Published in 2016

BACKGROUND: Assessment of depression in chronic pain patients by self-rating questionnaires developed and validated for use in normal and/or psychiatric populations is common. The aim of this study was to evaluate the psychometric properties of the Major Depression Inventory (MDI) in a sample of females with chronic widespread pain (CWP).

METHOD: A total of 263 females diagnosed with CWP and referred for rehabilitation completed the MDI as part of the baseline evaluation. Rasch analysis was applied to this dataset. Rasch measurement models allow detailed analyses of an instrument's rating scale and further aspects of validity, including fit of individual scale items to a unidimensional model indicating assessment of a single construct (depression), as a prerequisite for measurement.

RESULTS: The Rasch analysis revealed substantial problems with the rating scale properties of the MDI and lack of unidimensionality. In contrast to somatic items, MDI items related to depressed mood and negative view of oneself were distributed at the higher end of the item difficulty measurement scale, indicating low endorsement of these items.

DISCUSSION: From the perspective of the Rasch measurement model, the MDI demonstrated insufficient psychometric properties when used to identify and quantify severity of depression in a clinical sample of females with CWP. The observed item endorsement pattern indicated that, in this study population, the relatively high depression severity scores primarily pertained to a common core of pain-related somatic symptoms. Careful consideration when interpreting questionnaire-derived scores of depression implemented in research and routine clinical care of patients with chronic pain is warranted.

Originalsprog Engelsk
Tidsskrift Scandinavian Journal of Rheumatology
Vol/bind 45
Tidsskriftsnummer 3
Sider (fra-til) 236-46
Antal sider 11
ISSN 0300-9742
DOI
Status Udgivet - maj 2016

Towards evidence based research

Lund, H., Brunnhuber, K., Juhl, C., Robinson, K., Leenaars, M., Dorch, B. F., Jamtvedt, G., Nortvedt, M. W., Christensen, R. & Chalmers, I. 21 okt. 2016 I : B M J (Online). 355, s. i5440

Publikation: Forskning - peer reviewTidsskriftartikel

Originalsprog Engelsk
Tidsskrift B M J (Online)
Vol/bind 355
Sider (fra-til) i5440
ISSN 1756-1833
Status Udgivet - 21 okt. 2016

Treatment of adult patients with schizophrenia and complex mental health needs - A national clinical guideline

Baandrup, L., Østrup Rasmussen, J., Klokker, L., Austin, S. F., Bjørnshave, T., Bliksted, V. F., Fink-Jensen, A., Hedegaard Fohlmann, A., Peter Hansen, J., Kristine Nielsen, M., Sandsten, K. E., Schultz, V., Voss-Knude, S. & Nordentoft, M. apr. 2016 I : Nordic Journal of Psychiatry. 70, 3, s. 231-240 10 s., 3

Publikation: Forskning - peer reviewTidsskriftartikel

BACKGROUND AND AIM: The Danish Health and Medicines Authority assembled a group of experts to develop a national clinical guideline for patients with schizophrenia and complex mental health needs. Within this context, ten explicit review questions were formulated, covering several identified key issues.

METHODS: Systematic literature searches were performed stepwise for each review question to identify relevant guidelines, systematic reviews/meta-analyses, and randomized controlled trials. The quality of the body of evidence for each review question was assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system. Clinical recommendations were developed on the basis of the evidence, assessment of the risk-benefit ratio, and perceived patient preferences.

RESULTS: Based on the identified evidence, a guideline development group (GDG) recommended that the following interventions should be offered routinely: antipsychotic maintenance therapy, family intervention and assertive community treatment. The following interventions should be considered: long-acting injectable antipsychotics, neurocognitive training, social cognitive training, cognitive behavioural therapy for persistent positive and/or negative symptoms, and the combination of cognitive behavioural therapy and motivational interviewing for cannabis and/or central stimulant abuse. SSRI or SNRI add-on treatment for persistent negative symptoms should be used only cautiously. Where no evidence was available, the GDG agreed on a good practice recommendation.

CONCLUSIONS: The implementation of this guideline in daily clinical practice can facilitate good treatment outcomes within the population of patients with schizophrenia and complex mental health needs. The guideline does not cover all available interventions and should be used in conjunction with other relevant guidelines.

