Published in 2019

Night work during pregnancy and preterm birth-A large register-based cohort study

Specht, I. O., Hammer, P. E. C., Flachs, E. M., Begtrup, L. M., Larsen, A. D., Hougaard, K. S., Hansen, J., Hansen, Å. M., Kolstad, H. A., Rugulies, R., Garde, A. H. & Bonde, J. P., 2019, I : PLoS One. 14, 4, s. e0215748

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

BACKGROUND: Melatonin stimulates the production of progesterone, which is essential for the maintenance of pregnancy. Since melatonin in blood is reduced due to work under illuminated conditions during night work, it has been hypothesized that night work may increase the risk of preterm birth. Previous meta-analyses have not revealed increased risk of preterm birth in women working night shifts during pregnancy. Still, these studies might have been limited by inaccurate self-reports of timing, intensity and duration of night work most likely causing bias towards the null. The aim of this is study was to investigate if the frequency and duration of night work during the first (week 1-12) and second (week 13-22) trimester of pregnancy were associated with risk of preterm birth when objective and prospective data on night work are used.

METHOD: In a register-based prospective cohort study, we obtained individual day-to-day information on working hours from The Danish Working Hour Database (DWHD, a payroll database including all public service employees in administrative Danish Regions from 2007-2013) and information on preterm birth from the Danish Medical Birth Registry. Night-shift was defined as at least three working hours between 23:00 and 06:00. Preterm birth was defined as giving birth during gestational weeks 23-37. Odds of preterm birth according to working night shifts were analysed by logistic regression.

RESULTS: We identified 16,501 pregnant women eligible for the study, of which 10,202 women (61.8%) had at least one night-shift during the first 22 gestational weeks. The risk of preterm birth was not elevated among women working night shifts compared to women working only day shifts during either the first or second trimester. Within night-shift workers, the risk was not related to the number of night shifts, the duration of night shifts, consecutive night shifts or quick returns defined as short intervals between shifts. Odds of preterm birth was not related to change of working schedule from the first to second trimester, although women changing from night shifts in the first trimester to day work only in the second trimester displayed a weak increased odds of preterm birth (OR 1.21, 95%CI 0.98-1.49) compared to women working night shifts in both trimesters.

CONCLUSION: Our results, which are without bias from self-report of either exposure or outcome, are in line with the results of previous meta-analyses. Due to the detailed information on hours worked during pregnancy, we were able to investigate several dimensions of night work not previously investigated, of which none were associated with elevated risk of preterm birth.

Originalsprog Engelsk
Tidsskrift PLoS One
Vol/bind 14
Udgave nummer 4
Sider (fra-til) e0215748
ISSN 1932-6203
DOI
Status Udgivet - 2019

Opioid-Induced Reductions in Gait Variability in Healthy Volunteers and Individuals with Knee Osteoarthritis

Henriksen, M., Alkjær, T., Raffalt, P. C., Jørgensen, L., Bartholdy, C., Hansen, S. H. & Bliddal, H., 12 jan. 2019, I : Pain medicine (Malden, Mass.).

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Objective: To investigate differences in gait variability induced by two different single-dose opioid formulations and an inert placebo in healthy volunteers and knee osteoarthritis patients.

Design: Experimental, randomized, double-blinded, crossover study of inert placebo (calcium tablets), 50 mg of tapentadol, and 100 mg of tramadol.

Setting: Laboratory setting.

Subjects: Healthy volunteers and knee osteoarthritis patients.

Methods: At three visits, separated by seven days, one tablet was administered per visit according to the randomization code. At each visit, a baseline measurement was done before tablet administration, after which hourly measurements were performed for six hours, yielding a total of seven measurements per visit. Gait variability was measured by three-dimensional gait analysis, recorded during six minutes of continuous treadmill walking at self-selected speed. One hundred seventy gait cycles were identified from detection of clear events of the knee joint angle trajectories. Gait variability was assessed as average standard deviations over a gait cycle of the sacrum displacements and accelerations; sagittal plane ankle, knee, and hip joint angles; step widths; and stride times.

