8 results on '"Klingberg, Eva"'
Search Results
2. Weight loss is associated with sustained improvement of disease activity and cardiovascular risk factors in patients with psoriatic arthritis and obesity: a prospective intervention study with two years of follow-up
- Author
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Klingberg, Eva, Björkman, Sofia, Eliasson, Björn, Larsson, Ingrid, and Bilberg, Annelie
- Published
- 2020
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- View/download PDF
3. The National Prevalence of Clinically Diagnosed Psoriatic Arthritis in Sweden in 2017.
- Author
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Exarchou, Sofia, Wallman, Johan K., Giuseppe, Daniela Di, Klingberg, Eva, Sigurdardottir, Valgerdur, Wedrén, Sara, Lindström, Ulf, Turesson, Carl, Jacobsson, Lennart T. H., and Askling, Johan
- Abstract
Objective. Psoriatic arthritis (PsA) prevalence estimates vary across studies; studies based on national data are few. We aimed to estimate the prevalence of clinically diagnosed PsA in Sweden in 2017, overall and stratified by sex, age, education, and geography, and to quantify disease-modifying antirheumatic drug (DMARD) use among those in contact with specialized rheumatology care between 2015 and 2017. Methods. Individuals who were 18 to 79 years of age, alive and residing in Sweden on December 31, 2017, and had a prior PsA diagnosis were identified from the National Patient Register (NPR) and/or the Swedish Rheumatology Quality Register (SRQ). PsA prevalence was estimated according to a base case (BC) definition (ie, ≥ 1 main PsA International Classification of Diseases code from rheumatology or internal medicine departments in the NPR or a PsA diagnosis in the SRQ), according to 4 sensitivity analysis definitions, and for those seen in specialized rheumatology care between 2015 and 2017. In the latter group, DMARD use during 2017 was also assessed. Data for stratifications were retrieved from national registers. Results. The crude national prevalence of PsA for adults, aged 18 to 79 years, was estimated at 0.39%, according to the BC definition; 0.34% after accounting for diagnostic misclassification; and 0.32% to 0.50% across all sensitivity analyses. The prevalence was lower in males and in those with a higher level of education. The prevalence for those seen in specialized rheumatology care between 2015 and 2017 was estimated at 0.24%. During 2017, 32% of patients in this population received biologic or targeted synthetic DMARDs, and 41% received conventional synthetic DMARDs only. Conclusion. The prevalence of clinically diagnosed PsA in adults, aged 18 to 79 years, in Sweden in 2017 was around 0.35%. Among PsA cases in recent contact with specialized rheumatology care, almost three-fourths received DMARD therapy in 2017. [ABSTRACT FROM AUTHOR]
- Published
- 2023
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4. Incidence of extra-articular manifestations in ankylosing spondylitis, psoriatic arthritis and undifferentiated spondyloarthritis: results from a national register-based cohort study.
- Author
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Bengtsson, Karin, Forsblad-d'Elia, Helena, Deminger, Anna, Klingberg, Eva, Dehlin, Mats, Exarchou, Sofia, Lindström, Ulf, Askling, Johan, and Jacobsson, Lennart T H
- Subjects
PSORIASIS ,PSORIATIC arthritis ,INFLAMMATORY bowel diseases ,ANKYLOSING spondylitis ,AGE distribution ,DISEASE incidence ,SPONDYLOARTHROPATHIES ,SEX distribution ,DESCRIPTIVE statistics ,IRIDOCYCLITIS ,LONGITUDINAL method ,DISEASE risk factors ,DISEASE complications - Abstract
Objectives To estimate the incidence and strength of association of extra-articular manifestations [EAMs, here: anterior uveitis (AU), IBD and psoriasis] in patients with AS, undifferentiated SpA (uSpA) and PsA, compared with controls. Methods Three mutually exclusive cohorts of patients aged 18–69 years with AS (n = 8517), uSpA (n = 10 245) and PsA (n = 22 667) were identified in the Swedish National Patient Register 2001–2015. Age-, sex- and geography-matched controls were identified from the Swedish Population Register. Follow-up began 1 January 2006, or six months after the first SpA diagnosis, whichever occurred later, and ended at the first date of the EAM under study, death, emigration, 70 years of age, and 31 December 2016. Incidence rates (IRs) and incidence rate ratios were calculated for each EAM, and stratified by sex and age. Results Incidence rate ratios for incident AU, IBD and psoriasis were significantly increased in AS (20.2, 6.2, 2.5), uSpA (13.6, 5.7, 3.8) and PsA (2.5, 2.3, n.a) vs controls. Men with AS and uSpA had significantly higher IRs per 1000 person-years at risk for incident AU than women with AS (IR 15.8 vs 11.2) and uSpA (IR 10.1 vs 6.0), whereas no such sex difference was demonstrated in PsA or for the other EAMs. Conclusions AU, followed by IBD and psoriasis, is the EAM most strongly associated with AS and uSpA. Among the SpA subtypes, AS and uSpA display a largely similar pattern of EAMs, whereas PsA has a considerably weaker association with AU and IBD. [ABSTRACT FROM AUTHOR]
