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1. Validity and completeness of rheumatoid arthritis diagnoses in the nationwide DANBIO clinical register and the Danish National Patient Registry

Author

Ibfelt EH, Sørensen J, Jensen DV, Dreyer L, Schiøttz-Christensen B, Thygesen PH, Colic A, Raun JL, Manilo N, Rødgaard A, Poulsen UE, Rasmussen C, Hansen T, Unger B, Pelck R, Kincses A, Nordin H, Lorenzen T, Theibich A, Jensen Hansen IM, Espesen J, Grydehøj J, Holland-Fischer M, Loft AG, and Hetland ML

Subjects
Rheumatoid Arthritis, Validity, Incidence, Clinical Registry, Denmark, Infectious and parasitic diseases, RC109-216
Abstract

Else Helene Ibfelt,1 Jan Sørensen,2,3 Dorte V Jensen,4,5 Lene Dreyer,5,6 Berit Schiøttz‑Christensen,7 Pia H Thygesen,8 Ada Colic,9 Johnny L Raun,10 Natalia Manilo,11 Anne Rødgaard,4 Uta E Poulsen,12 Claus Rasmussen,13 Torben Hansen,14 Babara Unger,15 Randi Pelck,16 Anita Kincses,17 Henrik Nordin,18 Tove Lorenzen,19 Ali Theibich,20 Inger Marie Jensen Hansen,21 Jakob Espesen,22 Jolanta Grydehøj,23 Mette Holland-Fischer,24 Anne Gitte Loft,25 Merete Lund Hetland4,26 1Research Centre for Prevention and Health, Capital Region of Denmark, Rigshospitalet – Glostrup, Denmark; 2Centre of Health Economics Research, Institute of Public health, University of Southern Denmark, Odense, Denmark; 3Healthcare Outcome Research Centre, Royal College of Surgeons in Ireland, Dublin, Ireland; 4DANBiO and Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet – Glostrup, Glostrup, 5Center for Rheumatology and Spine Diseases, Gentofte University Hospital, Hellerup, 6The Parker Institute, Frederiksberg and Bispebjerg Hospital, Frederiksberg, 7Spine Centre of Southern Denmark, Hospital Lillebaelt, Middelfart, 8Department of Rheumatology, Odense University Hospital, Odense, 9Department of Rheumatology, Sydvestjysk Sygehus, Esbjerg/Grintsted, 10Department of Internal Medicine and Rheumatology, SLB – Fredericia Hospital, Fredericia, 11Department of Rheumatology, Frederiksberg Hospital, Copenhagen, 12Department of Rheumatology, Gigthospital Gråsten, Gråsten, 13Clinic of Internal Medicine, Rheumatology, Regionshospital Nordjylland, Hjørring, 14Department of Rheumatology, Holbæk sygehus, Holbæk, 15Department of Internal Medicine/Rheumatology, Hospitalsenheden Horsens, Horsens, 16Department of Rheumatology, Zealand University Hospital, Køge, 17Department of Rheumatology, Nordsjællands Hospitaler, Hillerød, 18Center for Rheumatology and Spine Diseases, Centre of Head and Orthopedics, Rigshospitalet, Copenhagen, 19Department of Rheumatology, Silkeborg Regional Hospital and University Clinic, Silkeborg, 20Department of Rheumatology, Slagelse Hospital, Slagelse, 21Department of Rheumatology and University of Southern Denmark, Svendborg Hospital, Odense, 22Department of Internal Medicine, Vejle Hospital, Vejle, 23Department of Rheumatology, Regional Hospital, West Jutland, Herning, 24Department of Rheumatology, Aalborg University Hospital, Ålborg, 25Department of Rheumatology, Aarhus University Hospital, Aarhus, 26Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark Objectives: In Denmark, patients with rheumatoid arthritis (RA) are registered in the nationwide clinical DANBIO quality register and the Danish National Patient Registry (DNPR). The aim was to study the validity of the RA diagnosis and to estimate the completeness of relevant RA cases in each registry.Study design and setting: Patients registered for the first time in 2011 with a diagnosis of RA were identified in DANBIO and DNPR in January 2013. For DNPR, filters were applied to reduce false-positive cases. The diagnosis was verified by a review of patient records. We calculated the positive predictive values (PPVs) of the RA diagnosis registrations in DANBIO and DNPR, and estimated the registry completeness of relevant RA cases for both DANBIO and DNPR. Updated data from 2011 to 2015 from DANBIO were retrieved to identify patients with delayed registration, and the registry completeness and PPV was recalculated.Results: We identified 1,678 unique patients in DANBIO or in DNPR. The PPV (2013 dataset) was 92% in DANBIO and 79% in DNPR. PPV for DANBIO on the 2015 update was 96%. The registry completeness of relevant RA cases was 43% in DANBIO, increasing to 91% in the 2015 update and 90% in DNPR.Conclusion: DANBIO held a high proportion of true RA cases (96%) and was found to be superior to the DNPR (79%) with regard to the validity of the diagnosis. Both registries were estimated to have a high completeness of RA cases treated in hospital care (~90%). Keywords: rheumatoid arthritis, validity, incidence, clinical registry, Denmark

