| 1. |
- Izadi, Z., et al.
(författare)
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Association Between Tumor Necrosis Factor Inhibitors and the Risk of Hospitalization or Death Among Patients With Immune-Mediated Inflammatory Disease and COVID-19
- 2021
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Ingår i: Jama Network Open. - : American Medical Association (AMA). - 2574-3805. ; 4:10
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Tidskriftsartikel (refereegranskat)abstract
- IMPORTANCE Although tumor necrosis factor (TNF) inhibitors are widely prescribed globally because of their ability to ameliorate shared immune pathways across immune-mediated inflammatory diseases (IMIDs), the impact of COVID-19 among individuals with IMIDs who are receiving TNF inhibitors remains insufficiently understood. OBJECTIVE To examine the association between the receipt of TNF inhibitor monotherapy and the risk of COVID-19-associated hospitalization or death compared with other commonly prescribed immunomodulatory treatment regimens among adult patients with IMIDs. DESIGN, SETTING, AND PARTICIPANTS This cohort study was a pooled analysis of data from 3 international COVID-19 registries comprising individuals with rheumatic diseases, inflammatory bowel disease, and psoriasis from March 12, 2020, to February 1, 2021. Clinicians directly reported COVID-19 outcomes as well as demographic and clinical characteristics of individuals with IMIDs and confirmed or suspected COVID-19 using online data entry portals. Adults (age >= 18 years) with a diagnosis of inflammatory arthritis, inflammatory bowel disease, or psoriasis were included. EXPOSURES Treatment exposure categories included TNF inhibitor monotherapy (reference treatment), TNF inhibitors in combination with methotrexate therapy, TNF inhibitors in combination with azathioprine/6-mercaptopurine therapy, methotrexate monotherapy, azathioprine/6-mercaptopurine monotherapy, and Janus kinase (Jak) inhibitor monotherapy. MAIN OUTCOMES AND MEASURES The main outcome was COVID-19-associated hospitalization or death. Registry-level analyses and a pooled analysis of data across the 3 registries were conducted using multilevel multivariable logistic regression models, adjusting for demographic and clinical characteristics and accounting for country, calendar month, and registry-level correlations. RESULTS A total of 6077 patients from 74 countries were included in the analyses; of those, 3215 individuals (52.9%) were from Europe, 3563 individuals (58.6%) were female, and the mean (SD) age was 48.8 (16.5) years. The most common IMID diagnoses were rheumatoid arthritis (2146 patients [35.3%]) and Crohn disease (1537 patients [25.3%]). A total of 1297 patients (21.3%) were hospitalized, and 189 patients (3.1%) died. In the pooled analysis, compared with patients who received TNF inhibitor monotherapy, higher odds of hospitalization or death were observed among those who received a TNF inhibitor in combination with azathioprine/6-mercaptopurine therapy (odds ratio [OR], 1.74; 95% CI, 1.17-2.58; P = .006), azathioprine/6-mercaptopurine monotherapy (OR, 1.84; 95% CI, 1.30-2.61; P = .001), methotrexate monotherapy (OR, 2.00; 95% CI, 1.57-2.56; P < .001), and Jak inhibitor monotherapy (OR, 1.82; 95% CI, 1.21-2.73; P = .004) but not among those who received a TNF inhibitor in combination with methotrexate therapy (OR, 1.18; 95% CI, 0.85-1.63; P = .33). Similar findings were obtained in analyses that accounted for potential reporting bias and sensitivity analyses that excluded patients with a COVID-19 diagnosis based on symptoms alone. CONCLUSIONS AND RELEVANCE In this cohort study, TNF inhibitor monotherapy was associated with a lower risk of adverse COVID-19 outcomes compared with other commonly prescribed immunomodulatory treatment regimens among individuals with IMIDs.
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| 5. |
- Izadi, Zara, et al.
