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The 75th Annual Meeting of The Canadian Rheumatology Association was held virtually on February 24-26, 2021. The program consisted of presentations covering original research, symposia, awards, and lectures. Highlights of the meeting include the following 2021 Award Winners Distinguished Rheumatologist, Rachel Shupak; Distinguished Investigator, Sasha Bernatsky; Distinguished Teacher-Educator, Elaine Yacyshyn; Emerging Investigator, Zahi Touma; Ian Watson Award for the Best Abstract on SLE Research by a Trainee, Raffaella Carlomagno; Phil Rosen Award for the Best Abstract on Clinical or Epidemiology Research by a Trainee, Kimberley Yuen; Best Abstract by a Rheumatology Resident, Ariane Barbacki; Best Abstract on Basic Science Research by a Trainee, Andrew Kwan; Best Abstract by a Post-Graduate Research Trainee, Luiza Grazziotin; Best Abstract on Quality Care Initiatives in Rheumatology, Nadia Luca; Best Abstract by a Medical Student, Daniel Levin; Best Abstract by an Undergraduate Student, Anson Lee; Best Abspondyloarthritis, vasculitis, osteoarthritis, fibromyalgia, and their respective diagnoses, treatments, and outcomes are reflected in the abstracts, which we are pleased to publish in this issue of The Journal.

To assess the reproducibility of patient-reported tender and swollen joint counts of RA patients compared to trained clinicians.

We conducted a systematic literature review and meta-analysis of studies comparing patient-reported tender and/or swollen joint counts (TJC and SJC) to clinician counts in patients with rheumatoid arthritis. We calculated a pooled summary estimates for correlation. Agreement was compared using a Bland and Altman approach.

14 studies were included in the meta-analysis. There were strong correlations between clinician and patient TJC, 0.78 (95% CI 0.76, 0.80), and clinician and patient SJC, 0.59 (95% CI 0.54, 0.63). TJC had good reliability ranging from 0.50 to 0.85. SJC had moderate reliability ranging from 0.28 to 0.77. Agreement for TJC reduced for higher TJC values, suggesting a positive bias for self-reported TJC, which was not observed for SJC.

This meta-analysis has identified a strong correlation for patient-reported and clinician TJC, and a moderate correlation for SJC. Patient-reported joint counts may be suitable for use in annual review for patients in remission and in monitoring treatment response for patients with rheumatoid arthritis. However, they are likely not appropriate for decisions on commencement of biologics. Further research is needed to identify patient groups where patient-reported joint counts are unsuitable.

This meta-analysis has identified a strong correlation for patient-reported and clinician TJC, and a moderate correlation for SJC. Patient-reported joint counts may be suitable for use in annual review for patients in remission and in monitoring treatment response for patients with rheumatoid arthritis. However, they are likely not appropriate for decisions on commencement of biologics. Further research is needed to identify patient groups where patient-reported joint counts are unsuitable.In this issue of The Journal of Rheumatology, Müskens, et al describe the effect of the introduction of an etanercept (ETN) biosimilar on antirheumatic medication cost1 After a Dutch rheumatology department launched this biosimilar as a substitute for the more expensive biologic ETN, the accumulated 3-monthly antirheumatic medication cost in that hospital pertaining to in- and outpatients with rheumatoid arthritis (RA), mainly consisting of cost of biologic disease-modifying antirheumatic drugs (bDMARD), decreased, as expected.

We aimed to describe the nature and frequency of gastrointestinal adverse drug reactions (GIADRs) of etanercept (ETN) using patient-reported and healthcare professional (HCP)-registered data and compared this frequency with the GI-ADR frequency of the widely used tumor necrosis factor-α inhibitor adalimumab (ADA).

Reported GI-ADRs of ETN for rheumatic diseases were collected from the Dutch Biologic Monitor and DREAM registries. We described the clinical course of GI-ADRs and compared the frequency with ADA in both data sources using Fisher exact test.

Out of 416 patients using ETN for inflammatory rheumatic diseases in the Dutch Biologic Monitor, 25 (6%) patients reported 36 GI-ADRs. In the DREAM registries 11 GI-ADRs were registered for 9 patients (2.3%), out of 399 patients using ETN, with an incidence of 7.1 per 1000 patient-years. Most GI-ADRs consisted of diarrhea, nausea, and abdominal pain. GI-ADRs led to ETN discontinuation in 1 patient (4%) and dose adjustment in 4 (16%) in the Dutch Biologic Monitor. Eight GI-ADRs (73%) led to ETN discontinuation in the DREAM registries. The frequency of GI-ADRs of ETN did not significantly differ from GI-ADRs of ADA in both data sources (Dutch Biologic Monitor ETN 8.7% vs ADA 5.3%,

= 0.07; DREAM ETN 2.8% vs ADA 4.7%,

= 0.16).

Most GI-ADRs associated with ETN concerned gastrointestinal symptoms. These ADRs may lead to dose adjustment or ETN discontinuation. The frequency of ETN-associated GI-ADRs was comparable to the frequency of ADA-associated GI-ADRs. learn more Knowledge about these previously unknown ADRs can facilitate early recognition and improve patient communication.

