1
|
Attia DHS, Mohamed ER, Ismaeel AY, Suliman YA, Moneim NHA, Abdel Noor RA. Insight into the Epidemiology of the Adult-onset Systemic Autoimmune Rheumatic Diseases in Egypt: A Descriptive Study of 8690 Patients. Curr Rheumatol Rev 2024; 20:522-533. [PMID: 38314595 DOI: 10.2174/0115733971277833231226071516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Revised: 11/05/2023] [Accepted: 12/07/2023] [Indexed: 02/06/2024]
Abstract
BACKGROUND/OBJECTIVE Although systemic autoimmune rheumatic diseases (SARDs) seem to be ubiquitous, Africa and the Middle East seem to be a remarkable exception with scarcity of data compared with the developed countries. Furthermore, most of the studies addressed a particular disease. This work aimed to shed light on the relative frequency and epidemiology of the different adult-onset SARDs in Egypt. METHODS This is a retrospective hospital-based study including six university hospitals providing free health care services: Cairo, Alexandria, Tanta, Suez Canal, Beni-Suef and Assiut University Hospitals. All available files for patients attending the outpatient clinics or admitted to the inpatient departments between January 2000 and December 2021 were retrospectively reviewed. Data about the patient's diagnosis, gender, age at disease onset, year of disease onset and residence were collected. RESULTS The study included 8690 patients. Rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), Behçet's disease (BD) and spondyloarthropathies (SPA) represented the main SARDs in Egypt. They mainly affect young patients below the age of 40 years. RA and SLE mainly affect females; males are mainly affected by axial SPA and BD. There is an increasing incidence of SARDs during the study period. CONCLUSION The study revealed the high burden of SARDs in Egypt, helping better allocation of economic resources for the management of diseases of the highest prevalence and those affecting the young reproductive age groups. Increased public and medical staff awareness about SARDs is recommended to help early referral of patients to rheumatologists and, hence, better estimation of their epidemiology.
Collapse
Affiliation(s)
- Doaa H S Attia
- Rheumatology and Rehabilitation Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Eman R Mohamed
- Physical Medicine, Rheumatology and Rehabilitation Department, Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Ahmed Y Ismaeel
- Internal Medicine Department, Faculty of Medicine, Beni-Suef University, Beni-Suef, Egypt
| | - Yossra A Suliman
- Rheumatology and Rehabilitation Department, Faculty of Medicine, Assiut University, Assiut, Egypt
| | - Nermeen H A Moneim
- Physical Medicine, Rheumatology & Rehabilitation Department, Faculty of Medicine, Suez Canal University, Suez, Egypt
| | - Rasha A Abdel Noor
- Internal Medicine and Rheumatology Department, Faculty of Medicine, Tanta University, Tanta, Egypt
| |
Collapse
|
2
|
Hokkanen AM, Aaltonen K, Relas H, Rutanen J, Kononoff A, Taimen K, Kauppi M, Puolakka K, Trokovic N, Nordström D. Impact of TNF inhibitor medication on working ability in axial spondyloarthritis: an observational national registry-based cohort study. Rheumatol Adv Pract 2023; 7:rkad050. [PMID: 37332300 PMCID: PMC10272299 DOI: 10.1093/rap/rkad050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Accepted: 05/03/2023] [Indexed: 06/20/2023] Open
Abstract
Objective The aim was to investigate the effect of TNF inhibitor (TNFi) initiation on working ability and health-care resource utilization among axial SpA patients in a real-life setting. Methods Patients with a clinical diagnosis of non-radiographic (nr-axSpA) or radiographic axial SpA initiating their first TNFi were identified from the National Register for Antirheumatic and Biologic Treatment in Finland. Sickness absences, including sick leave and disability pension, in- and outpatient days and rehabilitation rates, 1 year before and after initiating the medication were retrieved from national registries. Factors affecting result variables were studied using multivariate regression analysis. Results Overall, 787 patients were identified. Rates of work disability days per year were 55.6 the year before treatment onset and 55.2 the year after, with significant differences between patient subgroups. The rate of sick leave decreased after starting TNFi treatment. However, the rate of disability pension continued to rise. Patients with a diagnosis of nr-axSpA experienced a decrease in overall work disability and, especially, fewer sick leaves. No sex differences were detected. Conclusion TNFi interrupts the increase in work disabled days evident during the year before its initiation. However, the overall work disability remains high. Treating patients earlier in the nr-axSpA phase, regardless of sex, appears important in maintaining the ability to work.
