Lund University Publications
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Lund University Lund University Publications2000-01-01T00:00+00:001dailyToward designing human intervention studies to prevent osteoarthritis after knee injury : A report from an interdisciplinary OARSI 2023 workshop
https://lup.lub.lu.se/search/publication/d5ca13d8-681d-42e6-9c5f-a4d0f659e182
Whittaker, Jackie L.Kalsoum, RaneemBilzon, JamesConaghan, Philip G.Crossley, KayDodge, George R.Getgood, AlanLi, XiaojuanLosina, ElenaMason, Deborah J.Pietrosimone, BrianRisberg, May ArnaRoemer, FrankFelson, DavidCulvenor, Adam G.Meuffels, DuncanGerwin, NicoleSimon, Lee S.Lohmander, L. StefanEnglund, MartinWatt, Fiona E.2024-06Objective: The global impact of osteoarthritis is growing. Currently no disease modifying osteoarthritis drugs/therapies exist, increasing the need for preventative strategies. Knee injuries have a high prevalence, distinct onset, and strong independent association with post-traumatic osteoarthritis (PTOA). Numerous groups are embarking upon research that will culminate in clinical trials to assess the effect of interventions to prevent knee PTOA despite challenges and lack of consensus about trial design in this population. Our objectives were to improve awareness of knee PTOA prevention trial design and discuss state-of-the art methods to address the unique opportunities and challenges of these studies. Design: An international interdisciplinary group developed a workshop, hosted at the 2023 Osteoarthritis Research Society International Congress. Here we summarize the workshop content and outputs, with the goal of moving the field of PTOA prevention trial design forward. Results: Workshop highlights included discussions about target population (considering risk, homogeneity, and possibility of modifying osteoarthritis outcome); target treatment (considering delivery, timing, feasibility and effectiveness); comparators (usual care, placebo), and primary symptomatic outcomes considering surrogates and the importance of knee function and symptoms other than pain to this population. Conclusions: Opportunities to test multimodal PTOA prevention interventions across preclinical models and clinical trials exist. As improving symptomatic outcomes aligns with patient and regulator priorities, co-primary symptomatic (single or aggregate/multidimensional outcome considering function and symptoms beyond pain) and structural/physiological outcomes may be appropriate for these trials. To ensure PTOA prevention trials are relevant and acceptable to all stakeholders, future research should address critical knowledge gaps and challenges.https://lup.lub.lu.se/record/d5ca13d8-681d-42e6-9c5f-a4d0f659e182http://dx.doi.org/10.1016/j.ocarto.2024.100449scopus:85186749454pmid:38440780engOsteoarthritis and Cartilage Open; 6(2), no 100449 (2024)ISSN: 2665-9131Rheumatology and AutoimmunityKneeOsteoarthritisPost-traumatic osteoarthritisPreventionRandomised controlled trialsTrial designToward designing human intervention studies to prevent osteoarthritis after knee injury : A report from an interdisciplinary OARSI 2023 workshopcontributiontojournal/articleinfo:eu-repo/semantics/articletextPredictors of DAPSA28 remission in patients with psoriatic arthritis initiating a first TNF inhibitor : results from 13 European registries
https://lup.lub.lu.se/search/publication/fbf3b100-aed3-4594-9218-1d6a0fcff35e
Linde, LouiseØrnbjerg, Lykke M.Georgiadis, StylianosRasmussen, Simon H.Lindström, UlfAskling, JohanMichelsen, BrigitteDi Giuseppe, DanielaWallman, Johan K.Gudbjornsson, BjornLove, Thorvardur JonNordström, Dan C.Yli-Kerttula, TimoNekvindová, LucieVencovský, JiříIannone, FlorenzoCauli, AlbertoLoft, Anne GitteGlintborg, BenteLaas, KarinRotar, ZigaTomšič, MatijaMacFarlane, Gary J.Möller, BurkhardVan De Sande, MarleenCodreanu, CatalinNissen, Michael J.Birlik, MerihErten, SukranSantos, Maria J.Vieira-Sousa, ElsaHetland, Merete L.