Patients with non-Sjögren's sicca report poorer general and oral health-related quality of life than patients with Sjögren's syndrome: a cross-sectional study.

Understanding the impact of the disease on quality of life is crucial in patient management. In this cross-sectional study, general and oral health-related quality of life questionnaires, and thorough examinations of oral and ocular dryness were performed in age- and sex-matched patients with primary Sjögren's syndrome (pSS group), non-Sjögren's syndrome sicca (non-SS group) and healthy controls. General and oral health-related quality of life were investigated with the 36-Item Short Form Health Survey and the 14-Item Oral Health Impact Profile questionnaires, respectively. Subjective symptoms of xerostomia and ocular dryness were recorded using the Summated Xerostomia Inventory and Ocular Surface Disease Index, respectively. Clinical examinations included evaluation of clinical oral dryness scores, candida counts, unstimulated and stimulated saliva secretory rates, tear osmolarity, tear film break-up time, Schirmer I test and ocular surface staining. Both patient groups had pronounced signs and symptoms of xerostomia and ocular dryness. Even though the non-SS patients had less severe clinical signs than the pSS patients, they demonstrated much poorer general and oral health-related quality of life. In conclusion, non-SS patients require more attention in order to improve their quality of life.

High prevalence of inclusion body myositis in Norway; a population-based clinical epidemiology study.

BACKGROUND AND PURPOSE: Knowledge about the occurrence of sporadic inclusion body myositis (sIBM) in the general population is limited. Here, our aim was to identify and characterize every sIBM patient living in southeast Norway (population 2.64 million) from 2003 to 2012. METHOD: Two sIBM case finding strategies were applied. First, all hospital databases in southeast Norway were screened to identify cases with sIBM-compatible International Classification of Diseases 10 (ICD-10) codes. These cases were then manually chart reviewed. Secondly, all muscle histology reports encoded with inflammation were independently reviewed. Finally, cases were classified according to the 1997 and the 2011 European Neuro-Muscular Centre (ENMC) Research Diagnostic Criteria for sIBM. RESULTS: The combined case finding strategy identified 3160 patients with sIBM compatible ICD-10 codes, and a largely overlapping cohort of 500 patients having muscle biopsies encoded with inflammation. Detailed retrospective review of chart and histology data showed that 95 patients met the 2011 ENMC sIBM criteria and 92 met the 1997 criteria. Estimated point prevalence of sIBM was 33/1 000 000, equal with both criteria sets. Mean age at diagnosis was 66.9 years and mean diagnostic delay was 5.6 years. Chart review revealed higher frequencies of dysphagia (94% vs. 65%) and anti-Sjøgren syndrome A antibodies (39% vs. 12%) in female sIBM patients (n = 40) than in males. Coexisting rheumatic diseases were present in 25% of sIBM cases, with Sjøgren's syndrome in 10%. CONCLUSION: An estimated point prevalence of sIBM seven times higher than previously observed in Europe is reported. Our data show considerable diagnostic delay, a major challenge with new sIBM treatments in the pipeline.

High incidence and prevalence of systemic lupus erythematosus in Norway.

Our aim was to identify all patients with systemic lupus erythematosus (SLE) within the city of Oslo from 1999-2008 and to estimate the incidence and prevalence of SLE according to age, sex and ethnicity. Adults (16 years and over) with SLE were identified from five different sources. Only patients fulfilling four or more of the updated 1997 American College of Rheumatology (ACR) criteria were included. The incidence was stable during the nine year study period, with a mean annual incidence rate of 3.0 per 100,000 at risk (95% confidence interval (CI) 2.4-3.5). Females exhibited a bimodal pattern in age specific incidence with the first peak at 16-29 years of age and the second at 50-59 years of age. The overall prevalence was 51.8 per 100,000 population (95% CI 45.2-58.4), with 91.0 (95% CI 78.8-103.1) for females and 10.7 (95% CI 6.4-15.0) for males. The prevalence proportions for European descendants were similar to those for Asians but statistically significant lower than those for individuals adopted from non-European countries. The findings indicate a higher prevalence in Norwegians compared to Caucasians in Denmark and England. The higher prevalence of SLE in foreign adopted individuals warrants further examination.

The efficacy of rehabilitation for patients with rheumatoid arthritis: comparison between a 4-week rehabilitation programme in a warm and cold climate.

OBJECTIVES: To investigate the long-term effect (week 16) of a 4-week rehabilitation programme for patients with rheumatoid arthritis (RA) and to compare the effect of this intervention given in a Mediterranean or a Norwegian climate. METHODS: A randomized, controlled, parallel group design, where 124 RA patients applying for rehabilitation were randomized to a rehabilitation programme either in Norway or in a Mediterranean climate. The participants were examined clinically immediately before (week 0) and after (week 4) the rehabilitation period as well as in week 16 and answered a mailed questionnaire in week 28. The 28-Joint Disease Activity Score (DAS28), American College of Rheumatology (ACR) response and physical tests were used to measure clinical response. RESULTS: The baseline DAS28 value 4.45 (1.16) was reduced by -0.95 (1.05) in the Mediterranean climate and the baseline DAS28 value 4.18 (1.17) was reduced by -0.37 (0.92) in the Norwegian climate at week 16 (p = 0.003). An ACR20 improvement was achieved in 25% of the patients treated in the Mediterranean climate and in 15% of those treated in the Norwegian climate. Sustained improvement in all ACR core components at week 16 and in patient's assessment of health status at week 28 was found in the patients treated in the Mediterranean climate only. Tests of physical function, the 6-Minute Walk Test (6MWT) and the Timed Up and Go (TUG), showed comparable improvements in patients treated in both climates. CONCLUSIONS: RA patients showed immediate positive effects with regard to disease activity, physical function, and symptoms during a 4-week rehabilitation programme. The effects on disease activity and symptoms were larger and better maintained at least 3 months after rehabilitation in a warm rather than in a cold climate.