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

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dc.contributorHáskóli Íslandsen_US
dc.contributorUniversity of Icelanden_US
dc.contributor.authorWaldenlind, Kristin
dc.contributor.authorDelcoigne, Bénédicte
dc.contributor.authorSaevarsdottir, Saedis
dc.contributor.authorAskling, Johan
dc.contributor.departmentLæknadeild (HÍ)en_US
dc.contributor.departmentFaculty of Medicine (UI)en_US
dc.contributor.schoolHeilbrigðisvísindasvið (HÍ)en_US
dc.contributor.schoolSchool of Health Sciences (UI)en_US
dc.date.accessioned2020-12-17T11:50:45Z
dc.date.available2020-12-17T11:50:45Z
dc.date.issued2020-07-15
dc.descriptionPublisher's version (útgefin grein)en_US
dc.description.abstractObjective: 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))en_US
dc.description.sponsorshipThis 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.en_US
dc.description.versionPeer Revieweden_US
dc.format.extente001282en_US
dc.identifier.citationWaldenlind 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-2020-001282en_US
dc.identifier.doi10.1136/rmdopen-2020-001282
dc.identifier.issn2056-5933
dc.identifier.journalRMD Openen_US
dc.identifier.urihttps://hdl.handle.net/20.500.11815/2295
dc.language.isoenen_US
dc.publisherBMJen_US
dc.relation.ispartofseriesRMD Open;6(2)
dc.relation.urlhttps://syndication.highwire.org/content/doi/10.1136/rmdopen-2020-001282en_US
dc.rightsinfo:eu-repo/semantics/openAccessen_US
dc.subjectRheumatoid arthritisen_US
dc.subjectAutoimmune Diseasesen_US
dc.subjectEpidemiologyen_US
dc.subjectMethotrexateen_US
dc.subjectPatient Reported Outcome Measuresen_US
dc.subjectIktsýkien_US
dc.subjectSjálfsofnæmissjúkdómaren_US
dc.titleDoes autoimmune thyroid disease affects rheumatoid arthritis disease activity or response to methotrexate?en_US
dc.typeinfo:eu-repo/semantics/articleen_US
dcterms.licenseThis 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/.en_US

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