The field of rheumatoid arthritis (RA) is moving into identification of patients as early as possible and the ultimate aim is to prevent RA becoming a chronic disease. To this end, we studied the... Show moreThe field of rheumatoid arthritis (RA) is moving into identification of patients as early as possible and the ultimate aim is to prevent RA becoming a chronic disease. To this end, we studied the phase of Clinically Suspect Arthralgia (CSA). Patients with arthralgia that were considered by the rheumatologist to have an increased risk to progress to RA (CSA) had indeed an increased risk of RA. In addition, subclinical MRI-inflammation preceded clinical arthritis with a few months. Future research will shed more light on processes underlying progression from CSA to RA and effectiveness of treatment initiation in the CSA phase. The severity of the course of RA is variable between patients and this cannot be yet accurately predicted. In this thesis, we performed studies that contributed to the understanding of these differences in severity. Three genetic risk factors for more severe joint damage progression (two non-HLA and one HLA variation) and one for arthritis persistence were identified. Further research on functional implications of the identified variants and whether they might be useful as biomarkers to guide treatment decisions is needed. Show less
Secondary prevention of recurrent venous can be achieved in two ways, either by elimination of modifiable risk factors or by extending the anticoagulant treatment period in patients at high risk... Show moreSecondary prevention of recurrent venous can be achieved in two ways, either by elimination of modifiable risk factors or by extending the anticoagulant treatment period in patients at high risk of recurrence. The aim of this thesis was to identify modifiable risk factors for as well as factors that might be able to predict recurrent venous thrombotic events. This thesis reports on an increased risk of recurrences in women who continue or start using hormonal contraceptives after a first venous thrombotic event, suggesting that refraining from this modifiable risk factor decreases the risk of recurrence. Furthermore, this thesis describes several factors, male sex, unprovoked first event, levels of coagulation factor VIII and antibiotic use to be associated with recurrent venous thrombosis. These factors should eventually be taken together and used to build a prognostic model, which will be able to predict recurrences at a refined and individual level. Show less
