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- Ajeganova, S., et al.
(författare)
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The association between anti-carbamylated protein (anti-CarP) antibodies and radiographic progression in early rheumatoid arthritis : A study exploring replication and the added value to ACPA and rheumatoid factor
- 2017
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Ingår i: Annals of the Rheumatic Diseases. - : BMJ. - 0003-4967 .- 1468-2060. ; 76:1, s. 112-118
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Tidskriftsartikel (refereegranskat)abstract
- Objective Anti-carbamylated protein (anti-CarP) antibodies are reported to associate with more radiographic progression within the total rheumatoid arthritis (RA) population and anti-citrullinated peptide antibody (ACPA)-negative subgroup. We explored the association of anti-CarP with radiographic progression in RA and aimed to replicate the association and evaluate the added value of anti-CarP antibodies in relation to ACPA and rheumatoid factor (RF). Methods 576 Swedish and 628 Dutch patients with RA (2394 and 3247 sets of radiographs, respectively) were longitudinally studied. Replication was restricted to the Swedish patients. In both cohorts, the association of anti-CarP with radiographic progression was determined in strata of patients with similar ACPA and RF status; results of both cohorts were combined in fixed-effect meta-analyses. The net percentage of patients for whom the radiographic progression in 5 years was additionally correctly classified when adding anti-CarP to a model including ACPA and RF was evaluated. Results Anti-CarP associated with radiographic progression in the total Swedish RA population (beta=1.11 per year, p=8.75×10-13) and in the ACPAnegative subgroup (beta=1.14 per year, p=0.034). Anti- CarP associated with more radiographic progression in the strata of ACPA-positive/RF-negative, ACPA-negative/ RF-positive and ACPA-positive/RF-positive patients with RA (respective p values 0.014, 0.019 and 0.0056). A model including ACPA and RF correctly classified 54% and 57% of the patients; adding anti-CarP to this model did not increase these percentages (54% and 56% were correctly classified). Conclusions Anti-CarP antibodies associated with more severe radiographic progression in the total and ACPA-negative RA population. Anti-CarP-positivity had a statistically significant additive value to ACPA and RF, but did not improve correct classification of patients.
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| 2. |
- Bremander, Ann, 1957-, et al.
(författare)
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Functional Impairment in Patients with RA in an Eight Year Perspective
- 2017
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Ingår i: Annals of the Rheumatic Diseases. - London : BMJ Publishing Group Ltd. - 0003-4967 .- 1468-2060. ; 76:Suppl. 2, s. 1513-1514
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Tidskriftsartikel (refereegranskat)abstract
- Background: In people with Rheumatoid arthritis (RA) impaired physical functioning is an acute as well as long term effect of the disease. Observational performance tests reflecting range of motion in upper as well as in lower extremities should be easy to perform in the clinic as well as in research as a complement to self-reported measures of physical functioning. The Signal Of Functional Impairment (SOFI)1 is a performance test which so far has been applied only in Sweden but commonly used in the clinic and in long term follow-up clinical studies.Objectives: The aim was to study performance-based function assessed with SOFI over 8 years and, secondly, to study which items included in SOFI that were associated with change in functioning over time.Methods: An inception cohort of 1 052 patients with early RA, from the BARFOT-study, recruited 1992–2006 was investigated, mean (SD) age was 54 years (14), 70% were women. The patients were followed by a structured protocol at baseline, 3 and 6 months and at 1, 2, 5, and 8 years. SOFI consists of 3 parts measuring hand, arm (upper), and leg (lower) function (1). Hand function is tested by 4 movements; cylinder grip (H1), pen grip (H2), pincer grip (H3) and opposition of the thumb (H4). Arm function is assessed by 3 movements; hand behind the head and the ability to touch the cervical spine processes with fingers (A1), elbow supination (A2) and elbow extension (A3). Leg function is tested by 4 movements; the ability to touch the opposite knee with the heel while sitting (L1), knee extension in supine position (L2), dorsiflexion of the foot standing on a balance board (L3), and the ability to stand on tip toes without shoes (L4). An assessor scores the patient's ability to perform the different tests on an ordinal scale (0=normal, 1= partly impaired and 2= unable to perform). The range of SOFI scores is 0–44 (best to worst).Results: At baseline the mean (SD) SOFI was 7.2 (5.8), and at 1 year follow-up the improvement was 2.75 (5.65), p<0.001. From 1 year to 8 year follow-up the deterioration was 1.5 (4.6), p<0.001. When studying hand, upper and lower function separately, the pen grip and the ability to stand on tip toes improves most during the first year. From 1 to 8 year the pincer grip and the ability to stand on tip toes are the items that deteriorate most (Figure). Assessment of the pen grip, the pincer grip and the ability to stand on tip toes explain 58% to 70% of the SOFI score over time, with the highest rate at 5 (65%) and 8 years follow-up (70%).Conclusions: Functioning as assessed by SOFI improved during the first year in patients with early RA and then deteriorated slowly. Over a longer period, pincer grip and the ability to stand on tip toes seemed to be the two most important items to measure when assessing functional impairment over time. © 2017, BMJ Publishing Group Limited
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| 4. |
- Forslind, B., et al.
