Changes in sociodemographic characteristics at baseline in two Swedish cohorts of patients with early rheumatoid arthritis diagnosed 1996–98 and 2006–09

Hallert, Eva; Husberg, Magnus; Kalkan, Almina; Rahmqvist, Mikael; Bernfort, Lars

doi:10.3109/03009742.2014.930926

Cited by 6 publications

(7 citation statements)

References 26 publications

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“…With regard to country of origin from where the study population was drawn, 7 were from the UK,1–3 15–18 10 from the rest of Europe (3 the Netherlands, 3 Sweden, 1 Norway, 1 Germany, 1 Denmark),4 19–25 6 from USA and Canada,26–31 4 from South America (2 Chile, 1 Mexico, 1 Peru)32–35 and 3 from Asia (1 India, 1 China, 1 Singapore) 36–38. One study included multinational data 39.…”

Section: Resultsmentioning

confidence: 99%

“…The majority of articles included educational achievement in their definition of SES, either alone or in combination with other factors. Educational attainment alone was used as a proxy for SES in eight (27%) of the included articles,4 23–25 33 38–40 while a further eight combined education with factors including employment status, occupation, income, race and area of residence 21 22 26–28 31 36 37. Finally, one article categorised SES according to the area of the city in which patients were resident,20 and another article used type of occupation 19…”

Section: Resultsmentioning

confidence: 99%

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Association between social deprivation and disease activity in rheumatoid arthritis: a systematic literature review

et al. 2022

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Physical and mental illnesses are driven by ethnicity, social, environmental and economic determinants. Novel theoretical frameworks in rheumatoid arthritis (RA) focus on links and adverse interactions between and within biological and social factors. This review aimed to summarise associations between socioeconomic status (SES) and RA disease activity, and implications for future research. Articles studying the association between SES and RA disease activity were identified, from 1946 until March 2021. The research question was: Is there an association between social deprivation and disease activity in people with RA? Articles meeting inclusion criteria were examined by one author, with 10% screened at abstract and full paper stage by a second author. Disagreements were resolved with input from a third reviewer. Information was extracted on definition/measure of SES, ethnicity, education, employment, comorbidities, disease activity and presence/absence of association between SES and disease activity. Initially, 1750 articles were identified, with 30 articles ultimately included. SES definition varied markedly—10 articles used a formal scale and most used educational attainment as a proxy. Most studies controlled for lifestyle factors including smoking and body mass index, and comorbidities. Twenty-five articles concluded an association between SES and RA disease activity; two were unclear; three found no association. We have demonstrated the association between low SES and worse RA outcomes. There is a need for further research into the mechanisms underpinning this, including application of mixed-methods methodology and consideration of syndemic frameworks to understand bio–bio and bio–social interactions, to examine disease drivers and outcomes holistically.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Association between social deprivation and disease activity in rheumatoid arthritis: a systematic literature review

et al. 2022

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“…Two prospective Swedish early RA cohorts, designated “timely interventions in RA” (TIRA), formed the basis of the present study [ 33 ]. The prerequisites for inclusion were symptom duration ≥6 weeks but <12 months since the first joint swelling as judged by the patient, as well as the following: Fulfillment of at least four of seven of the 1987 revised American College of Rheumatology criteria for RA [ 34 ] ( n = 605 [95.1 %]) or Morning stiffness for ≥60 minutes and symmetrical arthritis and small joint arthritis (fingers, wrists, or toes) ( n = 31 [4.9 %]) …”

Section: Methodsmentioning

confidence: 99%

Circulating secretory IgA antibodies against cyclic citrullinated peptides in early rheumatoid arthritis associate with inflammatory activity and smoking