- Published
- 2021
- Full Text
- View/download PDF
5. Weight loss improves disease activity in patients with psoriatic arthritis and obesity: an interventional study
- Author
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Klingberg, Eva, Bilberg, Annelie, Bjorkman, Sofia, Hedberg, Martin, Jacobsson, Lennart, Forsblad-d'Elia, Helena, Carlsten, Hans, Eliasson, Bjorn, and Larsson, Ingrid
- Subjects
Adult ,Male ,Reumatologi och inflammation ,Weight loss ,lcsh:Diseases of the musculoskeletal system ,Diet, Reducing ,VLED ,Arthritis, Psoriatic ,Middle Aged ,Cardiovascular disease ,Metabolic syndrome ,Treatment Outcome ,Psoriatic arthritis ,Disease Progression ,Humans ,Psoriasis ,Female ,Obesity ,Prospective Studies ,lcsh:RC925-935 ,Rheumatology and Autoimmunity ,Aged ,Follow-Up Studies ,Research Article - Abstract
Background Obesity is over-represented in patients with psoriatic arthritis (PsA) and associated with higher disease activity, poorer effect of treatment and increased cardiovascular morbidity. Studies on the effects of weight loss are however needed. This study aimed to prospectively study the effects of weight loss treatment with very low energy diet (VLED) on disease activity in patients with PsA (CASPAR criteria) and obesity (body mass index BMI ≥ 33 kg/m2). Methods VLED (640 kcal/day) was taken during 12–16 weeks, depending on pre-treatment BMI. Afterwards, an energy-restricted diet was gradually reintroduced. Weight loss treatment was given within a structured framework for support and medical follow-up. Treatment with conventional synthetic and/or biologic disease-modifying anti-rheumatic drugs was held constant from 3 months before, until 6 months after baseline. Patients were assessed with BMI, 66/68 joints count, Leeds enthesitis index, psoriasis body surface area (BSA), questionnaires and CRP at baseline, 3 and 6 months. Primary outcome was the percentage of patients reaching minimal disease activity (MDA) and secondary outcomes were reaching Psoriatic Arthritis Response Criteria (PsARC) and American College of Rheumatology (ACR) response criteria. Results Totally 41/46 patients completed the study, 63% women, median age 54 years (IQR 48–62). At baseline increased BMI was associated with higher disease activity and poorer function. The median weight loss was 18.7 kg (IQR 14.6–26.5) or 18.6% (IQR 14.7–26.3) of the baseline weight. A majority of the disease activity parameters improved significantly after weight loss, including 68/66 tender/swollen joints count, CRP, BSA, Leeds enthesitis index, HAQ and patient VAS for global health, pain and fatigue. A larger weight loss resulted in more improvement in a dose-response manner. The percentage of patients with MDA increased from 29 to 54%, (p = 0.002). PsARC was reached by 46.3%. The ACR 20, 50 and 70 responses were 51.2%, 34.1% and 7.3% respectively. Conclusions Short-term weight loss treatment with VLED was associated with significant positive effects on disease activity in joints, entheses and skin in patients with PsA and obesity. The study supports the hypothesis of obesity as a promotor of disease activity in PsA. Trial registration ClinicalTrials.gov identifier: NCT02917434, registered on September 21, 2016—retrospectively registered Electronic supplementary material The online version of this article (10.1186/s13075-019-1810-5) contains supplementary material, which is available to authorized users.
- Published
- 2018
6. Risk of cardiac rhythm disturbances and aortic regurgitation in different spondyloarthritis subtypes in comparison with general population: a register-based study from Sweden.
- Author
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Bengtsson, Karin, Forsblad-D'Elia, Helena, Lie, Elisabeth, Klingberg, Eva, Dehlin, Mats, Exarchou, Sofia, Lindström, Ulf, Askling, Johan, and Jacobsson, Lennart T. H.
