Secular trends of sustained remission in rheumatoid arthritis, a nationwide study in Sweden

Rheumatology ◽  
2019 ◽  
Author(s):  
Jon T Einarsson ◽  
Minna Willim ◽  
Tore Saxne ◽  
Pierre Geborek ◽  
Meliha C Kapetanovic
Keyword(s):  
Symptom Onset ◽  
Secular Trend ◽  
Secular Trends ◽  
Treat To Target ◽  
Sustained Remission ◽  
Life Table Analysis ◽  
Treatment Start ◽  
Quality Register ◽  
Table Analysis ◽  
The One

Abstract Objectives The aim of this study of patients with RA in Sweden was to investigate secular trends in achieving sustained remission (SR), i.e. DAS28 <2.6 on at least two consecutive occasions and lasting for at least 6 months. Methods All adult RA patients registered in the Swedish Rheumatology Quality register through 2012, with at least three registered visits were eligible, a total of 29 084 patients. Year of symptom onset ranged from 1955, but for parts of the analysis only patients with symptom onset between 1994 and 2009 were studied. In total, 95% of patients fulfilled the ACR 1987 classification criteria for RA. Odds of reaching SR for each decade compared with the one before were calculated with logistic regression and individual years of symptom onset were compared with life table analysis. Results Of patients with symptom onset in the 1980s, 1990s and 2000s, 35.0, 43.0 and 45.6% reached SR, respectively (P < 0.001 for each increment), and the odds of SR were higher in every decade compared with the one before. The hazard ratio for reaching SR was 1.15 (95% CI 1.14, 1.15) for each year from 1994 to 2009 compared with the year before. Five years after symptom onset in 2009, 45.3% of patients had reached SR compared with 15.9% in 1999. Conclusion There is a clear secular trend towards increased incidence of SR in patients with RA in Sweden. This trend most likely reflects earlier diagnosis and treatment start, and adherence to national and international guidelines recommending the treat to target approach.

scholarly journals AB0302 USE OF TNF-INHIBITORS BEFORE, DURING AND THE FIRST YEAR AFTER PREGNANCY AMONG WOMEN WITH RHEUMATOID ARTHRITIS

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1450.2-1450
Author(s):  
H. Bjørngaard ◽  
H. Koksvik ◽  
B. Jakobsen ◽  
M. Wallenius
Keyword(s):  
Rheumatoid Arthritis ◽  
Disease Activity ◽  
Post Partum ◽  
Tnf Inhibitors ◽  
Treat To Target ◽  
Inflammatory Rheumatic Diseases ◽  
Tnf Inhibitor ◽  
Rheumatic Arthritis ◽  
Quality Register ◽  
In Pregnancy

Background:Treat to target is a goal, also in pregnant women with Rheumatoid arthritis (1). There is increasing evidence on safe use with TNF inhibitors during pregnancy. Adjusted use of TNF inhibitors preconception and throughout pregnancy may stabilize disease activity and prevent flares (2). Low disease activity is also beneficial for the fetus.Objectives:To study the use of TNF-inhibitors among women with Rheumatic arthritis during and after pregnancy.Methods:RevNatus is a Norwegian, nationwide quality register that monitors treatment of inflammatory rheumatic diseases before, during and after pregnancy. Data from RevNatus in the period October 2017 to October 2019 was used to map the use of all types of TNF inhibitors among 208 women with rheumatoid arthritis, diagnosed by the ACR/EULAR criteria. The use of medication was reported at the time of visit in outpatient clinic. The frequency of use of TNF inhibitors registered at seven timepoints from pre-pregnancy to twelve months after delivery.Results:The use of medication was reported at each visit for all the women with rheumatoid arthritis. Most of the women were not using TNF inhibitors before and beyond conception. Most of the women continuing TNF inhibitors beyond conception used certolizumab or etanercept. Adalimumab and infliximab were used in pregnancy (tabell 1).Tabell 1.certoliz-umabetane-rceptadalim-umabgolim-umabinflixi-mabNo TNF-inhibitorBefore pregnancyn=10521% (22)9% (10)3% (3)1% (1)66% (69)1.trimestern=8119% (15)10% (8)71% (58)2.trimestern=8810% (9)10% (9)80% (70)3.trimestern=9111% (10)5% (5)83% (76)6 weeks post partum n=9622% (21)13% (13)1% (1)1% (1)63% (60)6 months post partum n=8824% (21)18% (16)4% (4)1% (1)53% (46)12 months post partum n=8421% (18)17% (15)7% (6)2% (2)53% (43)Conclusion:Most of the women with rheumatic arthritis were not treated with TNF inhibitors before or in pregnancy. Women with rheumatic arthritis that continuing treatment with TNF inhibitors through pregnancy were using certilozumab and etanercept.References:[1]Gotestam Skorpen C, Hoeltzenbein M, Tincani A, Fischer-Betz R, Elefant E, Chambers C, et al. The EULAR points to consider for use of antirheumatic drugs before pregnancy, and during pregnancy and lactation. 2016;75(5):795-810.[2]van den Brandt S, Zbinden A, Baeten D, Villiger PM, Ostensen M, Forger F. Risk factors for flare and treatment of disease flares during pregnancy in rheumatoid arthritis and axial spondyloarthritis patients. Arthritis Res Ther. 2017;19(1):64.Disclosure of Interests:None declared

