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Lindqvist, Ulla
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Publications (10 of 30) Show all publications
Lindqvist, U., Wernroth, M. L., Husmark, T., Larsson, P., Geijer, M., Teleman, A., . . . Alenius, G.-M. -. (2017). DAPSA, DAS28 and MDA predict long-term treatment regime in psoriatic arthritis. The Swedish Early Psoriatic Arthritis Cohort. Clinical and Experimental Rheumatology, 35(6), 936-942
Open this publication in new window or tab >>DAPSA, DAS28 and MDA predict long-term treatment regime in psoriatic arthritis. The Swedish Early Psoriatic Arthritis Cohort
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2017 (English)In: Clinical and Experimental Rheumatology, ISSN 0392-856X, E-ISSN 1593-098X, Vol. 35, no 6, p. 936-942Article in journal (Refereed) Published
Abstract [en]

Objective To describe treatment patterns in the Swedish early psoriatic arthritis cohort (SwePsA) of the mono-/oligo-arthritic (M/O) and polyarthritis (P) and identify early predictive factors for treatment with disease-modifying anti-rheumatic (DMARD), non-steroidal anti-inflammatory drugs (NSAID), and tumour necrosis factor inhibition (TNFi) after 5 years. Methods Data for 198 M/O and P PsA were obtained within the programme for SwePsA. Multinomial and binary logistic regression analyses were used to assess the association between early predictive factors and treatment after 5 years adjusted for age at inclusion. The analysis of DMARD/NSAID was adjusted for medication at inclusion. Results After inclusion visit, DMARD was prescribed in 30% of M/O and 56% of P PsA; mainly methotrexate. TNFi was not prescribed at inclusion, but 23 patients were treated at 5-year follow-up. The adjusted OR (95% CI) for treatment with both DMARD and NSAID after 5 years was 3.65 (1.34 - 9.89) (p=0.010) for Disease Activity Score 28 (DAS28) >3.2 and 2.90 (1.20-6.99) (p=0.038) for Disease Activity Index in Psoriatic Arthritis (DAPSA) >14 at inclusion. TNFi treatment was, after adjusting for age, associated with high erythrocyte sedimentation rate (p=0.0043), high C-reactive protein (p=0.013), DAPSA (p<0.001), not reaching minimal disease activity (p=0.001) high health assessment questionnaire (p=0.001), patient's overall assessment on the visual analogue scale (VAS) (p=0.009), high pain VAS (p=0.007), and high number of tender and swollen joints (p=0.031) at inclusion. Conclusion Disease activity in early M/O and P PsA is to be considered in deciding the level of health care assessment and future pharmacological treatment. DAS28 >3.2 and DAPSA>14 early in the disease predict subsequent treatment with DMARD. For prediction of biological treatment, not reaching MDA at onset of disease, would be the composite index of choice.

Place, publisher, year, edition, pages
CLINICAL & EXPER RHEUMATOLOGY, 2017
Keyword
DMARD, NSAID, TNF-inhibition, minimal disease activity, remission
National Category
Rheumatology and Autoimmunity
Identifiers
urn:nbn:se:uu:diva-339706 (URN)000418418300008 ()28628468 (PubMedID)
Available from: 2018-01-26 Created: 2018-01-26 Last updated: 2018-01-26Bibliographically approved
Lindqvist, U., Gudbjornsson, B., Iversen, L., Laasonen, L., Ejstrup, L., Ternowitz, T. & Stahle, M. (2017). Disease activity in and quality of life of patients with psoriatic arthritis mutilans: the Nordic PAM Study. Scandinavian Journal of Rheumatology, 46(6), 454-460
Open this publication in new window or tab >>Disease activity in and quality of life of patients with psoriatic arthritis mutilans: the Nordic PAM Study
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2017 (English)In: Scandinavian Journal of Rheumatology, ISSN 0300-9742, E-ISSN 1502-7732, Vol. 46, no 6, p. 454-460Article in journal (Refereed) Published
Abstract [en]