Results: Twenty-four opioid-naïve and neurologically intact participants (12 healthy volunteers and 12 knee osteoarthritis patients) were included and completed the experiment. Tapentadol reduced the variability of sacrum displacements and accelerations compared with placebo and tramadol. There were no differences between experimental conditions regarding the variability in lower-extremity joint angle variability, step widths, or stride times.

Conclusions: In opioid-naïve and neurologically intact individuals, tapentadol seems to reduce movement variability during treadmill walking, compared with placebo and tramadol. This can be interpreted as a loss of adaptability that might increase the risk of falling if the system is perturbed.

Originalsprog Engelsk
Tidsskrift Pain medicine (Malden, Mass.)
ISSN 1526-2375
DOI
Status E-pub ahead of print - 12 jan. 2019

OBJECTIVE: To study the prognostic value of widespread pain and of musculoskeletal ultrasound (US) examination for subsequent treatment outcomes in patients with psoriatic arthritis (PsA).

METHODS: An exploratory prospective cohort study enrolled patients with PsA initiating biologic or conventional synthetic disease-modifying antirheumatic drugs in routine care. Clinical, US, and patient-reported measures were collected at baseline and after 4 months. Widespread nonarthritic pain (WP) was defined as a Widespread Pain Index score of ≥4 with pain in ≥4 of 5 regions. PsA activity by US was defined as color Doppler (yes/no) in selected entheses, joints, or tendons. The main response criteria included the American College of Rheumatology 20% improvement, the Disease Activity in Psoriatic Arthritis 50% improvement, and minimal disease activity. The primary analyses were age- and sex-adjusted logistic regression.

RESULTS: WP was present in 24 of 69 included patients (35%) and was associated with worse patient-reported and composite baseline measures, while US and other objective findings were similar to those in patients without WP. The odds of reaching minimal disease activity after 4 months were significantly greater for patients enrolled without WP (odds ratio 18.43 [95% confidence interval 1.51, 224.41]; P = 0.022), while WP did not impair other response measures. Patients with baseline color Doppler activity (n = 42 [61%]) had a worse objective PsA burden, but their chance of treatment response was comparable to those without color Doppler.

CONCLUSION: More than one-third of patients with PsA presented with WP, which was associated with worse patient-reported scores and failure to achieve minimal disease activity following conventional synthetic or biologic disease-modifying antirheumatic drug therapy. PsA activity by color Doppler US had no influence on subsequent treatment response in this PsA cohort.

Originalsprog Engelsk
Tidsskrift Arthritis Care & Research
Vol/bind 71
Udgave nummer 6
Sider (fra-til) 798-810
Antal sider 13
ISSN 2151-464X
DOI
Status Udgivet - jun. 2019

Bibliografisk note

© 2018, American College of Rheumatology.

Physical demand at work and sick leave due to low back pain: a cross-sectional study

Petersen, J., Kirkeskov, L., Hansen, B. B., Begtrup, L. M., Flachs, E. M., Boesen, M., Hansen, P., Bliddal, H. & Kryger, A. I., 22 maj 2019, I : BMJ Open. 9, 5, s. e026917

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

OBJECTIVES: To investigate if self-reported high physical demand at work, objective physical workload using a job exposure matrix (JEM) and fear-avoidance beliefs are associated with reported sick leave in the previous year in persons with low back pain (LBP). Second, to investigate if the effects of fear-avoidance and self-reported high physical demand at work on sick leave are modified by the objective physical workloads.

SETTINGS: Participants were recruited from general practice and by advertisement in a local newspaper.

PARTICIPANTS: 305participants with a current period of 2-4 weeks LBP and self-reported difficulty in maintaining physically demanding jobs due to LBP were interviewed, clinically examined and had an MRI at baseline.

MAIN OUTCOME MEASURES: Independent variables were high fear-avoidance, self-reported high physical demand at work and objective measures of physical workloads (JEM). Outcome was self-reported sick leave due to LBP in the previous year. Logistic regression and tests for interaction were used to identify risk factors and modifiers for the association with self-reported sick leave.

