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  • 1.
    Eriksson, Carl
    et al.
    Örebro University, School of Medical Sciences. Department of Gastroenterology, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
    Cao, Yang
    Örebro University, School of Medical Sciences. Örebro University Hospital. Unit of Biostatistics, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
    Rundquist, Sara
    Örebro University, School of Medical Sciences. Department of Gastroenterology, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
    Zhulina, Yaroslava
    Örebro University Hospital. Örebro University, School of Medical Sciences. Department of Gastroenterology, Örebro University Hospital, Örebro, Sweden.
    Henriksson, Ida
    Department of Gastroenterology, Örebro University Hospital, Örebro, Sweden.
    Montgomery, Scott
    Örebro University, School of Medical Sciences. Clinical Epidemiology Unit, Department of Medicine, Karolinska Institutet, Stockholm, Sweden; Department of Epidemiology and Public Health, University College London, London, UK .
    Halfvarson, Jonas
    Örebro University, School of Medical Sciences. 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, 1963-20102017In: Alimentary Pharmacology and Therapeutics, ISSN 0269-2813, E-ISSN 1365-2036, Vol. 46, no 8, p. 748-757Article in journal (Refereed)
    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.

  • 2.
    Eriksson, Carl
    et al.
    Örebro University, School of Medical Sciences. Department of Gastroenterology, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
    Cao, Yang
    Örebro University, School of Medical Sciences. Örebro University Hospital. Unit of Biostatistics, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
    Rundquist, Sara
    Örebro University, School of Medical Sciences. Department of Gastroenterology, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
    Zhulina, Yaroslava
    Örebro University, School of Health Sciences. Örebro University Hospital. Department of Gastroenterology, Örebro University Hospital, Örebro, Sweden.
    Henriksson, Ida
    Department of Gastroenterology, Örebro University Hospital, Örebro, Sweden.
    Montgomery, Scott
    Örebro University, School of Medical Sciences. Clinical Epidemiology Unit, Department of Medicine, Karolinska Institutet, Stockholm, Sweden; Department of Epidemiology and Public Health, University College London, London, UK.
    Halfvarson, Jonas
    Örebro University, School of Medical Sciences. Department of Gastroenterology, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
    Editorial: do thiopurines and biologics decrease the risk of colectomy? Authors' reply2017In: Alimentary Pharmacology and Therapeutics, ISSN 0269-2813, E-ISSN 1365-2036, Vol. 46, no 9, p. 897-898Article in journal (Other academic)
  • 3.
    Eriksson, Carl
    et al.
    Örebro University, School of Medical Sciences. Department of Gastroenterology, Faculty of Health and Medical Sciences, Örebro University, Örebro, Sweden.
    Rundquist, Sara
    Örebro University, School of Medical Sciences. Department of Gastroenterology, Faculty of Health and Medical Sciences, Örebro University, Örebro, Sweden.
    Cao, Yang
    Örebro University, School of Medical Sciences. Örebro University Hospital. Unit of Biostatistics, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
    Montgomery, Scott
    Örebro University, School of Medical Sciences. Clinical Epidemiology Unit, Department of Medicine, Karolinska Institutet, Stockholm, Sweden; Department of Epidemiology and Public Health, University College London, London, UK.
    Halfvarson, Jonas
    Örebro University, School of Medical Sciences. 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 study2019In: Gut, ISSN 0017-5749, E-ISSN 1468-3288, Vol. 68, no 4, p. 623-632Article in journal (Refereed)
    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.

