Publications by authors named "Kresten K Keller"

Objective: To compare the number of new erosions in two metacarpophalangeal (MCP) joints over one year assessed by high-resolution peripheral quantitative computed tomography (HR-pQCT) and conventional radiography (CR). Furthermore, to estimate the diagnostic accuracy of erosive progression by CR with HR-pQCT as the reference standard.

Methods: Paired sets of image data were available from patients with RA (n=310), who underwent HR-pQCT and CR, including the 2nd and 3rd MCP joints only of the dominant hand at baseline and at the one-year follow-up.

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  • The study aimed to assess the effectiveness of vascular ultrasound (US) in detecting giant cell arteritis (GCA) before and after starting glucocorticoid (GC) treatment in patients new to the condition.
  • A total of 48 treatment-naïve patients underwent various imaging tests, and US sensitivity showed high initial rates, followed by a decrease in sensitivity at days 3 and 10 after GC treatment, particularly for temporal artery (TA) assessments.
  • Findings suggest a rapid reduction in vasculitic signs after 3 days of treatment, emphasizing the need for early US evaluation within this timeframe to ensure accurate GCA diagnosis.
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  • - The study aimed to explore how common late-onset giant cell arteritis (GCA) is within the first year for patients newly diagnosed with polymyalgia rheumatica (PMR).
  • - Researchers used advanced imaging techniques like vascular ultrasonography and FDG-PET/CT scans to monitor PMR patients and confirm findings over a year, leading to the identification of GCA.
  • - Results showed a low incidence of late-onset GCA (32 per 1000 person-years) among PMR patients, indicating that subclinical GCA is also rare in the PMR population.
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Purpose: In routine care, clinicians may employ 2-[18F]fluoro-2-deoxy-D-glucose (FDG) positron emission tomography (PET) computed tomography (CT) to validate their initial clinical diagnosis of polymyalgia rheumatica (PMR). Nevertheless, the diagnostic utility of combining FDG-PET/CT findings with clinical presentation has not been explored. Therefore, this study aimed to investigate whether the diagnostic accuracy for PMR could be enhanced by combining FDG-PET/CT findings with the clinical baseline diagnosis or the 2012 ACR/EULAR clinical classification criteria for PMR.

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  • The DANIsh VASculitis cohort study (DANIVAS) is a national study in Denmark focused on collecting clinical data and biobank samples from patients with polymyalgia rheumatica (PMR) and giant cell arteritis (GCA).
  • The study aims to determine how new imaging techniques can help categorize GCA and PMR patients and assess their treatment needs, especially regarding large-vessel involvement and aneurysm risk.
  • Utilizing Denmark's established infrastructure for clinical studies and a national biobank, DANIVAS has the potential to gather extensive real-world data on various aspects of these diseases, aiding in the development of better management strategies.
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Introduction: Following the approval of tocilizumab (TCZ) for giant cell arteritis (GCA), recent studies have shown a high relapse frequency after abrupt discontinuation of TCZ. However, a thorough exploration of TCZ tapering compared to abrupt discontinuation has never been undertaken. Likewise, adverse events have only been scarcely investigated in routine care.

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Objectives: To investigate the diagnostic accuracy of high-resolution peripheral quantitative computed tomography (HR-pQCT) to assess erosive progression during one year compared to conventional radiography (CR) in rheumatoid arthritis (RA).

Methods: This prospective study included 359 patients with RA (disease duration ≥ 5 years) between March 2018 and October 2020. HR-pQCT and CR were obtained at inclusion and after one year.

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Purpose: 2-[18F]Fluoro-2-deoxy-D-glucose (FDG)-positron emission tomography (PET)/computed tomography (CT) has been suggested as an imaging modality to diagnose polymyalgia rheumatica (PMR). However, the applicability of FDG-PET/CT remains unclear, especially following glucocorticoid administration. This study aimed to investigate the diagnostic accuracy of FDG-PET/CT before and during prednisolone treatment, as well as following short-term prednisolone discontinuation.

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  • * Results indicated that BPs vary in location, size, and number depending on the type of arthritis, with PsA patients showing a greater number and larger size of BPs compared to RA patients and healthy controls.
  • * The review highlighted a lack of standard definitions and measurement techniques for BPs, emphasizing the need for consensus to improve diagnostic accuracy and disease monitoring, with only the treatment secukinumab showing potential effects on reducing BP progression.
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Objective: To develop international consensus-based recommendations for early referral of individuals with suspected polymyalgia rheumatica (PMR).

Methods: A task force including 29 rheumatologists/internists, 4 general practitioners, 4 patients and a healthcare professional emerged from the international giant cell arteritis and PMR study group. The task force supplied clinical questions, subsequently transformed into Population, Intervention, Comparator, Outcome format.

