Your participation in CATCH has allowed the team to look at a lot of data about people who are diagnosed with early rheumatoid arthritis and look at trends over a long period of time, to see what others like you have in common, or to see the most effective way to treat people with medications. The researchers then present these findings to other researchers at national and international scientific meetings - sometimes they give a talk and other times they will give a poster (at scientific meetings there are dedicated poster sessions where researchers really stand by posters that they've made about their research and findings at certain times and then talk to people who come by to read their posters). Researchers have to 'apply' to present their research and work at meetings, and they do that by creating an 'abstract' which is a shortened version of what they wish to present at a meeting.

All of the CATCH team research abstracts are provided here by year. Each abstract is split in to a 'short' version to give you a simple overview of the research, and if you click on the 'read more' section there is a longer version of the abstract with a few more details for you. If the CATCH team has published a scientific paper on this topic, we have also provided a link to the paper for you. We have tried to use simple language so that you can understand what the researchers did and what they found. You may wish to open our Glossary page beside the abstracts as you read them and we have also linked some more difficult terms directly to the Glossary so you can look up these words as you read (those words are shown in dark red).

If you are interested in reading the full scientific papers (also called manuscripts) that have resulted from CATCH research, you can click here and you will be redirected to a page that lists all papers that have been published according to year.

We thank you for your participation in CATCH - none of this research and none of these abstracts would be here without you.


Additions to Methotrexate with Conventional and Biologic DMARDs in Rheumatoid Arthritis: Are There Difference in Subsequent Time to Treatment Failure?

Cristiano Moura1, Vivian Bykerk2, Orit Schieir3, Marie-France Valois4, Susan Bartlett4, Carol Hitchon5, Janet Pope6, Gilles Boire7, Boulos Haraoui8, Edward Keystone9, Diane Tin10, Carter Thorne10, Sasha Bernatsky11, and CATCH investigators

 

1Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal; 2Hospital for Special Surgery, New York; 3University of Toronto, Toronto; 4McGill University, Montreal; 5University of Manitoba, Winnipeg; 6Western University, Department of Medicine, Division of Rheumatology, London; 7Université de Sherbrooke, Sherbrooke; 8Institut de Rhumatologie de Montréal, Montreal; 9Mount Sinai Hospital, University of Toronto, Toronto; 10Southlake Regional Health Centre, Newmarket; 11McGill University Health Centre, McGill University, Montreal.

The study compared RA treatments after a person was first treated with methotrexate but their RA did not respond to it or had to stop taking it because of a safety reason. 911 people in the CATCH study who started on methotrexate and who changed their medication were part of the study. After methotrexate, the most common next treatment was methotrexate plus another disease modifying anti-rheumatic drug (DMARD) or methotrexate and non-DMARDs. The results show that compared to people who started on a pill version of methotrexate, people on biologics and triple therapy (triple therapy is what it is called when people take methotrexate, sulfasalazine and hydroxychloroquine) were on these medications longer without other medication changes. 

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What was the purpose of the study?

The study looked at RA treatments that individuals took after first being treated with methotrexate but whose RA did not respond to it or had to stop taking it because of safety reasons.

How was this study done?

People in the CATCH study who started on methotrexate and who had to change their medication were part of the study. For example, these participants may have changed how they took methotrexate (pill or injection), lowered their dose or stopped taking methotrexate or other DMARD, or added another DMARD or biologic. All subsequent groups of patients were compared to people who took methotrexate by pill.

What were the results of the study?

911 people in the CATCH study who started on methotrexate and changed their medication were part of the study. After methotrexate, the most common next treatment was methotrexate plus another DMARD (33% of participants) or methotrexate and non-DMARDs (26% of participants). The results show that compared to people on a pill version of methotrexate, people on biologics and triple therapy (triple therapy is what it is called when people take methotrexate, sulfasalazine and hydroxychloroquine) were on these medications longer without other medication changes.


Does Guideline-Based Care Improve Outcomes That Matter to Canadian Patients? Tighter Control, Less Suffering, and Greater Well-Being over the Past Decade in CATCH RA Patients

Susan Bartlett1, Orit Schieir2, Marie- France Valois1, Carol Hitchon3, Janet Pope4, Gilles Boire5, Boulos Haraoui6, Edward Keystone7, Diane Tin8, Carter Thorne8, Vivian Bykerk9, and CATCH investigators.

1McGill University, Montreal; 2University of Toronto, Toronto; 3University of Manitoba, Winnipeg; 4Western University, Department of Medicine, Division of Rheumatology, London; 5Université de Sherbrooke, Sherbrooke; 6Department of Medicine, Centre Hospitalier de l'Université de Montréal, Montréal; 7Mount Sinai Hospital, University of Toronto, Toronto; 8Southlake Regional Health Centre, Newmarket; 9Hospital for Special Surgery, New York).