(författare)
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Environmental and societal factors associated with COVID-19-related death in people with rheumatic disease : an observational study
- 2022
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Ingår i: The Lancet Rheumatology. - : Elsevier. - 2665-9913. ; 4:9, s. e603-e613
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Tidskriftsartikel (refereegranskat)abstract
- Background: Differences in the distribution of individual-level clinical risk factors across regions do not fully explain the observed global disparities in COVID-19 outcomes. We aimed to investigate the associations between environmental and societal factors and country-level variations in mortality attributed to COVID-19 among people with rheumatic disease globally.Methods: In this observational study, we derived individual-level data on adults (aged 18–99 years) with rheumatic disease and a confirmed status of their highest COVID-19 severity level from the COVID-19 Global Rheumatology Alliance (GRA) registry, collected between March 12, 2020, and Aug 27, 2021. Environmental and societal factors were obtained from publicly available sources. The primary endpoint was mortality attributed to COVID-19. We used a multivariable logistic regression to evaluate independent associations between environmental and societal factors and death, after controlling for individual-level risk factors. We used a series of nested mixed-effects models to establish whether environmental and societal factors sufficiently explained country-level variations in death.Findings: 14 044 patients from 23 countries were included in the analyses. 10 178 (72·5%) individuals were female and 3866 (27·5%) were male, with a mean age of 54·4 years (SD 15·6). Air pollution (odds ratio 1·10 per 10 μg/m3 [95% CI 1·01–1·17]; p=0·0105), proportion of the population aged 65 years or older (1·19 per 1% increase [1·10–1·30]; p<0·0001), and population mobility (1·03 per 1% increase in number of visits to grocery and pharmacy stores [1·02–1·05]; p<0·0001 and 1·02 per 1% increase in number of visits to workplaces [1·00–1·03]; p=0·032) were independently associated with higher odds of mortality. Number of hospital beds (0·94 per 1-unit increase per 1000 people [0·88–1·00]; p=0·046), human development index (0·65 per 0·1-unit increase [0·44–0·96]; p=0·032), government response stringency (0·83 per 10-unit increase in containment index [0·74–0·93]; p=0·0018), as well as follow-up time (0·78 per month [0·69–0·88]; p<0·0001) were independently associated with lower odds of mortality. These factors sufficiently explained country-level variations in death attributable to COVID-19 (intraclass correlation coefficient 1·2% [0·1–9·5]; p=0·14).Interpretation: Our findings highlight the importance of environmental and societal factors as potential explanations of the observed regional disparities in COVID-19 outcomes among people with rheumatic disease and lay foundation for a new research agenda to address these disparities.
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| 6. |
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| 7. |
- Sparks, JA, et al.
(författare)
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Associations of baseline use of biologic or targeted synthetic DMARDs with COVID-19 severity in rheumatoid arthritis: Results from the COVID-19 Global Rheumatology Alliance physician registry
- 2021
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Ingår i: Annals of the rheumatic diseases. - : BMJ. - 1468-2060 .- 0003-4967. ; 80:9, s. 1137-1146
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Tidskriftsartikel (refereegranskat)abstract
- To investigate baseline use of biologic or targeted synthetic (b/ts) disease-modifying antirheumatic drugs (DMARDs) and COVID-19 outcomes in rheumatoid arthritis (RA).MethodsWe analysed the COVID-19 Global Rheumatology Alliance physician registry (from 24 March 2020 to 12 April 2021). We investigated b/tsDMARD use for RA at the clinical onset of COVID-19 (baseline): abatacept (ABA), rituximab (RTX), Janus kinase inhibitors (JAKi), interleukin 6 inhibitors (IL-6i) or tumour necrosis factor inhibitors (TNFi, reference group). The ordinal COVID-19 severity outcome was (1) no hospitalisation, (2) hospitalisation without oxygen, (3) hospitalisation with oxygen/ventilation or (4) death. We used ordinal logistic regression to estimate the OR (odds of being one level higher on the ordinal outcome) for each drug class compared with TNFi, adjusting for potential baseline confounders.ResultsOf 2869 people with RA (mean age 56.7 years, 80.8% female) on b/tsDMARD at the onset of COVID-19, there were 237 on ABA, 364 on RTX, 317 on IL-6i, 563 on JAKi and 1388 on TNFi. Overall, 613 (21%) were hospitalised and 157 (5.5%) died. RTX (OR 4.15, 95% CI 3.16 to 5.44) and JAKi (OR 2.06, 95% CI 1.60 to 2.65) were each associated with worse COVID-19 severity compared with TNFi. There were no associations between ABA or IL6i and COVID-19 severity.ConclusionsPeople with RA treated with RTX or JAKi had worse COVID-19 severity than those on TNFi. The strong association of RTX and JAKi use with poor COVID-19 outcomes highlights prioritisation of risk mitigation strategies for these people.
