20 results on '"Hammer, Hilde B"'
Search Results
2. Ultrasonography of Inflammatory and Structural Lesions in Hand Osteoarthritis: An Outcome Measures in Rheumatology Agreement and Reliability Study
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Mathiessen, Alexander, Hammer, Hilde B., Terslev, Lene, Kortekaas, Marion, D'Agostino, Maria A., Haugen, Ida K., Bruyn, George, Filippou, Georgios, Filippucci, Emilio, Kloppenburg, Margreet, Mancarella, Luana, Mandl, Peter, Möller, Ingrid, Mortada, Mohamed A., Naredo, Esperanza, Sedie, Andrea Delle, Sexton, Joseph, Wittoek, Ruth, Iagnocco, Annamaria, Ellegaard, Karen, Gandjbakhch, Frederique, Keen, Helen, Hammer, Hilde Berner, D'Agostino, Maria Antonietta, Vlychou, Marianna, and Damjanov, Nemanja
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medicine.medical_specialty ,business.industry ,Cartilage ,Ultrasound ,Joint effusion ,Rheumatology ,medicine.anatomical_structure ,Internal medicine ,medicine ,Ultrasonography ,medicine.symptom ,business ,Nuclear medicine ,Kappa ,Hand osteoarthritis ,Reliability (statistics) - Abstract
Objective To standardize and assess the reliability of ultrasonographic assessment of inflammatory and structural lesions in patients with hand osteoarthritis (OA). Methods The Outcome Measures in Rheumatology Ultrasound Working Group selected synovial hypertrophy (SH), joint effusion (JE), and power Doppler (PD) signals as the main inflammatory lesions in hand OA, and suggested osteophytes in the scapho-trapezio-trapezoid (STT) and cartilage defects in the proximal interphalangeal (PIP) joints as novel additions to previous structural scoring systems. A complementary imaging atlas provided detailed examples of the scores. A reliability exercise of static images was performed for the inflammatory features, followed by a patient-based exercise with 6 sonographers testing inflammatory and structural features in 12 hand OA patients. We used Cohen's kappa for intrareader and Light's kappa for interreader reliability for all features except PD, in which prevalence-adjusted bias-adjusted kappa (PABAK) was applied. Percentage agreement was also assessed. Results The web-based reliability exercise demonstrated substantial intra- and interreader reliability for all inflammatory features (kappa > 0.64). In the patient-based exercise, intra- and interreader reliability, respectively, varied: SH kappa = 0.73 and 0.45; JE kappa = 0.70 and 0.55; PD PABAK = 0.90 and 0.88; PIP joint cartilage kappa = 0.56 and 0.45; and STT osteophytes kappa = 0.62 and 0.36. Percentage close agreement was high for all features (>85%). Conclusion With ultrasound, substantial to excellent intrareader reliability was found for inflammatory features of hand OA. Interreader reliability was moderate, but overall high close agreement between readers suggests that better reliability is achievable after further training. Assessment of osteophytes in the STT joint and cartilage in the PIP joints achieved less reliability and the latter is not endorsed.
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- 2022
3. Brief Report: Validation of a Definition of Flare in Patients With Established Gout
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Gaffo, Angelo L., Dalbeth, Nicola, Saag, Kenneth G., Singh, Jasvinder A., Rahn, Elizabeth J., Mudano, Amy S., Chen, Yi‐Hsing, Lin, Ching‐Tsai, Bourke, Sandra, Louthrenoo, Worawit, Vazquez‐Mellado, Janitzia, Hernández‐Llinas, Hansel, Neogi, Tuhina, Vargas‐Santos, Ana Beatriz, da Rocha Castelar‐Pinheiro, Geraldo, Amorim, Rodrigo B. C., Uhlig, Till, Hammer, Hilde B., Eliseev, Maxim, Perez‐Ruiz, Fernando, Cavagna, Lorenzo, McCarthy, Geraldine M., Stamp, Lisa K., Gerritsen, Martijn, Fana, Viktoria, Sivera, Francisca, and Taylor, William
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- 2018
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4. Ultrasonography of inflammatory and structural lesions in hand osteoarthritis : an OMERACT agreement and reliability study
