The University of Western Australia – Rheumatology Group
Since the start of the UWA supported inaugural Chair of Rheumatology the following lines of Rheumatology research have been established at UWA. These are progressing well and some details and highlights are listed below:
- WA Rheumatic Disease Epidemiologic Register (WARDER):
WARDER is a big-data project of population-based routinely-collected administrative health data over 35 years for patients with rheumatic diseases with individual health data tracked over time in four WA Health registries namely Hospital Morbidity Data System for all admissions, WA Cancer Registry for cancer development , WA Mortality Registry and the Emergency Department Data Collection for all ED visits. These de-identified data are then linked through the Western Australian Data Linkage System with data of half a million individuals (half with rheumatic disease patients and half are age and gender matched controls) stored on the secure UWA research server.
- a) Collaboration established with researcher Dr J Tieu and medical scientist S Lester at the Basil Hetzel Institute/ Adelaide University regarding outcomes (mortality /cancer risk) in patients with ANCA associated vasculitis
– two presentations to be presented at EULAR 2020 (which now will be an e-
Congress) with respective manuscripts in preparation
- b) Ankylosing spondylitis project (M Ognjenovic/E Kelty)
– one paper on risk factors for vertebral fracture in AS patients published (see below)
– one paper on mortality and causes of death completed and submitted
– one manuscript on cancer survival in preparation
- c) IgA vasculitis project (J Nossent):
– 2 more papers published (see below)
– 2 additional papers submitted for review (two to be presented at EULAR 2020)
– one manuscript on impact of comorbid conditions in IgAV in preparation
– awarded best clinical research poster prize at APLAR 2019 meeting
- d) Rheumatoid Arthritis project (K Almutairi)
– RA prevalence metanalysis paper submitted (accepted for EULAR 2020)
– data collection for WARDER ICD coding validity for RA completed- paper in
– RA hospital admission rate and reasons paper in planning phase
- e) Gout project (H Keen/D Lopez/W Raymond):
– data extraction and cleaning complete; projects planned are:
– risk for myocardial infarction flowing gout flare
– mortality risk for gout patients in WA
- f) Giant cell arteritis (GCA) project (H Keen):
– data extraction and cleaning complete; projects/analyses planned:
– GCA prevalence in WA /GCA and mortality risk/GCA and blindness
- g) Systemic Lupus Erythematosus project (W Raymond):
– mortality risk and causes of death for SLE patients in WA submitted
– cardiovascular events risk and outcome in SLE – ongoing analysis
– viral infections as a cause and consequence of SLE (collaboration with University
(Hospital) Tromso in Norway
- h) Juvenile arthritis project (TBA):
– in planning phase with applications for funding pending
2) Perth Lupus Nephritis study:
– paper published on prognostic relevance of histological findings of Tubuloreticular bodies (see below)
– paper presented at ACR 2019 on usefulness of repeat biopsies – manuscript in preparation
3) Perth Lupus Registry:
– 181 patients in SCGH catchment have consented
– continuous data entry
– new research assistant recruited ( Michael Furfaro)
– redevelopment of online database (Redcap) near completion
– HREC approval extended to 2025/approval for expansion to FSH/RPH sites ongoing
– 2 papers from PLR data (on clinical SLE features and on direct health care cost for
SLE in WA) to be presented at EULAR 2020
4) Collaboration with assoc. profs G. Eilertsen and G. Bakland at the University (Hospital) Tromsø in Norway on the Tromsø SLE study and axial SpA cohort studies has been concluded with 4 papers published (see list).
List of published scientific papers (all papers acknowledge the support provided by AOFWA):
- Sharma C, Raymond W, Eilertsen G, Nossent J. Association of Achieving Lupus Low Disease Activity State Fifty Percent of the Time With Both Reduced Damage Accrual and Mortality in Patients With Systemic Lupus Erythematosus. Arthritis Care Res (Hoboken). 2020;72(3):447-51.