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| 9. |
- Abdulla, N., et al.
(författare)
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Epidemiology of hip fracture in Qatar and development of a country specific FRAX model
- 2022
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Ingår i: Archives of Osteoporosis. - : Springer Science and Business Media LLC. - 1862-3522 .- 1862-3514. ; 17:1
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Tidskriftsartikel (refereegranskat)abstract
- A Summary Hip fracture data were retrieved from electronical medical records for the years 2017-2019 in the State of Qatar and used to create a FRAX (R) model to facilitate fracture risk assessment. Hip fracture rates were comparable with estimates from Saudi Arabia, Abu Dhabi, and Kuwait but fracture probabilities varied due to differences in mortality. Objective This paper describes the epidemiology of osteoporotic fractures in the State of Qatar that was used to develop the country-specific fracture prediction FRAX (R) tool. Methods Hip fracture data were retrieved from electronic medical records for the years 2017-2019 in the State of Qatar. The age and sex specific incidence of hip fracture in Qatari residents and national mortality rates were used to create a FRAX (R) model. Fracture probabilities were compared with those from neighboring countries having FRAX models. Results Hip fracture rates were comparable with estimates from Saudi Arabia, Abu Dhabi and Kuwait. In contrast, probabilities of a major osteoporotic fracture or hip fracture were lower in Qatar than in Kuwait but higher than those in Abu Dhabi and Saudi Arabia due to differences in mortality. Conclusion The FRAX model should enhance accuracy of determining fracture probability among the Qatari population and help guide decisions about treatment.
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| 12. |
- Ishigaki, Kazuyoshi, et al.
(författare)
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Multi-ancestry genome-wide association analyses identify novel genetic mechanisms in rheumatoid arthritis
- 2022
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Ingår i: Nature Genetics. - : Springer Nature. - 1061-4036 .- 1546-1718. ; 54:11, s. 1640-1651
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Tidskriftsartikel (refereegranskat)abstract
- Rheumatoid arthritis (RA) is a highly heritable complex disease with unknown etiology. Multi-ancestry genetic research of RA promises to improve power to detect genetic signals, fine-mapping resolution and performances of polygenic risk scores (PRS). Here, we present a large-scale genome-wide association study (GWAS) of RA, which includes 276,020 samples from five ancestral groups. We conducted a multi-ancestry meta-analysis and identified 124 loci (P < 5 × 10−8), of which 34 are novel. Candidate genes at the novel loci suggest essential roles of the immune system (for example, TNIP2 and TNFRSF11A) and joint tissues (for example, WISP1) in RA etiology. Multi-ancestry fine-mapping identified putatively causal variants with biological insights (for example, LEF1). Moreover, PRS based on multi-ancestry GWAS outperformed PRS based on single-ancestry GWAS and had comparable performance between populations of European and East Asian ancestries. Our study provides several insights into the etiology of RA and improves the genetic predictability of RA.
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| 13. |
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| 14. |
- Olsen, A Ø, et al.
(författare)
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HBV frequency quintuplers
- 2005
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Ingår i: Book of abstracts: Intl Symp on Space Terahertz Technol, Göteborg, Sweden (2005).
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Konferensbidrag (refereegranskat)
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| 15. |
- Sattui, Sebastian E., et al.