Recommendations on how to treat RA patients called guidelines can increase quality of their care and improve their RA outcomes. The impact of recommendations on outcomes that patients report (called patient reported outcomes), as opposed to those measured by their rheumatologist, have not been evaluated. The study compared changes in patient reported outcomes (PROs) valued most by people with RA in the first year after being diagnosed with RA, as well as before and after certain practice guidelines were published. The study looked at disease activity, pain, fatigue, patient global, and the health assessment questionnaire scores in 1942 study participants. The results show that in the first year of a person’s diagnosis of RA, better RA control lead to comparable improvements in pain, fatigue and disability and greater overall well-being. These results also show that early identification and control of RA is important to improve long-term outcomes and quality of life.

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What was the purpose of the study?

Recommendations on how to treat RA patients called guidelines, can increase quality of their care and improve their RA outcomes. The impact of guidelines on outcomes that patients report (called patient reported outcomes or PROs), as opposed to those measured by their rheumatologist, have not been evaluated. This study set out to look at changes in PROs in the first year after RA diagnosis, as well as before and after the release of recommendations called Treat to Target in 2010 and Canadian RA Treatment recommendations in 2011.

How was this study done?

Participants in CATCH who were part of the study between 2007-16 who met 1987 or 2010 RA criteria and had active RA at the study start. Also standardized visits included clinical assessments, questionnaires, and laboratory tests every 3 months, treatment was at the discretion of their rheumatologist, and the CATCH investigators met every year to discuss ways to improve outcomes. The study looked at changes in DAS28; including measurements of pain, fatigue, patient global; and health assessment questionnaire (HAQ) at 6 and 12 months in the years before and after the release of the guidelines.

What were the results of the study?

1942 adults were in the study and at the start of the study, 95% of them had moderate or high disease activity measured by the DAS28. They were initially treated with a mix of DMARDs and methotrexate. Over time, the average disease activity scores decreased and improvements were seen in patient global, pain, fatigue, and HAQ. When comparing change in patient-reported outcomes in 2007-2010 against those in 2011-2016, there were more rapid improvements in patient global and pain at 6 and 12 months and similar improvements in HAQ and fatigue.

Results show that better control of RA control in the first year showed comparable improvements in pain, fatigue and disability. These symptoms are ones that patients identify as being very important to them, so improving these meant that they also felt greater overall well-being. This also shows the importance of early identification and control of RA to improve long-term outcomes and quality of life. 


Incidence of Infections in Early Arthritis

Meriem Kerbachi1, Louis Bessette2, Cristiano Moura3, Sasha Bernatsky4, Orit Schieir5, Susan Bartlett1, Carol Hitchon6, Janet Pope7, Gilles Boire8, Boulos Haraoui9, Edward Keystone10, Diane Tin11, Carter Thorne11, Vivian Bykerk12, and CATCH investigators.

1McGill University, Montreal; 2Laval University, Quebec; 3Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, 4McGill University Health Centre, McGill University, Montreal, 5University of Toronto, Toronto, 6University of Manitoba, Winnipeg, 7Western University, Department of Medicine, Division of Rheumatology, London; 8Université de Sherbrooke, Sherbrooke; 9Department of Medicine, Centre Hospitalier de l'Université de Montréal, Montréal; 10Mount Sinai Hospital, University of Toronto, Toronto; 11Southlake Regional Health Centre, Newmarket;12Hospital for Special Surgery, New York.

Few studies have looked at infection risk in patients with newly diagnosed rheumatoid arthritis (RA). This study aimed to estimate the incidence of infections in patients with early RA. Infections were reported by patients annually, and from January 2007 to November 2015, the researchers looked at the total number of infections. 1728 RA patients were part of the study and were observed for about 3 years. During the study, there were 452 infections were reported and 125 of these involved the patients spending time in the hospital. There were 84 cases of pneumonia with half of these pneumonia patients needing to spend time in the hospital. This study provides new data on infection in early RA patients, and these reported infections were not negligible.

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What was the purpose of the study?

Few studies have looked at infection risk in patients newly diagnosed with rheumatoid arthritis (RA). This study aimed to estimate the incidence of infections in patients with early RA.

How was this study done?

Infections were reported by patients yearly (chronic infections were not counted), and from January 2007 to November 2015, the researchers looked at the total number of infections to generate incidence rates.

What were the results of the study?

1728 RA patients were part of the study criteria and were followed for about 3 years. On average, participants had RA symptoms for about 6 months before they started the study, had active RA symptoms, and 33% of them were on steroids at the start, with 91% of them taking disease modifying anti-rheumatic drugs (also called DMARDs), and 73% taking methotrexate.

