SPARTAN News—Summer 2023
Volume 9 Issue 2
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Dear Lisa,
The 2023 SPARTAN Annual Meeting, held in May in Cleveland, was a resounding success. In addition to the key sessions recapped in this newsletter, I would like to highlight the Spondyloarthritis Review Course, attended by 49 learners in Cleveland and another 53 online, and the grant recipient/oral abstract session with excellent presentations from trainees and junior faculty. This was our second venture into hosting a hybrid meeting, and its success with virtual participants tuning in from around the globe strongly supports the decision to continue with this model into the post-pandemic future. That said, we are looking forward to having many SPARTAN members join us in person for next year's meeting. The invaluable experience of informal interactions during the poster session, coffee breaks, or social event is something that no online platform can replicate. So please mark your calendars for the 2024 SPARTAN Annual Meeting May 17-18, set to be hosted again in Cleveland.
The 2023 meeting was also a milestone that marked the 20th anniversary of our organization. Only a few of this year’s participants were present at the first meeting in Salt Lake City in 2003, when John Reveille and John Davis were elected co-chairs and the SPARTAN name, proposed by John Cush, was adopted. Over the years, our organization has grown impressively, with now more than one hundred full and associate members. In parallel, the breadth and depth of SPARTAN projects has expanded: ACR/SAA/SPARTAN treatment guidelines, various educational activities, CLASSIC, axSpA referral recommendations, BASIS, the list is incomplete. But there is more that we can do. The Spondyloarthritis Unmet Research Needs Conference IV in September will highlight existing knowledge gaps and research opportunities. I am confident that SPARTAN will be the platform for many more collaborative projects, large and small, to address these unmet needs.
Best,
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Joerg Ermann, MD
SPARTAN Chair
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Highlights from the SPARTAN Annual Meeting | |
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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 50th 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
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We have completed a major analysis of the CLASSIC study. This aimed to test the performance of the 2009 ASAS classification criteria using the final diagnostic evaluation of the rheumatologist as gold standard. Sensitivity and specificity of the criteria were 73.8% and 84.3%, respectively. Since the performance targets were prespecified as sensitivity of 75% and specificity of 90% we can conclude that the 2009 criteria are considered to have inadequate performance for the purposes of disease classification. The ASAS-SPARTAN CLASSIC steering committee is now working on further analyses aimed at developing revised/new classification criteria that meet the 75/90 performance targets. A meeting of SPARTAN members is being planned for the next ACR meeting to update the membership on the results of these analyses.
Dr. Walter P. Maksymowych F.R.C.P. (C)
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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!
Elaine Husni MD and Sibel Aydin MD, co-PIs
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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
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The EIDA team has been working hard to educate our non-rheumatologist colleagues about Axial Spondyloarthritis! We have delivered 20 talks (14 virtual, 6 in person) and reached an estimated 1700 learners! Another 15 talks are lined up for 2023 so far and we are scheduling into 2024.
If you have a contact for a group of physical therapists, chiropractors, primary care physicians, orthopedic physician assistants, or physiatrists who you think could benefit from our talk, please contact Lisa@spartangroup.org or Dax.Rumsey@ahs.ca. We provide both virtual and in-person talks for education events ranging from grand rounds to state annual meetings and national conferences. There is an honorarium for each presenter.
Dax G. Rumsey, MD, MSc, FRCP(C)
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Congratulations to SPARTAN Grant Awardees | |
SPARTAN is proud to support the next generation of researchers and leaders
in spondyloarthritis and pleased to announce this year's awardees.
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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.
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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.
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The Spondylitis Association of America and NIH/NIAMS are co-sponsoring the 2023 Spondyloarthritis Unmet Research Needs Conference IV in Bethesda, Maryland September 28-29. Co-chaired by Bob Colbert and Kristi Kuhn, this year's program brings together global experts to explore research opportunities in the spondyloarthritis field.
How do we address a range of biologic variables, social constructs, and health disparities in SpA diagnosis, treatment, and research?
What role will AI play in the future of SpA imaging?
What is the role of complementary medicine and how do we study it?
Registration is complimentary for physicians and scientists interested in SpA research. Learn more about the conference and register here.
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Are your member profile and membership category up to date?
To update, login to the member portal on the SPARTAN website here.
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The SPARTAN Governance Committee has
approved and welcomes our new members
Full Members:
Keith Colaco, Sonia Gupta, Simon Hong, Erin Treemarcki
Associate Members:
Cayla Alexander, Cleopatra Beaton, April Conlon, Ritu Madan, José Pablo Romero-López, Angelo Papachristos, Liya Stolyar, Rachael Stovall, Christy Vath
Trainee Members: Chesca Barrios, Ansaam Daoud, Pamela Manrique
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2023 Spondyloarthritis Unmet Research Needs Conference IV September 28-29 | Bethesda
ACR Convergence November 10–15 | San Diego
SPARTAN GRAPPA ASAS Symposium November 14 | San Diego
ASAS Workshop January 12-13, 2024 | Barcelona
SPARTAN Annual Meeting May 16-18, 2024 | Cleveland
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Join us on LinkedIn and Follow us on Twitter! | |
Thank you for the support of our industry partners | |
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. | | | | |