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Mathiessen, Alexander, Hammer, Hilde B., Terslev, Lene, Kortekaas, Marion C., D’Agostino, Maria A., Haugen, Ida K., Bruyn, George A., Filippou, Georgios, Filippucci, Emilio, Kloppenburg, Margreet, Mancarella, Luana, Mandl, Peter, Möller, Ingrid, Mortada, Mohamed A., Naredo, Esperanza, Delle Sedie, Andrea, Sexton, Joseph, Wittoek, Ruth, Iagnocco, Annamaria, Ellegaard, Karen, and The OMERACT Ultrasound working Group, [missing]
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hand osteoarthritis ,SCORING SYSTEM ,SYNOVITIS ,FEATURES ,PROGRESSION ,ultrasonography ,PREVALENCE ,outcome measures ,Rheumatology ,Medicine and Health Sciences ,ARTHRITIS ,BONE EROSIONS ,CLINICAL-TRIALS ,ULTRASOUND ,ASSOCIATIONS - Abstract
Objective To standardize and assess the reliability of ultrasonographic assessment of inflammatory and structural lesions in patients with hand osteoarthritis (OA). Methods The Outcome Measures in Rheumatology Ultrasound Working Group selected synovial hypertrophy (SH), joint effusion (JE), and power Doppler (PD) signals as the main inflammatory lesions in hand OA, and suggested osteophytes in the scapho-trapezio-trapezoid (STT) and cartilage defects in the proximal interphalangeal (PIP) joints as novel additions to previous structural scoring systems. A complementary imaging atlas provided detailed examples of the scores. A reliability exercise of static images was performed for the inflammatory features, followed by a patient-based exercise with 6 sonographers testing inflammatory and structural features in 12 hand OA patients. We used Cohen's kappa for intrareader and Light's kappa for interreader reliability for all features except PD, in which prevalence-adjusted bias-adjusted kappa (PABAK) was applied. Percentage agreement was also assessed. Results The web-based reliability exercise demonstrated substantial intra- and interreader reliability for all inflammatory features (kappa > 0.64). In the patient-based exercise, intra- and interreader reliability, respectively, varied: SH kappa = 0.73 and 0.45; JE kappa = 0.70 and 0.55; PD PABAK = 0.90 and 0.88; PIP joint cartilage kappa = 0.56 and 0.45; and STT osteophytes kappa = 0.62 and 0.36. Percentage close agreement was high for all features (>85%). Conclusion With ultrasound, substantial to excellent intrareader reliability was found for inflammatory features of hand OA. Interreader reliability was moderate, but overall high close agreement between readers suggests that better reliability is achievable after further training. Assessment of osteophytes in the STT joint and cartilage in the PIP joints achieved less reliability and the latter is not endorsed.
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- 2022
5. Ultrasonography of Inflammatory and Structural Lesions in Hand Osteoarthritis: An OMERACT Agreement and Reliability Study
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Mathiessen, Alexander, Hammer, Hilde B, Terslev, Lene, Kortekaas, Marion C, D'Agostino, Maria Antonietta, Haugen, Ida K, Bruyn, George A, Filippou, Georgios, Filippucci, Emilio, Kloppenburg, Margreet, Mancarella, Luana, Mandl, Peter, Möller, Ingrid, Mortada, Mohamed A, Naredo, Esperanza, Delle Sedie, Andrea, Sexton, Joseph, Wittoek, Ruth, Iagnocco, Annamaria, and Ellegaard, Karen
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outcome measures ,Settore MED/16 - REUMATOLOGIA ,Hand osteoarthritis ,ultrasonography - Published
- 2021
6. Associations of Body Mass Index With Pain and the Mediating Role of Inflammatory Biomarkers in People With Hand Osteoarthritis.
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Gløersen, Marthe, Steen Pettersen, Pernille, Neogi, Tuhina, Jafarzadeh, S. Reza, Vistnes, Maria, Thudium, Christian S., Bay‐Jensen, Anne‐Christine, Sexton, Joe, Kvien, Tore K., Hammer, Hilde B., and Haugen, Ida K.
