Rheumatoid arthritis (RA) is a lifelong chronic disease affecting about 300,000 Canadians (1% of the population). The complicated treatment pathways and patterns of care for rheumatoid arthritis combined with a high burden of disease make RA a fascinating candidate for testing n…
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The intestinal microbiome provides essential services for the host, influencing immune function, nutrient absorption, and susceptibility to pathogens. Dietary history, antibiotics treatment, and disease status have been associated with the bacterial community present within an i…
Background: The ability to measure health and the value of improving or declining health is crucial to the evaluation of health care interventions. Many generic and disease specific health status measures exist for use in patients with rheumatoid arthritis (RA). The Overall Stat…
Despite a growing armamentarium of therapies available to treat rheumatoid arthritis (RA), predicting response to therapy remains a clinical challenge. Witnessed variability in treatment outcomes translates to a large unmet clinical need; with significant risk of disease progres…
Introduction: Rheumatoid arthritis (RA) is known to be associated with an increased risk of cardiovascular disease (CVD), resulting in excess mortality. Dyslipidaemia has been identified as a major CVD risk factor in the general population. Current evidence would suggest that li…
Objectives: The aim of this thesis was to evaluate the clinical use of rituximab (RTX) in rheumatoid arthritis (RA) patients treated in routine clinical practice in the UK, taking account of the previous therapies (anti-tumour necrosis factor (anti-TNF) therapies).Methods: The a…
Introduction: Patients with inflammatory polyarthritis (IP) have an excess risk of cardiovascular (CVD) mortality due to accelerated atherosclerosis. Markers identifying individuals with subclinical atherosclerosis as measured by carotid intima-medial thickness (cIMT) and plaque…
Ultrasound (US) imaging has made significant progress over the past 20 years in relation to its role in inflammatory arthritis, and in particular, Rheumatoid Arthritis. Modern US machines provide crisp, detailed images of superficial anatomical structures which has facilitated t…
Despite the success of current biological agents, achievement of broader efficacy and improved safety profile remains an unmet need in rheumatoid arthritis therapy. Neovasculogenesis plays a vital role in the progression and perpetuation of rheumatoid arthritis and significant e…
Bone makes up a framework that provides protection for internal body organs. The homeostasis of bone is maintained by a balanced process involving old bone degradation and new bone formation. However, this balance can be altered in pathophysiological conditions such as in postme…
The ubiquitous ɣ-herpesvirus Epstein-Barr virus (EBV) infects B cells and modifies their differentiation programme leading to B cell activation and immortalization. Although different evidences support a link between EBV infection and rheumatoid arthritis (RA) and Sjogren’s synd…
Rheumatoid arthritis (RA) is a chronic inflammatory autoimmune disease which predominantly affects the synovial joints. Local gene therapy represents an approach to produce therapeuticmolecules (i.e. soluble TNF receptor (sTNFR)-Fc and interleukin-1 receptor antagonist (IL-1Ra))…
Aim: The aim of this thesis was to validate the 2010 American College of Rheumatology/European League Against Rheumatism classification criteria for rheumatoid arthritis (RA), in particular with respect to its construct validity and the role of autoantibodies within the criteria…
Despite the development of new biomarkers predicting prognosis in rheumatoid arthritis (RA) remains challenging and targeting of powerful biologics difficult. The presence of ectopic germinal centres (GC) within synovium has long been recognised (ectopic lymphoneogenesis [ELN]) …
Background: Inflammation is the natural reaction of the body to an antigen. In some conditions, this reaction continues even after the elimination of the antigen, entering a chronic stage; it targets normal cells of the body and causes extensive damage. Rheumatoid arthritis (RA)…