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Ludvigsson, Jonas F.ORCID iD iconorcid.org/0000-0003-1024-5602
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Publications (10 of 186) Show all publications
Visuri, I., Eriksson, C., Mårdberg, E., Grip, O., Gustavsson, A., Hjortswang, H., . . . Halfvarson, J. (2019). Anti-TNF agent drug survival in patients with IBD: real-world comparisons of individual anti-TNF agents based on the Swedish National Quality Registry for IBD (SWIBREG). Journal of Crohn's & Colitis, 13(Suppl. 1), S443-S444
Open this publication in new window or tab >>Anti-TNF agent drug survival in patients with IBD: real-world comparisons of individual anti-TNF agents based on the Swedish National Quality Registry for IBD (SWIBREG)
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2019 (English)In: Journal of Crohn's & Colitis, ISSN 1873-9946, E-ISSN 1876-4479, Vol. 13, no Suppl. 1, p. S443-S444Article in journal, Meeting abstract (Other academic) Published
Place, publisher, year, edition, pages
Oxford University Press, 2019
National Category
Gastroenterology and Hepatology
Identifiers
urn:nbn:se:oru:diva-73336 (URN)10.1093/ecco-jcc/jjy222.773 (DOI)000460544502205 ()
Available from: 2019-03-26 Created: 2019-03-26 Last updated: 2019-03-26Bibliographically approved
Weimers, P., Halfvarson, J., Sachs, M. C., Ludvigsson, J. F., Peter, I., Olén, O. & Burisch, J. (2019). Association between inflammatory bowel disease and Parkinson's disease: seek and you shall find? [Letter to the editor]. Gut, 68(1), 175-176
Open this publication in new window or tab >>Association between inflammatory bowel disease and Parkinson's disease: seek and you shall find?
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2019 (English)In: Gut, ISSN 0017-5749, E-ISSN 1468-3288, Vol. 68, no 1, p. 175-176Article in journal, Letter (Refereed) Published
Place, publisher, year, edition, pages
BMJ Publishing Group Ltd, 2019
Keywords
Epidemiology, inflammatory bowel disease
National Category
Gastroenterology and Hepatology
Identifiers
urn:nbn:se:oru:diva-71215 (URN)10.1136/gutjnl-2018-316937 (DOI)000455727900023 ()30021791 (PubMedID)2-s2.0-85050249090 (Scopus ID)
Available from: 2019-01-08 Created: 2019-01-08 Last updated: 2019-02-04Bibliographically approved
Wintzell, V., Svanström, H., Olén, O., Melbye, M., Ludvigsson, J. F. & Pasternak, B. (2019). Association between use of azathioprine and risk of acute pancreatitis in children with inflammatory bowel disease: a Swedish-Danish nationwide cohort study. Lancet Child and Adolescent Health, 3(3), 158-165
Open this publication in new window or tab >>Association between use of azathioprine and risk of acute pancreatitis in children with inflammatory bowel disease: a Swedish-Danish nationwide cohort study
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2019 (English)In: Lancet Child and Adolescent Health, E-ISSN 2352-4642, Vol. 3, no 3, p. 158-165Article in journal (Refereed) Published
Abstract [en]

Background: Studies have shown an association between use of azathioprine and increased risk of acute pancreatitis in adult inflammatory bowel disease. However, whether an association exists among paediatric patients is not known. We aimed to investigate whether use of azathioprine is associated with the risk of acute pancreatitis in children with inflammatory bowel disease.

Methods: We did a nationwide register-based cohort study in Sweden (2006-16) and Denmark (2000-16). All paediatric patients (<18 years of age) with inflammatory bowel disease during the study period were identified through hospital records. Episodes of incident azathioprine use and no use of any thiopurine were matched (1:1) using propensity scores, controlling for sociodemographic characteristics, comorbidities, previous treatment, indicators of disease severity, and health care use. Incident acute pancreatitis (physician-assigned diagnosis with ICD-10 code K85) occurring in the 90 days following treatment initiation were identified through outpatient and inpatient hospital records.