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BIOMARKERS ,C-reactive protein ,PAIN ,KNEE pain ,CONFIDENCE intervals ,LEPTIN ,EFFECT sizes (Statistics) ,HAND osteoarthritis ,PAIN threshold ,FACTOR analysis ,DESCRIPTIVE statistics ,QUESTIONNAIRES ,BODY mass index ,INFLAMMATORY mediators - Abstract
Objective: To examine the association of body mass index (BMI) with pain in people with hand osteoarthritis (OA), and explore whether this association, if causal, is mediated by systemic inflammatory biomarkers. Methods: In 281 Nor‐Hand study participants, we estimated associations between BMI and hand pain, as measured by the Australian/Canadian Osteoarthritis Hand Index (AUSCAN; range 0–20) and Numerical Rating Scale (NRS; range 0–10); foot pain, as measured by NRS (range 0–10); knee/hip pain, as measured by the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC; range 0–20); painful total body joint count; and pain sensitization. We fit natural‐effects models to estimate natural direct and natural indirect effects of BMI on pain through inflammatory biomarkers. Results: Each 5‐unit increase in BMI was associated with more severe hand pain (on average increased AUSCAN by 0.64 [95% confidence interval (95% CI) 0.23, 1.08]), foot pain (on average increased NRS by 0.65 [95% CI 0.36, 0.92]), knee/hip pain (on average increased WOMAC by 1.31 [95% CI 0.87, 1.73]), generalized pain, and pain sensitization. Mediation analyses suggested that the effects of BMI on hand pain and painful total body joint count were partially mediated by leptin and high‐sensitivity C‐reactive protein (hsCRP), respectively. Effect sizes for mediation by leptin were larger for the hands than for the lower extremities, and were statistically significant for the hands only. Conclusion: In people with hand OA, higher BMI is associated with greater pain severity in the hands, feet, and knees/hips. Systemic effects of obesity, measured by leptin, may play a larger mediating role for pain in the hands than in the lower extremities. Low‐grade inflammation, measured by hsCRP, may contribute to generalized pain in overweight/obese individuals. [ABSTRACT FROM AUTHOR]
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- 2022
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7. Practice of ultrasound-guided arthrocentesis and joint injection, including training and implementation, in Europe: results of a survey of experts and scientific societies
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Mandl, Peter, Naredo, Esperanza, Conaghan, Philip G., DʼAgostino, Maria-Antonietta, Wakefield, Richard J., Bachta, Artur, Backhaus, Marina, Hammer, Hilde B., Bruyn, George A. W., Damjanov, Nemanja, Filippucci, Emilio, Grassi, Walter, Iagnocco, Annamaria, Jousse-Joulin, Sandrine, Kane, David, Koski, Juhani M., Möller, Ingrid, De Miguel, Eugenio, Schmidt, Wolfgang A., Swen, Wijnand A. A., Szkudlarek, Marcin, Terslev, Lene, Ziswiler, Hans-Rudolf, Østergaard, Mikkel, and Balint, Peter V.
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- 2012
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8. Current state of musculoskeletal ultrasound training and implementation in Europe: results of a survey of experts and scientific societies
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Naredo, Esperanza, D’Agostino, Maria A., Conaghan, Philip G., Backhaus, Marina, Balint, Peter, Bruyn, George A. W., Filippucci, Emilio, Grassi, Walter, Hammer, Hilde B., Iagnocco, Annamaria, Kane, David, Koski, Juhani M., Szkudlarek, Marcin, Terslev, Lene, Wakefield, Richard J., Ziswiler, Hans-Rudolf, and Schmidt, Wolfgang A.
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- 2010
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9. Bone erosions at the distal ulna detected by ultrasonography are associated with structural damage assessed by conventional radiography and MRI: a study of patients with recent onset rheumatoid arthritis
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Hammer, Hilde B., Haavardsholm, Espen A., Bøyesen, Pernille, and Kvien, Tore K.
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- 2009
10. Associations Between Ultrasound‐Detected Synovitis, Pain, and Function in Interphalangeal and Thumb Base Osteoarthritis: Data From the Nor‐Hand Cohort.
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Fjellstad, Caroline M., Mathiessen, Alexander, Slatkowsky-Christensen, Barbara, Kvien, Tore K., Hammer, Hilde B., and Haugen, Ida K.
