Published in 2019

LOW SERUM LEVEL OF VITAMIN D AT TIME OF DIAGNOSIS IS ASSOCIATED WITH HIGHER ONE-YEAR REMISSION RATE IN PATIENTS WITH NEWLY DIAGNOSED RA, TREATED AGGRESSIVELY DURING FOLLOW-UP: POST-HOC ANALYSES OF THE CIMESTRA TRIAL

Herly, M., Steengaard-Pedersen, K., Vestergaard, P., Christensen, R. D. K., Østergaard, M., Junker, P., Hetland, M. L., Hørslev-Petersen, K. & Ellingsen, T., 2019, I : Annals of the Rheumatic Diseases. 78, Suppl. 2, s. 1112 1 s.

Publikation: Bidrag til tidsskriftKonferenceabstrakt i tidsskriftForskningpeer review

Originalsprog Engelsk
Tidsskrift Annals of the Rheumatic Diseases
Vol/bind 78
Udgave nummer Suppl. 2
Sider (fra-til) 1112
Antal sider 1
ISSN 0003-4967
Status Udgivet - 2019

Magnetic Resonance Imaging in Patients in Clinical Remission: Tenosynovitis and Osteitis Are Independent Predictors of Radiographic and MRI Damage Progression

Møller-Bisgaard, S. K., Hørslev-Petersen, K., Ejbjerg, B., Hetland, M. L., Ørnbjerg, L. M., Glinatsi, D. E., Møller, J. M., Boesen, M., Stengaard-Pedersen, K., Madsen, O. R., Jensen, B., Villadsen, J. A., Hauge, E-M., Bennett, P., Hendricks, O., Asmussen, K., Kowalski, M., Lindegaard, H., Bliddal, H., Krogh, N. S., Ellingsen, T., Nielsen, A., Larsen, L., Jurik, A. G., Thomsen, H. S. & Østergaard, M., 2019, I : Arthritis & Rheumatology. 71, S10, 3 s., 1173.

Publikation: Bidrag til tidsskriftKonferenceabstrakt i tidsskriftForskningpeer review

Originalsprog Engelsk
Artikelnummer 1173
Tidsskrift Arthritis & Rheumatology
Vol/bind 71
Udgave nummer S10
Antal sider 3
ISSN 1537-2960
Status Udgivet - 2019

MAGNETIC RESONANCE IMAGING TENOSYNOVITIS AND OSTEITIS ARE INDEPENDENT PREDICTORS OF RADIOGRAPHIC AND MRI DAMAGE PROGRESSION IN RHEUMATOID ARTHRITIS PATIENTS IN CLINICAL REMISSION

Møller-Bisgaard, S. K., Hørslev-Petersen, K., Ejbjerg, B., Hetland, M. L., Ørnbjerg, L. M., Glinatsi, D. E., Møller, J. M., Boesen, M., Stengaard-Pedersen, K., Madsen, O., Jensen, B., Villadsen, J., Hauge, E. M., Bennett, P., Hendricks, O., Asmussen, K., Kowalski, M., Lindegaard, H. M., Bliddal, H., Krogh, N. S., Ellingsen, T., Nielsen, A., Larsen, L., Jurik, A. G., Thomsen, H. S. & Østergaard, M., 2019, I : Annals of the Rheumatic Diseases. 78, Suppl. 2, s. 248-249 2 s.

Publikation: Bidrag til tidsskriftKonferenceabstrakt i tidsskriftForskningpeer review

Originalsprog Engelsk
Tidsskrift Annals of the Rheumatic Diseases
Vol/bind 78
Udgave nummer Suppl. 2
Sider (fra-til) 248-249
Antal sider 2
ISSN 0003-4967
Status Udgivet - 2019

Management of skin, mucosa and joint involvement of Behçet's syndrome: A systematic review for update of the EULAR recommendations for the management of Behçet's syndrome

Leccese, P., Ozguler, Y., Christensen, R., Esatoglu, S. N., Bang, D., Bodaghi, B., Celik, A. F., Fortune, F., Gaudric, J., Gül, A., Kötter, I., Mahr, A., Moots, R. J., 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. & Hatemi, G., feb. 2019, I : Seminars in Arthritis and Rheumatism. 48, 4, s. 752-762 11 s.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

OBJECTIVES: The aim of this systematic review was to inform the update of European League Against Rheumatism (EULAR) Recommendations for the management of Behçet's syndrome (BS), on the evidence for the treatment of skin, mucosa and joint involvement of BS.

