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The management of antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) has come a long way from the first postmortem descriptions of the diseases in the 1930s and 1950s1 Pivotal phases have been the introduction of glucocorticoids (GC) and cyclophosphamide (CYC), the association with ANCA in the 1980s, and consensus classification and nomenclature systems from 1990 onwards2.

To test shortened versions of the psoriatic arthritis (PsA) composite measures for use in routine clinical practice.

Clinical and patient-reported outcome measures (PROMs) were assessed in patients with PsA at 3 consecutive follow-up visits in a UK multicenter observational study. Shortened versions of the Composite Psoriatic Arthritis Disease Activity Index (CPDAI) and Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA) Composite Exercise (GRACE) measures were developed using PROMs and tested against the Disease Activity Score in 28 joints (DAS28), composite Disease Activity in Psoriatic Arthritis, and Routine Assessment of Patient Index Data (RAPID3). Discrimination between disease states and responsiveness were tested with the

-score, standardized response mean (SRM), and effect size (ES). Data were presented to members at the GRAPPA 2020 annual meeting and members voted on the recommended composite routine practice.

The SRM for the GRACE, 3 visual analog scale (VAS), annd has the best performance characteristics of the tested composite measures. GRAPPA members recommend further testing of the 3VAS and 4VAS in observational and trial datasets.Eleven Patient Research Partners (PRPs) attended the virtual Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA) 2020 Annual Meeting. PRPs fully participated in the panel discussion at the 2020 GRAPPA Annual Meeting on the topic of the coronavirus disease 2019 (COVID-19; caused by SARS-CoV-2). The members of the PRP group have been involved in many GRAPPA projects over the last year, including work on the GRAPPA-Outcome Measures in Rheumatology (OMERACT) Core Set, GRAPPA's 2020 Treatment Guidelines update project, and GRAPPA's Collaborative Research Network project.

To test the addition of pain and fatigue to the Composite Psoriatic Arthritis Disease Activity (CPDAI) and the Group for Research and Assessment of Psoriasis and PsA (GRAPPA) Composite Exercise (GRACE) composite measures of psoriatic arthritis (PsA).

Clinical and patient-reported outcome measures were assessed in patients with PsA at 3 consecutive follow-up visits over 6 months in a UK multicenter observational study. A pain visual analog scale and Functional Assessment of Chronic Illness Therapy Fatigue scale were added as modifications to the CPDAI and GRACE composite measures. Original and modified versions were tested against the PsA Disease Activity Score (PASDAS) and the Disease Activity Index for PsA (DAPSA). Discrimination between disease states and responsiveness were tested with

-scores, standardized response means (SRMs), and effect sizes. Data were presented to members at the 2020 annual meeting who then voted on the GRAPPArecommended composite and treatment targets for clinical trials.

OnE with the addition of pain and fatigue does not enhance responsiveness nor the measures' ability to detect disease status in terms of requiring treatment escalation. GRAPPA members voted for the PASDAS as the composite measure in clinical trials and MDA as the target.SAPHO (synovitis, acne, pustulosis, hyperostosis, and osteitis) syndrome is a rare chronic inflammatory disease involving bone, joints, and skin1 No consensus has been reached on the treatment of SAPHO syndrome and the current options may lead to variable outcomes2.Ultrasound (US) is a valuable imaging modality that can accurately identify relevant features of psoriatic arthritis (PsA), such as synovitis, tenosynovitis, and enthesitis. The Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA) Ultrasound Committee ran a workshop during the annual GRAPPA meeting that was held in July 2020. The group presented the following 3 topics (1) the transition from psoriasis to PsA and the role of US; (2) the effect of biomechanical forces on the entheses in health and disease, and insight for PsA pathogenesis; and (3) differentiation of enthesitis from pain sensitization use and limitations of clinical and sonographic evaluation of enthesitis. This article summarizes the key messages from this workshop.The Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA)-Outcome Measures in Rheumatology (OMERACT) Psoriatic Arthritis (PsA) Working Group provided updates at the 2020 GRAPPA annual meeting on its work toward developing a core outcome set for PsA. Working groups were set up for the 4 prioritized domains enthesitis, fatigue, structural damage, and physical function. Two instruments for measurement of physical function were provisionally endorsed (1) the Health Assessment Questionnaire-Disability Index and (2) the physical functioning domain in the Medical Outcomes Study 36-item Short Form survey.

In Rheumatoid Arthritis (RA), evidence regarding the effectiveness of a second biologic Disease Modifying Anti-Rheumatic Drugs (bDMARDs) in patients whose first ever bDMARD was a non-tumor-necrosis-factor-inhibitor (TNFi) bDMARD is limited. The objective of this study was therefore to assess the outcome of the second bDMARD (non-TNFi [rituximab, abatacept or tocilizumab, separately] and TNFi) after failure of a non-TNFi bDMARD as first bDMARD.

We identified RA patients from the five Nordic biologics registers started treatment with a non-TNFi as first ever bDMARD but switched to a second bDMARD. For the second bDMARD, we assessed survival-on-drug (at 6 and 12 months), and primary response (at 6 months).