Published
2017

2. HIV or HIV-Therapy? Causal attributions of symptoms and their impact on treatment decisions among women and men with HIV

Author

Kremer H, Sonnenberg-Schwan U, Arendt G, Brockmeyer NH, Potthoff A, Ulmer A, Graefe K, Lorenzen T, Starke W, and Walker UA

Subjects
HIV, antiretroviral treatment, gender, causal attribution, symptoms, side effects, Medicine
Abstract

Abstract Objectives Among people with HIV, we examined symptom attribution to HIV or HIV-therapy, awareness of potential side effects and discontinuation of treatment, as well as sex/gender differences. Methods HIV-patients (N = 168, 46% female) completed a comprehensive symptom checklist (attributing each endorsed symptom to HIV, HIV-therapy, or other causes), reported reasons for treatment discontinuations and potential ART-related laboratory abnormalities. Results Main symptom areas were fatigue/sleep/energy, depression/mood, lipodystrophy, and gastrointestinal, dermatological, and neurological problems. Top HIV-attributed symptoms were lack of stamina/energy in both genders, night sweats, depression, mood swings in women; and fatigue, lethargy, difficulties concentrating in men. Women attributed symptoms less frequently to HIV than men, particularly fa-tigue(p < .01). Top treatment-attributed symptoms were lipodystrophy and gastrointestinal problems in both genders. Symptom attribution to HIV-therapy did not differ between genders. Over the past six months, 22% switched/interrupted ART due to side effects. In women, side effect-related treatment decisions were more complex, involving more side effects and substances. Remarkably, women took predominantly protease inhibitor-sparing regimens (p = .05). Both genders reported only 15% of potential ART-related laboratory abnormalities but more than 50% had laboratory abnormalities. Notably, women had fewer elevated renal parameters (p < .01). Conclusions Men may attribute symptoms more often to HIV and maintain a treatment-regimen despite side effects, whereas women may be more prudent in avoiding treatment side effects. Lacking awareness of laboratory abnormalities in both genders potentially indicates gaps in physician-patient communication. Gender differences in causal attributions of symptoms/side effects may influence treatment decisions.

Published
2009
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3. OMERACT definition and reliability assessment of chronic ultrasound lesions of the axillary artery in giant cell arteritis

Author

Schafer, V, Chrysidis, S, Schmidt, W, Duftner, C, Iagnocco, A, Bruyn, G, Carrara, G, De Miguel, E, Diamantopoulos, A, Nielsen, B, Fredberg, U, Hartung, W, Hanova, P, Hansen, I, Hocevar, A, Juche, A, Kermani, T, Lorenzen, T, Macchioni, P, Milchert, M, Dohn, U, Mukhtyar, C, Monti, S, Ponte, C, Seitz, L, Scire, C, Terslev, L, Dasgupta, B, Keen, H, Pineda, C, Dejaco, C, Schafer V. S., Chrysidis S., Schmidt W. A., Duftner C., Iagnocco A., Bruyn G. A., Carrara G., De Miguel E., Diamantopoulos A. P., Nielsen B. D., Fredberg U., Hartung W., Hanova P., Hansen I. T., Hocevar A., Juche A., Kermani T. A., Lorenzen T., Macchioni P., Milchert M., Dohn U. M., Mukhtyar C., Monti S., Ponte C., Seitz L., Scire C. A., Terslev L., Dasgupta B., Keen H. I., Pineda C., Dejaco C., Schafer, V, Chrysidis, S, Schmidt, W, Duftner, C, Iagnocco, A, Bruyn, G, Carrara, G, De Miguel, E, Diamantopoulos, A, Nielsen, B, Fredberg, U, Hartung, W, Hanova, P, Hansen, I, Hocevar, A, Juche, A, Kermani, T, Lorenzen, T, Macchioni, P, Milchert, M, Dohn, U, Mukhtyar, C, Monti, S, Ponte, C, Seitz, L, Scire, C, Terslev, L, Dasgupta, B, Keen, H, Pineda, C, Dejaco, C, Schafer V. S., Chrysidis S., Schmidt W. A., Duftner C., Iagnocco A., Bruyn G. A., Carrara G., De Miguel E., Diamantopoulos A. P., Nielsen B. D., Fredberg U., Hartung W., Hanova P., Hansen I. T., Hocevar A., Juche A., Kermani T. A., Lorenzen T., Macchioni P., Milchert M., Dohn U. M., Mukhtyar C., Monti S., Ponte C., Seitz L., Scire C. A., Terslev L., Dasgupta B., Keen H. I., Pineda C., and Dejaco C.

