Data from clinical practice is needed to understand the safety, effectiveness, and optimal use of available and emerging treatment options for inflammatory arthritis. We have demonstrated the value of our individual registers in assessing the safety and effectiveness of TNF-inhibitors in RA, AS/SpA and PsA. Many outstanding issues, particularly in AS/SpA and PsA, can, however, only be addressed through collaboration across registers. The Nordic countries have similar healthcare systems and other national registers that can be linked together. ARTIS (Sweden), DAN-BIO (Denmark), NOR-DMARD (Norway), ROB-FIN (Finland) and ICEBIO (Iceland) represent some of the largest registers of inflammatory arthritis and their therapies.
The scientific output from our project comes in the format of abstracts and original scientific reports. For the scientific community, the primary sharing of results is thus via scientific journals and international conferences.
For the research community, networking and building a Nordic network of the next generation of rheumatology researchers has been an integral part of our project. In this regard, our biannual project meetings have typically attracted some 20 participants, many of whom are junior scientists, and the “communication of results” has been in the format of communication of the possibility to work with, and also how to work with, collaborative studies centered on clinical issues addressed via clinical registers.
For the clinical profession and patients, we think that our results, particular those regarding the effectiveness and safety of drugs, should best be implemented as part of national treatment guidelines for the diseases concerned. Science is much about incremental knowledge gains. Each of the Nordic countries has its own algorithm for how these guidelines are updated. We regard this process as particularly important, as the guideline updates may systematically factor in all available new evidence. Beyond this, the project website has attracted attention (as measured by contacts taken with the project PI) from various of stakeholders, including patient organisations, the pharmaceutical industry, and e-health companies.
Chatzidionysiou K, Aaltonen K, Nordström D, et al. SAT0669 How do we use biologics in patients with a history of malignancy? an assessment of treatment patterns using scandinavian registers. Annals of the Rheumatic Diseases 2017;76:1027.
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Glintborg B, Chatzidionysiou K, Askling J, et al. THU0361 Prescription patterns of biological disease modifying drugs and biosimilars in ankylosing spondylitis – a collaboration between biological registers in the five nordic countries. Annals of the Rheumatic Diseases 2017;76:341-342.
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Hellgren K, Dreyer L, Arkema EV For the ARTIS Study Group, For the DANBIO Study Group, et al. Cancer risk in patients with spondyloarthritis treated with TNF inhibitors: a collaborative study from the ARTIS and DANBIO registers. Annals of the Rheumatic Diseases 2017;76:105-111.
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Hetland M, Østergaard M, Askling J, et al. FRI0450 Commonalities and differences in data collection across european spondyloarthritis registries. Annals of the Rheumatic Diseases 2017;76:656-657.
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Jørgensen T, Dreyer L, Guðbjörnsson B, et al. FRI0518 Prescription patterns of tumour necrosis factor inhibitor and ustekinumab in psoriatic arthritis: a nordic population-based cohort study. Annals of the Rheumatic Diseases 2017;76:686.
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B Glintborg, U Lindström, K Aaltonen, EK Kristianslund, B Gudbjornsson, K Chatzidionysiou, J Askling, D Nordström, ML Hetland, D Di Giuseppe, L Dreyer, LE Kristensen, TS Jørgensen, K Eklund, G Grondal, S Ernestam, J Joensuu, MRK Törmänen, H Skydsgaard, J Hagfors, TK Kvien, E Lie, K Fagerli, AJ Geirsson, H Jonsson, SA Provan, NS Krogh & LTH Jacobsson (2018) Biological treatment in ankylosing spondylitis in the Nordic countries during 2010–2016: a collaboration between five biological registries, Scandinavian Journal of Rheumatology, DOI: 10.1080/03009742.2018.1444199.
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Chatzidionysiou K, Hetland ML, Frisell T, et al. Opportunities and challenges for real-world studies on chronic inflammatory joint diseases through data enrichment and collaboration between national registers: the Nordic example. RMD Open 2018;4:e000655. doi: 10.1136/rmdopen-2018-000655.
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Glintborg B, Lindström U, Aaltonen K, Kristianslund EK, Gudbjornsson B, Chatzidionysiou K, Askling J, Nordström D, Hetland ML, Di Giuseppe D, Dreyer L, Kristensen LE, Jørgensen TS, Eklund K, Grondal G, Ernestam S, Joensuu J, Törmänen M, Skydsgaard H, Hagfors J, Kvien TK, Lie E, Fagerli K, Geirsson AJ, Jonsson H, Provan SA, Krogh NS, Jacobsson L. Biological treatment in ankylosing spondylitis in the Nordic countries during 2010-2016: a collaboration between five biological registries. Scand J Rheumatol. 2018 Nov;47(6):465-474. doi: 10.1080/03009742.2018.1444199. Epub 2018 Aug 2. PMID: 30070923.
