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Eriksson, C., Bergemalm, D., Vigren, L., Nilsson, L., Visuri, I., Hjortswang, H., . . . Halfvarson, J. (2018). Clinical effectiveness of golimumab: Interim analysis of the observational study of patients with ulcerative colitis on golimumab in the Swedish National Quality Registry for IBD-GO-SWIBREG. Paper presented at 13th Congress of ECCO – European Crohn’s and Colitis Organisation, Vienna, Austria, February 14-17, 2018. Journal of Crohn's & Colitis, 12(Suppl. 1), S409-S410
Open this publication in new window or tab >>Clinical effectiveness of golimumab: Interim analysis of the observational study of patients with ulcerative colitis on golimumab in the Swedish National Quality Registry for IBD-GO-SWIBREG
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2018 (English)In: Journal of Crohn's & Colitis, ISSN 1873-9946, E-ISSN 1876-4479, Vol. 12, no Suppl. 1, p. S409-S410Article in journal, Meeting abstract (Other academic) Published
Place, publisher, year, edition, pages
Oxford University Press, 2018
National Category
Gastroenterology and Hepatology
Identifiers
urn:nbn:se:oru:diva-66750 (URN)000427318901372 ()
Conference
13th Congress of ECCO – European Crohn’s and Colitis Organisation, Vienna, Austria, February 14-17, 2018
Note

Funding Agency:

MSD

Available from: 2018-04-26 Created: 2018-04-26 Last updated: 2018-08-31Bibliographically approved
Eriksson, C., Rundquist, S., Lykiardopoulos, V., Karlen, P., Grip, O., Söderman, C., . . . Halfvarson, J. (2018). Clinical effectiveness of vedolizumab: Interim analysis of the Swedish observational study on vedolizumab assessing effectiveness and healthcare resource utilisation in patients with Crohn's disease (SVEAH CD). Journal of Crohn's & Colitis, 12(Suppl. 1), S494-S495
Open this publication in new window or tab >>Clinical effectiveness of vedolizumab: Interim analysis of the Swedish observational study on vedolizumab assessing effectiveness and healthcare resource utilisation in patients with Crohn's disease (SVEAH CD)
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2018 (English)In: Journal of Crohn's & Colitis, ISSN 1873-9946, E-ISSN 1876-4479, Vol. 12, no Suppl. 1, p. S494-S495Article in journal, Meeting abstract (Other academic) Published
Place, publisher, year, edition, pages
Oxford University Press, 2018
National Category
Gastroenterology and Hepatology
Identifiers
urn:nbn:se:oru:diva-66751 (URN)000427318902141 ()
Available from: 2018-04-26 Created: 2018-04-26 Last updated: 2018-08-30Bibliographically approved
Eriksson, C., Rundquist, S., Lykiardopoulos, V., Karlen, P., Grip, O., Söderman, C., . . . Halfvarson, J. (2018). Clinical effectiveness of vedolizumab: Interim analysis of the Swedish observational study on vedolizumab assessing effectiveness and healthcare resource utilisation in patients with ulcerative colitis (SVEAH UC). Journal of Crohn's & Colitis, 12(Suppl. 1), S382-S383
Open this publication in new window or tab >>Clinical effectiveness of vedolizumab: Interim analysis of the Swedish observational study on vedolizumab assessing effectiveness and healthcare resource utilisation in patients with ulcerative colitis (SVEAH UC)
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2018 (English)In: Journal of Crohn's & Colitis, ISSN 1873-9946, E-ISSN 1876-4479, Vol. 12, no Suppl. 1, p. S382-S383Article in journal, Meeting abstract (Other academic) Published
Place, publisher, year, edition, pages
Oxford University Press, 2018
National Category
Gastroenterology and Hepatology
Identifiers
urn:nbn:se:oru:diva-66753 (URN)000427318901324 ()
Note

Funding Agency:

Takeda

Available from: 2018-04-26 Created: 2018-04-26 Last updated: 2018-08-30Bibliographically approved
Siegel, C. A., Whitman, C. B., Spiegel, B. M. R., Feagan, B., Sands, B., Loftus, E. V., . . . Peyrin-Biroulet, L. (2018). Development of an index to define overall disease severity in IBD. Gut, 67(2), 244-254
Open this publication in new window or tab >>Development of an index to define overall disease severity in IBD
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2018 (English)In: Gut, ISSN 0017-5749, E-ISSN 1468-3288, Vol. 67, no 2, p. 244-254Article in journal (Refereed) Published
Abstract [en]

Background and aim: Disease activity for Crohn's disease (CD) and UC is typically defined based on symptoms at a moment in time, and ignores the long-term burden of disease. The aims of this study were to select the attributes determining overall disease severity, to rank the importance of and to score these individual attributes for both CD and UC.

