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Sjöberg, Mats
Publications (8 of 8) Show all publications
Sjöberg, M., Magnuson, A., Bjork, J., Benoni, C., Almer, S., Friis-Liby, I., . . . Tysk, C. (2013). Infliximab as rescue therapy in hospitalised patients with steroid-refractory acute ulcerative colitis: a long-term follow-up of 211 Swedish patients. Alimentary Pharmacology and Therapeutics, 38(4), 377-387
Open this publication in new window or tab >>Infliximab as rescue therapy in hospitalised patients with steroid-refractory acute ulcerative colitis: a long-term follow-up of 211 Swedish patients
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2013 (English)In: Alimentary Pharmacology and Therapeutics, ISSN 0269-2813, E-ISSN 1365-2036, Vol. 38, no 4, p. 377-387Article in journal (Refereed) Published
Abstract [en]

Background: Rescue therapy with infliximab (IFX) has been proven effective in a steroid-refractory attack of ulcerative colitis (UC). The long-term efficacy is not well described.

Aim: To present a retrospective study of IFX as rescue therapy in UC. Primary end points were colectomy-free survival at 3 and 12months.

Methods: In this multicentre study, 211 adult patients hospitalised between 1999 and 2010 received IFX 5mg/kg as rescue therapy due to a steroid-refractory, moderate-to-severe attack of UC. Exclusion criteria were duration of current flare for >12weeks, corticosteroid treatment for >8weeks before hospitalisation, previous IFX therapy or Crohn's disease.

Results: Probability of colectomy-free survival at 3months was 0.71 (95% CI, 0.64-0.77), at 12months 0.64 (95% CI, 0.57-0.70), at 3years 0.59 (95% CI, 0.52-0.66) and at 5years 0.53 (95% CI, 0.44-0.61). Steroid-free, clinical remission was achieved in 105/211 (50%) and 112/209 (54%) patients at 3 and 12months respectively. Of 75 colectomies during the first year, 48 (64%) were carried out during the first 14days, 13 (17%) on days 15-90 and 14 (19%) between 3 and 12months. There were three (1.4%) deaths during the first 3months.

Conclusions: Infliximab is an effective rescue treatment, both short- and long-term, in a steroid-refractory attack of UC. Most IFX failures underwent surgery during the first 14days, which calls for studies on how to optimise induction treatment with IFX. Serious complications, including mortality, were rare.

National Category
Medical and Health Sciences
Research subject
Medicine
Identifiers
urn:nbn:se:oru:diva-30236 (URN)10.1111/apt.12387 (DOI)000321773700004 ()
Available from: 2013-08-16 Created: 2013-08-16 Last updated: 2018-05-21Bibliographically approved
Sjöberg, M., Halfvarson, J. & Tysk, C. (2013). Letter: infliximab in severe ulcerative colitis - is it useful for all patients? Authors' reply [Letter to the editor]. Alimentary Pharmacology and Therapeutics, 38(11-12), 1413-1414
Open this publication in new window or tab >>Letter: infliximab in severe ulcerative colitis - is it useful for all patients? Authors' reply
2013 (English)In: Alimentary Pharmacology and Therapeutics, ISSN 0269-2813, E-ISSN 1365-2036, Vol. 38, no 11-12, p. 1413-1414Article in journal, Letter (Refereed) Published
National Category
Gastroenterology and Hepatology
Research subject
Internal Medicine
Identifiers
urn:nbn:se:oru:diva-36006 (URN)10.1111/apt.12521 (DOI)000326681400017 ()
Available from: 2014-08-21 Created: 2014-08-21 Last updated: 2018-05-22Bibliographically approved
Sjöberg, M., Walch, A., Meshkat, M., Gustavsson, A., Järnerot, G., Vogelsang, H., . . . Tysk, C. (2012). Infliximab or cyclosporine as rescue therapy in hospitalized patients with steroid-refractory ulcerative colitis: a retrospective observational study. Inflammatory Bowel Diseases, 18(2), 212-218
Open this publication in new window or tab >>Infliximab or cyclosporine as rescue therapy in hospitalized patients with steroid-refractory ulcerative colitis: a retrospective observational study
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2012 (English)In: Inflammatory Bowel Diseases, ISSN 1078-0998, E-ISSN 1536-4844, Vol. 18, no 2, p. 212-218Article in journal (Refereed) Published
Abstract [en]