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OSTEOARTHRITIS ,SYNOVITIS ,LOGISTIC regression analysis ,BONE spurs ,JOINT pain - Abstract
Objective: To explore whether ultrasound‐detected gray‐scale synovitis and power Doppler activity in the interphalangeal and first carpometacarpal (CMC1) joints are associated with pain and physical function in patients with hand osteoarthritis (OA). Methods: A total of 290 patients with hand OA underwent an ultrasound examination of the bilateral interphalangeal and CMC1 joints. Using logistic regression analyses with generalized estimating equations, we examined whether grade 0–3 gray‐scale synovitis and power Doppler activity were associated with pain in the same joint. Using linear regression analyses, we examined whether the degree of inflammation was associated with numeric rating scale and Australian/Canadian (AUSCAN) Osteoarthritis Hand Index hand pain, AUSCAN physical function, and grip strength scores. Analyses were made separately for interphalangeal and CMC1 joints, and adjusted for age, sex, body mass index, psychosocial factors, use of analgesics, and presence of osteophytes. Results: At joint level, increasing gray‐scale synovitis severity was associated with higher odds of pain upon palpation in both the interphalangeal (grade 2–3; odds ratio [OR] 3.17 [95% confidence interval (95% CI) 2.35, 4.28]) and CMC1 joints (grade 2–3; OR 4.40 [95% CI 2.10, 9.24]). Similar associations were found for power Doppler activity and joint pain in the previous 24 hours and 6 weeks. Power Doppler activity in CMC1 was also related to overall hand pain/physical function and lower grip strength. Conclusion: Inflammation in both the interphalangeal and CMC1 joints was associated with pain in the same joint. However, associations with hand pain, reduced physical function, and lower grip strength were only present for inflammation in the CMC1 joints, suggesting that lowering CMC1 inflammation is an important treatment target. [ABSTRACT FROM AUTHOR]
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- 2020
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11. Conventional versus ultrasound treat to target: no difference in magnetic resonance imaging inflammation or joint damage over 2 years in early rheumatoid arthritis.
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Sundin, Ulf, Aga, Anna-Birgitte, Skare, Øivind, Nordberg, Lena B, Uhlig, Till, Hammer, Hilde B, Heijde, Désirée van der, Kvien, Tore K, Lillegraven, Siri, Haavardsholm, Espen A, and group, the ARCTIC study
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RHEUMATOID arthritis treatment ,INFLAMMATION prevention ,BONE marrow ,COMPARATIVE studies ,CONFIDENCE intervals ,EDEMA ,LONGITUDINAL method ,MAGNETIC resonance imaging ,STATISTICAL sampling ,ULTRASONIC imaging ,RANDOMIZED controlled trials ,TREATMENT effectiveness ,DISEASE progression ,DESCRIPTIVE statistics - Abstract
Objective To investigate whether an ultrasound-guided treat-to-target strategy for early RA would lead to reduced MRI inflammation or less structural damage progression compared with a conventional treat-to-target strategy. Methods A total of 230 DMARD-naïve early RA patients were randomized to an ultrasound tight control strategy targeting DAS <1.6, no swollen joints and no power Doppler signal in any joint or a conventional strategy targeting DAS <1.6 and no swollen joints. Patients in both arms were treated according to the same DMARD escalation strategy. MRI of the dominant hand was performed at six time points over 2 years and scored according to the OMERACT RA MRI scoring system. A total of 218 patients had baseline and one or more follow-up MRIs and were included in the analysis. The mean MRI score change from baseline to each follow-up and the 2 year risk for erosive progression were compared between arms. Results MRI bone marrow oedema, synovitis and tenosynovitis improved over the first year and was sustained during the second year of follow-up, with no statistically significant differences between the ultrasound and the conventional arms at any time point. The 2 year risk for progression of MRI erosions was similar in both treatment arms: ultrasound arm 39%, conventional arm 33% [relative risk 1.16 (95% CI 0.81, 1.66), P = 0.40]. Conclusion Incorporating ultrasound information in treatment decisions did not lead to reduced MRI inflammation or less structural damage compared with a conventional treatment strategy. The findings support that systematic use of ultrasound does not provide a benefit in the follow-up of patients with early RA. Trial registration number Clinicaltrials.gov, http://clinicaltrials.gov , NCT01205854. [ABSTRACT FROM AUTHOR]
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- 2020
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12. Tender Joint Count and Inflammatory Activity in Patients With Established Rheumatoid Arthritis: Results From a Longitudinal Study.
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Hammer, Hilde B., Michelsen, Brigitte, Provan, Sella A., Sexton, Joe, Lampa, Jon, Uhlig, Tillmann, and Kvien, Tore K.