Abstract

Objectives: To define chronic ultrasound lesions of the axillary artery (AA) in long-standing giant cell arteritis (GCA) and to evaluate the reliability of the new ultrasound definition in a web-based exercise. Methods: A structured Delphi, involving an expert panel of the Large Vessel Vasculitis subgroup of the Outcome Measures in Rheumatology (OMERACT) Ultrasound Working Group was carried out. The reliability of the new definition was tested in a 2-round web-based exercise involving 23 experts and using 50 still images each from AA of long-standing and acute GCA patients, as well as 50 images from healthy individuals. Results: The final OMERACT ultrasound definition of chronic changes was based on measurement and appearance of the intima-media complex. The overall reliability of the new definition for chronic ultrasound changes in longstanding GCA of the AA was good to excellent with Light's kappa values of 0.79-0.80 for inter-reader reliability and mean Light's-kappa of 0.88 for intra-reader reliability. The mean inter-rater and intra-rater agreements were 86-87% and 92%, respectively. Good reliabilities were observed comparing the vessels with longstanding versus acute GCA with a mean agreement and kappa values of 81% and 0.63, respectively. Conclusion: The new OMERACT ultrasound definition for chronic vasculitis of the AA in GCA revealed a good to excellent inter- and intra-reader reliability in a web-based exercise of experts.

Published
2021

4. CERTOLIZUMAB-PEGOL, ABATACEPT, TOCILIZUMAB OR ACTIVE CONVENTIONALTHERAPY IN EARLY RHEUMATOID ARTHRITIS: CLINICAL AND RADIOGRAPHIC 48-WEEKS RESULTS OF THE INVESTIGATOR-INITIATED RANDOMIZED NORD-STARTRIAL

Author

Østergaard, M., Van Vollenhoven, R., Rudin, A., Hetland, M. L., Heiberg, M., Nordström, D., Nurmohamed, M., Gudbjornsson, B., Ørnbjerg, L. Midtbøll, Bøyesen, P., Olsen, I., Lend, K., Hørslev-Petersen, K., Uhlig, T., Sokka-Isler, T., Gröndal, G., Krabbe, S., Lindqvist, J., Gjertsson, I., Glinatsi, D., Kapetanovic, M. C., Aga, A. B., Faustini, F., Parmanne, P., Lorenzen, T., Cagnotto, G., Back, J., Hendricks, O., Vedder, D., Rannio, T., Grenholm, E., Lindegaard, H. M., Ljosa, M. K. A., Brodin, E., Soderbergh, A., Rizk, M., Hermansson, E., Uhrenholt, L., Larsson, P., Just, S. A., Bakland, G., Stevens, D., Laurberg, T. B., Haavardsholm, E. A., and Lampa, J.

Published
2022

5. OP0058 CERTOLIZUMAB-PEGOL, ABATACEPT, TOCILIZUMAB OR ACTIVE CONVENTIONAL THERAPY IN EARLY RHEUMATOID ARTHRITIS: CLINICAL AND RADIOGRAPHIC 48-WEEKS RESULTS OF THE INVESTIGATOR-INITIATED RANDOMIZED NORD-STAR TRIAL

Author

Østergaard, M., primary, Van Vollenhoven, R., additional, Rudin, A., additional, Hetland, M. L., additional, Heiberg, M., additional, Nordström, D., additional, Nurmohamed, M., additional, Gudbjornsson, B., additional, Midtbøll Ørnbjerg, L., additional, Bøyesen, P., additional, Olsen, I., additional, Lend, K., additional, Hørslev-Petersen, K., additional, Uhlig, T., additional, Sokka-Isler, T., additional, Gröndal, G., additional, Krabbe, S., additional, Lindqvist, J., additional, Gjertsson, I., additional, Glinatsi, D., additional, Kapetanovic, M. C., additional, Aga, A. B., additional, Faustini, F., additional, Parmanne, P., additional, Lorenzen, T., additional, Cagnotto, G., additional, Back, J., additional, Hendricks, O., additional, Vedder, D., additional, Rannio, T., additional, Grenholm, E., additional, Lindegaard, H. M., additional, Ljosa, M. K. A., additional, Brodin, E., additional, Soderbergh, A., additional, Rizk, M., additional, Hermansson, E., additional, Uhrenholt, L., additional, Larsson, P., additional, Just, S. A., additional, Bakland, G., additional, Stevens, D., additional, Laurberg, T. B., additional, Haavardsholm, E. A., additional, and Lampa, J., additional

Published
2022
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6. Serologie und PCR in der HHV-8 Diagnostik

Author

Albrecht, D., Meyer, T., Lorenzen, T., Stoehr, A., Meigel, W., Arndt, R., Plettenberg, A., Brockmeyer, Norbert H., editor, Hoffmann, Klaus, editor, Reimann, G., editor, Stücker, Markus, editor, Altmeyer, Peter, editor, and Brodt, R., editor

Published
2000
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11. Definitions and reliability assessment of elementary ultrasound lesions in giant cell arteritis: A study from the OMERACT large vessel vasculitis ultrasound working group