RESULTS: Self-reported physically demanding work and high fear-avoidance were significantly associated with prior sick leave due to LBP in the previous year with OR 1.75 95% CI (1.10 to 2.75) and 2.75 95% CI (1.61to 4.84), respectively. No objective physical workloads had significant associations. There was no modifying effect of objective physical workloads on the association between self-reported physical demand at work/high fear-avoidance and sick leave.

CONCLUSIONS: Occupational interventions to reduce sick leave due to LBP may have to focus more on those with high self-reported physical demands and high fear-avoidance, and less on individuals with the objectively highest physical workload.

TRIAL REGISTRATION NUMBER: NCT02015572; Post-results.

Originalsprog Engelsk
Tidsskrift BMJ Open
Vol/bind 9
Udgave nummer 5
Sider (fra-til) e026917
ISSN 2044-6055
DOI
Status Udgivet - 22 maj 2019

Bibliografisk note

© Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

Placebo: den mindst skadelige behandling ved artrose?

Bliddal, H., Henriksen, M. & Christensen, R., 24 jun. 2019, I : Ugeskrift for Laeger. 181, 26

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Originalsprog Dansk
Tidsskrift Ugeskrift for Laeger
Vol/bind 181
Udgave nummer 26
ISSN 0041-5782
Status Udgivet - 24 jun. 2019

OBJECTIVE: To examine the reporting completeness of exercise-based interventions for knee osteoarthritis (OA) in studies that form the basis of current clinical guidelines, and examine if the clinical benefit (pain and disability) from exercise is associated with the intervention reporting completeness.

DESIGN: Review of clinical OA guidelines METHODS: We searched MEDLINE and EMBASE for guidelines published between 2006 and 2016 including recommendations about exercise for knee OA. The studies used to inform a recommendation were reviewed for exercise reporting completeness. Reporting completeness was evaluated using a 12-item checklist; a combination of the Template for Intervention Description and Replication (TIDieR) and Consensus on Exercise Reporting Template (CERT). Each item was scored 'YES' or 'NO' and summarized as a proportion of interventions with complete descriptions and each intervention's completeness was summarized as the percentage of completely described items. The association between intervention description completeness score and clinical benefits was analyzed with a multilevel meta-regression.

RESULTS: From 10 clinical guidelines, we identified 103 original studies of which 100 were retrievable (including 133 interventions with 6,926 patients). No interventions were completely described on all 12 items (median 33% of items complete; range 17-75%). The meta-regression analysis indicated that poorer reporting was associated with greater effects on pain and no association with effects on disability.

CONCLUSION: The inadequate description of recommended interventions for knee OA is a serious problem that precludes replication of effective interventions in clinical practice. By consequence, the relevance and usability of clinical guideline documents and original study reports are diminished.

PROSPERO: CRD42016039742.

Originalsprog Engelsk
Tidsskrift Osteoarthritis and Cartilage
Vol/bind 27
Udgave nummer 1
Sider (fra-til) 3-22
Antal sider 20
ISSN 1063-4584
DOI
Status Udgivet - jan. 2019

Prevalence of psoriatic arthritis in patients with psoriasis: A systematic review and meta-analysis of observational and clinical studies

Alinaghi, F., Calov, M., Kristensen, L. E., Gladman, D. D., Coates, L. C., Jullien, D., Gottlieb, A. B., Gisondi, P., Wu, J. J., Thyssen, J. P. & Egeberg, A., 1 jan. 2019, I : Journal of the American Academy of Dermatology. 80, 1, s. 251-265.e19

