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Ekelund, Maria
Publications (7 of 7) Show all publications
Glerup, M., Thiel, S., Rypdal, V., Arnstad, E. D., Ekelund, M., Peltoniemi, S., . . . Herlin, T. (2019). Complement lectin pathway protein levels reflect disease activity in juvenile idiopathic arthritis: a longitudinal study of the Nordic JIA cohort. Pediatric Rheumatology, 17(1), Article ID 63.
Open this publication in new window or tab >>Complement lectin pathway protein levels reflect disease activity in juvenile idiopathic arthritis: a longitudinal study of the Nordic JIA cohort
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2019 (English)In: Pediatric Rheumatology, ISSN 1546-0096, E-ISSN 1546-0096, Vol. 17, no 1, article id 63Article in journal (Refereed) Published
Abstract [en]

Background

To determine the serum levels of the lectin pathway proteins early in the disease course and 17 years after disease onset and to correlate the protein levels to markers of disease activity in participants from a population-based Nordic juvenile idiopathic arthritis (JIA) cohort. Additionally, to assess the predictive value of lectin pathway proteins with respect to remission status.

Methods

A population-based cohort study of consecutive cases of JIA with a disease onset from 1997 to 2000 from defined geographical areas of Finland, Sweden, Norway and Denmark with 17 years of follow-up was performed. Clinical characteristics were registered and H-ficolin, M-ficolin, MASP-1, MASP-3, MBL and CL-K1 levels in serum were analyzed.

Results

In total, 293 patients with JIA were included (mean age 23.7 ± 4.4 years; mean follow-up 17.2 ± 1.7 years). Concentrations of the lectin protein levels in serum were higher at baseline compared to the levels 17 years after disease onset (p ≤ 0.006, n = 164). At baseline, the highest level of M-ficolin was observed in systemic JIA. Further, high M-ficolin levels at baseline and at 17-year follow-up were correlated to high levels of ESR. In contrast, high MASP-1 and MASP-3 tended to correlate to low ESR. CL-K1 showed a negative correlation to JADAS71 at baseline.

None of the protein levels had prognostic abilities for remission status 17 years after disease onset.

Conclusion

We hypothesize that increased serum M-ficolin levels are associated with higher disease activity in JIA and further, the results indicate that MASP-1, MASP-3 and CL-K1 are markers of inflammation.

Keywords
JIA, Lectin pathway proteins, Disease activity
National Category
Rheumatology and Autoimmunity
Identifiers
urn:nbn:se:uu:diva-394963 (URN)10.1186/s12969-019-0367-9 (DOI)000485261400001 ()31500626 (PubMedID)
Available from: 2019-10-18 Created: 2019-10-18 Last updated: 2019-10-18Bibliographically approved
Arnstad, E. D., Rypdal, V., Peltoniemi, S., Herlin, T., Berntson, L., Fasth, A., . . . Pelkonen, P. (2019). Early Self-Reported Pain in Juvenile Idiopathic Arthritis as Related to Long-Term Outcomes: Results From the Nordic Juvenile Idiopathic Arthritis Cohort Study. Arthritis care & research, 71(7), 961-969
Open this publication in new window or tab >>Early Self-Reported Pain in Juvenile Idiopathic Arthritis as Related to Long-Term Outcomes: Results From the Nordic Juvenile Idiopathic Arthritis Cohort Study
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2019 (English)In: Arthritis care & research, ISSN 2151-464X, E-ISSN 2151-4658, Vol. 71, no 7, p. 961-969Article in journal (Refereed) Published
Abstract [en]

