| 1. |
- Geborek, Pierre, et al.
(författare)
-
Tumour necrosis factor blockers do not increase overall tumour risk in patients with rheumatoid arthritis, but may be associated with an increased risk of lymphomas
- 2005
-
Ingår i: Annals of the Rheumatic Diseases. - : BMJ. - 1468-2060 .- 0003-4967. ; 64:5, s. 699-703
-
Tidskriftsartikel (refereegranskat)abstract
- Objective: To determine whether TNF blockers increase tumour risk in patients with RA. Material and methods: The South Swedish Arthritis Treatment Group register (SSATG) comprises over 90% of anti-TNF treated patients with RA in the area. 757 patients treated with etanercept or infliximab included between 1 February 1999 and 31 December 2002 were identified. 800 patients with conventional antirheumatic treatment in a community based cohort served as a comparison cohort. Tumours and deaths were identified in the cancer registry and population census registers. Patients were followed up from initiation of anti-TNF treatment or 1 July 1997 for the comparison group, until death or 31 December 2002. Results: In the anti-TNF group, 16 tumours ( 5 lymphomas) were identified in 1603 person-years at risk, and in the comparison group 69 tumours ( 2 lymphomas) in 3948 person-years. Standardised incidence ratios (SIRs) for total tumour relative risk for the anti-TNF group and the comparison group were 1.1 (95% confidence interval (CI) 0.6 to 1.8) and 1.4 ( 95% CI 1.1 to 1.8), respectively. The lymphoma relative risk (RR) was 11.5 ( 95% CI 3.7 to 26.9) and 1.3 ( 95% CI 0.2 to 4.5), respectively The total tumour RR excluding lymphoma was 0.79 ( 95% CI 0.4 to 1.42) and 1.39 ( 95% CI 1.08 to 1.76), respectively. Proportional hazard analysis for lymphomas yielded RR 4.9 ( 95% CI 0.9 to 26.2) in anti-TNF treated versus untreated patients. Conclusion: Community based patients with RA treated conventionally had an increased overall tumour risk compared with the background population. A possible additional increased risk for lymphoma associated with TNF blockers was based on few cases and needs confirmation.
|
|
| 2. |
- Olsson, Peter, et al.
(författare)
-
Associations of cigarette smoking with disease phenotype and type I interferon expression in primary Sjogren's syndrome
- 2019
-
Ingår i: Rheumatology International. - : Springer Science and Business Media LLC. - 0172-8172 .- 1437-160X. ; 39:9, s. 1575-1584
-
Tidskriftsartikel (refereegranskat)abstract
- Several studies have shown a negative association between smoking and primary Sjogren's syndrome (pSS), and smoking may interfere with the immune response. The purpose of this study was to investigate if smoking affects disease activity and disease phenotype in pSS. In this cross-sectional study, consecutive pSS patients filled out the EULAR Sjogren's Syndrome Patient Reported Index (ESSPRI) form and a structured questionnaire regarding smoking habits. EULAR Sjogren's Syndrome Disease Activity Index (ESSDAI) scores were calculated and blood samples were analysed for type I interferon signature using RT-PCR. Of 90 patients (93% women, median age 66.5 years), 72% were type I IFN signature positive and 6, 42 and 53% were current, former and never smokers, respectively. No significant differences by smoking status were found regarding ESSDAI total score, activity in the ESSDAI domains or type I IFN signature. Patients with a higher cumulative cigarette consumption (>= median) had higher scores in ESSPRI total [5.0 (3.0-6.3) vs 8.0 (6.0-8.3); p < 0.01] and ESSPRI sicca and pain domains. Comparing type I IFN signature negative and positive patients, the latter had significantly lower activity in ESSDAI articular domain (7/25 vs 3/64; p < 0.01) and lower scores in ESSPRI total [7.7 (5.2-8.2) vs 6.0 (4.0-7.7); p = 0.04]. Smoking was not associated with disease phenotype although patients with a higher cumulative cigarette consumption had worse symptoms in some disease domains. Current smokers were few making it difficult to draw any firm conclusions about associations to current smoking.
|
|
| 3. |
- Olsson, Peter, et al.
(författare)
-
Cigarette smoking and the risk of primary Sjogren's syndrome: a nested case control study
- 2017
-
Ingår i: Arthritis Research & Therapy. - : Springer Science and Business Media LLC. - 1478-6354 .- 1478-6362. ; 19
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Smoking is reported to affect the risk of a number of chronic disorders, including rheumatic diseases. Previous cross-sectional studies have shown a lower frequency of smoking in patients with primary Sjogren's syndrome (pSS). The aim of this study was to investigate the impact of smoking and socioeconomic status on the risk of subsequent diagnosis of pSS in a nested case-control study. Method: Participants in two large population-based health surveys who were later diagnosed with pSS were identified through linkage with the Malmo Sjogren's Syndrome Register. Matched controls were obtained from the health surveys. Results: Sixty-three patients with pSS with pre-diagnostic data from the health surveys were identified. Current smoking was associated with a significantly lower risk of later being diagnosed with pSS (odds ratio (OR) 0.3; 95% CI 0.1-0.6). Furthermore, former smoking was associated with an increased risk of subsequent pSS diagnosis (OR 4.0; 95% CI 1.8-8.8) compared to never smoking. Similar results were found in a sub-analysis of patients with reported symptom onset after inclusion in the health surveys. Socioeconomic status and levels of formal education had no significant impact on the risk of later being diagnosed with pSS. Conclusion: In this nested case-control study, current smoking was associated with a reduced risk of subsequent diagnosis of pSS. In addition, former smoking was associated with an increased risk. Whether this reflects a biological effect of cigarette smoking or other mechanisms should be further investigated in future studies.
|
|
| 4. |
- Olsson, Peter, et al.
(författare)
-
Smoking, disease characteristics and serum cytokine levels in patients with primary Sjogren's syndrome
- 2018
-
Ingår i: Rheumatology International. - : Springer Science and Business Media LLC. - 0172-8172 .- 1437-160X. ; 38:8, s. 1503-1510
-
Tidskriftsartikel (refereegranskat)abstract
- Smoking affects several disease processes. Epidemiological studies have previously found a negative association between primary Sjogren's syndrome (pSS) and smoking. The aim of this study was to examine whether markers of disease activity and cytokine expression in pSS patients differ between ever and never smokers. Fifty-one consecutive pSS patients and 33 population controls were included in the study. Clinical and standard laboratory parameters were registered. Serum cytokines (IL-1 beta, IL-2, IL-3, IL-4, IL-6, IL-8, IL-10, IL-12, IL-17, IL-18, IL-33, IFN-alpha, IFN-gamma, TNF-alpha, EGF, BAFF, Fas-ligand, RANTES, TGF-beta 1) were assessed. A positive lip biopsy was less prevalent among ever smoking patients compared to never smokers (81 vs 100%; p = 0.03). However, except for TNF-alpha, which was higher in ever smokers, no differences in cytokine levels were found when comparing ever and never smoking pSS patients. Furthermore, no significant differences were found between ever and never smoking patients in the ESSDAI total score, IgG levels, or complement levels. However, IL-6, IL-12, IL-17 and IL-18 were significantly increased in pSS patients compared to controls. In this study, a negative association between ever smoking and positive lip biopsy was found, confirming previous reports. Expected differences in cytokine levels compared to controls were noted, but no major differences were found between ever and never smoking pSS patients. Taking into account the negative association between pSS diagnosis and smoking in epidemiological studies, possible explanations include a local effect of smoking on salivary glands rather than systemic effects by cigarette smoke.
|
|