(författare)
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Outcomes of COVID-19 in patients with primary systemic vasculitis or polymyalgia rheumatica from the COVID-19 Global Rheumatology Alliance physician registry : a retrospective cohort study
- 2021
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Ingår i: The Lancet Rheumatology. - : Elsevier. - 2665-9913. ; 3:12, s. E855-E864
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Tidskriftsartikel (refereegranskat)abstract
- Background Patients with primary systemic vasculitis or polymyalgia rheumatica might be at a high risk for poor COVID-19 outcomes due to the treatments used, the potential organ damage cause by primary systemic vasculitis, and the demographic factors associated with these conditions. We therefore aimed to investigate factors associated with COVID-19 outcomes in patients with primary systemic vasculitis or polymyalgia rheumatica. Methods In this retrospective cohort study, adult patients (aged >= 18 years) diagnosed with COVID-19 between March 12, 2020, and April 12, 2021, who had a history of primary systemic vasculitis (antineutrophil cytoplasmic antibody [ANCA]-associated vasculitis, giant cell arteritis, Behcet's syndrome, or other vasculitis) or polymyalgia rheumatica, and were reported to the COVID-19 Global Rheumatology Alliance registry were included. To assess COVID-19 outcomes in patients, we used an ordinal COVID-19 severity scale, defined as: (1) no hospitalisation; (2) hospitalisation without supplemental oxygen; (3) hospitalisation with any supplemental oxygen or ventilation; or (4) death. Multivariable ordinal logistic regression analyses were used to estimate odds ratios (ORs), adjusting for age, sex, time period, number of comorbidities, smoking status, obesity, glucocorticoid use, disease activity, region, and medication category. Analyses were also stratified by type of rheumatic disease. Findings Of 1202 eligible patients identified in the registry, 733 (61.0%) were women arid 469 (39.0%) were men, and their mean age was 63.8 years (SD 17.1). A total of 374 (31.1%) patients had polymyalgia rheumatica, 353 (29.4%) had ANCA-associated vasculitis, 183 (15.2%) had giant cell arteritis, 112 (9.3%) had Behcet's syndrome, and 180 (15.0%) had other vasculitis. Of 1020 (84. 9%) patients with outcome data, 512 (S0.2%) were not hospitalised, 114 (11.2%) were hospitalised and did not receive supplemental oxygen, 239 (23 - 4%) were hospitalised and received ventilation or supplemental oxygen, and 155 (15.2%) died. A higher odds of poor COVID-19 outcomes were observed in patients who were older (per each additional decade of life OR 1.44 [95% CI 1. 31-1- 571), were male compared with female (1.38 [1.05-1.801), had more comorbidities (per each additional comorbidity 1.39 [1- 23-1- 581), were taking 10 mg/day or more of prednisolone compared with none (2.14 [1.50-3.04J), or had moderate, or high or severe disease activity compared with those who had disease remission or low disease activity (2.12 [1.49-3.021). Risk factors varied among different disease subtypes. Interpretation Among patients with primary systemic vasculitis and polymyalgia rheumatica, severe COVID-19 outcomes were associated with variable and largely unmodifiable risk factors, such as age, sex, and number of comorbidities, as well as treatments, including high-dose glucocorticoids. Our results could be used to info rm mitigation strategies for patients with these diseases.
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| 17. |
- Ayerden, N.P., et al.
(författare)
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Design, fabrication and characterization of LVOF-based IR microspectrometers
- 2014
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Ingår i: Proceedings of SPIE - The International Society for Optical Engineering. - : SPIE. - 0277-786X .- 1996-756X. - 9781628410785 ; 9130
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Konferensbidrag (refereegranskat)abstract
- This paper presents the design, fabrication and characterization of a linear variable optical filter (LVOF) that operates in the infrared (IR) spectral range. An LVOF-based microspectrometer is a tapered-cavity Fabry-Perot optical filter placed on top of a linear array of detectors. The filter transforms the optical spectrum into a lateral intensity profile, which is recorded by the detectors. The IR LVOF has been fabricated in an IC-compatible process flow using a resist reflow and is followed by the transfer etching of this resist pattern into the optical resonator layer. This technique provides the possibility to fabricate a small, robust and high-resolution micro-spectrometer in the IR spectral range directly on a detector chip. In these designs, the LVOF uses thin-film layers of sputtered Si and SiO 2 as the high and low refractive index materials respectively. By tuning the deposition conditions and analyzing the optical properties with a commercial ellipsometer, the refractive index for Si and SiO2 thin-films was measured and optimized for the intended spectral range. Two LVOF microspectrometers, one operating in the 1.8-2.8 μm, and the other in the 3.0-4.5 μm wavelength range, have been designed and fabricated on a silicon wafer. The filters consist of a Fabry-Perot structure combined with a band-pass filter to block the out-of-band transmission. Finally, the filters were fully characterized with an FTIR spectrometer and the transmission curve widening was investigated. The measured transmittance curves were in agreement with theory. The characterization shows a spectral resolution of 35-60 nm for the short wavelength range LVOF and 70 nm for the long wavelength range LVOF, which can be further improved using signal processing algorithms.
