Eric C Sayre

University of British Columbia - Vancouver, Vancouver, British Columbia, Canada

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Publications (95)340.4 Total impact

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    ABSTRACT: To determine the risk of newly recorded myocardial infarction (MI) and stroke among incident GCA cases compared with controls from the general population. We also evaluated time trends during follow-up. We conducted a matched cohort study (1996-2010) of all patients with incident GCA from the province of British Columbia, Canada. We estimated incidence rates of MI and stroke according to GCA disease duration. We calculated hazard ratios (HRs), adjusting for potential confounders. Among 809 individuals with GCA (mean age 75.9 years, 75.8% female), 83 developed MI and 60 developed stroke, with corresponding incidence rates of 38.1 and 26.4/1000 person-years, respectively. Compared with non-GCA cases, the age-, sex- and entry time-matched HRs were 2.75 (95% CI 2.16, 3.50) for MI and 2.21 (95% CI 1.68, 2.91) for stroke. When other covariates were adjusted for, the corresponding HRs were 1.77 (95% CI 1.29, 2.43) and 2.04 (95% CI 1.43, 2.93). The age-, sex- and entry time-matched HRs for MI and stroke were highest during the first year after GCA diagnosis [4.76 (95% CI 3.29, 6.88) and 3.20 (95% CI 2.11, 4.87), respectively]. These findings provide general population-based evidence that GCA patients are at a substantially increased risk of cardiovascular disease. Increased monitoring for this potentially fatal outcome and its modifiable risk factors is warranted for GCA patients. © The Author 2015. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: journals.permissions@oup.com.
    Rheumatology (Oxford, England) 08/2015; DOI:10.1093/rheumatology/kev262 · 4.44 Impact Factor
  • Annals of the Rheumatic Diseases 06/2015; 74(Suppl 2):86.1-86. DOI:10.1136/annrheumdis-2015-eular.2053 · 10.38 Impact Factor
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    ABSTRACT: To estimate the future risk and time trends of newly diagnosed venous thromboembolism (VTE) in individuals with incident systemic lupus erythematosus (SLE) in the general population.
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    ABSTRACT: To explore rheumatologists' perception of patient decision aids (PtDAs) and identify barriers to using them in clinical practice. A cross-sectional online survey was conducted with all members of the Canadian Rheumatology Association (CRA; N=459). We subsequently invited 10 respondents to participate in a 30-minute telephone interview to further explore their views on using PtDAs in clinical practice. Interview participants were purposefully sampled to achieve a balance in sex, years in clinical practice, and types of practice. In August - September 2013, 153 CRA members responded to the survey (response rate=33.3%); of those, 113 completed the entire questionnaire. 63 respondents (55.8%) were male, 54 (47.8%) were age 50 or older, and 55 (48.7%) practiced in a multidisciplinary setting. When asked their intention to use PtDAs, participants on average rated 5.7 (SD=2.9; 0=not likely, 10=very likely). 56.6% (n=64) believed that rheumatologists were unfamiliar with PtDAs, and 67.3% (n=76) thought that PtDAs would disturb their workflow. In-depth interviews revealed: 1) the perception that PtDAs were no different from any patient education tools, 2) the concern that PtDAs were of limited value in real life since they relied solely on randomized controlled trial data, and 3) the fear that PtDAs could impair doctor-patient communication. There was a sense of ambivalence among rheumatologists about PtDAs. Our interviews further revealed concerns regarding the utility and benefits of PtDAs in clinical practice. The results showed a need to familiarize physicians with PtDAs, and to develop strategies to support their integration in clinical practice. This article is protected by copyright. All rights reserved. © 2015, American College of Rheumatology.
    05/2015; DOI:10.1002/acr.22605
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    Osteoarthritis and Cartilage 04/2015; 23:A321-A322. DOI:10.1016/j.joca.2015.02.583 · 4.66 Impact Factor