Objective To study self-reported pain early in the disease course of juvenile idiopathic arthritis (JIA) as a predictor of long-term disease outcomes. Methods Consecutive cases of JIA with disease onset from 1997 to 2000 from defined geographical areas of Norway, Sweden, Finland, and Denmark were prospectively enrolled in this population-based cohort study. Self-reported, disease-related pain was measured on a 10-cm visual analog scale (VAS pain). Inclusion criteria were a baseline visit with a pain score 6 months after disease onset, followed by an 8-year study visit. Remission was defined according to Wallace et al (2004) preliminary criteria. Functional disability was measured by the Childhood Health Assessment Questionnaire and the Child Health Questionnaire Parent Form if the child was age <18 years and by the Health Assessment Questionnaire if age >= 18 years. Damage was scored using the Juvenile Arthritis Damage Index. Results The final study cohort consisted of 243 participants, and 120 participants (49%) had oligoarticular onset. At baseline, 76% reported a VAS pain score >0 compared to 57% reporting at 8 years. Half of those who reported baseline pain also reported pain at 8 years but at a lower intensity. Compared to no pain, higher pain intensity at baseline predicted more pain at 8 years, more functional disability, more damage, and less remission without medication. Baseline pain predicted more use of disease-modifying antirheumatic drugs/biologics during the disease course. Participants with oligoarticular JIA reporting pain at baseline were more likely to develop extended oligoarticular JIA or other JIA categories with an unfavorable prognosis. Conclusion Early self-reported, disease-related pain among children and adolescents with JIA is common and seems to predict persistent pain and unfavorable long-term disease outcomes.

Place, publisher, year, edition, pages
WILEY, 2019
National Category
Rheumatology and Autoimmunity
Identifiers
urn:nbn:se:uu:diva-390804 (URN)10.1002/acr.23715 (DOI)000473077200012 ()30055093 (PubMedID)
Available from: 2019-08-19 Created: 2019-08-19 Last updated: 2019-08-19Bibliographically approved
Nordal, E., Rypdal, V., Arnstad, E. D., Aalto, K., Berntson, L., Ekelund, M., . . . Rygg, M. (2019). Participation in school and physical education in juvenile idiopathic arthritis in a Nordic long-term cohort study. Pediatric Rheumatology, 17, Article ID 44.
Open this publication in new window or tab >>Participation in school and physical education in juvenile idiopathic arthritis in a Nordic long-term cohort study
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2019 (English)In: Pediatric Rheumatology, ISSN 1546-0096, E-ISSN 1546-0096, Vol. 17, article id 44Article in journal (Refereed) Published
Abstract [en]

Background: The aim of the study was to describe school attendance and participation in physical education in school among children with juvenile idiopathic arthritis (JIA).

Methods: Consecutive cases of JIA from defined geographical areas of Finland, Sweden and Norway with disease onset in 1997 to 2000 were followed for 8 years in a multi-center cohort study, aimed to be as close to population-based as possible. Clinical characteristics and information on school attendance and participation in physical education (PE) were registered.

Results: Participation in school and in PE was lowest initially and increased during the disease course. Eight years after disease onset 228/274 (83.2%) of the children reported no school absence due to JIA, while 16.8% reported absence during the last 2 months due to JIA. Full participation in PE was reported by 194/242 (80.2%), partly by 16.9%, and none by 2.9%. Lowest participation in PE was found among children with ERA and the undifferentiated categories. Absence in school and PE was associated with higher disease activity measures at the 8-year visit. School absence >1day at baseline predicted use of disease-modifying anti-rheumatic drugs, including biologics (DMARDs) (OR 1.2 (1.1-1.5)), and non-remission off medication (OR 1.4 (1.1-1.7) 8 years after disease onset.

Conclusion: School absence at baseline predicted adverse long-term outcome. In children and adolescents with JIA participation in school activities is mostly high after 8years of disease. For the minority with low participation, special attention is warranted to promote their full potential of social interaction and improve long-term outcome.

