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  • 1.
    Burisch, Johan
    et al.
    Department of gastroenterology, North Zealand Hospital, University of Copenhagen, Denmark.
    Chetcuti Zammit, Stefania
    Division of Gastroenterology, Mater Dei Hospital, Msida, Malta.
    Ellul, Pierre
    Division of Gastroenterology, Mater Dei Hospital, Msida, Malta.
    Turcan, Svetlana
    Department of Gastroenterology, State University of Medicine and Pharmacy of the Republic of Moldova, Chisinau, Republic of Moldova.
    Duricova, Dana
    IBD clinical and research centre, ISCARE., Prague, Czech Republic.
    Bortlik, Martin
    IBD clinical and research centre, ISCARE., Prague, Czech Republic; Institute of Pharmacology, 1st Faculty of Medicine, Charles University in Prague, Prague.
    Winther Andersen, Karina
    Medical Department, Regional Hospital of Viborg, Viborg, Denmark.
    Andersen, Vibeke
    Medical Department, Regional Hospital of Viborg, Viborg, Denmark; Focused research unit for Molecular Diagnostic and Clinical Research (MOK), IRS-Center Sonderjylland, Hospital of Southern Jutland, Aabenraa, Denmark; Institute of Molecular Medicine, University of Southern Denmark, Odense, Denmark.
    Kaimakliotis, Ioannis P.
    Nicosia private practice, Nicosia, Cyprus.
    Fumery, Mathurin
    Gastroenterology Unit, Epimad Registry, CHU Amiens Sud, Avenue Laennec-Salouel, Amiens University Hospital, Amiens, France.
    Gower-Rousseau, Corinne
    Public Health, Epidemiology and Economic Health, Registre Epimad, Lille University and Hospital, Lille, France; Lille Inflammation Research International Center LIRIC, Lille University, Lille, France.
    Girardin, Giulia
    Department of Surgical, Oncological and gastroenterological Sciences, Azienda, University of Padua, Padua, Italy.
    Valpiani, Daniela
    U.O. Gastroenterologia ed Endoscopia digestiva, Hospital Morgagni Pierantoni, Forlì, Italy.
    Goldis, Adrian
    Clinic of Gastroenterology, University of Medicine 'Victor Babes', Timisoara, Romania.
    Brinar, Marko
    Division of Gastroenterology and Hepatology, University Hospital Center Zagreb, Zagreb, Croatia.
    Čuković-Čavka, Silvija
    Division of Gastroenterology and Hepatology, University Hospital Center Zagreb, Zagreb, Croatia.
    Oksanen, Pia
    Department of Gastroenterology and Alimentary Tract Surgery, Tampere University Hospital, Tampere, Finland; University of Tampere, Tampere, Finland.
    Collin, Pekka
    Department of Gastroenterology and Alimentary Tract Surgery, Tampere University Hospital, Tampere, Finland; University of Tampere, Tampere, Finland.
    Barros, Luisa
    Department of Gastroenterology, Centro Hospitalar de São João EPE, Porto, Portugal.
    Magro, Fernando
    Department of Gastroenterology, Centro Hospitalar de São João EPE, Porto, Portugal; Department of Biomedicine, Institute of Pharmacology, Faculty of Medicine of Porto University, Porto, Portugal.
    Misra, Ravi
    IBD Department, St Marks Hospital, Imperial College London, London, UK.
    Arebi, Naila
    IBD Department, St Marks Hospital, Imperial College London, London, UK.
    Eriksson, Carl
    Örebro universitet, Institutionen för medicinska vetenskaper. Region Örebro län. Department of Gastroenterology.
    Halfvarson, Jonas
    Örebro universitet, Institutionen för medicinska vetenskaper. Department of Gastroenterology.
    Kievit, Hendrika Adriana Linda
    Department of Medicine, Herning Central Hospital, Herning, Denmark.
    Pedersen, Natalia
    Gastroenterology Department, Slagelse Hospital, Slagelse, Denmark.
    Kjeldsen, Jens
    Gastroenterology Department, Odense University Hospital, Odense, Denmark.
    Myers, Sally
    IBD Unit, Hull & East Yorkshire NHS Trust, Hull, UK.
    Sebastian, Shaji
    IBD Unit, Hull & East Yorkshire NHS Trust, Hull, UK.
    Katsanos, Konstantinos H.
    Department of Gastroenterology, University Hospital of Ioannina, Ioannina, Greece.
    Christodoulou, Dimitrios K.
    Department of Gastroenterology, University Hospital of Ioannina, Ioannina, Greece.
    Midjord, Jóngerð
    Medical Department, The National Hospital of the Faroe Islands, Torshavn, Faroe Islands.
    Nielsen, Kári Rubek
    Medical Department, The National Hospital of the Faroe Islands, Torshavn, Faroe Islands.
    Kiudelis, Gediminas
    Institute for Digestive Research, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania.
    Kupcinskas, Limas
    Institute for Digestive Research, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania; Department of Gastroenterology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania.
    Nikulina, Inna
    Department of Gastroenterology, Moscow Regional Research Clinical Institute, Moscow, Russian Federation.
    Belousova, Elena
    Department of Gastroenterology, Moscow Regional Research Clinical Institute, Moscow, Russian Federation.
    Schwartz, Doron
    Department of Gastroenterology and Hepatology, Soroka Medical Center and Ben Gurion University of the Negev, Beer Sheva, Israel.
    Odes, Selwyn
    Department of Gastroenterology and Hepatology, Soroka Medical Center and Ben Gurion University of the Negev, Beer Sheva, Israel.
    Salupere, Riina
    Department of Gastroenterology and Hepatology, Soroka Medical Center and Ben Gurion University of the Negev, Beer Sheva, Israel.
    Carmona, Amalia
    Department of Gastroenterology. Hospital POVISA, Vigo, Spain.
    Pineda, Juan R.
    Department of Gastroenterology. Hospital Alvaro Cunqueiro, Instituto Investigación Sanitaria Galicia Sur, EOXI de Vigo, Vigo, Spain.
    Vegh, Zsuzsanna
    1st Department of Medicine, Semmelweis University, Budapest, Hungary.
    Lakatos, Peter L.
    1st Department of Medicine, Semmelweis University, Budapest, Hungary; Division of Gastroenterology, McGill University Health Center, Montreal, Canada.
    Langholz, Ebbe
    Department of Gastroenterology, Herlev and Gentofte Hospital, University of Copenhagen, Denmark.
    Munkholm, Pia
    Department of gastroenterology, North Zealand Hospital, University of Copenhagen, Denmark.
    Epi-IBD, group
    Disease course of inflammatory bowel disease unclassified in a European population-based inception cohort: an Epi-IBD study2019Inngår i: Journal of Gastroenterology and Hepatology, ISSN 0815-9319, E-ISSN 1440-1746, Vol. 34, nr 6, s. 996-1003Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    BACKGROUND: A definitive diagnosis of Crohn's disease (CD) or ulcerative colitis (UC) is not always possible and a proportion of patients will be diagnosed as inflammatory bowel disease unclassified (IBDU). The aim of the study was to investigate the prognosis of patients initially diagnosed with IBDU and the disease course during the following five years.

    METHODS: The Epi-IBD study is a prospective population-based cohort of 1,289 IBD patients diagnosed in centres across Europe. Clinical data were captured prospectively throughout the follow-up period.

    RESULTS: Overall, 476 (37%) patients were initially diagnosed with CD, 701 (54%) with UC, and 112 (9%) with IBDU. During follow-up, 28 (25%) IBDU patients were changed diagnoses to either UC (n=20, 71%) or CD (n=8, 29%) after a median of six months (IQR: 4-12), while 84 (7% of the total cohort) remained IBDU. A total of 17 (15%) IBDU patients were hospitalized for their IBD during follow-up, while 8 (7%) patients underwent surgery. Most surgeries (n=6, 75%) were performed on patients whose diagnosis was later changed to UC; three of these colectomies led to a definitive diagnosis of UC. Most patients (n=107, 96%) received 5-aminosalicylic acid, while 11 (10%) patients received biologicals, of whom five remained classified as IBDU.

    CONCLUSIONS: In a population-based inception cohort, 7% of IBD patients were not given a definitive diagnosis of IBD after five years of follow-up. One in four patients with IBDU eventually were classified as CD or UC. Overall, the disease course and medication burden in IBDU patients were mild.

  • 2.
    Burisch, Johan
    et al.
    Department of Gastroenterology, North Zealand University Hospital, Frederikssund, Denmark.
    Eriksson, Carl
    Örebro universitet, Institutionen för medicinska vetenskaper. Region Örebro län. Department of Gastroenterology.
    Halfvarson, Jonas
    Örebro universitet, Institutionen för medicinska vetenskaper. Department of Gastroenterology.
    Odes, Selwyn
    Department of Internal Medicine, Ben-Gurion University of the Negev, Beer Sheva, Israel.
    Health-care costs of inflammatory bowel disease in a pan-European, community-based, inception cohort during 5 years of follow-up: a population-based study2020Inngår i: The Lancet Gastroenterology & Hepatology, ISSN 2468-1253, Vol. 5, nr 5, s. 454-464Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: Inflammatory bowel disease (IBD) places a significant burden on health-care systems because of its chronicity and need for expensive therapies and surgery. With increasing use of biological therapies, contemporary data on IBD health-care costs are important for those responsible for allocating resources in Europe. To our knowledge, no prospective long-term analysis of the health-care costs of patients with IBD in the era of biologicals has been done in Europe. We aimed to investigate cost profiles of a pan-European, community-based inception cohort during 5 years of follow-up.

    Methods: The Epi-IBD cohort is a community-based, prospective inception cohort of unselected patients with IBD diagnosed in 2010 at centres in 20 European countries plus Israel. Incident patients who were diagnosed with IBD according to the Copenhagen Diagnostic Criteria between Jan 1, and Dec 31,2010, and were aged 15 years or older the time of diagnosis were prospectively included. Data on clinical characteristics and direct costs (investigations and outpatient visits, blood tests, treatments, hospitalisations, and surgeries) were collected prospectively using electronic case-report forms. Patient-level costs incorporated procedures leading to the initial diagnosis of IBD and costs of IBD management during the 5-year follow-up period. Costs incurred by comorbidities and unrelated to IBD were excluded. We grouped direct costs into the following five categories: investigations (including outpatient visits and blood tests), conventional medical treatment, biological therapy, hospitalisation, and surgery.

    Findings: The study population consisted of 1289 patients with IBD, with 1073 (83%) patients from western Europe and 216 (17%) from eastern Europe. 488 (38%) patients had Crohn's disease, 717 (56%) had ulcerative colitis, and 84 (6%) had IBD unclassified. The mean cost per patient-year during follow-up for patients with IBD was (sic)2609 (SD 7389; median (sic)446 [IQR 164-1849]). The mean cost per patient-year during follow-up was (sic)3542 (8058; median (sic)717 [214-3512]) for patients with Crohn's disease, (sic)2088 (7058; median (sic)408 [133-1161]) for patients with ulcerative colitis, and (sic)1609 (5010; median (sic)415 [92-1228]) for patients with IBD unclassified (p<0.0001). Costs were highest in the first year and then decreased significantly during follow-up. Hospitalisations and diagnostic procedures accounted for more than 50% of costs during the first year. However, in subsequent years there was a steady increase in expenditure on biologicals, which accounted for 73% of costs in Crohn's disease and 48% in ulcerative colitis, in year 5. The mean annual cost per patient-year for biologicals was (sic)866 (SD 3056). The mean yearly costs of biological therapy were higher in patients with Crohn's disease ((sic)1782 [SD 4370]) than in patients with ulcerative colitis ((sic)286 [1427]) or IBD unclassified ((sic)521 [2807]; p<0.0001).

    Interpretation: Overall direct expenditure on health care decreased over a 5-year follow-up period. This period was characterised by increasing expenditure on biologicals and decreasing expenditure on conventional medical treatments, hospitalisations, and surgeries. In light of the expenditures associated with biological therapy, cost-effective treatment strategies are needed to reduce the economic burden of inflammatory bowel disease.

