Periodontitis in patients with systemic lupus erythematosus: A nation-wide study of 1990 patients

Background The aim of this study was to examine the association between systemic lupus erythematosus (SLE) and periodontitis in Norway during a 10-year period from 2008 through 2017. Methods In this population-based study, 1,990 patients were included in the SLE-cohort based on diagnostic codes registered in the Norwegian Patient Registry. The control group (n = 170,332) comprised patients registered with diagnostic codes for non-osteoporotic fractures or hip or knee replacement because of osteoarthritis. The outcome was periodontitis, defined by procedure codes registered in the Control and Payment of Health Refunds database. Logistic regression analyses were performed to estimate odds ratio for periodontitis in patients versus controls adjusted for potential covariates. Results Periodontitis was significantly more common in SLE patients compared to controls (OR 1.78, 95% CI 1.47-2.14) and the difference was highest in SLE-patients 20 to 30 years of age (OR 3.24, 95% CI 1.23 – 8.52). The periodontitis rate in SLE patients was in the same range as for patients with diabetes mellitus type 2. Conclusions Patients with SLE had an almost doubled risk of periodontitis compared with the control population, and the difference was most accentuated in the young patients. These findings warrant an increased focus on dental health in SLE-patients.publishedVersio

Periodontitis in patients with primary Sjögren's syndrome: A nation-wide register study

The aim of this study was to compare the occurrence of periodontitis in patients with primary Sjögren's syndrome (pSS) and a non-Sjögren's patient group during a 7-year period from 2011 through 2017. In this population-based study, the patients were identified based on the International Classification of Diseases-10 (ICD-10) codes registered in the Norwegian Patient Registry (NPR), which contains information on diagnosis and time of admission for all hospitalized patients in Norway. The pSS group comprised patients with ≥4 registrations with ICD-10 code M35.0 (Sjögren's syndrome) as the main diagnosis. The dependent variable was periodontitis, defined by procedure codes registered in the Norwegian Control and Payment of Health Reimbursement (KUHR). Logistic regression analyses estimated the odds ratio for periodontitis in pSS patients relative to non-pSS patients, adjusted for relevant covariates. Lastly, regression analyses were performed separately for each of the 6 age categories. In total, 760 (7.5%) patients in the pSS group and 22,178 (7.1%) in the non-pSS group had periodontitis. When adjusting for covariates, the presence of pSS had no association with periodontitis (OR = 1.06, 95% CI: 0.98–1.14).publishedVersio

Survival and death causes of patients with giant cell arteritis in Western Norway 1972-2012: a retrospective cohort study

Background: Our objective was to determine the survival and causes of death in a large and well-characterized cohort of patients with giant cell arteritis (GCA). Methods: This is a hospital-based, retrospective, observational cohort study including patients diagnosed with GCA in Western Norway during 1972–2012. Patients were identified through computerized hospital records using the International Classification of Diseases (ICD)-coding system. Medical records were reviewed. Patients were randomly assigned population controls matched on age, sex, and geography from the Central Population Registry of Norway (CPRN). Date and cause of death were obtained from the Norwegian Cause of Death Registry (NCoDR). The survival was analyzed using Kaplan-Meier methods with the Gehan-Breslow test and the causes of death using cumulative incidence and Cox models for competing risks. Results: We identified 881 cases with a clinical diagnosis of GCA of which 792 fulfilled the American College of Rheumatology (ACR) 1990 classification criteria. Among those fulfilling the ACR criteria, 528 were also biopsy-verified. Cases were matched with 2577 population controls. A total of 490 (56%) GCA patients and 1517 (59%) controls died during the study period. We found no difference in the overall survival of GCA patients compared to controls, p = 0.413. The most frequent underlying causes of death in both groups were diseases of the circulatory system followed by cancer. GCA patients had increased risk of dying of circulatory disease (HR 1.31, 95% CI 1.13–1.51, p < 0.001) but lower risk of dying of cancer (HR 0.56, 95% CI 0.42–0.73, p < 0.001) compared to population controls. Conclusions: We found no difference in the overall survival of GCA patients compared to matched controls, but there were differences in the distribution of underlying death causes.publishedVersio

