&lt;p&gt;A Swedish register-based, long-term inception cohort study of patients with rheumatoid arthritis – results of clinical relevance&lt;/p&gt;

Hafström, Ingiäld; Ajeganova, Sofia; Andersson, Maria; Bala, Sidona Valentina; Bergman, Stefan; Bremander, Ann; Forslind, Kristina; Malm, Karina; Svensson, Björn

doi:10.2147/oarrr.s218448

Cited by 19 publications

(16 citation statements)

References 65 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…BARFOT is a multicenter longitudinal observational study of RA patients in southern Sweden. 15 In short, patients with newly diagnosed RA were consecutively included between 1992 and 2006; inclusion criteria were disease duration of 12 months or less and fulfilling the ACR 1987 classification criteria. 16 The patients were assessed at inclusion, 3 and 6 months, at 1, 2, 5 and 8 years according to the same structured protocol, see “Clinical assessments” below.…”

Section: Methodsmentioning

confidence: 99%

Influence of Age and Sex on Disease Course and Treatment in Rheumatoid Arthritis

Nilsson¹,

Andersson²,

Hafström³

et al. 2021

OARRR

Self Cite

View full text Add to dashboard Cite

More than 50% of patients with rheumatoid arthritis (RA) are >65 years at diagnosis. Age of onset and sex may influence the disease course, outcome and treatment. This study follows a large cohort of patients with early RA to assess contributions of age and sex to disease outcomes. Methods: Patients from the BARFOT cohort, n=2837 (68% women), were followed for eight years at predefined time points to assess inflammation, function, joint destruction and treatment with disease modifying anti-rheumatic drugs (DMARDs) and glucocorticoids (GC). The patients were divided by sex and age at inclusion (<40, 40-54, 55-69 and ≥70 years). Results: For both sexes, disease activity, function and pain improved over time, significantly more in men than in women in all age groups. In men, those <40 years displayed significantly lower DAS28 compared with all other groups. This group was also the least represented group in the study. The Sharp van der Heijde Score (SHS) increased over time in both sexes and all age groups. Women ≥70 years showed less improvement in disability and the highest progression of SHS mainly due to increased joint space narrowing. Patients <40 years were more likely to receive biological DMARDs, while those ≥70 years more often received only GC treatment. Conclusion: There were significant age-and sex-dependent differences in the medical treatment and in outcome of RA 8 years after diagnosis. The differences were most pronounced in men<40 and women ≥70 years, but whether they are due to disease phenotype or treatment is unclear.

show abstract

Section: Methodsmentioning

confidence: 99%

Influence of Age and Sex on Disease Course and Treatment in Rheumatoid Arthritis

Nilsson¹,

Andersson²,

Hafström³

et al. 2021

OARRR

Self Cite

View full text Add to dashboard Cite

show abstract

“…The patients were assessed according to a structured protocol at baseline, 3 and 6 months, and at 1, 2, 5, and 8 years. The patients were treated with DMARDs in accordance with the recommended treatment strategy in Sweden as earlier described [ 15 , 16 ].…”

Section: Methodsmentioning

confidence: 99%

Distribution of erosions in hands and feet at the time for the diagnosis of RA and during 8-year follow-up

2020

Self Cite

View full text Add to dashboard Cite

Background Joint destruction in rheumatoid arthritis (RA) is usually evaluated by radiographs of both hands and feet, while the inflammatory status mostly is evaluated by DAS28 which, however, does not include the feet. Objectives To investigate the distribution of erosions in hands and feet in early RA over 8 years and its potential clinical implications. Furthermore, the group of patients never showing erosions has been addressed. Methods This study comprises 1041 patients from the BARFOT study of patients with early RA. Radiographs of hands and feet were performed at baseline, 1, 2, 5, and 8 years and evaluated by the Sharp van der Heijde scoring (SHS) method (32 joints in the hands and 12 in the feet). Disease activity was measured by DAS28, SR, CRP, and function with HAQ. Results In the feet, there were significantly more eroded joints in percent of examined joints than in the hands at all time points. Patients with erosions only in the feet were younger, more often seropositive and smokers. They had significantly lower baseline DAS28, than the patients with erosions only in the hands. The patients without erosions over time were, at diagnosis, significantly younger and less frequently seropositive compared with patients having erosions. Conclusions This study highlights the importance of evaluating the feet in patients with RA, both with clinical examinations and with imaging and lends support to the notion that seropositivity and smoking are risk factors for erosive disease. Further studies of patients with nonerosive disease are needed. Key Points:• Foot problems are common in RA• This study emphasizes the limitations of DAS28 and Sharp van der Heijde score as regards evaluating disease activity and radiographic damage• This study highlights the importance of evaluating the feet in patients with RA with clinical examinations and imaging• This study also points out the need of further studies of patients with non-erosive RA.

show abstract

“…38,39 COPD and TB also share other risk factors such as tobacco smoking 17,40 and diabetes. 35 Additionally, smoking (past or present) is common in patients with RA, 41 and has been identified as an independent risk factor for TB in these patients. 17 We did not find an increased TB risk associated with smoking, but due to missing data on smoking habits, especially among controls, this finding must be interpreted with caution.…”

Section: Discussionmentioning

confidence: 99%

Tuberculosis in Biologic-naïve Patients With Rheumatoid Arthritis: Risk Factors and Tuberculosis Characteristics

et al. 2021

View full text Add to dashboard Cite

Objective To investigate risk factors and characteristics of active tuberculosis (TB) in biologics-naïve rheumatoid arthritis (RA) patients. Methods Population-based case-control study using the Swedish Rheumatology Quality Register, the National Patient Register and the Tuberculosis Register to identify RA cases with active TB and matched RA controls without TB 2001-2014. Clinical data were obtained from medical records. TB risk was estimated as adjusted (adj) odds ratios (OR) with 95% confidence intervals (CI) using univariate and multivariable logistic regression analyses. Results After validation of diagnoses, the study included 31 RA cases with TB, and 122 matched RA controls. All except three cases had reactivation of latent TB. Pulmonary TB dominated (84%). Ever use of methotrexate was not associated with increased TB risk (adj OR 0.8; 95% CI 0.3-2.0), whereas ever treatment with leflunomide (adj OR 6.0; 95% CI 1.5-24.6), azathioprine (adj OR 3.8; 95% CI 1.1-13.8) and prednisolone (adj OR 2.4 (95% CI 1.0-5.9) was. There were no significant differences of maximum dose of prednisolone, treatment duration with prednisolone before TB, or cumulative dose of prednisolone the year before TB diagnosis between cases and controls. Obstructive pulmonary disease was associated with an increased TB risk (adj OR 3.9; 95% CI 1.4-10.7). Conclusion Several RA-associated factors may contribute to the increased TB risk in biologics-naïve RA patients, making risk of TB activation difficult to predict in the individual patient. To further decrease TB in RA patients, the results suggest that screening for latent TB should also be considered in biologics-naïve patients.

show abstract

<p>A Swedish register-based, long-term inception cohort study of patients with rheumatoid arthritis – results of clinical relevance</p>

Cited by 19 publications

References 65 publications

Influence of Age and Sex on Disease Course and Treatment in Rheumatoid Arthritis

Influence of Age and Sex on Disease Course and Treatment in Rheumatoid Arthritis

Distribution of erosions in hands and feet at the time for the diagnosis of RA and during 8-year follow-up

Tuberculosis in Biologic-naïve Patients With Rheumatoid Arthritis: Risk Factors and Tuberculosis Characteristics

Contact Info

Product

Resources

About