Collapse
Affiliation(s)
- Anna-Mari Hokkanen
- Correspondence to: Anna-Mari Hokkanen, ROB-FIN Register, Division of Rheumatology, Helsinki University Hospital, Keskussairaalankatu 7, 15850 Lahti, Finland. E-mail:
| | - Kalle Aaltonen
- Pharmaceuticals Pricing Board, Ministry of Social Affairs and Health, Helsinki, Finland
| | - Heikki Relas
- Division of Rheumatology, Helsinki University Hospital, Helsinki University, Helsinki, Finland
| | - Jarno Rutanen
- Unit of Health Sciences, Faculty of Social Sciences, Tampere University, Tampere, Finland
- Centre for Rheumatic Diseases, Tampere University Hospital, Tampere, Finland
| | | | - Kirsi Taimen
- Division of Medicine, Turku University Hospital, Turku, Finland
| | - Markku Kauppi
- Division of Rheumatology, Päijät-Häme Central Hospital, Lahti, Finland
- Division of Rheumatology, Helsinki University, Helsinki, Finland
| | - Kari Puolakka
- Helsinki Rheumatic Diseases and Inflammation Research Group, University of Helsinki, Helsinki, Finland
| | - Nina Trokovic
- ROB-FIN Register, Division of Rheumatology, Helsinki University Hospital, Helsinki, Finland
| | - Dan Nordström
- ROB-FIN Register, Division of Rheumatology, Helsinki University Hospital, Helsinki, Finland
| |
Collapse
|
3
|
Elfving P, Kononoff A, Huhtakangas J, Kautiainen H, Savolainen E, Arstila L, Barantseva J, Rannio T, Niinisalo H, Puolitaival A, Soininen K, Kariniemi S, Oksaranta M, Kaipiainen-Seppänen O. Incidence of seropositive rheumatoid arthritis in population-based studies in Northern Savo, Finland, during 1980-2020. Rheumatol Int 2023; 43:659-666. [PMID: 36629937 PMCID: PMC9833634 DOI: 10.1007/s00296-022-05268-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Accepted: 12/27/2022] [Indexed: 01/12/2023]
Abstract
The objective is to evaluate the incidence of seropositive rheumatoid arthritis (RA) over 40-year period in Northern Savo, Finland. Data on new seropositive RA patients according to the American College of Rheumatology (ACR) 1987 classification criteria were collected in 2020-2021. In 2020 data on tobacco exposure, patient-reported dental health and living in residences with fluoridated tap water were gathered. Incidence rates were estimated and age- and gender-adjusted to Northern Savo population. The results were compared with data acquired in studies from 1980, 1990, 2000, and 2010. In 2020, 46 seropositive RA patients (21 females and 25 males) were recorded. The crude incidence of seropositive RA fulfilling the ACR 87 criteria in 2020 was 22.3 (95% CI 16.3 to 29.8)/100 000 and age and gender-adjusted 22.3 (95% CI 15.9 to 28.8)/100 000. Tobacco exposure > 5 pack years occurred 18% of females and 56% of males. Only 16% of males were full dentate. A total of 242 incident seropositive RA (age ≥ 16 years, 55% females) were identified in all study years. No differences in the gender-specific incidence rates in each cohort or in incidence between the studies every 10 years were recorded. The incidence of seropositive RA decreased in the age group < 55 years, p = 0.003. There was no change in the incidence of seropositive RA between genders or the study years. A declining trend for occurrence of seropositive RA in the young and early middle-aged population may reflect change in risk factors.