  • 3.
    Burisch, Johan
    et al.
    Department of Gastroenterology, Nordsjællands Hospital, University of Copenhagen, Frederikssund, Denmark.
    Katsanos, Konstantinos H.
    Department of Gastroenterology, University Hospital of Ioannina, Ioannina, Greece.
    Christodoulou, Dimitrios K.
    Department of Gastroenterology, University Hospital of Ioannina, Ioannina, Greece.
    Barros, Luisa
    Department of Gastroenterology, Centro Hospitalar de São João EPE, Porto, Portugal.
    Magro, Fernando
    Department of Gastroenterology, Centro Hospitalar de São João EPE, Porto, Portugal; Department of Biomedicine, Institute of Pharmacology, Faculty of Medicine of Porto University, Porto, Portugal.
    Pedersen, Natalia
    Gastroenterology Department, Slagelse Hospital, Slagelse, Denmark.
    Kjeldsen, Jens
    Gastroenterology Department, Odense University Hospital, Odense, Denmark.
    Vegh, Zsuzsanna
    First Department of Medicine, Semmelweis University, Budapest, Hungary.
    Lakatos, Peter L.
    First Department of Medicine, Semmelweis University, Budapest, Hungary; Division of Gastroenterology, McGill University Health Center, Montreal, QC, Canada.
    Eriksson, Carl
    Örebro universitet, Institutionen för medicinska vetenskaper. Region Örebro län. Department of Gastroenterology.
    Halfvarson, Jonas
    Örebro universitet, Institutionen för medicinska vetenskaper. Department of Gastroenterology.
    Fumery, Mathurin
    Gastroenterology Unit, Epimad Registry, CHU Amiens Sud, Amiens University Hospital, Amiens, France.
    Gower-Rousseau, Corinne
    Public Health, Epidemiology and Economic Health, Registre Epimad, Lille University and Hospital, Lille, France; Lille Inflammation Research International Center LIRIC, Lille University, Lille, France.
    Brinar, Marko
    Division of Gastroenterology and Hepatology, University Hospital Center Zagreb, Zagreb, Croatia; School of Medicine, University of Zagreb, Zagreb, Croatia.
    Čuković-Čavka, Silvija
    Division of Gastroenterology and Hepatology, University Hospital Center Zagreb, Zagreb, Croatia; School of Medicine, University of Zagreb, Zagreb, Croatia.
    Nikulina, Inna
    Department of Gastroenterology, Moscow Regional Research Clinical Institute, Moscow, Russian Federation.
    Belousova, Elena
    Department of Gastroenterology, Moscow Regional Research Clinical Institute, Moscow, Russian Federation.
    Myers, Sally
    IBD Unit, Hull and East Yorkshire NHS Trust, Hull, UK.
    Sebastian, Shaji
    IBD Unit, Hull and East Yorkshire NHS Trust, Hull, UK.
    Kiudelis, Gediminas
    Institute for Digestive Research, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania.
    Kupcinskas, Limas
    Institute for Digestive Research, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania; Department of Gastroenterology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania.
    Schwartz, Doron
    Department of Gastroenterology and Hepatology, Soroka Medical Center, Beer Sheva, Israel; Ben Gurion University of the Negev; Beer Sheva, Israel.
    Odes, Selwyn
    Department of Gastroenterology and Hepatology, Soroka Medical Center, Beer Sheva, Israel; Ben Gurion University of the Negev; Beer Sheva, Israel.
    Kaimakliotis, Ioannis P.
    Nicosia Private Practice, Nicosia, Cyprus.
    Valpiani, Daniela
    U.O. Gastroenterologia ed Endoscopia digestiva, Hospital Morgagni Pierantoni, Forlì, Italy.
    D'Incà, Renata
    Department of Surgical, Oncological and Gastroenterological Sciences, Azienda, University of Padua, Padova, Italy.
    Salupere, Riina
    Division of Gastroenterology, Tartu University Hospital, University of Tartu, Tartu, Estonia.
    Zammit, Stefania Chetcuti
    Division of Gastroenterology, Mater Dei Hospital, Msida, Malta.
    Ellul, Pierre
    Division of Gastroenterology, Mater Dei Hospital, Msida, Malta.
    Duricova, Dana
    IBD Clinical and Research Centre, ISCARE, Prague, Czech Republic.
    Bortlik, Martin
    IBD Clinical and Research Centre, ISCARE, Prague, Czech Republic; Institute of Pharmacology, First Faculty of Medicine, Charles University in Prague, Prague, Czech Republic.
    Goldis, Adrian
    Clinic of Gastroenterology, University of Medicine ‘Victor Babes’, Timisoara, Romania.
    Kievit, Hendrika Adriana Linda
    Department of Medicine, Herning Central Hospital, Herning, Denmark.
    Toca, Alina
    Department of Gastroenterology, State University of Medicine and Pharmacy of the Republic of Moldova, Chisinau, Republic of Moldova.
    Turcan, Svetlana
    Department of Gastroenterology, State University of Medicine and Pharmacy of the Republic of Moldova, Chisinau, Republic of Moldova.
    Midjord, Jóngerð
    Medical Department, National Hospital of the Faroe Islands, Torshavn, Faroe Islands.
    Nielsen, Kári Rubek
    Medical Department, National Hospital of the Faroe Islands, Torshavn, Faroe Islands.
    Andersen, Karina Winther
    Medical Department, Regional Hospital of Viborg, Viborg, Denmark.
    Andersen, Vibeke
    Medical Department, Regional Hospital of Viborg, Viborg, Denmark; Focused Research Unit for Molecular Diagnostic and Clinical Research [MOK], IRS-Center Sonderjylland, Hospital of Southern Jutland, Aabenraa, Denmark; Institute of Molecular Medicine, University of Southern Denmark, Odense, Denmark.
    Misra, Ravi
    IBD Department, St Mark’s Hospital, London, UK.
    Arebi, Naila
    IBD Department, St Mark’s Hospital, London, UK.
    Oksanen, Pia
    Department of Gastroenterology and Alimentary Tract Surgery, Tampere University Hospital, Tampere, Finland; University of Tampere, Tampere, Finland.
    Collin, Pekka
    Department of Gastroenterology and Alimentary Tract Surgery, Tampere University Hospital, Tampere, Finland; University of Tampere, Tampere, Finland.
    de Castro, Luisa
    Department of Gastroenterology, Hospital Alvaro Cunqueiro, Instituto Investigación Sanitaria Galicia Sur, EOXI de Vigo, Vigo, Spain.
    Hernandez, Vicent
    Department of Gastroenterology, Hospital Alvaro Cunqueiro, Instituto Investigación Sanitaria Galicia Sur, EOXI de Vigo, Vigo, Spain.
    Langholz, Ebbe
    Department of Gastroenterology, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark.
    Munkholm, Pia
    Department of Gastroenterology, Nordsjællands Hospital, University of Copenhagen, Frederikssund, Denmark.
    Natural Disease Course of Ulcerative Colitis During the First Five Years of Follow-up in a European Population-based Inception Cohort-An Epi-IBD Study2019Inngår i: Journal of Crohn's & Colitis, ISSN 1873-9946, E-ISSN 1876-4479, Vol. 13, nr 2, s. 198-208Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background and Aims: Few population-based cohort studies have assessed the disease course of ulcerative colitis [UC] in the era of biological therapy and widespread use of immunomodulators. The aim of this study was to assess the 5-year outcome and disease course of patients with UC in the Epi-IBD cohort.

    Methods: In a prospective, population-based inception cohort of unselected patients with UC, patients were followed up from the time of their diagnosis, which included the collection of their clinical data, demographics, disease activity, medical therapy, and rates of surgery, cancers, and deaths. Associations between outcomes and multiple covariates were analysed by Cox regression analysis.

    Results: A total of 717 patients were included in the study. During follow-up, 43 [6%] patients underwent a colectomy and 163 [23%] patients were hospitalised. Of patients with limited colitis [distal to the left flexure], 90 [21%] progressed to extensive colitis. In addition, 92 [27%] patients with extensive colitis experienced a regression in disease extent, which was associated with a reduced risk of hospitalisation (hazard ratio [HR]: 0.5 95% CI: 0.3-0.8]. Overall, patients were treated similarly in both geographical regions; 80 [11%] patients needed biological therapy and 210 [29%] patients received immunomodulators. Treatment with immunomodulators was found to reduce the risk of hospitalisation [HR: 0.5 95% CI: 0.3-0.8].

    Conclusions: Although patients in this population-based cohort were treated more aggressively with immunomodulators and biological therapy than in cohorts from the previous two decades, their disease outcomes, including colectomy rates, were no different. However, treatment with immunomodulators was found to reduce the risk of hospitalisation.

  • 4.
    Burisch, Johan
    et al.
    Department of Gastroenterology, Nordsjællands Hospital, University of Copenhagen, Frederikssund, Denmark.
    Kiudelis, Gediminas
    Institute for Digestive Research, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania.
    Kupcinskas, Limas
    Institute for Digestive Research, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania; Department of Gastroenterology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania.
    Kievit, Hendrika Adriana Linda
    Department of Medicine, Herning Central Hospital, Herning, Denmark.
    Andersen, Karina Winther
    Medical Department, Regional Hospital of Viborg, Viborg, Denmark.
    Andersen, Vibeke
    Medical Department, Regional Hospital of Viborg, Viborg, Denmark; Focused research unit for Molecular Diagnostic and Clinical Research (MOK), IRS-Center Sonderjylland, Hospital of Southern Jutland, Aabenraa, Denmark.
    Salupere, Riina
    Division of Gastroenterology, Tartu University Hospital, University of Tartyu, Tartu, Estonia.
    Pedersen, Natalia
    Gastroenterology Department, Slagelse Hospital, Slagelse, Denmark.
    Kjeldsen, Jens
    Gastroenterology Department, Odense University Hospital, Odense, Denmark.
    D'Incà, Renata
    Department of Surgical, Oncological and Gastroenterological Sciences, Azienda, University of Padua, Padova, Italy.
    Valpiani, Daniela
    U.O. Gastroenterologia ed Endoscopia digestiva, Hospital Morgagni Pierantoni, Forlì, Italy.
    Schwartz, Doron
    Department of Gastroenterology and Hepatology, Soroka Medical Center, Ben Gurion University of the Negev, Beer Sheva, Israel.
    Odes, Selwyn
    Department of Gastroenterology and Hepatology, Soroka Medical Center, Ben Gurion University of the Negev, Beer Sheva, Israel.
    Olsen, Jóngerð
    Medical Department, The National Hospital of the Faroe Islands, Thorshavn, Denmark.
    Nielsen, Kári Rubek
    Medical Department, The National Hospital of the Faroe Islands, Thorshavn, Denmark.
    Vegh, Zsuzsanna
    1st Department of Medicine, Semmelweis University, Budapest, Hungary.
    Lakatos, Peter Laszlo
    1st Department of Medicine, Semmelweis University, Budapest, Hungary; Division of Gastroenterology, McGill University Health Center, Montreal, Canada.
    Toca, Alina
    Department of Gastroenterology, State University of Medicine and Pharmacy of the Republic of Moldova, Chisinau, Republic of Moldova.
    Turcan, Svetlana
    Department of Gastroenterology, State University of Medicine and Pharmacy of the Republic of Moldova, Chisinau, Republic of Moldova.
    Katsanos, Konstantinos H.
    Department of Gastroenterology, University Hospital of Ioannina, Ioannina, Greece.
    Christodoulou, Dimitrios K
    Department of Gastroenterology, University Hospital of Ioannina, Ioannina, Greece.
    Fumery, Mathurin
    Gastroenterology Unit, Epimad Registry, Centre hospitalier universitaire (CHU) Amiens Sud, Amiens University Hospital, Amiens, France.
    Gower-Rousseau, Corinne
    Public Health, Epidemiology and Economic Health, Registre Epimad, Lille Hospital, Lille University, Lille, France; Lille Inflammation Research International Center (LIRIC), Lille University, Lille, France.
    Zammit, Stefania Chetcuti
    Division of Gastroenterology, Mater Dei Hospital, Msida, Malta.
    Ellul, Pierre
    Division of Gastroenterology, Mater Dei Hospital, Msida, Malta.
    Eriksson, Carl
    Örebro universitet, Institutionen för medicinska vetenskaper. Department of Gastroenterology, Faculty of Health and Medical Sciences, Örebro University, Örebro, Sweden.
    Halfvarson, Jonas
    Örebro universitet, Institutionen för medicinska vetenskaper. Department of Gastroenterology, Faculty of Health and Medical Sciences, Örebro University, Örebro, Sweden.
    Magro, Fernando Jose
    Department of Gastroenterology, Centro Hospitalar de São João EPE, Porto, Portugal; Department of Biomedicine, Institute of Pharmacology, Faculty of Medicine, Porto University, Porto, Portugal.
    Duricova, Dana
    IBD Clinical and Research Centre (ISCARE), Prague, Czech Republic.
    Bortlik, Martin
    IBD Clinical and Research Centre (ISCARE), Prague, Czech Republic; Institute of Pharmacology, 1st Faculty of Medicine, Charles University in Prague, Prague, Czech Republic.
    Fernandez, Alberto
    Department of Gastroenterology, Hospital POVISA, Vigo, Spain.
    Hernández, Vicent
    Department of Gastroenterology, Hospital Alvaro Cunqueiro. Instituto Investigación Sanitaria Galicia Sur. EOXI de Vigo, Vigo, Spain.
    Myers, Sally
    IBD Unit, Hull and East Yorkshire NHS Trust, Hull, UK.
    Sebastian, Shaji
    IBD Unit, Hull and East Yorkshire NHS Trust, Hull, UK.
    Oksanen, Pia
    Department of Gastroenterology and Alimentary Tract Surgery, Tampere University Hospital, Tampere, Finland; University of Tampere, Tampere, Finland.
    Collin, Pekka
    University of Tampere, Tampere, Finland.
    Goldis, Adrian
    Clinic of Gastroenterology, University of Medicine 'Victor Babes', Timisoara, Romania.
    Misra, Ravi
    IBD Department, Imperial College London, London, UK.
    Arebi, Naila
    IBD Department, Imperial College London, London, UK.
    Kaimakliotis, Ioannis P.
    Nicosia private practice, Nicosia, Cyprus.
    Nikuina, Inna
    Department of Gastroenterology, Moscow Regional Research Clinical Institute, Moscow, Russian Federation.
    Belousova, Elena
    Department of Gastroenterology, Moscow Regional Research Clinical Institute, Moscow, Russian Federation.
    Brinar, Marko
    Division of Gastroenterology and Hepatology, University Hospital Center Zagreb, Zagreb, Croatia.
    Cukovic-Cavka, Silvija
    Division of Gastroenterology and Hepatology, University Hospital Center Zagreb, Zagreb, Croatia.
    Langholz, Ebbe
    Department of Gastroenterology, Herlev and Gentofte Hospital, University of Copenhagen, Herlev, Denmark.
    Munkholm, Pia
    Department of Gastroenterology, Nordsjællands Hospital, University of Copenhagen, Frederikssund, Denmark.
    Natural disease course of Crohn's disease during the first 5 years after diagnosis in a European population-based inception cohort: an Epi-IBD study2019Inngår i: Gut, ISSN 0017-5749, E-ISSN 1468-3288, Vol. 68, nr 3, s. 423-433Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    OBJECTIVE: The Epi-IBD cohort is a prospective population-based inception cohort of unselected patients with inflammatory bowel disease from 29 European centres covering a background population of almost 10 million people. The aim of this study was to assess the 5-year outcome and disease course of patients with Crohn's disease (CD).