Originalsprog Engelsk
Artikelnummer 3
Tidsskrift Nordic Journal of Psychiatry
Vol/bind 70
Tidsskriftsnummer 3
Sider (fra-til) 231-240
Antal sider 10
ISSN 0803-9488
DOI
Status Udgivet - apr. 2016

Treatment of persistent pain from torture: review and commentary

Williams, A. C. D. C. & Amris, K. 13 okt. 2016 I : Medicine, Conflict and Survival. s. 1-22 22 s.

Publikation: Forskning - peer reviewTidsskriftartikel

Torture and the conditions under which it is inflicted often leave persistent painful disorders. Because there may be no lasting signs, persistent pain is often misconceived as a somatic representation of psychological distress, also common after torture. This serious failure to understand the nature of persistent pain means that pain is largely overlooked and untreated in torture survivors. We carried out a systematic review on treatments for pain from torture, but found few studies and little use of current understanding and evidence. We discuss this in the context of treating pain associated with psychological distress and of the broader problems faced by the refugee and torture survivor that may take priority over pain. We propose clinical and research implications for this neglected field.

Originalsprog Engelsk
Tidsskrift Medicine, Conflict and Survival
Sider (fra-til) 1-22
Antal sider 22
ISSN 1362-3699
DOI
Status Udgivet - 13 okt. 2016

OBJECTIVE: Previous studies have suggested a link between inflammation and central sensitization of pain in patients with RA. We conducted a prospective cohort study to determine whether US Doppler (USD), temporal summation (TS) of pain-assessed at baseline-and the potential interaction between them could predict the treatment response in RA.

METHODS: Patients were recruited from Departments of Rheumatology in the Copenhagen area and from private clinics. RA patients, who were scheduled to initiate therapy with either a conventional synthetic DMARD (csDMARD; including DMARD-naïve patients) or a biologic DMARD (bDMARD) agent (including bDMARD switch), were included and examined before the start of treatment and after 4 months. During the 4 months, patients received routine care from their treating rheumatologist.

RESULTS: Multiple regression analysis was conducted, with change in DAS28 as the dependent variable. In unadjusted models, baseline USD score was significantly associated with DAS28 (β = 0.06; 95% CI: 0.02, 0.09; P < 0.001), whereas TS and their interaction were not. After adjusting for age, sex, disease duration, baseline DAS28 and whether patients initiated a csDMARD or a bDMARD, the USD score was still significantly associated with change in DAS28 (β = 0.032; 95% CI: 0.001, 0.064; P = 0.046), whereas TS remained insignificant.

CONCLUSION: USD assessed at baseline is valuable as a prognostic factor for change in disease activity in 'real-life' RA patients. We did not find evidence to suggest that TS or the interaction between USD and TS was prognostically important for this group of patients.

Originalsprog Engelsk
Tidsskrift Rheumatology (Online)
Vol/bind 55
Tidsskriftsnummer 6
Sider (fra-til) 1091-8
Antal sider 8
ISSN 1462-0332
DOI
Status Udgivet - jun. 2016

Ultrasound-Guided Injection Therapy of Achilles Tendinopathy With Platelet-Rich Plasma or Saline: A Randomized, Blinded, Placebo-Controlled Trial

Krogh, T. P., Ellingsen, T., Christensen, R., Jensen, P. & Fredberg, U. aug. 2016 I : The American journal of sports medicine. 44, 8, s. 1990-7 8 s.

Publikation: Forskning - peer reviewTidsskriftartikel

BACKGROUND: Achilles tendinopathy (AT) is a common and difficult to treat musculoskeletal disorder.

PURPOSE: To examine whether 1 injection of platelet-rich plasma (PRP) would improve outcomes more effectively than placebo (saline) after 3 months in patients with AT.

STUDY DESIGN: Randomized controlled trial; Level of evidence, 1.

METHODS: A total of 24 patients with chronic AT (median disease duration, 33 months) were randomized (1:1) to receive either a blinded injection of PRP (n = 12) or saline (n = 12). The primary endpoint was improvement in Victorian Institute of Sports Assessment-Achilles (VISA-A) score at 3 months. Secondary outcomes were pain at rest, pain while walking, pain when tendon was squeezed, ultrasonographic changes in tendon thickness, and color Doppler activity. Patients were informed that they could drop out after 3 months if they were dissatisfied with the treatment.

