane, Conaghan, Philip, Grainger, Andrew, O'Connor, Philip J., Evans, Rob, Emery, Paul, Hodgson, Richard, Fleischmann, Roy, Han, Chenglong, van der Heijde, Desiree, Xu, Weichun, Hsia, Elizabeth, Kavanaugh, Arthur, Gladman, Dafna, Chattopadhyay, Chandrabhusan, Beutler, Anna, Zayat, Ahmed S., Ellegard, Karen, Terslev, Lene, Wakefield, Richard J., Ciurtin, Coziana, Leandro, Maria, Dey, Dzifa, Nandagudi, Anupama, Giles, Ian, Shipley, Mike, Morris, Vanessa, Ioannou, John, Ehrenstein, Michael, Sen, Debajit, Chan, Marian, Quinlan, Tim M., Brophy, Richard, Mewar, Devesh, Patel, Dipti, Wilby, M. J., Pellegrini, Vincent, Eyes, Brian, Crooks, Daniel, Anderson, Marina, Ball, Elisabeth, McKeeman, Helen, Burns, James, Yau, Wing Hoi, Moore, Owen, Foo, Joanne, Benson, Claire, Patterson, Chris, Wright, Gary, Taggart, Allister, Drew, Sarah, Tanner, Lorraine, Sanyal, Kaushik, Bourke, Brian E., Alston, Claire, Baqai, Charlotte, Chard, Michael, Sandhu, Virinderjit, Jordan, Kelsey, Munns, Catherine, Zouita, Louisa, Shattles, Warren, Davies, Ursula, Makadsi, Raad, Griffith, Sian, Kiely, Patrick D., Dimofte, Ionela, Dabu, Mihaela, Dabu, Bogdan, Dobarro, David, Schreiber, Benjamin E., Warrell, Clare, Handler, Clive, Coghlan, Gerry, Denton, Chris, Ishorari, Jasmine, Bunn, Chris, Beynon, Huw, George Malal, Joby J., Boton-Maggs, Ben, Leung, Alexander, Farewell, Daniel, Choy, Ernest, Gullick, Nicola J., Choy, Ernest H., Wincup, Chris, Fisher, Ben, Charles, Peter, Pollard, Louise C., Kirkham, Bruce W., Ma, Margaret H., Ramanujan, Saroja, Cavet, Guy, Haney, Doug, Kingsley, Gabrielle H., Scott, David, Cope, Andrew, Singh, Animesh, Wilson, Jo, Isaacs, Anthony, Wing, Charlotte, McLaughlin, Maeve, Penn, Henry, Genovese, Mark C., Sebba, Anthony, Rubbert-Roth, Andrea, Scali, Juan, Zilberstein, Moshe, Thompson, Liz, Van Vollenhoven, Ronald, De Benedetti, Fabrizio, Brunner, Hermine, Allen, Roger, Brown, Diane, Chaitow, Jeffrey, Pardeo, Manuela, Espada, Graciela, Flato, Berit, Horneff, Gerd, Devlin, Clare, Kenwright, Andrew, Schneider, Rayfel, Woo, Patricia, Martini, Alberto, Lovell, Daniel, Ruperto, Nicola, John, Holly, Hale, Elizabeth D., Treharne, Gareth J., Carroll, Douglas, Mercer, Louise, Low, Audrey, Galloway, James, Watson, Kath, Lunt, Mark, Symmons, Deborah, Davies, Rebecca, Dixon, William, Balarajah, Sharmili, Sandhu, Amrita, Ariyo, Mercy, Rankin, Elizabeth, Sandoo, Aamer, van Zanten, Jet J. Veldhuijzen, Toms, Tracey E., Smith, Jacqueline P., Malik, Saadia, Toberty, Elizabeth, Thalayasingam, Nishanthi, Hamilton, Jennifer, Kelly, Clive, Puntis, Daniel, Saravanan, Vadivelu, Rynne, Martin, Heycock, Carol, Winter, Richard, Wardle, Phil, Toms, Tracey, Cadman, Susan, Nightingale, Peter, Kitas, George, Alhusain, Awal Z., Verstappen, Suzanne M., Mirjafari, Hoda, Charlton-Menys, Valentine, Bunn, Diane, Durrington, Paul, Cooney, Jennifer K., Moore, Jonathan P., Lemmey, Andrew, Jones, Jeremy G., Maddison, Peter J., Ahmad, Yasmeen A., Ahmed, Tazeen J., Leone, Francesca, Browne, Hannah K., Wig, Surabhi, Chevance, Aurelie, Moore, Tonia, Manning, Joanne, Vail, Andy, Herrick, Ariane L., Derrett-Smith, Emma, Hoyles, Rachel, Moinzadeh, Pia, Chighizola, Cecilia, Khan, Korsa, Abraham, David, Warrell, Clare E., Sykes, Rebecca, Muir, Lindsay, Ennis, Holly, Shiwen, Xu, Thompson, Katherine, Liu, Shangxi, Leask, Andrew, Abraham, David J., Strickland, Gemma, Pauling, John, Betteridge, Zoe, Dunphy, Juliet, Owen, Pat, McHugh, Neil, Abignano, Giuseppina, Cuomo, Giovanna, Buch, Maya H., Rosenberg, William M., Valentini, Gabriele, Del Galdo, Francesco, Jenkins, Jessica, Pauling, John D., Howell, Kevin, Nihtyanova, Svetlana, Fonseca, Carmen, Malaviya, Anshuman P., Hadjinicolaou, Andreas V., Nisar, Muhammad K., Ruddlesden, Michael, Furlong, Anita, Baker, Sharon, Hall, Frances C., Raut-Roy, Dominique, Peluso, Rosario, Dario Di Minno, M. N., Iervolino, Salvatore, Costa, Luisa, Atteno, Mariangela, Lofrano, Mariana, Soscia, Ernesto, Castiglione, Fabiana, Foglia, Francesca, Scarpa, Raffaele, Wallis, Dinny, Dougados, Maxime, Keystone, Edward, Heckaman, Michele, Mease, Philip, Landewé, Robert, Nguyen, Dianne, Winfield, Rachel A., Dyke, Claire, Clemence, Mark, Mackay, Kirsten, Haywood, Kirstie L., Packham, Jon, Jordan, Kelvin P., Davies, Helen, Brophy, Sinead, Irvine, Elizabeth, Cooksey, Roxanne, Dennis, Michael S., Siebert, Stefan, Ibrahim, Fowzia, Krueger, Gerald, Gathany, Tim, Mudivarthy, Surekha, Mack, Michael, Tandon, Neeta, Sieper, Joachim, Braun, Jürgen, van der Heijde, Désirée, Isaacs, John, Dahmen, Georg, Wollenhaupt, Jürgen, Schulze-Koops, Hendrik, Gsteiger, Sandro, Bertolino, Arthur, Hueber, Wolfgang, Tak, Paul P., Cohen, Carla J., Karaderi, Tugce, Pointon, Jennifer J., Wordsworth, Bryan P., Keidel, Sarah, Farrar, Claire, Appleton, Louise H., Adshead, Rebecca, Tahir, Hasan, Greenwood, Mandy, Donnelly, Simon P., Wajed, Julekha, and Kirkham, Bruce

