| 2991. |
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| 2992. |
- Ljung, L., et al.
(författare)
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Good response on tumour necrosis factor inhibitors is associated with a decreased risk of acute coronary syndrome in patients with rheumatoid arthritis
- 2014
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Ingår i: Scandinavian Journal of Rheumatology. - : Informa Healthcare. - 0300-9742 .- 1502-7732. ; 43:Suppl. 127 Meeting Abstract OP11/PP156, s. 8-8
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Background: Inflammatory activity, as well as traditional cardiovascular risk factors, is thought to underlie the increased risk of coronary disease in patients with rheumatoid arthritis (RA). We therefore wanted to evaluate whether the level of response to tumour necrosis factor inhibitors (TNFi) in RA are associated with the risk of acute coronary syndrome (ACS).Method: All patients with RA and no previous ischaemic heart disease who started treatment with a first TNFi during 2001–2010 as registered in the Swedish Biologics Register were identified. Of the patients (n ¼ 6615) at risk for exposure (i.e. EULAR response at 5 3 months), response data was available for 75% (n¼ 4938). For each patient, five matched referents were selected randomly from the Population Register. Follow-up was maximized to 1 and 2 years, respectively. The outcome, incident ACS, was defined as a primary discharge diagnosis of myocardial infarction or unstable angina, or myocardial infarction as the underlying cause of death. Incidence rates were calculated and adjusted Cox proportional hazard regression models were used for risk estimations.Results: During the first year of follow-up, 33 cases of ACS occurred among the patients. The risk (hazard ratio, HR) of ACS for good responders compared with none responders, fully adjusted, was 0.26 (95% CI 0.08–0.83), and for moderate responders compared with no responders 0.81 (95% CI 0.36–1.79). Compared with the general population no increase in the risk of ACS was observed among good responders (HR 0.74, 95% CI 0.27–2.06). The lower risk of ACS among good responders was also noted during 2 years of follow-up.Conclusions: Good EULAR response after 5 months of treatment with TNFi in RA patients was associated with a significantly decreased risk of ACS. In patients with good response on therapy, no significant increase in the risk of ACS was detectable in comparison with the risk in the general population during the 2 years after the evaluation.
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| 2993. |
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| 2994. |
- Ljung, Lotta, et al.
(författare)
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Interleukin-1 receptor antagonist is associated with both lipid metabolism and inflammation in rheumatoid arthritis
- 2007
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Ingår i: Clinical and Experimental Rheumatology. - 0392-856X .- 1593-098X. ; 25:4, s. 617-620
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: There is a relationship between cardiovascular morbidity, inflammatory activity, and changes in the lipid profile in rheumatoid arthritis (RA), although the mechanisms are not fully elaborated. Recent know-ledge that white adipose tissue (WAT) is a producer of immunologically and metabolically active substances gives another perspective to study.OBJECTIVE: To evaluate the relationship between interleukin-1 receptor antagonist (IL-1Ra) and variables associated with WAT and inflammation in RA.METHODS: Anthropometric, inflammatory and metabolic variables were assessed in 23 women with RA and 23 matched controls. Spearman, partial correlation and factor analyses were performed.RESULTS: Inflammatory markers were increased in patients. In both groups, IL-1Ra correlated with leptin independent of age and BMI. IL-1Ra also correlated with haptoglobin and apolipoprotein (Apo) B in patients and with soluble TNF receptor (sTNFR) 1 in controls. In factor analysis, three latent factors were identified among patients. The first loaded on IL-1Ra, leptin, BMI, ApoB and body fat content (BF%), the second loaded on IL1-Ra and sTNF-receptors and the third showed inverse loadings on ApoA-I together with loadings on ESR, haptoglobin, orosomucoid, BF% and BMI.CONCLUSION: IL-1Ra was associated with markers of inflammation and with fat-related factors in RA patients, suggesting a dualistic relationship of IL-1Ra in RA. IL-1Ra correlated independently with leptin in both patients and controls, indicating a relationship between inflammation and leptin.
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| 2995. |
- Ljung, Lotta, 1964-, et al.
