Epidemiologi av urinsyregikt

Gout is more prevalent in men than in women. However, there is a reduction in the difference in prevalence between men and women after menopause. The incidence is low in young age, but increases with increasing age, particularly after the age of 50. The risk of gout attack is to some extent dependent on the level of the serum concentration of urate. In the last decades the prevalence of gout has increased substantially, probably due to increase in the proportion of people with overweigth, disease promoting lifestyle changes, metabolic syndrome, diabetes and cardiovascular disease (CVD). Hypeuricemia inducing drugs may also play a role. Drugs may play an important role in the treatment of the acute gout attacks. However, changes in lifestyle and diet are important prophylactic efforts. High levels of serum urate may be a risk factor for the development of CVD, but at the moment it is not explored whether the serum urate level is a marker or an independent contributor to the morbidity and mortality of CVD.</jats:p

Effectiveness and Persistence in SB4- and Reference Etanercept–Treated Rheumatoid Arthritis Patients in Ordinary Clinical Practice in Norway

Objective Biosimilars represent cost-effective alternatives to reference biologic disease-modifying antirheumatic drugs. Our objective was to compare drug effectiveness and drug persistence in the treatment of rheumatoid arthritis (RA), assessing the etanercept biosimilar SB4 in efficacy and safety compared with reference etanercept in a Phase III, randomized controlled trial. We applied EULAR Points to Consider for Comparative Effectiveness Research in a retrospective database study of etanercept and SB4 in patients treated in clinical practice in Norway. Methods Patients with RA (n = 1,455) treated with etanercept or SB4 between 2010 and 2018 at 5 centers in Norway with ≥1 year of follow-up were included. Disease outcomes (Disease Activity Score in 28 joints [DAS28] at week 52) and drug persistence were compared between unmatched etanercept (n = 575) and SB4 (n = 299) cohorts and matched analyses (n = 172, both cohorts) using propensity score (PS) matching to adjust for confounders. Results In unmatched analyses, the difference in change from baseline between etanercept (n = 221) and SB4 (n = 106) for DAS28 at week 52 was mean –0.02 (95% confidence interval [95% CI] –0.32, 0.27), demonstrating equivalence by the predetermined equivalence margin (±0.6). In PS-matched analyses, the difference between etanercept (n = 49) and SB4 (n = 49) was 0.03 (95% CI –0.46, 0.52), within the predefined equivalence margin. Persistence using the drug at week 52 was similar between etanercept (0.62 [95% CI 0.57, 0.65]) and SB4 (0.66 [95% CI 0.60, 0.71]) cohorts in the unmatched analysis; in PS-matched cohorts, persistence at week 52 was 0.52 (95% CI 0.44, 0.59) for etanercept and 0.68 (95% CI 0.61, 0.75) for SB4. Conclusion Outcomes for disease status/drug persistence at week 52 were similar between patients with RA treated with etanercept or SB4.publishedVersio

Revmatoid artritt i Norge - demografi, sykdomskarakteristika og behandling : en sammenligning med andre europeiske land og USA

Bakgrunn: Revmatoid artritt (RA) er en kronisk inflammatorisk leddsykdom som gir økt sykelighet og dødelighet. Nye biologiske legemidler har de siste 10 årene bedret prognosen betydelig. I 2005 ble QUEST-RA (Quantitative Standard Monitoring of Patients with Rheumatoid Arthritis) prosjektet etablert for å sammenligne sykdomsstatus og behandling hos RA-pasienter i forskjellige land. I denne artikkelen presenteres status for RA-pasienter i Norge sammenlignet med andre europeiske land og USA. Materiale og metode: Tilfeldig utvalgte RA-pasienter fulgt opp ved revmatologisk poliklinikk ved Sørlandet sykehus i Kristiansand (n=100) og St. Olavs Hospital i Trondheim (n=100) ble inkludert. I henhold til protokoll ble demografiske, sykdoms- og behandlingsdata registrert. Resultater: Norske RA-pasienter skilte seg lite fra gjennomsnittet i andre land med hensyn til alder, utdannelse og sykdomsvarighet. Sykdomsalvorlighet og sykdomsstatus til norske RA-pasienter er sammenlignbare med pasienter fra land som har lavest sykdomsaktivitet og best helsestatus. I Norge er andelen som behandles med biologiske legemidler ca 30%, og Norge er blant de land med størst andel pasienter som behandles med denne legemiddelgruppen. Fortolkning: RA-pasienter i Norge er blant de i Europa som har lavest sykdomsaktivitet. En årsak antas å være den relativt utbredte bruken av biologiske legemidler i Norge.publishedVersionCopyright (c) 2015 Norsk epidemiologi Creative Commons License This work is licensed under a Creative Commons Attribution 4.0 International License

Norwegian society of rheumatology recommendations on diagnosis and treatment of patients with giant cell arteritis