Objective: To describe the social status and health-related quality of life of patients with psoriatic arthritis mutilans (PAM) in the Nordic countries.Method: Patients with at least one mutilated joint confirmed by radiology were studied. Disease activity involving joints and skin, physician-assessed disease activity, and patient's education and work status were recorded. Data from the 36-item Short Form Health Survey, Health Assessment Questionnaire and Dermatology Life Quality Index questionnaire were gathered and correlated with disease duration, pain, and general well-being (visual analogue scale). The controls were 58 Swedish patients with long-standing psoriatic arthritis sine PAM.Results: Sixty-seven patients were included. Patients with PAM had a protracted disease history (3314years) and disease onset at a relatively early age (30 +/- 12years). Overall inflammatory activity at inclusion was mild to moderate. The mean number of mutilated joints was 8.2 and gross deformity was found in 16% of patients. Forty per cent were treated with biological and 32% with conventional synthetic disease-modifying anti-rheumatic drugs. Forty-two per cent had retired early or were on sick leave. Impaired functional capacity with little or no ability to perform self-care or everyday tasks was reported by 21% of the patients. Patients between 45 and 60years of age reported the most impaired quality of life in comparison to the control group.Conclusion: PAM seriously affects social functioning. Whether early recognition of PAM and new forms of therapy can improve disease outcome and quality of life remains to be studied.

National Category
Rheumatology and Autoimmunity
Identifiers
urn:nbn:se:uu:diva-343159 (URN)10.1080/03009742.2017.1278787 (DOI)000415723100005 ()28276958 (PubMedID)
Available from: 2018-02-26 Created: 2018-02-26 Last updated: 2018-02-26Bibliographically approved
Matt, P. & Lindqvist, U. (2016). Experiences of Rituximab Treatment in RF+ Rheumatoid Arthritis. Paper presented at Annual European Congress of Rheumatology (EULAR), JUN 08-11, 2016, London, ENGLAND. Annals of the Rheumatic Diseases, 75, 732-733
Open this publication in new window or tab >>Experiences of Rituximab Treatment in RF+ Rheumatoid Arthritis
2016 (English)In: Annals of the Rheumatic Diseases, ISSN 0003-4967, E-ISSN 1468-2060, Vol. 75, p. 732-733Article in journal, Meeting abstract (Other academic) Published
Place, publisher, year, edition, pages
BMJ PUBLISHING GROUP, 2016
National Category
Rheumatology and Autoimmunity
Identifiers
urn:nbn:se:uu:diva-347378 (URN)10.1136/annrheumdis-2016-eular.4768 (DOI)000401523103382 ()
Conference
Annual European Congress of Rheumatology (EULAR), JUN 08-11, 2016, London, ENGLAND
Available from: 2018-04-09 Created: 2018-04-09 Last updated: 2018-04-09Bibliographically approved
Matt, P., Lindqvist, U. & Kleinau, S. (2016). On The Relationship between Rheumatoid Factors, Monocyte Subsets and FC Receptor Function in Early Ra. Paper presented at Annual European Congress of Rheumatology (EULAR), JUN 08-11, 2016, London, ENGLAND. Annals of the Rheumatic Diseases, 75, 695-695
Open this publication in new window or tab >>On The Relationship between Rheumatoid Factors, Monocyte Subsets and FC Receptor Function in Early Ra
2016 (English)In: Annals of the Rheumatic Diseases, ISSN 0003-4967, E-ISSN 1468-2060, Vol. 75, p. 695-695Article in journal, Meeting abstract (Other academic) Published
Place, publisher, year, edition, pages
BMJ PUBLISHING GROUP, 2016
National Category
Rheumatology and Autoimmunity
Identifiers
urn:nbn:se:uu:diva-347377 (URN)10.1136/annrheumdis-2016-eular.4818 (DOI)000401523103286 ()
Conference
Annual European Congress of Rheumatology (EULAR), JUN 08-11, 2016, London, ENGLAND
Available from: 2018-04-09 Created: 2018-04-09 Last updated: 2018-04-09Bibliographically approved
Matt, P., Lindqvist, U. & Kleinau, S. (2015). Elevated Membrane and Soluble CD64: A Novel Marker Reflecting Altered Fc gamma R Function and Disease in Early Rheumatoid Arthritis That Can Be Regulated by Anti-Rheumatic Treatment. PLoS ONE, 10(9), Article ID e0137474.
Open this publication in new window or tab >>Elevated Membrane and Soluble CD64: A Novel Marker Reflecting Altered Fc gamma R Function and Disease in Early Rheumatoid Arthritis That Can Be Regulated by Anti-Rheumatic Treatment
2015 (English)In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 10, no 9, article id e0137474Article in journal (Refereed) Published
Abstract [en]