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RHEUMATOID arthritis diagnosis ,C-reactive protein ,RESEARCH ,ULTRASONIC imaging ,INFLAMMATION ,RESEARCH methodology ,EVALUATION research ,MEDICAL cooperation ,SEVERITY of illness index ,ANTIRHEUMATIC agents ,COMPARATIVE studies ,RHEUMATOID arthritis ,RESEARCH funding ,JOINTS (Anatomy) ,LONGITUDINAL method - Abstract
Objective: The tender joint count (TJC) is included in composite disease activity scores (CDAS) (the Disease Activity Score in 28 joints, the Clinical Disease Activity Index, and the Simplified Disease Activity Index). The impact of having predominantly tender joints was explored by use of the Tender-Swollen Joint Count Difference (TSJD), and ultrasound (US) provided a measure of joint inflammation. The current study aimed to explore the cross-sectional and longitudinal associations between the TSJD and a spectrum of outcome measures, including US scores in patients with established rheumatoid arthritis (RA) during follow-up and while receiving treatment with biologic disease-modifying antirheumatic drugs (bDMARDs).Methods: This was an observational study of 209 patients with established RA consecutively included upon initiation of bDMARD treatment and followed-up with clinical, laboratory, and comprehensive US examinations at 0, 1, 2, 3, 6, and 12 months. Patients were categorized into 2 groups: those with predominantly tender joints (TSJD >0) and those with predominantly swollen joints (TSJD ≤0). Statistical analyses included Pearson's correlation coefficient, an independent samples t-test, and regression analyses.Results: The TJC had high correlations only with patient-reported outcomes (PROMs) (P < 0.001). Levels from CDAS and PROMs were significantly higher (P < 0.001) at all visits in patients with TSJD >0 compared to those with TSJD <0. Laboratory markers and assessor's global visual analog scale scores were similar, and US sum scores were significantly lower (P < 0.001-0.03). The baseline TSJD positively predicted levels of all CDAS at 6 months (P < 0.001-0.019) but was a negative predictor of US sum scores (gray-scale and power Doppler) at 6 and 12 months (P < 0.001).Conclusion: Patients with predominantly tender joints had higher CDAS but lower levels of inflammation as defined by US. These findings indicate that inclusion of the TJC in the CDAS may contribute to misleading information about inflammatory activity. [ABSTRACT FROM AUTHOR]- Published
- 2020
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13. Development of semiquantitative ultrasound scoring system to assess cartilage in rheumatoid arthritis.
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Mandl, Peter, Studenic, Paul, Filippucci, Emilio, Bachta, Artur, Backhaus, Marina, Bong, David, Bruyn, George A W, Collado, Paz, Damjanov, Nemanja, Dejaco, Christian, Delle-Sedie, Andrea, Miguel, Eugenio De, Duftner, Christina, Gessl, Irina, Gutierrez, Marwin, Hammer, Hilde B, Hernandez-Diaz, Cristina, Iagnocco, Annmaria, Ikeda, Kei, and Kane, David
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CARTILAGE ,DELPHI method ,EXECUTIVES ,EXERCISE ,FINGER joint ,RELIABILITY (Personality trait) ,RHEUMATOID arthritis ,RHEUMATOLOGY ,ULTRASONIC imaging ,METACARPOPHALANGEAL joint ,DISEASE prevalence - Abstract
Objectives To develop and test the reliability of a new semiquantitative scoring system for the assessment of cartilage changes by ultrasound in a web-based exercise as well as a patient exercise of patients with RA. Methods A taskforce of the Outcome Measures in Rheumatology Ultrasound Working Group performed a systematic literature review on the US assessment of cartilage in RA, followed by a Delphi survey on cartilage changes and a new semiquantitative US scoring system, and finally a web-based exercise as well as a patient exercise. For the web-based exercise, taskforce members scored a dataset of anonymized static images of MCP joints in RA patients and healthy controls, which also contained duplicate images. Subsequently, 12 taskforce members used the same US to score cartilage in MCP and proximal interphalangeal joints of six patients with RA in in a patient reliability exercise. Percentage agreement and prevalence of lesions were calculated, as intrareader reliability was assessed by weighted kappa and interreader reliability by Light's kappa. Results The three-grade semiquantitative scoring system demonstrated excellent intrareader reliability (kappa: 0.87 and 0.83) in the web-based exercise and the patient exercise, respectively. Interreader reliability was good in the web-based exercise (kappa: 0.64) and moderate (kappa: 0.48) in the patient exercise. Conclusion Our study demonstrates that ultrasound is a reliable tool for evaluating cartilage changes in the MCP joints of patients with RA and supports further development of a new reliable semiquantitative ultrasound scoring system for evaluating cartilage involvement in RA. [ABSTRACT FROM AUTHOR]
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- 2019
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14. Vitamin B-6 Status Correlates with Disease Activity in Rheumatoid Arthritis Patients During Treatment with TNFα Inhibitors.
