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Udumyan, Ruzan
Publications (10 of 57) Show all publications
Davidsson, S., Messing Eriksson, A., Udumyan, R., Swanholm, P., Lewin Lundh, M., Widing, C., . . . Fall, K. (2023). Androgen deprivation therapy in men with prostate cancer is not associated with COVID-2019 infection. The Prostate, 83(6), 555-562
Open this publication in new window or tab >>Androgen deprivation therapy in men with prostate cancer is not associated with COVID-2019 infection
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2023 (English)In: The Prostate, ISSN 0270-4137, E-ISSN 1097-0045, Vol. 83, no 6, p. 555-562Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Androgens may play a role in severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection and host responses as the virus is dependent on the androgen-regulated protein transmembrane serine protease 2 for cell entry. Studies have indicated that prostate cancer patients receiving androgen deprivation therapy (ADT) are at reduced risk of SARS-CoV-2 infection and serious complications compared with patients without ADT, but data are inconsistent.

METHODS: A total of 655 prostate cancer patients who were under surveillance at two urology departments in Sweden on April 1, 2020 were included in the study as well as 240 patients with benign prostatic hyperplasia (BPH). At follow-up early in 2021, the participants completed a questionnaire containing information about symptoms compatible with coronavirus disease 2019 (COVID-19). Blood samples were also collected for the assessment of SARS-CoV-2 IgG antibodies (SARS-CoV-2 Total; Siemens). We used multivariable logistic regression models to calculate odds ratios (ORs) and 95% confidence intervals (CIs) for the association between ADT and the risk of SARS-CoV-2 infection.

RESULTS: The cumulative incidence of SARS-CoV-2 seropositivity was 13.4% among patients receiving ADT and 10.4% among patients without ADT. After adjusting for potential confounders, we observed no differences in symptoms or risk of SARS-CoV-2 infection between patients with and without ADT (OR: 0.98; 95% CI: 0.52-1.85). Higher body mass index, Type 1 diabetes, and prostate cancer severity, defined by high Gleason score (8-10; OR: 2.06; 95% CI: 1.04-4.09) or elevated levels of prostate-specific antigen (>20 µg/l; OR: 2.15; 95% CI: 1.13-4.07) were associated with increased risk of SARS-CoV-2 infection. Overall, the risk of SARS-CoV-2 infection was not higher among men with prostate cancer than among men with BPH.

CONCLUSIONS: Our results do not support the hypothesis that ADT use in prostate cancer patients reduces the risk or symptom severity of SARS-CoV-2 infection or that prostate cancer patients are at increased risk of COVID-19 compared with men without prostate cancer.

Place, publisher, year, edition, pages
Alan R. Liss Inc., 2023
Keywords
COVID-19, SARS-CoV-2, androgen deprivation therapy, prostate cancer
National Category
Infectious Medicine Urology and Nephrology Cancer and Oncology
Identifiers
urn:nbn:se:oru:diva-103314 (URN)10.1002/pros.24485 (DOI)000915900700001 ()36658755 (PubMedID)2-s2.0-85147012865 (Scopus ID)
Funder
Prostatacancerförbundet
Note

Funding agency:

Örebro County Research Foundation

Available from: 2023-01-26 Created: 2023-01-26 Last updated: 2023-04-11Bibliographically approved
Henriksson, I., Udumyan, R., Nilsson, E., Önnerhag, K., Rorsman, F., Werner, M., . . . Nyhlin, N. (2023). Clinical outcomes and sick leave in relation to UDCA treatment in Swedish patients with primary biliary cholangitis. Scandinavian Journal of Gastroenterology, 58(1), 70-75
Open this publication in new window or tab >>Clinical outcomes and sick leave in relation to UDCA treatment in Swedish patients with primary biliary cholangitis
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2023 (English)In: Scandinavian Journal of Gastroenterology, ISSN 0036-5521, E-ISSN 1502-7708, Vol. 58, no 1, p. 70-75Article in journal (Refereed) Published
Abstract [en]

OBJECTIVES: Primary biliary cholangitis (PBC) is an autoimmune liver disease that may progress into liver cirrhosis. Ursodeoxycholic acid (UDCA) is known to prevent or delay the disease progression, but little is known about work incapacity in PBC patients. We aimed to compare clinical outcomes (transplantation-free survival; cirrhosis development) and sick leave in patients with PBC with and without UDCA therapy.