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Background: Wide-ranging prevalence estimates of psoriatic arthritis (PsA) in patients with psoriasis have been reported. Objectives: To assess the prevalence and incidence of PsA in patients with psoriasis. Methods: Two authors independently searched 3 databases for studies reporting on the prevalence or incidence of PsA in patients with psoriasis. A proportion meta-analysis was performed to calculate the pooled proportion estimates of PsA in patients with psoriasis. Results: A total of 266 studies examining 976,408 patients with psoriasis were included. Overall, the pooled proportion (95% confidence interval [CI]) of PsA among patients with psoriasis was 19.7% (95% CI, 18.5%-20.9%). In children and adolescents (<18 years of age), the pooled prevalence was 3.3% (95% CI, 2.1%-4.9%). The PsA prevalence was 22.7% (95% CI, 20.6%-25.0%) in European patients with psoriasis, 21.5% (95% CI, 15.4%-28.2%) in South American patients with psoriasis, 19.5% (95% CI, 17.1%-22.1%) in North American patients with psoriasis, 15.5% (95% CI, 0.009%-51.5%) in African patients with psoriasis, and 14.0% (95% CI, 95% CI, 11.7%-16.3%) in Asian patients with psoriasis. The prevalence of PsA was 23.8% (95% CI, 20.1%-27.6%) in studies in which the Classification Criteria for Psoriatic Arthritis were applied. The incidence of PsA among patients with psoriasis ranged from 0.27 to 2.7 per 100 person-years. Limitations: Between-study heterogeneity may have affected the estimates. Conclusions: We found that 1 in 4 patients with psoriasis have PsA. With the growing recognition of the Classification Criteria for Psoriatic Arthritis, more homogenous and comparable prevalence estimates are expected to be reported.

Originalsprog Engelsk
Tidsskrift Journal of the American Academy of Dermatology
Vol/bind 80
Udgave nummer 1
Sider (fra-til) 251-265.e19
ISSN 0190-9622
DOI
Status Udgivet - 1 jan. 2019

Response to: 'Mandatory, cost-driven switching from originator etanercept to its biosimilar SB4: possible fallout on non-medical switching' by Cantini and Benucci

Glintborg, B., Loft, A. G., Omerovic, E., Hendricks, O., Linauskas, A., Espesen, J., Danebod, K., Jensen, D. V., Nordin, H., Dalgaard, E. B., Chrysidis, S., Kristensen, S., Raun, J. L., Lindegaard, H., Manilo, N., Jakobsen, S. H., Hansen, I. M. J., Dalsgaard Pedersen, D., Sørensen, I. J., Andersen, L. S., Grydehøj, J., Mehnert, F., Krogh, N. S. & Hetland, M. L., 2019, I : Annals of the Rheumatic Diseases.

Publikation: Bidrag til tidsskriftKommentar/debatForskningpeer review

Originalsprog Engelsk
Tidsskrift Annals of the Rheumatic Diseases
ISSN 0003-4967
DOI
Status E-pub ahead of print - 2019

Objectives: To investigate temporal trends in the incidence and prevalence of gout in the adult Danish population.

Methods: Using the nationwide Danish National Patient Registry, we calculated the number of incident gout patients (per 100 000 person-years) within each 1 year period from 1995 to 2015 and the prevalence of gout in 2000 and 2015. Further, we calculated age- and gender-specific incidence rates of gout from 1995 to 2015.

Results: We identified a total of 45 685 incident gout patients (72.9% males) with a mean age of 65 years (s.d. 16) at diagnosis. In both genders, an increase in age-standardized incidence rates was observed from 32.3/100 000 (95% CI 30.7, 33.9) in 1995 to 57.5/100 000 (95% CI 55.6, 59.5) in 2015 (P < 0.001). Similar trends were observed for 8950 cases diagnosed in rheumatology departments. We likewise observed an increase in the prevalence of gout from 0.29% (95% CI 0.29, 0.30) in 2000 to 0.68% (95% CI 0.68, 0.69) in 2015.

Conclusions: The annual incidence rate of gout increased by almost 80% in Denmark between 1995 and 2015. The prevalence increased by nearly 130% between 2000 and 2015. Reasons for this are unknown but may include an increase in risk factors (e.g. obesity, diabetes mellitus), longer life expectancy and increased awareness of the disease among patients and/or health professionals.