We included 620 patients starting a second bDMARD (ABA 86, RTX 40, TCZ 67 and TNFi 427) following failure of a first non-TNFI bDMARD. At 6 and 12 months after start of their second bDMARD, around 70% and 50%, respectively, remained on treatment, and at 6 months less than one third of patients were still on their second bDMARD and had reached low disease activity or remission according to DAS28. For those patients whose second bMDARD was a TNFI, the corresponding proportion was slightly higher (40%).

The survival-on-drug and primary response of a second bDMARD in RA patients switching due to failure of a non-TNFi bDMARD as first bDMARD is modest. RO4929097 Some patients may benefit from TNFi when used after failure of a non-TNFi as first bDMARD.

The survival-on-drug and primary response of a second bDMARD in RA patients switching due to failure of a non-TNFi bDMARD as first bDMARD is modest. Some patients may benefit from TNFi when used after failure of a non-TNFi as first bDMARD.Rheumatoid arthritis (RA) has become an expensive disease to treat with the introduction of biological therapies in the early 2000s. Therefore, it is of crucial importance that researchers, together with clinicians, search for treatment strategies with the best value for money. That is why we would like to thank the authors of the paper entitled, "Effect on Costs and Quality‑adjusted Life-years of Treat-to-target Treatment Strategies Initiating Methotrexate, or Tocilizumab, or Their Combination in Early Rheumatoid Arthritis," published in this issue of The Journal of Rheumatology, for their honorable attempt1.This article summarizes sessions that dealt with axial psoriatic arthritis (axPsA) at the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA) 2020 virtual meeting. The summary includes the symposium, which comprised a plenary presentation by Dr. Dafna Gladman from Toronto, Canada, as well as a panel discussion with Dr. Philip Helliwell, Dr. Denis Poddubnyy, and Dr. Gladman, moderated by Dr. Philip Mease. In addition, the paper also summarizes Dr. Mease's "Meet the Expert" session, which focused on axPsA.

To estimate the healthcare resource utilization (HRU) in patients with giant cell arteritis (GCA) compared with the general population in southern Sweden.

The study sample comprised 653 patients with GCA along with 10 age-, sex-, and residency area-matched reference subjects per patient. Data on public and private healthcare consultations and hospitalizations were extracted from the Skåne Healthcare Register. We assessed trajectories of primary and specialist healthcare visits, as well as hospital admissions and inpatient days from 3 years before through 5 years after the date of GCA diagnosis for patients and matched references. HRU was analyzed using generalized estimating equations adjusted for sex, age at the index year, calendar year of diagnosis, education, income, marital status, place of birth, and Charlson Comorbidity Index. Inverse probability weighting was used to account for dropout during study.

Patients with GCA had higher rates of healthcare visits than the references from the year before GCA diagnosis and up to 4 years after diagnosis, with the largest relative (rate ratio 1.85, 95% CI 1.68-2.05) and absolute (mean difference 10.2, 95% CI 8.1-12.3 visits per person) differences in the year of diagnosis. Similar trajectories were observed for primary and specialist healthcare visits. For hospital admissions and inpatient days, the differences disappeared 1 year after diagnosis date.

Patients with GCA utilized healthcare services at a significantly higher rate than the reference population. The increased utilization among Swedish patients with GCA was evident 1 year before and prolonged up to 4 years after diagnosis date.

Patients with GCA utilized healthcare services at a significantly higher rate than the reference population. The increased utilization among Swedish patients with GCA was evident 1 year before and prolonged up to 4 years after diagnosis date.Undoubtedly, individuals with systemic lupus erythematosus (SLE) are at higher risk for developing cerebrovascular disease than counterparts from the general population without SLE. In a metaanalysis of studies from around the world, the likelihood of individuals with SLE developing both ischemic and hemorrhagic stroke (intracerebral and/or subarachnoid hemorrhage) was more than 2 times that of the general population1 Risks for stroke appear to be highest soon after SLE diagnosis, and concomitant antiphospholipid syndrome (APS) in these patients does not markedly exacerbate risks for ischemic stroke2.

The evaluation of the evolution of telomere length from peripheral blood leukocytes (PBL) in subjects from the Osteoarthritis Initiative (OAI) cohort in relation to the incidence of osteoarthritis (OA) and explore its possible interactive influence with the mitochondrial DNA (mtDNA) haplogroup.

Dynamics of telomere sequence loss was quantified in PBL from initially healthy individuals, without symptoms or radiological signs, 78 carrying the mtDNA cluster HV and 47 with cluster JT, from the OAI, during a 72-month follow-up. The incidence of knee OA during this period (n=39) was radiographically established when Kellgren-Lawrence (KL) score increased from < 2 at recruitment to ≥ 2 during 72 months of follow-up. Multivariate analysis using binary logistic regression was performed to assess PBL telomere loss and mtDNA haplogroups as associated risk factors of incidence of knee OA RESULTS Carriers of cluster HV showed an OA incidence twice that of the JT carriers (n=30 vs. n=9). Rate of PBL telomere loss was higher in cluster HV carriers and in incident individuals.