Findings: We identified 3574 azathioprine episodes and 18 700 no-use episodes, which resulted in 3374 pairs after propensity score matching; baseline characteristics in the matched cohort were well balanced. Among the matched azathioprine episodes, mean age was 14.3 years (SD 3.1), 1854 (54.9%) were male, 1923 (57.0%) had Crohn's disease, and 1451 (43.0%) had ulcerative colitis or unclassified inflammatory bowel disease. Within the first 90 days following initiation of azathioprine, 40 acute pancreatitis events occurred (incidence rate 49.1 events per 1000 person-years) compared with six events in the no-use group (8.4 events per 1000 person-years). Azathioprine use was associated with an increased risk of acute pancreatitis (incidence rate ratio 5.82 [95% CI 2.47-13.72]; absolute difference 1.0 [95% CI 0.3-2.6] events per 100 patients) during the 90-day risk period.

Interpretation: Use of azathioprine was associated with an increased risk of acute pancreatitis in children with inflammatory bowel disease during the first 90 days following treatment initiation, suggesting the need for regular and rigorous monitoring. The risk of acute pancreatitis needs to be considered when deciding on optimal treatment strategies.

Place, publisher, year, edition, pages
Elsevier, 2019
National Category
Pediatrics
Identifiers
urn:nbn:se:oru:diva-72869 (URN)10.1016/S2352-4642(18)30401-2 (DOI)000458662400016 ()30685366 (PubMedID)2-s2.0-85061370852 (Scopus ID)
Funder
Swedish Research Council, 2016-01974Åke Wiberg Foundation
Note

Funding Agencies:

Frimurare Barnhuset Foundation

Strategic Research Area Epidemiology programme at Karolinska Institutet

Available from: 2019-03-01 Created: 2019-03-01 Last updated: 2019-03-01Bibliographically approved
Hagström, H., Höijer, J., Andreasson, A., Bottai, M., Johansson, K., Ludvigsson, J. F. & Stephansson, O. (2019). Body mass index in early pregnancy and future risk of severe liver disease: a population-based cohort study. Alimentary Pharmacology and Therapeutics, 49(6), 789-796
Open this publication in new window or tab >>Body mass index in early pregnancy and future risk of severe liver disease: a population-based cohort study
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2019 (English)In: Alimentary Pharmacology and Therapeutics, ISSN 0269-2813, E-ISSN 1365-2036, Vol. 49, no 6, p. 789-796Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: In young men, high body mass index (BMI) has been linked to liver disease later in life, but it is unclear if this also applies to women.

AIM: To study the association between BMI early in life and development of liver disease later in life in women.

METHODS: We obtained data on early pregnancy BMI from 1 139 458 Swedish women between 1992 and 2015. National registers were used to ascertain incident severe liver disease, defined as cirrhosis, decompensated liver disease (hepatocellular carcinoma, oesophageal varices, hepatorenal syndrome or hepatic encephalopathy) or liver failure. A Cox regression model was used to investigate associations of BMI with incident severe liver disease adjusting for maternal age, calendar year, country of birth, smoking, civil status and education.

RESULTS: (95% CI 1.02-1.05). A diagnosis of diabetes was associated with an increased risk of severe liver disease independent of baseline BMI.

CONCLUSION: A high BMI early in life in women is associated with a dose-dependent, increased risk for future severe liver disease.

Place, publisher, year, edition, pages
Blackwell Science Ltd., 2019
National Category
Public Health, Global Health, Social Medicine and Epidemiology Gastroenterology and Hepatology
Identifiers
urn:nbn:se:oru:diva-72885 (URN)10.1111/apt.15162 (DOI)000459827800015 ()30714185 (PubMedID)2-s2.0-85060992724 (Scopus ID)
Note

Funding Agencies:

Stockholm County (Clinical Postdoctorial Appointment)  

Bengt Ihre Fellowship 

Available from: 2019-03-04 Created: 2019-03-04 Last updated: 2019-03-13Bibliographically approved
Everhov, Å. H., Sachs, M. C., Malmborg, P., Nordenvall, C., Myrelid, P., Khalili, H., . . . Olén, O. (2019). Changes in inflammatory bowel disease subtype during follow-up and over time in 44,302 patients. Scandinavian Journal of Gastroenterology, 54(1), 55-63
Open this publication in new window or tab >>Changes in inflammatory bowel disease subtype during follow-up and over time in 44,302 patients
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2019 (English)In: Scandinavian Journal of Gastroenterology, ISSN 0036-5521, E-ISSN 1502-7708, Vol. 54, no 1, p. 55-63Article in journal (Refereed) Published
Abstract [en]

AIM: To investigate inflammatory bowel disease (IBD) register-based subtype classifications over a patient's disease course and over time.

