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Co-morbidity in pat...
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Innala, Lena,1060-Umeå universitet,Reumatologi
(author)
Co-morbidity in patients with early rheumatoid arthritis - inflammation matters
- Article/chapterEnglish2016
Publisher, publication year, extent ...
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2016-01-28
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BioMed Central,2016
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electronicrdacarrier
Numbers
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LIBRIS-ID:oai:DiVA.org:umu-117189
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https://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-117189URI
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https://doi.org/10.1186/s13075-016-0928-yDOI
Supplementary language notes
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Language:English
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Summary in:English
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Subject category:ref swepub-contenttype
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Subject category:art swepub-publicationtype
Notes
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Background: Patients with rheumatoid arthritis (RA) suffer from co-morbidities that contribute to a shortened lifespan. Inflammation is important for the development of cardiovascular disease, but little is known on its relationship with other co-morbidities. We investigated the role of inflammation for the development of new comorbidities in early RA. Methods: Since 1995, all patients with early RA in Northern Sweden are included in a prospective study on comorbidities, with a total of 950 patients being included. At the time for this study, 726 had been ill for >= 5 years. Data on co-morbidities, clinical and laboratory disease activity and pharmacological therapy were collected from patient records and further validated using a questionnaire at RA onset (T0) and after 5 years (T5). Results: Of the patients, 53.2 % of the patients had one or more co-morbidity at onset, the commonest being: hypertension (27.3 %), obstructive pulmonary disease (13.9 %), diabetes (8.0 %), hypothyroidism (6.3 %) and malignancy (5.0 %). After 5 years, 41.0 % had developed at least one new co-morbidity, the most common being: hypertension (15.1 %), malignancy (7.6 %), stroke/transient ischemic accident (5.1 %), myocardial infarction (4.3 %) and osteoporosis (3.7 %). Age at disease onset, a raised erythrocyte sedimentation rate (ESR) at inclusion, previous treatment with glucocorticoids (GC; p < 0.001 for all), extra-articular RA (Ex-RA; p < 0.01), DAS28 (area under the curve) at 24 months (p < 0.05), previous smoking at inclusion (p = 0.058) and male gender (p < 0.01) were associated with a new co-morbidity overall at T5. Treatment with biologics (p < 0.05) reduced the risk. In multiple logistic regression modelling, ESR (p = 0.036) at inclusion was associated with a new co-morbidity after 5 years, adjusted for age, sex, smoking and GC treatment. In a similar model, Ex-RA (p < 0.05) was associated with a new co-morbidity at T5. In a third model, adjusted for age and sex, a new pulmonary co-morbidity was associated with a smoking history at inclusion (p < 0.01), but not with ESR. Conclusion: There was substantial co-morbidity among early RA patients already at disease onset, with considerable new co-morbidity being added during the first five years. Measures of disease activity were associated with the occurrence of a new co-morbidity indicating that the inflammation is of importance in this context.
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Sjöberg, Clara,1986-Umeå universitet,Reumatologi(Swepub:umu)clsj0002
(author)
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Möller, Bozena
(author)
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Ljung, Lotta,1964-Umeå universitet,Reumatologi(Swepub:umu)LJLO0001
(author)
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Smedby, Torgny
(author)
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Södergren, Anna,1977-Umeå universitet,Reumatologi(Swepub:umu)anayxt97
(author)
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Magnusson, Staffan
(author)
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Rantapää-Dahlqvist, Solbritt,1947-Umeå universitet,Reumatologi(Swepub:umu)sora0001
(author)
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Wållberg-Jonsson, Solveig,1953-Umeå universitet,Reumatologi(Swepub:umu)sowa0001
(author)
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Umeå universitetReumatologi
(creator_code:org_t)
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In:Arthritis Research & Therapy: BioMed Central181478-6362
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