Over the study 452 infections were reported and 125 of these involved patients needing to spend time in the hospital. There were 84 cases of pneumonia with half of these pneumonia patients needing to spend time in the hospital.

This study provides new data on infection in early RA patients, and these reported infections were not negligible.


Methotrexate Treatment Strategies in an Early Rheumatoid Arthritis Cohort

Cristiano Moura1, Vivian Bykerk2, Orit Schieir3, Marie-France Valois4, Susan Bartlett4, Carol Hitchon5, Janet Pope6, Gilles Boire7, Boulos Haraoui8, Edward Keystone9, Diane Tin10, Carter Thorne10, Sasha Bernatsky11, and CATCH investigators 

1Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal; 2Hospital for Special Surgery, New York; 3University of Toronto, Toronto; 4McGill University, Montreal; 5University of Manitoba, Winnipeg; 6Western University, Department of Medicine, Division of Rheumatology, London; 7Université de Sherbrooke, Sherbrooke; 8Institut de Rhumatologie de Montréal, Montreal; 9Mount Sinai Hospital, University of Toronto, Toronto; 10Southlake Regional Health Centre, Newmarket; 11McGill University Health Centre, McGill University, Montreal.

 

Methotrexate is often used as one of the first treatments of RA. How methotrexate is taken can vary greatly, so this study aimed to see how methotrexate was being used by people who have early RA. Participants in the study were taking methotrexate as a first treatment and then had to change medications either due to safety reasons or because their RA was no longer responding. Study participants were 1,484 early RA patients and most of them started on methotrexate alone (in pill or injectable form) or methotrexate plus another medication. The results showed that people who took methotrexate plus another medication were on this combination longer than people who started on methotrexate only.

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What was the purpose of the study?

Methotrexate is often used as one of the first treatments of RA. How methotrexate is taken can vary greatly, so this study aimed to see how methotrexate was being used by people who have early RA.

How was this study done?

Participants in the study were taking methotrexate as a first treatment and then had to change either due to safety reasons or because their RA was no longer responding. Study participants were 1,484 early RA patients and most of them started on methotrexate along (in pill or injectable form) or methotrexate plus another medication.

What were the results of the study?

Overall, 911 participants needed to change their medication in some way during the study- which may have included changing the form of methotrexate they took (pill or injectable), adding or stopping a DMARD or biologic, changing dose or frequency of a DMARD or biologic, stopping because their medication was not working for their RA, or stopping because of safety reasons. Compared to patients only taking oral methotrexate only, patients taking methotrexate plus any other combination of DMARDs or biologics stayed on those types of medications longer before needing to make a change to their medication.


Time Trends over a Decade Show Earlier Intensified Medication Strategies and Improved Outcomes in Canadians with Early Inflammatory Arthritis

Orit Schieir1, Marie-France Valois2, Susan Bartlett2, Kathleen Andersen3, Carol Hitchon4, Janet Pope5, Gilles Boire6, Boulos Haraoui7, Diane Tin8, Carter Thorne8, Edward Keystone9, Vivian Bykerk10, and CATCH investigators.

1University of Toronto, Toronto; 2McGill University, Montreal; McGill University, Montreal; 3McGIll University, Beaconsfield, 4University of Manitoba, Winnipeg, 5Western University, Department of Medicine, Division of Rheumatology, London; 6Université de Sherbrooke, Sherbrooke; 7Institut de Rhumatologie de Montréal, Montreal; 8Southlake Regional Health Centre, Newmarket; 9Mount Sinai Hospital, University of Toronto, Toronto; 10Hospital for Special Surgery, New York.

 

Treatment recommendations are created by physicians for their peers to follow, and are aimed at improving RA outcomes for people through early identification and a targeted approach to their treatment. The study looked at trends over the past 10 years including patient characteristics, treatment approaches and RA activity in the first year after diagnosis in the CATCH study. The results showed that earlier, more intensified treatment that is suggested in treatment recommendations has resulted in lower RA activity for patients and more patients reaching remission.

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What was the purpose of the study?

Treatment recommendations are created based on data and are aimed at improving RA outcomes for people through early identification and a targeted approach to their treatment. The study looked trends over the past 10 years including patient characteristics, treatment approaches and RA activity in the first year after diagnosis in the CATCH study.

How was this study done?

Participants in CATCH were part of the study if they had complete disease activity score (DAS28) measures in their records every 6 months from 2007-2016, and clinical assessments, questionnaires, and laboratory investigations every 3 months for the first year. Treatment was up to their rheumatologist, and CATCH investigators met every year to talk about how they could improve outcomes in the CATCH participants. Trends in patient characteristics, early treatment strategies with conventional disease modifying anti-rheumatic drugs (also called DMARDs) and biologics and disease activity over 12 months were examined. The researchers tried to identify any predictors that prevented patients from being in low disease activity or remission by 1 year after diagnosis.

