Karin Kilian

• Kilian, Karin; Brunborg, Cathrine; Holme, Sigrun Skaar; Garen, Torhild; Gunnarsson, Ragnar & Molberg, Øyvind (2025). Incidence and prevalence of ANCA-associated vasculitis in Oslo, Norway, applying different criteria-based case definitions: a population-based cohort study. RMD Open. 11(3), s. 005526–005526. doi: 10.1136/rmdopen-2025-005526. Fulltekst i vitenarkiv Vis sammendrag

  Objective To provide complete data on the incidence and prevalence of antineutrophil cytoplasmic antibody-associated vasculitides (AAV) over the years 2000–2016 in the Oslo area, Norway, with 528 924 adults (aged 18+) in 2016. Methods From administrative databases, we identified all cases with International Classification of Disease, 10th Revision (ICD-10) codes indicative of necrotising small vessel vasculitis during 2000–2016 in the Oslo area. We manually chart reviewed every case identified through the ICD-10 search to confirm (or reject) a clinical AAV diagnosis. Cases with confirmed clinical AAV were classified by the European Medicine Agency (EMA) algorithm and the 2022 American College of Rheumatology/European Alliance of Associations for Rheumatology (ACR/EULAR 2022) classification criteria. Results Among 469 cases with an ICD-10 code indicative of small vessel vasculitis, chart review confirmed AAV in 133 cases with 97 having new onset during the study. Of these 97 incident cases, 57 (60%) were classified as granulomatosis with polyangiitis (GPA), 29 (31%) as microscopic polyangiitis (MPA) and 9 (9%) as eosinophilic granulomatosis with polyangiitis (EGPA) per ACR/EULAR 2022 criteria, while 2 remained unclassified. There was an 11% discordance in AAV case classification between the 2022 criteria and the EMA algorithm. The mean annual incidence of AAV in adults was 12.2 per million (7.3 for GPA, 3.7 for MPA and 1.2 for EGPA). Across the study period, incidence rates increased numerically, and prevalence peaked at 143.7 AAV cases/million adults in 2016. Conclusion This population-based study adds new evidence that AAV increases in Europe and indicates that using the ACR/EULAR 2022 criteria shifts cases from GPA to MPA relative to the EMA algorithm, affecting epidemiology estimates.

• Zeng, Linan; Walsh, Michael; Guyatt, Gordon H; Siemieniuk, Reed A C; Collister, David & Booth, Michelle [Vis alle 22 forfattere av denne artikkelen] (2022). Plasma exchange and glucocorticoid dosing for patients with ANCA-associated vasculitis: A clinical practice guideline. The BMJ. doi: 10.1136/bmj-2021-064597. Fulltekst i vitenarkiv
• Holme, Sigrun Skaar; Kilian, Karin; Eggesbø, Heidi Beate; Moen, Jon Magnus & Molberg, Øyvind (2021). Impact of baseline clinical and radiological features on outcome of chronic rhinosinusitis in granulomatosis with polyangiitis. Arthritis Research & Therapy. ISSN 1478-6354. 23(18), s. 1–11. doi: 10.1186/s13075-020-02401-x. Fulltekst i vitenarkiv Vis sammendrag

  Background Granulomatosis with polyangiitis (GPA) causes a recurring inflammation in nose and paranasal sinuses that clinically resembles chronic rhinosinusitis (CRS) of other aetiologies. While sinonasal inflammation is not among the life-threatening features of GPA, patients report it to have major negative impact on quality of life. A relatively large proportion of GPA patients have severe CRS with extensive damage to nose and sinus structures evident by CT, but risk factors for severe CRS development remain largely unknown. In this study, we aimed to identify clinical and radiological predictors of CRS-related damage in GPA. Methods We included GPA patients who had clinical data sets from time of diagnosis, and two or more paranasal sinus CT scans obtained ≥12 months apart available for analysis. We defined time from first to last CT as the study observation period, and evaluated CRS development across this period using CT scores for inflammatory sinus bone thickening (osteitis), bone destructions, and sinus opacifications (here defined as mucosal disease). In logistic regression, we applied osteitis as main outcome measure for CRS-related damage. Results We evaluated 697 CT scans obtained over median 5 years observation from 116 GPA patients. We found that 39% (45/116) of the GPA patients remained free from CRS damage across the study observation period, while 33% (38/116) had progressive damage. By end of observation, 32% (37/116) of the GPA patients had developed severe osteitis. We identified mucosal disease at baseline as a predictor for osteitis (odds ratio 1.33), and we found that renal involvement at baseline was less common in patients with severe osteitis at last CT (41%, 15/37) than in patients with no osteitis (60%, 27/45). Conclusions In this largely unselected GPA patient cohort, baseline sinus mucosal disease associated with CRS-related damage, as measured by osteitis at the end of follow-up. We found no significant association with clinical factors, but the data set indicated an inverse relationship between renal involvement and severe sinonasal affliction.