Methods: Using a modified Delphi panel, 14 members of the International Organization for the Study of Inflammatory Bowel Diseases (IOIBD) selected the most important attributes related to IBD. Eighteen IOIBD members then completed a statistical exercise (conjoint analysis) to create a relative ranking of these attributes. Adjusted utilities were developed by creating proportions for each level within an attribute.

Results: For CD, 15.8% of overall disease severity was attributed to the presence of mucosal lesions, 10.9% to history of a fistula, 9.7% to history of abscess and 7.4% to history of intestinal resection. For UC, 18.1% of overall disease severity was attributed to mucosal lesions, followed by 14.0% for impact on daily activities, 11.2% C reactive protein and 10.1% for prior experience with biologics. Overall disease severity indices were created on a 100-point scale by applying each attribute's average importance to the adjusted utilities.

Conclusions: Based on specialist opinion, overall CD severity was associated more with intestinal damage, in contrast to overall UC disease severity, which was more dependent on symptoms and impact on daily life. Once validated, disease severity indices may provide a useful tool for consistent assessment of overall disease severity in patients with IBD.

Place, publisher, year, edition, pages
London, United Kingdom: BMJ Publishing Group Ltd, 2018
Keywords
Crohn's Disease, IBD, Ulcerative Colitis
National Category
Gastroenterology and Hepatology
Identifiers
urn:nbn:se:oru:diva-53356 (URN)10.1136/gutjnl-2016-312648 (DOI)000419604800009 ()27780886 (PubMedID)
Note

Funding Agencies:

AbbVie  

Tillotts 

Available from: 2016-11-02 Created: 2016-11-02 Last updated: 2018-09-06Bibliographically approved
Vatn, S., Karlsson, M. C., Carstens, A., Detlie, T. E., Ricanek, P., Bergemalm, D., . . . Vatn, M. H. (2018). Faecal microbiota in newly diagnosed Crohn's disease and its relation to treatment escalation. Journal of Crohn's & Colitis, 12(Suppl. 1), S555-S555
Open this publication in new window or tab >>Faecal microbiota in newly diagnosed Crohn's disease and its relation to treatment escalation
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2018 (English)In: Journal of Crohn's & Colitis, ISSN 1873-9946, E-ISSN 1876-4479, Vol. 12, no Suppl. 1, p. S555-S555Article in journal, Meeting abstract (Other academic) Published
Place, publisher, year, edition, pages
Oxford University Press, 2018
National Category
Gastroenterology and Hepatology
Identifiers
urn:nbn:se:oru:diva-66758 (URN)000427318902249 ()
Available from: 2018-04-26 Created: 2018-04-26 Last updated: 2018-09-12Bibliographically approved
Vatn, S., Karlsson, M. C., Carstens, A., Detlie, T. E., Ricanek, P., Lindquist, C. M., . . . Vatn, M. H. (2018). Faecal microbiota in treatment-naive ulcerative colitis and its relation to treatment escalation. Journal of Crohn's & Colitis, 12(Suppl. 1), S557-S557
Open this publication in new window or tab >>Faecal microbiota in treatment-naive ulcerative colitis and its relation to treatment escalation
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2018 (English)In: Journal of Crohn's & Colitis, ISSN 1873-9946, E-ISSN 1876-4479, Vol. 12, no Suppl. 1, p. S557-S557Article in journal, Meeting abstract (Other academic) Published
Place, publisher, year, edition, pages
Oxford University Press, 2018
National Category
Gastroenterology and Hepatology
Identifiers
urn:nbn:se:oru:diva-66757 (URN)000427318902253 ()
Available from: 2018-04-26 Created: 2018-04-26 Last updated: 2018-09-12Bibliographically approved
Örtqvist, A. K., Lundholm, C., Halfvarson, J., Ludvigsson, J. F. & Almqvist, C. (2018). Fetal and early life antibiotics exposure and very early onset inflammatory bowel disease: a population-based study. Gut, Article ID gutjnl-2017-314352.
Open this publication in new window or tab >>Fetal and early life antibiotics exposure and very early onset inflammatory bowel disease: a population-based study
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2018 (English)In: Gut, ISSN 0017-5749, E-ISSN 1468-3288, article id gutjnl-2017-314352Article in journal (Refereed) Epub ahead of print
Abstract [en]

OBJECTIVE: Earlier studies on antibiotics exposure and development of IBD (Crohn's disease (CD) and ulcerative colitis (UC)) may have been biased by familial factors and gastroenteritis. We aimed to estimate the association between antibiotics during pregnancy or infantile age and very early onset (VEO) IBD.