- Ognjenovic M, Raymond W, Inderjeeth C, Keen H, Preen D, Nossent J. The risk and consequences of vertebral fracture in patients with Ankylosing Spondylitis: a population-based data linkage study. J Rheumatol. 2020.
- Nossent JC, Raymond W, Keen H, Preen DB, Inderjeeth CA. Infection Rates Before and After Diagnosis of IgA Vasculitis in Childhood: A Population-wide Study Using Non-exposed Matched Controls. J Rheumatol. 2020;47(3):424-30.
- Al Mutairi KB, Nossent JC, Inderjeeth CA. Validity of Self-reported Diagnosis of Rheumatoid Arthritis. J Rheumatol. 2020.
- Raymond WD, Eilertsen GO, Shanmugakumar S, Nossent JC. The Impact of Cytokines on the Health-Related Quality of Life in Patients with Systemic Lupus Erythematosus. Journal of clinical medicine. 2019;8(6).
- Raymond WD, Eilertsen GO, Nossent J. Principal component analysis reveals disconnect between regulatory cytokines and disease activity in Systemic Lupus Erythematosus. Cytokine. 2019;114:67-73.
- Nossent JC, Sagen-Johnsen S, Bakland G. Disease Activity and Patient-Reported Health Measures in Relation to Cytokine Levels in Ankylosing Spondylitis. Rheumatology and therapy. 2019;6(3):369-78.
- Nossent JC, Sagen-Johnsen S, Bakland G. IL-1A gene variation in relation to cytokine levels and clinical characteristics in ankylosing spondylitis. European journal of rheumatology. 2019;6(2):67-70.
- Nossent J, Raymond W, Ognjenovic M, Kang A, Chakera A, Wong D. The importance of tubuloreticular inclusions in lupus nephritis. Pathology. 2019;51(7):727-32.
- Nossent J, Raymond W, Keen H, Inderjeeth C, Preen D. Pregnancy outcomes in women with a history of immunoglobulin A vasculitis. Rheumatology (Oxford). 2019;58(5):884-8.
Other Rheumatology researchers/activities in WA
- Associate Professor Helen Keen (at FSH/RPH) is currently investigating
- The continued role for ultrasound examination in the diagnosis an management of various joint diseases including gout and osteoarthrosis
- The efficacy of an early referral clinic for patients with Giant cell arteritis where rapid ultrasound examination of the temporal arteries is used to guide management. If successful this will obviate the need for tissue biopsies and help reduce the occurrence of vision loss as the most devastating complication of this condition.
- A clinical trial of the use of Krill oil to reduce flare frequency in gout patients
- Establishing a local branch of the Australian Arthritis and Autoimmune Biobank Collaborative (https://nsw.biobanking.org/biobanks/view/70), where bio samples (serum, DNA and tissue samples) collected from consenting patients with a range of rheumatic diseases can be stored for later access by researchers for specific projects (genetic, molecular, translational).
1: Cai G, Keen HI, Host LV, Aitken D, Laslett LL, Winzenberg T, Wluka AE, Black
D, Jones G. Once-yearly zoledronic acid and change in abdominal aortic
calcification over 3 years in postmenopausal women with osteoporosis: results
from the HORIZON Pivotal Fracture Trial. Osteoporos Int. 2020 May 2
2: Loh K, Sharma C, Keen HI. Australian tertiary institutions are failing people
with gout. Intern Med J. 2020 Mar;50(3):386.
3: Chowalloor P, Raymond WD, Cheah P, Keen H. The burden of subclinical
intra-articular inflammation in gout. Int J Rheum Dis. 2020 Feb 27.
4: Keen HI, Robinson PC, Dalbeth N, Hill C. Time to recognise gout as a chronic
disease. Med J Aust. 2020 Apr;212(6):285-285.