RESULTS: After 3 months, all 24 patients were reassessed (no dropouts). No difference between the PRP and the saline group could be observed with regard to the primary outcome (VISA-A score: mean difference [MD], -1.3; 95% CI, -17.8 to 15.2; P = .868). Secondary outcomes were pain at rest (MD, 1.6; 95% CI, -0.5 to 3.7; P = .137), pain while walking (MD, 0.8; 95% CI, -1.8 to 3.3; P = .544), pain when tendon was squeezed (MD, 0.3; 95% CI, -0.2 to 0.9; P = .208), color Doppler activity (MD, 0.3; 95% CI, -0.2 to 0.8; P = .260), and tendon thickness (MD, 0.8 mm; 95% CI, 0.1 to 1.6 mm; P = .030). After the 3-month follow-up, a large dropout was observed: 75% of patients in the PRP group and 33% in the saline group.

CONCLUSION: PRP injection did not result in an improved VISA-A score over a 3-month period in patients with chronic AT compared with placebo. The only secondary outcome demonstrating a statistically significant difference between the groups was change in tendon thickness; this difference indicates that a PRP injection could increase tendon thickness compared with saline injection. The conclusions are limited to the 3 months after treatment owing to the large dropout rate.

Originalsprog Engelsk
Tidsskrift The American journal of sports medicine
Vol/bind 44
Tidsskriftsnummer 8
Sider (fra-til) 1990-7
Antal sider 8
ISSN 0363-5465
DOI
Status Udgivet - aug. 2016

Using serum urate as a validated surrogate end point for flares in patients with gout: protocol for a systematic review and meta-regression analysis

Morillon, M. B., Stamp, L., Taylor, W., Fransen, J., Dalbeth, N., Singh, J. A., Christensen, R. & Lassere, M. 2016 I : B M J Open. 6, 9, s. e012026

Publikation: Forskning - peer reviewTidsskriftartikel

INTRODUCTION: Gout is the most common inflammatory arthritis in men over 40 years of age. Long-term urate-lowering therapy is considered a key strategy for effective gout management. The primary outcome measure for efficacy in clinical trials of urate-lowering therapy is serum urate levels, effectively acting as a surrogate for patient-centred outcomes such as frequency of gout attacks or pain. Yet it is not clearly demonstrated that the strength of the relationship between serum urate and clinically relevant outcomes is sufficiently strong for serum urate to be considered an adequate surrogate. Our objective is to investigate the strength of the relationship between changes in serum urate in randomised controlled trials and changes in clinically relevant outcomes according to the 'Biomarker-Surrogacy Evaluation Schema version 3' (BSES3), documenting the validity of selected instruments by applying the 'OMERACT Filter 2.0'.

METHODS AND ANALYSIS: A systematic review described in terms of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) reporting guidelines will identify all relevant studies. Standardised data elements will be extracted from each study by 2 independent reviewers and disagreements are resolved by discussion. The data will be analysed by meta-regression of the between-arm differences in the change in serum urate level (independent variable) from baseline to 3 months (or 6 and 12 months if 3-month values are not available) against flare rate, tophus size and number and pain at the final study visit (dependent variables).

ETHICS AND DISSEMINATION: This study will not require specific ethics approval since it is based on analysis of published (aggregated) data. The intended audience will include healthcare researchers, policymakers and clinicians. Results of the study will be disseminated by peer-reviewed publications.

TRIAL REGISTRATION NUMBER: CRD42016026991.