METHODS: The medical records of 526 patients with PBC diagnosed from 2004 to 2016 were reviewed retrospectively. Sick leave data retrieved from the Swedish Social Insurance Agency were analysed for a sub-cohort of patients and matched controls. Cox regression was used for analysis of clinical outcomes. Logistic and conditional logistic regressions were used for sick leave analysis.

RESULTS: A total of 10.6% of patients died and 3.4% received liver transplantation over a median follow-up time of 5.7 years. UDCA-untreated patients (HR 3.62 (95%CI 2.02-6.49)) and UDCA non-responders (HR 3.78 (95% CI 1.87-7.66)) had higher mortality or transplantation rates than UDCA responders. Patients with PBC had higher odds of sick leave (OR 2.50; 95% CI 1.69-3.70) than matched controls. Untreated patients were more likely to be on sick leave (OR 3.22; 95% CI 1.12-9.25) two years after diagnosis than UDCA responders.

CONCLUSION: Both untreated patients and UDCA non-responders had lower liver transplantation-free survival rates than UDCA responders. Patients with PBC were more likely to be on sick leave compared to matched controls from the general population.

Place, publisher, year, edition, pages
Taylor & Francis, 2023
Keywords
Cholestatic liver disease, cirrhosis, transplantation-free survival, ursodeoxycholic acid, work ability
National Category
Gastroenterology and Hepatology
Identifiers
urn:nbn:se:oru:diva-100747 (URN)10.1080/00365521.2022.2103729 (DOI)000843087800001 ()35993428 (PubMedID)2-s2.0-85136548730 (Scopus ID)
Note

Funding agency:

Local office for Research and Development in Orebro OLL-714841/-589921/-812941/942386

Available from: 2022-08-23 Created: 2022-08-23 Last updated: 2023-12-08Bibliographically approved
Khamisi, S., Udumyan, R., Sjölin, G., Calissendorff, J., Filipsson Nyström, H., Holmberg, M., . . . Ljunggren, Ö. (2023). Fracture incidence in Graves' disease: A population-based study. Thyroid, 33(11), 1349-1357
Open this publication in new window or tab >>Fracture incidence in Graves' disease: A population-based study
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2023 (English)In: Thyroid, ISSN 1050-7256, E-ISSN 1557-9077, Vol. 33, no 11, p. 1349-1357Article in journal (Refereed) Published
Abstract [en]

Background Population-based studies have indicated an increase in bone turnover in hyperthyroidism with a subsequent decrease in bone mineral density and an increased risk of fractures, especially in postmenopausal women. However, heterogeneity between studies prevents a definitive conclusion. Graves' disease (GD) is an autoimmune disease, and it is the most common cause of hyperthyroidism. The aim of this study was to investigate fracture risk in patients with GD. Methods A total of 2134 patients with incident GD and 21261 age, sex- and county-matched controls were included 16-18 years after diagnosis in a retrospective cohort study. Drug and patient national registries in Sweden were used to assess the risk of developing skeletal complications. Up to ten age, sex- and county-matched controls per patient were selected from databases from The National Board of Health and Welfare and Statistics Sweden. Cox proportional hazards models were fitted to estimate hazard ratios (HR) and 95% confidence intervals. Results There were no significant differences in fracture rates between GD and controls but after adjustment for co-morbidities, the data showed higher vertebral fracture rates in male GD patients aged >52 years compared to male controls, HR=2.83 (1.05-7.64). The rates of osteoporosis treatments as well as treatment with corticosteroids were higher in patients with GD. However, HR for the association between GD and fractures remained largely unchanged after adjustment for osteoporosis treatments and treatments with corticosteroids. Conclusions There were no significant differences in total fracture rate between GD and the general population. However, men older than 52 years had a higher vertebral fracture rate. This study also shows that patients with treated GD receive more osteoporosis treatments compared to the general population.