(författare)
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Elemental content of anagen hairs in a normal Caucasian population studies with proton induced X-ray emission (PIXE)
- 1986
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Ingår i: Scanning electron microscopy. - Chicago : IIT research institute. - 0586-5581. ; :Pt 1, s. 237-241
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Tidskriftsartikel (refereegranskat)abstract
- The elemental content of anagen hair fibers in a Caucasian population of healthy females and males in the age range 10-69 years was performed to constitute a baseline for further studies of pathological conditions. Proton induced X-ray emission (PIXE) analyses were performed on single hair fibers in triplicate from 103 individuals in order to determine sulfur, zinc, calcium, and chlorine content. The hair fibers were all anagen hairs collected from a site little influenced by genetic and hormonal influences 1.5 cm above the right ear of the probands. An area 5-8 mm from the follicle bottom was chosen for the analysis in all cases to minimize effect of hair-do contamination. The average sulfur content was 0.049 g/g and the average zinc content 170 micrograms/g. These results were not significantly influenced by chloroform/ethanol rinsing before analysis. The calcium and chlorine contents were 330 micrograms/g and 0.0033 g/g respectively. The latter data are expected to be more seriously influenced by external factors (e.g., contamination) than sulfur and zinc. No correlation between elemental concentration and sex was found for sulfur and zinc in the present material. PIXE analysis of single hair fibers yields valuable information on the elemental composition of hair fibers and can be rapidly and efficiently performed after simple mounting procedures.
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| 5. |
- Forslind, K., et al.
(författare)
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Hand bone loss measured by digital X-ray radiogrammetry is a predictor of joint damage in early rheumatoid arthritis
- 2009
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Ingår i: Scandinavian Journal of Rheumatology. - : Informa UK Limited. - 0300-9742 .- 1502-7732. ; 38:6, s. 431-438
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Tidskriftsartikel (refereegranskat)abstract
- Objective: The aim of this study was to evaluate whether loss of bone measured by digital X-ray radiogrammetry (DXR) of hands early in the course of rheumatoid arthritis (RA) may predict future radiographic joint damage after 1 and 2 years. Methods: A total of 166 patients with early RA, who were part of the Better Anti-Rheumatic FarmacOTherapy (BARFOT) low-dose prednisolone study, were included. The patients had been randomized to treatment with 7.5 mg prednisolone daily or no prednisolone when they started with their first disease-modifying anti-rheumatic drug (DMARD) therapy. Radiographs of hands and feet were taken at baseline and after 1 and 2 years and assessed by the van der Heijde modified Sharp (vdH-S) score. Hand bone density (HBD) was measured on the same radiographs by DXR. Changes in HBD and hand bone loss (HBL) were calculated. HBL was defined as a change in DXR bone mineral density (DXR-BMD) during the first year by more than 0.0048 g/cm. Results: HBL was found in 64% of the patients. Patients with HBL had radiological progression significantly more often than patients without (80% vs. 57%, p=0.012). Patients not treated with prednisolone had HBL more often than patients with this treatment (83% vs. 44%, p=0.001). In multiple regression analyses, HBL and change in DXR-BMD during the first year proved to be independent predictors of radiological progression. Conclusions: Loss of bone measured by DXR was found to be an independent predictor of radiological joint damage and may thus be an additional tool in the process of treatment decision in early RA.
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| 6. |
- Hafstrom, I., et al.
(författare)
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A Swedish register-based, long-term inception cohort study of patients with rheumatoid arthritis - results of clinical relevance
- 2019
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Ingår i: Open Access Rheumatology-Research and Reviews. - 1179-156X. ; 11, s. 207-217
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: At the end of the twentieth century, the outcome of rheumatoid arthritis (RA) was shown to be unsatisfactory and new therapeutic strategies were introduced. This initiated a register-based long-term study of early RA, the Better Anti-Rheumatic PharmacOTherapy (BARFOT) study. The aims were to evaluate the disease course and to acquire knowledge for improved care. Patients and methods: BARFOT is a multicentre observational study of patients with early RA, consecutively included 1992-2006. The patients are followed in daily practice according to a structured protocol for 15 years and data recorded in a web-based register. Also, through linkage of the BARFOT register to national registers we have acquired information on comorbidity and mortality. Results: In all, 2857 patients have been included and over 80 scientific articles have been published. Phenotypic characteristics at disease onset, i.e. gender, smoking habits and autoantibody profiles have been addressed. The disease course over 15 years was described. Early predictors for persistent disease activity, impaired function, joint damage and comorbidities have been identified. Treatment strategies have been studied. A randomized sub-study gave strong support for the treatment of recent RA with low-dose prednisolone in combination with disease-modifying anti-rheumatic drug. Furthermore, the impact of lifestyle factors, such as smoking, alcohol consumption, body weight and physical activity has been addressed. Conclusion: A register-based study like BARFOT has provided a basis for optimal long-term management of patients with RA. In addition, the register has made it possible to perform a diversity of studies of RA addressing various issues of major relevance to the patients.
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