Originalsprog Engelsk
Tidsskrift B M J Open
Vol/bind 6
Tidsskriftsnummer 9
Sider (fra-til) e012026
ISSN 2044-6055
DOI
Status Udgivet - 2016

Fortification of margarine with vitamin D was mandatory in Denmark during 1961-1985. The aim of the study was to assess whether gestational and early infancy exposure to margarine fortification was associated with seasonality of birth in Danish type 1 diabetes (T1D) patients. The risks of T1D in Danes born during various exposure periods around margarine fortification termination in 1985 were analyzed. As expected, the T1D hazards in males unexposed to margarine fortification and born in spring were higher than in males born in autumn: relevant hazard ratios (95% confidence intervals) in various exposure groups ranged from 1.74 (1.112/2.708) to 37.43 (1.804/776.558). There were no indications of seasonality of birth in males exposed to fortification, nor in both exposed and unexposed females. The study suggests that early life exposure to low-dose vitamin D from fortified food eliminates seasonality of birth in T1D male patients. Further studies are required to investigate the identified gender differences.

Originalsprog Engelsk
Tidsskrift Journal of Developmental Origins of Health and Disease
Vol/bind 7
Tidsskriftsnummer 1
Sider (fra-til) 114-19
ISSN 2040-1744
DOI
Status Udgivet - 2016

”Self‐efficacy and Rehabilitation of Patients with Fibromyalgia”

Rasmussen, M. U., Sjölund, B. H., Rydahl-Hansen, S., Amris, K., Mortensen, E. L. & Danneskiold-Samsøe, B. 2016

Publikation: ForskningPh.d.-afhandling

Originalsprog Engelsk
Status Udgivet - 2016

Published in 2015

The aim was to assess change in activities of daily living (ADL) ability amongst asylum seekers and if there were any difference between tortured and non-torture following a 10 months post-arrival period, and if self-reported health and exposure to torture were factors related to change in ADL-ability. The study was a combined baseline, follow-up correlational study amongst individuals from Afghanistan, Iran and Syria, living in Danish asylum centers. Forty-three persons aged 20-50, were invited and participated in the baseline study. Twenty-two were still in asylum center at the follow-up and 17 of them participated. ADL-ability was measured using Assessment of Motor and Process Skills and questionnaires about exposure to torture, self-reported mental health and pain. ADL motor and process measures, well-being and self-rated health declined from baseline to follow-up. Measures of pain and depression increased. Exposure to physical torture and change in ADL motor (r = 0.525) measures were associated, as well as change in current pain and change in ADL process (r = 0.525) measures. Due to preponderance of torture survivors analysis of group difference was not applicable. Health care workers should be aware of ADL concerns and exposure to torture in this population to best address their needs within rehabilitation settings.

Originalsprog Engelsk
Tidsskrift Journal of immigrant and minority health / Center for Minority Public Health
Vol/bind 17
Tidsskriftsnummer 3
Sider (fra-til) 852-9
Antal sider 8
DOI
Status Udgivet - jun. 2015

Adherence to methotrexate in rheumatoid arthritis: a danish nationwide cohort study

Bliddal, H., Eriksen, S. A., Christensen, R., Lorenzen, T., Hansen, M. S., Østergaard, M., Dreyer, L., Luta, G. & Vestergaard, P. 2015 I : Arthritis. 2015, s. 915142

Publikation: Forskning - peer reviewTidsskriftartikel

Objectives. To study adherence to methotrexate (MTX) and factors of importance thereof in patients with rheumatoid arthritis (RA). Methods. Patients with a hospital diagnosis of RA (ICD10 codes M05.X or M06.X) after January 1, 1997, and aged ≥18 years at the date of first diagnosis/contact, with at least one prescription of MTX (L04AX03), were included. Results. A total of 18,703 (47.6%) patients had ever used MTX among 39,286 with a diagnosis of RA; among the MTX users, 16,503 (88.2%) had filed more than one MTX prescription. The median time from diagnosis to first MTX prescription was 0.66 (IQR 0.26-1.80) years. In those who filed more than one MTX prescription, the mean adherence time for ≥7.5 mg MTX per week was 1,925 (IQR 467-3,056) days for patients treated in private practice versus 1,892 (IQR 452-3,316) days for patients treated in hospital. The main determinants of nonadherence were female gender, younger age, and time from diagnosis to initiation of MTX. Conclusions. Treatment at hospital or in private practice did not influence the adherence to MTX. Nonmodifiable factors of importance were gender and age, while adherence to MTX therapy decreased with time lapse between diagnosis and prescription.