Originalsprog Engelsk
Tidsskrift Rheumatology (Oxford, England)
ISSN 1462-0324
DOI
Status E-pub ahead of print - 2019

GOALS: It is unclear whether social inequality exists for mortality after stroke. Results of studies on the relation between socioeconomic position (SEP) and mortality after stroke have been inconsistent and inconclusive.

MATERIAL AND METHODS: We studied the association between SEP expressed by income and the risk of death after stroke by merging data on incident stroke from Danish registries with nationwide coverage. We identified all incident cases of stroke hospitalized in Denmark 2003-2012 (n = 60503). Patients were followed up to 9years after stroke (median 2.6 years). Adjusting for age and sex we studied all-cause death and cause-specific death by stroke, cardiac disease, cancer, and other diseases certified by death records and stratified by income.

RESULTS: Of the patients 20,953 (34.6%) had died within follow-up: Death by stroke 8018 (13.2%); cardiac disease 4250 (7.0%); cancer 3060 (5.0%); other diseases 5625 (9.2%). Long-term mortality rates were inversely related to income for all causes of death. The difference in mortality between the lowest and the highest income group at 5years after stroke was 15.5% (relative) and 5.7% (absolute). Differences in short-term mortality (1-month to 1-year) between income groups were small and clinically insignificant.

CONCLUSIONS: Social inequality in mortality after stroke expressed by income was pronounced for long-term mortality while not for short-term mortality. It seems that social inequality is expressed in a greater risk among stroke patients with low income for the advent of new diseases subsequently leading to death rather than in their ability to survive the incident stroke.

Originalsprog Engelsk
Tidsskrift Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association
ISSN 1052-3057
DOI
Status Udgivet - 28 mar. 2019

Bibliografisk note

Copyright © 2019 Elsevier Inc. All rights reserved.

AIMS: To investigate whether intensive lifestyle intervention induce partial or complete type 2 diabetes (T2D) remission.

MATERIALS AND METHODS: In a secondary analysis of a randomized, assessor-blinded, single-center trial, patients with non-insulin dependent T2D (duration<10 years), were randomly assigned (2:1, stratified by sex, from April 2015 to August 2016) to a lifestyle intervention group (n=64) or a standard care group (n=34). The primary outcome was partial or complete T2D remission defined as non-diabetic glycemia with no glucose-lowering medications at the outcome assessments at both 12- and 24-months from baseline. All participants received standard care with a standardized, blinded, target-driven medical therapy during the initial 12-months. The lifestyle intervention moreover included 5-6 weekly aerobic and combined aerobic and strength training sessions (30-60 min) and individual dietary plans aiming for BMI ≤ 25 kg/m2 . No intervention was provided during the 12 months follow-up period.

RESULTS: Among 98 randomized participants, 93 (mean [SD] age, 54.6 [8.9] years; 46 [43%] women; mean [SD] baseline HbA1c 49.3 [9.3] mmol/mol) completed follow-up. At follow-up, 23%(14) in the intervention and 7%(2) in the standard care group met the criteria for any T2D remission (odds ratio (OR) [95% CI] 4.4 [0.8 to 21.4], p=0.08). Assuming participants lost-to-follow-up (N=5) had relapsed, the OR [95% CI] for T2D remission was 4.4 [1.0 to 19.8] (p=0.048).

CONCLUSIONS: The statistically non-significant three-fold increased remission rate of T2D in the lifestyle intervention group calls for further large-scale studies to understand how to implement sustainable lifestyle interventions in T2D.

STUDY REGISTRATION: ClinicalTrials.gov registration (NCT02417012). This article is protected by copyright. All rights reserved.

Originalsprog Engelsk
Tidsskrift Diabetes, Obesity and Metabolism
ISSN 1462-8902
DOI
Status E-pub ahead of print - 5 jun. 2019

Bibliografisk note

This article is protected by copyright. All rights reserved.