Author

Chrysidis, S, Duftner, C, Dejaco, C, Schafer, V, Ramiro, S, Carrara, G, Scire, C, Hocevar, A, Diamantopoulos, A, Iagnocco, A, Mukhtyar, C, Ponte, C, Naredo, E, De Miguel, E, Bruyn, G, Warrington, K, Terslev, L, Milchert, M, D'Agostino, M, Koster, M, Rastalsky, N, Hanova, P, Macchioni, P, Kermani, T, Lorenzen, T, Dohn, U, Fredberg, U, Hartung, W, Dasgupta, B, Schmidt, W, Chrysidis S., Duftner C., Dejaco C., Schafer V. S., Ramiro S., Carrara G., Scire C. A., Hocevar A., Diamantopoulos A. P., Iagnocco A., Mukhtyar C., Ponte C., Naredo E., De Miguel E., Bruyn G. A., Warrington K. J., Terslev L., Milchert M., D'Agostino M. A., Koster M. J., Rastalsky N., Hanova P., Macchioni P., Kermani T. A., Lorenzen T., Dohn U. Mo., Fredberg U., Hartung W., Dasgupta B., Schmidt W. A., Chrysidis, S, Duftner, C, Dejaco, C, Schafer, V, Ramiro, S, Carrara, G, Scire, C, Hocevar, A, Diamantopoulos, A, Iagnocco, A, Mukhtyar, C, Ponte, C, Naredo, E, De Miguel, E, Bruyn, G, Warrington, K, Terslev, L, Milchert, M, D'Agostino, M, Koster, M, Rastalsky, N, Hanova, P, Macchioni, P, Kermani, T, Lorenzen, T, Dohn, U, Fredberg, U, Hartung, W, Dasgupta, B, Schmidt, W, Chrysidis S., Duftner C., Dejaco C., Schafer V. S., Ramiro S., Carrara G., Scire C. A., Hocevar A., Diamantopoulos A. P., Iagnocco A., Mukhtyar C., Ponte C., Naredo E., De Miguel E., Bruyn G. A., Warrington K. J., Terslev L., Milchert M., D'Agostino M. A., Koster M. J., Rastalsky N., Hanova P., Macchioni P., Kermani T. A., Lorenzen T., Dohn U. Mo., Fredberg U., Hartung W., Dasgupta B., and Schmidt W. A.

Abstract

Objectives To define the elementary ultrasound (US) lesions in giant cell arteritis (GCA) and to evaluate the reliability of the assessment of US lesions according to these definitions in a web-based reliability exercise. Methods Potential definitions of normal and abnormal US findings of temporal and extracranial large arteries were retrieved by a systematic literature review. As a subsequent step, a structured Delphi exercise was conducted involving an expert panel of the Outcome Measures in Rheumatology (OMERACT) US Large Vessel Vasculitis Group to agree definitions of normal US appearance and key elementary US lesions of vasculitis of temporal and extracranial large arteries. The reliability of these definitions on normal and abnormal blood vessels was tested on 150 still images and videos in a web-based reliability exercise. Results Twenty-four experts participated in both Delphi rounds. From originally 25 statements, nine definitions were obtained for normal appearance, vasculitis and arteriosclerosis of cranial and extracranial vessels. The 'halo' and 'compression' signs were the key US lesions in GCA. The reliability of the definitions for normal temporal and axillary arteries, the 'halo' sign and the 'compression' sign was excellent with inter-rater agreements of 91-99% and mean kappa values of 0.83-0.98 for both inter-rater and intra-rater reliabilities of all 25 experts. Conclusions The 'halo' and the 'compression' signs are regarded as the most important US abnormalities for GCA. The inter-rater and intra-rater agreement of the new OMERACT definitions for US lesions in GCA was excellent.

Published
2018

12. Assessing vasculitis in giant cell arteritis by ultrasound: Results of OMERACT patient-based reliability exercises

Author

Schafer, V, Chrysidis, S, Dejaco, C, Duftner, C, Iagnocco, A, Bruyn, G, Carrara, G, D'Agostino, M, De Miguel, E, Diamantopoulos, A, Fredberg, U, Hartung, W, Hocevar, A, Juche, A, Kermani, T, Koster, M, Lorenzen, T, Macchioni, P, Milchert, M, Dohn, U, Mukhtyar, C, Ponte, C, Ramiro, S, Scire, C, Terslev, L, Warrington, K, Dasgupta, B, Schmidt, W, Schafer V. S., Chrysidis S., Dejaco C., Duftner C., Iagnocco A., Bruyn G. A., Carrara G., D'Agostino M. A., De Miguel E., Diamantopoulos A. P., Fredberg U., Hartung W., Hocevar A., Juche A., Kermani T. A., Koster M. J., Lorenzen T., Macchioni P., Milchert M., Dohn U. M., Mukhtyar C., Ponte C., Ramiro S., Scire C. A., Terslev L., Warrington K. J., Dasgupta B., Schmidt W. A., Schafer, V, Chrysidis, S, Dejaco, C, Duftner, C, Iagnocco, A, Bruyn, G, Carrara, G, D'Agostino, M, De Miguel, E, Diamantopoulos, A, Fredberg, U, Hartung, W, Hocevar, A, Juche, A, Kermani, T, Koster, M, Lorenzen, T, Macchioni, P, Milchert, M, Dohn, U, Mukhtyar, C, Ponte, C, Ramiro, S, Scire, C, Terslev, L, Warrington, K, Dasgupta, B, Schmidt, W, Schafer V. S., Chrysidis S., Dejaco C., Duftner C., Iagnocco A., Bruyn G. A., Carrara G., D'Agostino M. A., De Miguel E., Diamantopoulos A. P., Fredberg U., Hartung W., Hocevar A., Juche A., Kermani T. A., Koster M. J., Lorenzen T., Macchioni P., Milchert M., Dohn U. M., Mukhtyar C., Ponte C., Ramiro S., Scire C. A., Terslev L., Warrington K. J., Dasgupta B., and Schmidt W. A.