Collapse
Affiliation(s)
- Pia Elfving
- Department of Medicine, Kuopio University Hospital, PO. Box 100, 70029 KYS, Kuopio, Finland
- Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland
| | - Aulikki Kononoff
- Department of Medicine, Kuopio University Hospital, PO. Box 100, 70029 KYS, Kuopio, Finland
- Iisalmi Hospital, Iisalmi, Finland
- Pihlajalinna, Kuopio, Finland
- Mehiläinen, Kuopio, Finland
| | - Johanna Huhtakangas
- Department of Medicine, Kuopio University Hospital, PO. Box 100, 70029 KYS, Kuopio, Finland
| | - Hannu Kautiainen
- Department of Public Health, Kuopio University Hospital, Kuopio, Finland
- Folkhälsan Research Center, Helsinki, Finland
| | - Elina Savolainen
- Department of Medicine, Kuopio University Hospital, PO. Box 100, 70029 KYS, Kuopio, Finland
| | - Leena Arstila
- Iisalmi Hospital, Iisalmi, Finland
- Terveystalo, Kuopio, Finland
| | - Julia Barantseva
- Department of Medicine, Kuopio University Hospital, PO. Box 100, 70029 KYS, Kuopio, Finland
| | - Tuomas Rannio
- Iisalmi Hospital, Iisalmi, Finland
- Mehiläinen, Kuopio, Finland
| | - Helena Niinisalo
- Department of Medicine, Kuopio University Hospital, PO. Box 100, 70029 KYS, Kuopio, Finland
- Varkaus Hospital, Varkaus, Finland
- Suonenjoki Health Centre, Suonenjoki, Finland
| | | | - Kati Soininen
- Department of Medicine, Kuopio University Hospital, PO. Box 100, 70029 KYS, Kuopio, Finland
| | - Simo Kariniemi
- Department of Medicine, Kuopio University Hospital, PO. Box 100, 70029 KYS, Kuopio, Finland
| | - Minni Oksaranta
- Department of Medicine, Kuopio University Hospital, PO. Box 100, 70029 KYS, Kuopio, Finland
| | | |
Collapse
|
4
|
Zeidler H, Hudson AP. Quo vadis reactive arthritis? Curr Opin Rheumatol 2022; 34:218-224. [PMID: 35699331 DOI: 10.1097/bor.0000000000000880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
PURPOSE OF REVIEW We provide an overview of recent articles which describe new thinking regarding HLA-B27-associated reactive arthritis (ReA), including those additional infection-related arthritides triggered by microbes that often are grouped under the term ReA. RECENT FINDINGS With the advent and continuation of the pandemic, an increasing number of cases and case series of post-COVID-19 arthritis have been reported and classified as ReA. Further, arthritis after COVID-19 vaccination is a new entity included within the spectrum of ReA. New causative microorganisms identified in case reports include Clostridium difficile, Mycoplasma pneumoniae, Giardia lamblia, Leptospira , and babesiosis. SARS-CoV-2 is emerging as a significant etiologic agent for apparent ReA. SUMMARY It is now clear that comprehensive clinical and laboratory investigations, synovial fluid analyses, and close follow-up of patients all are essential to differentiate ReA from diseases that may present with similar clinical attributes. Further, and importantly, additional research is required to define the wide diversity in causative agents, epidemiology, and rare case presentations of these arthritides. Finally, new classification and diagnostic criteria, and updated treatment recommendations, are essential to the advancement of our understanding of ReA.
Collapse
Affiliation(s)
- Henning Zeidler
- Clinic of Rheumatology and Immunology, Hannover Medical School, Hannover, Germany
| | - Alan P Hudson
- Department of Biochemistry, Microbiology, and Immunology, Wayne State University School of Medicine, Detroit, Michigan, USA
| |
Collapse
|
5
|
Kononoff A, Vuolteenaho K, Hämäläinen M, Kautiainen H, Elfving P, Savolainen E, Arstila L, Niinisalo H, Rutanen J, Marjoniemi O, Moilanen E, Kaipiainen-Seppänen O. Metabolic Syndrome, Disease Activity, and Adipokines in Patients With Newly Diagnosed Inflammatory Joint Diseases. J Clin Rheumatol 2021; 27:e349-e356. [PMID: 32453216 DOI: 10.1097/rhu.0000000000001412] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To investigate metabolic syndrome (MetS), disease activity, and adipokine levels among patients with rheumatoid arthritis (RA), spondyloarthritis (SpA), and undifferentiated arthritis (UA) at the time of diagnosis and after 1 year of follow-up. METHODS Patients with inflammatory joint diseases participating in the Northern Savo 2010 population-based longitudinal epidemiological study were evaluated for components of MetS (by National Cholesterol Education Program's Adult Treatment Panel III) and clinical parameters of disease activity. The adipokines adiponectin, adipsin, resistin, and leptin were measured at baseline and after 1 year of treatment with disease-modifying antirheumatic drugs. RESULTS Among 176 patients, MetS was detected in 42% of RA, 36% of SpA, and 51% of UA patients. Metabolic syndrome was associated with higher disease activity as measured by patient global assessment in RA and UA patients and increased pain in RA patients. Leptin levels were increased in patients with MetS, showing a linearly increasing trend with the number of components of MetS in SpA and UA, but not in RA. In RA patients, decrease in disease activity correlated with decrease in leptin levels. Resistin did not associate with MetS, but a decrease in resistin correlated with decrease in disease activity in RA and UA. In SpA, increased adiponectin level correlated with relief in disease activity, but not with MetS. CONCLUSIONS Metabolic syndrome was common in patients with newly diagnosed arthritides and associated with higher disease activity and increased leptin levels. Resistin responded to treatment of arthritis in RA and UA, leptin in RA, and adiponectin in SpA.