METHODS: A systematic literature search, data extraction, statistical analyses and assessment of the quality of evidence were performed according to a pre-specified protocol using the PRISMA guidelines. Studies that assessed the efficacy of an intervention in comparison to an active comparator or placebo for oral ulcers, genital ulcers, papulopustular lesions, nodular lesions or arthritis were included. Where possible, risk ratios were calculated for binary outcomes and mean difference for continuous outcomes.

RESULTS: Among the 3927 references that were screened, 37 were included in the analyses. Twenty-seven of these assessed mucocutaneous and 17 assessed joint involvement. Twenty-one of these studies were randomised controlled trials (RCTs). RCTs with colchicine, azathioprine, interferon-alpha, thalidomide, etanercept and apremilast showed beneficial results with some differences according to lesion type and gender. These agents were generally well tolerated with few adverse events causing withdrawal from the study.

CONCLUSIONS: RCTs comprised more than a half (21/37, 57%) of the sources included in the evidence synthesis related to skin, mucosa and joint involvement applicable for the EULAR Recommendations for the management of BS. Differences in the outcome measures that were used across the included studies often made it difficult to combine and compare the results.

Originalsprog Engelsk
Tidsskrift Seminars in Arthritis and Rheumatism
Vol/bind 48
Udgave nummer 4
Sider (fra-til) 752-762
Antal sider 11
ISSN 0049-0172
DOI
Status Udgivet - feb. 2019

Bibliografisk note

Copyright © 2018 Elsevier Inc. All rights reserved.

BACKGROUND: Few studies have examined the relationship between eating frequency and long-term change in body weight, and the results have been inconsistent.

OBJECTIVE: We examined the associations between eating frequency and 6-y changes in body mass index (BMI; in kg/m2), fat mass, fat-free mass, body fat percentage, and waist circumference.

METHODS: The study consisted of Danish men (n = 1080) and women (n = 1044) aged 35-67 y with repeated measures of eating frequency, adiposity, and covariates during 11 y. Multiple linear regression was used to assess the associations between baseline eating frequency and subsequent change in BMI, fat mass, fat-free mass, fat percentage, and waist circumference, as well as the association between initial change in eating frequency and subsequent change in the same outcomes.

RESULTS: Total baseline eating frequency was not associated with change in outcomes. However, when separately examining regular meals and snacks, each additional daily meal was associated with a subsequent 6-y change in BMI of -0.14 (95% CI: -0.27, -0.00). Similar tendencies of inverse associations were found for change in fat mass (P = 0.04), fat-free mass (P = 0.07), and waist circumference (P = 0.05). We found no association between initial change in total eating frequency and subsequent change in outcomes. However, each additional daily regular meal after 5 y was associated with a subsequent 6-y change in BMI of -0.16 (95% CI: -0.30, -0.01). Inverse associations were also seen for fat (P = 0.04) and fat-free mass (P = 0.05). In contrast, an increase in daily frequency of snacking was associated with an increase in fat mass (P = 0.04) and fat percentage (P = 0.02).

CONCLUSIONS: Our results indicate that total frequency of eating has little or no influence on adiposity among middle-aged Danish men and women. Consumption of regular meals, but not snack consumption, showed a weak inverse association with longitudinal gains in BMI.

Originalsprog Engelsk
Tidsskrift The Journal of Nutrition
Vol/bind 149
Udgave nummer 5
Sider (fra-til) 824-830
Antal sider 7
ISSN 0022-3166
DOI
Status Udgivet - 1 maj 2019

Bibliografisk note

Copyright © American Society for Nutrition 2019.

The condition of active muscles determines an individual's ability to carry out daily activities and has implications for an athlete's performance. Multi-frequency bioimpedance (mfBIA) is a non-invasive, well-known, validated, and much used method to assess muscle condition. However, it is rarely used to its full potential. Our aim was to apply mfBIA fully in the assessment of an adult healthy population, to compare muscle condition in different functional rested muscle groups, with age, and between men and women, and establish a control data set. Fifty healthy subjects (25 men/25 women) aged 20-69 years, participated. mfBIA measurements at a frequency range of 4-1000 kHz were taken from muscles of the lower and the upper extremities, the upper back, and the hand. Data were analyzed using ImpediMed software, giving Impedance, Resistance, Reactance, Phase Angle, Center Frequency, external and internal Resistance, and Membrane Capacitance. Differences between means were tested for statistical significance. A P value >0.05 was considered nonsignificant. While no difference in the mfBIA parameters was seen with age, a highly significant gender difference was seen. At rest, women's muscles cf men's showed a significantly higher center frequency and intra- and extra-cellular resistance, while the membrane capacitance was lower. A set of values for mfBIA parameters for healthy adult individuals are given for some of the main muscles which are frequently part of muscle assessment. The documented gender difference in muscle condition at rest has important implications in work situations, during physical rehabilitation and when training for competitive sports.