Abstract

Objective: To test the reliability of Outcome Measures in Rheumatology Clinical Trials (OMERACT) consensus-based ultrasound definitions for normal and vasculitic temporal and axillary arteries in patients with giant cell arteritis (GCA) and in controls. Methods: A preliminary 1-day meeting and a full 3-day meeting fulfilling OMERACT Ultrasound Group guidelines were held. Temporal and axillary arteries were examined at 2 timepoints by 12 sonographers on 4 patients with GCA and 2 controls. The aim was to test inter- and intrareader reliability for normal findings, halo sign, and compression sign. In both meetings, patients had established GCA. Pathology was more recent in the full meeting, which was preceded by 6 h of training. Scanning time was 15-20 min instead of 10-13 min. Results: In the preliminary exercise, interreader reliabilities were fair to moderate for the overall diagnosis of GCA (Light k 0.29-0.51), and poor to fair for identifying vasculitis in the respective anatomical segments (Light k 0.02-0.46). Intrareader reliabilities were moderate (Cohen k 0.32-0.64). In the main exercise, interreader reliability was good to excellent (Light k 0.76-0.86) for the overall diagnosis of GCA, and moderate to good (Light k 0.46-0.71) for identifying vasculitis in the respective anatomical segments. Intrareader reliability was excellent for diagnosis of GCA (Cohen k 0.91) and good (Cohen k 0.71-0.80) for the anatomical segments. Conclusion: OMERACT-derived definitions of halo and compression signs of temporal and axillary arteries are reliable in recent-onset GCA if experienced sonographers (> 300 examinations) have 15-20 min for a standardized examination with prior training and apply > 15 MHz probes.

Published
2018

19. OP0018 A MULTICENTER RANDOMIZED STUDY IN EARLY RHEUMATOID ARTHRITIS TO COMPARE ACTIVE CONVENTIONAL THERAPY VERSUS THREE BIOLOGICAL TREATMENTS: 24 WEEK EFFICACY RESULTS OF THE NORD-STAR TRIAL

Author

Hetland, M. L., primary, Haavardsholm, E. A., additional, Rudin, A., additional, Nordström, D., additional, Nurmohamed, M., additional, Gudbjornsson, B., additional, Lampa, J., additional, Hørslev-Petersen, K., additional, Uhlig, T., additional, Gröndal, G., additional, Ǿstergaard, M., additional, Heiberg, M., additional, Twisk, J., additional, Krabbe, S., additional, Lend, K., additional, Olsen, I., additional, Lindqvist, J., additional, Ekwall, A. K. H., additional, Grøn, K. L., additional, Kapetanovic, M. C., additional, Faustini, F., additional, Tuompo, R., additional, Lorenzen, T., additional, Cagnotto, G., additional, Baecklund, E., additional, Hendricks, O., additional, Vedder, D., additional, Sokka-Isler, T., additional, Husmark, T., additional, Ljosa, M. K. A., additional, Brodin, E., additional, Ellingsen, T., additional, Soderbergh, A., additional, Rizk, M., additional, Reckner, Å., additional, Larsson, P., additional, Uhrenholt, L., additional, Just, S. A., additional, Stevens, D., additional, Laurberg, T. B., additional, Bakland, G., additional, and Van Vollenhoven, R., additional

Published
2020
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23. On the pathogenesis of IDDM

Author

Nerup, J., Mandrap-Poulsen, T., Helqvist, S., Andersen, H. U., Pociot, F., Reimers, J. I., Cuartero, B. G., Karlsen, A. E., Bjerre, U., and Lorenzen, T.

Published
1994
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28. Remission of cutaneous Mycobacterium haemophilum infection as a result of antiretroviral therapy in a human immunodeficiency virus-infected patient. (Brief Report)

Author

Paech, V., Lorenzen, T., Krosigk, A. von, Stemm, A. von, Meigel, W.M., Stoehr, A., Rusch-Gerdes, S., Richter, E., and Plettenberg, A.