(författare)
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Low-energy fractures in rheumatoid arthritis - associations with genes and clinical characteristics
- 2019
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Ingår i: Annals of the Rheumatic Diseases. - : BMJ Publishing Group Ltd. - 0003-4967 .- 1468-2060. ; 78, s. 344-345
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Background: Patients with rheumatoid arthritis (RA) have increased risk of osteoporosis and low-energy fractures. Several genes associated with bone mineralization, osteoporosis or risk of fracture in the general population have been identified.Objectives: To analyse the association between nine selected SNPs and the risk of low-energy fracture, taking clinical patient characteristics into account.Methods: We identified a cohort of patients (n=896, 70% women, age at inclusion 60.0±14.8 years) with RA according to ACR criteria from the catchment area of the register of Umeå injury database, Umeå, Sweden, which enabled identification of low-energy fractures (n=254). The follow-up (mean 8.8±6.1 years, total 7928 person-years) started two years after RA diagnosis but not earlier than January 1, 1993 and ended at the first of December 31, 2011, death or the first low-energy fracture. Nine SNPs were analysed in all patients with available DNA-samples (n=667) using KASPTM genotyping assays (LGC genomics Ltd, Hoddesdon, UK): rs3801387 (WNT16), rs6666455 (SOAT), rs3736228 (LRP5), rs4796995 (FAM210A), rs4792909 (SOST), rs2062377 (TNFRSF11B/OPG), rs884205 (TNFRSF11A/RANK), rs9533090 (TNFSF11/RANKL), and rs1373004 (DKK1). Anti-CCP was analysed and clinical patient characteristics (duration of RA, ever smoking, disease activity the first two years after RA diagnosis, and joint erosions) were extracted from patient files. Associations between the risk of fracture and risk alleles in the cohort were evaluated using Kaplan-Meier curves (K-M) and Cox proportional hazards models: crude, adjusted for age and sex, and for clinical patient characteristics.Results: The SNPs: rs1373004, rs4792909, and rs2062377 were associated with the risk of fracture in K-M analyses (Figure 1). For the other genes no significant associations were observed. Patients carrying the risk allele of rs1373004 (22.6% of the patients), or who were homozygous for the risk allele of SNP rs4792909 (38.6%), had a >50% higher risk of low-energy fracture compare to other patients, irrespectively of disease characteristics (Table 1). The association between rs2062377 and the risk of fracture was not independent of clinical patient characteristics (Table 1).
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| 2996. |
- Ljung, Lotta, 1964-, et al.
(författare)
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Methotrexate in Our Hearts
- 2019
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Ingår i: Journal of Rheumatology. - : Journal of Rheumatology Publishing Company Limited. - 0315-162X .- 1499-2752. ; 46:5, s. 447-449
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
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| 2997. |
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| 2998. |
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| 2999. |
- Ljung, Lotta, et al.
(författare)
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Patterns of comorbidity and disease characteristics among patients with ankylosing spondylitis : a cross-sectional study
- 2018
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Ingår i: Clinical Rheumatology. - : Springer London. - 0770-3198 .- 1434-9949. ; 37:3, s. 647-653
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Tidskriftsartikel (refereegranskat)abstract
- The knowledge of the development of comorbidities in patients with ankylosing spondylitis (AS) is limited. The aim of this study was to analyse associations between AS disease characteristics and comorbidity and to evaluate patterns of comorbidities in patients with AS. Patients with AS, fulfilling the modified New York Criteria, were identified (n =3D 346, mean age 56 +/- 15 years, 75% men, 99% HLA B27 positive). Through a review of the patient records, data on disease activity parameters, laboratory results, disease manifestations, and diagnoses of any clinically significant comorbidity was obtained. Four categories of comorbidities of interest were identified: A. arrhythmias, conduction disorders, and valvular heart disease; B. atherosclerosis and atherosclerotic CVD; C. spinal and non-spinal fractures; and D. obstructive sleep apnoea syndrome. Associations between AS disease characteristics and comorbidities in categories were assessed in logistic regression models. Differences in proportions of comorbidities was analysed using two-sided chi-square. Age was associated with all four categories of comorbidities, and male sex with arrhythmias, conduction disorders, valvular heart disease, and obstructive sleep apnoea syndrome. Early disease onset and long disease duration, respectively, were associated with arrhythmias, conduction disorders, and valvular heart disease. Obstructive sleep apnoea syndrome was associated with features of the metabolic syndrome. Patients with atherosclerotic cardiovascular disease had an increased risk of most other comorbidities, similar to, but more pronounced than patients with arrhythmias, conduction disorders and valvular heart disease. Comorbid conditions motivate clinical awareness among patients with AS. Longitudinal studies are needed to establish preventive measures.
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| 3000. |
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