DESIGN: In this cohort study of 827 239 children born in Sweden between 2006 and 2013, we examined the link between exposure to systemic antibiotics and VEO-IBD (diagnosis <6 years of age), using Cox proportional hazard regression models. Information on antibiotics and IBD was retrieved from the nationwide population-based Swedish Prescribed Drug Register and the National Patient Register. We specifically examined potential confounding from parental IBD and gastroenteritis.

RESULTS: Children exposed to antibiotics during pregnancy were at increased risk of IBD compared with general population controls (adjusted HR (aHR) 1.93; 95% CI 1.06 to 3.50). Corresponding aHRs were 2.48 (95% CI 1.01 to 6.08) for CD and 1.25 (95% CI 0.47 to 3.26) for UC, respectively. For antibiotics in infantile age, the aHR for IBD was 1.11 (95% CI 0.57 to 2.15); for CD 0.72 (95% CI 0.27 to 1.92) and 1.23 (95% CI 0.45 to 3.39) for UC. Excluding children with gastroenteritis 12 months prior to the first IBD diagnosis retained similar aHR for antibiotics during pregnancy and CD, while the association no longer remained significant for IBD.

CONCLUSION: We found that exposure to antibiotics during pregnancy, but not in infantile age, is associated with an increased risk of VEO-IBD regardless of gastroenteritis. The risk increase for exposure in pregnancy may be due to changes in the microbiota.

Place, publisher, year, edition, pages
BMJ Publishing Group Ltd, 2018
Keywords
Antibiotics, crohn’s colitis, epidemiology, inflammatory bowel disease, ulcerative colitis
National Category
Medical and Health Sciences Gastroenterology and Hepatology Pediatrics
Identifiers
urn:nbn:se:oru:diva-66361 (URN)10.1136/gutjnl-2017-314352 (DOI)29321166 (PubMedID)
Available from: 2018-04-06 Created: 2018-04-06 Last updated: 2018-09-14Bibliographically approved
Eriksson, C., Bergenmalm, D., Vigren, L., Nilsson, L., Visuri, I., Hjortswang, H., . . . Halfvarson, J. (2018). Golimumab är effektivt vid ulcerös kolit under svenska förhållanden. Interimsanalys av en svensk prospektiv multi-centerstudie, GO-SWIBREG. In: : . Paper presented at Gastrodagarna 2018, Falun, Sweden, 16-18 maj, 2018.
Open this publication in new window or tab >>Golimumab är effektivt vid ulcerös kolit under svenska förhållanden. Interimsanalys av en svensk prospektiv multi-centerstudie, GO-SWIBREG
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2018 (English)Conference paper, Poster (with or without abstract) (Refereed)
Abstract [sv]

Bakgrund: Randomiserade kontrollerade prövningar har visat effekt av golimumab vid ulcerös kolit men studiedeltagare och förhållanden i kliniska prövningar motsvarar inte alltid svensk klinisk vardag. Syftet med denna studie var att utvärdera säkerhet och effekt av behandling med golimumab vid ulcerös kolit under svenska förhållanden.

Metod: Detta är en prospektiv kohortstudie med inklusion av patienter från svenska sjukhus. Patienter med måttlig till svår aktiv ulcerös kolit, definierad som endoskopiskt Mayo score ≥2 och som påbörjade golimumab fr.o.m. 1/6-2014 inkluderades efter att informerat samtycke inhämtats. Kliniska karakteristika, behandling, klinisk-, biokemisk- och endoskopisk aktivitet liksom skattning av livskvalité samlades in vid inklusion samt prospektivt med hjälp av ett elektroniskt studieformulär, integrerat i svenska kvalitetsregistret för IBD (SWIBREG). Primärt effektmått var klinisk effekt vid 3 samt 12 månader (definierat som minskat Mayo score med ≥3 poäng eller 30 % från inklusion), samt klinisk remission (definierad som Mayo score ≤ 2 utan några enskilda poäng >1). Kontinuerliga data presenteras som median och kvartilavstånd. För statistisk jämförelse mellan inklusion och uppföljning användes Wilcoxon-signed rank test. Data från induktionsbehandling samt 3-månadersuppföljning presenteras här.

Resultat: 50 patienter inkluderades t.o.m. 15/9-2017. Vid studiestart var 24/50 (48 %) samtidigt behandlade med immunmodulerare, 16/50 (32 %) med perorala kortikosteroider samt 27/50 (54 %) med 5-ASA. Totalt hade 35/50 (70 %) tidigare fått behandling med minst en TNF-hämmare (tabell 1). Efter 12 veckor hade 37/50 (74 %), fortfarande behandling med golimumab. Av de patienter som fortsatte med golimumab till vecka 12 var 8 (22 %) i klinisk remission och 13 (35 %) uppvisade klinisk respons. Totalt Mayo score minskade i median från 7 (6-10) vid inklusion till 5 (1-8) vid 12 veckor (p<0.01). Fekalt calprotektin minskade från 710 (275-1850) µg/g till 390 (45-870) µg/g (p=0.02). Livskvalitet hos golimumab-behandlade patienter förbättrades, uppmätt som en signifikant minskning av poäng på short health scale (p=0.04).