Collapse
Affiliation(s)
- Aulikki Kononoff
- From the Department of Medicine, Kuopio University Hospital, Kuopio
| | - Katriina Vuolteenaho
- The Immunopharmacology Research Group, Faculty of Medicine and Health Technology, Tampere University and Tampere University Hospital, Tampere
| | - Mari Hämäläinen
- The Immunopharmacology Research Group, Faculty of Medicine and Health Technology, Tampere University and Tampere University Hospital, Tampere
| | | | - Pia Elfving
- From the Department of Medicine, Kuopio University Hospital, Kuopio
| | - Elina Savolainen
- From the Department of Medicine, Kuopio University Hospital, Kuopio
| | | | | | - Jarno Rutanen
- From the Department of Medicine, Kuopio University Hospital, Kuopio
| | - Olga Marjoniemi
- From the Department of Medicine, Kuopio University Hospital, Kuopio
| | - Eeva Moilanen
- The Immunopharmacology Research Group, Faculty of Medicine and Health Technology, Tampere University and Tampere University Hospital, Tampere
| | | |
Collapse
|
6
|
Zeidler H, Hudson AP. Reactive Arthritis Update: Spotlight on New and Rare Infectious Agents Implicated as Pathogens. Curr Rheumatol Rep 2021; 23:53. [PMID: 34196842 PMCID: PMC8247622 DOI: 10.1007/s11926-021-01018-6] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/21/2021] [Indexed: 12/11/2022]
Abstract
Purpose of Review This article presents a comprehensive narrative review of reactive arthritis (ReA) with focus on articles published between 2018 and 2020. We discuss the entire spectrum of microbial agents known to be the main causative agents of ReA, those reported to be rare infective agents, and those reported to be new candidates causing the disease. The discussion is set within the context of changing disease terminology, definition, and classification over time. Further, we include reports that present at least a hint of effective antimicrobial therapy for ReA as documented in case reports or in double-blind controlled studies. Additional information is included on microbial products detected in the joint, as well as on the positivity of HLA-B27. Recent Findings Recent reports of ReA cover several rare causative microorganism such as Neisseria meningitides, Clostridium difficile, Escherichia coli, Hafnia alvei, Blastocytosis, Giardia lamblia, Cryptosporidium, Cyclospora cayetanensis, Entamoeba histolytica/dispar, Strongyloides stercoralis, β-haemolytic Streptococci, Mycobacterium tuberculosis, Mycoplasma pneumoniae, Mycobacterium bovis bacillus Calmette-Guerin, and Rickettsia rickettsii. The most prominent new infectious agents implicated as causative in ReA are Staphylococcus lugdunensis, placenta- and umbilical cord–derived Wharton’s jelly, Rothia mucilaginosa, and most importantly the SARS-CoV-2 virus. Summary In view of the increasingly large spectrum of causative agents, diagnostic consideration for the disease must include the entire panel of post-infectious arthritides termed ReA. Diagnostic procedures cannot be restricted to the well-known HLA-B27-associated group of ReA, but must also cover the large number of rare forms of arthritis following infections and vaccinations, as well as those elicited by the newly identified members of the ReA group summarized herein. Inclusion of these newly identified etiologic agents must necessitate increased research into the pathogenic mechanisms variously involved, which will engender important insights for treatment and management of ReA. Supplementary Information The online version contains supplementary material available at 10.1007/s11926-021-01018-6.