• Holme, Sigrun Skaar; Moen, Jon Magnus; Kilian, Karin Renate; Eggesbø, Heidi Beate & Molberg, Øyvind (2020). Impact of Paranasal Sinus Surgery in Granulomatosis With Polyangiitis: A Longitudinal Computed Tomography Study. The Laryngoscope. ISSN 0023-852X. 130(8), s. E460–E468. doi: 10.1002/lary.28639. Fulltekst i vitenarkiv Vis sammendrag

  Objectives/Hypothesis Severe chronic rhinosinusitis (CRS) in patients with granulomatosis with polyangiitis (GPA) failing medical therapies can be treated with paranasal sinus surgery. Whether this surgery protects from progressive sinonasal damage remains unknown. Here, we aimed to analyze time‐dependent relations between sinus surgeries and computed tomography (CT) imaging features in the CRS of GPA. Study Design Longitudinal observational study. Methods We assessed CRS features including bone thickening by global osteitis scoring scale, bone erosions, and mucosal thickening by Lund‐Mackay scores in serial paranasal sinus CT scans (742 CT scans in total) from a cohort of 127 well‐characterized GPA patients. Data on sinonasal surgical procedures were from a mandatory national registry and from chart review. We defined the time from baseline CT to last CT as the study observation period in each patient. Datasets were analyzed by linear mixed models. Results We found that 23/127 cohort patients had one or more paranasal sinus surgical procedures, and 96% of these (22/23) had osteitis by CT after surgery. In patients with nasal surgery alone or no surgery, we identified osteitis in 7/11 (64%) and 45/93 (48%), respectively. During the observation period of a median of 5 years, 38 patients had progression of their sinus osteitis, with the highest annual osteitis progression rates observed around the time of surgery. Conclusions In this cohort, paranasal sinus surgery was associated with prevalence, severity, and progression rate of sinus osteitis, indicating that sinus surgery does not reduce the bone damage development in the CRS of GPA.

• Holme, Sigrun Skaar; Moen, Jon Magnus; Kilian, Karin Renate; Haukeland, Hilde; Molberg, Øyvind & Eggesbø, Heidi Beate (2019). Development of CT-based methods for longitudinal analyses of paranasal sinus osteitis in granulomatosis with polyangiitis. BMC Medical Imaging. 19(1), s. 1–11. doi: 10.1186/s12880-019-0315-7. Fulltekst i vitenarkiv Vis sammendrag

  Background Even though progressive rhinosinusitis with osteitis is a major clinical problem in granulomatosis with polyangiitis (GPA), there are no studies on how GPA-related osteitis develops over time, and no quantitative methods for longitudinal assessment. Here, we aimed to identify simple and robust CT-based methods for capture and quantification of time-dependent changes in GPA-related paranasal sinus osteitis and compare performance of the methods under study in a largely unselected GPA cohort. Methods GPA patients (n = 121) with ≥3 paranasal CT scans obtained ≥12 months apart and control patients not having GPA or rhinosinusitis (n = 15) were analysed by: (i) Global osteitis scoring scale (GOSS), originally developed for chronic rhinosinusitis; (ii) Paranasal sinus volume by manual segmentation; (iii) Mean maxillary and sphenoid diameter normalised to landmark distances (i.e. diameter ratio measurement, DRM). Results Time-dependent changes in GPA-related osteitis were equally well measured by the simple DRM and the labour-intensive volume method while GOSS missed ongoing changes in cases with extensive osteitis. GOSS at last CT combined with DRM identified three distinct patient groups: (i) The no osteitis group, who had no osteitis and no change in DRM from baseline CT to last CT (45/121 GPA patients and 15/15 disease controls); (ii) Stable osteitis group, with presence of osteitis, but no change in DRM across time (31 GPA); (iii) Progressive osteitis, defined by declining DRM (45 GPA). Conclusions We suggest DRM and GOSS as complementary methods for capturing, classifying and quantifying time-dependent changes in GPA-related osteitis.

• Garen, Torhild Oddveig; Lerang, Karoline; Hoffmann-Vold, Anna-Maria; Andersson, Anna Helena; Midtvedt, Øyvind & Brunborg, Cathrine [Vis alle 21 forfattere av denne artikkelen] (2019). Mortality and causes of death across the systemic connective tissue diseases and the primary systemic vasculitides. Rheumatology. ISSN 1462-0324. 58(2), s. 313–320. doi: 10.1093/rheumatology/key285. Fulltekst i vitenarkiv
• Hoffmann-Vold, Anna-Maria; Fretheim, Håvard Halland; Midtvedt, Øyvind; Kilian, Karin Renate; Angelshaug, Marianne & Chaudhary, Asad [Vis alle 12 forfattere av denne artikkelen] (2018). Frequencies of borderline pulmonary hypertension before and after the DETECT algorithm: Results from a prospective systemic sclerosis cohort. Rheumatology. ISSN 1462-0324. 57(3), s. 480–487. doi: 10.1093/rheumatology/kex435. Fulltekst i vitenarkiv

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