Place, publisher, year, edition, pages
Mary Ann Liebert, 2023
National Category
Orthopaedics
Identifiers
urn:nbn:se:oru:diva-108380 (URN)10.1089/thy.2023.0162 (DOI)37725590 (PubMedID)2-s2.0-85175449682 (Scopus ID)
Available from: 2023-09-20 Created: 2023-09-20 Last updated: 2024-01-12Bibliographically approved
Udumyan, R., Botteri, E., Jerlström, T., Montgomery, S., Smedby, K. E. & Fall, K. (2022). Beta-blocker use and urothelial bladder cancer survival: a Swedish register-based cohort study. Acta Oncologica, 61(8), 922-930
Open this publication in new window or tab >>Beta-blocker use and urothelial bladder cancer survival: a Swedish register-based cohort study
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2022 (English)In: Acta Oncologica, ISSN 0284-186X, E-ISSN 1651-226X, Vol. 61, no 8, p. 922-930Article in journal (Refereed) Published
Abstract [en]

Background: Recent observational studies linked beta-adrenergic receptor blocker use with improved survival in patients with several cancer types, but there is no information on the potential effects of beta-blockers in patients with bladder cancer. Literature from pre-clinical studies is also limited, but urothelial cancer can exhibit significant overexpression of beta-adrenergic receptors relative to normal urothelial tissue, suggesting that urothelial cancer may benefit from beta-blockade therapy. We thus aimed to explore the possible association between beta-blocker use and bladder cancer-specific mortality (BCSM) among patients with urothelial bladder cancer.

Material and methods: Patients diagnosed during 2006-2014 and identified from the Swedish Cancer Register (n = 16,669) were followed until 31 December 2015. Cox regression was used to evaluate the association of beta-blockers dispensed within 90 days prior to cancer diagnosis with BCSM (primary outcome) and all-cause mortality, while controlling for socio-demographic factors, tumor characteristics, comorbidity, other medications and surgical procedures. Hazard ratios (HR) with 95% confidence intervals (CI) were reported.

Results: Overall, beta-blocker use was associated with lower BCSM [HR 0.88 (95%CI 0.81-0.96)]. Especially use of nonselective beta-blockers showed a clear inverse association in comparison with both nonuse [0.66 (0.50-0.86)] and use of other antihypertensive medications [0.72 (0.54-0.95)]. The inverse association was most pronounced among patients with locally advanced/metastatic disease: [0.35 (0.18-0.68)]. A lower-magnitude inverse association was observed for selective beta-blocker use [0.91 (0.83-0.99)]. Largely similar inverse associations were observed for hydrophilic [0.82 (0.70-0.95)] and lipophilic [0.91 (0.83-1.00)] beta-blocker use.

Conclusion: beta-blocker use, particularly of the nonselective type, was associated with lower BCSM, especially in patients with locally advanced/metastatic urothelial bladder cancer.

Place, publisher, year, edition, pages
Taylor & Francis Group, 2022
Keywords
Adrenergic signaling, beta-blocker, urothelial bladder cancer, survival, cohort study
National Category
Cancer and Oncology
Identifiers
urn:nbn:se:oru:diva-100418 (URN)10.1080/0284186X.2022.2101902 (DOI)000830641200001 ()35881046 (PubMedID)
Funder
Swedish Cancer Society, CAN 2013/650
Available from: 2022-08-05 Created: 2022-08-05 Last updated: 2022-08-22Bibliographically approved
Bergengren, L., Ryen, L., Flodström, C., Fadl, H., Udumyen, R., Karlsson, M. G. & Helenius, G. (2022). Effectiveness and costs of an implemented primary HPV cervical screening programme in Sweden: A population based cohort study. Preventive Medicine Reports, 25, Article ID 101675.
Open this publication in new window or tab >>Effectiveness and costs of an implemented primary HPV cervical screening programme in Sweden: A population based cohort study
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2022 (English)In: Preventive Medicine Reports, E-ISSN 2211-3355, Vol. 25, article id 101675Article in journal (Refereed) Published
Abstract [en]

Swedish guidelines recommend cervical screening with primary HPV for women ≥ 30 years of age. The aim of this study was to compare an implemented HPV cervical screening programme in the Region of Örebro County from September 1, 2016, with the former cytology-based screening programme.