et al. 2016

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BackgroundA possible association between mucosal immunization and inflammation, as well as the initiation and propagation of rheumatoid arthritis (RA), is attracting renewed interest. The aim of this study was to evaluate the possible occurrence and clinical correlations of circulating secretory immunoglobulin A (SIgA) antibodies against the second-generation cyclic citrullinated peptides (CCP) among patients with recent-onset RA followed prospectively over 3 years.MethodsBaseline serum samples from 636 patients with recent-onset RA were analyzed for SIgA anti-CCP antibodies by using an enzyme-linked immunosorbent assay with a secondary antibody directed against secretory component. SIgA anti-CCP status at baseline was analyzed in relation to smoking, HLA-DRB1/shared epitope (SE), and the disease course over 3 years. Significant findings were evaluated in regression analysis that included age, sex, smoking, and SE.ResultsSeventeen percent of the patients tested positive for circulating SIgA anti-CCP, and the occurrence was confirmed by detection of secretory component in an affinity-purified IgA anti-CCP fraction. SIgA anti-CCP positivity at baseline was associated with slightly higher baseline erythrocyte sedimentation rate (ESR) (mean 38 vs. 31 mm/first hour, p = 0.004) and C-reactive protein (CRP) (mean 30 vs. 23 mg/L, p = 0.047). During follow-up, SIgA anti-CCP-positive patients had a higher mean AUC regarding ESR (adjusted p = 0.003), although there were no significant differences regarding CRP, tender and swollen joint counts, or radiological joint damage (median Larsen progression 1.0 vs. 1.0, p = 0.22). SIgA anti-CCP was associated significantly with smoking (79 % ever smokers among SIgA anti-CCP-positive patients vs. 59 % in SIgA anti-CCP-negative patients, adjusted OR 2.19, 95 % CI 1.01–4.37, p = 0.027) but not with carriage of the SE (80 % vs. 73 %, p = 0.62).ConclusionsCirculating SIgA anti-CCP, which is present in a subgroup of patients with early RA, is not related to SE, but it is environmentally linked to cigarette smoking. This finding strengthens the hypothesis that immunization against citrullinated peptides and/or proteins may occur at mucosal surfaces of the airways. Analysis of SIgA antibodies in serum may be a convenient and more versatile means to investigate the “mucosal connection” in RA compared with analyses in mucosal fluid samples.

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“…Symptom duration was <12 months. Follow-up procedures in TIRA-2 have been detailed previously (9,17). Radiographic damage was graded according to the Larsen method (18).…”

Section: Methodsmentioning

confidence: 99%

Extramucosal Formation and Prognostic Value of Secretory Antibodies in Rheumatoid Arthritis

Martinsson

Kling

Ljungberg

et al. 2022

Arthritis & Rheumatology

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Objective To investigate levels and possible extramucosal formation of secretory Ig, including anti–citrullinated protein antibodies (ACPAs), in rheumatoid arthritis (RA). Methods Three patient groups were studied: 1) ACPA‐positive patients with musculoskeletal pain without clinical arthritis, 2) patients with recent‐onset RA, and 3) patients with established RA. In baseline serum samples (groups 1 and 2) and paired synovial fluid samples (group 3), we analyzed total secretory IgA, total secretory IgM, free secretory component (SC), and SC‐containing ACPA. Extramucosal formation of SC‐containing ACPA was investigated by preincubating RA sera and affinity‐purified ACPA with recombinant free SC. Results Compared to healthy controls, serum levels of total secretory IgA and total secretory IgM were increased both in patients with early RA and at‐risk patients (P < 0.05). Patients with early RA with elevated total secretory Ig had significantly higher disease activity during the 3‐year follow‐up period compared to those without increased levels. At‐risk patients who developed arthritis during follow‐up (39 of 82) had higher baseline total secretory IgA levels compared to those who did not (P = 0.041). In established RA, total secretory IgA and total secretory IgM levels were higher in serum than in synovial fluid (P < 0.0001), but SC‐containing ACPAs adjusted for total secretory Ig concentration were higher in synovial fluid (P < 0.0001). Preincubation with recombinant free SC yielded increased SC‐containing ACPA reactivity in sera as well as in affinity‐purified IgA and IgM ACPA preparations. Conclusion Circulating secretory Ig are elevated before and at RA onset. In the presence of free SC, secretory Ig may form outside the mucosa, and SC‐containing ACPAs are enriched in RA joints. These findings shed important new light on the mucosal connection in RA development.

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Changes in sociodemographic characteristics at baseline in two Swedish cohorts of patients with early rheumatoid arthritis diagnosed 1996–98 and 2006–09

Cited by 6 publications

References 26 publications

Association between social deprivation and disease activity in rheumatoid arthritis: a systematic literature review

Association between social deprivation and disease activity in rheumatoid arthritis: a systematic literature review

Circulating secretory IgA antibodies against cyclic citrullinated peptides in early rheumatoid arthritis associate with inflammatory activity and smoking

Extramucosal Formation and Prognostic Value of Secretory Antibodies in Rheumatoid Arthritis

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