Life table analysis of the risk of Type 1 (insulin-dependent) diabetes mellitus in siblings according to islet cell antibodies and HLA markers

Diabetologia ◽  
1992 ◽  
Vol 35 (10) ◽  
pp. 951-957 ◽  
Author(s):  
I. Deschamps ◽  
C. Boitard ◽  
J. Hors ◽  
M. Busson ◽  
A. Marcelli-Barge ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Life Table ◽  
Islet Cell ◽  
Islet Cell Antibodies ◽  
Insulin Dependent Diabetes Mellitus ◽  
Dependent Diabetes Mellitus ◽  
Life Table Analysis ◽  
Table Analysis ◽  
Insulin Dependent

Life Table Analysis of Prime Time Programs on a Television Network

1967 ◽  
Vol 21 (2) ◽  
pp. 21
Author(s):  
Melvin Prince
Keyword(s):  
Life Table ◽  
Prime Time ◽  
Life Table Analysis ◽  
Television Network ◽  
Table Analysis

FRI0279 USE OF TNF-INHIBITORS BEFORE, DURING AND THE FIRST YEAR AFTER PREGNANCY IN WOMEN WITH SPONDYLOARTHRITIS

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 727.1-727
Author(s):  
H. Bjørngaard ◽  
H. Koksvik ◽  
B. Jakobsen ◽  
M. Wallenius
Keyword(s):  
Disease Activity ◽  
Post Partum ◽  
Tnf Inhibitors ◽  
Treat To Target ◽  
Inflammatory Rheumatic Diseases ◽  
Tnf Inhibitor ◽  
Quality Register ◽  
Frequency Of Use ◽  
Asas Criteria ◽  
Pregnancy And Lactation

Background:Treat to target is a goal in pregnant women with spondyloarthristis. There is increasing evidence on safe use with TNF inhibitors during pregnancy (1). Adjusted use of TNF inhibitors preconception and throughout pregnancy may stabilize disease activity and prevent flares (2). Low disease activity is also beneficial for the fetus.Objectives:To study the use of TNF-inhibitors among women with spondyloarthritis in Norway before, during and after pregnancy.Methods:RevNatus is a Norwegian, nationwide quality register that monitors treatment of inflammatory rheumatic diseases before, during and after pregnancy. Data from RevNatus in the period October 2017 to October 2019 were used to map the use of all types of TNF inhibitors among 208 women with spondyloarthitis, fulfilling the ASAS criteria.The use of medication was reported at the time of visit in outpatient clinic. The frequency of use of TNF inhibitors is registered at seven timepoints from pre-pregnancy to twelve months after delivery.Results:The use of TNF-inhibitors was reported at each visit for all the women with spondyloarthritis. Most women are not using TNF inhibitors before and beyond conception. Most of the women continuing TNF inhibitors beyond conception, used certolizumab, etanercept, or adalimumab. Infliximab or golimumab were not used in pregnancy (tabell 2).Table 2:SPACertoli-zumabEtaner-ceptAdali-mumabGolim-umabInflik-simabNo TNF -inhibitorBefore Pregnancyn=13910% (14)8% (11)6% (9)6% (9)69% (96)1.trimestern=1027% (7)7% (7)2 % (2)84% (86)2.trimestern=1047% (7)6% (6)1% (1)87% (90)3. trimestern=953% (3)2% (2)1% (1)94% (89)6 weeks post partumn=10015% (15)10% (10)8% (8)3% (3)64% (64)6 months post partumn=8219% (16)12% (10)7% (6)2% (2)2% (2)55% (46)12 months post partumn=7422% (16)15% (11)7% (5)4% (3)5% (4)47% (35)Conclusion:A majority of the women with spondyloarthritis were not treated with TNF inhibitors before or during pregnancy. Only a few of the women with spondylosthritis continued treatment with TNF inhibitors during pregnancy.References:[1]Gotestam Skorpen C, Hoeltzenbein M, Tincani A, Fischer-Betz R, Elefant E, Chambers C, et al. The EULAR points to consider for use of antirheumatic drugs before pregnancy, and during pregnancy and lactation. 2016;75(5):795-810.[2]van den Brandt S, Zbinden A, Baeten D, Villiger PM, Ostensen M, Forger F. Risk factors for flare and treatment of disease flares during pregnancy in rheumatoid arthritis and axial spondyloarthritis patients. Arthritis Res Ther. 2017;19(1):64.Disclosure of Interests:None declared