Objectives Fc receptors (FcR) interacting with immune complexes (ICs) is a central event in the immune pathogenesis of rheumatoid arthritis (RA). Here we asked if a specific FcR is linked to RA pathogenesis and if FcR activities relate to disease and treatment outcome in early RA. Material and Methods Twenty autoantibody-positive RA patients and 33 HC were included. The patients were evaluated before and after treatment with methotrexate and prednisolone. At follow-up, the EULAR response criteria were applied to determine the individual treatment outcomes. Serum immunoglobulin levels were measured and the expression of FcR for IgG (Fc gamma R) and IgA (Fc alpha R) on peripheral blood monocytes were determined by flow cytometry. The monocytic Fc gamma R function was evaluated by human IgG1 and IgG3 IC-binding and TNF alpha stimulated release. Plasma levels of soluble FcRs (sFcRs) were determined with ELISA. Results The IgG1 and IgG3 levels were elevated in the RA sera. The RA monocytes expressed more CD64 and cell surface-bound IgG than HC monocytes, and showed an impaired Fc gamma R function as reflected by changes in IC-binding and decreased IC-stimulated TNF alpha secretion. These findings correlated significantly with different disease activity markers. Furthermore, sFcRs were elevated in the patient plasma, and sCD64 was specific for RA (compared with a reference group of patients with active psoriatic arthritis). Following treatment, immunoglobulins and sFcR levels were reduced, whereas membrane CD64 was only decreased in patients with good response to treatment. Conclusions Early RA patients display increased membrane and soluble CD64 and an impaired Fc gamma R function correlating with joint disease activity. Beneficial responses of anti-rheumatic treatment in patients reduce CD64. These data suggest sCD64 as an important objective biomarker in RA.

National Category
Rheumatology and Autoimmunity
Identifiers
urn:nbn:se:uu:diva-265908 (URN)10.1371/journal.pone.0137474 (DOI)000361800700021 ()26406605 (PubMedID)
Available from: 2015-11-04 Created: 2015-11-04 Last updated: 2017-12-01Bibliographically approved
Do, L., Dahl, C. P., Kerje, S., Hansell, P., Mörner, S., Lindqvist, U., . . . Hellman, U. (2015). High Sensitivity Method to Estimate Distribution of Hyaluronan Molecular Sizes in Small Biological Samples Using Gas-Phase Electrophoretic Mobility Molecular Analysis. International Journal of Cell Biology, 2015, Article ID 938013.
Open this publication in new window or tab >>High Sensitivity Method to Estimate Distribution of Hyaluronan Molecular Sizes in Small Biological Samples Using Gas-Phase Electrophoretic Mobility Molecular Analysis
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2015 (English)In: International Journal of Cell Biology, ISSN 1687-8876, E-ISSN 1687-8884, Vol. 2015, article id 938013Article in journal (Refereed) Published
Abstract [en]

Hyaluronan is a negatively charged polydisperse polysaccharide where both its size and tissue concentration play an important role in many physiological and pathological processes. The various functions of hyaluronan depend on its molecular size. Up to now, it has been difficult to study the role of hyaluronan in diseases with pathological changes in the extracellular matrix where availability is low or tissue samples are small. Difficulty to obtain large enough biopsies from human diseased tissue or tissue from animal models has also restricted the study of hyaluronan. In this paper, we demonstrate that gas-phase electrophoretic molecular mobility analyzer (GEMMA) can be used to estimate the distribution of hyaluronan molecular sizes in biological samples with a limited amount of hyaluronan. The low detection level of the GEMMA method allows for estimation of hyaluronan molecular sizes from different parts of small organs. Hence, the GEMMA method opens opportunity to attain a profile over the distribution of hyaluronan molecular sizes and estimate changes caused by disease or experimental conditions that has not been possible to obtain before.