Subjects
Mycobacterial infections -- Care and treatment, Hemophilus infections -- Care and treatment, Antiviral agents -- Usage, HIV patients -- Drug therapy, HIV (Viruses) -- Drug therapy, Health, Health care industry
Published
2002

29. Definitions and reliability assessment of elementary ultrasound lesions in giant cell arteritis: A study from the OMERACT large vessel vasculitis ultrasound working group

Author

Chrysidis, S., Duftner, C., Dejaco, C., Schafer, V. S., Ramiro, S., Carrara, G., Scire, C. A., Hocevar, A., Diamantopoulos, A. P., Iagnocco, A., Mukhtyar, C., Ponte, C., Naredo, E., De Miguel, E., Bruyn, G. A., Warrington, K. J., Terslev, L., Milchert, M., D'Agostino, Maria Antonietta, Koster, M. J., Rastalsky, N., Hanova, P., Macchioni, P., Kermani, T. A., Lorenzen, T., Dohn, U. Mo., Fredberg, U., Hartung, W., Dasgupta, B., Schmidt, W. A., D'Agostino M. A. (ORCID:0000-0002-5347-0060), Chrysidis, S., Duftner, C., Dejaco, C., Schafer, V. S., Ramiro, S., Carrara, G., Scire, C. A., Hocevar, A., Diamantopoulos, A. P., Iagnocco, A., Mukhtyar, C., Ponte, C., Naredo, E., De Miguel, E., Bruyn, G. A., Warrington, K. J., Terslev, L., Milchert, M., D'Agostino, Maria Antonietta, Koster, M. J., Rastalsky, N., Hanova, P., Macchioni, P., Kermani, T. A., Lorenzen, T., Dohn, U. Mo., Fredberg, U., Hartung, W., Dasgupta, B., Schmidt, W. A., and D'Agostino M. A. (ORCID:0000-0002-5347-0060)

Abstract

Objectives To define the elementary ultrasound (US) lesions in giant cell arteritis (GCA) and to evaluate the reliability of the assessment of US lesions according to these definitions in a web-based reliability exercise. Methods Potential definitions of normal and abnormal US findings of temporal and extracranial large arteries were retrieved by a systematic literature review. As a subsequent step, a structured Delphi exercise was conducted involving an expert panel of the Outcome Measures in Rheumatology (OMERACT) US Large Vessel Vasculitis Group to agree definitions of normal US appearance and key elementary US lesions of vasculitis of temporal and extracranial large arteries. The reliability of these definitions on normal and abnormal blood vessels was tested on 150 still images and videos in a web-based reliability exercise. Results Twenty-four experts participated in both Delphi rounds. From originally 25 statements, nine definitions were obtained for normal appearance, vasculitis and arteriosclerosis of cranial and extracranial vessels. The 'halo' and 'compression' signs were the key US lesions in GCA. The reliability of the definitions for normal temporal and axillary arteries, the 'halo' sign and the 'compression' sign was excellent with inter-rater agreements of 91-99% and mean kappa values of 0.83-0.98 for both inter-rater and intra-rater reliabilities of all 25 experts. Conclusions The 'halo' and the 'compression' signs are regarded as the most important US abnormalities for GCA. The inter-rater and intra-rater agreement of the new OMERACT definitions for US lesions in GCA was excellent.

Published
2018

30. Assessing vasculitis in giant cell arteritis by ultrasound: Results of OMERACT patient-based reliability exercises

Author

Schafer, V. S., Chrysidis, S., Dejaco, C., Duftner, C., Iagnocco, A., Bruyn, G. A., Carrara, G., D'Agostino, Maria Antonietta, De Miguel, E., Diamantopoulos, A. P., Fredberg, U., Hartung, W., Hocevar, A., Juche, A., Kermani, T. A., Koster, M. J., Lorenzen, T., Macchioni, P., Milchert, M., Dohn, U. M., Mukhtyar, C., Ponte, C., Ramiro, S., Scire, C. A., Terslev, L., Warrington, K. J., Dasgupta, B., Schmidt, W. A., D'Agostino M. A. (ORCID:0000-0002-5347-0060), Schafer, V. S., Chrysidis, S., Dejaco, C., Duftner, C., Iagnocco, A., Bruyn, G. A., Carrara, G., D'Agostino, Maria Antonietta, De Miguel, E., Diamantopoulos, A. P., Fredberg, U., Hartung, W., Hocevar, A., Juche, A., Kermani, T. A., Koster, M. J., Lorenzen, T., Macchioni, P., Milchert, M., Dohn, U. M., Mukhtyar, C., Ponte, C., Ramiro, S., Scire, C. A., Terslev, L., Warrington, K. J., Dasgupta, B., Schmidt, W. A., and D'Agostino M. A. (ORCID:0000-0002-5347-0060)

Abstract

Objective: To test the reliability of Outcome Measures in Rheumatology Clinical Trials (OMERACT) consensus-based ultrasound definitions for normal and vasculitic temporal and axillary arteries in patients with giant cell arteritis (GCA) and in controls. Methods: A preliminary 1-day meeting and a full 3-day meeting fulfilling OMERACT Ultrasound Group guidelines were held. Temporal and axillary arteries were examined at 2 timepoints by 12 sonographers on 4 patients with GCA and 2 controls. The aim was to test inter- and intrareader reliability for normal findings, halo sign, and compression sign. In both meetings, patients had established GCA. Pathology was more recent in the full meeting, which was preceded by 6 h of training. Scanning time was 15-20 min instead of 10-13 min. Results: In the preliminary exercise, interreader reliabilities were fair to moderate for the overall diagnosis of GCA (Light k 0.29-0.51), and poor to fair for identifying vasculitis in the respective anatomical segments (Light k 0.02-0.46). Intrareader reliabilities were moderate (Cohen k 0.32-0.64). In the main exercise, interreader reliability was good to excellent (Light k 0.76-0.86) for the overall diagnosis of GCA, and moderate to good (Light k 0.46-0.71) for identifying vasculitis in the respective anatomical segments. Intrareader reliability was excellent for diagnosis of GCA (Cohen k 0.91) and good (Cohen k 0.71-0.80) for the anatomical segments. Conclusion: OMERACT-derived definitions of halo and compression signs of temporal and axillary arteries are reliable in recent-onset GCA if experienced sonographers (> 300 examinations) have 15-20 min for a standardized examination with prior training and apply > 15 MHz probes.