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    ABSTRACT: We would like to thank Dr Moiseev1 for his interest in our recent paper on the risk of venous thromboembolism (VTE) in patients with giant cell arteritis (GCA).2 We agree that all systemic autoimmune rheumatic diseases (SARDs) are associated with an increased risk of VTE, as we and others have reported.3-6 Additionally, we have confirmed the increased risk of VTE in patients with GCA in another sample, and those … [Full text of this article]
    Annals of the Rheumatic Diseases 11/2014; 74(3). DOI:10.1136/annrheumdis-2014-206853 · 10.38 Impact Factor
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    ABSTRACT: Identifying persons with early rheumatoid arthritis (RA) is a major challenge. The role of the Internet in making decisions about seeking care has not been studied. We developed a method for early diagnosis and referral using the Arthritis Foundation's website. A person with less than 3 months of joint pain symptom who has not yet sought medical attention was screened. Prescreened persons are linked to a self-scoring questionnaire and get a "likelihood" of RA statement. If "likely," the person is offered a free evaluation and biomarker testing performed by Quest Diagnostics. The system available only to Massachusetts's residents yielded a small steady flow of screen-positive individuals. Over 21 months, 43,244 persons took the Arthritis Foundation website prescreening questionnaire; 196 were from Massachusetts and 60 took the self-scoring algorithm. Of the 48 who screened positive, 29 set up an appointment for a free evaluation, but six never came in. Twenty-four subjects were evaluated and diagnosed independently by three rheumatologists. One met the 1987 American College of Rheumatology (ACR) criteria for RA and two met the 2010 ACR/EULAR RA criteria. The 24 examined individuals were contacted at a minimum of 1 year and asked to redo the case-finding questionnaire and asked about their health resource utilization during the interval. Seventeen of the 24 subjects responded, and 10 had seen a health professional. Three of the 17 had a diagnosis of RA; all were on at least methotrexate. Internet case finding was useful in identifying new potential RA cases. The system's performance characteristics are theoretically limited only by the number of study sites available. However, the major barrier may be that seeing a health professional is not a priority for many individuals with early symptoms.
    Clinical Rheumatology 10/2014; 34(3). DOI:10.1007/s10067-014-2796-7 · 1.77 Impact Factor
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    ABSTRACT: Importance Patients with giant cell arteritis (GCA) may have an increased risk of pulmonary embolism (PE), similar to other systemic vasculitidies; however, no relevant population data are available to date. Objective To evaluate the future risk and time trends of new venous thromboembolism (VTE) in individuals with incident GCA at the general population level. Design Observational cohort study. Setting General population of British Columbia. Participants 909 patients with incident GCA and 9288 age-matched, sex-matched and entry-time-matched control patients without a history of VTE. Main outcome measures We calculated incidence rate ratios (IRR) overall, and stratified by GCA duration. We calculated HR of PE and deep vein thrombosis (DVT), adjusting for potential VTE risk factors. Results Among 909 individuals with GCA (mean age 76 years, 73% women), 18 developed PE and 20 developed DVT. Incidence rates (IR) of VTE, PE and DVT were 13.3, 7.7 and 8.5 per 1000 person-years (PY) in GCA cohort, versus 3.7, 1.9 and 2.2 per 1000 PY in the comparison cohort. The corresponding IRRs (95% CI) for VTE, PE and DVT were 3.58 (2.33 to 5.34), 3.98 (2.22 to 6.81) and 3.82 (2.21 to 6.34) with the highest IRR observed in the first year of GCA diagnosis (7.03, 7.23 and 7.85, respectively). Corresponding fully adjusted HRs (95% CI) were 2.49 (1.45 to 4.30), 2.71 (1.32 to 5.56) and 2.78 (1.39 to 5.54). Conclusions and significance These findings provide general population-based evidence that patients with GCA have an increased risk of VTE, calling for increased vigilance in preventing this serious, but preventable complication, especially within months after GCA diagnosis.
    Annals of the Rheumatic Diseases 09/2014; DOI:10.1136/annrheumdis-2014-205665 · 10.38 Impact Factor