Most GI-ADRs associated with ETN concerned gastrointestinal symptoms. These ADRs may lead to dose adjustment or ETN discontinuation. The frequency of ETN-associated GI-ADRs was comparable to the frequency of ADA-associated GI-ADRs. Knowledge about these previously unknown ADRs can facilitate early recognition and improve patient communication.

Psoriatic arthritis (PsA) substantially impairs quality of life. Clinical trials generally focus on polyarticular PsA, but less is known about the assessment and management of oligoarticular and moderate PsA. An online survey was conducted to determine Canadian rheumatologists' perspectives on the definition and treatment of oligoarticular and moderate PsA.

Regional and national experts treating patients with PsA were asked to complete an online survey to assess their approach to identifying and managing patients with PsA. Survey questions were developed based on guidance from a committee of Canadian rheumatologists.

Sixty-four of 78 rheumatologists responded, representing 6 major Canadian provinces. Nearly half of respondents were in practice >20 years. The majority of rheumatologists reported using swollen joint count (SJC) to describe moderate PsA (86.4%) and oligoarticular PsA (96.7%), and considered location of inflammation in PsA assessments. SJC cutoff scores for reporting moderate PsA varied among rheumatologists, suggesting lack of an agreed-upon definition for moderate PsA. Sixty-eight percent of rheumatologists identified access to treatment as the greatest challenge with oligoarticular PsA.

According to the surveyed rheumatologists, SJC remains a key assessment when defining oligoarticular and moderate PsA. Although the number of joints is considered when determining the impact of PsA on patients, joint location and functional impairment are also considered when describing the disease as moderate. Access to treatment for patients with <5 affected joints is challenging.

According to the surveyed rheumatologists, SJC remains a key assessment when defining oligoarticular and moderate PsA. Although the number of joints is considered when determining the impact of PsA on patients, joint location and functional impairment are also considered when describing the disease as moderate. Access to treatment for patients with less then 5 affected joints is challenging.

To describe the perspectives of patients with inflammatory arthritis (IA) on outcome domains of trials evaluating medication adherence interventions.

Adult patients (≥ 18 yrs) with IA taking disease-modifying antirheumatic drugs from centers across Australia, Canada, and the Netherlands participated in 6 focus groups to discuss outcome domains that they consider important when participating in medication adherence trials. We analyzed the transcripts using inductive thematic analysis.

Of the 38 participants, 23 (61%) had rheumatoid arthritis and 21 (55%) were female. The mean age was 57.3 ± (SD 15.0) years. Improved outcome domains that patients wanted from participating in an adherence trial were categorized into 5 types medication adherence, adherence-related factors (supporting adherence; e.g., medication knowledge), pathophysiology (e.g., physical functioning), life impact (e.g., ability to work), and economic impact (e.g., productivity loss). Three overarching themes reflecting why these outcome domains matter to patients were identified how taking medications could improve patients' emotional and physical fitness to maintain their social function; how improving knowledge and confidence in self-management increases patients' trust and motivation to take medications as agreed with minimal risk of harms; and how respect and reassurance, reflecting health care that values patients' opinions and is sensitive to patients' individual goals, could improve medication-taking behavior.

Patients value various outcome domains related to their overall well-being, confidence in medication use, and patient-healthcare provider relationships to be evaluated in future adherence trials.

Patients value various outcome domains related to their overall well-being, confidence in medication use, and patient-healthcare provider relationships to be evaluated in future adherence trials.Psoriatic arthritis (PsA) is a potentially progressive immune-mediated musculoskeletal disease with the involvement of synovium, enthesis, and axial structures (especially the cervical spine and sacroiliac joints), along with the involvement of skin and nails. Even a short delay in the diagnosis and commencement of antirheumatic therapy can cause long-term damage and disabilities.1.Over the last 20 years, there has been tremendous growth in understanding the multifaceted aspects of gout. These developments in research span the gamut from elucidating mechanisms by which urate crystals trigger cellular inflammation, to an exciting expansion of available therapeutic modalities to manage gout.1,2,3,4,5.

Colchicine has been considered a life-long therapy for Familial Mediterranean fever (FMF). Recent studies describe patients who discontinued colchicine, but data pertaining to predictors of success were not provided. The aims of our study are to describe a cohort of pediatric patients with FMF who discontinued colchicine therapy, and to identify factors predicting successful termination of colchicine.

This study describes a cohort of pediatric patients with FMF who discontinued colchicine therapy following a relatively prolonged attack-free period (≥6 month), and identifies factors predicting successful termination. Data collected included demographic, clinical, and laboratory characteristics of children diagnosed with FMF < 16 years who underwent a trial of colchicine discontinuation. Data from patients who successfully ceased colchicine therapy were compared to that of patients who relapsed.

Of 571 patients with FMF, 59 (10.3%) discontinued colchicine therapy. The average attack-free period before enrollment was 1.