Advances in the treatment of inflammatory arthritis have made a dramatic difference in the lives of people with this disease. However, there is still much to be done. In the Inflammatory Arthritis Center (IAC), our goals are to expand the understanding of how and why inflammatory arthritis develops and to improve patient care. Below are some of our ongoing research projects.
To be eligible for all IAC studies, one must be under the care of an HSS rheumatologist.
RA Cohort Study
For patients diagnosed with rheumatoid arthritis (RA)
Patients with rheumatoid arthritis (RA) may voluntarily be included in the RA Cohort. By joining, patients have the opportunity to learn about active or planned research studies they may be eligible for. Enrolled patients can request information about studies that are of interest to them, and they will be updated on a regular basis about education programs in the IAC. In turn, physicians and researchers use the anonymized information in the RA cohort to better describe their RA patient population, and to identify potential subjects appropriate for IAC research projects.
CATCH-US: Consortium of Early Arthritis Cohorts
For early rheumatoid arthritis (ERA) patients, or those newly diagnosed with RA (less than 6 months)
Patients have different experiences with their RA, requiring different levels of treatment. Research has proven that early identification and treatment can significantly improve a patient’s experience with the disease. However, research also suggests that many patients are not treated in the way that could best improve their outcomes. Although we know that early treatment is important, we still don’t know if there are factors that can predict how an individual patient’s disease will progress over time.
The goal of CATCH-US is to better understand predictors of treatment response in early rheumatoid arthritis (ERA) patients. Vivian Bykerk, MD has expanded this Canada-based multicenter observational study of patients newly diagnosed with RA to sites in the United States. We have been enrolling ERA patients in CATCH-US here at HSS since 2014 with additional sites beginning enrollment this year.
Perioperative Flare in Total Joint Replacement
For rheumatoid arthritis (RA) patients undergoing total joint replacement or arthroplasty
HSS orthopedic surgeons lead the field in both innovation and in the number of joint replacement surgeries performed each year. As Medical Director of the Combined Arthritis Program (CAP), Susan Goodman, MD, along with surgeon collaborators, is looking closely at patients with RA undergoing hip, knee, shoulder or elbow joint replacement (arthroplasty). The goals of this research are to:
- Examine the relationship between medication withdrawal prior to surgery and the incidence of flare or disease worsening
- Determine the rate of postoperative flare in these RA patients
- Understand the relationship between postoperative disease flare and arthroplasty outcomes
HSS SpA Cohort
For patients diagnosed with ankylosing spondylitis (AS) and psoriatic arthritis (PsA)
IAC Investigators are interested in learning more about spondyloarthritis (SpA). We are actively collecting data on consenting patients with specific types of SpA, including ankylosing spondylitis (AS) and psoriatic arthritis (PsA). Eligible AS and PsA patients include those who, for the preceding three months, have not received biologic treatment such as adalimumab, etanercept, infliximab, golimumab, certolizumab pegol, or other biologic therapies.
Usual care for patients with AS or SpA would include regular assessments of pain, function, mobility, spine, and joint motion, etc., about twice a year. Treatment interventions may include physical therapy, analgesics, NSAIDs, DMARDs or biologic therapies. As part of the HSS SpA Cohort, this detailed information would be recorded at pre-determined intervals, along with clinical information such as disease activity, tender and swollen joint counts, dactylitis, enthesitis, and spine involvement.
For information about the HSS SpA Cohort, email Shirin Dey.
Our researchers often explore collaborations with the pharmaceutical industry that may benefit our patients. The IAC has begun enrolling subjects for important clinical trials:
Etanercept Clinical Trial (Amgen, Inc)
The SEAM Study: Patients with RA who are already on etanercept and methotraxate
Etanercept has become a well-established agent in the management of rheumatoid arthritis or RA, and can be used either as monotherapy or in combination with methotrexate. Dr. Vivian Bykerk along with members of the Inflammatory Arthritis Center will be studying patients with RA who are already on the combination of etanercept and methotrexate, and are beginning to enroll subjects for this study which will evaluate the effectiveness of three separate treatment regimens on maintaining remission of RA:
- Etanercept monotherapy
- Methotrexate monotherapy
- Combination etanercept plus methotrexate therapy
The clinical hypotheses are:
- Etanercept monotherapy is superior to methotrexate monotherapy for maintaining remission in subjects with RA who were on etanercept plus methotrexate therapy.
- Etanercept plus methotrexate therapy is superior to methotrexate monotherapy for maintaining remission in subjects with RA who were on etanercept plus methotrexate therapy.
To discuss collaboration or participation in the SEAM study, or for any additional details, please email Shirin Dey.
Complete study details including additional study sites are listed on www.ClinicalTrials.gov, NCT# 02373813.
Abatacept Clinical Trial (Bristol-Myers Squibb)
The AVERT 2 Study: Patients with early rheumatoid arthritis
Attainment of remission, evidenced by a reduction in disease activity, has become an important goal of RA treatment. Dr. Vivian Bykerk along with members of the Inflammatory Arthritis Center have begun to enroll subjects for a study evaluating the effectiveness of two treatment regimens in achieving remission (defined as SDAI < 3.3 @ week 24) in patients with ERA. Investigators will compare Abatacept in combination with Methotrexate versus Methotrexate Monotherapy in this 2 year, multicenter study.
To discuss your collaboration or participation in the AVERT 2 study, or for any additional details, please email Daisy Crego.
Complete study details including additional study sites are listed on www.ClinicalTrials.gov, NCT# 02504268.
PROMIS Rheumatoid Arthritis Interview Study
PROMIS (Patient Reported Outcomes Measurement Information System)* is an NIH-funded system of highly reliable, precise measures of patient-reported health status for physical, mental, and social well-being. Recent studies suggest that PROMIS may also provide additional data that is useful during clinical visits for facilitating shared decision-making and long-term disease management. The goal of the PROMIS RA Interview Study is to study the responsiveness (sensitivity to change) of selected PROMIS measures in people with RA and establish minimally important differences for these measures. This information is necessary before measures can be adopted and used in clinical care and research.
We have completed enrollment for PROMIS at HSS. For additional information about the PROMIS RA Interview Study at HSS please email Annie Hoang.
* Information about PROMIS is available here.
The HSS Early Arthritis Initiative connects patients quickly and efficiently with a rheumatologist who can evaluate their joint pain and get each patient started on an appropriate course of treatment.