HeRA Collection:

Data driven attempt to create a clinical algorithm for identification of women with rheumatoid arthritis at high risk of osteoporosis.

Sun, 01 Oct 2000 00:00:00 GMT

Title: Data driven attempt to create a clinical algorithm for identification of women with rheumatoid arthritis at high risk of osteoporosis. Authors: Kvien, Tore Kristian; Haugeberg, Glenn; Uhlig, Till; Falch, J A; Halse, J I; Lems, W F; Dijkmans, B A; Woolf, A D Abstract: To examine relations between osteoporosis and low bone mass and demographic and clinical variables in patients with rheumatoid arthritis (RA), in an attempt to develop a data driven clinical tool for identification of patients at high risk of osteoporosis.; All patients were recruited from a county based register and were examined cross sectionally with a variety of clinical and health status measures as well as bone density measures (anteroposterior spine L2-4, total hip, and femoral neck). Associations between osteoporosis (T score < or = -2.5SD) and low bone mass (T score < or = -1SD), on the one hand, and demographic and clinical measures, on the other, were examined bivariately and by logistic regression analyses.; 394 patients with a mean age of 54.8 years were examined. The percentages having osteoporosis/low bone mass were 16.8/45.8, 14.7/54.5 and 14.7/55.5 in spine L2-4, total hip, and femoral neck, respectively. Osteoporosis and low bone mass were bivariately related to age, body mass index (BMI), disease duration, disease process measures, presence of deformed joints, physical disability, current use of corticosteroids, and history of non-vertebral fracture. In multivariate analyses, age >60 years, low BMI, and current use of corticosteroids were consistently related to osteoporosis and to low bone mass at all sites. The presence of deformed joints was associated with osteoporosis at the total hip, and a history of previous non-vertebral fracture with osteoporosis at the femoral neck. The Modified Health Assessment Questionnaire (MHAQ) > or = 1.5 and non-vertebral fracture were also independently associated with low bone mass at the hip. The logistic regression analyses models could, however, only predict osteoporosis with a sensitivity of about 50-60% and a specificity of 80-90% at the various measurement sites, and low bone mass with a sensitivity and specificity of about 70%.; Consideration of demographic and disease markers may be of some help in predicting presence of osteoporosis or low bone mass, but a combination of markers cannot be used as a clinical tool with sufficient sensitivity and specificity for the identification of osteoporosis or low bone mass in patients with RA.

The course of rheumatoid arthritis and predictors of psychological, physical and radiographic outcome after 5 years of follow-up.

Sat, 01 Jul 2000 00:00:00 GMT

Title: The course of rheumatoid arthritis and predictors of psychological, physical and radiographic outcome after 5 years of follow-up. Authors: Uhlig, Till; Smedstad, L M; Vaglum, P; Moum, T; Gérard, N; Kvien, Tore Kristian Abstract: : To examine the course of RA over 5 yr and identify predictors of psychological, physical and radiographic outcome.; Out of 238 patients with rheumatoid arthritis of no more than 4 (mean 2.2) yr duration, 182 (76%) completed a clinical examination with follow-up at 1, 2, and 5 yr. The course of the disease was assessed by measures of psychological and physical health status, disease process and radiographic damage.; : Over 5 yr we observed at a group level a stable disease course for measures of disease process, psychological and physical health status. Radiographic damage progressed. Health status and radiographic damage after 5 yr were predicted by the baseline measures for the respective outcome. Physical function was also predicted by age and by psychological status when the physical dimension of the Arthritis Impact Measurement Scales was chosen as outcome variable. Erythrocyte sedimentation rate and presence of rheumatoid factor predicted radiographic progression.; : The 5 yr course of RA was characterized by preserved health status measures and clinically preserved disease process measures, whereas joint damage progressed steadily. Outcomes after 5 yr can be predicted partly by certain measures at baseline.

Bone mineral density in systemic lupus erythematosus: comparison with rheumatoid arthritis and healthy controls.

Tue, 01 Feb 2000 00:00:00 GMT

Title: Bone mineral density in systemic lupus erythematosus: comparison with rheumatoid arthritis and healthy controls. Authors: Gilboe, Inge Margrethe; Kvien, Tore Kristian; Haugeberg, Glenn; Husby, Gunnar Abstract: OBJECTIVES: To examine bone mineral density (BMD) frequency of osteoporosis and reduced bone mass in systemic lupus erythematosus (SLE), and compare the data of the SLE patients with matched rheumatoid arthritis (RA) patients and healthy controls. Secondly, to study possible correlations between BMD, demographic and disease variables in the SLE patients. METHODS: Measures of BMD assessed by dual energy x ray absorptiometry were obtained from 75 SLE patients aged

Sicca symptoms, saliva and tear production, and disease variables in 636 patients with rheumatoid arthritis.

Thu, 01 Jul 1999 00:00:00 GMT

Title: Sicca symptoms, saliva and tear production, and disease variables in 636 patients with rheumatoid arthritis. Authors: Uhlig, Till; Kvien, Tore Kristian; Jensen, J L; Axéll, T Abstract: OBJECTIVES: (1) To estimate the prevalence of ocular and oral sicca symptoms (SISY) or reduced saliva and tear production; (2) to relate SISY and sicca signs to measures of disease activity, damage, and health status; and (3) to examine the relation between symptoms and objective signs of tear and saliva production in a large sample of representative patients with rheumatoid arthritis (RA). METHODS: From an unselective county RA register 636 patients (age 20-70 years) were examined with Schirmer-I test (ST), unstimulated whole saliva (UWS), questions on SISY and measures of disease activity, damage and health status. RESULTS: Ocular sicca symptoms were reported in 38%, oral sicca symptoms in 50%, and a combination of both in 27%. Reduced tear production was present in 29%, and reduced saliva production in 17%. The minimum frequency of secondary Sjögren's syndrome was 7%. Measurements of exocrine disease manifestations were to variable extents bivariately correlated to disease activity measures, physical disability, pain, fatigue, and use of xerogenic drugs, but were not related to deformed joint count. Multivariate analyses revealed significant associations between disease activity and reduced saliva production. Only weak associations between SISY and tear or saliva production were observed. CONCLUSION: SISY, reduced tear and saliva production were frequent extra-articular manifestations in RA, but were only weakly intercorrelated. High disease activity and at least two SISY were independent predictors of reduced saliva production, but ocular and oral dryness did not seem to be closely related to disease duration, disease activity, damage or health status.