Umeå University's logo

umu.sePublications
Change search
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf
Incidence and predisposing factors of extra-articular manifestations in contemporary rheumatoid arthritis
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Rheumatology. Academic Specialist Center, Center for Rheumatology, Health Care Services Stockholm County (SLSO), Stockholm, Sweden.ORCID iD: 0000-0001-8999-0925
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Rheumatology.
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Rheumatology.
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Rheumatology.
Show others and affiliations
2024 (English)In: European journal of internal medicine, ISSN 0953-6205, E-ISSN 1879-0828Article in journal (Refereed) In press
Abstract [en]

Objective: Rheumatoid arthritis [RA) is a chronic inflammatory disease, with potential for extra-articular manifestations (ExRA). The incidence and predisposing factors for ExRA and the mortality were evaluated in an early RA inception cohort.

Methods: Patients (n = 1468; 69 % females, mean age (SD) 57.3(16.3) years) were consecutively included at the date of diagnosis, between 1 January 1996 and 31 December 2016, and assessed prospectively. In December 2016 development of ExRA was evaluated by a patient questionnaire and a review of medical records. Cumulative incidence and incidence rates were compared between 5-year periods and between patients included before and after 1 January 2001. Cox proportional hazard regression models were used to identify predictors for ExRA, and models with ExRA as time-dependent variables to estimate the mortality.

Results: After a mean (SD) follow-up of 9.3(4.9) years, 238 cases (23.3 %) had ExRA and 151 (14.7 %) had ExRA without rheumatoid nodules. Most ExRA developed within 5 years from diagnosis. Rheumatoid nodules (10.5 %) and keratoconjunctivitis sicca (7.1 %) were the most frequent manifestations, followed by pulmonary fibrosis (6.1 %). The ExRA incidence among more recently diagnosed patients was similar as to the incidence among patients diagnosed before 2001. Seropositivity, smoking and early biological treatment were associated with development of ExRA. After 15 years 20 % had experienced ExRA. ExRA was associated with increased mortality, HR 3.029 (95 % CI 2.177–4.213).

Conclusions: Early development of ExRA is frequent, particularly rheumatoid nodules. Predisposing factors were age, RF positivity, smoking and early biological treatment. The patients with ExRA had a 3-fold increase in mortality.

Place, publisher, year, edition, pages
2024.
Keywords [en]
ACPA, Disease modifying anti-rheumatic drugs, RF, Rheumatoid arthritis
National Category
Rheumatology and Autoimmunity
Identifiers
URN: urn:nbn:se:umu:diva-224250DOI: 10.1016/j.ejim.2024.04.026Scopus ID: 2-s2.0-85192184871OAI: oai:DiVA.org:umu-224250DiVA, id: diva2:1857983
Funder
Swedish Research Council, K2013–52X-20307–07–3Swedish Research Council, 2018–02551Stiftelsen Konung Gustaf V:s 80-årsfondSwedish Rheumatism AssociationUmeå UniversityAvailable from: 2024-05-15 Created: 2024-05-15 Last updated: 2024-05-15

Open Access in DiVA

fulltext(878 kB)24 downloads
File information
File name FULLTEXT01.pdfFile size 878 kBChecksum SHA-512
85ccae8e5650fd823a67e789bf52f3baa8361d45ec6e81cbcb8bb44724dd3593726474d768a074cf360b9e87c74c48af64fcafda2fbe0a2e5a09496735e7b90b
Type fulltextMimetype application/pdf

Other links

Publisher's full textScopus

Authority records

Ljung, LottaJönsson, EliasLundquist, AndersRantapää-Dahlqvist, Solbritt

Search in DiVA

By author/editor
Ljung, LottaJönsson, EliasLundquist, AndersRantapää-Dahlqvist, Solbritt
By organisation
RheumatologyStatistics
In the same journal
European journal of internal medicine
Rheumatology and Autoimmunity

Search outside of DiVA

GoogleGoogle Scholar
Total: 24 downloads
The number of downloads is the sum of all downloads of full texts. It may include eg previous versions that are now no longer available

doi
urn-nbn

Altmetric score

doi
urn-nbn
Total: 162 hits
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf