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Annual updates: SpA and PsA SPARCC

This update from May 27, 2013, by Vinod Chandran explores the SpA and PsA database's importance, reviewing study results and disclosing affiliations. The research focuses on identifying and predicting the course of axial and peripheral arthritis, sacroiliitis, and familial aggregation tendencies, among others. The SPARCC aims to enhance SpA patient health in Canada through improved diagnosis, defining, and care predictions via genetic studies, biomarker identification, personalized treatments, and early detection strategies. The network has made significant progress in genetics, biomarker validation, unique populations like children and First Nations, outcome measures, and knowledge exchange. Future research areas include longitudinal joint damage progression, quality of life comparisons, and economic impacts. The SPARCC project aims to address gaps in SpA understanding and care in North America.

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Annual updates: SpA and PsA SPARCC

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  1. Annual updates: SpA and PsA SPARCC 27 May 2013 Vinod Chandran

  2. Learning Objectives To understand the utility of a spondyloarthritis database Review results of studies conducted using the database

  3. Disclosures Honoraria: Abbott/Abbvie, Amgen, Bristol-Myers Squibb, Celgene, Janssen, Pfizer Advisory Board: Abbott/Abbvie, Amgen, Celgene, Janssen, Pfizer Research Grants: Abbvie

  4. Spondyloarthritis peripheral as well as axial arthritis radiological sacroiliitis mucosal and skin inflammation tendency for familial aggregation absence of rheumatoid factors absence of subcutaneous nodules A group of inflammatory rheumatic diseases with the following common features: Ann Rheum Dis 2011;70:1-3.

  5. A trans-disciplinary national research program focusing on Genetic and Pathogenesis Studies and Outcome Measures for Patients with SpA Established 2003 Funded by The Arthritis Society National Research Initiative Grant 2006-2010

  6. The SPARCC Executive Committee

  7. SPARCC Objectives Overall Objective To improve the health of SpA patients in Canada by better defining, diagnosing, and predicting the course of AS and PsA The three objectives and key elements of the SPARCC research network are Improved understanding of the biological basis of SpA Improved clinical outcomes in SpA Improved assessment of the impact of SpA in Canada.

  8. SPARCC Research Areas of focus •Cohort expansion and detailed longitudinal follow up •Identification and validation of biomarkers •Development of personalized treatments •Development of strategies for early detection •Development of tools and techniques for best practices for clinicians

  9. SPARCC Achievements •Advances in Genetics and Outcome Measures Unique Populations juvenile SpA First Nations population Access to Care Social Role Participation measuring the impact of SpA on quality of life Knowledge Transfer and Exchange •Establishment of a common clinical database •Partnership with the Canadian Spondylitis Association (CSA)

  10. SPARCC Database AS=ankylosing spondylitis; PsA=psoriatic arthritis; nXR=non-radiographic AS; ReA=reactive arthritis; USpA=undifferentiated Spondyloarthritis.

  11. SPARCC Database Demographics

  12. SPARCC Database Extra-articular features at 1st Visit

  13. SPARCC Database Co-morbid conditions

  14. SPARCC Database Medication Use 1st Visit

  15. SPARCC Achievements AS IL-1 gene cluster, IL-23R, and ERAP-1 Functional implications of ERAP1 GWAS and meta-analysis underway Immunochip analysis with IGAS consortium CNV analysis UGT2B17 gene CNV Exome sequencing PsA HLA-Cw6/MICA/TNF-α/KIR alleles, IL-1 gene cluster, IL-23R GWAS and meta-analysis underway ReA TLR2 Advances in Genetics Ann Rheum Dis 2008;67:1305-9. Arthritis Rheum 2008;58:1020-5. Arthritis Rheum 2009;60:1317-23. Ann Rheum Dis 2010;69:297-300. J Rheumatol2009;36:137-40. Arthritis Rheum 2008;58:3436-8.

  16. SPARCC Achievements Multiplex assay of a panel of 58 biomarkers in AS: identification of high priority candidates for prediction of structural damage Osteocalcin and RANTES higher in AS Progressor subgroup: MMP-9, TGFα, TNFα elevated Non-progressor subgroup: eotaxin, IFNα-2, and MCP-3 elevated Advances in Biomarkers Arthritis Rheum 63(10suppl):S644, 2011.

  17. SPARCC Achievements INSPIRE study MRI SPARCC MRI scoring system Impact Social Role Participation Questionnaire Work Instability Advances in Outcome Measures J Rheumatol 2007;34:1740-5. J Rheumatol 2007;34:1733-9. Arthritis Rheum2007;57:501-7. Ann Rheum Dis 2011;70:1765-9. Arthritis Rheum 2012;64(Suppl 10):S 595-6

  18. SPARCC Achievements Advances in Unique Populations Paediatric Populations Validation of outcome measures used in adult SpA in Juvenile SpA Whole-body MRI First Nations Access to effective therapeutics amongst SpA patients from the First Nations peoples in British Columbia

  19. SPARCC Achievements The CRA/SPARCC Treatment Recommendations for the Management of Spondyloarthritis: A National Multidisciplinary Stakeholder Project Advances in Access to Care & Guidelines of SPARCC/CRA J Rheumatol 2007;34:2273-84.

  20. SPARCC Achievements Advances in Knowledge Transfer and Exchange Handbook for physicians entitled Ankylosing Spondylitis: Assessment Scores, Classification and Diagnostic Criteria Public Symposia on SpA in collaboration with the Canadian Spondylitis Association Web videos (sparcc.ca ) Spinal mobility measurements Video archive of all the public patient fora Annual Fellows training day

  21. Future Direction Longitudinal changes in SpA predictors for progression of joint damage Compare differences among SpA over time Compare quality of life and function among different SpA Comparison amongst different regions of Canada Gender effect on disease progression Drug Response Economic impact Co-morbidities Imaging Access to Care Predictive profiles of radiographic progression: Serum biomarker analysis SpA in children (novel markers for prognosis and activity) SpA in First Nations (prevalence, genetic susceptibility, care gaps)

  22. Summary Spondyloarthritis not well studied in North America SPARCC developed to address need SPARCC has made important new observations in SpA and has a significant international profile SPARCC will continue to further research, advocacy and education in SpA

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