What were the results of the study?

Over 10 years, 2822 participants were enrolled in the CATCH study. Most were treated with conventional DMARDs (95% of participants), that was often methotrexate on its own or in combination with other DMARDs (77% of participants). A few other trends were observed:

  • Patient characteristics when participants started the study changed slightly over time with increases in age, being male, education, income, and declines in smoking;
  • Obesity rates, comorbidities and RA characteristics stayed the same for new participants entering CATCH;
  • Most people started CATCH with moderate or high disease activity (87% of patients), and disease activity at 6 and 12 months improved a lot over time;
  • Remission defined by DAS28 at 12 months increased by over 30% and 20% more patients achieved low disease activity or remission by 6 months
  • Methotrexate use showed that over time doses of methotrexate for patients were increased earlier, there was more use of injectable methotrexate, and earlier use of methotrexate with other therapies;
  • There was a faster time to using biologics over time;
  • People who continued to have moderate to high RA activity at one year after diagnosis tended to be older and female, have a lower education, were non-white, were overweight or obese, and had more comorbidities.

The results showed that earlier, more intensified treatment that is suggested in treatment recommendations has resulted in lower RA activity for patients and more patients reaching the target of remission.


Trends in Adherence to Glucocorticoid-Induced Osteoporosis Guidelines: Results from the CATCH Cohort

Stephanie Gottheil1, Orit Schieir2, Carter Thorne3, Gilles Boire4, Diane Tin3, Susan Bartlett5, Boulos Haraoui6, Carol Hitchon7, Edward Keystone8, Vivian Bykerk9, Janet Pope10, and CATCH investigators.

1Western University, London; 2University of Toronto, Toronto; 3Southlake Regional Health Centre, Newmarket; 4Université de Sherbrooke, Sherbrooke; 5McGill University, Montreal; 6Department of Medicine, Centre Hospitalier de l'Université de Montréal, Montréal; 7University of Manitoba, Winnipeg; 8Mount Sinai Hospital, University of Toronto, Toronto; 9Hospital for Special Surgery, New York; 10Western University, Department of Medicine, Division of Rheumatology, London.

People with RA who take glucocorticoids for a long time to treat their RA are also at high risk of developing osteoporosis or breaking a bone. To prevent this from happening, physicians should be prescribing anti-osteoporosis medication according to treatment guidelines that have been developed. The researchers showed that only some patients who should have been taking anti-osteoporosis medication to prevent osteoporosis because of their long-term glucocorticoid use were actually taking it. However it appeared that physicians were following newer guidelines developed in 2017 about this practice to prescribe anti-oseteoporosis medication because more patients were taking those medications.

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What was the purpose of the study?

People with RA who take glucocorticoids for a long time to treat their RA are also at high risk of developing osteoporosis or breaking a bone. To prevent this from happening, physicians should be prescribing anti-osteoporosis medication, but this does not happen as often as it should. Treatment guidelines for this practice have been created, but it does not appear that physicians are treating according to these recommendations. The study aimed to see if physicians are following the guidelines about prescribing anti-osteoporosis medications to people with RA who take glucocorticoids for a long time.

How was this study done?

Participants from CATCH were included in the study if they were over 50 years of age, did not have osteoporosis, and 6 months after they were diagnosed with RA. There were guidelines developed in 2010 and 2017 for the use of anti-osteoporosis medications in patients. To estimate how well the physicians were following  the guidelines developed in 2010 (which is also called 'adherence to the guidelines'), patients on anti-osteoporosis medications and taking more than 7.5 mg prednisone daily for more than 3 months, were counted. To estimate adherence to the 2017 guidelines, the researchers looked at the use of anti-osteoporosis medications in patients taking less than 2.5 mg prednisone daily for over 3 months and FRAX of more than 10 (FRAX is the Fracture Risk Assessment Tool). 

What were the results of the study?

Of 1468 patients, there were 282 patients who met the criteria for taking anti-osteoporosis medication according to the 2010 guidelines, but only 54 patients were taking the medication. Adherence to the 2017 guidelines was higher and 74 patients were on anti-osteoporosis medication.

In this study, about 20% of patients should have been taking anti-osteoporosis medications to prevent osteoporosis due to long-term use of glucocorticoids according to 2010 guidelines while 19% of them received the medications. However, long term use of glucocorticoids decreased over time which is good considering these drugs' risks with fracture and osteoporosis. The researchers concluded that there was increased adherence by the physicians to the  2017 guidelines because more patients were taking anti-osteoporosis medication.