Place, publisher, year, edition, pages
BMC, 2019
Keywords
Juvenile idiopathic arthritis, Participation, Physical activity, Physical education, School, Epidemiology
National Category
Rheumatology and Autoimmunity
Identifiers
urn:nbn:se:uu:diva-390780 (URN)10.1186/s12969-019-0341-6 (DOI)000475708400002 ()31307487 (PubMedID)
Available from: 2019-08-16 Created: 2019-08-16 Last updated: 2019-08-16Bibliographically approved
Glerup, M., Stoustrup, P., Matzen, L. H., Rypdal, V., Nordal, E., Frid, P., . . . Pedersen, T. K. (2018). Long-Term Outcome of Temporomandibular Joint Arthritis in Juvenile Idiopathic Arthritis: Results of 18-Year Follow-up in the Population-Based Nordic JIA Cohort. Arthritis & Rheumatology, 70
Open this publication in new window or tab >>Long-Term Outcome of Temporomandibular Joint Arthritis in Juvenile Idiopathic Arthritis: Results of 18-Year Follow-up in the Population-Based Nordic JIA Cohort
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2018 (English)In: Arthritis & Rheumatology, ISSN 2326-5191, E-ISSN 2326-5205, Vol. 70Article in journal, Meeting abstract (Other academic) Published
Place, publisher, year, edition, pages
John Wiley & Sons, 2018
National Category
Rheumatology and Autoimmunity
Identifiers
urn:nbn:se:uu:diva-369625 (URN)000447268902081 ()
Available from: 2018-12-17 Created: 2018-12-17 Last updated: 2018-12-17Bibliographically approved
Rypdal, V., Arnstad, E. D., Aalto, K., Berntson, L., Ekelund, M., Fasth, A., . . . Nordal, E. (2018). Predicting unfavorable long-term outcome in juvenile idiopathic arthritis: results from the Nordic cohort study. Arthritis Research & Therapy, 20, Article ID 91.
Open this publication in new window or tab >>Predicting unfavorable long-term outcome in juvenile idiopathic arthritis: results from the Nordic cohort study
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2018 (English)In: Arthritis Research & Therapy, ISSN 1478-6354, E-ISSN 1478-6362, Vol. 20, article id 91Article in journal (Refereed) Published
Abstract [en]

Background: The aim was to develop prediction rules that may guide early treatment decisions based on baseline clinical predictors of long-term unfavorable outcome in juvenile idiopathic arthritis (JIA).

Methods: In the Nordic JIA cohort, we assessed baseline disease characteristics as predictors of the following outcomes 8 years after disease onset. Non-achievement of remission off medication according to the preliminary Wallace criteria, functional disability assessed by Childhood Health Assessment Questionnaire (CHAQ) and Physical Summary Score (PhS) of the Child Health Questionnaire, and articular damage assessed by the Juvenile Arthritis Damage Index-Articular (JADI-A). Multivariable models were constructed, and cross-validations were performed by repeated partitioning of the cohort into training sets for developing prediction models and validation sets to test predictive ability.

Results: The total cohort constituted 423 children. Remission status was available in 410 children: 244 (59.5%) of these did not achieve remission off medication at the final study visit. Functional disability was present in 111/340 (32.7%) children assessed by CHAQ and 40/199 (20.1%) by PhS, and joint damage was found in 29/216 (13.4%). Model performance was acceptable for making predictions of long-term outcome. In validation sets, the area under the curves (AUCs) in the receiver operating characteristic (ROC) curves were 0.78 (IQR 0.72-0.82) for non-achievement of remission off medication, 0.73 (IQR 0.67-0.76) for functional disability assessed by CHAQ, 0.74 (IQR 0.65-0.80) for functional disability assessed by PhS, and 0.73 (IQR 0.63-0.76) for joint damage using JADI-A.

Conclusion: The feasibility of making long-term predictions of JIA outcome based on early clinical assessment is demonstrated. The prediction models have acceptable precision and require only readily available baseline variables. Further testing in other cohorts is warranted.

