Psoriatic arthritis, axial spondyloarthritis and rheumatoid arthritis in Norway: nationwide prevalence and use of biologic agents.

OBJECTIVE: To estimate the prevalence of psoriatic arthritis (PsA), axial spondyloarthritis (axSpA) and rheumatoid arthritis (RA) and the use of biologic agents in these diseases in Norway. METHODS: From the Norwegian Patient Registry (NPR), we identified as PsA, axSpA and RA patients ≥18 years those with ≥2 recorded episodes with diagnostic coding for index disease (L40.5, M07.0-M07.3 for PsA; M45, M46.0, M46.1, M46.8 and M46.9 for axSpA; M05-M06 for RA). We calculated the point prevalence of PsA, axSpA and RA as per the 1st of January 2017 in the Norwegian adult population (age ≥18). Dispensed disease-modifying antirheumatic drug (DMARD) prescriptions were obtained from the Norwegian Prescription Database and biologic DMARDs given in hospitals from the NPR. RESULTS: The point prevalence of PsA, axSpA, RA, and any of these diseases in total was 0.46%, 0.41%, 0.78%, and 1.56%, respectively. Among women, the prevalence of PsA, axSpA, and RA was 0.50%, 0.37%, and 1.10%, and among men 0.43%, 0.45%, and 0.46%, respectively. In 2017, 27.3% of RA patients, 25.7% of PsA patients and 35.1% of axSpA patients used biologic DMARDs. Treatment with biologics was more frequent in younger age groups in all three diseases, and became more infrequent especially after age ≥55 years. CONCLUSION: In Norway, the combined prevalence of PsA, axSpA, and RA was over 1.5%. Reflecting the good overall access to highly effective but costly biologic treatments, more than a fourth of these patients used biologic agents, which corresponds to over 0.4% of Norwegian adult population.

Degree of arterial stiffness is comparable across inflammatory joint disease entities.

OBJECTIVES: Inflammatory joint disease (IJD) is associated with an increased risk of developing cardiovascular disease (CVD). Arterial stiffness is both a risk factor and a surrogate marker for CVD. This study aims to compare arterial stiffness across patients with rheumatoid arthritis, ankylosing spondylitis, and psoriatic arthritis, and, by extension, to explore the relationship between arterial stiffness and the estimated CVD risk by the Systematic COronary Risk Evaluation (SCORE) algorithm. METHOD: During the study period, from April 2017 to June 2018, 196 patients with IJD visited the Preventive Cardio-Rheuma Clinic in Oslo, Norway. A CVD risk stratification was performed, including the assessment of traditional risk factors and the measurement of arterial stiffness. RESULTS: Thirty-six patients (18.4%) had elevated aortic pulse wave velocity (aPWV) (≥ 10 m/s). After adjustment for age and heart rate, arterial stiffness was comparable across the IJD entities (p = 0.69). Associated factors, revealed by regression analysis, were age, blood pressure, heart rate, presence of carotid plaques, establis hed CVD, non-steroidal anti-inflammatory drugs, and statin use. Furthermore, aPWV was positively correlated with estimated CVD risk (r = 0.7, p < 0.001) and patients with a very high predicted CVD risk (SCORE ≥ 10%) had significantly higher aPWV than patients at lower CVD risk (9.2 vs 7.5 m/s, p < 0.001). CONCLUSION: The degree of arterial stiffness was comparable across the IJD entities and was highly associated with the estimated CVD risk. Our findings support the need for an increased focus on prevention of CVD in all patients with IJD.

Determination of Al, Cu, Li and Mn in spruce seeds and plant reference materials by slurry sampling graphite furnace atomic absorption spectrometry.

An ultrasonic slurry sampling graphite furnace AAS method was developed for the determination of Al, Cu, Li and Mn in spruce seeds, NBS SRM 1575 pine needles and GBW CRM 07602 bush branches and leaves. The only sample preparation was grinding in a Mixer Mill before preparing a slurry by adding 0.14 mol/L nitric acid to a small sample aliquot. Cryogenic grinding was used for the spruce seeds to solve the problem of agglomerating during grinding at room temperature. A modified sample tray was applied allowing the use of both the commercial 1.5 mL vials and home-made 15 mL vials. With optimal conditions for ultrasonic agitation the homogeneity and particle size distributions in the slurries prepared in the two different vials were similar. Several aspects of the slurry sampling approach are discussed and data of important parameters are given, including the total number of particles injected into the graphite furnace, densities of the materials and percentage of analyte extracted into the liquid phase of the slurry. The density of the materials was determined by two methods; by using a Coulter particle analyser and by using a gravimetric method. The two methods gave similar accuracy and precision. The concentration ranges of the elements (in microg g(-1)) were: 80-2100 for Al, 3-15 for Cu, 0.06-2.5 for Li and 50-700 for Mn. External calibration with aqueous standards was employed. Chemical modifiers were not found to be necessary. The relative standard deviations were in the range 1.7-7%. Analyses of the two certified plant reference materials confirmed the accuracy of the method. In addition no significant difference was found for analyses of digested and slurried spruce seeds. The detection limit was 10 ng g(-1) for Li and 170 ng g(-1) for Cu. The characteristic mass (area measurements) was 4.4 pg for Li and 11 pg for Cu. For Al and Mn less sensitive wavelengths were used.