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    ABSTRACT: Background/objective Patients with polymyositis (PM) and dermatomyositis (DM) may have an increased risk of venous thromboembolism (VTE); however, no general population data are available to date. The purpose of this study was to estimate the future risk and time trends of new VTE (deep venous thrombosis (DVT) or pulmonary embolism (PE)) in individuals with incident PM/DM at the general population level. Methods We assembled a retrospective cohort of all patients with incident PM/DM in British Columbia and a corresponding comparison cohort of up to 10 age-matched, sex-matched and entry-time-matched individuals from the general population. We calculated incidence rate ratios (IRR) for VTE, DVT and PE and stratified by disease duration. We calculated HRs adjusting for relevant confounders. Results Among 752 cases with inflammatory myopathies, 443 had PM (58% female, mean age 60 years) and 355 had DM (65% female, mean age 56 years); 46 subjects developed both diseases. The corresponding IRRs (95% CI) for VTE, DVT and PE in PM were 8.14 (4.62 to 13.99), 6.16 (2.50 to 13.92) and 9.42 (4.59 to 18.70), respectively. Overall, the highest IRRs for VTE, DVT and PE were observed in the first year after PM diagnosis (25.25, 9.19 and 38.74, respectively). Fully adjusted HRs for VTE, DVT and PE remained statistically significant (7.0 (3.34 to 14.64), 6.16 (2.07 to 18.35), 7.23 (2.86 to 18.29), respectively). Similar trends were seen in DM. Conclusions These findings provide the first general population-based evidence that patients with PM/DM have an increased risk of VTE. Increased vigilance of this serious but preventable complication is recommended.
    Annals of the Rheumatic Diseases 09/2014; DOI:10.1136/annrheumdis-2014-205800 · 10.38 Impact Factor
  • 69th Annual Meeting of the Canadian-Rheumatology-Association (CRA); 07/2014
  • 69th Annual Meeting of the Canadian-Rheumatology-Association (CRA); 07/2014
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    ABSTRACT: Background Chronic obstructive pulmonary disease (COPD) has been recently recognized as an inflammatory disease. A recent Swedish hospital-based study (1) found an increased risk of COPD in patients with a number of autoimmune conditions including systemic lupus erythematosus (SLE). We wonder if the risk is also present in SLE patients from the general population. Objectives To assess the future risk of newly recorded COPD cases among incident SLE cases compared to controls from the general population using physician billing and hospitalization data that covers the entire province of British Columbia (BC), Canada. Methods Our data includes all health professionals and hospital visits covered by the comprehensive provincial medical services plan (1990-2010) and all dispensed medication (1996-2010), for all BC residents. We conducted a retrospective matched cohort (1996-2010) study among patients satisfying at least one of the following validated criteria: a) One diagnostic code for SLE (ICD-9-CM =710.0) on at least two visits within a two-year period by a non-rheumatologist physician; b) One ICD-9 code by a rheumatologist or from hospitalization; c) absence of a prior SLE diagnosis between 1990 and 1995. Ten controls matched by birth year, sex and calendar year of exposure were randomly selected from the general population for each case. Outcome: we used validated criteria to define COPD (first ICD-9-CM: 491, 492, 496, 493.2, or ICD-10-CM J43 or J44) from hospitals or death certificates. We estimated relative risks (RRs) by comparing SLE cases with age-, sex- and entry-time-matched comparison cohorts, adjusting for confounders. Sensitivity analyses were conducted to assess for unmeasured confounders. Results Among 4486 individuals with incident SLE, 96 developed COPD (incidence rate =4.96 per 1,000 person years) (see table). The age-, sex- and entry-time matched RRs were significantly increased in the SLE cohort when compared with controls (RR 2.31, 95% CI 1.83-2.89). After adjusting for covariates the results remained statistically significant. The risk of developing COPD was highest within the first year following the diagnosis of SLE, decreasing over time and remaining significant up to 4 years after diagnosis. Our