Published
2018

34. a Structured and Extensive Training Program on Vascular Ultrasound, Results in an Excellent Agreement Between Ultrasound and Temporal Artery Biopsy in the Diagnosis of Giant Cell Arteritis

Author

Chrysidis, S., Fredberg, U., Dohn, U. M., Lorenzen, T., Terslev, L., Larsen, K., and Diamantopoulos, A. P.

Subjects
ultrasound *temporal artery *health practitioner *blood vessel biopsy *diagnosis *giant cell arteritis *American *college *rheumatology *human *training patient vasculitis examination reading transducer compression standardization artery wall workshop clip Denmark education Norway rheumatic polymyalgia swelling feedback system machine
Abstract

Background/Purpose: There is an increased use of vascular ultrasound (US) for diagnosing giant cell arteritis (GCA). Consequently, extensive and structured training of ultrasonographers performing vascular ultrasound is required in order to ensure standardization of examination technique and machine settings to obtain reliable results. The primary aim of this study was to evaluate the results of a standardized training program for ultrasonographers in the diagnosis of temporal artery (TA) vasculitis in GCA. Methods: Rheumatologists with long-standing experience in musculoskeletal US were extensively trained in the use of vascular US by a specific program. Initially participation in the International Workshop on US in Large Vessel Vasculitis and Polymyalgia Rheumatica in Kristiansand, Norway (5 hours theoretical and 10 hours supervised hands-on education) followed by a two day workshop in Denmark (6 hours of supervised hands-on trainings and 1 hour of image evaluation)with additional training and standardization of scanning technique and optimization of settings . Immediately after this training program a US study on patients suspected for GCA was initiated. Patients were examined with high-end US equipment with high resolution transducers, optimized vascular settings and standardized examination technique. After the US examination of TA, a temporal artery biopsy (TAB) was performed. Pictures and film clips of all three TA branches in two planes were recorded and evaluated by the performing sonographer and by a blinded expert. Detailed feedback on the US technique was given to the performing sonographer by the external expert. US was considered positive in the presence of the halo sign (hypoechoic arterial wall swelling) and/or the presence of a positive compression-sign (arterial wall remaining visible upon compression with US transducer). Results: During 12 months, 37 patients from three Danish Rheumatologic Departments (Esbjerg, Glostrup, Silkeborg) suspected to have GCA were recruited. In 20 patients with a positive TAB for GCA, US was positive in all patients according to both the performing sonographer and the blinded external expert. In 15 patients with negative TAB, neither the performing sonographer, nor the external reader found signs of vasculitis. In one patient with a negative TAB, US showed vasculitis (both readers) and in one the local sonographer's finding of US vasculitis was rejected by the blinded expert. In total, 222 branches of TA were scanned and vasculitis changes were observed in 82 branches (expert) and in 80 branches (performing sonographer). The inter-observer agreement between the performing sonographer and the blinded expert was excellent in all three centres/departments (Cohens kappacoefficient: Esbjerg k=0.88, Glostrup k=0.90 and Silkeborg k=0.82). Conclusion: Following an intense structured training program on vascular ultrasound using high quality equipment, we were able to obtain an excellent agreement between US of TA and subsequent TAB in patients suspected for GCA. Furthermore, an excellent interobserver agreement between the performing sonographers and the blinded expert reader were seen. This training set-up could be useful in the implementation of US for diagnosing GCA.

Published
2015

35. THU0635 Defining The Optimal Biological Monotherapy in Rheumatoid Arthritis:A Systematic Review and Network Meta-Analysis of Randomised Trials

Author

Tarp, S, Furst, D E, Døssing, A, Østergaard, M, Lorenzen, T, Hansen, M, Singh, J, Choy, E, Boers, M., Suarez-Almazor, M, Kristensen, L, Bliddal, H, Christensen, R, Tarp, S, Furst, D E, Døssing, A, Østergaard, M, Lorenzen, T, Hansen, M, Singh, J, Choy, E, Boers, M., Suarez-Almazor, M, Kristensen, L, Bliddal, H, and Christensen, R

Published
2016

38. THU0635 Defining The Optimal Biological Monotherapy in Rheumatoid Arthritis: A Systematic Review and Network Meta-Analysis of Randomised Trials