The clinical effectiveness by means of number of high-grade squamous intraepithelial lesions (HSILs) and cervical cancer cases detected in histology within 12 months after the screening test, together with cost implications were the main outcomes. Data were retrieved from the Swedish National Cervical Screening Registry between the years 2014-2015 (cytology based screening) and 2017-2018(HPV based screening), including screening information such as invitations and cytology and histology diagnoses.

The detection rate of HSIL + among women ≥ 30 years of age was 1.2 times higher with HPV screening, but data revealed an increase in direct colposcopy referral rate by 54% and a higher percentage of irrelevant findings (≤LSIL). Screening based on HPV for women ≥ 30 has increased yearly cost from 1 to 1.3 million EUR, while increasing the number of HSIL + identified. Two thirds of the total costs are from visits for screening samples in the programme.

HPV screening detected more cases of HSIL + compared to cytology screening among women ≥ 30 although high colposcopy rate, high rate of clinical irrelevant findings and higher costs were shown in the HPV-based screening programme, which implies that alterations in the screening programme in the future are important to consider.

Place, publisher, year, edition, pages
Elsevier, 2022
Keywords
Cervical cancer, Health economy, Human papilloma virus (HPV), Screening
National Category
Cancer and Oncology Obstetrics, Gynecology and Reproductive Medicine
Identifiers
urn:nbn:se:oru:diva-97298 (URN)10.1016/j.pmedr.2021.101675 (DOI)000748438200026 ()35127354 (PubMedID)2-s2.0-85121919588 (Scopus ID)
Funder
Region Örebro County, OLL-841131
Available from: 2022-02-08 Created: 2022-02-08 Last updated: 2024-01-02Bibliographically approved
Zhulina, Y., Udumyan, R., Tysk, C. & Halfvarson, J. (2022). Mortality in patients with Crohn's disease in Örebro, Sweden 1963-2010. Scandinavian Journal of Gastroenterology, 57(2), 153-164
Open this publication in new window or tab >>Mortality in patients with Crohn's disease in Örebro, Sweden 1963-2010
2022 (English)In: Scandinavian Journal of Gastroenterology, ISSN 0036-5521, E-ISSN 1502-7708, Vol. 57, no 2, p. 153-164Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Some studies have suggested a reduced life expectancy in patients with Crohn's disease (CD) compared with the general population. The evidence, however, is inconsistent.

AIMS: Prompted by such studies, we studied survival of CD patients in Örebro county, Sweden.

METHODS: From the medical records, we identified all patients diagnosed with CD during 1963-2010 with follow-up to the end of 2011. We estimated: overall survival, net and crude probabilities of dying from CD, relative survival ratio (RSR), and excess mortality rate ratios (EMRR) at 10-year follow-up.

RESULTS: The study included 492 patients (226 males, 266 females). Median age at diagnosis was 32 years (3-87). Net and crude probabilities of dying from CD increased with increasing age and were higher for women. Net survival of patients aged ≥60 at diagnosis was worse for patients diagnosed during 1963-1985 (54%) than for patients diagnosed during 1986-1999 (88%) or 2000-2010 (93%). Overall, CD patients' survival was comparable to that in the general population [RSR = 0.98; 95% CI: (0.95-1.00)]. However, significantly lower than expected survival was suggested for female patients aged ≥60 diagnosed during the 1963-1985 [RSR = 0.47 (0.07-0.95)]. The adjusted model suggested that, compared with diagnostic period 1963-1985, disease-related excess mortality declined during 2000-2010 [EMRR = 0.36 (0.07-1.96)]; and age ≥60 at diagnosis [EMRR = 7.99 (1.64-39.00), reference: age 40-59], female sex [EMRR = 4.16 (0.62-27.85)], colonic localization [EMRR = 4.20 (0.81-21.88), reference: ileal localization], and stricturing/penetrating disease [EMRR = 2.56 (0.52-12.58), reference: inflammatory disease behaviour] were associated with poorer survival.

CONCLUSION: CD-related excess mortality may vary with diagnostic period, age, sex and disease phenotype.Key summaryThere is inconsistent evidence on life expectancy of patients with Crohn's diseaseCrohn's disease-specific survival improved over time.Earlier diagnosis period, older age at diagnosis, female sex, colonic disease and complicated disease behaviour seems to be associated with excess Crohn's disease-related mortality.