    DESIGN: Patients were followed up prospectively from the time of diagnosis, including collection of their clinical data, demographics, disease activity, medical therapy, surgery, cancers and deaths. Associations between outcomes and multiple covariates were analysed by Cox regression analysis.

    RESULTS: In total, 488 patients were included in the study. During follow-up, 107 (22%) patients received surgery, while 176 (36%) patients were hospitalised because of CD. A total of 49 (14%) patients diagnosed with non-stricturing, non-penetrating disease progressed to either stricturing and/or penetrating disease. These rates did not differ between patients from Western and Eastern Europe. However, significant geographic differences were noted regarding treatment: more patients in Western Europe received biological therapy (33%) and immunomodulators (66%) than did those in Eastern Europe (14% and 54%, respectively, P<0.01), while more Eastern European patients received 5-aminosalicylates (90% vs 56%, P<0.05). Treatment with immunomodulators reduced the risk of surgery (HR: 0.4, 95% CI 0.2 to 0.6) and hospitalisation (HR: 0.3, 95% CI 0.2 to 0.5).

    CONCLUSION: Despite patients being treated early and frequently with immunomodulators and biological therapy in Western Europe, 5-year outcomes including surgery and phenotype progression in this cohort were comparable across Western and Eastern Europe. Differences in treatment strategies between Western and Eastern European centres did not affect the disease course. Treatment with immunomodulators reduced the risk of surgery and hospitalisation.

  • 5.
    Eriksson, Carl
    Örebro universitet, Institutionen för medicinska vetenskaper.
    Epidemiological and therapeutic aspects of Inflammatory Bowel Disease2018Doktoravhandling, med artikler (Annet vitenskapelig)
    Abstract [en]

    Introduction: The two main forms of inflammatory bowel disease (IBD) are Crohn’s disease and ulcerative colitis. These are chronic inflammatory disorders, mainly affecting the gastrointestinal tract.

    Aims: The overall aims of this thesis were to study the epidemiology of ulcerative colitis in Örebro, Sweden; to examine certain aspects of anaemia in IBD; and to determine the clinical effectiveness of medical treatments.

    Material and methods: Cohort studies with the sampling frame defined by the geographic boundaries of the primary catchment area of Örebro University Hospital (Papers I‒III), or by the entire IBD population in Sweden registered in the Swedish national quality registry for IBD (SWIBREG; paper IV), were performed to determine the epidemiology of ulcerative colitis, the incidence and prevalence of anaemia in IBD, and the clinical effectiveness of thiopurine drugs and vedolizumab in routine care.

    Results: A fivefold increase in the incidence and a tenfold increase in the prevalence of ulcerative colitis was observed in Örebro during the past 50 years. In parallel, the prognosis, in terms of risk for colectomy within 10 years from diagnosis, improved during the same time period. Earlier and more widespread use of thiopurine drugs may have contributed to the decrease in colectomies. Anaemia is common in IBD, particularly in Crohn’s disease. Vedolizumab, a new drug targeting leucocyte migration to the gut, appears to be well tolerated and effective in Swedish real-world IBD care.

    Conclusion: Ulcerative colitis is on the rise, and data from Örebro indicate that the number of IBD patients in Sweden already exceeds 70,000. Improved knowledge of long-term outcomes of medical therapy may have far-reaching implications for future IBD management.

    Delarbeid
    1. Changes in medical management and colectomy rates: a population-based cohort study on the epidemiology and natural history of ulcerative colitis in Orebro, Sweden, 1963-2010
    Åpne denne publikasjonen i ny fane eller vindu >>Changes in medical management and colectomy rates: a population-based cohort study on the epidemiology and natural history of ulcerative colitis in Orebro, Sweden, 1963-2010
    Vise andre…
    2017 (engelsk)Inngår i: Alimentary Pharmacology and Therapeutics, ISSN 0269-2813, E-ISSN 1365-2036, Vol. 46, nr 8, s. 748-757Artikkel i tidsskrift (Fagfellevurdert) Published
    Abstract [en]

    Background: Whether the epidemiology of ulcerative colitis (UC) has changed during recent decades is partly unknown.

    Aim: To depict temporal trends in the epidemiology and medical treatment of UC as well as the long-term risk of progression in disease extent and colectomy, during 1963-2010.

    Methods: Patients were identified by evaluation of all medical records in the archive of the Colitis Clinic, Orebro University Hospital. Comparisons were made between three time periods, 1963-1975, 1976-1990 and 1991-2005.

    Results: The annual age-standardised incidence increased from 3.5 to 18.5 per 100 000 during the study period (P < .01). Correspondingly, the prevalence increased from 44 to 474 per 100 000 between 1965 and 2010. A higher proportion of males than females had extensive colitis at diagnosis (odds ratio: 1.55; 95% CI 1.17-2.05; P < .01). The risk for progression in disease extent was 34.5% and 18.5% at 10 years, for patients with proctitis and left-sided colitis, respectively (P < .01). The use of 5-aminosalicylates, within 10 years, rise from 79% to 92% between 1963-1975 and 1976-1990 (P < .01). Thiopurine use increased from 7% in 1976-1990 to 34% during 1991-2005 (P < .01). The colectomy rate at 10 years was 13.5% (95% CI 11.1%-15.8%), and the risk was lower among patients diagnosed in 1991-2005 compared to 1963-1975 (adjusted hazard ratio: 0.61; 95% CI 0.39-0.94; P = .02).

    Conclusion: The incidence and prevalence of UC increased over time, and the observed prevalence in 2010 is among the highest reported. In parallel, a decrease in colectomy rates was observed during the most recent decades, potentially reflecting improved medical treatment.

    sted, utgiver, år, opplag, sider
    Hoboken, USA: John Wiley & Sons, 2017
    HSV kategori
    Identifikatorer
    urn:nbn:se:oru:diva-61349 (URN)10.1111/apt.14268 (DOI)000411717800005 ()28833287 (PubMedID)2-s2.0-85029232492 (Scopus ID)
    Merknad

    Funding Agency:

    Swedish Government's Agreement for Medical Training and Research  OLL-549221

    Tilgjengelig fra: 2017-10-09 Laget: 2017-10-09 Sist oppdatert: 2018-08-06bibliografisk kontrollert
    2. Incidence, prevalence, and clinical outcome of anaemia in inflammatory bowel disease: A population-based cohort study
    Åpne denne publikasjonen i ny fane eller vindu >>Incidence, prevalence, and clinical outcome of anaemia in inflammatory bowel disease: A population-based cohort study
    Vise andre…
    (engelsk)Manuskript (preprint) (Annet vitenskapelig)
    HSV kategori
    Identifikatorer
    urn:nbn:se:oru:diva-66679 (URN)
    Tilgjengelig fra: 2018-04-19 Laget: 2018-04-19 Sist oppdatert: 2018-04-19bibliografisk kontrollert
    3. Impact of thiopurines on the natural history and surgical outcome of ulcerative colitis: a cohort study
    Åpne denne publikasjonen i ny fane eller vindu >>Impact of thiopurines on the natural history and surgical outcome of ulcerative colitis: a cohort study
    Vise andre…
    2019 (engelsk)Inngår i: Gut, ISSN 0017-5749, E-ISSN 1468-3288, Vol. 68, nr 4, s. 623-632Artikkel i tidsskrift (Fagfellevurdert) Published
    Abstract [en]

    OBJECTIVE: Thiopurines are used as maintenance therapy in ulcerative colitis (UC), but whether these drugs influence the natural history of the disease is unknown. We aimed to assess the effect of thiopurines in terms of colectomy, hospital admission, progression in disease extent and anti-tumour necrosis factor (TNF) therapy within 10 years from initiation.

    DESIGN: Patients diagnosed with UC within the Örebro University Hospital catchment area, during 1963-2010, who initiated thiopurines (n=253) were included. To overcome the risk of confounding by indication, we compared patients who stopped treatment within 12 months because of an adverse reaction (n=76) with patients who continued therapy or discontinued due to other reasons (n=177) and assessed long-term outcomes using Cox regression with adjustment for potential confounding factors.

    RESULTS: The cumulative probability of colectomy within 10 years was 19.5% in tolerant patients compared with 29.0% in intolerant (adjusted HR 0.49; 95% CI 0.21 to 0.73). The probability of hospital admission was 34.0% in tolerant versus 56.2% in intolerant patients (adjusted HR 0.36; 95% CI 0.23 to 0.56). The risk for progression in disease extent was 20.4% in tolerant patients compared with 48.8% in intolerant (adjusted HR 0.47; 95% CI 0.21 to 1.06). Within 10 years, 16.1% of tolerant and 27.5% of intolerant patients received anti-TNF therapy (adjusted HR 0.49; 95% CI 0.26 to 0.92).