METHODS: We examined International Classification of Diseases coding in patients with ≥2 IBD diagnostic listings in the National Patient Register 2002-2014 (n = 44,302).

RESULTS: 18% of the patients changed diagnosis (17% of adults, 29% of children) during a median follow-up of 3.8 years. Of visits with diagnoses of Crohn's disease (CD) or ulcerative colitis (UC), 97% were followed by the same diagnosis, whereas 67% of visits with diagnosis IBD-unclassified (IBD-U) were followed by another IBD-U diagnosis. Patients with any diagnostic change changed mostly once (47%) or twice (31%), 39% from UC to CD, 33% from CD to UC and 30% to or from IBD-U. Using a classification algorithm based on the first two diagnoses ('incident classification'), suited for prospective cohort studies, the proportion adult patients with CD, UC, and IBD-U 2002-2014 were 29%, 62%, and 10% (43%, 45%, and 12% in children). A classification model incorporating additional information from surgeries and giving weight to the last 5 years of visits ('prevalent classification'), suited for description of a study population at end of follow-up, classified 31% of adult cases as CD, 58% as UC and 11% as IBD-U (44%, 38%, and 18% in children).

CONCLUSIONS: IBD subtype changed in 18% during follow-up. The proportion with CD increased and UC decreased from definition at start to end of follow-up. IBD-U was more common in children.

Place, publisher, year, edition, pages
Taylor & Francis, 2019
Keywords
Crohn’s disease, IBD-U, Inflammatory bowel disease, indeterminate colitis, inflammatory bowel disease unclassified, register-based definition, ulcerative colitis
National Category
Gastroenterology and Hepatology
Identifiers
urn:nbn:se:oru:diva-72038 (URN)10.1080/00365521.2018.1564361 (DOI)000462902700008 ()30700170 (PubMedID)2-s2.0-85060872917 (Scopus ID)
Funder
The Swedish Medical AssociationSwedish Research CouncilSwedish Cancer SocietyThe Karolinska Institutet's Research FoundationStockholm County Council
Note

Funding Agencies:

Bengt Ihre foundation  

Mag-tarmfonden 

Karolinska Institutet (ALF)

Available from: 2019-02-12 Created: 2019-02-12 Last updated: 2019-04-16Bibliographically approved
Ludvigsson, J. F. & Lashkariani, M. (2019). Cohort profile: ESPRESSO (Epidemiology Strengthened by histoPathology Reports in Sweden). Clinical Epidemiology, 11, 101-114
Open this publication in new window or tab >>Cohort profile: ESPRESSO (Epidemiology Strengthened by histoPathology Reports in Sweden)
2019 (English)In: Clinical Epidemiology, ISSN 1179-1349, E-ISSN 1179-1349, Vol. 11, p. 101-114Article in journal (Refereed) Published
Abstract [en]

The ESPRESSO study constitutes a novel approach to examine the etiology and prognosis of gastrointestinal disease in which histopathology plays a prominent role. Between 2015 and 2017, all pathology departments (n=28) in Sweden were contacted and asked to procure histopathology record data from the gastrointestinal tract (pharynx to anus), liver, gallbladder, and pancreas. For each individual, local histopathology IT personnel retrieved data on personal identity number, date of histopathology, topography (where the biopsy is taken), morphology (biopsy appearance), and where available free text. In total, between 1965 and 2017, histopathology record data were available in 2.1 million unique individuals, but the number of data entries was 6.1 million because more than one biopsy was performed in many of the study participants. Index individuals with histopathology data were matched with up to five controls from the general population. We also identified all first-degree relatives (parents, children, full siblings), and the index individual's first spouse. The total study population consisted of 13.0 million individuals. Data from all the study participants have been linked to Swedish National Healthcare Registers allowing research not only on such aspects as fetal and perinatal conditions and the risk of future gastrointestinal disease but also on the risk of comorbidity and complications (including cancer and death). Furthermore, the ESPRESSO database allows researchers and practitioners to identify diagnoses and disease phenotypes not currently indexed in national registers (including disease precursors). The ESPRESSO database increases the sensitivity and specificity of already-recorded diseases in the national health registers. This paper is an overview of the ESPRESSO database.