Covid-19 hos pasienter med kronisk inflammatorisk leddsykdom

BAKGRUNN Siden pasienter med kronisk inflammatorisk leddsykdom kan være mer utsatt for infeksjoner, ønsket vi å undersøke forekomsten av covid-19 i denne gruppen og se om forhold ved den revmatiske sykdommen, pasienten eller behandlingen hadde betydning. MATERIALE OG METODE 27 907 pasienter registrert i Norsk kvalitetsregister for artrittsykdommer (NorArtritt) ble koblet til Meldingssystem for smittsomme sykdommer og Norsk intensiv- og pandemiregister for å finne forekomsten av covid-19 i 2020 og andel innlagt i sykehus. Standardisert insidensforhold (SIR) ble beregnet ved sammenligning med kjønns- og aldersspesifikk forekomst i den generelle befolkningen. Ved logistisk regresjonsanalyse ble det undersøkt om diagnose, alder, kjønn, sykdomsaktivitet, komorbiditet eller medikamentell behandling hadde betydning for forekomsten. RESULTATER 185 av pasientene i NorArtritt fikk påvist covid-19, hvorav 10 % ble innlagt på sykehus. Forekomsten var lavere enn i den generelle befolkningen (SIR 0,84; 95 %-konfidensintervall (KI): 0,72 til 0,97, P = 0,02). Ung alder og lav sykdomsaktivitet var knyttet til høyere smitteforekomst. De andre faktorene hadde ingen signifikant betydning. FORTOLKNING At forekomsten av covid-19 var lavere enn i normalbefolkningen og innad i gruppen lavere hos dem med moderat/høy sykdomsaktivitet og høyere alder, skyldes trolig at pasienter med kronisk aktiv sykdom og høy alder i større grad har beskyttet seg mot smitte.publishedVersio

Trends in the occurrence of ischaemic heart disease over time in rheumatoid arthritis: 1821 patients from 1972 to 2017

Objective To evaluate trends of acute myocardial infarction (AMI) and ischaemic heart disease (IHD) in rheumatoid arthritis (RA) patients compared with the general population over time. Method We performed a retrospective cohort study of 1821 RA patients diagnosed from 1972 to 2013. Aggregated counts of the total population of the same county (Hordaland, Norway) and period were used for comparison. Information on AMI and IHD events was obtained from hospital patient administrative systems or cardiovascular registries. We estimated incidence rates and excess of events [standardized event ratio (SER) with 95% confidence interval (CI)] compared with the general population by Poisson regression. Results There was an average annual decline of 1.6% in age- and gender-adjusted AMI incidence rates from 1972 to 2017 (p < 0.035). The difference in events (excess events) in RA patients compared with the general population declined on average by 1.3% per year for AMI and by 2.3% for IHD from 1972 to 2014. There were no significant excess AMI (SER 1.05, 95% CI 0.82–1.35) or IHD events (SER 1.02, 95% CI 0.89–1.16) for RA patients diagnosed after 1998 compared with the general population. Conclusion Incidence rates and excess events of AMI and IHD in RA patients declined from 1972 to 2017. There were no excess AMI or IHD events in RA patients diagnosed after 1998 compared with the general population.publishedVersio

Periodontitis in patients with systemic lupus erythematosus: A nation-wide study of 1990 patients

Background The aim of this study was to examine the association between systemic lupus erythematosus (SLE) and periodontitis in Norway during a 10-year period from 2008 through 2017. Methods In this population-based study, 1,990 patients were included in the SLE-cohort based on diagnostic codes registered in the Norwegian Patient Registry. The control group (n = 170,332) comprised patients registered with diagnostic codes for non-osteoporotic fractures or hip or knee replacement because of osteoarthritis. The outcome was periodontitis, defined by procedure codes registered in the Control and Payment of Health Refunds database. Logistic regression analyses were performed to estimate odds ratio for periodontitis in patients versus controls adjusted for potential covariates. Results Periodontitis was significantly more common in SLE patients compared to controls (OR 1.78, 95% CI 1.47-2.14) and the difference was highest in SLE-patients 20 to 30 years of age (OR 3.24, 95% CI 1.23 – 8.52). The periodontitis rate in SLE patients was in the same range as for patients with diabetes mellitus type 2. Conclusions Patients with SLE had an almost doubled risk of periodontitis compared with the control population, and the difference was most accentuated in the young patients. These findings warrant an increased focus on dental health in SLE-patients