Abstract

Background: Foot surgery is common in patients with RA but research into surgical outcomes is limited and conceptually flawed as current outcome measures lack face validity: to date no one has asked patients what is important to them. This study aimed to determine which factors are important to patients when evaluating the success of foot surgery in RA Methods: Semi structured interviews of RA patients who had undergone foot surgery were conducted and transcribed verbatim. Thematic analysis of interviews was conducted to explore issues that were important to patients. Results: 11 RA patients (9 ♂, mean age 59, dis dur = 22yrs, mean of 3 yrs post op) with mixed experiences of foot surgery were interviewed. Patients interpreted outcome in respect to a multitude of factors, frequently positive change in one aspect contrasted with negative opinions about another. Overall, four major themes emerged. Function: Functional ability & participation in valued activities were very important to patients. Walking ability was a key concern but patients interpreted levels of activity in light of other aspects of their disease, reflecting on change in functional ability more than overall level. Positive feelings of improved mobility were often moderated by negative self perception ("I mean, I still walk like a waddling duck”). Appearance: Appearance was important to almost all patients but perhaps the most complex theme of all. Physical appearance, foot shape, and footwear were closely interlinked, yet patients saw these as distinct separate concepts. Patients need to legitimize these feelings was clear and they frequently entered into a defensive repertoire ("it's not cosmetic surgery; it's something that's more important than that, you know?”). Clinician opinion: Surgeons' post operative evaluation of the procedure was very influential. The impact of this appraisal continued to affect patients' lasting impression irrespective of how the outcome compared to their initial goals ("wh