Published in 2018

2018 update of the EULAR recommendations for the management of Behçet's syndrome

Hatemi, G., Christensen, R., Bang, D., Bodaghi, B., Celik, A. F., Fortune, F., Gaudric, J., Gul, A., Kötter, I., Leccese, P., Mahr, A., Moots, R., Ozguler, Y., Richter, J., Saadoun, D., Salvarani, C., Scuderi, F., Sfikakis, P. P., Siva, A., Stanford, M., Tugal-Tutkun, I., West, R., Yurdakul, S., Olivieri, I. & Yazici, H., jun. 2018, I : Annals of the Rheumatic Diseases. 77, 6, s. 808-818 11 s.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Several new treatment modalities with different mechanisms of action have been studied in patients with Behçet's syndrome (BS). The aim of the current effort was to update the recommendations in the light of these new data under the auspices of the European League Against Rheumatism (EULAR) Standing Committee for Clinical Affairs. A task force was formed that included BS experts from different specialties including internal medicine, rheumatology, ophthalmology, dermatology, neurology, gastroenterology, oral health medicine and vascular surgery, along with a methodologist, a health professional, two patients and two fellows in charge of the systematic literature search. Research questions were determined using a Delphi approach. EULAR standardised operating procedures was used as the framework. Results of the systematic literature review were presented to the task force during a meeting. The former recommendations were modified or new recommendations were formed after thorough discussions followed by voting. The recommendations on the medical management of mucocutaneous, joint, eye, vascular, neurological and gastrointestinal involvement of BS were modified; five overarching principles and a new recommendation about the surgical management of vascular involvement were added. These updated, evidence-based recommendations are intended to help physicians caring for patients with BS. They also attempt to highlight the shortcomings of the available clinical research with the aim of proposing an agenda for further research priorities.

Originalsprog Engelsk
Tidsskrift Annals of the Rheumatic Diseases
Vol/bind 77
Udgave nummer 6
Sider (fra-til) 808-818
Antal sider 11
ISSN 0003-4967
DOI
Status Udgivet - jun. 2018

A core domain set for hidradenitis suppurativa trial outcomes: an international Delphi process

HIdradenitis SuppuraTiva cORe outcomes set International Collaboration (HISTORIC), sep. 2018, I : British Journal of Dermatology. 179, 3, s. 642-650 9 s.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

BACKGROUND: There is no consensus on core outcome domains for hidradenitis suppurativa (HS). Heterogeneous outcome measure instruments in clinical trials likely leads to outcome-reporting bias and limits the ability to synthesize evidence.

OBJECTIVES: To achieve global multistakeholder consensus on a core outcome set (COS) of domains regarding what to measure in clinical trials for HS.

METHODS: Six stakeholder groups participated in a Delphi process that included five anonymous e-Delphi rounds and four face-to-face consensus meetings to reach consensus on the final COS. The aim was for a 1 : 1 ratio of patients to healthcare professionals (HCPs).

RESULTS: A total of 41 patients and 52 HCPs from 19 countries in four continents participated in the consensus process, which yielded a final COS that included five domains: pain, physical signs, HS-specific quality of life, global assessment and progression of course. A sixth domain, symptoms, was highly supported by patients and not by HCPs but is recommended for the core domain set.

CONCLUSIONS: Routine adoption of the COS in future HS trials should ensure that core outcomes of importance to both patients and HCPs are collected.

Originalsprog Engelsk
Tidsskrift British Journal of Dermatology
Vol/bind 179
Udgave nummer 3
Sider (fra-til) 642-650
Antal sider 9
ISSN 0007-0963
DOI
Status Udgivet - sep. 2018

A systematic review of measurement properties of patient reported outcome measures in psoriatic arthritis: A GRAPPA-OMERACT initiative

Højgaard, P., Klokker, L., Orbai, A-M., Holmsted, K., Bartels, E. M., Leung, Y. Y., Goel, N., de Wit, M., Gladman, D. D., Mease, P., Dreyer, L., Kristensen, L. E., FitzGerald, O., Tillett, W., Gossec, L., Helliwell, P., Strand, V., Ogdie, A., Terwee, C. B. & Christensen, R., 2018, I : Seminars in Arthritis and Rheumatism. 47, 5, s. 654-665

