Publications by authors named "Siri Lillegraven"

Objectives: To explore the agreement between patient-reported flare status and clinically significant flare status in patients with rheumatoid arthritis (RA) in sustained remission.

Method: Patients with RA in remission for ≥12 months on stable treatment were included in the ARCTIC REWIND tapering trials and pooled 12-month data used in current analyses. Patient-reported flare status was assessed according to the Outcome Measures in Rheumatology flare questionnaire; 'Are you having a flare of your RA at this time?' (yes/no).

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Background: The treatment of failed ankle replacements is debated, and little is published about the medium- and long-term results of revision implants. We wanted to examine prosthesis survival and physical function at least 5 years after insertion of the Salto XT revision prosthesis.

Methods: All consecutive patients operated with a Salto XT revision prosthesis underwent clinical and radiologic examinations preoperatively and after 3, 12, 24, and 60 months.

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Purpose: Treatment with direct-acting oral anticoagulants (DOACs) is increasing among hip-fracture patients, with accompanying safety concerns regarding spinal anesthesia (SA). The aim of this study was to investigate if DOAC use is associated with increased waiting time before surgery, increased mortality, or other adverse events.

Methods: Registry data on surgically treated hip-fracture cases at a single hospital between 2015 and 2021 were analyzed.

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  • A study investigated the long-term effects of tapering disease-modifying antirheumatic drugs (DMARDs) in rheumatoid arthritis patients who were in sustained remission, with a focus on the risks of disease flare-ups over a 3-year period.
  • Patients aged 18-80 were randomly assigned to one of three treatment strategies: stable-dose DMARDs, half-dose DMARDs, or a tapering regimen that led to drug withdrawal after a year.
  • The trial enrolled 160 patients, with a majority being women, and aimed to assess flare-free survival rates, ultimately finding that most patients maintained remission throughout the follow-up period.
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Objectives: To explore the performance of the EULAR-initiated patient-reported Rheumatoid Arthritis Impact of Disease (RAID) questionnaire in relation to flares in disease activity, including comparison with other disease activity outcomes.

Methods: Patients with rheumatoid arthritis in sustained remission were randomised to continued stable treatment or tapering in the ARCTIC REWIND project. In patients with flares within 12 months, we compared RAID (total score and components) at the flare visit with the visit prior to and the visit following flare, using Wilcoxon signed-rank test.

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Background: Patients with chronic inflammatory joint diseases such as axial spondyloarthritis have traditionally received regular follow-up in specialist health care to maintain low disease activity. The follow-up has been organized as prescheduled face-to-face visits, which are time-consuming for both patients and health care professionals. Technology has enabled the remote monitoring of disease activity, allowing patients to self-monitor their disease and contact health care professionals when needed.

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Objectives: Many patients with rheumatoid arthritis (RA) require treatment with tumour necrosis factor inhibitor (TNFi) to reach remission. It is debated whether tapering of TNFi to discontinuation should be considered in sustained remission. The aim of ARCTIC REWIND TNFi was to assess the effect of tapering TNFi to withdrawal compared with stable treatment on the risk of disease activity flares in patients with RA in remission ≥1 year.

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Methotrexate is one of the cornerstones of rheumatoid arthritis (RA) therapy. Genetic factors or single nucleotide polymorphisms (SNPs) are responsible for 15%-30% of the variation in drug response. Identification of clinically effective SNP biomarkers for predicting methotrexate (MTX) sensitivity has been a challenge.

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  • The study aims to investigate mortality rates and causes of death among Norwegian patients with rheumatoid arthritis (RA), psoriatic arthritis (PsA), and axial spondyloarthritis (axSpA) compared to the general population using a nationwide registry from 2008 to 2017.
  • Researchers found that RA and axSpA are linked to higher all-cause mortality, while women with PsA also experience slightly increased mortality rates.
  • The leading causes of death for all groups were cardiovascular diseases, neoplasms, and respiratory diseases, highlighting the need for better management of associated health issues among these patients despite modern treatments.
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  • The study aimed to identify factors that prevent patients with rheumatoid arthritis (RA) from achieving ACR/EULAR Boolean remission and compared those who fully met the criteria to those who partially did.
  • Out of 203 RA patients in the ARCTIC trial, 112 (55%) achieved remission, but factors such as patient global assessment (PGA) and tender joints were significant obstacles for others.
  • Imaging results showed no major differences in inflammation levels between both groups, yet the likelihood of using biologic DMARDs was notably higher in those not fully meeting the remission criteria.
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  • The study looked at how often serious infections happen in people with rheumatoid arthritis (RA) and psoriatic arthritis (PsA) who are treated with a specific medicine called TNFi.
  • They found that patients with RA were older and took more medications, and those with RA got serious infections more often than those with PsA.
  • Overall, patients with PsA had a lower chance of getting serious infections compared to those with RA when using TNFi.
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Objectives: Fatigue is a frequent symptom in rheumatoid arthritis (RA) and has high impact on quality of life. We explored associations between disease activity and fatigue in patients with early RA during the initial 24 months of modern treat-to-target therapy and predictors of fatigue after 24 months of follow-up.

Methods: Data were obtained from the treat-to-target, tight control Aiming for Remission in Rheumatoid Arthritis: a Randomised Trial Examining the Benefit of Ultrasound in a Clinical Tight Control Regime (ARCTIC) trial.

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Importance: Sustained remission has become an achievable goal for patients with rheumatoid arthritis (RA) receiving conventional synthetic disease-modifying antirheumatic drugs (csDMARDs), but how to best treat patients in clinical remission remains unclear.

Objective: To assess the effect of tapering of csDMARDs, compared with continuing csDMARDs without tapering, on the risk of flares in patients with RA in sustained remission.

Design, Setting, And Participants: ARCTIC REWIND was a multicenter, randomized, parallel, open-label noninferiority study conducted in 10 Norwegian hospital-based rheumatology practices.

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  • Rheumatoid arthritis (RA) is influenced by various factors, with recent studies highlighting the role of dysregulated microRNAs (miRNAs) in immune cells, particularly focusing on CD19+ B cells, which are crucial in RA pathogenesis.
  • A study analyzed miRNA expression in CD19+ B cells from newly diagnosed RA patients, successfully treated patients in remission, and healthy controls, revealing significant differences in miRNA expression, particularly between MTX treated patients and controls.
  • The findings suggest specific miRNAs, previously linked to RA dysregulation, may regulate B cell functions, indicating the need for further research on miRNA-gene interactions and their potential to predict RA treatment outcomes.
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Objectives: To investigate if inflammation detected by MRI or ultrasound at rheumatoid arthritis (RA) onset is predictive of erosive progression or poor response to methotrexate monotherapy, and to investigate if subclinical inflammation in remission is predictive of future treatment escalation or erosive progression.

Methods: In a 2-year study, 218 patients with disease-modifying antirheumatic drug-naïve early RA were treated by a tight-control treat-to-target strategy corresponding to current recommendations. MRI and ultrasound were performed at regular intervals.

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  • The study investigates DNA methylation differences in CD4 T cell populations from rheumatoid arthritis (RA) patients compared to healthy controls, focusing on CD4 memory and naïve T cells.
  • Results show a significant disparity in differentially methylated positions (DMPs), with 904 DMPs in CD4 memory cells versus only 19 in naïve cells among RA patients.
  • Findings indicate that methylation differences are influenced by disease status, with newly diagnosed and untreated patients showing increased methylation in most DMPs, while treated patients in remission show decreased methylation, highlighting the complexity of RA's impact on immune cell function.
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