    CONCLUSION: Based on the novel approach of comparing patients tolerant and intolerant to thiopurines, we reveal that thiopurines have a profound beneficial impact of the natural history and long-term colectomy rates of UC.

    sted, utgiver, år, opplag, sider
    BMJ Publishing Group Ltd, 2019
    Emneord
    6-mercaptopurine, azathioprine, chronic ulcerative colitis, tnf-alpha
    HSV kategori
    Identifikatorer
    urn:nbn:se:oru:diva-66417 (URN)10.1136/gutjnl-2017-315521 (DOI)000471830300008 ()29618498 (PubMedID)2-s2.0-85062170737 (Scopus ID)
    Merknad

    Funding Agency:

    Swedish government's agreement on medical training and research  OLL-549221

    Tilgjengelig fra: 2018-04-09 Laget: 2018-04-09 Sist oppdatert: 2019-11-08bibliografisk kontrollert
    4. Long-term effectiveness of vedolizumab in inflammatory bowel disease: a national study based on the Swedish National Quality Registry for Inflammatory Bowel Disease (SWIBREG)
    Åpne denne publikasjonen i ny fane eller vindu >>Long-term effectiveness of vedolizumab in inflammatory bowel disease: a national study based on the Swedish National Quality Registry for Inflammatory Bowel Disease (SWIBREG)
    Vise andre…
    2017 (engelsk)Inngår i: Scandinavian Journal of Gastroenterology, ISSN 0036-5521, E-ISSN 1502-7708, Vol. 52, nr 6-7, s. 722-729Artikkel i tidsskrift (Fagfellevurdert) Published
    Abstract [en]

    Objectives: Clinical trials have demonstrated the efficacy of vedolizumab in inflammatory bowel disease (IBD). However, these findings may not reflect the clinical practice. Therefore, we aimed to describe a vedolizumab-treated patient population and assess long-term effectiveness.

    Materials and methods: Patients initiating vedolizumab between 1 June 2014 and 30 May 2015 were identified through the Swedish National Quality Registry for IBD. Prospectively collected data on treatment and disease activity were extracted. Clinical remission was defined as Patient Harvey Bradshaw index<5 in Crohn's disease (CD) and Patient Simple Clinical Colitis Activity index<3 in ulcerative colitis (UC).

    Results: Two-hundred forty-six patients (147CD, 92 UC and 7 IBD-Unclassified) were included. On study entry, 86% had failed TNF-antagonist and 48% of the CD patients had undergone1 surgical resection. After a median follow-up of 17 (IQR: 14-20) months, 142 (58%) patients remained on vedolizumab. In total, 54% of the CD- and 64% of the UC patients were in clinical remission at the end of follow-up, with the clinical activity decreasing (p<.0001 in both groups). Faecal-calprotectin decreased in CD (p<.0001) and in UC (p=.001), whereas CRP decreased in CD (p=.002) but not in UC (p=.11). Previous anti-TNF exposure (adjusted HR: 4.03; 95% CI: 0.96-16.75) and elevated CRP at baseline (adjusted HR: 2.22; 95% CI: 1.10-4.35) seemed to be associated with discontinuation because of lack of response. Female sex was associated with termination because of intolerance (adjusted HR: 2.75; 95% CI: 1.16-6.48).

    Conclusion: Vedolizumab-treated patients represent a treatment-refractory group. A long-term effect can be achieved, even beyond 1 year of treatment.

    sted, utgiver, år, opplag, sider
    Taylor & Francis, 2017
    Emneord
    Vedolizumab, clinical practice, inflammatory bowel disease, Crohn's disease, ulcerative colitis
    HSV kategori
    Identifikatorer
    urn:nbn:se:oru:diva-57787 (URN)10.1080/00365521.2017.1304987 (DOI)000399808100018 ()28362144 (PubMedID)2-s2.0-85018512957 (Scopus ID)
    Merknad

    Funding Agencies:

    Swedish Government  OLL-549221  OLL-526131  ALFSKANE-539811 

    Hedlund Foundation  

    Österlund Foundation  

    Tilgjengelig fra: 2017-05-23 Laget: 2017-05-23 Sist oppdatert: 2018-07-31bibliografisk kontrollert
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    Epidemiological and therapeutic aspects of Inflammatory Bowel Disease
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  • 6.
    Eriksson, Carl
    et al.
    Örebro universitet, Institutionen för medicinska vetenskaper.
    Bergemalm, Daniel
    Örebro universitet, Institutionen för medicinska vetenskaper.
    Vigren, L.
    Dept Med, Div Gastroenterol, Hosp Trelleborg, Trelleborg, Sweden.
    Nilsson, L.
    Dept Internal Med, Danderyd Hosp, Stockholm, Sweden.
    Visuri, Isabella
    Örebro universitet, Institutionen för medicinska vetenskaper.
    Hjortswang, H.
    Dept Gastroenterol, Linköping Univ, Linköping, Sweden; Dept Clin & Expt Med, Linköping, Sweden.
    Udumyan, Ruzan
    Örebro universitet, Institutionen för medicinska vetenskaper.
    Almer, S.
    Dept Med, Gastrocentrum, Karolinska Inst, Stockholm, Sweden.
    Seddighzadeh, M.
    Merck Sharp & Dohme Ltd, Stockholm, Sweden.
    Hertervig, E.
    Dept Gastroenterol, Skane Univ Hosp, Lund, Sweden.
    Karlen, P.
    Dept Internal Med, Danderyd Hosp, Stockholm, Sweden.
    Strid, H.
    Dept Internal Med, Södra Älvsborgs Hosp, Borås, Sweden.
    Halfvarson, Jonas
    Örebro universitet, Institutionen för medicinska vetenskaper.
    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-SWIBREG2018Inngår i: Journal of Crohn's & Colitis, ISSN 1873-9946, E-ISSN 1876-4479, Vol. 12, nr Suppl. 1, s. S409-S410Artikkel i tidsskrift (Annet vitenskapelig)
  • 7.
    Eriksson, Carl
    et al.
    Örebro universitet, Institutionen för medicinska vetenskaper. Department of Gastroenterology, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
    Cao, Yang
    Örebro universitet, Institutionen för medicinska vetenskaper. Region Örebro län. Unit of Biostatistics, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
    Rundquist, Sara
    Örebro universitet, Institutionen för medicinska vetenskaper. Department of Gastroenterology, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
    Zhulina, Yaroslava
    Region Örebro län. Örebro universitet, Institutionen för medicinska vetenskaper. Department of Gastroenterology, Örebro University Hospital, Örebro, Sweden.
    Henriksson, Ida
    Department of Gastroenterology, Örebro University Hospital, Örebro, Sweden.
    Montgomery, Scott
    Örebro universitet, Institutionen för medicinska vetenskaper. Clinical Epidemiology Unit, Department of Medicine, Karolinska Institutet, Stockholm, Sweden; Department of Epidemiology and Public Health, University College London, London, UK .
    Halfvarson, Jonas
    Örebro universitet, Institutionen för medicinska vetenskaper. Department of Gastroenterology, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
    Changes in medical management and colectomy rates: a population-based cohort study on the epidemiology and natural history of ulcerative colitis in Orebro, Sweden, 1963-20102017Inngår i: Alimentary Pharmacology and Therapeutics, ISSN 0269-2813, E-ISSN 1365-2036, Vol. 46, nr 8, s. 748-757Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: Whether the epidemiology of ulcerative colitis (UC) has changed during recent decades is partly unknown.

    Aim: To depict temporal trends in the epidemiology and medical treatment of UC as well as the long-term risk of progression in disease extent and colectomy, during 1963-2010.

    Methods: Patients were identified by evaluation of all medical records in the archive of the Colitis Clinic, Orebro University Hospital. Comparisons were made between three time periods, 1963-1975, 1976-1990 and 1991-2005.

    Results: The annual age-standardised incidence increased from 3.5 to 18.5 per 100 000 during the study period (P < .01). Correspondingly, the prevalence increased from 44 to 474 per 100 000 between 1965 and 2010. A higher proportion of males than females had extensive colitis at diagnosis (odds ratio: 1.55; 95% CI 1.17-2.05; P < .01). The risk for progression in disease extent was 34.5% and 18.5% at 10 years, for patients with proctitis and left-sided colitis, respectively (P < .01). The use of 5-aminosalicylates, within 10 years, rise from 79% to 92% between 1963-1975 and 1976-1990 (P < .01). Thiopurine use increased from 7% in 1976-1990 to 34% during 1991-2005 (P < .01). The colectomy rate at 10 years was 13.5% (95% CI 11.1%-15.8%), and the risk was lower among patients diagnosed in 1991-2005 compared to 1963-1975 (adjusted hazard ratio: 0.61; 95% CI 0.39-0.94; P = .02).

    Conclusion: The incidence and prevalence of UC increased over time, and the observed prevalence in 2010 is among the highest reported. In parallel, a decrease in colectomy rates was observed during the most recent decades, potentially reflecting improved medical treatment.

  • 8.
    Eriksson, Carl
    et al.
    Örebro universitet, Institutionen för medicinska vetenskaper. Department of Gastroenterology, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
    Cao, Yang
    Örebro universitet, Institutionen för medicinska vetenskaper. Region Örebro län. Unit of Biostatistics, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
    Rundquist, Sara
    Örebro universitet, Institutionen för medicinska vetenskaper. Department of Gastroenterology, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
    Zhulina, Yaroslava
    Örebro universitet, Institutionen för hälsovetenskaper. Region Örebro län. Department of Gastroenterology, Örebro University Hospital, Örebro, Sweden.
    Henriksson, Ida
    Department of Gastroenterology, Örebro University Hospital, Örebro, Sweden.
    Montgomery, Scott
    Örebro universitet, Institutionen för medicinska vetenskaper. Clinical Epidemiology Unit, Department of Medicine, Karolinska Institutet, Stockholm, Sweden; Department of Epidemiology and Public Health, University College London, London, UK.
    Halfvarson, Jonas
    Örebro universitet, Institutionen för medicinska vetenskaper. Department of Gastroenterology, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
    Editorial: do thiopurines and biologics decrease the risk of colectomy? Authors' reply2017Inngår i: Alimentary Pharmacology and Therapeutics, ISSN 0269-2813, E-ISSN 1365-2036, Vol. 46, nr 9, s. 897-898Artikkel i tidsskrift (Annet vitenskapelig)
  • 9.
    Eriksson, Carl
    et al.
    Dept Med, Div Gastroenterol, Örebro Univ Hosp, Örebro, Sweden.
    Gustavsson, Anders
    Örebro universitet, Hälsoakademin.
    Kronvall, Thomas
    Dept Cardiol, Örebro Univ Hosp, Örebro, Sweden.
    Tysk, Curt
    Örebro universitet, Hälsoakademin.
    Hepatotoxicity by bosentan in a patient with portopulmonary hypertension: a case-report and review of the literature2011Inngår i: Journal of Gastrointestinal and Liver Diseases, ISSN 1841-8724, E-ISSN 1842-1121, Vol. 20, nr 1, s. 77-80Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Bosentan is an endothelin receptor antagonist approved for treatment of pulmonary arterial hypertension. Mild liver reactions occur in about 10% of treated patients but severe hepatotoxicity is rare. We present clinical data and treatment outcome of a severe drug induced liver injury due to bosentan in a patient with non-cirrhotic portopulmonary hypertension. After 18 months of uncomplicated therapy with bosentan 125 mg b.i.d., the patient developed a severe mixed hepatic injury. Serum levels of bilirubin were 316 µmol/l (ref. value <20 micromol/l), AST 14 µkat/l (ref. value < 0.9 µkat/l), ALT 10 µkat/l (ref. value < 0.9 µkat/l), ALP 8 µkat/l (ref. value <1.8 µkat/l) and INR 1.8 (ref. value 0.9-1.1). Complete diagnostic work-up disclosed no other cause of hepatotoxicity. Treatment with prednisolone 40 mg/day in tapering doses was ultimately added and the patient made a full recovery. Subsequent treatment with sildenafil and ambrisentan for pulmonary arterial hypertension was well tolerated and liver function tests have remained normal during 12 months' follow-up. A review of the literature revealed three other women with severe hepatotoxicity due to bosentan. Bosentan may cause severe liver injury, even after long uneventful therapy, and current recommendations on regular monitoring of liver function tests are reinforced. Ambrisentan may be a therapeutic alternative in patients with pulmonary arterial hypertension and hepatotoxicity by bosentan.