Originalsprog Engelsk
Tidsskrift Physiological Reports
Vol/bind 7
Udgave nummer 11
Sider (fra-til) e14109
ISSN 2051-817X
DOI
Status Udgivet - jun. 2019

Bibliografisk note

© 2019 The Authors. Physiological Reports published by Wiley Periodicals, Inc. on behalf of The Physiological Society and the American Physiological Society.

Night work and miscarriage: a Danish nationwide register-based cohort study

Begtrup, L. M., Specht, I. O., Hammer, P. E. C., Flachs, E. M., Garde, A. H., Hansen, J., Hansen, Å. M., Kolstad, H. A., Larsen, A. D. & Bonde, J. P., maj 2019, I : Occupational and Environmental Medicine. s. 302-308 7 s.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

OBJECTIVE: Observational studies indicate an association between working nights and miscarriage, but inaccurate exposure assessment precludes causal inference. Using payroll data with exact and prospective measurement of night work, the objective was to investigate whether working night shifts during pregnancy increases the risk of miscarriage.

METHODS: A cohort of 22 744 pregnant women was identified by linking the Danish Working Hour Database (DWHD), which holds payroll data on all Danish public hospital employees, with Danish national registers on births and admissions to hospitals (miscarriage). The risk of miscarriage during pregnancy weeks 4-22 according to measures of night work was analysed using Cox regression with time-varying exposure adjusted for a fixed set of potential confounders.

RESULTS: In total 377 896 pregnancy weeks (average 19.7) were available for follow-up. Women who had two or more night shifts the previous week had an increased risk of miscarriage after pregnancy week 8 (HR 1.32 (95% CI 1.07 to 1.62) compared with women, who did not work night shifts. The cumulated number of night shifts during pregnancy weeks 3-21 increased the risk of miscarriages in a dose-dependent pattern.

CONCLUSIONS: The study corroborates earlier findings that night work during pregnancy may confer an increased risk of miscarriage and indicates a lowest observed threshold level of two night shifts per week.

Originalsprog Engelsk
Tidsskrift Occupational and Environmental Medicine
Sider (fra-til) 302-308
Antal sider 7
ISSN 1351-0711
DOI
Status Udgivet - maj 2019

Bibliografisk note

© Author(s) (or their employer(s)) 2019. No commercial re-use. See rights and permissions. Published by BMJ.

Night work and sick leave during pregnancy: a national register-based within-worker cohort study

Hammer, P. E. C., Garde, A. H., Begtrup, L. M., Flachs, E. M., Hansen, J., Hansen, Å. M., Hougaard, K. S., Kolstad, H. A., Larsen, A. D., Pinborg, A. B., Specht, I. O. & Bonde, J. P., mar. 2019, I : Occupational and Environmental Medicine. 76, 3, s. 163-168 6 s.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

OBJECTIVE: The aim of our study was to investigate the acute effect of night work during pregnancy on the risk of calling in sick the following day using register-based information and the workers as their own controls.

METHODS: Using the payroll-based national Danish Working Hour Database, including all public hospital employees in Denmark, we identified 9799 pregnant women with ≥1 day shift and ≥1 night shift and ≥1 day of sick leave during the first 32 pregnancy weeks from January 2007 to December 2013. We performed fixed effects logistic regression, that is, within-worker comparisons, of the risk of sick leave of any duration starting within 24 hours after night shifts of different length versus day shifts.

RESULTS: Most of the participants were nurses (64%) or physicians (16%). We found an increased relative risk of sick leave following night shifts compared with day shifts during all pregnancy trimesters. The risk was highest for night shifts lasting >12 hours (OR 1.37, 95% CI 1.15 to 1.63 for nurses; OR 1.87, 95% CI 1.69 to 2.08 for physicians) and among women aged >35 years (OR 1.42, 95% CI 1.24 to 1.63).