Publikation: Bidrag til tidsskriftReviewForskningpeer review

Originalsprog Engelsk
Tidsskrift Seminars in Arthritis and Rheumatism
Vol/bind 47
Udgave nummer 5
Sider (fra-til) 654-665
ISSN 0049-0172
DOI
Status Udgivet - 2018

Bibliografisk note

COPECARE

Acute sensory and motor response to 45-s heavy isometric holds for the plantar flexors in patients with Achilles tendinopathy

O'Neill, S., Radia, J., Bird, K., Rathleff, M. S., Bandholm, T., Jorgensen, M. & Thorborg, K. 1 aug. 2018 I : Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

PURPOSE: The purpose of this study was to explore the immediate effects of heavy isometric plantar flexor exercise on sensory output (pain during a functional task and mechanical pain sensitivity) and motor output (plantar flexor torque) in individuals with Achilles tendinopathy.

METHODS: Sixteen subjects with Achilles tendinopathy participated in the study, mean (SD) age 48.6 (8.9) years and Victorian institute assessment-Achilles (VISA-A) score 61.3 (23.0). Sensory testing assessing pain during a functional task, mechanical pain sensitivity and motor output, and plantar flexor peak torque was completed prior to the intervention. All subjects completed a 45-s heavy isometric plantar flexor contraction and were then re-tested using the same sensory and motor tests. Motor output was assessed using isokinetic dynamometry at speeds previously identified as of interest in subjects with Achilles tendinopathy.

RESULTS: Only 9 of the 16 subjects experienced pain during a functional task, self-reported pain was 4.2 (1.9) numerical rating scale (NRS) pre-intervention and 4.9 (3.2) NRS postintervention (n.s.). Mechanical pressure sensitivity was 446.5 (± 248.5) g/mm2 pre-intervention and 411.8 (± 211.8) g/mm2 post-intervention (n.s.). Mean concentric plantar flexor torque at 90 and 225°/s was 47.1 (14.5) and 33.6 (11.6) Nm, respectively, pre-intervention and 53.0 (18.5) and 33.4 (6.6) Nm post-intervention (p = 0.039 and n.s.). Eccentric torque at 90°/s was 98.5 (34.2) Nm preintervention versus 106.0 (41.4) Nm post-intervention (n.s.).

CONCLUSION: In this exploratory study, patients with Achilles tendinopathy had a varied sensory and motor output response to heavy isometric contractions. Using the recommended approach of heavy 45-s isometric contractions did not offer a meaningful acute benefit for sensory or motor output for subjects with Achilles tendinopathy. Based on this study, heavy 45-s isometric contractions cannot be recommended for immediate pain relief or improved motor output for patients with Achilles tendinopathy.

LEVEL OF EVIDENCE: IV, prospective cohort study.

Originalsprog Engelsk
Tidsskrift Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA
ISSN 0942-2056
DOI
Status E-pub ahead of print - 1 aug. 2018
Originalsprog Engelsk
Artikelnummer P19
Tidsskrift Endocrine Abstracts
Vol/bind 56
ISSN 1479-6848
DOI
Status Udgivet - 2018

An MRI guided treat-to-target strategy in rheumatoid arthritis patients in clinical remission improved MRI inflammation but not damage progression – Results from the IMAGINE-RA randomised controlled trial

Møller-Bisgaard, S. K., Hørslev-Petersen, K., Ejbjerg, B., Glinatsi, D. E., Hetland, M. L., Ørnbjerg, L. M., Møller, J. M., Boesen, M., Christensen, R. D. K., Stengaard-Pedersen, K., Madsen, O. R., Jensen, B., Villadsen, J., Hauge, E. M., Bennett, P., Hendricks, O., Asmussen, K., Kowalski, M. R., Lindegaard, H., Nielsen, S. M., Bliddal, H., Krogh, N., Ellingsen, T., Nielsen, A. H., Balding, L., Jurik, A. G., Thomsen, H. & Østergaard, M., 2018, I : Annals of the Rheumatic Diseases. 77, Suppl. 2, s. 126 1 s., OP0149.