Follow-Up Life Table Analysis

1981 ◽  
pp. 191-210
Author(s):  
Ron N. Forthofer ◽  
Robert G. Lehnen
Keyword(s):  
Life Table ◽  
Life Table Analysis ◽  
Table Analysis

scholarly journals Decomposing Indigenous life expectancy gap by risk factors: a life table analysis

2013 ◽  
Vol 11 (1) ◽  
Author(s):  
Yuejen Zhao ◽  
Jo Wright ◽  
Stephen Begg ◽  
Steven Guthridge
Keyword(s):  
Risk Factors ◽  
Life Expectancy ◽  
Life Table ◽  
Life Table Analysis ◽  
Table Analysis

Application of life table analysis to the onset of dementia in a genetically informative design

1999 ◽  
Vol 88 (2) ◽  
pp. 207-210 ◽  
Author(s):  
Samuel F. Posner ◽  
Nancy L. Pedersen ◽  
Margaret Gatz
Keyword(s):  
Life Table ◽  
Life Table Analysis ◽  
Table Analysis

scholarly journals Revisiting the guidelines for ending isolation for COVID-19 patients

eLife ◽  
2021 ◽  
Vol 10 ◽  
Author(s):  
Yong Dam Jeong ◽  
Keisuke Ejima ◽  
Kwang Su Kim ◽  
Shoya Iwanami ◽  
Ana I Bento ◽  
...  
Keyword(s):  
Symptom Onset ◽  
Fixed Time ◽  
Fixed Number ◽  
Mathematical Framework ◽  
Viral Dynamics ◽  
Repeated Testing ◽  
Personalized Approach ◽  
The One ◽  
Scientific Rationale

Since the start of the COVID-19 pandemic, two mainstream guidelines for defining when to end the isolation of SARS-CoV-2-infected individuals have been in use: the one-size-fits-all approach (i.e. patients are isolated for a fixed number of days) and the personalized approach (i.e. based on repeated testing of isolated patients). We use a mathematical framework to model within-host viral dynamics and test different criteria for ending isolation. By considering a fixed time of 10 days since symptom onset as the criterion for ending isolation, we estimated that the risk of releasing an individual who is still infectious is low (0–6.6%). However, this policy entails lengthy unnecessary isolations (4.8–8.3 days). In contrast, by using a personalized strategy, similar low risks can be reached with shorter prolonged isolations. The obtained findings provide a scientific rationale for policies on ending the isolation of SARS-CoV-2-infected individuals.

scholarly journals Obstructive Jaundice in Chronic Pancreatitis

HPB Surgery ◽  
1989 ◽  
Vol 1 (4) ◽  
pp. 263-270 ◽  
Author(s):  
M. J. Hollands ◽  
J. M. Little
Keyword(s):  
Chronic Pancreatitis ◽  
Obstructive Jaundice ◽  
Good Prognosis ◽  
Stent Insertion ◽  
Life Table Analysis ◽  
Pancreatic Calcification ◽  
Intraoperative Cytology ◽  
Table Analysis ◽  
Benign Nature ◽  
Time Of Presentation

Significant obstructive jaundice in chronic pancreatitis is generally considered to be rare. Eleven of 57 consecutive patients with proven chronic pancreatitis have developed significant obstructive jaundice of more than transient duration. Eight presented as jaundice complicating known pancreatitis and three as jaundice of unknown cause.Life table analysis showed a steady rise in the risk of developing jaundice up to the end of 10 years from the onset of chronic pancreatitis. Jaundice was found to occur in the presence of more “destructive” disease, and jaundiced patients had a higher incidence of pancreatic calcification, diabetes and malabsorption at the time of presentation with jaundice.Obstructive jaundice caused by chronic pancreatitis was found to carry a good prognosis for jaundice, for pain and for life. Only one of the 11 patients died in hospital.It is important to distinguish chronic pancreatitis from cancer in these patients. Pre-operative and intraoperative cytology have been helpful. Stent insertion is not an appropriate method of treatment for these patients because of the benign nature of the disease and the possibility of exacerbating the pancreatitis. It is important to be aware of another form of “malignant masquerade” causing obstructive jaundice.

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