National Category
Cell and Molecular Biology
Identifiers
urn:nbn:se:uu:diva-272639 (URN)10.1155/2015/938013 (DOI)26448761 (PubMedID)
Available from: 2016-01-15 Created: 2016-01-15 Last updated: 2018-01-10Bibliographically approved
Laasonen, L., Gudbjornsson, B., Ejstrup, L., Iversen, L., Ternowitz, T., Stahle, M. & Lindqvist, U. (2015). Radiographic development during three decades in a patient with psoriatic arthritis mutilans. ACTA RADIOLOGICA OPEN, 4(7)
Open this publication in new window or tab >>Radiographic development during three decades in a patient with psoriatic arthritis mutilans
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2015 (English)In: ACTA RADIOLOGICA OPEN, ISSN 2058-4601, Vol. 4, no 7Article in journal (Refereed) Published
Abstract [en]

Psoriatic arthritis mutilans (PAM) is the most severe and rare form of psoriatic arthritis (PsA). We describe radiological development in a typical case of PAM covering three decades in order to elucidate the need for early diagnosis of PAM. Radiographs of hands and feet, taken from 1981 to 2010, were evaluated using the Psoriatic Arthritis Ratingen Score (PARS). When PsA was diagnosed, in 1981, gross deformity was observed in the second PIP joint of the left foot. Several pencil-in-cup deformities and gross osteolysis were present in the feet in the first decade of the disease. Over 10 years, many joints had reached maximum scores. During the follow-up, other joints became involved and the disease developed clinically. Reporting early signs suggestive of PAM, e.g. pencil-in cup deformities and gross osteolysis in any joint, should be mandatory and crucial. This would heighten our awareness of PAM, accelerate the diagnosis, and lead to improved effective treatment in order to minimize joint damages resulting in PAM.

Keyword
Radiology, psoriasis, arthritis, mutilans, follow-up
National Category
Radiology, Nuclear Medicine and Medical Imaging
Identifiers
urn:nbn:se:uu:diva-272420 (URN)10.1177/2058460115588098 (DOI)000366016800002 ()
Available from: 2016-01-25 Created: 2016-01-13 Last updated: 2016-01-25Bibliographically approved
Geijer, M., Lindqvist, U., Husmark, T., Alenius, G.-M., Larsson, P. T., Teleman, A. & Theander, E. (2015). The Swedish Early Psoriatic Arthritis Registry 5-year Followup: Substantial Radiographic Progression Mainly in Men with High Disease Activity and Development of Dactylitis. Journal of Rheumatology, 42(11), 2110-2117
Open this publication in new window or tab >>The Swedish Early Psoriatic Arthritis Registry 5-year Followup: Substantial Radiographic Progression Mainly in Men with High Disease Activity and Development of Dactylitis
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2015 (English)In: Journal of Rheumatology, ISSN 0315-162X, E-ISSN 1499-2752, Vol. 42, no 11, p. 2110-2117Article in journal (Refereed) Published
Abstract [en]

Objective. To describe early radiographic findings in patients from the Swedish psoriatic arthritis (SwePsA) registry, progression of destruction, correlations with clinical disease variables, and predictors of destruction. Methods. Hand and foot radiographs were available for 72 of 197 SwePsA patients followed for 5 years. Clinical data were collected according to the SwePsA protocol. Results. Disease characteristics and clinical improvement were similar in men and women. Radiographic abnormalities were more pronounced in men. Total Wassenberg radiographic score at baseline was 0 in 45% of men and 51% of women. One man and one woman had a score >10. At 5 years, total score was 0 in 14% of men and 40% of women (p = 0.018); 17% of men and 7% of women had scores >10. Mean total scores for men and women had increased. Baseline erythrocyte sedimentation rate was associated with baseline total radiographic score. In men, swollen joint count was positively, and in women tender joint count negatively, correlated to total radiographic score. After 5 years, only male scores, mainly hand scores, significantly correlated with 28-joint Disease Activity Score and Disease Activity Index for Psoriatic Arthritis scores, swollen joint count, and dactylitis. Achieving remission or minimal disease activity after 5 years protected against structural damage, mainly in men. Conclusion. Radiographic progression in early PsA was generally slow but substantial. Male sex appears to be a risk factor for early radiographic damage while the presence of baseline radiographic damage and dactylitis developing during followup seem to predict further destruction. Hand and foot radiograph scoring cannot be substituted with clinical signs.