Collapse
Affiliation(s)
- Henning Zeidler
- Division of Clinical Immunology and Rheumatology, Hannover Medical School, Carl-Neuberg-Straße 1, 30625, Hannover, Germany.
| | - Alan P Hudson
- Department of Biochemistry, Microbiology, and Immunology, Wayne State University School of Medicine, Detroit, MI, USA
| |
Collapse
|
7
|
Kononoff A, Hörkkö S, Pussinen P, Kautiainen H, Elfving P, Savolainen E, Arstila L, Niinisalo H, Rutanen J, Marjoniemi O, Kaipiainen-Seppänen O. Antibodies to malondialdehyde-acetaldehyde modified low-density lipoprotein in patients with newly diagnosed inflammatory joint disease. Scand J Rheumatol 2020; 50:113-117. [PMID: 32985314 DOI: 10.1080/03009742.2020.1795244] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Objective:To assess antibodies to malondialdehyde-acetaldehyde-modified low-density lipoprotein (MAA-LDL) in patients with newly diagnosed inflammatory joint disease.Method: Patients with rheumatoid arthritis (RA), spondyloarthritis (SpA), and undifferentiated arthritis (UA), participating in the Northern Savo 2010 Study, were evaluated for metabolic syndrome (MetS), metabolic and inflammatory markers, antibodies to MAA-LDL, Aggregatibacter actinomycetemcomitans, and Porphyromonas gingivalis.Results: Among 135 newly diagnosed untreated patients, of whom 53 (39%) were diagnosed to have RA, 44 (33%) SpA, and 38 (28%) UA, 49%, 30%, and 47%, respectively, had MetS. After adjusting for age and gender, anti-MAA-LDL immunoglobulin (Ig)A (p = 0.009), IgG (p = 0.031), and IgM (p = 0.001) levels differed between the diagnostic categories, but not in patients with MetS present or absent. All antibody classes to MAA-LDL correlated with erythrocyte sedimentation rate (ESR), and IgA and IgG antibodies with high-sensitivity C-reactive protein (hs-CRP). IgA antibodies to MAA-LDL correlated with rheumatoid factor (RF), anti-citrullinated protein antibodies (ACPAs), fasting plasma glucose, IgA antibodies to A. actinomycetemcomitans, and in IgA and IgG antibodies to P. gingivalis.Conclusion: Among various arthritis groups, antibodies to MAA-LDL were most common in RA. Antibodies to modified lipoproteins were associated with inflammation measured by ESR and hs-CRP. IgA antibodies to MAA-LDL correlated with age, antibodies to periodontal bacteria, RF, ACPA, and fasting glucose. Associations between antibodies to MAA-LDL and antibodies to periodontal bacteria, RA-associated antibodies, inflammatory parameters, and plasma glucose already reflect cardiovascular burden in inflammatory joint diseases at diagnosis.
Collapse
Affiliation(s)
- A Kononoff
- Department of Medicine, Kuopio University Hospital, Kuopio, Finland
| | - S Hörkkö
- Institute of Diagnostics, Medical Microbiology and Immunology, Research Unit of Biomedicine, Oulu, Finland.,University of Oulu and Medical Research Center and Nordlab Oulu, Oulu University Hospital, Oulu, Finland
| | - P Pussinen
- Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland
| | - H Kautiainen
- Unit of Primary Health Care, Kuopio University Hospital, Kuopio, Finland.,Unit of Family Practice, Central Finland Central Hospital, Jyväskylä, Finland
| | - P Elfving
- Department of Medicine, Kuopio University Hospital, Kuopio, Finland
| | - E Savolainen
- Department of Medicine, Kuopio University Hospital, Kuopio, Finland
| | - L Arstila
- Department of Medicine, Kuopio University Hospital, Kuopio, Finland.,Department of Medicine, Iisalmi Hospital, Iisalmi, Finland
| | - H Niinisalo
- Department of Medicine, Varkaus Hospital, Varkaus, Finland.,Outpatient Department, Suonenjoki Health Centre, Suonenjoki, Finland
| | - J Rutanen
- Department of Medicine, Kuopio University Hospital, Kuopio, Finland
| | - O Marjoniemi
- Department of Medicine, Kuopio University Hospital, Kuopio, Finland
| | | |
Collapse
|
8
|
Kononoff A, Elfving P, Pussinen P, Hörkkö S, Kautiainen H, Arstila L, Laasonen L, Savolainen E, Niinisalo H, Rutanen J, Marjoniemi O, Hämäläinen M, Vuolteenaho K, Moilanen E, Kaipiainen-Seppänen O. Association of rheumatoid arthritis disease activity and antibodies to periodontal bacteria with serum lipoprotein profile in drug naive patients. Ann Med 2020; 52:32-42. [PMID: 32011179 PMCID: PMC7877970 DOI: 10.1080/07853890.2020.1724321] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