Originalsprog Engelsk
Tidsskrift Arthritis
Vol/bind 2015
Sider (fra-til) 915142
ISSN 2090-1984
DOI
Status Udgivet - 2015
Originalsprog Engelsk
Tidsskrift Arthritis & Rheumatology
Vol/bind 67
Tidsskriftsnummer S10
Sider (fra-til) 223-5
Antal sider 3
ISSN 1537-2960
Status Udgivet - 2015

OBJECTIVES: To compare data based on computerized and paper versions of health status questionnaires (HSQs) for sampling patient-reported outcomes (PROs) in patients with fibromyalgia (FM). In addition, to examine associations between patient characteristics (age, education, computer experience) and differences between versions. Finally, to evaluate the acceptability of computer-based questionnaires among patients with FM.

METHOD: The study population comprised female patients diagnosed with FM. All patients completed six HSQs: the Fibromyalgia Impact Questionnaire (FIQ), the Major Depression Inventory (MDI), the 36-item Short Form Health Survey (SF-36), the painDETECT questionnaire (PDQ), the Coping Strategies Questionnaire (CSQ), and the Generalized Anxiety Disorder Self-Assessment Questionnaire (GAD-10), both on paper and using a touch screen. One HSQ was tested at a time in a repeated randomized cross-over design. The two versions were completed with a 5-min interval and between each HSQ the participants had a 5-min break. Means, mean differences with 95% confidence intervals (CIs), medians, median differences, and intraclass correlation coefficients (ICCs) were calculated for all HSQs, including relevant subscales. Associations between patient characteristics and differences between versions were explored using Spearman's correlation coefficients.

RESULTS: Twenty women, mean age 48.4 years, participated in the study. Except for one item, ICCs between touch-screen and paper versions of the HSQs examined indicated acceptable agreement (ICC = 0.71-0.99). Overall, mean and median differences revealed no differences between versions. No significant associations were observed for patient characteristics. None of the participants preferred paper questionnaires over computerized versions.

CONCLUSIONS: The computerized HSQs using a touch screen gave comparable results to answers given on paper and were generally preferred by the participants.

Originalsprog Engelsk
Tidsskrift Scandinavian Journal of Rheumatology
Vol/bind 44
Tidsskriftsnummer 6
Sider (fra-til) 503-10
Antal sider 8
ISSN 0300-9742
DOI
Status Udgivet - nov. 2015

Antibodies to infliximab and adalimumab in patients with rheumatoid arthritis in clinical remission: a cross-sectional study

Eng, G. P., Bendtzen, K., Bliddal, H., Stoltenberg, M., Szkudlarek, M., Fana, V., Lindegaard, H. M., Omerovic, E., Højgaard, P., Jensen, E. K. & Bouchelouche, P. N. 2015 I : Arthritis. 2015, s. 784825

Publikation: Forskning - peer reviewTidsskriftartikel

Objective. To investigate if antibodies towards biological TNF-α inhibitors (anti-TNFi Abs) are present in patients with rheumatoid arthritis (RA) in clinical remission and to relate any anti-TNFi Abs to circulating level of TNF-α inhibitor (TNFi). Methods. Patients with RA, treated with infliximab or adalimumab, and in clinical remission (DAS28(CRP) < 2.6) were included from 6 out-patient clinics. In blood samples, presence of anti-TNFi Abs was determined by radioimmunoassay, and concentration of bioactive TNFi was measured by a cell-based reporter gene assay. Results. Anti-TNFi Abs were present in 8/44 patients (18%) treated with infliximab and 1/49 patients (2%) treated with adalimumab (p = 0.012). In the former group, anti-TNFi Abs corresponded with low levels of TNFi (p = 0.048). Anti-TNFi Ab-positive patients had shorter disease duration at initiation of TNFi therapy (p = 0.023) but were similar for the rest of the compared parameters. Conclusions. In RA patients in clinical remission, anti-TNFi Abs occur frequently in patients treated with infliximab, while they occur rarely in patients treated with adalimumab. Presence of anti-infliximab Abs is accompanied by low or undetectable levels of infliximab. These data suggest that continued infliximab treatment may be redundant in a proportion of RA patients treated with infliximab and in clinical remission.