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ATRIAL fibrillation treatment ,ANKYLOSING spondylitis ,AORTIC valve insufficiency ,ARRHYTHMIA ,ATRIAL fibrillation ,CARDIAC pacemakers ,COMPARATIVE studies ,HEART block ,LONGITUDINAL method ,RESEARCH methodology ,MEDICAL cooperation ,PSORIATIC arthritis ,RESEARCH ,SEX distribution ,SPONDYLOARTHROPATHIES ,EVALUATION research ,DISEASE incidence ,ACQUISITION of data ,PROPORTIONAL hazards models ,DISEASE complications ,THERAPEUTICS - Abstract
Objectives: To describe the incidence of atrioventricular (AV) block II-III, atrial fibrillation (AF), pacemaker implantation (PM) and aortic regurgitation in patients with ankylosing spondylitis (AS), undifferentiated spondyloarthritis (uSpA) and psoriatic arthritis (PsA) compared with the general population (GP) and with each other.Methods: A prospective nationwide study with cohorts of patients with AS (n=6448), PsA (n=16 063) and uSpA (n=5190) and a GP (n=2 66 435) cohort, identified in 2001-2009 in the Swedish National Patient and Population registers. Follow-up began on 1 January 2006 and ended at event, death, emigration or 31 December 2012. Age-standardised and sex-standardised incidence rates and hazard ratios (HRs) were calculated.Results: The highest incidence rates were noted for AF (5.5-7.4 events per 1000 person-years), followed by PM (1.0-2.0 events per 1000 person-years). HRs for AV block, AF, PM and aortic regurgitation were significantly increased in AS (HRs 2.3, 1.3, 2.1 and 1.9), uSpA (HRs 2.9, 1.3, 1.9 and 2.0) and PsA (HRs 1.5, 1.5, 1.6 and 1.8) compared with the GP cohort. The highest HRs were seen for AV block in male uSpA (HR 4.2) and AS (HR 2.5) compared with GP. Compared with PsA, significantly increased HRs were noted for PM (HR 1.5) in AS and for AV block (HR 1.8) in uSpA.Conclusions: Patients with SpA are at increased risk of aortic regurgitation, cardiac rhythm disturbances and, as a probable consequence, also PM. Particularly for AF, the most common arrhythmia, increased caution is warranted, whereas AV block should be looked for especially in men with AS or uSpA. [ABSTRACT FROM AUTHOR]- Published
- 2018
- Full Text
- View/download PDF
7. Weight Loss Improves Disease Activity in Patients with Psoriatic Arthritis and Obesity: An Interventional Study.
- Author
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KLINGBERG, EVA, BILBERG, ANNELIE, BJÖRKMAN, SOFIA, HEDBERG, MARTIN, JACOBSSON, LENNART, FORSBLAD-D'ELIA, HELENA, CARLSTEN, HANS, ELIASSON, BJÖRN, and LARSSON, INGRID
- Subjects
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PSORIATIC arthritis , *WEIGHT loss , *OBESITY , *BODY surface area , *BODY mass index , *C-reactive protein - Abstract
Background: Obesity is overrepresented in patients with psoriatic arthritis (PsA) and associated with higher disease activity, poorer effect of treatment, and increased cardiovascular morbidity. However, studies on the effects of weight loss are needed. This study aimed to prospectively study the effects of weight loss treatment with a very low energy diet (VLED) on disease activity in patients with PsA (CASPAR criteria) and obesity (body mass index [BMI≥33kg/m2). Methods: VLED (640kcal/day) was taken for 12 to 16 weeks, depending on pretreatment BMI. Afterward, an energy-restricted diet was gradually reintroduced. Weight loss treatment was given within a structured framework for support and medical follow-up. Treatment with conventional synthetic and/or biologic disease-modifying antirheumatic drugs was held constant from three months before, until six months after baseline. Patients were assessed with BMI, 66/68 joints count, Leeds enthesitis index, psoriasis body surface area (BSA), questionnaires, and C-reactive protein (CRP) at baseline, three, and six months. Primary outcome was the percentage of patients reaching minimal disease activity (MDA) and secondary outcomes were reaching Psoriatic Arthritis Response Criteria (PsARC) and American College of Rheumatology (ACR) response criteria. Results: In total, 41 of 46 patients completed the study, 63 percent of whom were women, with a median age of 54 years (interquartile range [IQR] 48-62). At baseline, increased BMI was associated with higher disease activity and poorer function. The median weight loss was 18.7kg (IQR 14.6-26.5) or 18.6 percent (IQR 14.7-26.3) of the baseline weight. A majority of the disease activity parameters improved significantly after weight loss, including 68/66 tender/swollen joints count, CRP, BSA, Leeds enthesitis index, Health Assessment Questionnaire (HAQ) and patient Visual Analogue Scale (VAS) for global health, pain, and fatigue. A larger weight loss resulted in more improvement in a dose-response manner. The percentage of patients with MDA increased from 29 to 54 percent, (p=0.002). PsARC was reached by 46.3 percent of patients. The ACR 20, 50 and 70 responses were 51.2, 34.1, and 7.3 percent of patients, respectively. Conclusion: Short-term weight loss treatment with VLED was associated with significant positive effects on disease activity in joints, entheses, and skin in patients with PsA and obesity. The study supports the hypothesis of obesity as a promotor of disease activity in PsA. Trial registration: ClinicalTrials.gov identifier: NCT02917434, registered on September 21, 2016--retrospectively registered. [ABSTRACT FROM AUTHOR]
- Published
- 2019
8. Comment on: Incidence of extra-articular manifestations in AS, PsA and undifferentiated SpA: results from a national register-based cohort study. Reply.
- Author
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Bengtsson, Karin, Forsblad-d'Elia, Helena, Deminger, Anna, Klingberg, Eva, Dehlin, Mats, Exarchou, Sofia, Lindström, Ulf, Askling, Johan, and Jacobsson, Lennart T H
- Subjects
PSORIASIS ,PSORIATIC arthritis ,INFLAMMATORY bowel diseases ,ANKYLOSING spondylitis ,DISEASE incidence ,SPONDYLOARTHROPATHIES ,IRIDOCYCLITIS ,DISEASE risk factors ,DISEASE complications - Published
- 2022
- Full Text
- View/download PDF
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