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| 18. |
- Emadi, A., et al.
(författare)
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An UV linear variable optical filter-based micro-spectrometer
- 2010
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Ingår i: Procedia Engineering, Proc. Eurosensors XXIV, September 5-8, 2010, Linz, Austria. - : Elsevier BV. - 1877-7058. ; 5, s. 416-419
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Konferensbidrag (refereegranskat)abstract
- This paper presents the design, fabrication and spectral measurements of an Ultra-Violet (UV) Linear Variable Optical Filter (LVOF)-based micro-spectrometer operating in the 300 nm - 400 nm wavelength range. The UV LVOF has been fabricated in an IC-Compatible process using resist reflow. Characterization by passing monochromatic light through the LVOF, shows high linearity of the profile. It is expected that using signal processing, spectral resolution better than 0.5 nm can be achieved with this UV LVOF. The filter provides the possibility to have a robust high-resolution micro-spectrometer in the UV on a CMOS chip.
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| 19. |
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| 20. |
- Emadi, A., et al.
(författare)
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Design, fabrication and measurements with a UV Linear-Variable Optical Filter microspectrometer
- 2012
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Ingår i: Proceedings of SPIE - The International Society for Optical Engineering. - : SPIE. - 0277-786X .- 1996-756X. - 9780819491312 ; 8439, s. Art. no. 84390V-
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Konferensbidrag (refereegranskat)abstract
- An IC-Compatible Linear-Variable Optical Filter (LVOF) for application in the UV spectral range between 310 nm and 400 nm has been fabricated using resist reflow and an optimized dry-etching. The LVOF is mounted on the top of a commercially available CMOS camera to result in a UV microspectrometer. A special calibration technique has been employed that is based on an initial spectral measurement on a Xenon lamp. The image recorded on the camera during calibration is used in a signal processing algorithm to reconstruct the spectrum of the Mercury lamp and the calibration data is subsequently used in UV spectral measurements. Experiments on fabricated LVOF-based microspectrometer with this calibration approach implemented reveal a spectral resolution of 0.5 nm.
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| 21. |
- Emadi, A., et al.
(författare)
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Fabrication and characterization of IC-Compatible Linear Variable Optical Filters with application in a micro-spectrometer
- 2010
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Ingår i: Sensors and Actuators, A: Physical. - : Elsevier BV. - 0924-4247. ; 162:2; Sp. Iss. SI, s. 400-405
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Tidskriftsartikel (refereegranskat)abstract
- This paper reports on an IC-Compatible process for the fabrication of Linear Variable Optical Filter (LVOF). The LVOF is integrated with a detector array to result in a micro-spectrometer. The technological challenge in fabrication of an LVOF is fabrication of a well-controlled tapered cavity layer. Very small taper angles, ranging from 0.001 degrees to 0.1 degrees. are fabricated in a resist layer by just one lithography step and a subsequent reflow process. The 3D pattern of resist structures is subsequently transferred into SiO2 by an appropriate etching. Complete LVOF fabrication involves CMOS-compatible deposition of a lower dielectric mirror using a stack of dielectrics on the wafer, tapered layer formation and the deposition of the top dielectric mirror. The design principle, IC-Compatible processing and the characterization results on fabricated LVOFs are presented. (C) 2010 Elsevier B.V. All rights reserved.
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| 22. |
- Emadi, A., et al.