  • 4.
    Eriksson, Carl
    et al.
    Örebro University, School of Medical Sciences.
    Rundquist, Sara
    Örebro University, School of Medical Sciences.
    Cao, Yang
    Örebro University, School of Medical Sciences. Örebro University Hospital.
    Montgomery, Scott
    Örebro University, School of Medical Sciences.
    Halfvarson, Jonas
    Örebro University, School of Medical Sciences.
    The impact of thiopurine drugs on the natural history and surgical outcome of ulcerative colitis: A cohort study2018In: Journal of Crohn's & Colitis, ISSN 1873-9946, E-ISSN 1876-4479, Vol. 12, no Suppl. 1, p. S481-S481Article in journal (Other academic)
  • 5.
    Eriksson, Carl
    et al.
    Örebro University, School of Medical Sciences. Department of Gastroenterology, Örebro University Hospital, Örebro, Sweden.
    Rundquist, Sara
    Örebro University, School of Medical Sciences.
    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 University, School of Medical Sciences. Örebro University Hospital.
    A Swedish observational study (SVEAH) on vedolizumab assessing effectiveness and healthcare resource utilization in patients with inflammatory bowel disease2017In: Journal of Crohn's & Colitis, ISSN 1873-9946, E-ISSN 1876-4479, Vol. 11, no Suppl. 1, p. S262-S263Article in journal (Refereed)
  • 6.
    Eriksson, Carl
    et al.
    Örebro University, School of Medical Sciences.
    Rundquist, Sara
    Örebro University, School of Medical Sciences.
    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 University, School of Medical Sciences.
    Udumyan, Ruzan
    Örebro University, School of Medical Sciences.
    Hjortswang, H.
    Dept Gastroenterol, Linköping Univ, Linöping, Sweden.
    Halfvarson, Jonas
    Örebro University, School of Medical Sciences.
    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)2018In: Journal of Crohn's & Colitis, ISSN 1873-9946, E-ISSN 1876-4479, Vol. 12, no Suppl. 1, p. S494-S495Article in journal (Other academic)
  • 7.
    Eriksson, Carl
    et al.
    Örebro University, School of Medical Sciences.
    Rundquist, Sara
    Örebro University, School of Medical Sciences.
    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 University, School of Medical Sciences.
    Udumyan, Ruzan
    Örebro University, School of Medical Sciences.
    Hjortswang, H.
    Dept Gastroenterol, Linköping Univ, Linköping, Sweden.
    Halfvarson, Jonas
    Örebro University, School of Medical Sciences.
    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)2018In: Journal of Crohn's & Colitis, ISSN 1873-9946, E-ISSN 1876-4479, Vol. 12, no Suppl. 1, p. S382-S383Article in journal (Other academic)
  • 8.
    Eriksson, Carl
    et al.
    Örebro University, School of Medical Sciences. Örebro University Hospital. Department of Gastroenterology.
    Rundquist, Sara
    Örebro University, School of Medical Sciences. Department of Gastroenterology.
    Lykiardopoulos, V.
    Department of Gastroenterology, Linköping University, Linköping, Sweden.
    Udumyan, Ruzan
    Örebro University, School of Medical Sciences. 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 University, School of Medical Sciences. Örebro University, School of Health Sciences. Department of Gastroenterology.
    Hjortswang, H.
    Department of Gastroenterology, Linköping University, Linköping, Sweden.
    Halfvarson, Jonas
    Örebro University, School of Medical Sciences. Department of Gastroenterology.
    Real-world effectiveness of vedolizumab in ulcerative colitis: Week 52 results from the Swedish multi-centre, prospective, observational SVEAH UC study2020In: Journal of Crohn's & Colitis, ISSN 1873-9946, E-ISSN 1876-4479, Vol. 14, no Suppl. 1, p. S576-S577Article in journal (Other academic)
  • 9.
    Rundquist, Sara
    et al.
    Örebro University, School of Medical Sciences.
    Eriksson, Carl
    Örebro University, School of Medical Sciences.
    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 University, School of Medical Sciences. Örebro University Hospital. Clinical Epidemiology Unit, Department of Medicine, Karolinska Institutet, Stockholm, Sweden; Department of Epidemiology and Public Health, University College London, London, UK.
    Halfvarson, Jonas
    Örebro University, School of Medical Sciences.
    Clinical effectiveness of golimumab in Crohn´s disease – an observational study based on the Swedish National Quality Registry for Inflammatory Bowel Disease (SWIBREG)2018Conference paper (Other academic)
  • 10.
    Rundquist, Sara
    et al.
    Örebro University, School of Medical Sciences. Department of Gastroenterology.
    Eriksson, Carl
    Örebro University, School of Medical Sciences. Örebro University Hospital. 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 University, School of Medical Sciences. Clinical Epidemiology Unit, Department of Medicine, Karolinska Institutet, Stockholm, Sweden; Department of Epidemiology and Public Health, University College London, London, UK.
    Halfvarson, Jonas
    Örebro University, School of Medical Sciences. 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)2018In: Scandinavian Journal of Gastroenterology, ISSN 0036-5521, E-ISSN 1502-7708, Vol. 53, no 10-11, p. 1257-1263Article in journal (Refereed)
    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.

  • 11.
    Rundquist, Sara
    et al.
    Örebro University, School of Medical Sciences. Department of Gastroenterology.
    Sachs, M.
    Clinical Epidemiology Division, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden.
    Eriksson, Carl
    Örebro University, School of Medical Sciences. Örebro University Hospital. 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 University, School of Medical Sciences. Department of Clinical Epidemiology and Biostatistics.
    Halfvarson, Jonas
    Örebro University, School of Medical Sciences. Department of Gastroenterology.
    Effectiveness of anti-TNF vs. vedolizumab as a second biologic in IBD: results from national Swedish registers2020In: Journal of Crohn's & Colitis, ISSN 1873-9946, E-ISSN 1876-4479, Vol. 14, no Suppl. 1, p. S317-S318Article in journal (Other academic)
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