Place, publisher, year, edition, pages
BIOMED CENTRAL LTD, 2018
Keywords
Juvenile idiopathic arthritis, Disease activity, Prediction, Outcome research
National Category
Rheumatology and Autoimmunity
Identifiers
urn:nbn:se:uu:diva-356395 (URN)10.1186/s13075-018-1571-6 (DOI)000431297600003 ()29724248 (PubMedID)
Available from: 2018-07-25 Created: 2018-07-25 Last updated: 2018-07-25Bibliographically approved
Glerup, M., Rypdal, V., Arnstad, E. D., Ekelund, M., Peltoniemi, S., Aalto, K., . . . Herlin, T. (2018). Remission Status after 18 Years of Follow-up in the Population-Based Nordic Juvenile Idiopathic Arthritis (JIA) Cohort. Arthritis & Rheumatology, 70
Open this publication in new window or tab >>Remission Status after 18 Years of Follow-up in the Population-Based Nordic Juvenile Idiopathic Arthritis (JIA) Cohort
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2018 (English)In: Arthritis & Rheumatology, ISSN 2326-5191, E-ISSN 2326-5205, Vol. 70Article in journal, Meeting abstract (Other academic) Published
Place, publisher, year, edition, pages
John Wiley & Sons, 2018
National Category
Rheumatology and Autoimmunity
Identifiers
urn:nbn:se:uu:diva-369626 (URN)000447268903052 ()
Available from: 2018-12-17 Created: 2018-12-17 Last updated: 2018-12-17Bibliographically approved
Ekelund, M., Berntson, L., Consolaro, A., Bovis, F. & Ruperto, N. (2018). The Swedish version of the Juvenile Arthritis Multidimensional Assessment Report (JAMAR). Rheumatology International, 38(Suppl. 1), 371-377
Open this publication in new window or tab >>The Swedish version of the Juvenile Arthritis Multidimensional Assessment Report (JAMAR)
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2018 (English)In: Rheumatology International, ISSN 0172-8172, E-ISSN 1437-160X, Vol. 38, no Suppl. 1, p. 371-377Article in journal (Refereed) Published
Abstract [en]

The Juvenile Arthritis Multidimensional Assessment Report (JAMAR) is a new parent/patient-reported outcome measure that enables a thorough assessment of the disease status in children with juvenile idiopathic arthritis (JIA). We report the results of the cross-cultural adaptation and validation of the parent and patient versions of the JAMAR in the Swedish language. The reading comprehension of the questionnaire was tested in 10 JIA parents and patients. Each participating centre was asked to collect demographic, clinical data and the JAMAR in 100 consecutive JIA patients or all consecutive patients seen in a 6-month period and to administer the JAMAR to 100 healthy children and their parents. The statistical validation phase explored descriptive statistics and the psychometric issues of the JAMAR: the 3 Likert assumptions, floor/ceiling effects, internal consistency, Cronbach's alpha, interscale correlations, test-retest reliability and construct validity (convergent and discriminant validity). A total of 68 JIA patients (8.8% systemic, 44.1% oligoarticular, 13.2% RF negative polyarthritis, 33.9% other categories) and 76 healthy children, were enrolled in two centres. The JAMAR components discriminated well healthy subjects from JIA patients. All JAMAR components revealed good psychometric performances. In conclusion, the Swedish version of the JAMAR is a valid tool for the assessment of children with JIA and is suitable for use both in routine clinical practice and clinical research.

Place, publisher, year, edition, pages
SPRINGER HEIDELBERG, 2018
Keywords
Juvenile idiopathic arthritis, Disease status, Functional ability, Health-related quality of life, JAMAR
National Category
Rheumatology and Autoimmunity Nursing
Identifiers
urn:nbn:se:uu:diva-352712 (URN)10.1007/s00296-018-3975-7 (DOI)000429656500047 ()29637346 (PubMedID)
Available from: 2018-06-07 Created: 2018-06-07 Last updated: 2018-06-07Bibliographically approved
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