Keyword
PSORIATIC ARTHRITIS, RADIOGRAPHY, DESTRUCTION, JOINT EROSIONS, OUTCOME, DISEASE ACTIVITY SCORE
National Category
Rheumatology and Autoimmunity
Identifiers
urn:nbn:se:uu:diva-270635 (URN)10.3899/jrheum.150165 (DOI)000365221400017 ()26472410 (PubMedID)
Available from: 2016-01-01 Created: 2016-01-01 Last updated: 2017-12-01Bibliographically approved
Lindqvist, U., Theander, E., Husmark, T., Larsson, P., Teleman, A., Alenius, G.-M. & Geijer, M. (2015). The Swedish Early Psoriatic Arthritis (SWEPSA) registry 5-year follow-up: Slow radiographic progression with highest scores in male feet and patients with baseline x-ray abnormalities. Paper presented at 4th World Psoriasis and Psoriatic Arthritis Conference on Psoriasis - New Insights and Innovations, OCT, 2015, Stockholm, SWEDEN. Journal of Investigative Dermatology, 135, S1-S1
Open this publication in new window or tab >>The Swedish Early Psoriatic Arthritis (SWEPSA) registry 5-year follow-up: Slow radiographic progression with highest scores in male feet and patients with baseline x-ray abnormalities
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2015 (English)In: Journal of Investigative Dermatology, ISSN 0022-202X, E-ISSN 1523-1747, Vol. 135, p. S1-S1Article in journal, Meeting abstract (Other academic) Published
National Category
Rheumatology and Autoimmunity
Identifiers
urn:nbn:se:uu:diva-265955 (URN)000361160500002 ()
Conference
4th World Psoriasis and Psoriatic Arthritis Conference on Psoriasis - New Insights and Innovations, OCT, 2015, Stockholm, SWEDEN
Available from: 2015-11-05 Created: 2015-11-04 Last updated: 2017-12-01Bibliographically approved
Matt, P., Lindqvist, U. & Kleinau, S. (2015). Up-regulation of CD64-expressing monocytes with impaired Fc gamma R function reflects disease activity in polyarticular psoriatic arthritis. Scandinavian Journal of Rheumatology, 44(6), 464-473
Open this publication in new window or tab >>Up-regulation of CD64-expressing monocytes with impaired Fc gamma R function reflects disease activity in polyarticular psoriatic arthritis
2015 (English)In: Scandinavian Journal of Rheumatology, ISSN 0300-9742, E-ISSN 1502-7732, Vol. 44, no 6, p. 464-473Article in journal (Refereed) Published
Abstract [en]

Objectives: The aim of this study was to assess monocyte Fc receptor (FcR) status and function in patients with active psoriatic arthritis (PsA) in relation to healthy controls (HC) and to disease activity.Method:The study population comprised 23 patients with active polyarticular PsA and 33 age- and gender-matched HC. Immunoglobulin (Ig) levels, inflammatory laboratory parameters, patient-reported outcomes of joint disease activity, skin scoring (Psoriasis Area and Severity Index, PASI), and joint status were determined in the patients. Monocytes were analysed for the expression of FcRs for IgG (FcR) class I (CD64), IIa (CD32a), IIb (CD32b), and III (CD16), the FcR for IgA (FcR) (CD89), and surface-bound IgG. The monocytic FcR function was assessed by evaluating IgG immune complex (IC) binding and tumour necrosis factor (TNF)- production following IgG-IC stimulation. The monocytes were further subdivided and analysed according to their CD14 and CD16 expression.Results:The PsA patients presented elevated serum levels of IgG1, 2, and 3 and increased numbers of CD64(+) monocytes. Furthermore, the PsA monocytes exhibited increased cell-bound IgG, and the FcR function was affected in terms of reduced IgG-IC-mediated TNF- release. These findings correlated significantly with different markers of joint disease activity. PsA was also accompanied by an increase in the CD16 low-expressing monocyte subset.Conclusions:An intensified humoral immune response affects monocytes and their FcR status in active polyarticular PsA. The up-regulated CD64(+) monocytes seem to be have an important role in psoriatic joint inflammation. These cells may prove to be a useful target in future PsA therapeutic interventions.

National Category
Rheumatology and Autoimmunity
Identifiers
urn:nbn:se:uu:diva-274343 (URN)10.3109/03009742.2015.1020864 (DOI)000364826400006 ()26084203 (PubMedID)
Funder
Swedish Research Council
Available from: 2016-01-21 Created: 2016-01-21 Last updated: 2017-11-30Bibliographically approved
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