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Predictors of drug ...
Predictors of drug survival : A cohort study comparing anti-tumour necrosis factor agents using the Swedish inflammatory bowel disease quality register
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- Visuri, Isabella, 1991- (författare)
- Örebro universitet,Institutionen för medicinska vetenskaper,Department of Gastroenterology,Örebro Univ, Sweden
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- Eriksson, Carl, 1981- (författare)
- Örebro universitet,Institutionen för medicinska vetenskaper,Region Örebro län,Department of Gastroenterology,Örebro Univ, Sweden; Karolinska Inst, Sweden
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- Olén, Ola (författare)
- Karolinska Institutet
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- Cao, Yang, Associate Professor, 1972- (författare)
- Örebro universitet,Institutionen för medicinska vetenskaper,Region Örebro län,Clinical Epidemiology and Biostatistics,Örebro Univ, Sweden
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- Mårdberg, Emelie (författare)
- Department of Gastroenterology, Faculty of Medicine and Health, Örebro University, Örebro, Sweden; Department of Internal Medicine, Falu hospital, Falun, Sweden,Örebro Univ, Sweden; Falun Cent Hosp, Sweden
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- Grip, Olof (författare)
- Department of Gastroenterology, Skåne University Hospital, Malmö, Sweden,Skåne Univ Hosp, Sweden
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- Gustavsson, Anders (författare)
- Department of Internal Medicine, Central Hospital, Karlstad, Sweden,Cent Hosp Karlstad, Sweden
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- Hjortswang, Henrik, 1966- (författare)
- Linköpings universitet,Avdelningen för diagnostik och specialistmedicin,Medicinska fakulteten,Region Östergötland, Mag- tarmmedicinska kliniken
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- Karling, Pontus (författare)
- Umeå universitet,Avdelningen för medicin,Umeå Univ, Sweden
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- Montgomery, Scott, 1961- (författare)
- Karolinska Institutet,Örebro universitet,Institutionen för medicinska vetenskaper,Clinical Epidemiology Division, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden; Clinical Epidemiology and Biostatistics, School of Medical Sciences, Örebro University, Örebro, Sweden,Karolinska Inst, Sweden; Örebro Univ, Sweden
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- Myrelid, Pär, 1970- (författare)
- Linköpings universitet,Avdelningen för kirurgi, ortopedi och onkologi,Medicinska fakulteten,Region Östergötland, Kirurgiska kliniken US
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- Ludvigsson, Jonas F., 1969- (författare)
- Karolinska Institutet,Örebro universitet,Institutionen för medicinska vetenskaper,Region Örebro län,Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; Department of Paediatrics, Örebro University Hospital, Örebro, Sweden,Karolinska Inst, Sweden; Örebro Univ Hosp, Sweden
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- Halfvarson, Jonas, 1970- (författare)
- Örebro universitet,Institutionen för medicinska vetenskaper,Department of Gastroenterology,Örebro Univ, Sweden
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(creator_code:org_t)
- 2021-07-19
- 2021
- Engelska.
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Ingår i: Alimentary Pharmacology and Therapeutics. - : Blackwell Science Ltd.. - 0269-2813 .- 1365-2036. ; 54:7, s. 931-943
- Relaterad länk:
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https://doi.org/10.1...
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https://onlinelibrar...
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https://umu.diva-por... (primary) (Raw object)
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https://liu.diva-por... (primary) (Raw object)
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https://urn.kb.se/re...
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https://doi.org/10.1...
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https://urn.kb.se/re...
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https://urn.kb.se/re...
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http://kipublication...
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Abstract
Ämnesord
Stäng
- Background: Whether long-term effectiveness differs between anti-tumour necrosis factor (anti-TNF) agents is unknown.Aims: To examine drug survival of first-line anti-TNF agents and identify predictors of discontinuation. To reduce channelling bias, we also compared drug survival of the second anti-TNF.Methods: Biologic-naive patients (N = 955) recorded in the Swedish IBD Quality Register (SWIBREG) were examined. We used propensity score matching, comparing drug survival over up to three years of follow-up. Cox regression estimated adjusted hazard ratios (aHRs) with 95% confidence intervals (CIs).Results: In Crohn's disease, discontinuation because of lack/loss of response was 32% [95%CI = 26%-38%] for infliximab versus 16% [95%CI = 11%-21%] for adalimumab. Infliximab [vs adalimumab; aHR = 1.96; 95%CI = 1.20-3.21] and colonic disease (L2) [vs no L2; aHR = 2.17; 95% CI = 1.26-3.75] were associated with higher discontinuation rates, whereas normalised CRP at three months [aHR = 0.40; 95% CI = 0.19-0.81] with a lower rate. Consistently, patients who switched from adalimumab to infliximab (vs infliximab to adalimumab) had earlier discontinuation (P = 0.04). Concomitant use of immunomodulators was associated with a lower adverse drug reaction-mediated discontinuation rate [aHR = 0.46; 95% CI = 0.28-0.77], in part explained by fewer infusion reactions [aHR = 0.27; 95% CI = 0.08-0.89]. In ulcerative colitis, the probability of discontinuation because of lack/loss of response was 40% [95% CI = 33%-47%] for infliximab versus 37% [95% CI = 21%-53%] for adalimumab. Disease duration >= 10 years [aHR = 0.25; 95% CI = 0.10-0.58] and normalised CRP after three months [aHR = 0.39; 95% CI = 0.18-0.84] were associated with lower discontinuation rates.Conclusions: Clinical characterisation of patients may aid decision-making on anti-TNF treatment. The consistently shorter drug survival for infliximab (vs adalimumab) in Crohn's disease, suggests a potential difference between the two drugs.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Gastroenterologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Gastroenterology and Hepatology (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Medicinska och farmaceutiska grundvetenskaper -- Farmakologi och toxikologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Basic Medicine -- Pharmacology and Toxicology (hsv//eng)
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Visuri, Isabella ...
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Eriksson, Carl, ...
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Olén, Ola
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Cao, Yang, Assoc ...
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Mårdberg, Emelie
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Grip, Olof
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Gustavsson, Ande ...
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Hjortswang, Henr ...
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Karling, Pontus
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Montgomery, Scot ...
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Myrelid, Pär, 19 ...
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Ludvigsson, Jona ...
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Halfvarson, Jona ...
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- Om ämnet
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- MEDICIN OCH HÄLSOVETENSKAP
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MEDICIN OCH HÄLS ...
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och Klinisk medicin
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och Gastroenterologi
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- MEDICIN OCH HÄLSOVETENSKAP
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MEDICIN OCH HÄLS ...
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och Medicinska och f ...
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och Farmakologi och ...
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Alimentary Pharm ...
- Av lärosätet
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Örebro universitet
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Umeå universitet
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Linköpings universitet
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Karolinska Institutet