Originalsprog Engelsk
Tidsskrift Arthritis
Vol/bind 2015
Sider (fra-til) 784825
ISSN 2090-1984
DOI
Status Udgivet - 2015
Originalsprog Engelsk
Tidsskrift Pain
Udgivelsesdato 2015
ISSN 0304-3959
Status Afsendt

Assessing Elementary Lesions in Gout by Ultrasound: Results of an OMERACT Patient-based Agreement and Reliability Exercise

Terslev, L., Gutierrez, M., Christensen, R., Balint, P. V., Bruyn, G. A., Delle Sedie, A., Filippucci, E., Garrido, J., Hammer, H. B., Iagnocco, A., Kane, D., Kaeley, G. S., Keen, H., Mandl, P., Naredo, E., Pineda, C., Schicke, B., Thiele, R., D'Agostino, M. A., Schmidt, W. A. & OMERACT US Gout Task Force nov. 2015 I : Journal of Rheumatology. 42, 11, s. 2149-54 6 s.

Publikation: Forskning - peer reviewTidsskriftartikel

OBJECTIVE: To test the reliability of the consensus-based ultrasound (US) definitions of elementary gout lesions in patients.

METHODS: Eight patients with microscopically proven gout were evaluated by 16 sonographers for signs of double contour (DC), aggregates, erosions, and tophi in the first metatarsophalangeal joint and the knee bilaterally. The patients were examined twice using B-mode US to test agreement and inter- and intraobserver reliability of the elementary components.

RESULTS: The prevalence of the lesions were DC 52.8%, tophus 61.1%, aggregates 29.8%, and erosions 32.4%. The intraobserver reliability was good for all lesions except DC, where it was moderate. The best reliability per lesion was seen for tophus (κ 0.73, 95% CI 0.61-0.85) and lowest for DC (κ 0.53, 95% CI 0.38-0.67). The interobserver reliability was good for tophus and erosions, but fair to moderate for aggregates and DC, respectively. The best reliability was seen for erosions (κ 0.74, 95% CI 0.65-0.81) and lowest for aggregates (κ 0.21, 95% CI 0.04-0.37).

CONCLUSION: This is the first step to test consensus-based US definitions on elementary lesions in patients with gout. High intraobserver reliability was found when applying the definition in patients on all elementary lesions while interobserver reliability was moderate to low. Further studies are needed to improve the interobserver reliability, particularly for DC and aggregates.

Originalsprog Engelsk
Tidsskrift Journal of Rheumatology
Vol/bind 42
Tidsskriftsnummer 11
Sider (fra-til) 2149-54
Antal sider 6
ISSN 0315-162X
DOI
Status Udgivet - nov. 2015

Association between tobacco smoking and response to tumour necrosis factor α inhibitor treatment in psoriatic arthritis: results from the DANBIO registry

Højgaard, P., Glintborg, B., Hetland, M. L., Hansen, T. H., Lage-Hansen, P. R., Petersen, M., Holland-Fischer, M., Nilsson, A. C., Loft, A. G., Andersen, B. N., Adelsten, T., Jensen, J., Omerovic, E., Christensen, R., Tarp, U., Ostgård, R. & Dreyer, L. 2015 I : Annals of the Rheumatic Diseases. 74, 12, s. 2130-6

Publikation: Forskning - peer reviewTidsskriftartikel

OBJECTIVES: To investigate the association between tobacco smoking and disease activity, treatment adherence and treatment responses among patients with psoriatic arthritis (PsA) initiating the first tumour necrosis factor α inhibitor therapy (TNFi) in routine care.

METHODS: Observational cohort study based on the Danish nationwide DANBIO registry. Kaplan-Meier plots, logistic and Cox regression analyses by smoking status (current/previous/never smoker) were calculated for treatment adherence, ACR20/50/70-responses and EULAR-good-response. Additional stratified analyses were performed according to gender and TNFi-subtype (adalimumab/etanercept/infliximab).