Place, publisher, year, edition, pages
DOVE Medical Press Ltd., 2019
Keywords
cohort, gallbladder, gut, liver, pancreas, population-based, colon, pathology, endoscopy, celiac, inflammatory bowel disease, colitis, esophagus
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:oru:diva-72188 (URN)10.2147/CLEP.S191914 (DOI)000456428300001 ()30679926 (PubMedID)
Available from: 2019-02-07 Created: 2019-02-07 Last updated: 2019-02-07Bibliographically approved
Ho, P. J., Tan, C. S., Shawon, S. R., Eriksson, M., Lim, L. Y., Miao, H., . . . Li, J. (2019). Comparison of self-reported and register-based hospital medical data on comorbidities in women. Scientific Reports, 9(1), Article ID 3527.
Open this publication in new window or tab >>Comparison of self-reported and register-based hospital medical data on comorbidities in women
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2019 (English)In: Scientific Reports, ISSN 2045-2322, E-ISSN 2045-2322, Vol. 9, no 1, article id 3527Article in journal (Refereed) Published
Abstract [en]

Breast cancer patients commonly present with comorbidities which are known to influence treatment decisions and survival. We aim to examine agreement between self-reported and register-based medical records (National Patient Register [NPR]). Ascertainment of nine conditions, using individually-linked data from 64,961 women enrolled in the Swedish KARolinska MAmmography Project for Risk Prediction of Breast Cancer (KARMA) study. Agreement was assessed using observed proportion of agreement (overall agreement), expected proportion of agreement, and Cohen's Kappa statistic. Two-stage logistic regression models taking into account chance agreement were used to identify potential predictors of overall agreement. High levels of overall agreement (i.e. ≥86.6%) were observed for all conditions. Substantial agreement (Cohen's Kappa) was observed for myocardial infarction (0.74), diabetes (0.71) and stroke (0.64) between self-reported and NPR data. Moderate agreement was observed for preeclampsia (0.51) and hypertension (0.46). Fair agreement was observed for heart failure (0.40) and polycystic ovaries or ovarian cysts (0.27). For hyperlipidemia (0.14) and angina (0.10), slight agreement was observed. In most subgroups we observed negative specific agreement of >90%. There is no clear reference data source for ascertainment of conditions. Negative specific agreement between NPR and self-reported data is consistently high across all conditions.

Place, publisher, year, edition, pages
Nature Publishing Group, 2019
National Category
Cancer and Oncology
Identifiers
urn:nbn:se:oru:diva-73200 (URN)10.1038/s41598-019-40072-0 (DOI)000460381600100 ()30837593 (PubMedID)2-s2.0-85062585961 (Scopus ID)
Note

Funding Agencies:

Marit and Hans Rausing's Initiative Against Breast Cancer  

Kamprad Family Foundation  

Singapore National Research Foundation Fellowship  NRF-NRFF2017-02 

National Medical Research Council Clinician Scientist Award  NMRC/CSA-SI/0015/2017 

National University Cancer Institute Singapore Centre Grant Programme  CGAug16M005 

Breast Cancer Prevention Programme under SSHSPH-Res-Prog 

Available from: 2019-03-18 Created: 2019-03-18 Last updated: 2019-03-25Bibliographically approved
Liu, P.-H., Lebwohl, B., Burke, K. E., Ivey, K. L., Ananthakrishnan, A. N., Lochhead, P., . . . Khalili, H. (2019). Dietary Gluten Intake and Risk of Microscopic Colitis Among US Women without Celiac Disease: A Prospective Cohort Study. American Journal of Gastroenterology, 114(1), 127-134
Open this publication in new window or tab >>Dietary Gluten Intake and Risk of Microscopic Colitis Among US Women without Celiac Disease: A Prospective Cohort Study
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2019 (English)In: American Journal of Gastroenterology, ISSN 0002-9270, E-ISSN 1572-0241, Vol. 114, no 1, p. 127-134Article in journal (Refereed) Published
Abstract [en]

OBJECTIVE: Microscopic colitis is a common cause of chronic watery diarrhea among the elderly. Although the prevalence of celiac disease appears to be higher in patients with microscopic colitis, the relationship between dietary gluten intake and risk of microscopic colitis among individuals without celiac disease has not been explored.