Objective: We investigated lipid concentrations, particle sizes and antibodies binding to periodontal bacteria Aggregatibacter actinomycetemcomitans and Porphyromonas gingivalis and to malondialdehyde-acetaldehyde (MAA) modified low-density lipoprotein in immunoglobulin (Ig) class A, G and M among patients with newly diagnosed rheumatoid arthritis (RA) in a population-based cohort.Methods: Concentrations and sizes of lipoprotein particles analysed by proton nuclear magnetic resonance spectroscopy and antibody levels to MAA modified low-density lipoprotein were studied at baseline and after one-year of follow-up. Serum Ig A and G class antibodies to periodontal bacteria were determined at baseline.Results: Sixty-three patients were divided into tertiles according to disease activity by disease activity score with 28 joint count and erythrocyte sedimentation rate (ESR) (<3.9, 3.9-4.7, >4.7). Small low-density lipoprotein concentration was lowest in the tertile with the highest disease activity. In high-density lipoprotein, the concentrations of total, medium and small particles decreased with disease activity. The particle size in low-density lipoprotein associated with disease activity and the presence of antibodies to P. gingivalis. Ig G and M antibodies to MAA modified low-density lipoprotein correlated with disease activity. Inflammation associated changes faded by one year.Conclusions: Drug naive RA patients had proatherogenic changes in lipid profiles, but they were reversible, when inflammation diminished.Key messagesPatients with drug naive rheumatoid arthritis showed proatherogenic lipid profiles.Reversible changes in lipid profiles can be achieved as response to inflammation suppression.Active therapy aimed at remission is essential in all patients with rheumatoid arthritis.
Collapse
Affiliation(s)
- Aulikki Kononoff
- Department of Medicine, Kuopio University Hospital, Kuopio, Finland
| | - Pia Elfving
- Department of Medicine, Kuopio University Hospital, Kuopio, Finland
| | - Pirkko Pussinen
- Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland
| | - Sohvi Hörkkö
- Institute of Diagnostics, Medical Microbiology and Immunology, Research Unit of Biomedicine, Oulu University Hospital, University of Oulu and Medical Research Center and Nordlab Oulu, Oulu, Finland
| | - Hannu Kautiainen
- Unit of Primary Health Care, Kuopio University Hospital, Kuopio, Finland.,Unit of Family Practice, Central Finland Central Hospital, Jyväskylä, Finland
| | - Leena Arstila
- Department of Medicine, Kuopio University Hospital, Kuopio, Finland.,Department of Medicine, Iisalmi Hospital
| | - Leena Laasonen
- Helsinki Medical Imaging Center, Helsinki University Hospital, Helsinki, Finland
| | - Elina Savolainen
- Department of Medicine, Kuopio University Hospital, Kuopio, Finland
| | - Helena Niinisalo
- Department of Medicine, Varkaus Hospital.,Outpatient Clinic, Suonenjoki Health Center
| | - Jarno Rutanen
- Department of Medicine, Kuopio University Hospital, Kuopio, Finland
| | - Olga Marjoniemi
- Department of Medicine, Kuopio University Hospital, Kuopio, Finland
| | - Mari Hämäläinen
- School of Medicine, The Immunopharmacology Research Group, Tampere University Hospital, University of Tampere, Tampere, Finland
| | - Katriina Vuolteenaho
- School of Medicine, The Immunopharmacology Research Group, Tampere University Hospital, University of Tampere, Tampere, Finland
| | - Eeva Moilanen
- School of Medicine, The Immunopharmacology Research Group, Tampere University Hospital, University of Tampere, Tampere, Finland
| | | |
Collapse
|
9
|
Abstract
Epidemiological studies of spondyloarthritides (SpA) are rare and data for our country are lacking. We aimed to determine the incidence of SpA in a well-defined region in Slovenia.We performed a retrospective chart review of adults diagnosed with SpA between January 2014 and December 2016 at an integrated secondary/tertiary medical center, which provides rheumatology services to almost a half of the adult national population, that is, 700,000 adults. Potential cases were ascertained by searching the electronic medical records for ICD-10 codes M02, M07, M13, M45, M 46.1, K50, K51, and L40. SpA cases were stratified as axial and peripheral SpA and then the annual incidence rates of SpA overall and both subsets were estimated.During the 3-year period we identified 302 SpA cases (55.0% males, median [interquartile range] age 46.7 [35.0-57.5] years). 98 (32.5%) of them had predominantly axial SpA and the remainder peripheral SpA. The estimated annual incidence rate per 100,000 adults in our region was 14.3 (95% confidence interval [CI] 12.8-16.0) for SpA overall, 4.6 (95% CI 3.8-5.6) for axial SpA, and 9.6 (95% CI 8.4-11.1) for peripheral SpA.The estimated annual incidence rate of 14.3 cases per 100,000 adults in SpA overall was comparable to that of rheumatoid arthritis in our population. The peripheral SpA was twice as common as axial SpA.