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Objectives: To compare if the 4th and 5th metatarsophalangeal (MTP) joints evaluated by high-resolution peripheral quantitative computed tomography (HR-pQCT) could classify more patients with erosive rheumatoid arthritis (RA) compared with conventional radiography (CR) of the hands, wrists, and feet. Furthermore, we characterize and quantify bone erosions in the two MTP joints by HR-pQCT.

Methods: This single-center cross-sectional study included patients with established RA (disease duration ≥5 years).

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Objectives: We evaluated sensitivity to change and discriminative abilities of vascular US scores in disease monitoring in the follow-up of a prospective cohort of new-onset cranial and large-vessel (LV) GCA patients.

Methods: Baseline and follow-up (8 weeks, 24 weeks and 15 months) US of temporal arteries (TA), carotid and axillary arteries (LV) included assessment of halo and measurement of the intima media complex (IMC). Max IMC, max halo IMC, sum IMC, sum halo IMC, mean IMC, halo count and the Southend halo score were calculated.

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Objectives: To explore current management practices for PMR by general practitioners (GPs) and rheumatologists including implications for clinical trial recruitment.

Methods: An English language questionnaire was constructed by a working group of rheumatologists and GPs from six countries. The questionnaire focused on: 1: Respondent characteristics; 2: Referral practices; 3: Treatment with glucocorticoids; 4: Diagnostics; 5: Comorbidities; and 6: Barriers to research.

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Objectives: To develop an Outcome Measures in Rheumatology (OMERACT) ultrasonography score for monitoring disease activity in giant cell arteritis (GCA) and evaluate its metric properties.

Methods: The OMERACT Instrument Selection Algorithm was followed. Forty-nine members of the OMERACT ultrasonography large vessel vasculitis working group were invited to seven Delphi rounds.

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Smartphone-based pedometer sensor telemedicine applications could be useful for measuring disease activity and predicting the risk of developing comorbidities, such as pulmonary or cardiovascular disease, in patients with rheumatoid arthritis (RA), but the sensors have not been validated in this patient population. The aim of this study was to validate step counting with an activity-tracking application running the inbuilt Android smartphone pedometer virtual sensor in patients with RA. Two Android-based smartphones were tested in a treadmill test-bed setup at six walking speeds and compared to manual step counting as the gold standard.

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Objective: To compare in images, obtained by high-resolution peripheral quantitative computed tomography (HR-pQCT) and conventional radiography (CR) of the second and third metacarpophalangeal (MCP) joints, the minimal erosive cortical break needed to differentiate between pathological and physiological cortical breaks.

Methods: In this single-center cross-sectional study, patients with established rheumatoid arthritis (disease duration ≥ 5 yrs) had their second and third MCP joints of the dominant hand investigated by HR-pQCT and CR. Empirical estimation was used to find the optimal cut-off value for the number of erosions and total erosive volume, which were detectable between patients with and without erosions in the second and third MCP joints according to CR.

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Introduction: Giant cell arteritis (GCA) and polymyalgia rheumatica (PMR) can be concurrent diseases. We aimed to estimate the point-prevalence of concurrent GCA and PMR. Additionally, an incidence rate (IR) of GCA presenting after PMR diagnosis in patients was estimated.

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Objective: High-resolution peripheral quantitative computed tomography (HR-pQCT) requires longer immobilization time than conventional radiography, which challenges patient acceptance and image quality. Therefore, the aim was to investigate the acceptance of HR-pQCT in patients with rheumatoid arthritis (RA), and secondly the effect of an inflatable hand immobilization device on motion artefacts of the metacarpophalangeal (MCP) joints.

Methods: Fifty patients with established RA and a median (interquartile range) age of 64.

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  • * A total of 353 RA patients were analyzed; results showed that 18.7% had non-erosive RA while 81.3% had erosive RA based on CR, with HR-pQCT demonstrating high sensitivity but low specificity for classification.
  • * The findings concluded that HR-pQCT and CR have comparable accuracy for diagnosing erosive RA, indicating that scanning just two joints can be as effective as evaluating a larger number of joints.
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Objectives: To evaluate the efficacy of a fast track clinic (FTC) for patients suspected of polymyalgia rheumatica (PMR) regarding symptom duration, prednisolone initiation before rheumatological assessment, number of hospital contacts before diagnosis, and cancer diagnosis.

Methods: It is a retrospective cohort study with a one year follow-up period. Patients referred to the FTC (1st August 2016 to 25th June 2019) were compared to a historical cohort of PMR patients (1st August 2014 to 1st August 2016).

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  • The primary vasculitides are a diverse group of immune-related diseases categorized by the size of the affected blood vessels, with recent studies exploring more specific immunological mechanisms.
  • A systematic review of 40 studies revealed the efficacy of various biologic therapies, such as tocilizumab for large vessel vasculitis and rituximab for granulomatosis with polyangiitis and microscopic polyangiitis.
  • Findings indicate that targeting specific cytokines and cellular mechanisms can help refine the classification of vasculitis and may lead to distinct treatment approaches based on disease subtype.
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