Covid-19 hos pasienter med kronisk inflammatorisk leddsykdom

BAKGRUNN Siden pasienter med kronisk inflammatorisk leddsykdom kan være mer utsatt for infeksjoner, ønsket vi å undersøke forekomsten av covid-19 i denne gruppen og se om forhold ved den revmatiske sykdommen, pasienten eller behandlingen hadde betydning. MATERIALE OG METODE 27 907 pasienter registrert i Norsk kvalitetsregister for artrittsykdommer (NorArtritt) ble koblet til Meldingssystem for smittsomme sykdommer og Norsk intensiv- og pandemiregister for å finne forekomsten av covid-19 i 2020 og andel innlagt i sykehus. Standardisert insidensforhold (SIR) ble beregnet ved sammenligning med kjønns- og aldersspesifikk forekomst i den generelle befolkningen. Ved logistisk regresjonsanalyse ble det undersøkt om diagnose, alder, kjønn, sykdomsaktivitet, komorbiditet eller medikamentell behandling hadde betydning for forekomsten. RESULTATER 185 av pasientene i NorArtritt fikk påvist covid-19, hvorav 10 % ble innlagt på sykehus. Forekomsten var lavere enn i den generelle befolkningen (SIR 0,84; 95 %-konfidensintervall (KI): 0,72 til 0,97, P = 0,02). Ung alder og lav sykdomsaktivitet var knyttet til høyere smitteforekomst. De andre faktorene hadde ingen signifikant betydning. FORTOLKNING At forekomsten av covid-19 var lavere enn i normalbefolkningen og innad i gruppen lavere hos dem med moderat/høy sykdomsaktivitet og høyere alder, skyldes trolig at pasienter med kronisk aktiv sykdom og høy alder i større grad har beskyttet seg mot smitte

Bacterial Findings in Infected Hip Joint Replacements in Patients with Rheumatoid Arthritis and Osteoarthritis: A Study of 318 Revisions for Infection Reported to the Norwegian Arthroplasty Register

High rates of Staphylococcus aureus are reported in prosthetic joint infection (PJI) in rheumatoid arthritis (RA). RA patients are considered to have a high risk of infection with bacteria of potentially oral or dental origin. One thousand four hundred forty-three revisions for infection were reported to the Norwegian Arthroplasty Register (NAR) from 1987 to 2007. For this study 269 infection episodes in 255 OA patients served as control group. In the NAR we identified 49 infection episodes in 37 RA patients from 1987 to 2009. The RA patients were, on average, 10 years younger than the OA patients and there weremore females (70% versus 54%).We found no differences in the bacterial findings in RA and OA. A tendency towards a higher frequency of Staphylococcus aureus (18% versus 11%) causing PJI was found in the RA patients compared to OA. There were no bacteria of potential odontogenic origin found in the RA patients, while we found 4% in OA. The bacteria identified in revisions for infection in THRs in patients with RA did not significantly differ from those in OA. Bacteria of oral or dental origin were not found in infected hip joint replacements in RA

Survival and death causes of patients with giant cell arteritis in Western Norway 1972-2012: a retrospective cohort study

Background: Our objective was to determine the survival and causes of death in a large and well-characterized cohort of patients with giant cell arteritis (GCA). Methods: This is a hospital-based, retrospective, observational cohort study including patients diagnosed with GCA in Western Norway during 1972–2012. Patients were identified through computerized hospital records using the International Classification of Diseases (ICD)-coding system. Medical records were reviewed. Patients were randomly assigned population controls matched on age, sex, and geography from the Central Population Registry of Norway (CPRN). Date and cause of death were obtained from the Norwegian Cause of Death Registry (NCoDR). The survival was analyzed using Kaplan-Meier methods with the Gehan-Breslow test and the causes of death using cumulative incidence and Cox models for competing risks. Results: We identified 881 cases with a clinical diagnosis of GCA of which 792 fulfilled the American College of Rheumatology (ACR) 1990 classification criteria. Among those fulfilling the ACR criteria, 528 were also biopsy-verified. Cases were matched with 2577 population controls. A total of 490 (56%) GCA patients and 1517 (59%) controls died during the study period. We found no difference in the overall survival of GCA patients compared to controls, p = 0.413. The most frequent underlying causes of death in both groups were diseases of the circulatory system followed by cancer. GCA patients had increased risk of dying of circulatory disease (HR 1.31, 95% CI 1.13–1.51, p < 0.001) but lower risk of dying of cancer (HR 0.56, 95% CI 0.42–0.73, p < 0.001) compared to population controls. Conclusions: We found no difference in the overall survival of GCA patients compared to matched controls, but there were differences in the distribution of underlying death causes