Slutsats: Golimumab-behandlade patienter i Sverige utgör en svårbehandlad grupp. Trots det kan förbättring av kliniska parametrar, inflammatorisk aktivitet och upplevd livskvalité uppnås redan efter 12 veckors golimumab-behandling.

National Category
Gastroenterology and Hepatology
Identifiers
urn:nbn:se:oru:diva-67281 (URN)
Conference
Gastrodagarna 2018, Falun, Sweden, 16-18 maj, 2018
Available from: 2018-06-15 Created: 2018-06-15 Last updated: 2018-09-11Bibliographically approved
Keita, A. V., Lindqvist, C. M., Ost, A., Magana, C. D., Schoultz, I. & Halfvarson, J. (2018). Gut barrier dysfunction: a primary defect in twins with Crohn's disease predominantly caused by genetic predisposition. Journal of Crohn's & Colitis, 12(Suppl. 1), S1-S1
Open this publication in new window or tab >>Gut barrier dysfunction: a primary defect in twins with Crohn's disease predominantly caused by genetic predisposition
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2018 (English)In: Journal of Crohn's & Colitis, ISSN 1873-9946, E-ISSN 1876-4479, Vol. 12, no Suppl. 1, p. S1-S1Article in journal, Meeting abstract (Other academic) Published
Place, publisher, year, edition, pages
Oxford University Press, 2018
National Category
Gastroenterology and Hepatology
Identifiers
urn:nbn:se:oru:diva-66756 (URN)000427318900002 ()
Available from: 2018-04-25 Created: 2018-04-25 Last updated: 2018-04-25Bibliographically approved
Keita, Å. V., Lindqvist, C. M., Öst, Å., Magana, C. D. L., Schoultz, I. & Halfvarson, J. (2018). Gut barrier dysfunction: a primary defect in twins with Crohn's disease predominantly caused by genetic predisposition. Journal of Crohn's & Colitis
Open this publication in new window or tab >>Gut barrier dysfunction: a primary defect in twins with Crohn's disease predominantly caused by genetic predisposition
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2018 (English)In: Journal of Crohn's & Colitis, ISSN 1873-9946, E-ISSN 1876-4479Article in journal (Refereed) Epub ahead of print
Abstract [en]

Background and aims: The aetiology of Crohn's disease is poorly understood. By investigating twin pairs discordant for Crohn's disease we aimed to assess if the dysregulated barrier represents a cause or a consequence of inflammation and to evaluate the impact of genetic predisposition on barrier function.

Methods: Ileal biopsies from 15 twin pairs discordant for Crohn's disease (monozygotic n=9, dizygotic n=6) and 10 external controls were mounted in Ussing chambers to assess paracellular permeability to51Chromium (Cr)-EDTA and trancellular passage to non-pathogenic E. coli K-12. Experiments were performed with and without provocation with acetylsalicylic acid. Immunofluorescence and ELISA were used to quantify the expression level of tight junction proteins.

Results: Healthy co-twins and affected twins displayed increased 51Cr-EDTA permeability at 120 min both with Acetylsalicylic acid (p<0.001) and without (p<0.001) when compared to controls. A significant increase in 51Cr-EDTA flux was seen already at 20 minutes in healthy monozygotic co-twins compared to controls (p≤0.05) when stratified by zygosity, but not in healthy dizygotic co-twins. No difference in E. coli passage was observed between groups. Immunofluorescence of the tight junction proteins claudin-5 and tricellulin showed lower levels in healthy co-twins (p<0.05) and affected twins (p<0.05) compared to external controls, while ELISA only showed lower tricellulin in Crohn's disease twins (p<0.05).

Conclusion: Our results suggest that barrier dysfunction is a primary defect in Crohn's disease, since changes were predominantly seen in healthy monozygotic co-twins. Passage of E. coli seems to be a consequence of inflammation rather than representing a primary defect.

Place, publisher, year, edition, pages
Elsevier, 2018
National Category
Gastroenterology and Hepatology
Identifiers
urn:nbn:se:oru:diva-66791 (URN)10.1093/ecco-jcc/jjy045 (DOI)29659773 (PubMedID)
Available from: 2018-04-27 Created: 2018-04-27 Last updated: 2018-08-29Bibliographically approved
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