Place, publisher, year, edition, pages
Taylor & Francis, 2022
Keywords
Crohn’s disease, crude probability of dying from CD, excess mortality rate ratio, net probability of dying from CD, overall survival, relative survival ratio
National Category
Gastroenterology and Hepatology
Identifiers
urn:nbn:se:oru:diva-95180 (URN)10.1080/00365521.2021.1991466 (DOI)000710903100001 ()34693837 (PubMedID)2-s2.0-85118192756 (Scopus ID)
Available from: 2021-10-27 Created: 2021-10-27 Last updated: 2023-12-08Bibliographically approved
Eriksson, C., Rundquist, S., Lykiardopoulos, V., Udumyan, R., Karlén, P., Grip, O., . . . Halfvarson, J. (2021). Real-world effectiveness of vedolizumab in inflammatory bowel disease: week 52 results from the Swedish prospective multicentre SVEAH study. Therapeutic Advances in Gastroenterology, 14, Article ID 17562848211023386.
Open this publication in new window or tab >>Real-world effectiveness of vedolizumab in inflammatory bowel disease: week 52 results from the Swedish prospective multicentre SVEAH study
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2021 (English)In: Therapeutic Advances in Gastroenterology, ISSN 1756-283X, E-ISSN 1756-2848, Vol. 14, article id 17562848211023386Article in journal (Refereed) Published
Abstract [en]

Background: Prospectively and systematically collected real-world data on vedolizumab are scarce. We aimed to assess the long-term clinical effectiveness of vedolizumab in inflammatory bowel disease (IBD).

Methods: This study was a prospective, observational, multicentre study. Overall, 286 patients with active IBD were included (Crohn's disease, n = 169; ulcerative colitis, n = 117). The primary outcomes were clinical response at week 12 and clinical remission at week 52, based on the Harvey Bradshaw Index and the partial Mayo Clinic score. Secondary outcomes included clinical remission at week 12, clinical response at week 52, corticosteroid-free clinical remission at week 52, changes in biochemical measures, and health-related quality of life (HRQoL).

Results: At baseline, 88% of the patients were exposed to anti-TNF and 41% of the patients with Crohn's disease had undergone ⩾1 surgical resection. At week 12, clinical response was 27% and remission 47% in Crohn's disease; corresponding figures in ulcerative colitis were 52% and 34%. Clinical response, remission and corticosteroid-free remission at week 52 were 22%, 41% and 40% in Crohn's disease and 49%, 47% and 46% in ulcerative colitis, respectively. A statistically significant decrease in median faecal-calprotectin and C-reactive protein was observed at 12 and 52 weeks in patients with Crohn's disease and ulcerative colitis. The HRQoL measures Short Health Scale and EuroQol 5-Dimensions improved in both Crohn's disease and ulcerative colitis patients (p < 0.001). Clinical disease activity at baseline was inversely associated with clinical remission at week 52.

Conclusion: Vedolizumab proved effective for the treatment of refractory IBD in clinical practice.

Place, publisher, year, edition, pages
Sage Publications, 2021
Keywords
Crohn’s disease, inflammatory bowel disease, ulcerative colitis, vedolizumab
National Category
Gastroenterology and Hepatology
Identifiers
urn:nbn:se:oru:diva-93482 (URN)10.1177/17562848211023386 (DOI)000687984600001 ()34276808 (PubMedID)2-s2.0-85109172373 (Scopus ID)
Note

Funding agency:

Takeda Pharmaceutical Company Ltd EUPAS22735

Available from: 2021-08-12 Created: 2021-08-12 Last updated: 2021-09-07Bibliographically approved
Xu, Y., Udumyan, R., Fall, K., Ljungqvist, O., Montgomery, S. & Gustafsson, U. O. (2021). Validity of Routinely Collected Swedish Data in the International Enhanced Recovery After Surgery (ERAS) Database. World Journal of Surgery, 45(6), 1622-1629
Open this publication in new window or tab >>Validity of Routinely Collected Swedish Data in the International Enhanced Recovery After Surgery (ERAS) Database
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2021 (English)In: World Journal of Surgery, ISSN 0364-2313, E-ISSN 1432-2323, Vol. 45, no 6, p. 1622-1629Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: This study aims to assess patient coverage, validity and data quality in the Swedish part of the International Enhanced Recovery After Surgery (ERAS) Interactive Audit System (EIAS).

