Clinical aspects of biological treatment in inflammatory bowel disease

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Karlqvist, Sara,1992-Örebro universitet,Institutionen för medicinska vetenskaper (författare)

Clinical aspects of biological treatment in inflammatory bowel disease

BokEngelska2024

Förlag, utgivningsår, omfång ...

Örebro :Örebro University,2024
108 s.
printrdacarrier

Nummerbeteckningar

LIBRIS-ID:oai:DiVA.org:oru-111283
ISBN:9789175295527
ISBN:9789175295534
https://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-111283URI

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Språk:engelska
Sammanfattning på:engelska

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Serie

Örebro Studies in Medicine,1652-4063 ;290

Anmärkningar

Inflammatory bowel disease (IBD) including its main subtypes, Crohn’s disease and ulcerative colitis, is a chronic and recurrent inflammatory condition that affects the entire gastrointestinal system. Biological treatment has revolutionized the therapeutic armamentarium in the past two decades. The growing number of therapeutic options advocates for head-to-head comparisons, evaluation in clinical practice and assessment of safety. Therefore, this thesis aims to evaluate different facets of biological treatment in real-world cohorts.In Paper I, we examined the potential effectiveness of golimumab in Crohn’s disease using data from The Swedish National Quality Register for Inflammatory Bowel Disease (SWIBREG). The findings indicate a drug retention rate of 35% after a median follow-up of 89 (IQR: 32–158) weeks. Paper II constituted a prospective, multicentre, observational cohort study investigating the effectiveness of vedolizumab and its impact on quality of life in a Swedish clinical setting. The percentage of patients in clinical remission after 52 weeks was 41% for Crohn's disease and 47% for ulcerative colitis. Improvements in biochemical markers and health-related quality of life measures were observed at 12 and 52 weeks in both subtypes of IBD. In Paper III, second-line biological treatments were compared in propensity score-matched cohorts based on combined data from multiple high-quality Swedish nationwide registers. The effectiveness and safety of secondline anti-TNF and vedolizumab were similar at 12 months in Crohn’s disease (n=198) and ulcerative colitis (n=202). Based on propensity score-matched data from nationwide health registers, Paper IV showed that vedolizumab was associated with higher hazard ratios of serious infections than anti-TNF in Crohn’s disease but not in ulcerative colitis.To conclude, this thesis suggests that golimumab might have a role in treating Crohn’s disease. It also increased knowledge about the real-world effectiveness of vedolizumab. Lastly, the thesis underscored aspects of efficacy and safety when contrasting vedolizumab with anti-TNF.

Ämnesord och genrebeteckningar

MEDICIN OCH HÄLSOVETENSKAP Klinisk medicin Allmänmedicin hsv//swe
MEDICAL AND HEALTH SCIENCES Clinical Medicine General Practice hsv//eng
ulcerative colitis
Crohn’s disease
anti-TNF
vedolizumab
comparative effectiveness
serious infections
inflammatory bowel disease
clinical aspects
register-based studies

Biuppslag (personer, institutioner, konferenser, titlar ...)

Halfvarson, Jonas,professor,1970-Örebro universitet,Institutionen för medicinska vetenskaper(Swepub:oru)jshn (preses)
Eriksson, Carl,PhD,1981-Örebro universitet,Institutionen för medicinska vetenskaper(Swepub:oru)clen (preses)
Montgomery, Scott,professor,1961-Örebro universitet,Institutionen för medicinska vetenskaper(Swepub:oru)smy (preses)
Sachs, Michael,PhDDepartment of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; Section of Biostatistics, Department of Public Health, University of Copenhagen, Denmark (preses)
Kirchgesner, Julien,docentDepartment of Gastroenterology, Hôpital Saint-Antoine, Institut Pierre Louis d'Epidémiologie et de Santé Publique, INSERM, Assistance Publique-Hôpitaux de Paris, Sorbonne Université, Paris, France (opponent)
Örebro universitetInstitutionen för medicinska vetenskaper (creator_code:org_t)

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