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SPARTAN News—Industry Edition

Summer 2023

Volume 9 Issue 2

Dear {First Name}

Greetings and welcome to the summer edition of our SPARTAN newsletter! Below the message from our chair Dr. Joerg Ermann, you will find a recap of our 2023 annual meeting highlights as well as updates on major SPARTAN projects encompassing our dual missions of education and research. None of this would be possible without the ongoing generosity and support of our industry partners. I would also like to thank the industry representatives who made time to meet with us in Cleveland. We highly value your intellectual input. It is also helpful for us to learn about our partner’s interests and priorities in the Spondyloarthritis field. We look forward to continuing this valuable partnership and to seeing you at future events (see Save the Date below).

Best wishes,

Judy  

Judith Smith, MD, PhD

SPARTAN Past Chair

Industry Relations Committee Chair

The SPARTAN keynote was presented this year by Vijay Kuchroo, DVM, PhD (Harvard Medical School and Brigham and Women’s Hospital): Th17 Cells in Autoimmunity and Autoimmune Diseases. In addition to his scientific narrative, he regaled us with the “T Cell Blues.”

Year in Review

Clinical (observational) studies, presented by Maureen Dubreuil

The revised ASAS/EULAR recommendations for the management of axial spondyloarthritis were highlighted https://t.co/atedhRwyZ9. Much of the focus this year was on MRI, including the ASAS MRI Working Group consensus definition for spinal lesions https://pubmed.ncbi.nlm.nih.gov/35609977/, and a data-driven approach for defining MRI inflammatory and structural lesions in the SI joints in juvenile spondyloarthritis https://pubmed.ncbi.nlm.nih.gov/36063392/ -- both efforts led by SPARTAN members (Walter Maksymowych and Pam Weiss, respectively). Other highlighted studies regarding MRI of the SI joint included one assessing serial postpartum imaging https://pubmed.ncbi.nlm.nih.gov/36704824/ and two with conflicting findings regarding differences in lesions by increasing age https://pubmed.ncbi.nlm.nih.gov/35436391/.

Basic and translational research, presented by Kristi Kuhn

Theme 1 focused on antigens, with studies about the TCR beta repertoire in axSpA https://pubmed.ncbi.nlm.nih.gov/36325356/, and the much discussed Nature paper addressing pathogenesis in HLA-B27+ individuals with axSpA and anterior uveitis: https://pubmed.ncbi.nlm.nih.gov/36477533/. Theme 2 focused on IL-17 producing T lymphocytes, including questions about where IL-17 is coming from, focusing on peripheral blood MAIT cells and resident MAIT cells in the entheses https://pubmed.ncbi.nlm.nih.gov/35166073/ . Theme 3 focused on new bone formation, and highlighted the connection of the 2021 Nobel Prize winning discovery of Piezo1, a mechanotransducer, with new bone formation at entheseal tissue https://pubmed.ncbi.nlm.nih.gov/36543525/.

Clinical trials, presented by Phillip Mease

Under the auspices of OMERACT and ASAS, a core outcome measure set was defined https://pubmed.ncbi.nlm.nih.gov/35680390/. The rest of the focus was on JAK inhibitors, including 2-year data from SELECT-AXIS 1 and 2 for upadacitinib for bio-naïve and bio-refractory r-axSpA as well as nr-axSpA. Safety of upadacitinib was highlighted in pooled analyses including RA, AS, PsA, and atopic dermatitis, looking at outcomes of serious infection, opportunistic infection, herpes zoster, major cardiovascular events, thromboembolism, and malignancy https://pubmed.ncbi.nlm.nih.gov/36754548/. Promising phase 2 data for r-axSpA and nr-axSpA with bimekizumab were presented, from the BE-MOBILE 1 and 2 trials https://pubmed.ncbi.nlm.nih.gov/36649967/. Finally, the “topic du jour” of difficult to treat axSpA, presented as an ACR22 abstract with more to come.

The 50^th anniversary of the discovery of the association between ankylosing spondylitis and HLA-B27 received a special session.

Muhammad Asim Khan described HLA-B27 discovery and its subsequent association with AS, its global prevalence and heterogeneity, role in diagnosis and polygenic risk score, and unraveling its disease link by introducing arthritogenic peptide hypothesis. He described impact of HLA-B27 on lifetime risk for axSpA among family members, shortening of lifespan of AS patients, but emphasized that people in the general population possessing HLA-B27 have normal lifespan.

Nigil Haroon gave an overview of the understanding of HLA-B27’s role in pathogenesis, from GWAS studies looking at ERAP1 and 2, to our understanding of misfolding and autophagy. He ended with a pathogenic model, described in this 2017 review https://pubmed.ncbi.nlm.nih.gov/28446810/ and a rare, highly penetrant genetic variant of familial axSpA discovered in a family in Newfoundland https://pubmed.ncbi.nlm.nih.gov/25956157/.



Michael Weisman provided us with a history lesson, starting with the powerful influence of Walter Bauer at the MGH who, from the 1930’s to the 1950’s, insisted that AS was only a spinal variant of RA to our current appreciation and research findings that HLA-B27 provides associations, at a group level, to the more restricted phenotypes of SpA such as male gender and axial disease.