results remained statistically significant after adjusting for the potential impact of an unmeasured confounder (adjusted RRs ranging between 1.58–1.98 in all sensitivity analyses). Conclusions This is the first general population-based study indicating a two-fold increased risk of COPD in patients with SLE. The risk of developing COPD was highest within the first year, declining thereafter, suggesting the potential pathogenic role of inflammation in the development of COPD. References Acknowledgements Research funded by an operating grant by the Canadian Arthritis Network/The Arthritis Society and the BC Lupus Society (Grant 10-SRP-IJD-01) Disclosure of Interest : None declared DOI 10.1136/annrheumdis-2014-eular.3912
    Annals of the Rheumatic Diseases 06/2014; 73(Suppl 2):180-180. DOI:10.1136/annrheumdis-2014-eular.3912 · 10.38 Impact Factor
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    ABSTRACT: Purpose To assess the association between subchondral sclerosis detected at baseline with MRI and cartilage loss over time in the same region of the knee in a cohort of subjects with knee pain. Methods 163 subjects with knee pain participated in a longitudinal study to assess knee osteoarthritis progression. Subjects received baseline knee radiographs as well as baseline and 3-year follow-up MRI examinations. Baseline subchondral sclerosis and bone marrow lesions (BMLs) were scored semiquantitatively on MRI in each region from 0 to 3. Cartilage morphology at baseline and follow-up was scored semiquantitatively from 0 to 4. The association between baseline subchondral sclerosis and cartilage loss in the same region of the knee was evaluated using logistic regression, adjusting the results for age, gender, body mass index, and the presence of concomitant BMLs. Results The prevalence of subchondral sclerosis detected by MRI in the regions of the knee varied between 1.6% (trochlea) and 17% (medial tibia). The occurrence of cartilage loss over time in regions varied between 6% (lateral tibia) and 13.1% (medial femur). The prevalence of radiographically-detected subchondral sclerosis in compartments varied from 2.9% (patellofemoral) to 14.2% (medial tibiofemoral). In logistic regression models, there were no significant associations between baseline subchondral sclerosis detected by MRI and cartilage loss in the same region of the knee. Conclusion Baseline subchondral sclerosis as detected by MRI did not increase the risk of cartilage loss over time.
    Osteoarthritis and Cartilage 04/2014; 22(4). DOI:10.1016/j.joca.2014.01.006 · 4.66 Impact Factor
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    Canadian Rheumatology Association-Arthritis Health Professions Association (CRA-AHPA) Annual Scientific Meeting, Whistler, British Columbia; 02/2014
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    Canadian Rheumatology Association- Arthritis Health Professions Association (CRA-AHPA) Annual Scientific Meeting, Whistler, British Columbia; 02/2014
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    Canadian Rheumatology Association-Arthritis Health Professions Association (CRA-AHPA) Annual Scientific Meeting, Whistler, British Columbia; 02/2014
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    Canadian Rheumatology Association-Arthritis Health Professionals Association (CRA-AHPA) Annual Scientific Meeting, Whistler, British Columbia; 02/2014
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    Canadian Rheumatology Association-Arthritis Health Professions Association (CRA-AHPA) Annual Scientific Meeting, Whistler, British Columbia; 02/2014
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    Canadian Rheumatology Association-Arthritis Health Professions Association (CRA-AHPA) Annual Scientific Meeting, Whistler, British Columbia; 02/2014

Publication Stats

519 Citations
340.40 Total Impact Points

Institutions

  • 2004–2015
    • University of British Columbia - Vancouver
      • Department of Orthopaedics
      Vancouver, British Columbia, Canada
    • The Arthritis Society
      Toronto, Ontario, Canada
  • 2006–2014
    • Arthritis Research Centre of Canada
      Richmond, British Columbia, Canada
  • 2006–2009
    • Simon Fraser University
      • Department of Statistics and Actuarial Sciences
      Burnaby, British Columbia, Canada