CONCLUSION: Among Danish public hospital employees night shifts during pregnancy, especially shifts longer than 12 hours, increased the risk of calling in sick the following day independent of personal factors and time-invariant confounders in all pregnancy trimesters.

Originalsprog Engelsk
Tidsskrift Occupational and Environmental Medicine
Vol/bind 76
Udgave nummer 3
Sider (fra-til) 163-168
Antal sider 6
ISSN 1351-0711
DOI
Status Udgivet - mar. 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

OMERACT Development of a Core Domain Set of Outcomes for Shared Decision-making Interventions

Toupin-April, K., Barton, J. L., Fraenkel, L., Meara, A., Li, L. C., Brooks, P., de Wit, M., Stacey, D., Légaré, F., Shea, B., Lyddiatt, A., Hofstetter, C., Christensen, R., Scholte Voshaar, M., Suarez-Almazor, M. E., Boonen, A., Meade, T., March, L., Jull, J. E., Campbell, W., Alten, R., Karuranga, S., Morgan, E. M., Kelly, A., Kaufman, J., Hill, S., Maxwell, L. J., Beaton, D., El-Miedany, Y., Mittoo, S., Bartlett, S. J., Singh, J. A. & Tugwell, P. S., okt. 2019, I : Journal of Rheumatology. 46, 10, s. 1409-1414 6 s.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

OBJECTIVE: The Outcome Measures in Rheumatology (OMERACT) Shared Decision Making (SDM) Working Group aims to determine the core outcome domain set for measuring the effectiveness of SDM interventions in rheumatology trials.

METHODS: A white paper was developed to clarify the draft core domain set. It was then used to prepare for interviews to investigate reasons for lack of consensus on it and to suggest further improvements.

RESULTS: OMERACT scientists/clinicians (n = 13) and patients (n = 10) suggested limiting the core domain set to outcome domains, removing process domains, and clarifying remaining domains.

CONCLUSION: A revised core domain set will undergo further consensus-building.

Originalsprog Engelsk
Tidsskrift Journal of Rheumatology
Vol/bind 46
Udgave nummer 10
Sider (fra-til) 1409-1414
Antal sider 6
ISSN 0315-162X
DOI
Status Udgivet - okt. 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

Osteoarthritis phenotypes and novel therapeutic targets

Van Spil, W. E., Kubassova, O., Boesen, M., Bay-Jensen, A-C. & Mobasheri, A., jul. 2019, I : Biochemical Pharmacology. 165, s. 41-48 8 s.

Publikation: Bidrag til tidsskriftReviewForskningpeer review

The success of disease-modifying osteoarthritis drug (DMOAD) development is still elusive. While there have been successes in preclinical and early clinical studies, phase 3 clinical trials have failed so far and there is still no approved, widely available DMOAD on the market. The latest research suggests that, among other causes, poor trial outcomes might be explained by the fact that osteoarthritis (OA) is a heterogeneous disease with distinct phenotypes. OA trials might be more successful if they would address and target a specific phenotype. The increasing availability of advanced techniques to detect particular OA characteristics expands the possibilities to distinguish between such potential OA phenotypes. Magnetic resonance imaging is among the key imaging techniques to stratify and monitor patients with changes in bone, cartilage and inflammation. Biochemical markers have mainly used as secondary parameters and could further delineate phenotypes. Moreover, post-hoc analyses of trial data have suggested the existence of distinct pain phenotypes and their relevance in the design of clinical trials. Although ongoing work in the field supports the concept of OA heterogeneity, this has not yet resulted in more effective treatment options. This paper reviews the current knowledge about potential OA phenotypes and suggests that combining patient clinical data, quantitative imaging, biochemical markers and utilizing data-driven approaches in patient selection and efficacy assessment will allow for more successful development of effective DMOADs.

Originalsprog Engelsk
Tidsskrift Biochemical Pharmacology
Vol/bind 165
Sider (fra-til) 41-48
Antal sider 8
ISSN 0006-2952
DOI
Status Udgivet - jul. 2019

Bibliografisk note

Copyright © 2019 The Authors. Published by Elsevier Inc. All rights reserved.