Collapse
Affiliation(s)
- Alojzija Hočevar
- University Medical Centre Ljubljana, Department of Rheumatology
- Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | | | - Rok Ješe
- University Medical Centre Ljubljana, Department of Rheumatology
| | | | - Matija Tomšič
- University Medical Centre Ljubljana, Department of Rheumatology
- Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Ziga Rotar
- University Medical Centre Ljubljana, Department of Rheumatology
- Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| |
Collapse
|
10
|
Muilu P, Rantalaiho V, Kautiainen H, Virta LJ, Eriksson JG, Puolakka K. Increasing incidence and shifting profile of idiopathic inflammatory rheumatic diseases in adults during this millennium. Clin Rheumatol 2018; 38:555-562. [PMID: 30259249 DOI: 10.1007/s10067-018-4310-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2018] [Revised: 09/12/2018] [Accepted: 09/20/2018] [Indexed: 02/08/2023]
Abstract
To explore the trends in the incidence of idiopathic inflammatory rheumatic diseases (IIRDs) after the turn of the millennium. From a nationwide register maintained by the Social Insurance Institution of Finland, we collected all adult patients with IIRDs granted a new special reimbursement for anti-rheumatic drugs between 2000 and 2014. Temporal trends in the incidences of various IIRDs were estimated in three 5-year intervals. A total of 58,405 adult patients were identified. Between 2000-2004 and 2010-2014, the age-adjusted incidence rate of IIRDs increased from 114 to 116/100000 [incidence rate ratio (IRR) 1.03 (95% CI 1.01 to 1.06)] in women and from 67 to 69/100,000 [IRR 1.10 (95% CI 1.06-1.14)] in men. The incidence of seropositive rheumatoid arthritis (RA) remained stable while that of seronegative RA decreased. For other diagnoses, the incidences either increased (unspecified arthritis, psoriatic arthritis, spondyloarthritis), remained stable (reactive arthritis), or decreased (SLE and the group of diseases with the ICD-10 code M35). The gender difference in spondyloarthritis leveled as the incidence in women increased at a higher rate than in men. Mean age at IIRD diagnosis decreased among women. The total age-adjusted incidence of IIRDs has gradually increased, due to the increase in unspecified arthritis, psoriatic arthritis, and spondyloarthritis. This, in addition to the ascending number of individuals at risk in the population, translates into a growing burden to the health care system.
Collapse
Affiliation(s)
- Paula Muilu
- Department of Medicine, Tampere University Hospital, PL 2000, 33521, Tampere, Finland.
| | - Vappu Rantalaiho
- Centre for Rheumatic Diseases, Tampere University Hospital, Arvo Ylponkatu 6, 33520, Tampere, Finland.,Faculty of Medicine and Life Sciences, University of Tampere, Tampere, Finland
| | - Hannu Kautiainen
- Department of General Practice and Primary Health Care, University of Helsinki, PL 20, 00014, Helsinki, Finland.,Unit of Primary Health Care, Turku University Hospital, Turku, Finland
| | - Lauri Juhani Virta
- Research Department, Social Insurance Institution of Finland, PL 450, 00056, Turku, Finland
| | - Johan Gunnar Eriksson
- Department of General Practice and Primary Health Care, University of Helsinki, PL 20, 00014, Helsinki, Finland.,Folkhälsan Research Center, Helsinki, Finland
| | - Kari Puolakka
- Department of Medicine, South Karelia Central Hospital, Valto Kakelankatu 3, 53130, Lappeenranta, Finland
| |
Collapse
|