(författare)
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Linear variable optical filter-based ultraviolet microspectrometer
- 2012
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Ingår i: Applied Optics. - 1559-128X .- 2155-3165. ; 51:19, s. 4308-4315
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Tidskriftsartikel (refereegranskat)abstract
- An IC-compatible linear variable optical filter (LVOF) for application in the UV spectral range between 310 and 400 nm has been fabricated using resist reflow and an optimized dry-etching. The LVOF is mounted on the top of a commercially available CMOS camera to result in a UV microspectrometer. A special calibration technique has been employed that is based on an initial spectral measurement on a xenon lamp. The image recorded on the camera during calibration is used in a signal processing algorithm to reconstruct the spectrum of the mercury lamp and the calibration data is subsequently used in UV spectral measurements. Experiments on a fabricated LVOF-based microspectrometer with this calibration approach implemented reveal a spectral resolution of 0.5 nm.
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| 23. |
- Ghaderi, M., et al.
(författare)
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Design, fabrication and characterization of infrared LVOFs for measuring gas composition
- 2014
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Ingår i: Journal of Micromechanics and Microengineering. - : IOP Publishing. - 1361-6439 .- 0960-1317. ; 24:8, s. Art. no. 084001-
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Tidskriftsartikel (refereegranskat)abstract
- This paper presents the design, fabrication and characterization of a linear-variable optical-filter (LVOF) that will be used in a micro-spectrometer operating in infrared (IR) for natural gas composition measurement. An LVOF is placed on top of an array of detectors and transforms the optical spectrum into a lateral intensity profile, which is recorded by the detectors. The IR LVOF was fabricated in an IC-compatible process using a photoresist reflow technique, followed by transfer etching of the photoresist into the optical resonator layer. The spectral range between 3 to 5 mu m contains the absorption peaks for hydrocarbons, carbon-monoxide and carbon-dioxide. The resulting optical absorption is utilized to measure the gas concentrations in a sample volume. Two LVOF structures were designed and fabricated on silicon wafers using alternate layers of sputtered silicon and silicon-dioxide as the high- and low- refractive index materials. These filters consist of a Fabry-Perot resonator combined with a band-pass filter designed to block out-of-band transmissions. Finally, the filters were fully characterized with an FTIR spectrometer and showed satisfactory agreement with the optical thin-film simulations. The characterization showed a spectral resolution of 100 nm, which can be further improved with signal processing algorithms. This method makes it possible to fabricate small and robust LVOFs with high resolving power in the IR spectral range directly on the detector array chip.
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| 24. |
- Khamisi, Selwan, et al.
(författare)
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Serum thyroglobulin is associated with orbitopathy in Graves' disease
- 2021
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Ingår i: Journal of Endocrinological Investigation. - : Springer Nature. - 0391-4097 .- 1720-8386. ; 44:9, s. 1905-1911
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Tidskriftsartikel (refereegranskat)abstract
- Purpose Serum thyroglobulin levels are often elevated in Graves' disease (GD) and in most cases decrease during treatment. Its relation to Graves' orbitopathy (GO) has not been clarified. Previously, a risk of GO has been linked to smoking, TSH receptor stimulation, high TSH-receptor antibodies (TRAb), low thyroid peroxidase and thyroglobulin antibodies (TPOAb, TgAb). Methods We examined Tg levels in 30 consecutive patients with GD were given drug therapy (methimazole + thyroxine) for up to 24 months. GO was identified by clinical signs and symptoms. 17 patients had GO, 11 of whom had it at diagnosis while 6 developed GO during treatment. During the study, 5 subjects were referred to radioiodine treatment, 3 to surgery. The remaining 22 subjects (GO n = 12, non-GO n = 10) completed the drug regimen. Results At diagnosis, Tg levels in GO patients (n = 11) were higher (84, 30-555 mu g/L, median, range) than in non-GO patients (n = 19) (38, 3.5-287 mu g/L), p = 0.042. Adding the 6 subjects who developed eye symptoms during treatment to the GO group (n = 17), yielded p = 0.001 vs. non-GO (n = 13). TRAb tended to be higher, while TPOAb and TgAb tended to be lower in the GO group. For the 22 patients who completed the drug regimen, Tg levels were higher in GO (n = 12) vs. non-GO (n = 10), p = 0.004, whereas TRAb levels did not differ. Conclusion The data may suggest that evaluation of thyroglobulin levels in GD could contribute to identify patients at increased risk of developing GO. Possibly, thyroidal release of Tg in GD reflects a disturbance that also impacts retroorbital tissues.
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