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Sande, Jon Sigurd, Ulvik, Arve, Midttun, Øivind, Ueland, Per M, Hammer, Hilde B, Valen, Merete, Apalset, Ellen M, and Gjesdal, Clara G
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RHEUMATOID arthritis ,VITAMIN B6 ,TUMOR necrosis factors ,GOLIMUMAB ,ETANERCEPT - Abstract
Background: A frequent observation in inflammatory conditions, including rheumatoid arthritis (RA), is low circulating amounts of pyridoxal 5'-phosphate (PLP), the metabolically active form of vitamin B-6. Recently, a functional marker of vitamin B-6 status, the ratio of 3-hydroxykynurenine (HK): xanthurenic acid (XA) in plasma (HK: XA), was proposed.Objective: We investigated vitamin B-6 status in patients with RA before and after established treatment with TNFα inhibitors.Methods: We performed a longitudinal study of RA patients (n = 106, 36% men, median age 54 y) starting first treatment with a TNFα inhibitor (infliximab, etanercept, adalimumab, golimumab, or certolizumab). Clinical assessment (Disease Activity Score for 28 standard joints, DAS28), joint ultrasonography, and blood draw were performed at baseline and after 3 mo treatment. Plasma concentrations of PLP, HK, and XA were measured by liquid chromatography-tandem mass spectrometry. Associations of changes in vitamin B-6 markers with change in DAS28 were assessed by generalized additive models regression and with European League Against Rheumatism (EULAR) response categories by linear regression.Results: At baseline PLP was inversely correlated with CRP (ρ = -0.27, P = 0.007), whereas HK: XA correlated with DAS28 (ρ = 0.46, P < 0.001), CRP (ρ = 0.36, P < 0.001), and ultrasonography scores (ρ = 0.29-0.35, P ≤ 0.003). After 3 mo treatment, the change (a 33% overall reduction) in DAS28 was related to changes in both PLP (ß = -0.28, P = 0.01) and HK: XA (ß = 0.33, P < 0.001). Good responders (45%) according to EULAR criteria experienced a 31% increase in PLP (P = 0.003) and an 11% decrease in HK: XA (P = 0.1), whereas nonresponders (24%) experienced a 25% increase in HK: XA (P = 0.02).Conclusion: Two independent measures of vitamin B-6 status confirm an association with disease activity in RA patients. The association of HK: XA with disease activity may also imply perturbations in kynurenine metabolism in RA. This trial was registered at helseforskning.etikkom.no as 2011/490. [ABSTRACT FROM AUTHOR]- Published
- 2019
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15. Predictors of sustained remission in patients with early rheumatoid arthritis treated according to an aggressive treat-to-target protocol.
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Sundlisæter, Nina Paulshus, Olsen, Inge C, Aga, Anna-Birgitte, Hammer, Hilde B, Uhlig, Till, Heijde, Désirée van der, Kvien, Tore K, Lillegraven, Siri, Haavardsholm, Espen A, and group, ARCTIC study
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ANTIRHEUMATIC agents ,ALGORITHMS ,CONFIDENCE intervals ,MULTIPLE regression analysis ,RHEUMATOID arthritis ,TREATMENT effectiveness ,DISEASE remission ,DISEASE duration ,ODDS ratio ,PROGNOSIS - Abstract
Objectives To study prognostic factors for achievement of sustained remission in early RA patients receiving semi-personalized tight controlled treatment, and to assess the consistency of potential predictors across definitions of sustained remission. Methods DMARD-naïve early RA patients with symptom duration <2 years were treated according to a pre-defined algorithm within the Aiming for Remission in rheumatoid arthritis: a randomised trial examining the benefit of ultrasound in a Clinical TIght Control regimen trial. The algorithm allowed treatment adjustments based on established risk factors for a worse outcome. Multivariate logistic regression was used to examine baseline predictors of achieving sustained DAS remission at 16–24 months, and to assess predictors of secondary remission outcomes (all sustained 16–24 months): ACR/EULAR Boolean, Simplified Disease Activity Index (SDAI), no swollen joints and a composite outcome of DAS remission, no swollen joints and no radiographic progression. Results Of 222 patients, 118 (53%) reached sustained DAS remission, while 53 (24%) reached sustained ACR/EULAR Boolean and 73 (33%) sustained SDAI remission. More joint tenderness, assessed by Ritchie Articular Index, was a negative predictor of reaching sustained DAS remission (odds ratio (OR) = 0.90/U, 95% CI: 0.86, 0.94), sustained ACR/EULAR Boolean remission (OR = 0.92, 95% CI: 0.86, 0.98), sustained SDAI remission (OR = 0.94, 95% CI: 0.90, 1.00) as well as the two alternative definitions of sustained remission. Short symptom duration at baseline predicted sustained Boolean and SDAI remission. Other identified predictors were inconsistent across outcomes. Conclusion A higher tender joint score at baseline consistently reduced the chance of reaching sustained remission across all definitions. Our results support sustained remission as an achievable goal in early RA, especially when initiating DMARDs within 3 months symptom duration. Trial registration ClinicalTrials.gov, http://clinicaltrials.gov, NCT01205854 [ABSTRACT FROM AUTHOR]
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- 2018
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16. The Impact of Ultrasound on the Use and Efficacy of Intraarticular Glucocorticoid Injections in Early Rheumatoid Arthritis.