36. Serial analysis of clinical and imaging indices reveals prolonged efficacy of TNF-α and IL-6 receptor targeted therapies in refractory Takayasu arteritis.

Author

Youngstein T, Peters JE, Hamdulay SS, Mewar D, Price-Forbes A, Lloyd M, Jeffery R, Kinderlerer AR, and Mason JC

Subjects
Adolescent, Adult, Arterial Occlusive Diseases etiology, Arterial Occlusive Diseases immunology, Biological Therapy methods, Cyclophosphamide administration & dosage, Cyclophosphamide adverse effects, Disease Progression, Drug Monitoring, Drug Resistance, Female, Follow-Up Studies, Humans, Immunosuppressive Agents administration & dosage, Immunosuppressive Agents adverse effects, Magnetic Resonance Angiography methods, Male, Prednisone administration & dosage, Prednisone adverse effects, Retrospective Studies, Severity of Illness Index, Time Factors, Treatment Outcome, United Kingdom epidemiology, Antibodies, Monoclonal, Humanized administration & dosage, Antibodies, Monoclonal, Humanized adverse effects, Arterial Occlusive Diseases prevention & control, Receptors, Interleukin-6 antagonists & inhibitors, Takayasu Arteritis complications, Takayasu Arteritis drug therapy, Takayasu Arteritis epidemiology, Takayasu Arteritis immunology, Takayasu Arteritis physiopathology, Tumor Necrosis Factor-alpha antagonists & inhibitors
Abstract

Objectives: We analysed a large cohort of patients with Takayasu arteritis, seeking robust clinical evidence for prolonged responses to tumour necrosis factor-α (TNF-α) and interleukin-6 receptor (IL-6R) antagonists in severe refractory disease., Methods: Case notes from ninety-eight patients with Takayasu arteritis were retrospectively reviewed. Drug treatment, laboratory and serial non-invasive imaging data were analysed, and the Indian Takayasu arteritis activity (ITAS) and damage scores (TADs) calculated., Results: Nine patients were treated with biologic therapies. All had previously received high dose prednisolone and ≥1 conventional immunosuppressant. Five patients had failed cyclophosphamide. The patients prescribed biologics had more extensive arterial injury than the remainder of the cohort and persistent active disease (ITAS range 2-9, CRP 12-206 mg/L, TADs 3--1). Eight patients were prescribed anti-TNF-α therapy, three IL-6R blockade. The mean duration of anti-TNF-α treatment was 42 months (maximum 8 years). One patient developed new arterial stenoses while receiving anti-TNF-α and subsequently achieved disease remission with tocilizumab. Two patients have now demonstrated sustained responses to IL-6R inhibition at 19 and 20 months. Following introduction of biologic therapy, serial non-invasive imaging has revealed no significant progression in arterial injury. A significant fall in CRP (p<0.01), prednisolone dose (p<0.01) and ITAS (p<0.01) was observed, with no increase in TADs., Conclusions: We report for the first time sustained responses to both anti-TNF-α and IL6R antagonists in refractory Takayasu arteritis. As 5/9 patients were cyclophosphamide non-responders, we propose that biologics should now be considered ahead of cyclophosphamide in these young patients.