METHOD: All Swedish ERAS centers that recorded colorectal surgery data in EIAS between January 1, 2017, and December 31, 2017, were included (N = 12). Information registered in EIAS was compared with data from electronic medical records at each hospital to assess the overall coverage of EIAS. Twenty random-selected patients from each of the contributing centers were assessed for accuracy for a set of clinically relevant variables. All patients admitted to the contributing centers were included for the assessment of rate of missing on a selection of key clinical variables.

RESULTS: Eight hospitals provided complete information for the evaluation, while four hospitals only allowed assessment of coverage and missing data. The eight hospitals had an overall coverage of 98.8% in EIAS (n = 1301) and the four 86.7% (n = 811). The average agreement for the assessed postoperative outcome variables was 96.5%. The accuracy was excellent for 'length of hospital stay,' 'reoperation,' and 'any complications,' but lower for other types of complications. Only a few variables had more than 5% missing data, and missingness was associated with hospital type and size.

CONCLUSION: This validation of the Swedish part of the international ERAS database suggests high patient coverage in EIAS and high agreement and limited missingness in clinically relevant variables. This validation approach or a modified version can be used for continued validation of the International ERAS database.

Place, publisher, year, edition, pages
Springer, 2021
National Category
Surgery
Identifiers
urn:nbn:se:oru:diva-90983 (URN)10.1007/s00268-021-06094-4 (DOI)000637638200001 ()33825960 (PubMedID)2-s2.0-85103904298 (Scopus ID)
Funder
The Karolinska Institutet's Research Foundation
Note

Funding Agency:

ERAS Society 

Available from: 2021-04-13 Created: 2021-04-13 Last updated: 2021-06-02Bibliographically approved
Udumyan, R., Montgomery, S., Duberg, A.-S., Fang, F., Valdimarsdottir, U., Ekbom, A., . . . Fall, K. (2020). Beta-adrenergic receptor blockers and liver cancer mortality in a national cohort of hepatocellular carcinoma patients. Scandinavian Journal of Gastroenterology, 55(5), 597-605
Open this publication in new window or tab >>Beta-adrenergic receptor blockers and liver cancer mortality in a national cohort of hepatocellular carcinoma patients
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2020 (English)In: Scandinavian Journal of Gastroenterology, ISSN 0036-5521, E-ISSN 1502-7708, Vol. 55, no 5, p. 597-605Article in journal (Refereed) Published
Abstract [en]

Background: β-adrenergic signaling has been implicated in the pathology of hepatocellular carcinoma (HCC), but the evidence from clinical studies is limited. In this national population-based cohort study, we investigated the possible association of β-adrenergic receptor blockers and cancer-specific mortality among patients with primary HCC diagnosed in Sweden between 2006 and 2014.

Methods: Patients were identified from the Swedish Cancer Register (n = 2104) and followed until 31 December 2015. We used Cox regression to evaluate the association of β-blockers dispensed within 90 days prior to cancer diagnosis, ascertained from the national Prescribed Drug Register, with liver cancer mortality identified from the Cause of Death Register, while controlling for socio-demographic factors, tumor characteristics, comorbidity, other medications and treatment procedures.

Results: Over a median follow-up of 9.9 months, 1601 patients died (of whom 1309 from liver cancer). Compared with non-use, β-blocker use at cancer diagnosis [n = 714 (predominantly prevalent use, 93%)] was associated with lower liver cancer mortality [0.82 (0.72-0.94); p = .005]. Statistically significant associations were observed for non-selective [0.71 (0.55-0.91); p = .006], β1-receptor selective [0.86 [0.75-1.00); p = .049] and lipophilic [0.78 (0.67-0.90); p = .001] β-blockers. No association was observed for hydrophilic β-blockers [1.01 (0.80-1.28); p = .906] or other antihypertensive medications. Further analysis suggested that the observed lower liver cancer mortality rate was limited to patients with localized disease at diagnosis [0.82 (0.67-1.01); p = .062].