  • 10.
    Eriksson, Carl
    et al.
    Örebro universitet, Institutionen för medicinska vetenskaper.
    Henriksson, Ida
    Department of Gastroenterology, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
    Brus, Ole
    Örebro universitet, Institutionen för medicinska vetenskaper.
    Zhulina, Yaroslava
    Örebro universitet, Institutionen för medicinska vetenskaper. Region Örebro län.
    Nyhlin, Nils
    Örebro universitet, Institutionen för medicinska vetenskaper. Region Örebro län.
    Tysk, Curt
    Department of Gastroenterology, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
    Montgomery, Scott
    Örebro universitet, Institutionen för medicinska vetenskaper. Karolinska Institutet, Stockholm, Sweden; University College London, London, United Kingdom.
    Incidence, prevalence, and clinical outcome of anaemia in inflammatory bowel disease: A population-based cohort studyManuskript (preprint) (Annet vitenskapelig)
  • 11.
    Eriksson, Carl
    et al.
    Örebro universitet, Institutionen för medicinska vetenskaper. Region Örebro län. Department of Gastroenterology.
    Henriksson, Ida
    Department of Gastroenterology, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
    Brus, Ole
    Örebro universitet, Institutionen för medicinska vetenskaper.
    Zhulina, Yaroslava
    Örebro universitet, Institutionen för medicinska vetenskaper. Region Örebro län. Department of Gastroenterology.
    Nyhlin, Nils
    Örebro universitet, Institutionen för medicinska vetenskaper. Region Örebro län. Department of Gastroenterology.
    Tysk, Curt
    Department of Gastroenterology, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
    Montgomery, Scott
    Örebro universitet, Institutionen för medicinska vetenskaper. Clinical Epidemiology Unit, Department of Medicine, Karolinska Institutet, Stockholm, Sweden; Department of Epidemiology and Public Health, University College London, London, UK.
    Halfvarson, Jonas
    Örebro universitet, Institutionen för medicinska vetenskaper. Department of Gastroenterology.
    Incidence, prevalence and clinical outcome of anaemia in inflammatory bowel disease: a population-based cohort study2018Inngår i: Alimentary Pharmacology and Therapeutics, ISSN 0269-2813, E-ISSN 1365-2036, Vol. 48, nr 6, s. 638-645Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    BACKGROUND: The incidence and short-term outcome of anaemia in inflammatory bowel disease (IBD) are largely unknown.

    AIM: To determine the incidence, prevalence and clinical outcome of anaemia in terms of resolution of anaemia within 12 months. We also planned to assess risk factors for anaemia in IBD.

    METHODS: A random sample of 342 patients was obtained from the population-based IBD cohort of Örebro University Hospital, Sweden, consisting of 1405 patients diagnosed between 1963 and 2010. Haemoglobin measurements recorded from 1 January 2011 to 31 December 2013 were extracted from the Clinical Chemistry data system.

    RESULTS: In Crohn's disease, the incidence rate of anaemia was 19.3 (95% CI: 15.4-23.7) per 100 person-years and the prevalence was 28.7% (CI: 22.0-36.2), compared with 12.9 (CI: 9.8-16.5) and 16.5% (CI: 11.2-22.9) for ulcerative colitis. Crohn's disease was associated with an increased incidence (OR = 1.60; CI: 1.02-2.51) and prevalence of anaemia (OR = 2.04; CI: 1.20-3.46) compared to ulcerative colitis. Stricturing disease phenotype in Crohn's disease (HR = 2.59; CI: 1.00-6.79) and extensive disease in ulcerative colitis (HR = 2.40; CI: 1.10-5.36) were associated with an increased risk of anaemia. Despite a higher probability of receiving specific therapy within 3 months from the diagnosis of anaemia, Crohn's disease patients had a worse outcome in terms of resolution of anaemia within 12 months (56% vs 75%; P = 0.03).

    CONCLUSIONS: Anaemia is a common manifestation of IBD even beyond the first years after the diagnosis of IBD. Crohn's disease is associated with both an increased risk and a worse outcome.

  • 12.
    Eriksson, Carl
    et al.
    Örebro universitet, Institutionen för medicinska vetenskaper. Region Örebro län. Department of Gastroenterology, Faculty of Medicine and Health, Örebro university, Örebro, Sweden.
    Marsal, Jan
    Immunology Section, Lund University, Lund, Sweden; Department of Gastroenterology, Skåne University Hospital, Lund, Sweden.
    Bergemalm, Daniel
    Örebro universitet, Institutionen för medicinska vetenskaper. Region Örebro län. Department of Gastroenterology, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
    Vigren, Lina
    Department of Internal Medicine, Ystad Hospital, Ystad, Sweden.
    Björk, Jan
    Department of Medicine, Center for Digestive Diseases, Karolinska University Hospital, Karolinska Institutet Solna, Stockholm, Sweden.
    Eberhardson, Michael
    Department of Medicine, Center for Digestive Diseases, Karolinska University Hospital, Karolinska Institutet Solna, Stockholm, Sweden.
    Karling, Pontus
    Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden.
    Söderman, Charlotte
    Department of Internal Medicine, St Göran Hospital, Stockholm, Sweden.
    Myrelid, Pär
    Department of Clinical and Experimental Medicine, Linköping University and Department of Surgery, Linköping University Hospital, Linköping, Sweden.
    Cao, Yang
    Örebro universitet, Institutionen för medicinska vetenskaper. Region Örebro län. Department of Clinical Epidemiology and Biostatistics, School of Medical Sciences, Örebro University, Örebro, Sweden; Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
    Sjöberg, Daniel
    Center for Clinical Research Dalarna, Uppsala University, Falun, Sweden.
    Thörn, Mari
    Department of Medical Sciences, Section of Gastroenterology and Hepatology, Uppsala University, Uppsala, Sweden.
    Karlén, Per
    Department of Internal Medicine, Danderyd Hospital, Stockholm, Sweden.
    Hertervig, Erik
    Department of Gastroenterology, Skåne University Hospital, Lund, Sweden.
    Strid, Hans
    Department of Internal Medicine, Södra Älvsborgs Sjukhus, Borås, Sweden.
    Ludvigsson, Jonas F.
    Örebro universitet, Institutionen för medicinska vetenskaper. Region Örebro län. Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; Department of Pediatrics, Örebro University Hospital, Örebro, Sweden.
    Almer, Sven
    Department of Medicine, Center for Digestive Diseases, Karolinska University Hospital, Karolinska Institutet Solna, Stockholm, Sweden.
    Halfvarson, Jonas
    Örebro universitet, Institutionen för medicinska vetenskaper. Region Örebro län. Department of Gastroenterology, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
    Long-term effectiveness of vedolizumab in inflammatory bowel disease: a national study based on the Swedish National Quality Registry for Inflammatory Bowel Disease (SWIBREG)2017Inngår i: Scandinavian Journal of Gastroenterology, ISSN 0036-5521, E-ISSN 1502-7708, Vol. 52, nr 6-7, s. 722-729Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objectives: Clinical trials have demonstrated the efficacy of vedolizumab in inflammatory bowel disease (IBD). However, these findings may not reflect the clinical practice. Therefore, we aimed to describe a vedolizumab-treated patient population and assess long-term effectiveness.

    Materials and methods: Patients initiating vedolizumab between 1 June 2014 and 30 May 2015 were identified through the Swedish National Quality Registry for IBD. Prospectively collected data on treatment and disease activity were extracted. Clinical remission was defined as Patient Harvey Bradshaw index<5 in Crohn's disease (CD) and Patient Simple Clinical Colitis Activity index<3 in ulcerative colitis (UC).

    Results: Two-hundred forty-six patients (147CD, 92 UC and 7 IBD-Unclassified) were included. On study entry, 86% had failed TNF-antagonist and 48% of the CD patients had undergone1 surgical resection. After a median follow-up of 17 (IQR: 14-20) months, 142 (58%) patients remained on vedolizumab. In total, 54% of the CD- and 64% of the UC patients were in clinical remission at the end of follow-up, with the clinical activity decreasing (p<.0001 in both groups). Faecal-calprotectin decreased in CD (p<.0001) and in UC (p=.001), whereas CRP decreased in CD (p=.002) but not in UC (p=.11). Previous anti-TNF exposure (adjusted HR: 4.03; 95% CI: 0.96-16.75) and elevated CRP at baseline (adjusted HR: 2.22; 95% CI: 1.10-4.35) seemed to be associated with discontinuation because of lack of response. Female sex was associated with termination because of intolerance (adjusted HR: 2.75; 95% CI: 1.16-6.48).

    Conclusion: Vedolizumab-treated patients represent a treatment-refractory group. A long-term effect can be achieved, even beyond 1 year of treatment.

  • 13.
    Eriksson, Carl
    et al.
    Örebro universitet, Institutionen för medicinska vetenskaper. Department of Gastroenterology, Faculty of Health and Medical Sciences, Örebro University, Örebro, Sweden.
    Rundquist, Sara
    Örebro universitet, Institutionen för medicinska vetenskaper. Department of Gastroenterology, Faculty of Health and Medical Sciences, Örebro University, Örebro, Sweden.
    Cao, Yang
    Örebro universitet, Institutionen för medicinska vetenskaper. Region Örebro län. Unit of Biostatistics, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
    Montgomery, Scott
    Örebro universitet, Institutionen för medicinska vetenskaper. Clinical Epidemiology Unit, Department of Medicine, Karolinska Institutet, Stockholm, Sweden; Department of Epidemiology and Public Health, University College London, London, UK.
    Halfvarson, Jonas
    Örebro universitet, Institutionen för medicinska vetenskaper. Department of Gastroenterology, Faculty of Health and Medical Sciences, Örebro University, Örebro, Sweden.
    Impact of thiopurines on the natural history and surgical outcome of ulcerative colitis: a cohort study2019Inngår i: Gut, ISSN 0017-5749, E-ISSN 1468-3288, Vol. 68, nr 4, s. 623-632Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    OBJECTIVE: Thiopurines are used as maintenance therapy in ulcerative colitis (UC), but whether these drugs influence the natural history of the disease is unknown. We aimed to assess the effect of thiopurines in terms of colectomy, hospital admission, progression in disease extent and anti-tumour necrosis factor (TNF) therapy within 10 years from initiation.

    DESIGN: Patients diagnosed with UC within the Örebro University Hospital catchment area, during 1963-2010, who initiated thiopurines (n=253) were included. To overcome the risk of confounding by indication, we compared patients who stopped treatment within 12 months because of an adverse reaction (n=76) with patients who continued therapy or discontinued due to other reasons (n=177) and assessed long-term outcomes using Cox regression with adjustment for potential confounding factors.

    RESULTS: The cumulative probability of colectomy within 10 years was 19.5% in tolerant patients compared with 29.0% in intolerant (adjusted HR 0.49; 95% CI 0.21 to 0.73). The probability of hospital admission was 34.0% in tolerant versus 56.2% in intolerant patients (adjusted HR 0.36; 95% CI 0.23 to 0.56). The risk for progression in disease extent was 20.4% in tolerant patients compared with 48.8% in intolerant (adjusted HR 0.47; 95% CI 0.21 to 1.06). Within 10 years, 16.1% of tolerant and 27.5% of intolerant patients received anti-TNF therapy (adjusted HR 0.49; 95% CI 0.26 to 0.92).

    CONCLUSION: Based on the novel approach of comparing patients tolerant and intolerant to thiopurines, we reveal that thiopurines have a profound beneficial impact of the natural history and long-term colectomy rates of UC.

