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FältnamnIndikatorerMetadata
00007101naa a2200769 4500
001oai:gup.ub.gu.se/277480
003SwePub
008240528s2019 | |||||||||||000 ||eng|
009oai:DiVA.org:umu-155961
0247 a https://gup.ub.gu.se/publication/2774802 URI
0247 a https://doi.org/10.1186/s13075-019-1810-52 DOI
0247 a https://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-1559612 URI
040 a (SwePub)gud (SwePub)umu
041 a eng
042 9 SwePub
072 7a ref2 swepub-contenttype
072 7a art2 swepub-publicationtype
1001 a Klingberg, Evau Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för reumatologi och inflammationsforskning,Institute of Medicine, Department of Rheumatology and Inflammation Research4 aut0 (Swepub:gu)xkliev
2451 0a Weight loss improves disease activity in patients with psoriatic arthritis and obesity: an interventional study
264 c 2019-01-11
264 1b Springer Science and Business Media LLC,c 2019
520 a BackgroundObesity is over-represented in patients with psoriatic arthritis (PsA) and associated with higher disease activity, poorer effect of treatment and increased cardiovascular morbidity. Studies on the effects of weight loss are however needed. This study aimed to prospectively study the effects of weight loss treatment with very low energy diet (VLED) on disease activity in patients with PsA (CASPAR criteria) and obesity (body mass index BMI 33kg/m(2)).MethodsVLED (640kcal/day) was taken during 12-16weeks, depending on pre-treatment BMI. Afterwards, an energy-restricted diet was gradually reintroduced. Weight loss treatment was given within a structured framework for support and medical follow-up.Treatment with conventional synthetic and/or biologic disease-modifying anti-rheumatic drugs was held constant from 3months before, until 6months after baseline.Patients were assessed with BMI, 66/68 joints count, Leeds enthesitis index, psoriasis body surface area (BSA), questionnaires and CRP at baseline, 3 and 6months. Primary outcome was the percentage of patients reaching minimal disease activity (MDA) and secondary outcomes were reaching Psoriatic Arthritis Response Criteria (PsARC) and American College of Rheumatology (ACR) response criteria.ResultsTotally 41/46 patients completed the study, 63% women, median age 54years (IQR 48-62). At baseline increased BMI was associated with higher disease activity and poorer function.The median weight loss was 18.7kg (IQR 14.6-26.5) or 18.6% (IQR 14.7-26.3) of the baseline weight. A majority of the disease activity parameters improved significantly after weight loss, including 68/66 tender/swollen joints count, CRP, BSA, Leeds enthesitis index, HAQ and patient VAS for global health, pain and fatigue. A larger weight loss resulted in more improvement in a dose-response manner. The percentage of patients with MDA increased from 29 to 54%, (p=0.002). PsARC was reached by 46.3%. The ACR 20, 50 and 70 responses were 51.2%, 34.1% and 7.3% respectively.ConclusionsShort-term weight loss treatment with VLED was associated with significant positive effects on disease activity in joints, entheses and skin in patients with PsA and obesity. The study supports the hypothesis of obesity as a promotor of disease activity in PsA.Trial registrationClinicalTrials.gov identifier: NCT02917434, registered on September 21, 2016retrospectively registered
650 7a MEDICIN OCH HÄLSOVETENSKAPx Klinisk medicin0 (SwePub)3022 hsv//swe
650 7a MEDICAL AND HEALTH SCIENCESx Clinical Medicine0 (SwePub)3022 hsv//eng
650 7a MEDICIN OCH HÄLSOVETENSKAPx Klinisk medicinx Reumatologi och inflammation0 (SwePub)302102 hsv//swe
650 7a MEDICAL AND HEALTH SCIENCESx Clinical Medicinex Rheumatology and Autoimmunity0 (SwePub)302102 hsv//eng
653 a Psoriatic arthritis
653 a Psoriasis
653 a Obesity
653 a Metabolic syndrome
653 a Weight loss
653 a VLED
653 a Cardiovascular disease
653 a adipose-tissue
653 a metabolic syndrome
653 a severity
653 a risk
653 a enthesitis
653 a spondyloarthritis
653 a inflammation
653 a prevalence
653 a adipokines
653 a criteria
653 a Rheumatology
653 a evoo mll
653 a 1995
653 a arthritis and rheumatism
653 a v38
653 a p44
653 a Psoriatic arthritis
7001 a Bilberg, Annelie,d 1965u Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för reumatologi och inflammationsforskning,Institute of Medicine, Department of Rheumatology and Inflammation Research4 aut0 (Swepub:gu)xbillb
7001 a Björkman, Sofiau Gothenburg University,Göteborgs universitet,Institutionen för medicin,Institute of Medicine4 aut
7001 a Hedberg, M.4 aut
7001 a Jacobsson, Lennart T. H.,d 1954u Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för reumatologi och inflammationsforskning,Institute of Medicine, Department of Rheumatology and Inflammation Research4 aut0 (Swepub:gu)xjacle
7001 a Forsblad d'Elia, Helena,d 1961u Umeå universitet,Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för reumatologi och inflammationsforskning,Institute of Medicine, Department of Rheumatology and Inflammation Research,Reumatologi,Department of Rheumatology and Inflammation Research, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden4 aut0 (Swepub:umu)hefo0034
7001 a Carlsten, Hans,d 1954u Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för reumatologi och inflammationsforskning,Institute of Medicine, Department of Rheumatology and Inflammation Research4 aut0 (Swepub:gu)xcahan
7001 a Eliasson, Björn,d 1959u Gothenburg University,Göteborgs universitet,Institutionen för medicin,Institute of Medicine4 aut0 (Swepub:gu)xelibj
7001 a Larsson, Ingrid,d 1963u Gothenburg University,Göteborgs universitet,Institutionen för medicin,Institute of Medicine4 aut0 (Swepub:gu)xlaing
7102 a Göteborgs universitetb Institutionen för medicin, avdelningen för reumatologi och inflammationsforskning4 org
7730 t Arthritis Res Therd : Springer Science and Business Media LLCg 21:1q 21:1x 1478-6354x 1478-6362
7730 t Arthritis Research & Therapyd : Springer Science and Business Media LLCg 21:1q 21:1x 1478-6362
8564 u https://arthritis-research.biomedcentral.com/track/pdf/10.1186/s13075-019-1810-5
8564 u https://doi.org/10.1186/s13075-019-1810-5y Fulltext
8564 u https://umu.diva-portal.org/smash/get/diva2:1286787/FULLTEXT01.pdfx primaryx Raw objecty fulltext:print
8564 8u https://gup.ub.gu.se/publication/277480
8564 8u https://doi.org/10.1186/s13075-019-1810-5
8564 8u https://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-155961

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