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Intet resumé

Is the decline of the increasing incidence of non-Hodgkin lymphoma in Sweden and other countries a result of cancer preventive measures?

Is the decline of the increasing incidence of non-Hodgkin lymphoma (NHL) in Sweden and other countries a result of cancer preventive measures? The yearly age-standardized incidence of NHL increased significantly in Sweden during 1971-1990, for men an average of 3.2% and for women 3.1%. The corresponding figures for 1991-2000 were -0.8% and -0.2%, respectively. A decline of the increasing incidence has also been seen in other countries, such as the United States, Finland, and Denmark. Immunosuppression is one established risk factor for NHL, possibly with interaction with Epstein-Barr virus. Phenoxyacetic acids and chlorophenols, both pesticides, have been associated with NHL. Use of these chemicals was banned in Sweden in 1977 and 1978, respectively. Also, persistent organic pollutants such as polychlorinated biphenyls, hexachlorobenzene, chlordanes, and dioxins have been shown to increase the risk. Exposure of the whole population occurs predominantly through the food chain. Exposure to such chemicals was highest in the 1960s and 1970s. Because of regulation in the 1970s, exposure has declined substantially in the population. The change in incidence of NHL in Sweden and other countries may serve as a good example of how prohibition and limitation of exposure may be reflected in cancer statistics some decades later

Astrometric radial velocities III. Hipparcos measurements of nearby star clusters and associations

Radial motions of stars in nearby moving clusters are determined from accurate proper motions and trigonometric parallaxes, without any use of spectroscopy. Assuming that cluster members share the same velocity vector (apart from a random dispersion), we apply a maximum-likelihood method on astrometric data from Hipparcos to compute radial and space velocities (and their dispersions) in the Ursa Major, Hyades, Coma Berenices, Pleiades, and Praesepe clusters, and for the alpha Persei, Scorpius-Centaurus, and `HIP 98321' associations. The radial motion of the Hyades cluster is determined to within 0.47 km/s (standard error), and that of its individual stars to within 0.6 km/s. For other clusters, Hipparcos data yield astrometric radial velocities with typical accuracies of a few km/s. A comparison of these astrometric values with spectroscopic radial velocities in the literature shows a good general agreement and, in the case of the best-determined Hyades cluster, also permits searches for subtle astrophysical differences, such as evidence for enhanced convective blueshifts of F-dwarf spectra, and decreased gravitational redshifts in giants. Similar comparisons for the Scorpius OB2 complex indicate some expansion of its associations, albeit slower than expected from their ages. As a by-product from the radial-velocity solutions, kinematically improved parallaxes for individual stars are obtained, enabling Hertzsprung-Russell diagrams with unprecedented accuracy in luminosity. For the Hyades (parallax accuracy 0.3 mas), its main sequence resembles a thin line, possibly with wiggles in it.Comment: 18 pages, 7 figures, accepted for publication in A&

Opportunities and challenges for real-world studies on chronic inflammatory joint diseases through data enrichment and collaboration between national registers : the Nordic example

RMD Open 2018;4:e000655. doi:10.1136/ rmdopen-2018-000655Peer reviewe

Treatment retention of infliximab and etanercept originators versus their corresponding biosimilars : Nordic collaborative observational study of 2334 biologics naive patients with spondyloarthritis

Objective Although clinical trials support equivalence of originator products and biosimilars for etanercept and infliximab, real-world studies among biologics-naive patients with spondyloarthritis (SpA) are lacking. The objectives were to compare treatment retention in biologics-naive patients with SpA starting either the originator product or a biosimilar of infliximab and etanercept, and to explore the baseline characteristics of these patients. Methods Patients with SpA (ankylosing spondylitis/non-radiographical axial SpA/undifferentiated SpA), starting infliximab or etanercept as their first-ever biological disease-modifying antirheumatic drug during January 2014-June 2017 were identified in five Nordic biologics-rheumatology registers. Baseline characteristics were retrieved from each registry; comorbidity data were identified through linkage to national health registers. Country-specific data were pooled, and data on infliximab and etanercept were analysed separately. Comparisons of treatment retention between originators and biosimilars were assessed through survival probability curves, retention rates (2 years for infliximab/1 year for etanercept) and Hazard Ratios (HR). Results We included 1319 patients starting infliximab (24% originator/76% biosimilar), and 1015 patients starting etanercept (49% originator/51% biosimilar). Baseline characteristics were largely similar for the patients treated with the originators compared with the corresponding biosimilars. Survival probability curves were highly similar for the originator and its biosimilar, as were retention rates: infliximab 2-year retention originator, 44% (95% CI 38% to 50%)/biosimilar, 46% (95% CI: 42% to 51%); and etanercept 1-year retention originator, 66% (95% CI 61% to 70%)/biosimilar, 73% (95% CI 68% to 78%). HRs were not statistically significant. Conclusion This observational study of biologics-naive patients with SpA from five Nordic countries showed similar baseline characteristics and very similar retention rates in patients treated with originators versus biosimilars, for both infliximab and etanercept, indicating comparable effectiveness in clinical practice.Peer reviewe

Impact of discordance between patient's and evaluator's global assessment on treatment outcomes in 14 868 patients with spondyloarthritis

Funding: This work was supported by Novartis. Novartis had no influence on the data collection, statistical analyses, manuscript preparation or decision to submit.Peer reviewedPostprintPostprintPostprintPostprin