  • 14.
    Eriksson, Carl
    et al.
    Örebro universitet, Institutionen för medicinska vetenskaper.
    Rundquist, Sara
    Örebro universitet, Institutionen för medicinska vetenskaper.
    Cao, Yang
    Örebro universitet, Institutionen för medicinska vetenskaper. Region Örebro län.
    Montgomery, Scott
    Örebro universitet, Institutionen för medicinska vetenskaper.
    Halfvarson, Jonas
    Örebro universitet, Institutionen för medicinska vetenskaper.
    The impact of thiopurine drugs on the natural history and surgical outcome of ulcerative colitis: A cohort study2018Inngår i: Journal of Crohn's & Colitis, ISSN 1873-9946, E-ISSN 1876-4479, Vol. 12, nr Suppl. 1, s. S481-S481Artikkel i tidsskrift (Annet vitenskapelig)
  • 15.
    Eriksson, Carl
    et al.
    Örebro universitet, Institutionen för medicinska vetenskaper. Department of Gastroenterology, Örebro University Hospital, Örebro, Sweden.
    Rundquist, Sara
    Örebro universitet, Institutionen för medicinska vetenskaper.
    Lykiardopoulos, B.
    Department of Gastroenterology, Linköping University, Linköping, Sweden.
    Karlén, P.
    Department of Internal Medicine, Danderyd Hospital, Stockholm, Sweden.
    Grip, O.
    Department of Gastroenterology, Skåne University Hospital, Malmö, Sweden.
    Söderman, C.
    Department of Internal Medicine, St Göran Hospital, Stockholm, Sweden.
    Almer, S.
    Department of Medicine, Center for Digestive Diseases, Karolinska University Hospital, Karolinska Institute, Stockholm, Sweden.
    Hertervig, E.
    Department of Gastroenterology, Skåne University Hospital, Lund, Sweden.
    Gunnarsson, J.
    Department of Internal Medicine, Kungsbacka Hospital, Kungsbacka, Sweden.
    Delin, J.
    Department of Gastroenterology, Ersta hospital, Stockholm, Sweden.
    Strid, H.
    Department of Internal Medicine, Södra Älvsborgs Sjukhus, Borås, Sweden.
    Sjöberg, M.
    Department of Internal Medicine, Skaraborgs Hospital, Lidköping, Sweden.
    Öberg, D.
    Department of Internal Medicine, Sunderby Hospital, Sunderbyn, Sweden.
    Hjortswang, H.
    Department of Gastroenterology, Linköping University, Linköping, Sweden.
    Halfvarson, Jonas
    Örebro universitet, Institutionen för medicinska vetenskaper. Region Örebro län.
    A Swedish observational study (SVEAH) on vedolizumab assessing effectiveness and healthcare resource utilization in patients with inflammatory bowel disease2017Inngår i: Journal of Crohn's & Colitis, ISSN 1873-9946, E-ISSN 1876-4479, Vol. 11, nr Suppl. 1, s. S262-S263Artikkel i tidsskrift (Fagfellevurdert)
  • 16.
    Eriksson, Carl
    et al.
    Örebro universitet, Institutionen för medicinska vetenskaper.
    Rundquist, Sara
    Örebro universitet, Institutionen för medicinska vetenskaper.
    Lykiardopoulos, V.
    Dept Gastroenterol, Linköping Univ, Linköping, Sweden.
    Karlen, P.
    Dept Internal Med, Danderyd Hosp, Stockholm, Sweden.
    Grip, O.
    Dept Gastroenterol, Skane Univ Hosp, Malmö, Sweden.
    Söderman, C.
    Dept Internal Med, St Goran Hosp, Stockholm, Sweden.
    Almer, S.
    Dept Med, Karolinska Inst, Stockholm, Sweden.
    Hertervig, E.
    Dept Gastroenterol, Skåne Univ Hosp, Lund, Sweden.
    Gunnarsson, J.
    Dept Internal Med, Kungsbacka Hosp, Kungsbacka, Sweden.
    Malmgren, C.
    Takeda Pharma AB, Solna, Sweden.
    Delin, J.
    Dept Gastroenterol, Ersta Hosp, Stockholm, Sweden.
    Strid, H.
    Dept Internal Med, Södra Älvsborgs Hosp, Borås, Sweden.
    Sjöberg, M.
    Dept Internal Med, Skaraborgs Hosp, Lidköping, Sweden.
    Öberg, D.
    Dept Internal Med, Sunderby Hosp, Sunderbyn, Sweden.
    Bergemalm, Daniel
    Örebro universitet, Institutionen för medicinska vetenskaper.
    Udumyan, Ruzan
    Örebro universitet, Institutionen för medicinska vetenskaper.
    Hjortswang, H.
    Dept Gastroenterol, Linköping Univ, Linöping, Sweden.
    Halfvarson, Jonas
    Örebro universitet, Institutionen för medicinska vetenskaper.
    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)2018Inngår i: Journal of Crohn's & Colitis, ISSN 1873-9946, E-ISSN 1876-4479, Vol. 12, nr Suppl. 1, s. S494-S495Artikkel i tidsskrift (Annet vitenskapelig)
  • 17.
    Eriksson, Carl
    et al.
    Örebro universitet, Institutionen för medicinska vetenskaper.
    Rundquist, Sara
    Örebro universitet, Institutionen för medicinska vetenskaper.
    Lykiardopoulos, V.
    Dept Gastroenterol, Linköping Univ, Linköping, Sweden.
    Karlen, P.
    Dept Internal Med, Danderyd Hosp, Stockholm, Sweden.
    Grip, O.
    Dept Gastroenterol, Skåne Univ Hosp, Malmö, Sweden.
    Söderman, C.
    Dept Internal Med, St Göran Hosp, Stockholm, Sweden.
    Almer, S.
    Dept Med, Karolinska Inst, Stockholm, Sweden.
    Hertervig, E.
    Dept Gastroenterol, Skåne Univ Hosp, Lund, Sweden.
    Gunnarsson, J.
    Dept Internal Med, Kungsbacka Hosp, Kungsbacka, Sweden.
    Malmgren, C.
    Takeda Pharma AB, Solna, Sweden.
    Delin, J.
    Dept Gastroenterol, Ersta Hosp, Stockholm, Sweden.
    Strid, H.
    Dept Internal Med, Södra Älvsborgs Hosp, Borås, Sweden.
    Sjöberg, M.
    Dept Internal Med, Skaraborgs Hosp, Lidköping, Sweden.
    Öberg, D.
    Dept Internal Med, Sunderby Hosp, Sunderbyn, Sweden.
    Bergemalm, Daniel
    Örebro universitet, Institutionen för medicinska vetenskaper.
    Udumyan, Ruzan
    Örebro universitet, Institutionen för medicinska vetenskaper.
    Hjortswang, H.
    Dept Gastroenterol, Linköping Univ, Linköping, Sweden.
    Halfvarson, Jonas
    Örebro universitet, Institutionen för medicinska vetenskaper.
    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)2018Inngår i: Journal of Crohn's & Colitis, ISSN 1873-9946, E-ISSN 1876-4479, Vol. 12, nr Suppl. 1, s. S382-S383Artikkel i tidsskrift (Annet vitenskapelig)
  • 18.
    Eriksson, Carl
    et al.
    Örebro universitet, Institutionen för medicinska vetenskaper. Region Örebro län. Department of Gastroenterology.
    Rundquist, Sara
    Örebro universitet, Institutionen för medicinska vetenskaper. Department of Gastroenterology.
    Lykiardopoulos, V.
    Department of Gastroenterology, Linköping University, Linköping, Sweden.
    Udumyan, Ruzan
    Örebro universitet, Institutionen för medicinska vetenskaper. Clinical Epidemiology and Biostatistics.
    Karlén, P.
    Department of Internal Medicine, Danderyd Hospital, Stockholm, Sweden.
    Grip, O.
    Department of Gastroenterology, Skåne University Hospital, Malmö, Sweden.
    Söderman, C.
    Department of Internal Medicine, St Göran Hospital, Stockholm, Sweden.
    Almer, S.
    BD-Unit-Gastroenterology, Karolinska University Hospital, Stockholm, Sweden.
    Hertervig, E.
    Department of Gastroenterology, Skåne University Hospital, Lund, Sweden.
    Gunnarsson, J.
    Department of Internal Medicine, Kungälv Hospital, Kungälv, Sweden.
    Malmgren, C.
    Takeda Pharma AB, Takeda, Stockholm, Sweden.
    Delin, J.
    Department of Gastroenterology, Ersta Hospital, Stockholm, Sweden.
    Strid, H.
    Department of Internal Medicine, Södra Älvsborgs Hospital, Borås, Sweden.
    Sjöberg, M.
    Department of Internal Medicine, Skaraborgs Hospital, Lidköping, Sweden.
    Öberg, D.
    Department of Internal Medicine, Sunderby Hospital, Sunderbyn, Sweden.
    Bergemalm, Daniel
    Örebro universitet, Institutionen för medicinska vetenskaper. Örebro universitet, Institutionen för hälsovetenskaper. Department of Gastroenterology.
    Hjortswang, H.
    Department of Gastroenterology, Linköping University, Linköping, Sweden.
    Halfvarson, Jonas
    Örebro universitet, Institutionen för medicinska vetenskaper. Department of Gastroenterology.
    Real-world effectiveness of vedolizumab in ulcerative colitis: Week 52 results from the Swedish multi-centre, prospective, observational SVEAH UC study2020Inngår i: Journal of Crohn's & Colitis, ISSN 1873-9946, E-ISSN 1876-4479, Vol. 14, nr Suppl. 1, s. S576-S577Artikkel i tidsskrift (Annet vitenskapelig)
  • 19.
    Moens, A.
    et al.
    University Hospitals Leuven, Department of Gastroenterology and Hepatology, Leuven, Belgium; Catholic University Leuven, Chronic Diseases, Metabolism and Ageing, Leuven, Belgium.
    van der Woude, C.
    Erasmus MC, Department of Gastroenterology and Hepatology, Rotterdam, The Netherlands.
    Julsgaard, M.
    Aarhus University Hospital, Department of Gastroenterology and Hepatology, Aarhus, Denmark.
    Sebastian, S.
    Hull and East Yorkshire NHS Trust, IBD Unit, Hull, UK; University of Hull and York, Hull York Medical School, Hull, UK.
    Arebi, N.
    St. Marks Hospital, Department of Gastroenterology, London, UK.
    Alzinaty, M.
    St. Marks Hospital, Department of Gastroenterology, London, UK.
    Humblet, E.
    Ziekenhuis Oost-Limburg – Campus Sint-Jan, Department of Gastroenterology, Genk, Belgium.
    Kok, K. B.
    Barts Health NHS Trust, Department of Gastroenterology, London, UK.
    Sheridan, J.
    St. Vincent’s University Hospital, Department of Gastroenterology, Dublin, Ireland.
    De Saint-Joseph, C. Gilletta
    Hop Rangueil, Dept Gastroenterol, Toulouse, France..
    Nancey, S.
    CHU Lyon, Department of Gastroenterology and Hepatology, Lyon, France.
    Rahier, J. -F
    CHU UCL Namur, Université catholique de Louvain, Deparment of Gastroenterology, Yvoir, Belgium.
    Bossuyt, P.
    Imeldaziekenhuis, Department of Gastroenterology, Bonheiden, Belgium.
    Cremer, A.
    Hôpital Erasme, Université Libre de Bruxelles, Department of Gastroenterology, Brussels, Belgium.
    Dewit, S.
    Mariaziekenhuis Noord-Limburg, Department of Gastroenterology, Overpelt, Belgium.
    Eriksson, Carl
    Örebro universitet, Institutionen för medicinska vetenskaper. Region Örebro län. Department of Gastroenterology.
    Hoentjen, F.
    Radboud UMC, Department of Gastroenterology, Nijmegen, The Netherlands.
    Krause, T.
    Opernstrasse, Department of Gastroenterology, Kassel, Germany.
    Louis, E.
    CHU Liège, Department of Gastroenterology, Liège, Belgium.
    Macken, E.
    Universiteit ziekenhuis Antwerpen, Department of Gastroenterology, Antwerpen, Belgium.
    Milenkovic, Z.
    Military Medical Academy Belgrade, Department of Gastroenterology, Belgrade, Serbia.
    Nijs, J.
    Sint-Trudo Ziekenhuis, Department of Gastroenterology, St-Truiden, Belgium.
    Posen, A.
    AZ Vesalius, Department of Gastroenterology, Tongeren, Belgium.
    Van Hootegem, A.
    AZ Klina, Department of Gastroenterology, Brasschaat, Belgium.
    Van Moerkercke, W.
    AZ Groeninge, Department of Gastroenterology, Kortrijk, Belgium.
    Vermeire, S.
    University Hospitals Leuven, Department of Gastroenterology and Hepatology, Leuven, Belgium; Catholic University Leuven, Chronic Diseases, Metabolism and Ageing, Leuven, Belgium.
    Shitrit, A. Bar-Gil
    Shaare Zedek Medical Center, Hebrew University Jerusalem, Digestive diseases institute, Jerusalem, Israel.
    Ferrante, M.
    University Hospitals Leuven, Department of Gastroenterology and Hepatology, Leuven, Belgium; Catholic University Leuven, Chronic Diseases, Metabolism and Ageing, Leuven, Belgium.
    Pregnancy outcomes in IBD patients treated with vedolizumab, anti-TNF, or conventional therapy2019Inngår i: Journal of Crohn's & Colitis, ISSN 1873-9946, E-ISSN 1876-4479, Vol. 13, nr Suppl. 1, s. S41-S42Artikkel i tidsskrift (Annet vitenskapelig)
  • 20.
    Moens, Annick
    et al.
    Department of Gastroenterology and Hepatology, University Hospitals Leuven, Leuven, Belgium; Department of Chronic Diseases, Metabolism and Ageing, Ku Leuven, Leuven, Belgium.
    van der Woude, C. Janneke
    Erasmus MC, Rotterdam, Netherlands.
    Julsgaard, Mette
    Aarhus University Hospital, Aarhus, Denmark.
    Humblet, Evelien
    Ziekenhuis Oost‐Limburg ‐ Campus Sint‐Jan, Genk, Belgium.
    Sheridan, Juliette
    St. Vincent's University Hospital, Dublin, Ireland.
    Baumgart, Daniel C.
    University of Alberta, Edmonton AB, Canada.
    De Saint-Joseph, Cyrielle Gilletta
    Hôpital Rangueil, Toulouse, France.
    Nancey, Stéphane
    CHU Lyon, Lyon, France.
    Rahier, Jean-Francois
    CHU UCL Namur, Université catholique de Louvain, Yvoir, Belgium.
    Bossuyt, Peter
    Imeldaziekenhuis, Bonheiden, Belgium.
    Cremer, Anneline
    Erasme Hospital, Université Libre de Bruxelles, Brussels, Belgium.
    Dewit, Sophie
    Mariaziekenhuis Noord-Limburg, Overpelt, Belgium.
    Eriksson, Carl
    Örebro universitet, Institutionen för medicinska vetenskaper. Region Örebro län.
    Hoentjen, Frank
    Radboud University Medical Center, Nijmegen, The Netherland.
    Krause, Thomas
    Opernstrasse, Kassel, Germany.
    Louis, Edouard
    CHU Liege, Liege, Belgium.
    Macken, Elisabeth
    Universiteit zieken‐huis Antwerpen UZA, Belgium.
    Milenkovic, Zoran
    Military Medical Academy Belgrade, Belgrade, Serbia.
    Nijs, Jochen
    Sint‐Trudo Ziekenhuis, Sint‐Truiden, Belgium.
    Posen, Annelies
    AZ Vesalius, Tongeren, Belgium.
    Van Hootegem, Anneleen
    AZ Klina, Brasschaat, Belgium.
    Van Moerkercke, Wouter
    AZ Groeninge, Kortrijk, Belgium.
    Vermeire, Severine
    Department of Gastroenterology and Hepatology, University Hospitals Leuven, Leuven, Belgium; Department of Chronic Diseases, Metabolism and Ageing, Ku Leuven, Leuven, Belgium.
    Shitrit, Ariella Bar-Gil
    Shaare Zedek Medical Center, Hebrew University Jerusalem, Jerusalem, Israel.
    Ferrante, Marc
    Department of Gastroenterology and Hepatology, University Hospitals Leuven, Leuven, Belgium; Department of Chronic Diseases, Metabolism and Ageing, Ku Leuven, Leuven, Belgium.
    Pregnancy outcomes in inflammatory bowel disease patients treated with vedolizumab, anti-TNF or conventional therapy: results of the European CONCEIVE study2020Inngår i: Alimentary Pharmacology and Therapeutics, ISSN 0269-2813, E-ISSN 1365-2036, Vol. 51, nr 1, s. 129-138Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: Women with inflammatory bowel diseases (IBD) often receive biologicals during pregnancy to maintain disease remission. Data on outcome of vedolizumab-exposed pregnancies (VDZE) are sparse.