Jean Liew, MD

Exciting developments are underway for the Biomarkers in Axial Spondyloarthritis Investigative Study (BASIS)! Recently, the project has taken a major leap forward with the selection of a dynamic and highly capable contract research organization. After careful evaluation with an open call for proposals to find the perfect partner for this groundbreaking project, the SPARTAN Board has given its enthusiastic approval to CARE Arthritis. They will join forces with the experienced and skilled biorepository entity at Cleveland Clinic to co-manage BASIS.

With these new developments, the BASIS project is poised to scale new heights and make unprecedented advancements in our understanding of axial spondyloarthritis.The BASIS Steering Committee is actively exploring funding partnerships. This will ensure that BASIS receives the necessary resources and support to drive cutting-edge research, data collection and analysis, and collaboration with leading experts in the field. Together, we are forging a path towards groundbreaking discoveries that will revolutionize the landscape of axial spondyloarthritis research and ultimately improve the lives of patients worldwide. Stay tuned for more updates as BASIS continues to unfold its potential and chart new territories in the pursuit of scientific discovery!

Development Group:

Kristine A. Kuhn, MD, PhD *

Scoville Endowed Chair and Head, Division of Rheumatology, Associate Professor of Medicine and of Immunology and Microbiology, University of Colorado Anschutz Medical Campus

Sibel Zehra Aydin, MD *

Professor of Medicine, Tier 2 Research Chair in Inflammatory Arthritis, Director of Research, Division of Rheumatology, Associate Scientist at the Ottawa Hospital Research Institute, University of Ottawa

Liron Caplan, MD, PhD

Associate Professor of Medicine, Division of Rheumatology, University of Colorado Anschutz Medical Campus

and Denver Veterans Affairs Medical Center

Atul Deodhar, MD, MRCP *

Professor of Medicine; Medical Director, Rheumatology Clinics, Immunology infusion center, and home infusion program; Division of Arthritis and Rheumatic Diseases, Oregon Health Sciences University

Joerg Ermann, MD

Assistant Professor of Medicine, Division of Rheumatology, Inflammation and Immunity, Brigham and Women’s Hospital and Harvard Medical School

M. Elaine Husni, MD, MPH *

Vice Chair of Rheumatology and Director, Arthritis and Musculoskeletal Center, Scholtz Family Chair of Translational Functional Medicine Research, Dept of Rheumatic and Immunologic Diseases, Cleveland Clinic

Walter Maksymowych MB ChB, FACP, FRCP(C) *

Professor of Medicine, University of Alberta

Chief Medical Officer, CARE Arthritis

John Reveille, MD

Professor of Medicine, The University of Texas McGovern Medical School

Judith Smith, MD, PhD *

Associate Professor of Pediatrics, Division of Allergy, Immunology, and Rheumatology, University of Wisconsin School of Medicine and Public Health

Matthew Stoll, MD, PhD

Associate Professor of Pediatrics, Division of Pediatric Rheumatology, University of Alabama at Birmingham

 An asterisk indicates the BASIS Steering Committee.

Elaine Husni MD and Sibel Aydin MD, co-PIs

REFERRAL RECOMMENDATIONS

During the 2023 SPARTAN Annual Meeting, Drs. Abhijeet Danve, Maureen Dubreuil, and Atul Deodhar shared the progress of the SPARTAN Referral Recommendations project. The objective is to create guidelines for referral of patients with chronic back pain and suspected axSpA to rheumatologists. The team presented results of discrete choice experiments which assessed the relative importance of SpA features for an axSpA diagnosis. The investigators then presented two versions of the draft referral recommendations; one based on major and minor criteria, and one based on a points system. SPARTAN members voted on their preferred strategy. Abstracts from this project have been submitted to 2023 ACR Convergence.

Abhijeet Danve MD MHS

Mentored Fellowship Award

Adam Mayer, MD, Children’s Hospital of Philadelphia/University of Pennsylvania (Pamela Weiss, MD, Mentor)

“Clarifying the toolkit for pain control in spondyloarthritis with IBD: Association of prescription NSAID use with IBD-related hospitalization, a retrospective analysis across the age spectrum”

Patricia Remalante-Rayco, MD, Schroeder Arthritis Institute, Toronto Western Hospital, University Health Network (Nigil Haroon, MD, PhD, Mentor)

“The Role of DRAK2 and as a Potential Biomarker of Disease Activity and Treatment Response in Axial Spondyloarthritis”

The Mentored Fellowship Award is $5,000 each for fellow and mentor totalling $10,000.

Early Career Investigator Award

Mark Hwang, MD (University of Texas Health Science Center)

“The Relationship Between HLA-B27 Positivity and Inflammatory Back Pain in the US Population”

Akihiro Nakamura, MD, PhD (Queen’s University, Ontario)

“Spatial Gene Profiles for New Bone Formation in Ankylosing Spondylitis”

The Early Career Investigator Award is a maximum of $25,000 per project per year for two years.

SPARTAN is a network of health care professionals in North America who are dedicated to research, awareness and treatment of spondyloarthritis. SPARTAN is funded through educational grants from companies with an interest in this area of medicine.