ObjectiveTo provide clinical guidance to Norwegian Rheumatologists and other clinicians involved in diagnosing and treating patients with giant cell arteritis (GCA).MethodsThe available evidence in the field was reviewed, and the GCA working group wrote draft guidelines. These guidelines were discussed and revised according to standard procedures within the Norwegian Society of Rheumatology. The European Alliance of Associations for Rheumatology (EULAR) recommendations for imaging and treatment in large vessel vasculitis and the British Society for Rheumatology (BSR) guidelines for diagnostics and treatment in GCA informed the development of the current guidelines.ResultsA total of 13 recommendations were developed. Ultrasound is recommended as the primary diagnostic test. In patients with suspected GCA, treatment with high doses of Prednisolone (40–60 mg) should be initiated immediately. For patients with refractory disease or relapse, Methotrexate (MTX) should be used as the first-line adjunctive therapy, followed by tocilizumab (TCZ).ConclusionNorwegian recommendations for diagnostics and treatment to improve management and outcome in patients with GCA were developed

Paid work is associated with improved health-related quality of life in patients with rheumatoid arthritis

Numerous patients with rheumatoid arthritis (RA) end their working career due to consequences of the disease. No publication has reported whether there is an independent association between patients' health-related quality of life (HRQOL) and employment status. The objective of the study was to investigate the association of paid work and HRQOL in patients with RA whilst controlling for demographics and disease severity. This was a cross-sectional study. Three hundred and ten patients were consecutively recruited from two Norwegians hospitals when commencing disease modifying anti-rheumatic drug treatment. Data on demographics, employment status, disease activity (DAS28-3), physical functioning, pain, tiredness, and HRQOL (SF-36) were collected. HRQOL were compared between 123 patients working full- or part-time and 187 patients not working due to disability pension, retirement, being students or “home workers”. The regression analyses showed an independent positive association between paid work and the physical (p = 001) and the mental component (p = 012) of the SF-36 when controlling for demographics and disease severity. Paid work was statistically significantly associated with better HRQOL in patients with RA. The positive association of performing paid work and HRQOL imply that health care providers should thoroughly evaluate the possibilities for the patients to continue with paid work

Rare variants with large effects provide functional insights into the pathology of migraine subtypes, with and without aura

Migraine is a complex neurovascular disease with a range of severity and symptoms, yet mostly studied as one phenotype in genome-wide association studies (GWAS). Here we combine large GWAS datasets from six European populations to study the main migraine subtypes, migraine with aura (MA) and migraine without aura (MO). We identified four new MA-associated variants (in PRRT2, PALMD, ABO and LRRK2) and classified 13 MO-associated variants. Rare variants with large effects highlight three genes. A rare frameshift variant in brain-expressed PRRT2 confers large risk of MA and epilepsy, but not MO. A burden test of rare loss-of-function variants in SCN11A, encoding a neuron-expressed sodium channel with a key role in pain sensation, shows strong protection against migraine. Finally, a rare variant with cis-regulatory effects on KCNK5 confers large protection against migraine and brain aneurysms. Our findings offer new insights with therapeutic potential into the complex biology of migraine and its subtypes.</p

Rare variants with large effects provide functional insights into the pathology of migraine subtypes, with and without aura

Migraine is a complex neurovascular disease with a range of severity and symptoms, yet mostly studied as one phenotype in genome-wide association studies (GWAS). Here we combine large GWAS datasets from six European populations to study the main migraine subtypes, migraine with aura (MA) and migraine without aura (MO). We identified four new MA-associated variants (in PRRT2, PALMD, ABO and LRRK2) and classified 13 MO-associated variants. Rare variants with large effects highlight three genes. A rare frameshift variant in brain-expressed PRRT2 confers large risk of MA and epilepsy, but not MO. A burden test of rare loss-of-function variants in SCN11A, encoding a neuron-expressed sodium channel with a key role in pain sensation, shows strong protection against migraine. Finally, a rare variant with cis-regulatory effects on KCNK5 confers large protection against migraine and brain aneurysms. Our findings offer new insights with therapeutic potential into the complex biology of migraine and its subtypes.</p

Rare variants with large effects provide functional insights into the pathology of migraine subtypes, with and without aura

Publisher Copyright: © 2023, The Author(s).Migraine is a complex neurovascular disease with a range of severity and symptoms, yet mostly studied as one phenotype in genome-wide association studies (GWAS). Here we combine large GWAS datasets from six European populations to study the main migraine subtypes, migraine with aura (MA) and migraine without aura (MO). We identified four new MA-associated variants (in PRRT2, PALMD, ABO and LRRK2) and classified 13 MO-associated variants. Rare variants with large effects highlight three genes. A rare frameshift variant in brain-expressed PRRT2 confers large risk of MA and epilepsy, but not MO. A burden test of rare loss-of-function variants in SCN11A, encoding a neuron-expressed sodium channel with a key role in pain sensation, shows strong protection against migraine. Finally, a rare variant with cis-regulatory effects on KCNK5 confers large protection against migraine and brain aneurysms. Our findings offer new insights with therapeutic potential into the complex biology of migraine and its subtypes.Peer reviewe