    Aims: The aim was to assess pregnancy and child outcomes of VDZE pregnancies and to compare these results to anti-TNF exposed (TNFE) or both immunomodulatory and biologic unexposed (CON IBD) pregnancies.

    Methods: A retrospective multicentre case-control observational study was performed.

    Results: VDZE group included 79 pregnancies in 73 IBD women. The TNFE and CON IBD group included 186 pregnancies (162 live births) in 164 IBD women and 184 pregnancies (163 live births) in 155 IBD women, respectively. At conception, cases more often had active disease ([VDZE: 36% vs TNFE: 17%, P = .002] and [VDZE: 36% vs CON IBD: 24%, P = .063]). No significant difference in miscarriage rates were found between groups (VDZE and TNFE: 16% vs 13%, P = .567; VDZE and CON IBD: 16% vs 10%, P = .216). In live-born infants, median gestational age and birthweight were similar between groups. Median Apgar score at birth was numerically equal. Prematurity was similar in the VDZE group compared to the control groups, even when correcting for disease activity during pregnancy. The frequency of congenital anomalies was comparable between groups as were the percentages of breastfed babies. During the first year of life, no malignancies were reported and infants' infection risk did not significantly differ between groups.

    Conclusion: No new safety signal was detected in VDZE pregnancies although larger, prospective studies are required for confirmation.

  • 21.
    Phillips, F.
    et al.
    NIHR Nottingham Digestive Diseases Biomedical Research Centre, Gastroenterology, Nottingham, UK.
    Verstockt, B.
    KU Leuven, Chronic Diseases- Metabolism and Ageing- TARGID-IBD Unit, Leuven, Belgium; University Hospitals Leuven, Gastroenterology and Hepatology, Leuven, Belgium.
    Sladek, M.
    Jagiellonian University Medical College, Department of Paediatrics- Gastroenterology and Nutrition, Krakow, Poland.
    de Boer, N.
    Amsterdam UMC-VU University Medical Center, Department of Gastroenterology and Hepatology- AG&M Research Institute, Amsterdam, The Netherlands.
    Katsanos, K.
    University of Ioannina School of Health Sciences, Division of Gastroenterology- Department of Internal Medicine-Faculty of Medicine, Ioannina, Greece.
    Karmiris, K.
    Venizeleio General Hospital, Department of Gastroenterology, Heraklion, Greece.
    Albshesh, A.
    Sheba Medical Center-Tel Hashomer, Department of Gastroenterology, Tel Hashomer, Israel; Tel-Aviv University, Sackler School of Medicine, Tel-Aviv, Israel.
    Eriksson, Carl
    Örebro universitet, Institutionen för medicinska vetenskaper. Region Örebro län. Department of Gastroenterology.
    Bergemalm, Daniel
    Örebro universitet, Institutionen för medicinska vetenskaper. Örebro universitet, Institutionen för hälsovetenskaper. Department of Gastroenterology.
    Molner, T.
    University of Szeged, First Department of Medicine, Szeged, Hungary.
    Ellul, P.
    Mater Dei Hospital, Department of Medicine- Division of Gastroenterology, Msida, Malta.
    Orofacial granulomatosis in Crohn's disease: an ECCO CONFER multi-centre case series2020Inngår i: Journal of Crohn's & Colitis, ISSN 1873-9946, E-ISSN 1876-4479, Vol. 14, nr Suppl. 1, s. S209-S210Artikkel i tidsskrift (Annet vitenskapelig)
  • 22.
    Rundquist, Sara
    et al.
    Örebro universitet, Institutionen för medicinska vetenskaper.
    Eriksson, Carl
    Örebro universitet, Institutionen för medicinska vetenskaper.
    Nilsson, Linda
    Department of Internal Medicine, Danderyd Hospital, Stockholm, Sweden.
    Angelison, Leif
    Department of Internal Medicine, Helsingborg Hospital, Helsingborg, Sweden.
    Jäghult, Susanna
    Stockholm Gastro Center, Karolinska Institutet, Danderyd Hospital, Stockholm, Sweden.
    Björk, Jan
    Department of Medicine, Center for Digestive Diseases, Karolinska University Hospital, Stockholm, Sweden.
    Grip, Olof
    Department of Gastroenterology, Skåne University Hospital Malmö, Malmö, Sweden.
    Hjortswang, Henrik
    Department of Gastroenterology, Linköping University, Linköping, Sweden.
    Strid, Hans
    Department of Internal Medicine, Södra Älvsborgs Sjukhus, Borås, Sweden.
    Karlén, Per
    Department of Internal Medicine, Danderyd Hospital, Stockholm, Sweden.
    Montgomery, Scott
    Örebro universitet, Institutionen för medicinska vetenskaper. Region Örebro län. Clinical Epidemiology Unit, Department of Medicine, Karolinska Institutet, Stockholm, Sweden; Department of Epidemiology and Public Health, University College London, London, UK.
    Halfvarson, Jonas
    Örebro universitet, Institutionen för medicinska vetenskaper.
    Clinical effectiveness of golimumab in Crohn´s disease – an observational study based on the Swedish National Quality Registry for Inflammatory Bowel Disease (SWIBREG)2018Konferansepaper (Annet vitenskapelig)
  • 23.
    Rundquist, Sara
    et al.
    Örebro universitet, Institutionen för medicinska vetenskaper. Department of Gastroenterology.
    Eriksson, Carl
    Örebro universitet, Institutionen för medicinska vetenskaper. Region Örebro län. Department of Gastroenterology.
    Nilsson, Linda
    Department of Internal Medicine, Danderyd Hospital, Stockholm, Sweden.
    Angelison, Leif
    Department of Internal Medicine, Helsingborg Hospital, Helsingborg, Sweden.
    Jäghult, Susanna
    Stockholm Gastro Center, Karolinska Institutet, Danderyd Hospital, Stockholm, Sweden.
    Björk, Jan
    Department of Medicine, Center for Digestive Diseases, Karolinska University Hospital, Stockholm, Sweden.
    Grip, Olof
    Department of Gastroenterology, Skåne University Hospital Malmö, Malmö, Sweden.
    Hjortswang, Henrik
    Department of Gastroenterology, Linköping University, Linköping, Sweden.
    Strid, Hans
    Department of Internal Medicine, Södra Älvsborgs Sjukhus, Borås, Sweden.
    Karlén, Per
    Department of Internal Medicine, Danderyd Hospital, Stockholm, Sweden.
    Montgomery, Scott
    Örebro universitet, Institutionen för medicinska vetenskaper. Clinical Epidemiology Unit, Department of Medicine, Karolinska Institutet, Stockholm, Sweden; Department of Epidemiology and Public Health, University College London, London, UK.
    Halfvarson, Jonas
    Örebro universitet, Institutionen för medicinska vetenskaper. Department of Gastroenterology.
    Clinical effectiveness of golimumab in Crohn's disease: an observational study based on the Swedish National Quality Registry for Inflammatory Bowel Disease (SWIBREG)2018Inngår i: Scandinavian Journal of Gastroenterology, ISSN 0036-5521, E-ISSN 1502-7708, Vol. 53, nr 10-11, s. 1257-1263Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    OBJECTIVE: The effectiveness of golimumab in Crohn's disease (CD) is largely unknown as it is not approved for the treatment of the disease. We aimed to identify the population of CD patients treated with golimumab in Sweden, to assess the effectiveness of golimumab (defined as the drug retention rate), and to identify predictors of drug discontinuation.

    METHODS: Patients with CD who received at least one injection of golimumab were identified through the Swedish National Quality Registry for Inflammatory Bowel Disease, which includes prospectively collected clinical information. Cox regression models were used to identify predictors of golimumab discontinuation.

    RESULTS: The study cohort involved 94 patients of whom the majority (96.8%) had previously discontinued at least one anti-tumour necrosis factor (anti-TNF) agent. The drug retention rate at 12 weeks was 85.1%. Predictors of golimumab discontinuation at 12 weeks were previous surgery (adjusted HR = 7.52, 95% CI: 1.12-50.36), concomitant corticosteroid use at baseline (adjusted HR = 5.70, 95% CI: 1.13-28.68) and female sex (adjusted HR = 6.59; 95% CI: 1.04-41.62). The median duration of follow-up was 89 (IQR: 32-158) weeks. The drug retention at the most recent follow-up was 35.1%. Predictors of golimumab discontinuation at the most recent follow-up were corticosteroid use at baseline (adjusted HR = 2.60, 95% CI: 1.17-5.79) and female sex (adjusted HR = 2.24; 95% CI: 1.19-4.23).

    CONCLUSION: Patients with CD treated with golimumab were a treatment-refractory group. Despite this, more than one-third of the patients appeared to have had clinical benefit after a median follow-up of more than 1.5 years.