5: Laslett LL, Antony B, Wluka AE, Hill C, March L, Keen HI, Otahal P, Cicuttini
FM, Jones G. KARAOKE: Krill oil versus placebo in the treatment of knee
osteoarthritis: protocol for a randomised controlled trial. Trials. 2020 Jan
6: Wong PC, Lee G, Sedie AD, Hanova P, Inanc N, Jousse-Joulin S, Ohrndorf S,
Stoenoiu MS, Keen HI, Terslev L, D’Agostino MA, Bruyn GA. Musculoskeletal
Ultrasound in Systemic Lupus Erythematosus: Systematic Literature Review by the
Lupus Task Force of the OMERACT Ultrasound Working Group. J Rheumatol. 2019
7: Mandl P, Studenic P, Filippucci E, Bachta A, Backhaus M, Bong D, Bruyn GAW,
Collado P, Damjanov N, Dejaco C, Delle-Sedie A, De Miguel E, Duftner C, Gessl I,
Gutierrez M, Hammer HB, Hernandez-Diaz C, Iagnocco A, Ikeda K, Kane D, Keen H,
Kelly S, Kővári E, Möller I, Møller-Dohn U, Naredo E, Nieto JC, Pineda C, Platzer
A, Rodriguez A, Schmidt WA, Supp G, Szkudlarek M, Terslev L, Thiele R, Wakefield
RJ, Windschall D, D’Agostino MA, Balint PV; OMERACT Ultrasound Cartilage Task
Force Group. Development of semiquantitative ultrasound scoring system to assess
cartilage in rheumatoid arthritis. Rheumatology (Oxford). 2019 Oct
8: Terslev L, Naredo E, Keen HI, Bruyn GAW, Iagnocco A, Wakefield RJ, Conaghan
PG, Maxwell LJ, Beaton DE, Boers M, D’Agostino MA. The OMERACT Stepwise Approach to Select and Develop Imaging Outcome Measurement Instruments: The
Musculoskeletal Ultrasound Example. J Rheumatol. 2019 Oct;46(10):1394-1400.
9: Sharma C, Keen H. Ten-year retrospective review of the incidence of serious
infections in patients on biologic disease modifying agents for rheumatoid
arthritis in three tertiary hospitals in Western Australia. Intern Med J. 2019
10: Ihdayhid D, Edelman J, Keen HI. Vaccination for hepatitis B virus in an
Australian pre-biologic population with rheumatoid arthritis. Clin Exp Rheumatol.
Clinical Professor Charles Inderjeeth (at SCGH)
- Is involved in clinical trials of new drugs for various rheumatic conditions through Linear Clinical Research (https://www.linear.org.au/about-us/) which is a state-of-the-art, clinical trials facility operating out of QEII Medical Centre to make innovative therapies available to the local community.
- Has main research interest in the clinical field of bone health and is involved in clinical and more basic studies into various aspects of both osteoarthrosis and osteoporosis
- Is involved in investigations into the effects of aging on cognitive and musculoskeletal health
1: Iddagoda MT, Inderjeeth CA, Chan K, Raymond WD. Prognostication accuracy of
final destination in poststroke patients requiring transitional care. Australas J
Ageing. 2019 Nov 19.
2: Inderjeeth CA, Raymond WD. Case finding with GARVAN fracture risk calculator
in primary prevention of fragility fractures in older people. Arch Gerontol
Geriatr. 2020 Jan – Feb;86:103940.
3: Iddagoda MT, Inderjeeth CA, Chan K, Raymond WD. Post-stroke sleep disturbances
and rehabilitation outcomes: a prospective cohort study. Intern Med J. 2020
4: David SM, Chan K, Inderjeeth C, Raymond WD. Rehabilitation Indices associated
with sustaining a minimal trauma fracture within 12 months of a stroke in Western
Australia. Australas J Ageing. 2019 Jun;38(2):107-115
5: Sim M, Prince RL, Scott D, Daly RM, Duque G, Inderjeeth CA, Zhu K, Woodman RJ,
Hodgson JM, Lewis JR. Sarcopenia Definitions and Their Associations With
Mortality in Older Australian Women. J Am Med Dir Assoc. 2019 Jan;20(1):76-82.e2.