Background: Cyclosporine (CsA) or infliximab (IFX) are used as rescue therapies in steroid-refractory, severe attacks of ulcerative colitis (UC). There are no data comparing the efficacy of these two alternatives. Methods: Outcome of rescue therapy was retrospectively studied in two cohorts of patients hospitalized due to steroid-refractory moderate to severe UC: 1) a Swedish-Danish cohort (n 49) treated with a single infusion of IFX; 2) an Austrian cohort (n 43) treated with intravenous CsA. After successful rescue therapy, maintenance immunomodulator treatment was given to 27/33 (82%) of IFX patients and to 31/40 (78%) of CsA patients. Endpoints were colectomy-free survival at 3 and 12 months. Kaplan-Meier and Cox regression models were used to evaluate the association between treatment groups and colectomy. Results: At 15 days, colectomy-free survival in the IFX cohort was 36/49 (73%) versus 41/43 (95%) in the CsA cohort (P = 0.005), at 3 months 33/49 (67%) versus 40/43 (93%) (P = 0.002), and at 12 months 28/49 (57%) versus 33/43 (77%) (P = 0.034). After adjusting for potential confounding factors, Cox regression analysis yielded adjusted hazard ratios for risk of colectomy in IFX-treated patients of 11.2 (95% confidence interval [CI] 2.4-53.1, P = 0.002) at 3 months and of 3.0 (95% CI 1.1-8.2, P = 0.030) at 12 months in comparison with CsA-treated patients. There were no opportunistic infections or mortality. Conclusions: Colectomy frequencies were significantly lower after rescue therapy with CsA than with a single infusion of IFX both at 3 and 12 months' follow-up. The superiority of CsA was seen principally during the first 15 days.