RESULTS: Among 1388 PsA patients included in the study, 1148 (83%) had known smoking status (33% current, 41% never and 26% previous smokers). Median follow-up time was 1.22 years (IQR 0.44-2.96). At baseline, current smokers had lower Body Mass Index (27 kg/m(2) (23-30)/28 kg/m(2) (24-31)) (median (IQR)), shorter disease duration (3 years (1-8)/5 years (2-10)), lower swollen joint count (2 (0-5)/3 (1-6)), higher visual-analogue-scale (VAS) patient global (72 mm (54-87)/68 mm (50-80)), VAS fatigue (72 mm (51-86)/63 mm (40-77)) and Health Assessment Questionnaire (HAQ) score (1.1 (0.7 to 1.5)/1.0 (0.5 to 1.5)) than never smokers (all p<0.05). Current smokers had shorter treatment adherence than never smokers (1.56 years (0.97 to 2.15)/2.43 years (1.88 to 2.97), (median (95% CI)), log rank p=0.02) and poorer 6 months' EULAR-good-response rates (23%/34%), ACR20 (24%/33%) and ACR50 response rates (17%/24%) (all p<0.05), most pronounced in men. In current smokers, the treatment adherence was poorer for infliximab (HR) 1.62, 95% CI 1.06 to 2.48) and etanercept (HR 1.74, 1.14 to 2.66) compared to never smokers, but not for adalimumab (HR 0.80, 0.52 to 1.23).

CONCLUSION: In PsA, smokers had worse baseline patient-reported outcomes, shorter treatment adherence and poorer response to TNFi's compared to non-smokers. This was most pronounced in men and in patients treated with infliximab or etanercept.

Originalsprog Engelsk
Tidsskrift Annals of the Rheumatic Diseases
Vol/bind 74
Tidsskriftsnummer 12
Sider (fra-til) 2130-6
ISSN 0003-4967
DOI
Status Udgivet - 2015

Association of different levels of depressive symptoms with symptomatology, overall disease severity, and quality of life in women with fibromyalgia

Soriano-Maldonado, A., Amris, K., Ortega, F. B., Segura-Jiménez, V., Estévez-López, F., Álvarez-Gallardo, I. C., Aparicio, V. A., Delgado-Fernández, M., Henriksen, M. & Ruiz, J. R. dec. 2015 I : Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation. 24, 12, s. 2951-7 7 s.

Publikation: Forskning - peer reviewTidsskriftartikel

PURPOSE: This study examined the associations of different levels of depression with pain, sleep quality, fatigue, functional exercise capacity, overall fibromyalgia (FM) severity, and health-related quality of life (HRQoL) in women with FM.

METHODS: A total of 451 women with FM participated in this cross-sectional study. Depressive symptoms (Beck Depression Inventory; BDI-II), pain intensity (numerical rating scale; NRS), pain sensitivity (algometry), sleep quality (Pittsburgh Sleep Quality Index), fatigue (Multidimensional Fatigue Inventory), functional exercise capacity (6-min walk test), FM severity (revised Fibromyalgia Impact Questionnaire), and HRQoL (SF-36) were assessed.

RESULTS: Participants with severe depressive symptoms had significantly higher pain intensity (NRS = 1.1; 95 % CI 0.3-1.8), fatigue (12.6-units; 95 % CI 8.2-17.1) and overall FM severity (12.6-units; 95 % CI 11.4-23.7), as well as poorer sleep quality (3.2-units; 95 % CI 1.7-4.7) and mental component of HRQoL (-17.0-units; 95 % CI -21.0 to -12.9) than participants with minimal signs of depression. There was no association of signs of depression with pain sensitivity, exercise capacity, or the physical component of HRQoL (P > 0.05).

CONCLUSIONS: These results extend current knowledge on the association of signs of depression with FM severity and quality of life in women with FM, and suggest that severity of depressive symptoms could potentially be a prognostic factor to be considered in future prospective intervention studies.

Originalsprog Engelsk
Tidsskrift Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation
Vol/bind 24
Tidsskriftsnummer 12
Sider (fra-til) 2951-7
Antal sider 7
ISSN 0962-9343
DOI
Status Udgivet - dec. 2015

Association of Physical Fitness With Fibromyalgia Severity in Women: The al-Ándalus Project

Soriano-Maldonado, A., Henriksen, M., Segura-Jiménez, V., Aparicio, V. A., Carbonell-Baeza, A., Delgado-Fernández, M., Amris, K. & Ruiz, J. R. sep. 2015 I : Archives of Physical Medicine and Rehabilitation. 96, 9, s. 1599-605 7 s.