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Grøn KL, Arkema EV, Glintborg B The ARTIS Study Group, et al. Risk of serious infections in patients with rheumatoid arthritis treated in routine care with abatacept, rituximab and tocilizumab in Denmark and Sweden. Annals of the Rheumatic Diseases 2019;78:320-327
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Lindström U, Glintborg B, Di Giuseppe D, Nordström D, Aarrestad Provan S, Gudbjornsson B, Askling J, Lund Hetland M, Aaltonen K, Krogh NS, Geirsson AJ, Jacobsson LTH. Treatment retention of infliximab and etanercept originators versus their corresponding biosimilars: Nordic collaborative observational study of 2334 biologics naïve patients with spondyloarthritis. RMD Open. 2019 Oct 23;5(2):e001079. doi: 10.1136/rmdopen-2019-001079. PMID: 31749988; PMCID: PMC6827791.
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Glintborg B, Lindstrom U, De Giuseppe D, Provan SA, Gudbjornsson B, Hetland ML, Michelsen B, Wallman J, Aaltonen K, Hokkanen AM, Nordström D, Jørgensen TS, Hansen RL, Jon Geirsson A, Grøn K, Krogh NS, Askling J, Kristensen LE, Jacobsson L; DANBIO (Denmark), ARTIS/SRQ (Sweden), ICEBIO (Iceland), ROB-FIN (Finland), NOR-DMARD (Norway) registries. One-year treatment outcomes of secukinumab versus tumor necrosis factor inhibitors in Spondyloarthritis. Arthritis Care Res (Hoboken). 2020 Nov 30. doi: 10.1002/acr.24523. Epub ahead of print. PMID: 33253491
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U Lindström, B Glintborg, D Di Giuseppe, TS Jörgensen, B Gudbjornsson, KL Görn, SA Provan, B Michelsen, ML Hetland, JK Wallman, D Nordström, N Trokovic, TJ Love, NS Krogh, J Askling, LTH Jacobsson, LE Kristensen. Comparison of treatment retention and response to secukinumab versus tumor necrosis factor inhibitors in psoriatic arthritis. Rheumatology 2020 doi.org/10.1093/rheumatology/keaa825.
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Lund Hansen R, Schoedt Jørgensen T, Dreyer L, Hetland ML, Glintborg B, Askling J, Di Giuseppe D, Jacobsson LTH, Wallman JK, Nordstrom D, Aaltonen K, Kristianslund EK, Kvien TK, Provan SA, Gudbjornsson B, Love TJ, Kristensen LE. Inflammatory hallmarks of lesser prominence in psoriatic arthritis patients starting biologics: a Nordic population-based cohort study. Rheumatology (Oxford). 2020 Jun 27:keaa237. doi: 10.1093/rheumatology/keaa237. Epub ahead of print. PMID: 32591790.
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Kopp TI, Delcoigne B, Arkema EV, Magyari M, Locht H, Sellebjerg FT, Cordtz RL, Jensen DV, Askling J, Dreyer L. Response to: 'Neuroinflammatory events after anti-TNFα therapy' by Kaltsonoudis et al. Ann Rheum Dis. 2020 May 20:annrheumdis-2020-217802. doi: 10.1136/annrheumdis-2020-217802. Epub ahead of print. PMID: 32434821
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Kopp TI, Delcoigne B, Arkema EV, Jacobsen RK, Magyari M, Ibfelt EH, Locht H, Sellebjerg F, Cordtz RL, Jensen DV, Askling J, Dreyer L. Risk of neuroinflammatory events in arthritis patients treated with tumour necrosis factor alpha inhibitors: a collaborative population-based cohort study from Denmark and Sweden. Ann Rheum Dis. 2020 May;79(5):566-572. doi: 10.1136/annrheumdis-2019-216693. Epub 2020 Mar 11. PMID: 32161058
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Hellgren, K., Ballegaard, C., Delcoigne, B., Cordtz, R., Nordström, D., Aaltonen, K., Gudbjornsson, B., Love, T. J., Aarrestad Provan, S., Sexton, J., Zobbe, K., Kristensen, L. E., Askling, J., & Dreyer, L. (2021). Risk of solid cancers overall and by subtypes in patients with psoriatic arthritis treated with TNF inhibitors - a Nordic cohort study. Rheumatology (Oxford, England), 60(8), 3656–. doi.org/10.1093/rheumatology/keaa828
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