Pain Measurement in Rheumatic and Musculoskeletal Diseases: Where To Go from Here? Report from a Special Interest Group at OMERACT 2018

Chiarotto, A., Kaiser, U., Choy, E., Christensen, R., Conaghan, P. G., Cowern, M., Gill, M., de Wit, M., Gargon, E., Horgan, B., Kirkham, J. J., Simon, L. S., Singh, J. A., Tugwell, P., Turk, D. C. & Mease, P. J., okt. 2019, I : Journal of Rheumatology. 46, 10, s. 1355-1359 5 s.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

OBJECTIVE: Establishing a research agenda on standardizing pain measurement in clinical trials in rheumatic and musculoskeletal diseases (RMD).

METHODS: Discussion during a meeting at the Outcome Measures in Rheumatology (OMERACT) 2018, prepared by a systematic review of existing core outcome sets and a patient online survey.

RESULTS: Several key questions were debated: Is pain a symptom or a disease? Are pain core (sub)domains consistent across RMD? How to account for pain mechanistic descriptors (e.g., central sensitization) in pain measurement?

CONCLUSION: Characterizing and assessing the spectrum of pain experience across RMD in a standardized fashion is the objective of the OMERACT Pain Working Group.

Originalsprog Engelsk
Tidsskrift Journal of Rheumatology
Vol/bind 46
Udgave nummer 10
Sider (fra-til) 1355-1359
Antal sider 5
ISSN 0315-162X
DOI
Status Udgivet - okt. 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.

Patient Perspectives on DMARD Safety Concerns in Rheumatology Trials: Results from Inflammatory Arthritis Patient Focus Groups and OMERACT Attendees Discussion

Andersen, K. M., Kelly, A., Lyddiatt, A., Bingham, C. O., Bykerk, V. P., Batterman, A., Westreich, J., Jones, M. K., Cross, M., Brooks, P. M., March, L., Shea, B., Tugwell, P., Simon, L. S., Christensen, R. & Bartlett, S. J., sep. 2019, I : Journal of Rheumatology. 46, 9, s. 1168-1172 5 s.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

OBJECTIVE: The Outcome Measures in Rheumatology (OMERACT) Safety Working Group is identifying core safety domains that matter most to patients with rheumatic disease.

METHODS: International focus groups were held with 39 patients with inflammatory arthritis to identify disease-modifying antirheumatic drug (DMARD) experiences and concerns. Themes were identified by pragmatic thematic coding and discussed in small groups by meeting attendees.

RESULTS: Patients view DMARD side effects as a continuum and consider the cumulative effect on day-to-day function. Disease and drug experiences, personal factors, and life circumstances influence tolerance of side effects and treatment persistence.

CONCLUSION: Patients weigh overall adverse effects and benefits over time in relation to experiences and life circumstances.

Originalsprog Engelsk
Tidsskrift Journal of Rheumatology
Vol/bind 46
Udgave nummer 9
Sider (fra-til) 1168-1172
Antal sider 5
ISSN 0315-162X
DOI
Status Udgivet - sep. 2019

Patient-reported 1-year outcome not affected by body mass index in 3,327 total knee arthroplasty patients

Overgaard, A., Lidgren, L., Sundberg, M., Robertsson, O. & W-Dahl, A., aug. 2019, I : Acta Orthopaedica (Print Edition). 90, 4, s. 360-365 6 s.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Background and purpose - Patient-reported outcome (PRO) in total knee arthroplasty (TKA) patients with high body mass index (BMI) is controversial. We compared pain, function, quality of life, general health, and satisfaction among different BMI categories preoperatively and 1 year after primary TKA. Patients and methods - 4,318 patients were operated with a TKA for knee osteoarthritis in the Region of Skane in 2013-2015. In all, 3,327 patients (77%) had complete PRO data and information on BMI and were included. Preoperatively the patients filled in the Knee injury and Osteoarthritis Outcome Score (KOOS) and EQ-VAS (general health). 1 year postoperatively the same questionnaires were filled in together with a question asking whether they were satisfied with the surgery. Information on age, sex, BMI, and ASA grade were obtained from the Swedish Knee Arthroplasty Register. Each patient was classified as Outcome Measures in Rheumatology- Osteoarthritis Research Society International (OMERACT-OARSI) responder or not based on a combination of absolute and relative changes in scores. Welch's t-test and a chi-square test were used in the statistical analysis. Results - Both preoperatively and 1 year postoperatively the obese patients reported somewhat worse scores than the normal weight and overweight. The differences were small with 1 exception, the KOOS sport- and recreation function postoperatively, where normal-weight and overweight patients reported fewer problems than obese patients with a BMI over 35 (40 and 39 points vs. 31 points, p < 0.001). Similar proportions of patients were satisfied and categorized as OMERACT-OARSI responders in the different BMI categories. Interpretation - The degree of improvement in PROs 1 year after TKA surgery does not seem to be affected by BMI.

