81 research outputs found
Osteoporosis-related fractures in men and women with established and early rheumatoid arthritis: predictors and risk compared with the general population
No full textAbstract Objectives To study the risk of osteoporosis-related fractures in a community-based sample of men and women with rheumatoid arthritis (RA) overall, as well as early (< 1 year of disease duration, follow-up time maximum 10 years) and established (RA diagnosis since ≥ 5 years on July 1, 1997) RA, compared with the general population. To study potential risk factors for fractures in patients with RA from baseline questionnaire data. Methods A community-based cohort of patients with RA (n = 1928) was studied and compared to matched general population controls. Information on osteoporosis-related fractures (hip, proximal upper arm, distal forearm and vertebral fractures) during the period July 1, 1997 to December 31, 2017 was obtained by linkage to the Swedish National Inpatient Register and the Cause of Death Register. The incidence of fractures was estimated in patients and controls. Cox regression models were used to assess the relation between RA and the risk of fractures and to assess potential predictors of fractures in RA patients. Analyses were stratified by sex, and performed in all patients with RA, and in subsets with early and established RA. Results The overall incidence of osteoporosis-related fractures in the RA cohort was 10.6 per 1000 person-years (95% CI 9.31; 12.0). There was an increased risk of fractures overall in both men (hazard ratio (HR) 1.55, 95% CI 1.03; 2.34) and women (HR 1.52; 95% CI 1.27; 1.83) with RA compared to controls, with significantly increased risk also in the hip. No increased risk of osteoporosis-related fractures overall was seen in patients with early RA (HR 1.01, 95% CI 0.69; 1.49). Higher age, longer duration of RA, higher HAQ scores and higher scores in the visual analogue scale for global health were predictors of fractures. Conclusion Both men and women with RA were at increased risk of osteoporosis-related fractures. Patients with early RA did not have significantly increased risk during the first 10 years of disease in this study
Leisure activities in rheumatoid arthritis: Change after disease onset and associated factors
No full textThe objective of this investigation was to examine the relationship between leisure-time occupations, quality of life disease activity among patientswith rheumatoid arthritis. Fifty patients with rheumatoid arthritis-39 females and 11 males, age 30-45 years and belonging to functional class I-III according to Steinbrocker er al (1949)-were recuited from the register at a hospital clinic and from a private outpatient clinic. The participants completed a questionnaire concerning education, occupation, pain, morning stiffness, currentleisure activities and those pursued before the onset of the disease, and including the Quality of Life Scale (QoLS). The patients had given up two-thirds of their leisure activites since the onset of the disease. This decrease wa observed for both aexes. It correlated positivly with present disease activity, measures as pain on a visual analogue scale and as morning stiffness, and negativly with the present QoLS. Longitudinal studies are needed to disent
Circulating Interleukin 17A and Other Inflammatory Proteins May Predict Cardiovascular Disease in Early Rheumatoid Arthritis
No full textObjective. The objective of this study was to investigate the impact of 92 inflammatory proteins on the risk of cardiovascular disease (CVD) in patients with early rheumatoid arthritis (RA). Methods. This study included consecutive patients with early RA recruited between 1995 and 2002. Stored plasma samples were analyzed for 92 inflammatory proteins. CVD diagnoses were retrieved from national in-patient and cause-of-death registries. Statistical analyses were predesignated as hypothesis-driven or exploratory. For the latter, proteins were selected based on principal component analysis (ie, factor loading > 0.5 within main components). Potential predictors of CVD and coronary artery disease (CAD) were assessed using Cox regression. Results. Data on baseline levels of proteins and CVD were available for 163 patients. As hypothesized, levels of interleukin 17A (IL-17A) were associated with CVD (hazard ratio 1.35, 95% CI 1.02-1.78, adjusted for age, sex, hypertension, diabetes, smoking, and erythrocyte sedimentation rate [ESR]), although not significantly with CAD. Osteoprotegerin (OPG) levels were significantly associated with both outcomes, but only in crude models. No associations were observed for IL-6, tumor necrosis factor, monocyte chemotactic protein-1, or IL-8. In the exploratory analyses, MCP-3 in particular had significant associations with both outcomes in crude models. Conclusion. Circulating IL-17A at RA diagnosis predicted future CVD, although we cannot exclude the possibility that this finding is due to multiple testing. The association was independent of traditional CVD risk factors, and of ESR at the time of diagnosis. Further, OPG may be a predictor of CVD. We also identified some novel potential biomarkers for CVD in RA
Osteoporosis-related fractures in men and women with established and early rheumatoid arthritis [Elektronisk resurs] : predictors and risk compared with the general population