Conclusion: β-blocker use was associated with lower liver cancer mortality rate in this national cohort of patients with HCC. A higher-magnitude inverse association was observed in relation to non-selective β-blocker use.

Place, publisher, year, edition, pages
Taylor & Francis, 2020
Keywords
Register-based cohort study, beta-adrenergic signaling, non-selective beta-blockers, selective beta-blockers, survival analysis
National Category
Cancer and Oncology
Identifiers
urn:nbn:se:oru:diva-81928 (URN)10.1080/00365521.2020.1762919 (DOI)000535001500001 ()32412855 (PubMedID)2-s2.0-85085013155 (Scopus ID)
Funder
Swedish Cancer Society, CAN 2013/650
Note

Funding Agency:

Johnson & Johnson USA

Janssen Biotech Inc

Available from: 2020-05-19 Created: 2020-05-19 Last updated: 2023-12-08Bibliographically approved
Bennet, L., Udumyan, R., Östgren, C., Rolandsson, O., Jansson, S. & Wandell, P. (2020). Mortality in first- and second- generation immigrants to Sweden diagnosed with type 2 diabetes. Paper presented at 56th Annual Meeting of the European-Association-for-the-Study-of-Diabetes (EASD 2020 Virtual), September 21-25, 2020. Diabetologia, 63(Suppl. 1), S43-S43
Open this publication in new window or tab >>Mortality in first- and second- generation immigrants to Sweden diagnosed with type 2 diabetes
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2020 (English)In: Diabetologia, ISSN 0012-186X, E-ISSN 1432-0428, Vol. 63, no Suppl. 1, p. S43-S43Article in journal, Meeting abstract (Other academic) Published
Abstract [en]

Background and aims: Non-western immigrants to Europe are at high risk for type 2 diabetes (T2D). In this nationwide study including incident cases of T2D, the aim was to compare mortality in first- and second generation immigrants with native Swedes.

Materials and methods: Patients living in Sweden diagnosed with a new-onset pharmacologically treated T2D between 2006 to 2012 were identified through the Swedish Prescription Drug Register. Patients were followed until December 31, 2016 for all-cause mortality (ACM) and until December 31, 2012 for cause-specific mortality (CSM). Analyses were adjusted for age at diagnosis, sex, year of diagnosis, socioeconomy, education, treatment and region. Comparisons were assessed using coxregression analysis.

Results: In total, 169 300 individuals (129 533 (76.3%) native Swedes; 31 988 (18.9%) first-generation immigrants, and 7 799 (4.8%) second-generation immigrants with either one or both parents born outside Sweden) were diagnosed with T2D between 2006 and 2012 and fulfilled inclusion criteria. First-generation immigrants had lower ACM rate [hazard ratio (HR): 0.85, 95% CI 0.82 to 0.89] compared with native Swedes. The mortality was particularly low in persons born in the Middle East [0.45,0.40 to 0.51], Asia [0.56, 0.46 to 0.68], and Africa [0.88. 0.82 to 0.95]. Mortality rates decreased with older age at migration and shorter stay in Sweden, with the lowest rate in those originating from the Middle East living in Sweden <25 years [0.40, 0.34 to 0.46]. First-generation immigrants born in the Middle East (0.43; 0.30-0.62), and Asia (0.38; 0.19- 0.77) had lower cardiovascular disease related mortality rates compared with native Swedes. Middle Eastern immigrants further displayed lower cancer related mortality rate (0.59, 0.42 to 0.84) compared with native Swedes. Second generation immigrants displayed similar survival rates as native Swedes.

Conclusion: Our data indicate that in T2D patients, exposure to the Swedish environment seems to have a larger impact on mortality risk than region of origin. This study indicates protecting mechanisms on mortality related to the non-western environment.

Place, publisher, year, edition, pages
Springer, 2020
National Category
Endocrinology and Diabetes
Identifiers
urn:nbn:se:oru:diva-85836 (URN)000565776600085 ()
Conference
56th Annual Meeting of the European-Association-for-the-Study-of-Diabetes (EASD 2020 Virtual), September 21-25, 2020
Available from: 2020-09-22 Created: 2020-09-22 Last updated: 2020-10-15Bibliographically approved
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