Published
2014

38. Inflammatory osteoarthritis which was precipitated by Arimidex and resolved with tamoxifen.

Author

Williams S, Michael B, Mewar D, and Tunn E

Subjects
Anastrozole, Antineoplastic Agents, Hormonal therapeutic use, Breast Neoplasms complications, Disease Progression, Female, Humans, Middle Aged, Nitriles therapeutic use, Osteoarthritis complications, Osteoarthritis diagnosis, Osteoarthritis drug therapy, Triazoles therapeutic use, Antineoplastic Agents, Hormonal adverse effects, Breast Neoplasms drug therapy, Nitriles adverse effects, Osteoarthritis chemically induced, Selective Estrogen Receptor Modulators therapeutic use, Tamoxifen therapeutic use, Triazoles adverse effects
Abstract

We report the case of a 51-year-old woman who presented with an inflammatory flare of osteoarthritis of the small joints of her hands occurring in a temporal relationship with the commencement of Arimidex, prescribed to reduce systemic oestrogen levels to treat breast cancer. Following the cessation of Arimidex and the initiation of tamoxifen, a specific oestrogen receptor antagonist, this flare resolved. It has long been observed that during the menopause, as oestrogen levels decline, many women develop osteoarthritis or experience progression of the disease. However, this theory of oestrogen-dependent osteoarthritis has not been consistently demonstrated in animal models. As far as the authors are aware, this is the first case in which systemic oestrogen reduction has resulted in a severe osteoarthritis flare but targeted oestrogen receptor blockade led to a resolution of symptoms. These findings may inform the pathophysiological process underlying oestrogen-dependent osteoarthritis, although further series are needed.

Published
2010
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39. Functional characterization of NF-kappaB inhibitor-like protein 1 (NFkappaBIL1), a candidate susceptibility gene for rheumatoid arthritis.

Author

Greetham D, Ellis CD, Mewar D, Fearon U, an Ultaigh SN, Veale DJ, Guesdon F, and Wilson AG

Subjects
Adaptor Proteins, Signal Transducing, Arthritis, Rheumatoid pathology, Biopsy, Carbon-Nitrogen Ligases metabolism, Cells, Cultured, DEAD-box RNA Helicases metabolism, Female, Genetic Predisposition to Disease, HeLa Cells, Histocompatibility Antigens Class II metabolism, Humans, Male, Neoplasm Proteins metabolism, Peptide Elongation Factor 1 metabolism, Protein Biosynthesis genetics, Protein Isoforms metabolism, RNA Processing, Post-Transcriptional, RNA, Messenger metabolism, Synovial Membrane metabolism, Synovial Membrane pathology, Tissue Distribution, Arthritis, Rheumatoid genetics, Histocompatibility Antigens Class II genetics, Histocompatibility Antigens Class II physiology
Abstract

Several studies have implicated the NF-kappaB inhibitor-like protein 1 (NFkBIL1) gene located in the class III region of the major histocompatibility complex (MHC) as a possible susceptibility locus for rheumatoid arthritis (RA). Based on limited homology, it has been suggested to be a member of the inhibitor of NF-kappaB (IkappaB) family of proteins, but a role in mRNA processing has also been proposed. We have investigated the expression of NFkBIL1 in RA synovial tissue and characterized its function. Real-time PCR showed the two NFkBIL1 mRNA splice variants are expressed in a tissue-specific manner. Dual immunofluorescent staining of human RA synovium with polyclonal anti-NFkBIL1 antibodies and anti-CD68, anti-CD3 or anti-factor VIII showed that NFkBIL1 was expressed in the rheumatoid synovial lining and sub-lining layers and co-localized in CD68+ and CD3+, but not Factor VIII+ cells. Confocal microscopy of cultured synovial fibroblasts revealed expression in speckled nuclear and homogenous cytoplasmic distributions, suggesting shuttling between the cytoplasmic and nuclear compartments. Functional tests showed that NFkBIL1 isoforms were incapable of associating with NF-kappaB and did not inhibit it, thus disproving the hypothesis that NFkBIL1 functions as an IkappaB. Affinity purification of endogenous NFkBIL1 proteins and co-immunoprecipitation experiments showed that NFkBIL1 can associate with mRNA and with three protein partners, identified by mass spectrometry as leukophysin, translation elongation factor 1 alpha and CTP synthase I. These data support a potential role for NFkBL1 in the pathogenesis of RA and indicates that it may be involved in mRNA processing or the regulation of translation.

Published
2007
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