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Does autoimmune thyroid disease affects rheumatoid arthritis disease activity or response to methotrexate?

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dc.contributor Háskóli Íslands
dc.contributor University of Iceland
dc.contributor.author Waldenlind, Kristin
dc.contributor.author Delcoigne, Bénédicte
dc.contributor.author Saevarsdottir, Saedis
dc.contributor.author Askling, Johan
dc.date.accessioned 2020-12-17T11:50:45Z
dc.date.available 2020-12-17T11:50:45Z
dc.date.issued 2020-07-15
dc.identifier.citation Waldenlind K, Delcoigne B, Saevarsdottir S, et alDoes autoimmune thyroid disease affect rheumatoid arthritis disease activity or response to methotrexate?RMD Open 2020;6:e001282. doi: 10.1136/rmdopen-2020-001282
dc.identifier.issn 2056-5933
dc.identifier.uri https://hdl.handle.net/20.500.11815/2295
dc.description Publisher's version (útgefin grein)
dc.description.abstract Objective: To investigate if autoimmune thyroid disease (AITD) impacts rheumatoid arthritis (RA) disease activity or response to methotrexate. Methods A nationwide register-based cohort study of 9 004 patients with new-onset RA from the Swedish Rheumatology Quality Register year 2006-2016, with linkage to other nationwide registers to identify comorbidity with AITD defined as thyroxine prescription before RA diagnosis, excluding non-autoimmune causes. We compared RA disease activity using 28-joint Disease Activity Score (DAS28) and its components, and EULAR response, between patients with and without AITD, using logistic regression. Results At diagnosis, patient reported outcome measures (PROMs; patient global, Health Assessment Questionnaire Disability Index and pain) but not objective disease activity measures (erythrocyte sedimentation rate and swollen joint count) were significantly higher (p<0.05 for all PROMs) among RA patients with AITD compared with those without. The level of DAS28 was 5.2 vs 5.1. By contrast, AITD had little influence on EULAR response to methotrexate at 3 months (OR of non/moderate response=0.95, 95% CI 0.8 to 1.1), nor at 6 months. When stratified by age, however, AITD was more common among EULAR non/moderate responders at 3 and 6 months in patients below 45 years resulting in ORs of non/moderate response of 1.44 (0.76-2.76) and 2.75 (1.04-7.28). Conclusion At diagnosis, RA patients with concomitant AITD score worse on patient reported but not on objective RA disease activity measures, while DAS28 was only marginally elevated. The overall chance of achieving a EULAR good response at 3 or 6 months remains unaffected, although among a limited subgroup of younger patients, AITD may be a predictor for an inferior primary response. © Author(s) (or their employer(s))
dc.description.sponsorship This work was supported by research grants from the Swedish Research Council, the Swedish Cancer Society, the Swedish HeartLung Foundation, Nordforsk, Vinnova and FOREUM. Financial support information: Dr Askling has acted or acts as PI in agreements between Karolinska Institutet and the following entities, mainly related to the safety monitoring of immunomodulators in rheumatology: Abbvie, BMS, Eli Lilly, Merck, Pfizer, Roche, Samsung Bioepis, Sanofi.
dc.format.extent e001282
dc.language.iso en
dc.publisher BMJ
dc.relation.ispartofseries RMD Open;6(2)
dc.rights info:eu-repo/semantics/openAccess
dc.subject Rheumatoid arthritis
dc.subject Autoimmune Diseases
dc.subject Epidemiology
dc.subject Methotrexate
dc.subject Patient Reported Outcome Measures
dc.subject Iktsýki
dc.subject Sjálfsofnæmissjúkdómar
dc.title Does autoimmune thyroid disease affects rheumatoid arthritis disease activity or response to methotrexate?
dc.type info:eu-repo/semantics/article
dcterms.license This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.
dc.description.version Peer Reviewed
dc.identifier.journal RMD Open
dc.identifier.doi 10.1136/rmdopen-2020-001282
dc.relation.url https://syndication.highwire.org/content/doi/10.1136/rmdopen-2020-001282
dc.contributor.department Læknadeild (HÍ)
dc.contributor.department Faculty of Medicine (UI)
dc.contributor.school Heilbrigðisvísindasvið (HÍ)
dc.contributor.school School of Health Sciences (UI)

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