Author

Tarp, S., primary, Furst, D.E., additional, Døssing, A., additional, Østergaard, M., additional, Lorenzen, T., additional, Hansen, M., additional, Singh, J., additional, Choy, E., additional, Boers, M., additional, Suarez-Almazor, M., additional, Kristensen, L., additional, Bliddal, H., additional, and Christensen, R., additional

Published
2016
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43. THU0241 Association Between Tobacco Smoking and Response to Tumor Necrosis Factor Alpha Inhibitor Treatment in Ankylosing Spondylitis: Results from the Danish Nationwide Danbio Registry

Author

Glintborg, B., primary, Højgaard, P., additional, Hetland, M.L., additional, Chrysidis, S., additional, Espesen, J., additional, Holland-Fischer, M., additional, Johansen, F.J., additional, Jensen, J., additional, Hansen, I.M.J., additional, Hansen, T.H., additional, Kollerup, G., additional, Krogh, N.S., additional, Loft, A.G.R., additional, Lorenzen, T., additional, Mosborg, P., additional, Nilsson, C., additional, Nordin, H., additional, Oeftiger, S.F., additional, Pelck, R., additional, Rasmussen, C., additional, Unger, B., additional, and Dreyer, L., additional

Published
2015
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46. SAT0065 Effectiveness and Drug Adherence of Biologic Monotherapy in Danish Rheumatoid Arthritis Patients: A Cohort Study of Clinical Practice in the Danbio Registry

Author

Jørgensen, T., primary, Kristensen, L., additional, Christensen, R., additional, Bliddal, H., additional, Lorenzen, T., additional, Hansen, M., additional, Østergaard, M., additional, Jensen, J., additional, Zanjani, L., additional, Laursen, T., additional, Butt, S., additional, Dam, M., additional, Lindegaard, H., additional, Espesen, J., additional, Hendricks, O., additional, Kumar, P., additional, Kincses, A., additional, Larsen, L., additional, Andersen, M., additional, Næser, E., additional, Jensen, D., additional, Grydehøj, J., additional, Unger, B., additional, Dufour, N., additional, Sørensen, V., additional, Vildhøj, S., additional, Hansen, I., additional, Raun, J., additional, Krogh, N., additional, and Hetland, M., additional

Published
2014
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47. P1197 REAL-WORLD TREATMENT WITH FIRST GENERATION TRIPLE THERAPY FOR HCV-GT1 DIFFICULT-TO-TREAT PATIENTS: FINAL RESULTS OF AN OBSERVATIONAL STUDY IN PATIENTS WITH ADVANCED LIVER DISEASE AND NONRESPONSE

Author

Petersen, J., primary, Olah, K., additional, Unger, S., additional, Lorenzen, T., additional, Kuhlendahl, F., additional, Wursthorn, K., additional, Plettenberg, A., additional, Stoehr, A., additional, Czaja-Harder, C., additional, and Buggisch, P., additional

Published
2014
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48. Physician’s global assessment is affected by physician’s age and gender, but not by patient age and gender in rheumatoid arthritis patients treated in routine care. Data from the Danish nationwide DANBIO registry.

Author

Egholm, C.L., Pincus, T., Dreyer, L., Glintborg, Bente, Kowalski, M., Lorenzen, T., Madsen, Ole Rintek, Nordin, H., Rasmussen, C., Hetland, Merete Lund, Egholm, C.L., Pincus, T., Dreyer, L., Glintborg, Bente, Kowalski, M., Lorenzen, T., Madsen, Ole Rintek, Nordin, H., Rasmussen, C., and Hetland, Merete Lund

Published
2012

49. Two-year drug survival and treatment effect of abatacept and tocilizumab in the treatment of rheumatoid arthritis in routine care. Results from the nationwide Danish Danbio Registry.

Author

Leffers, H.C., Østergaard, Mikkel, Glintborg, Bente, Krogh, N.S., Tarp, U., Lorenzen, T., Hansen, Annette, Hansen, M.S., Dreyer, L., Jakobsen, M.S., Hetland, Merete Lund, Leffers, H.C., Østergaard, Mikkel, Glintborg, Bente, Krogh, N.S., Tarp, U., Lorenzen, T., Hansen, Annette, Hansen, M.S., Dreyer, L., Jakobsen, M.S., and Hetland, Merete Lund

Published
2012

50. The efficacy of active physiotherapy vs. passive/no intervention for pain relief in patients with rheumatoid arthritis: A systematic literature review and meta-analysis.

Author

Møller-Bisgaard, Signe Kaas, Christensen, R., Pedersen, Susanne Juhl, Hansen, Michael Sejer, Hørslev-Petersen, K., Lindegaard, H., Lorenzen, T., Madsen, Ole Rintek, Thamsborg, Gorm Milan, Østergaard, Mikkel, Møller-Bisgaard, Signe Kaas, Christensen, R., Pedersen, Susanne Juhl, Hansen, Michael Sejer, Hørslev-Petersen, K., Lindegaard, H., Lorenzen, T., Madsen, Ole Rintek, Thamsborg, Gorm Milan, and Østergaard, Mikkel

Published
2011

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