  • 24.
    Rundquist, Sara
    et al.
    Örebro universitet, Institutionen för medicinska vetenskaper. Department of Gastroenterology.
    Sachs, M.
    Clinical Epidemiology Division, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden.
    Eriksson, Carl
    Örebro universitet, Institutionen för medicinska vetenskaper. Region Örebro län. Department of Gastroenterology.
    Olén, O.
    Clinical Epidemiology Division, Department of Medicine Solna, Department of Clinical Science and Education Södersjukhuset, Karolinska Institutet, Stockholm, Sweden.
    Montgomery, Scott
    Örebro universitet, Institutionen för medicinska vetenskaper. Department of Clinical Epidemiology and Biostatistics.
    Halfvarson, Jonas
    Örebro universitet, Institutionen för medicinska vetenskaper. Department of Gastroenterology.
    Effectiveness of anti-TNF vs. vedolizumab as a second biologic in IBD: results from national Swedish registers2020Inngår i: Journal of Crohn's & Colitis, ISSN 1873-9946, E-ISSN 1876-4479, Vol. 14, nr Suppl. 1, s. S317-S318Artikkel i tidsskrift (Annet vitenskapelig)
  • 25.
    Shrestha, Sarita
    et al.
    Örebro universitet, Institutionen för medicinska vetenskaper.
    Olén, Ola
    Department of Clinical Science and Education, Karolinska Institutet, Stockholm, Sweden; Clinical Epidemiology Division, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden; Department of Pediatric Gastroenterology and Nutrition, Sachs' Children and Youth Hospital, Stockholm, Sweden.
    Eriksson, Carl
    Örebro universitet, Institutionen för medicinska vetenskaper. Region Örebro län. Clinical Epidemiology Division, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden; Department of Gastroenterology, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
    Everhov, Åsa H.
    Department of Clinical Science and Education, Karolinska Institutet, Stockholm, Sweden; Clinical Epidemiology Division, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden.
    Myrelid, Pär
    Division of Surgery, Department of Clinical and Experimental Medicine, Faulty of Health Sciences, Linköping University; Department of Surgery, County Council of Östergötland Linköping, Linköping, Sweden.
    Visuri, Isabella
    Örebro universitet, Institutionen för medicinska vetenskaper.
    Ludvigsson, Jonas F.
    Örebro universitet, Institutionen för medicinska vetenskaper. Region Örebro län. Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; Department of Pediatrics, Örebro University Hospital, Örebro University, Örebro, Sweden; Division of Epidemiology and Public Health, School of Medicine, University of Nottingham, Nottingham, UK; Department of Medicine, Celiac Disease Center, Columbia University College of Physicians and Surgeons, New York, NY, USA.
    Schoultz, Ida
    Örebro universitet, Institutionen för medicinska vetenskaper.
    Montgomery, Scott
    Örebro universitet, Institutionen för medicinska vetenskaper. Clinical Epidemiology Division, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden; Department of Epidemiology and Public Health, University College London, London, UK.
    Sachs, Michael C.
    Clinical Epidemiology Division, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden.
    Halfvarson, Jonas
    Örebro universitet, Institutionen för medicinska vetenskaper. Department of Gastroenterology.
    Olsson, Malin
    Department of Surgery, County Council of Östergötland, Linköping, Sweden.
    Hjortswang, Henrik
    Department of Gastroenterology and Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden.
    Bengtsson, Jonas
    Department of Surgery, Sahlgrenska University Hospital/Östra, Gothenburg, Sweden.
    Strid, Hans
    Department of Internal Medicine, Södra Älvsborgs Hospital, Borås, Sweden.
    Andersson, Marie
    Department of Internal Medicine, Södra Älvsborgs Hospital, Borås, Sweden.
    Jäghult, Susanna
    Stockholm Gastro Center, Karolinska Institutet, Stockholm, Sweden.
    Eberhardson, Michael
    Department of Medicine, Karolinska Institutet, Stockholm, Sweden.
    Nordenvall, Caroline
    Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden; Department of Colorectal Cancer, Karolinska University Hospital, Stockholm, Sweden.
    Björk, Jan
    Unit of Internal Medicine, Institute Medicine Solna, Karolinska Institutet, Stockholm, Sweden; Unit of Biostatistics, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
    Fagerberg, Ulrika L.
    Center for Clinical Research, Västmanland Hospital, Västerås, Sweden and Uppsala University, Uppsala, Sweden; Department of Pediatrics, Västmanland Hospital, Västerås, Sweden; Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.
    Rejler, Martin
    Department of Medicine, Region Jönköping County Council, Jönköping, Sweden; Jönköping Academy for Improvement of Health and Welfare, Jönköping University, Jönköping, Sweden.
    Grip, Olof
    Department of Gastroenterology, Skåne University Hospital, Malmö, Sweden.
    Karling, Pontus
    Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden.
    Block, Mattias
    Department of Surgery, Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, SSORG - Scandinavian Surgical Outcomes Research Group, Sahlgrenska University Hospital/Östra, Gothenburg, Sweden.
    Angenete, Eva
    Department of Surgery, SSORG - Scandinavian Surgical Outcomes Research Group, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Department of Surgery, Region Västra Götaland, Sahlgrenska University Hospital/Östra, Gothenburg, Sweden.
    Hellström, Per M.
    Department of Gastroenterology, Skåne University Hospital, Malmö, Sweden.
    Gustavsson, Anders
    Department of Internal Medicine, Central Hospital, Karlstad, Sweden; Department of Medical Sciences, Uppsala University, Uppsala, Sweden.
    The use of ICD codes to identify IBD subtypes and phenotypes of the Montreal classification in the Swedish National Patient Register2020Inngår i: Scandinavian Journal of Gastroenterology, ISSN 0036-5521, E-ISSN 1502-7708, Vol. 55, nr 4, s. 430-435Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Introduction: Whether data on International Classification of Diseases (ICD)-codes from the Swedish National Patient Register (NPR) correctly correspond to subtypes of inflammatory bowel disease (IBD) and phenotypes of the Montreal classification scheme among patients with prevalent disease is unknown.

    Materials and methods: We obtained information on IBD subtypes and phenotypes from the medical records of 1403 patients with known IBD who underwent biological treatment at ten Swedish hospitals and retrieved information on their IBD-associated diagnostic codes from the NPR. We used previously described algorithms to define IBD subtypes and phenotypes. Finally, we compared these register-generated subtypes and phenotypes with the corresponding information from the medical records and calculated positive predictive values (PPV) with 95% confidence intervals.

    Results: Among patients with clinically confirmed disease and diagnostic listings of IBD in the NPR (N = 1401), the PPV was 97 (96-99)% for Crohn's disease, 98 (97-100)% for ulcerative colitis, and 8 (4-11)% for IBD-unclassified. The overall accuracy for age at diagnosis was 95% (when defined as A1, A2, or A3). Examining the validity of codes representing disease phenotype, the PPV was 36 (32-40)% for colonic Crohn's disease (L2), 61 (56-65)% for non-stricturing/non-penetrating Crohn's disease behaviour (B1) and 83 (78-87)% for perianal disease. Correspondingly, the PPV was 80 (71-89)% for proctitis (E1)/left-sided colitis (E2) in ulcerative colitis.

    Conclusions: Among people with known IBD, the NPR is a reliable source of data to classify most subtypes of prevalent IBD, even though misclassification commonly occurred in Crohn's disease location and behaviour and also among IBD-unclassified patients.

  • 26.
    Visuri, Isabella
    et al.
    Örebro universitet, Institutionen för medicinska vetenskaper. Department of Gastroenterology.
    Eriksson, Carl
    Örebro universitet, Institutionen för medicinska vetenskaper. Region Örebro län. Department of Gastroenterology.
    Mårdberg, E.
    Örebro University, Department of Gastroenterology, Faculty of Medicine and Health, Örebro, Sweden.
    Grip, O.
    Skåne University Hospital, Department of Gastroenterology, Malmö, Sweden.
    Gustavsson, A.
    Central Hospital, Department of Internal Medicine, Karlstad, Sweden.
    Hjortswang, H.
    Linköping University, Department of Clinical and Experimental Medicine, Linköping, Sweden; Linköping University, Department of Gastroenterology, Linköping, Sweden.
    Karling, P.
    Umeå University, Department of Public Health and Clinical Medicine, Umeå, Sweden.
    Montgomery, Scott
    Örebro universitet, Institutionen för medicinska vetenskaper. Region Örebro län. University College London, Department of Epidemiology and Public Health, London, UK; Karolinska Institutet, Clinical Epidemiology Unit, Department of Medicine Solna, Stockholm, Sweden.
    Myrelid, P.
    Linköping University, Department of Clinical and Experimental Medicine, Linköping, Sweden; Linköping University Hospital, Department of Surgery, Linköping, Sweden.
    Olén, O.
    Karolinska Institutet, Clinical Epidemiology Unit, Department of Medicine Solna, Stockholm, Sweden; Stockholm South General Hospital, Sachs’ Children and Youth Hospital, Stockholm, Sweden; Karolinska Institutet, Department of Clinical Science and Education Södersjukhuset, Stockholm, Sweden .
    Ludvigsson, Jonas F.
    Örebro universitet, Institutionen för medicinska vetenskaper. Region Örebro län. Karolinska Institutet, Department of Medical Epidemiology and Biostatistics, Stockholm, Sweden; Örebro University Hospital, Department of Pediatrics, Örebro, Sweden.
    Halfvarson, Jonas
    Örebro universitet, Institutionen för medicinska vetenskaper. Department of Gastroenterology.
    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)2019Inngår i: Journal of Crohn's & Colitis, ISSN 1873-9946, E-ISSN 1876-4479, Vol. 13, nr Suppl. 1, s. S443-S444Artikkel i tidsskrift (Annet vitenskapelig)
  • 27.
    Wildeman, Peter
    et al.
    Örebro universitet, Institutionen för medicinska vetenskaper. Department of Orthopedics.
    Tevell, Staffan
    Örebro universitet, Institutionen för medicinska vetenskaper. Department of Infectious Diseases, Karlstad, and Centre for Clinical Research, Region Värmland, Karlstad, Sweden.
    Eriksson, Carl
    Örebro universitet, Institutionen för medicinska vetenskaper. Region Örebro län.
    Campillay Lagos, Amaya
    Department of Laboratory Medicine, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
    Söderquist, Bo
    Örebro universitet, Institutionen för medicinska vetenskaper. Department of Laboratory Medicine.
    Stenmark, Bianca
    Örebro universitet, Institutionen för medicinska vetenskaper. Region Örebro län. Department of Laboratory Medicine.
    Genomic characterization and outcome of prosthetic joint infections caused by Staphylococcus aureusManuskript (preprint) (Annet vitenskapelig)
  • 28.
    Wildeman, Peter
    et al.
    Örebro universitet, Institutionen för medicinska vetenskaper. Department of Orthopedics.
    Tevell, Staffan
    Örebro universitet, Institutionen för medicinska vetenskaper. Department of Infectious Diseases, Karlstad, and Centre for Clinical Research, Region Värmland, Karlstad, Sweden..
    Eriksson, Carl
    Örebro universitet, Institutionen för medicinska vetenskaper. Region Örebro län.
    Lagos, Amaya Campillay
    Department of Laboratory Medicine, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
    Söderquist, Bo
    Örebro universitet, Institutionen för medicinska vetenskaper. Department of Laboratory Medicine.
    Stenmark, Bianca
    Örebro universitet, Institutionen för medicinska vetenskaper.
    Genomic characterization and outcome of prosthetic joint infections caused by Staphylococcus aureus2020Inngår i: Scientific Reports, ISSN 2045-2322, E-ISSN 2045-2322, Vol. 10, nr 1, artikkel-id 5938Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Staphylococcus aureus is a commensal colonizing the skin and mucous membranes. It can also act as a pathogen, and is the most common microorganism isolated from prosthetic joint infections (PJIs). The aim of this study was to explore the genomic relatedness between commensal and PJI S. aureus strains as well as microbial traits and host-related risk factors for treatment failure. Whole-genome sequencing (WGS) was performed on S. aureus isolates obtained from PJIs (n = 100) and control isolates from nares (n = 101). Corresponding clinical data for the PJI patients were extracted from medical records. No PJI-specific clusters were found in the WGS phylogeny, and the distribution of the various clonal complexes and prevalence of virulence genes among isolates from PJIs and nares was almost equal. Isolates from patients with treatment success and failure were genetically very similar, while the presence of an antibiotic-resistant phenotype and the use of non-biofilm-active antimicrobial treatment were both associated with failure.In conclusion, commensal and PJI isolates of S. aureus in arthroplasty patients were genetically indistinguishable, suggesting that commensal S. aureus clones are capable of causing PJIs. Furthermore, no association between genetic traits and outcome could be demonstrated, stressing the importance of patient-related factors in the treatment of S. aureus PJIs.

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