Østergaard, Mikkel2024-03-01Objectives: In bio-naïve patients with PsA initiating a TNF inhibitor (TNFi), we aimed to identify baseline predictors of Disease Activity index for PsA in 28 joints (DAPSA28) remission (primary objective) and DAPSA28 moderate response at 6 months, as well as drug retention at 12 months across 13 European registries. Methods: Baseline demographic and clinical characteristics were retrieved and the three outcomes investigated per registry and in pooled data, using logistic regression analyses on multiply imputed data. In the pooled cohort, selected predictors that were either consistently positive or negative across all three outcomes were defined as common predictors. Results: In the pooled cohort (n=13 369), 6-month proportions of remission, moderate response and 12-month drug retention were 25%, 34% and 63% in patients with available data (n=6954, n=5275 and n=13 369, respectively). Five common baseline predictors of remission, moderate response and 12-month drug retention were identified across all three outcomes. The odds ratios (95% CIs) for DAPSA28 remission were: age, per year: 0.97 (0.96-0.98); disease duration, years (<2 years as reference): 2-3 years: 1.20 (0.89-1.60), 4-9 years: 1.42 (1.09-1.84), ≥10 years: 1.66 (1.26-2.20); men vs women: 1.85 (1.54-2.23); CRP of >10 vs ≤10 mg/l: 1.52 (1.22-1.89) and 1mm increase in patient fatigue score: 0.99 (0.98-0.99). Conclusion: Baseline predictors of remission, response and adherence to TNFi therapy were identified, of which five were common for all three outcomes, indicating that the predictors emerging from our pooled cohort may be considered generalizable from country level to disease level.https://lup.lub.lu.se/record/fbf3b100-aed3-4594-9218-1d6a0fcff35ehttp://dx.doi.org/10.1093/rheumatology/kead284scopus:85186323294pmid:37314967engRheumatology (United Kingdom); 63(3), pp 751-764 (2024)ISSN: 1462-0324Rheumatology and AutoimmunityDAPSA28drug retentionfirst TNF-inhibitorpredictorsPsAreal-world evidencePredictors of DAPSA28 remission in patients with psoriatic arthritis initiating a first TNF inhibitor : results from 13 European registriescontributiontojournal/articleinfo:eu-repo/semantics/articletextParticipation in cardiovascular screening consultations, the who, when and why - A cohort study on patients with rheumatoid arthritis
https://lup.lub.lu.se/search/publication/42c03109-8fa6-4f58-9cf8-49fb55653739
Karstensen, Julie KatrineBremander, AnnChristensen, Jeanette ReffstrupPrimdahl, Jette2024Background: In accordance with the EULAR recommendations, the Danish Hospital for Rheumatic Diseases have systematically invited patients with rheumatoid arthritis (RA) to cardiovascular (CV) risk assessment since 2011. Patients with high risk are invited to a follow-up screening after one year. To optimize the screening and tailor it to individual needs, information about who accepts vs. declines follow-up is needed. Thus, the aim of this study was to explore participation in systematic CV risk assessment among patients with RA. Furthermore, to explore differences between patients with low vs. high risk, and between patients with high risk who accept vs. decline follow-up. Methods: Data from 2,222 outpatients with RA in the period 2011-2021 were retrieved, and of these 1,522 were under 75 years and eligible to be invited. To assess the 10-year risk for CV death, the modified Systematic Coronary Risk Evaluation (mSCORE), derived by multiplying the SCORE by 1.5, was used. Logistic regression analyses were used to explore differences in CV risk factors (triglycerides, HbA1c, lifestyle factors) and measures of disease impact (pain, fatigue, patient global assessment, HAQ, EQ-5D-5L) between patients with low vs. high risk. Differences between high risk patients who accepted vs. declined follow-up were analysed using Wilcoxon rank sum test and chi-squared test for groups. Results: One thousand one hundred forty-nine received a CV screening invitation and 91 declined participation. Patients with high risk had significantly longer disease duration (OR; 95 CI) (1.017; 1.002-1.032), higher levels of triglycerides (1.834; 1.475-2.280), HbA1C (1.046; 1.020-1.070), pain (1.006; 1.001-1.012), and HAQ-score (1.305; 1.057-1.612) compared to patients