6: Sim M, Prince RL, Scott D, Daly RM, Duque G, Inderjeeth CA, Zhu K, Woodman RJ,
Hodgson JM, Lewis JR. Utility of four sarcopenia criteria for the prediction of
falls-related hospitalization in older Australian women. Osteoporos Int. 2019
7: Inderjeeth CA, Inderjeeth AJ, Raymond WD. A multicentre observational study
comparing patient reported outcomes to assess reliability of swollen and tender
joint assessments and response to certolizumab treatment as compared to clinician
assessments in rheumatoid arthritis. Int J Rheum Dis. 2019 Jan;22(1):73-80.
8: Inderjeeth CA, Raymond WD, Briggs AM, Geelhoed E, Oldham D, Mountain D.
Implementation of the Western Australian Osteoporosis Model of Care: a fracture
liaison service utilising emergency department information systems to identify
patients with fragility fracture to improve current practice and reduce
re-fracture rates: a 12-month analysis. Osteoporos Int. 2018 Aug;29(8):1759-1770.
9: Bernard S, Inderjeeth C, Raymond W. Higher Charlson Comorbidity Index scores
do not influence Functional Independence Measure score gains in older rehabilitation patients. Australas J Ageing. 2016 Dec;35(4):236-241.
Dr Graeme Carroll (at FSH) is focussed on researching
- the role of the protein mannose binding lectin (MBL) in Rheumatoid Arthritis, especially the effect that MBL deficiency has in the disease course and complications (infections/lung disease) for patients with rheumatoid arthritis.
- causal factors and treatments for the arthritis that complicates Haemochromatosis and the implications for management of this arthropathy and possibly one common form of Osteoarthritis;
- patterns of joint disease (phenotypes) in Osteoarthritis and the potential mechanisms whereby joint laxity or hypermobility due to defects in collagen and other connective tissue macromolecules may contribute to some of these phenotypes.
1: Makin K, Easter T, Kemp M, Kendall P, Bulsara M, Coleman S, Carroll GJ.
Undetectable mannose binding lectin is associated with HRCT proven bronchiectasis
in rheumatoid arthritis (RA). PLoS One. 2019 Apr 10;14(4):e0215051.
2: Carroll GJ, Makin K, Garnsey M, Bulsara M, Carroll BV, Curtin SM, Allan EM,
McLean-Tooke A, Bundell C, Kemp ML, Deshpande P, Ihdayhid D, Coleman S, Easter T, Triplett J, Disteldorf T, Marsden CH, Lucas M. Undetectable Mannose Binding Lectin and Corticosteroids Increase Serious Infection Risk in Rheumatoid
Arthritis. J Allergy Clin Immunol Pract. 2017 Nov – Dec;5(6):1609-1616.
Assoc Prof R Will (at Colin Bayliss Research and Teaching Unit, Victoria park)
- Is researching the efficacy of various (mechanisms of ) drug delivery on pain modulation for patients with osteoarthrosis
- Participates in drug trials for a number of rheumatic conditions
1: Wright A, Benson HAE, Moss P, Will R. Monitoring the Clinical Response to an
Innovative Transdermal Delivery System for Ibuprofen. Pharmaceutics. 2019 Dec
9;11(12). pii: E664.
2: Moss P, Benson HAE, Will R, Wright A. Patients With Knee Osteoarthritis Who
Score Highly on the PainDETECT Questionnaire Present With Multimodality
Hyperalgesia, Increased Pain, and Impaired Physical Function. Clin J Pain. 2018
3: Wright A, Benson HAE, Will R, Moss P. Cold Pain Threshold Identifies a
Subgroup of Individuals With Knee Osteoarthritis That Present With Multimodality
Hyperalgesia and Elevated Pain Levels. Clin J Pain. 2017 Sep;33(9):793-803