No full textObjectives: To study the risk of osteoporosis-related fractures in a community-based sample of men and women with rheumatoid arthritis (RA) overall, as well as early (< 1 year of disease duration, follow-up time maximum 10 years) and established (RA diagnosis since ≥ 5 years on July 1, 1997) RA, compared with the general population. To study potential risk factors for fractures in patients with RA from baseline questionnaire data. Methods: A community-based cohort of patients with RA (n = 1928) was studied and compared to matched general population controls. Information on osteoporosis-related fractures (hip, proximal upper arm, distal forearm and vertebral fractures) during the period July 1, 1997 to December 31, 2017 was obtained by linkage to the Swedish National Inpatient Register and the Cause of Death Register. The incidence of fractures was estimated in patients and controls. Cox regression models were used to assess the relation between RA and the risk of fractures and to assess potential predictors of fractures in RA patients. Analyses were stratified by sex, and performed in all patients with RA, and in subsets with early and established RA. Results: The overall incidence of osteoporosis-related fractures in the RA cohort was 10.6 per 1000 person-years (95% CI 9.31; 12.0). There was an increased risk of fractures overall in both men (hazard ratio (HR) 1.55, 95% CI 1.03; 2.34) and women (HR 1.52; 95% CI 1.27; 1.83) with RA compared to controls, with significantly increased risk also in the hip. No increased risk of osteoporosis-related fractures overall was seen in patients with early RA (HR 1.01, 95% CI 0.69; 1.49). Higher age, longer duration of RA, higher HAQ scores and higher scores in the visual analogue scale for global health were predictors of fractures. Conclusion: Both men and women with RA were at increased risk of osteoporosis-related fractures. Patients with early RA did not have significantly increased risk during the first 10 years of disease in this study
AB0285 PREDICTORS OF UNACCEPTABLE PAIN, AND UNACCEPTABLE PAIN WITH LOW INFLAMMATION, IN EARLY RHEUMATOID ARTHRITIS
No full textAdditional file 1 of Osteoporosis-related fractures in men and women with established and early rheumatoid arthritis: predictors and risk compared with the general population
No full textSupplementary Material
SAT0445 ADEQUATE URATE LOWERING THERAPY FOR GOUT IS RARE IN CLINICAL PRACTICE BUT PRESERVES RENAL FUNCTION WHEN EFFECTED
No full textDisability Related to the Upper Extremities in Early Rheumatoid Arthritis—Long-Term Course and Disease Variable Impact : A Cohort Study
No full textObjective. To investigate the course of disability related to the upper extremities (UEs) in early rheumatoid arthritis (RA), and to assess correlations between such disability and clinical variables, including grip force. Methods. In an inception cohort of patients with early RA (diagnosed 1995-2005, N = 222, follow-up 10 yrs), disability of the UEs was assessed using a subscore of the Health Assessment Questionnaire–Disability Index (HAQ-DI-UE), and average grip force of the dominant hand was measured. Changes between consecutive follow-up visits in the HAQ-DI-UE subscore, and correlations at each visit with key clinical variables, were assessed. The relation between joint involvement and HAQ-DI-UE was examined using multivariate linear regression analysis. Results. The HAQ-DI-UE decreased significantly from inclusion to the 6-month follow-up (mean change –0.26, 95% CI –0.18 to –0.34), and increased significantly after 2 years. There were fairly strong correlations for HAQ-DI-UE with grip force (r = –0.50 to –0.62), patient global assessment (r = 0.53 to 0.64), and patient-reported pain (r = 0.54 to 0.60) at all timepoints through 5 years, but only moderate to weak correlations with swollen joints, C-reactive protein, and erythrocyte sedimentation rate. At inclusion, wrist synovitis and tender proximal interphalangeal joints both had an independent effect on HAQ-DI-UE, whereas tenderness of the shoulder and the wrist had a greater importance at 6 months. Conclusion. Disability related to the UEs decreased significantly during the first 6 months, and increased again after 2 years. The correlations with clinical variables underline the major effect of pain and impaired hand function in early RA
Circulating Interleukin 17A and Other Inflammatory Proteins May Predict Cardiovascular Disease in Early Rheumatoid Arthritis
No full textObjective. The objective of this study was to investigate the impact of 92 inflammatory proteins on the risk of cardiovascular disease (CVD) in patients with early rheumatoid arthritis (RA). Methods. This study included consecutive patients with early RA recruited between 1995 and 2002. Stored plasma samples were analyzed for 92 inflammatory proteins. CVD diagnoses were retrieved from national in-patient and cause-of-death registries. Statistical analyses were predesignated as hypothesis-driven or exploratory. For the latter, proteins were selected based on principal component analysis (ie, factor loading > 0.5 within main components). Potential predictors of CVD and coronary artery disease (CAD) were assessed using Cox regression. Results. Data on baseline levels of proteins and CVD were available for 163 patients. As hypothesized, levels of interleukin 17A (IL-17A) were associated with CVD (hazard ratio 1.35, 95% CI 1.02-1.78, adjusted for age, sex, hypertension, diabetes, smoking, and erythrocyte sedimentation rate [ESR]), although not significantly with CAD. Osteoprotegerin (OPG) levels were significantly associated with both outcomes, but only in crude models. No associations were observed for IL-6, tumor necrosis factor, monocyte chemotactic protein-1, or IL-8. In the exploratory analyses, MCP-3 in particular had significant associations with both outcomes in crude models. Conclusion. Circulating IL-17A at RA diagnosis predicted future CVD, although we cannot exclude the possibility that this finding is due to multiple testing. The association was independent of traditional CVD risk factors, and of ESR at the time of diagnosis. Further, OPG may be a predictor of CVD. We also identified some novel potential biomarkers for CVD in RA
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