with low risk and they more often declined follow-up (43% vs. 28%, p < 0.001). Those who declined a follow-up invitation were older (p = 0.016) and had shorter disease duration (p = 0.006) compared to those who accepted follow-up. Conclusion: A first CV screening consultation was accepted by most patients with RA, while only every other patient with high to very high CV risk adhered to a follow-up screening consultation. Neither measures of disease impact nor lifestyle factors were associated with adherence. Further studies are needed to explore the patients' motivation, barriers and facilitators for adherence or non-adherence to a follow-up consultation.https://lup.lub.lu.se/record/42c03109-8fa6-4f58-9cf8-49fb55653739http://dx.doi.org/10.1186/s41927-024-00378-7scopus:85185669191pmid:38383437engBMC Rheumatology; 8(1), no 8 (2024)ISSN: 2520-1026Rheumatology and AutoimmunityCardiovascular risk assessmentCardiovascular risk managementHealth behaviourRheumatoid arthritisParticipation in cardiovascular screening consultations, the who, when and why - A cohort study on patients with rheumatoid arthritiscontributiontojournal/articleinfo:eu-repo/semantics/articletextDevelopment of radiographic classification criteria for hand osteoarthritis : a methodological report (Phase 2)
https://lup.lub.lu.se/search/publication/b7cf7acf-ec3a-4ec5-9597-aac5547f3c09
Haugen, Ida K.Felson, DavidAbhishek, AbhishekBerenbaum, FrancisEdwards, John JamesHerrero Beaumont, GabrielHermann-Eriksen, MereteHill, Catherine L.Ishimori, MarikoJonsson, HelgiKarjalainen, TeemuLeung, Ying YingMaheu, EmmanuelMallen, Christian D.Moe, Rikke HeleneRamonda, RobertaRitschl, ValentinStamm, Tanja A.Szekanecz, Zoltanvan der Giesen, Florus J.Ritt, Marco J.P.F.Wittoek, RuthKjeken, IngvildOsteras, Ninavan de Stadt, Lotte A.Englund, MartinDziedzic, Krysia S.Marshall, M.Bierma-Zeinstra, SitaHansen, PaulGreibrokk, ElsieSmeets, WilmaKloppenburg, Margreet2022-02ObjectivesIn Phase 1 of developing new hand osteoarthritis (OA) classification criteria, features associated with hand OA were identified in a population with hand complaints. Radiographic findings could better discriminate patients with hand OA and controls than clinical examination findings. The objective of Phase 2 was to achieve consensus on the features and their weights to be included in three radiographic criteria sets of overall hand OA, interphalangeal OA and thumb base OA.MethodsMultidisciplinary, international expert panels were convened. Patient vignettes were used to identify important features consistent with hand OA. A consensus-based decision analysis approach implemented using 1000minds software was applied to identify the most important features and their relative importance influencing the likelihood of symptoms being due to hand OA. Analyses were repeated for interphalangeal and thumb base OA. The reliability and validity of the proposed criteria sets were tested.ResultsThe experts agreed that the criteria sets should be applied in a population with pain, aching or stiffness in hand joint(s) not explained by another disease or acute injury. In this setting, five additional criteria were considered important: age, morning stiffness, radiographic osteophytes, radiographic joint space narrowing and concordance between symptoms and radiographic findings. The reliability and validity were very good.ConclusionRadiographic features were considered critical when determining whether a patient had symptoms due to hand OA. The consensus-based decision analysis approach in Phase 2 complemented the data-driven results from Phase 1, which will form the basis of the final classification criteria sets.https://lup.lub.lu.se/record/b7cf7acf-ec3a-4ec5-9597-aac5547f3c09http://dx.doi.org/10.1136/rmdopen-2021-002024pmid:35121640scopus:85124173434engRMD Open; 8(1), no e002024 (2022)ISSN: 2056-5933Rheumatology and Autoimmunityepidemiologyhealth careosteoarthritisoutcome assessmentDevelopment of radiographic classification criteria for hand osteoarthritis : a methodological report (Phase 2)contributiontojournal/articleinfo:eu-repo/semantics/articletext