METHODS: We conducted a prospective study of 160,744 US women without celiac disease enrolled in the Nurses' Health Study (NHS) and the NHSII. Dietary gluten intake was estimated using validated food frequency questionnaires every 4 years. Microscopic colitis was confirmed through medical records review. We used Cox proportional hazard modeling to estimate the multivariable-adjusted hazard ratio (HR) and 95% confidence interval (CI).

RESULTS: We documented 219 incident cases of microscopic colitis over more than 20 years of follow-up encompassing 3,716,718 person-years (crude incidence rate: 5.9/100,000 person-years) in NHS and NHSII. Dietary gluten intake was not associated with risk of microscopic colitis (Ptrend = 0.88). Compared to individuals in the lowest quintile of energy-adjusted gluten intake, the adjusted HR of microscopic colitis was 1.18 (95% CI: 0.77-1.78) for the middle quintile and 1.03 (95% CI: 0.67-1.58) for the highest quintile. Additional adjustment for primary dietary sources of gluten including refined and whole grains did not materially alter the effect estimates (All Ptrend ≥ 0.69). The null association did not differ according to lymphocytic or collagenous subtypes (Pheterogeneity = 0.72) and was not modified by age, smoking status, or body mass index (All Pinteraction ≥ 0.17).

CONCLUSION: Dietary gluten intake during adulthood was not associated with risk of microscopic colitis among women without celiac disease.

Place, publisher, year, edition, pages
Blackwell Publishing, 2019
National Category
Gastroenterology and Hepatology
Identifiers
urn:nbn:se:oru:diva-68919 (URN)10.1038/s41395-018-0267-5 (DOI)30181535 (PubMedID)
Available from: 2018-09-13 Created: 2018-09-13 Last updated: 2019-02-11Bibliographically approved
Ludvigsson, J. F. & Murray, J. A. (2019). Epidemiology of Celiac Disease. Gastroenterology Clinics of North America, 48(1), 1-18
Open this publication in new window or tab >>Epidemiology of Celiac Disease
2019 (English)In: Gastroenterology Clinics of North America, ISSN 0889-8553, E-ISSN 1558-1942, Vol. 48, no 1, p. 1-18Article in journal (Refereed) Published
Abstract [en]

Celiac disease is a common, chronic inflammatory disorder of the small intestine triggered by exposure to gluten in individuals with certain genetic types. This disorder affects people of any age or gender. Although often thought to be European in origin, it is now global in extent. Presentations are variable, from asymptomatic patients to severe malnutrition. Initial detection usually relies on celiac-specific serology, and confirmation often requires intestinal biopsy. There have been substantial increases in prevalence and incidence over the last 2 decades for reasons that are almost certainly environmental but for which there is no clarity as to cause.

Place, publisher, year, edition, pages
Saunders Elsevier, 2019
Keywords
Celiac disease, Epidemiology, Gluten, Incidence, Mortality, Prevalence, Risk factors
National Category
Gastroenterology and Hepatology
Identifiers
urn:nbn:se:oru:diva-73113 (URN)10.1016/j.gtc.2018.09.004 (DOI)000459749000003 ()30711202 (PubMedID)2-s2.0-85058221641 (Scopus ID)
Funder
Swedish Society of MedicineStockholm County CouncilSwedish Research Council, 2013-2429
Available from: 2019-03-14 Created: 2019-03-14 Last updated: 2019-03-14Bibliographically approved
Örtqvist, A. K., Lundholm, C., Halfvarson, J., Ludvigsson, J. F. & Almqvist, C. (2019). Fetal and early life antibiotics exposure and very early onset inflammatory bowel disease: a population-based study. Gut, 68(2), 218-225
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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2019 (English)In: Gut, ISSN 0017-5749, E-ISSN 1468-3288, Vol. 68, no 2, p. 218-225Article in journal (Refereed) Published
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, 2019
Keywords
Antibiotics, crohn’s colitis, epidemiology, inflammatory bowel disease, ulcerative colitis
National Category
Gastroenterology and Hepatology Pediatrics
Identifiers
urn:nbn:se:oru:diva-66361 (URN)10.1136/gutjnl-2017-314352 (DOI)000459027800008 ()29321166 (PubMedID)2-s2.0-85049136111 (Scopus ID)
Funder
Swedish Heart Lung FoundationSwedish Asthma and Allergy Association
Available from: 2018-04-06 Created: 2018-04-06 Last updated: 2019-03-07Bibliographically approved
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Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0003-1024-5602

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