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Nordberg, Lena B., Haavardsholm, Espen A., Lillegraven, Siri, Aga, Anna‐Birgitte, Sexton, Joe, Lie, Elisabeth, Hammer, Hilde B., Uhlig, Till, Kvien, Tore K., Olsen, Inge C., and van der Heijde, Désirée
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THERAPEUTIC use of glucocorticoids ,RHEUMATOID arthritis diagnosis ,ANTIRHEUMATIC agents ,GLUCOCORTICOIDS ,INTRA-articular injections ,JOINT diseases ,PALPATION ,RHEUMATOID arthritis ,ULTRASONIC imaging ,TREATMENT effectiveness ,DISEASE remission ,CARPAL joints ,METATARSOPHALANGEAL joint ,ODDS ratio - Abstract
Objective: Intraarticular glucocorticoid injections are common in rheumatoid arthritis (RA) treatment. This study was undertaken to investigate whether ultrasound in combination with clinical examination is better than clinical examination alone at identifying joints that will benefit from intraarticular injections, and to compare the efficacy of ultrasound‐guided versus palpation‐guided procedures. Methods: In the treat‐to‐target Aiming for Remission in Rheumatoid Arthritis: a Randomised Trial Examining the Benefit of Ultrasonography in a Clinical Tight Control Regimen (ARCTIC), patients with early RA were randomized 1:1 to follow‐up with or without ultrasound. In addition to disease‐modifying antirheumatic drugs, intraarticular glucocorticoids were used to treat inflamed joints. The distribution of injections was assessed in both study groups. The relationship of clinical and ultrasound findings at the time of injection with treatment efficacy was examined, with non‐swollen joint at the next visit as the outcome measure. Treatment success was compared across study groups to evaluate ultrasound‐guided versus palpation‐guided procedures. Results: More injections were administered in the ultrasound group than in the conventional strategy group (n = 770 versus 548), especially in intercarpal joints (n = 58 versus 5) and metatarsophalangeal joints (n = 200 versus 104). Injecting clinically swollen joints without power Doppler (PD) activity on ultrasound was not efficacious compared to not injecting (odds ratio [OR] 1.3; P = 0.59). Efficacy was best in swollen joints (OR 9.0; P = 0.001) and non‐swollen joints (OR 8.4; P = 0.016) with moderate PD activity. Treatment success was similar for the ultrasound‐guided and palpation‐guided procedures. Conclusion: Our findings indicate that the efficacy of intraarticular glucocorticoid injections varies according to ultrasound findings at the time of injection, supporting the use of ultrasound as a tool to select joints that will benefit from intraarticular injections. However, ultrasound needle guidance was not superior to palpation guidance. [ABSTRACT FROM AUTHOR]
- Published
- 2018
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17. Pain Catastrophizing, Subjective Outcomes, and Inflammatory Assessments Including Ultrasound: Results From a Longitudinal Study of Rheumatoid Arthritis Patients.