Originalsprog Engelsk
Tidsskrift Acta Orthopaedica (Print Edition)
Vol/bind 90
Udgave nummer 4
Sider (fra-til) 360-365
Antal sider 6
ISSN 1745-3674
DOI
Status Udgivet - aug. 2019

Patients with rheumatoid arthritis acquire sustainable skills for home monitoring: a prospective dual-country cohort study (ELECTOR clinical trial I)

Skougaard, M., Bliddal, H., Christensen, R., Ellegaard, K., Nielsen, S. M., Zavada, J., Oreska, S., Krogh, N. S., Holm, C. C., Hetland, M. L., Vencovsky, J., Røgind, H., Taylor, P. C. & Gudbergsen, H., 15 aug. 2019, I : Journal of Rheumatology.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

OBJECTIVE: In an eHealth setting, to investigate intra- and inter-rater reliability and agreement of joint assessments and disease activity score (DAS28CRP) in patients with rheumatoid arthritis (RA) and test the effect of repeated joint assessment training.

METHODS: Patients with DAS28CRP ≤5.1 were included in a prospective cohort study (clinicaltrials.gov: NCT02317939). Intra-rater reliability and agreement of patient-performed joint counts were assessed through completion of five joint assessments over a two-month period. All patients received training on joint assessment at baseline, only half of the patients received repeated training. A subset of patients was included in an appraisal of inter-rater reliability and agreement comparing joint assessments completed by patients, healthcare professionals (HCPs), and ultrasonography. Cohen's Kappa coefficients and intraclass correlation coefficients (ICC) were used for quantifying of reliability of joint assessments and DAS28CRP. Agreement was assessed using Bland-Altman plots.

RESULTS: Intra-rater reliability was excellent with ICC of 0.87 (95%CI: 0.83 to 0.90) and minimal detectable change of 1.13. ICCs for inter-rater reliability ranged between 0.69 and 0.90 (good to excellent). Patients tended to rate DAS28CRP slightly higher than HCPs. In patient receiving repeated training, a mean difference in DAS28CRP of -0.08 was observed (limits of agreements of -1.06 and 0.90). After 2 months, reliability between patients and HCPs was similar between groups receiving single or repeated training.

CONCLUSION: Patient-performed assessments of joints and DAS28CRP in an eHealth home-monitoring solution were reliable and comparable with HCPs. Patients can acquire the necessary skills to conduct a correct joint assessment after initial and thorough training.

Originalsprog Engelsk
Tidsskrift Journal of Rheumatology
ISSN 0315-162X
DOI
Status E-pub ahead of print - 15 aug. 2019

OBJECTIVE: To investigate the association between pain and perfusion in bone marrow lesions with and without cysts assessed dynamic contrast-enhanced (DCE)-MRI in patients with knee osteoarthritis.

SUBJECTS AND METHODS: In a cross-sectional setting, perfusion in bone marrow lesions was assessed using 3 Tesla MRI and correlated (Spearman's rank correlation) to pain using the knee injury and osteoarthritis outcome score (KOOS). Bone marrow lesions were assessed across the whole knee with DCE-MRI using heuristic variable and non-contrast-enhanced-MRI using MRI osteoarthritis knee score.

RESULTS: Data were available from 107 participants. The participants had a mean age of 60.8 years, mean BMI of 34.5 kg/m2, mean KOOS-pain of 63.7 (0-100 scale), and mean bone marrow lesion sum score of 6.5 (0-45 scale). The bivariate association between KOOS-pain and the heuristic perfusion variable time to peak in bone marrow lesions containing subchondral cysts showed a statistically significant correlation (r = 0.40; p = 0.002). The perfusion variables were not correlated with KOOS-pain in bone marrow lesions without cysts.

CONCLUSION: In this cross-sectional study, the rate of perfusion (TTP) in bone marrow lesions containing subchondral cysts was associated with pain in patients with knee OA. DCE-MRI has a potential to be used for separating subtypes of OA.

Originalsprog Engelsk
Tidsskrift Skeletal Radiology
Sider (fra-til) e-pub
ISSN 0364-2348
DOI
Status E-pub ahead of print - 9 dec. 2019

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

Pages