Publikation: Bidrag til tidsskriftKonferenceabstrakt i tidsskriftForskningpeer review

Originalsprog Engelsk
Artikelnummer OP0149
Tidsskrift Annals of the Rheumatic Diseases
Vol/bind 77
Udgave nummer Suppl. 2
Sider (fra-til) 126
Antal sider 1
ISSN 0003-4967
Status Udgivet - 2018

An MRI Guided Treat-to-Target Strategy in Rheumatoid Arthritis Patients in Clinical Remission Improved MRI Inflammation but Not Damage Progression – Results from the Imagine-RA Randomized Controlled Trial

Møller-Bisgaard, S. K., Hørslev-Petersen, K., Ejbjerg, B. J., Glinatsi, D. E., Hetland, M. L., Ørnbjerg, L. M., Møller, J. M., Boesen, M., Christensen, R. D. K., Stengaard-Petersen, K., Madsen, O. R., Jensen, B., Villadsen, J. A., Hauge, E-M., Bennett, P., Hendricks, O., Asmussen, K., Kowalski, M. R., Lindegaard, H., Nielsen, S. M., Bliddal, H., Krogh, N. S., Ellingsen, T., Nielsen, A., Balding, L., Jurik, A. G., Thomsen, H. S. & Østergaard, M., 2018, I : Arthritis & Rheumatology. 70, S9, 2 s., 867.

Publikation: Bidrag til tidsskriftKonferenceabstrakt i tidsskriftForskningpeer review

Originalsprog Engelsk
Artikelnummer 867
Tidsskrift Arthritis & Rheumatology
Vol/bind 70
Udgave nummer S9
Antal sider 2
ISSN 1537-2960
Status Udgivet - 2018

Antibody-Mediated Neutralization of uPA Proteolytic Function Reduces Disease Progression in Mouse Arthritis Models

Almholt, K., Hebsgaard, J. B., Nansen, A., Andersson, C., Pass, J., Rønø, B., Thygesen, P., Pelzer, H., Loftager, M., Lund, I. K., Høyer-Hansen, G., Frisch, T., Jensen, C. H., Otte, K. S., Søe, N. H., Bartels, E. M., Andersen, M., Bliddal, H. & Usher, P. A., 1 feb. 2018, I : Journal of immunology (Baltimore, Md. : 1950). 200, 3, s. 957-965

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Genetic absence of the urokinase-type plasminogen activator (uPA) reduces arthritis progression in the collagen-induced arthritis (CIA) mouse model to an extent just shy of disease abrogation, but this remarkable observation has not been translated into therapeutic intervention. Our aim was to test the potential in mice of an Ab that blocks the proteolytic capacity of uPA in the CIA model and the delayed-type hypersensitivity arthritis model. A second aim was to determine the cellular origins of uPA and the uPA receptor (uPAR) in joint tissue from patients with rheumatoid arthritis. A mAb that neutralizes mouse uPA significantly reduced arthritis progression in the CIA and delayed-type hypersensitivity arthritis models. In the CIA model, the impact of anti-uPA treatment was on par with the effect of blocking TNF-α by etanercept. A pharmacokinetics evaluation of the therapeutic Ab revealed target-mediated drug disposition consistent with a high turnover of endogenous uPA. The cellular expression patterns of uPA and uPAR were characterized by double immunofluorescence in the inflamed synovium from patients with rheumatoid arthritis and compared with synovium from healthy donors. The arthritic synovium showed expression of uPA and uPAR in neutrophils, macrophages, and a fraction of endothelial cells, whereas there was little or no expression in synovium from healthy donors. The data from animal models and human material provide preclinical proof-of-principle that validates uPA as a novel therapeutic target in rheumatic diseases.

Originalsprog Engelsk
Tidsskrift Journal of immunology (Baltimore, Md. : 1950)
Vol/bind 200
Udgave nummer 3
Sider (fra-til) 957-965
ISSN 0022-1767
DOI
Status Udgivet - 1 feb. 2018

Pages