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Hammer, Hilde B., Uhlig, Till, Kvien, Tore K., and Lampa, Jon
- Abstract
Objective: Pain catastrophizing is conceptualized as a negative cognitive-affective response to anticipated or actual pain and has been associated with important pain-related outcomes. The objective of this prospective study of established rheumatoid arthritis (RA) patients was to explore how pain catastrophizing was related to patient-reported outcomes (PROs), composite scores, and assessments of inflammatory activity.Methods: RA patients starting biologic disease-modifying antirheumatic drugs were examined at baseline and after 1, 2, 3, 6, and 12 months with PROs (joint pain/patient's global visual analog scale [VAS], modified Health Assessment Questionnaire, Rheumatoid Arthritis Impact of Disease score), clinical and laboratory assessments (tender/swollen joint count, assessor's global VAS, erythrocyte sedimentation rate/C-reactive protein [CRP] level), ultrasound (US) (gray scale [GS]/power Doppler [PD] of 36 joints and 4 tendons), and pain catastrophizing. The composite scores for Disease Activity Score in 28 joints, Clinical Disease Activity Index, and Simplified Disease Activity Index were calculated. Statistical calculations included independent samples t-test, paired samples t-test, one-way analysis of variance, Pearson's correlations, and linear and logistic regression.Results: Of 209 patients included, 152 (72.7%) completed 12-month followup. Pain catastrophizing, PROs, and clinical and inflammatory assessments decreased significantly (P < 0.001). Pain catastrophizing was strongly correlated with the PROs and composite scores (P < 0.001) but not with the inflammatory parameters (swollen joint count, CRP level, and GS/PD US). Patients with higher levels of pain catastrophizing had higher PROs and composite scores during the study (P < 0.001) but not inflammatory assessments. Baseline pain catastrophizing was negatively associated with achievement of remission at 6 and 12 months (P < 0.05).Conclusion: Pain catastrophizing was strongly associated with PROs and composite measures, but not with markers of inflammation. High levels of pain catastrophizing reduced the likelihood of achieving composite score remission and should be a factor to consider in a treat-to-target strategy. [ABSTRACT FROM AUTHOR]- Published
- 2018
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18. Comment on: Dual-energy computed tomography vs ultrasound, alone or combined, for the diagnosis of gout: a prospective study of accuracy.
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Christiansen, Sara Nysom, Hammer, Hilde B, Torp-Pedersen, Søren, and Terslev, Lene
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GOUT diagnosis , *EXPERIMENTAL design , *COMPUTED tomography , *GOUT - Published
- 2021
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19. Is synovial hypertrophy without Doppler activity sensitive to change? Post-hoc analysis from a rheumatoid arthritis ultrasound study.
- Author
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Terslev, Lene, Østergaard, Mikkel, Sexton, Joe, and Hammer, Hilde Berner
- Published
- 2018
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20. Current state of musculoskeletal ultrasound training and implementation in Europe: Results of a survey of experts and scientific societies
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David Kane, Maria A. D'Agostino, Marcin Szkudlarek, Lene Terslev, George A W Bruyn, Marina Backhaus, Hilde Berner Hammer, Hans Rudolf Ziswiler, Annamaria Iagnocco, Philip G. Conaghan, Peter V. Balint, Emilio Filippucci, Richard J. Wakefield, Juhani M. Koski, Walter Grassi, Esperanza Naredo, and Wolfgang A. Schmidt
- Subjects
Societies, Scientific ,medicine.medical_specialty ,Settore MED/16 - REUMATOLOGIA ,media_common.quotation_subject ,MEDLINE ,Musculoskeletal ultrasound ,Training (civil) ,Education ,State (polity) ,Rheumatology ,Surveys and Questionnaires ,Medical ,medicine ,Training ,Humans ,Pharmacology (medical) ,Musculoskeletal Diseases ,media_common ,Ultrasonography ,Medical education ,business.industry ,Scientific ,Continuing ,Europe ,Physical therapy ,Education, Medical, Continuing ,Clinical Competence ,education ,europe ,musculoskeletal ultrasound ,training ,business ,Societies - Abstract
Objective. To document the current state of musculoskeletal US (MSUS) training and extent of implementation among rheumatologists in the member countries of EULAR. Methods. An English-language questionnaire, divided into five sections (demographics, clinical use of MSUS, overall MSUS training for rheumatologists, MSUS education in the rheumatology training curriculum and education in MSUS offered by the national rheumatology society) was sent by e-mail to three different groups: (i) all national rheumatology societies of EULAR; (ii) all national societies of the European Federation of Societies for Ultrasound in Medicine and Biology; and (iii) 19 senior rheumatologists involved in MSUS training from 14 European countries. Results. Thirty-one (70.5%) out of 44 countries responded to the questionnaire (59.1% of national rheumatology societies, 34.5% of the national US societies and 100% of expert ultrasonographers). Rheumatology was listed among medical specialities that mainly perform MSUS in 20 (64.5%) countries; however, in most [19 (63.3%)] countries
- Published
- 2010
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