Place, publisher, year, edition, pages
John Wiley & Sons, 2012
Keywords
Ulcerative colitis, cyclosporine, infliximab, rescue therapy, colectomy
National Category
Medical and Health Sciences Gastroenterology and Hepatology
Research subject
Medicine
Identifiers
urn:nbn:se:oru:diva-21631 (URN)10.1002/ibd.21680 (DOI)000298957800004 ()21438096 (PubMedID)2-s2.0-84855698480 (Scopus ID)Malden, USA (Local ID)Malden, USA (Archive number)Malden, USA (OAI)
Available from: 2012-02-14 Created: 2012-02-14 Last updated: 2018-08-28Bibliographically approved
Zhulina, Y., Lindberg, E., Sjöberg, M., Nyhlin, N., Wickbom, A., Eriksson, C., . . . Halfvarson, J. (2011). Inflammatorisk tarmsjukdom i Örebro 2010: en epidemiologisk uppdatering. Gastrokuriren, 16(29), PO-10-PO-10
Open this publication in new window or tab >>Inflammatorisk tarmsjukdom i Örebro 2010: en epidemiologisk uppdatering
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2011 (Swedish)In: Gastrokuriren, ISSN 1651-0453, Vol. 16, no 29, p. PO-10-PO-10Article in journal, Meeting abstract (Other academic) Published
Place, publisher, year, edition, pages
Svensk Gastroenterologisk Förening, 2011
National Category
Gastroenterology and Hepatology
Research subject
Medicine
Identifiers
urn:nbn:se:oru:diva-25511 (URN)
Available from: 2012-08-29 Created: 2012-08-29 Last updated: 2017-10-18Bibliographically approved
Sjöberg, M., Almer, S., Befrits, R., Benoni, C., Carlson, M., Eriksson, A., . . . Tysk, C. (2011). Infliximab as Rescue Therapy in Steroid-Refractory Acute Ulcerative Colitis: A Retrospective Follow-up Study. Paper presented at Conference on Digestive Disease Week 2011, Chicago, Illinois, USA, May 07-10, 2011.. Gastroenterology, 140(5), S590-S590
Open this publication in new window or tab >>Infliximab as Rescue Therapy in Steroid-Refractory Acute Ulcerative Colitis: A Retrospective Follow-up Study
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2011 (English)In: Gastroenterology, ISSN 0016-5085, E-ISSN 1528-0012, Vol. 140, no 5, p. S590-S590Article in journal, Meeting abstract (Other academic) Published
Place, publisher, year, edition, pages
Phildalphia, USA: Saunders Elsevier, 2011
National Category
Gastroenterology and Hepatology
Research subject
Internal Medicine
Identifiers
urn:nbn:se:oru:diva-36872 (URN)000290167302529 ()
Conference
Conference on Digestive Disease Week 2011, Chicago, Illinois, USA, May 07-10, 2011.
Available from: 2014-09-17 Created: 2014-09-17 Last updated: 2017-12-05Bibliographically approved
Sjöberg, M., Almer, S., Befrits, R., Benoni, C., Carlson, M., Eriksson, A., . . . Tysk, C. (2011). Infliximab som “rescue terapi” vid steroidrefraktärt skov av ulcerös kolit: en retrospektiv uppföljningsstudie. Gastrokuriren, 16(29), PO-14-PO-14
Open this publication in new window or tab >>Infliximab som “rescue terapi” vid steroidrefraktärt skov av ulcerös kolit: en retrospektiv uppföljningsstudie
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2011 (Swedish)In: Gastrokuriren, ISSN 1651-0453, Vol. 16, no 29, p. PO-14-PO-14Article in journal, Meeting abstract (Other academic) Published
Place, publisher, year, edition, pages
Svensk Gastroenterologisk Förening, 2011
National Category
Gastroenterology and Hepatology
Research subject
Medicine
Identifiers
urn:nbn:se:oru:diva-25513 (URN)
Available from: 2012-08-29 Created: 2012-08-29 Last updated: 2017-10-17Bibliographically approved
Sjöberg, M., Almer, S., Befrits, R., Benoni, C., Carlson, M., Eriksson, A., . . . Tysk, C. (2011). Long-term efficacy of rescue therapy with infliximab in steroid-refractory acute attack of ulcerative colitis. Gut, 60(Suppl 3), A48-A48
Open this publication in new window or tab >>Long-term efficacy of rescue therapy with infliximab in steroid-refractory acute attack of ulcerative colitis
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2011 (English)In: Gut, ISSN 0017-5749, E-ISSN 1468-3288, Vol. 60, no Suppl 3, p. A48-A48Article in journal (Refereed) Published
Place, publisher, year, edition, pages
BMJ Publishing Group Ltd, 2011
National Category
Gastroenterology and Hepatology
Research subject
Medicine
Identifiers
urn:nbn:se:oru:diva-25517 (URN)
Available from: 2012-08-29 Created: 2012-08-29 Last updated: 2019-03-06Bibliographically approved
Sjöberg, M., Walch, A., Meshkat, M., Gustavsson, A., Järnerot, G., Vogelsang, H., . . . Tysk, C. (2010). Cyclosporin eller infliximab som rescue terapi vid steroidfraktär ulcerös kolit: en retrospective observationsstudie. Gastrokuriren, 15(2), 34-34
Open this publication in new window or tab >>Cyclosporin eller infliximab som rescue terapi vid steroidfraktär ulcerös kolit: en retrospective observationsstudie
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2010 (Swedish)In: Gastrokuriren, ISSN 1651-0453, Vol. 15, no 2, p. 34-34Article in journal, Meeting abstract (Other academic) Published
Place, publisher, year, edition, pages
Svensk Gastroenterologisk Förening, 2010
National Category
Gastroenterology and Hepatology
Research subject
Medicine
Identifiers
urn:nbn:se:oru:diva-25497 (URN)
Available from: 2012-08-29 Created: 2012-08-29 Last updated: 2017-10-17Bibliographically approved
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