Publikation: Forskning - peer reviewTidsskriftartikel

OBJECTIVES: To assess the association between physical fitness and fibromyalgia (FM) severity in women with FM as well as to assess whether different fitness components present an independent relation with FM severity.

DESIGN: Population-based cross-sectional study.

SETTING: University facilities and FM associations.

PARTICIPANTS: Women with FM (N=444).

INTERVENTIONS: Not applicable.

MAIN OUTCOME MEASURES: FM severity was assessed with the Revised Fibromyalgia Impact Questionnaire (FIQR). Aerobic fitness (6-min walk test), muscle strength (handgrip, chair stand, and arm curl tests), flexibility (chair sit and reach and back scratch tests), and motor agility (8 foot Up and Go test) were measured with the Senior Fitness Test battery and digital dynamometry. A standardized composite score (hereafter "global fitness profile") was calculated and divided into quintiles.

RESULTS: Overall, physical fitness was significantly associated with the FIQR total and subscale scores, regardless of the fitness test used (all P<.05). The 6-minute walk and back-scratch tests were independently associated with the FIQR total score (R(2)=.88; both P<.005). The group with the highest global fitness profile had 16% lower FM severity than did the group with the lowest global fitness profile (P<.001).

CONCLUSIONS: Our results suggest that higher physical fitness is consistently associated with lower FM severity in women with FM. Aerobic fitness and flexibility present independent associations with FM severity. However, the FIQR variability explained by these fitness tests was rather low (<10%), and further research on the potential disagreement between performance-based physical fitness and different self-reported outcomes in women with FM is warranted.

Originalsprog Engelsk
Tidsskrift Archives of Physical Medicine and Rehabilitation
Vol/bind 96
Tidsskriftsnummer 9
Sider (fra-til) 1599-605
Antal sider 7
ISSN 0003-9993
DOI
Status Udgivet - sep. 2015

Associations between Exposure to Persistent Organic Pollutants in Childhood and Overweight up to 12 Years Later in a Low Exposed Danish Population

Tang-Péronard, J. L., Jensen, T. K., Andersen, H. R., Ried-Larsen, M., Grøntved, A., Andersen, L. B., Timmermann, C. A. G., Nielsen, F. & Heitmann, B. L. 29 jul. 2015 I : Obesity Facts. 8, 4, s. 282-292 11 s.

Publikation: Forskning - peer reviewTidsskriftartikel

BACKGROUND: Persistent organic pollutants (POPs) have metabolic disrupting abilities and are suggested to contribute to the obesity epidemic. We investigated whether serum concentrations of POPs at 8-10 years of age were associated with subsequent development of overweight at age 14-16 and 20-22 years.

METHODS: The study was based on data from the European Youth Heart Study, Danish component (1997). Concentrations of several polychlorinated biphenyls (PCBs) and the organochlorine pesticides p,p-dichlorodiphenyldichloroethylene (DDE) and hexachlorobenzene (HCB) were measured in serum from children aged 8-10 years (n = 509). Information on BMI z-scores, waist circumference and % body fat were collected at clinical examinations at ages 8-10, 14-16 and 20-22 years. Multiple linear regression analyses were performed taking potential confounders into account.

RESULTS: Overall, POP serum concentrations were low: median ΣPCB 0.18 µg/g lipid, DDE 0.04 µg/g lipid and HCB 0.03 µg/g lipid. POPs were generally not associated with weight gain at 14-16 and 20-22 years of age, except for an inverse association among the highest exposed girls at 20-22 years of age, which might possibly be explained by multiple testing or residual confounding.

CONCLUSION: This study suggests that, in a low exposed population, childhood serum concentrations of PCB, DDE, and HCB are not associated with subsequent weight gain. © 2015 S. Karger GmbH, Freiburg.

Originalsprog Engelsk
Tidsskrift Obesity Facts
Vol/bind 8
Tidsskriftsnummer 4
Sider (fra-til) 282-292
Antal sider 11
ISSN 1662-4025
DOI
Status Udgivet - 29 jul. 2015

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