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BACKGROUND: There are conflicting data on the risk of acute coronary syndrome (ACS) in patients with inflammatory bowel disease (IBD). Only a few previous reports include patients diagnosed during the last decade. AIM: To assess and compare the risk of ACS between patients with IBD and the general population. METHODS: In this cohort study, we used nationwide registers to identify patients diagnosed with IBD in Sweden 2003-2021. Every patient was matched by birth year, sex, calendar year and area of residence with up to 10 general population comparators. The primary outcome was incident ACS. We used semi-parametric Cox proportional hazard models to estimate hazard ratios (HRs). RESULTS: We identified 76,517 patients with IBD (Crohn's disease [CD], N = 22,732; ulcerative colitis [UC], N = 42,194 and IBD-unclassified, N = 11,591) and 757,141 comparators. During a median follow-up of 8 years, 2546 patients with IBD (37.5/10,000 person-years) were diagnosed with ACS compared with 19,598 (28.0/10,000 person-years) among comparators (HR 1.30; 95% confidence interval 1.24-1.35) after adjustments for confounding factors, and approximately one extra case of ACS in 100 IBD patients followed for 10 years. The highest HRs for ACS were in patients with elderly onset IBD (≥60 years) and among patients with CD or UC with extra-intestinal manifestations. No increased HRs were observed in patients diagnosed with IBD before the age of 40. CONCLUSION: In this contemporary cohort of patients with IBD, exposed to modern IBD care, there was an increased risk for ACS compared with individuals from the general population.

Background: Better prognostic measures for ulcerative colitis (UC) could significantly advance patient care. While the prognostic capacity of circulating proteins in UC has been explored, the role of mucosal proteins remains largely unknown. We examined mucosal protein markers in patients with incident ulcerative colitis and evaluated their prognostic value. Methods: Biopsies from macroscopically inflamed colonic/rectal mucosa of adult patients in the Swedish inception cohort of IBD (SIC IBD) were obtained at diagnosis of UC. Patients were followed prospectively, and clinical data were recorded after 3 and 12 months. Disease course was categorised as indolent or aggressive at 12 months, based on a composite outcome of colectomy, hospital admission for active disease, treatment refractoriness towards ≥2 biological agents; the use of >2 courses of corticosteroids, or a cumulative dose of >2.5 g. Relative estimates of 162 protein markers were assessed in homogenised tissue supernatants, using proximity extension assay technology (Olink Proteomics, Uppsala, Inflammation and Oncology II panel). Mann-Whitney U test, with Benjamini-Hochberg correction was used to identify differentially regulated mucosal proteins in aggressive vs indolent disease course, with a 5% false discovery rate (FDR). Smoothly clipped absolute deviation regularised logistic regression models were used to identify prognostic signatures distinguishing aggressive from indolent disease course. Performance was estimated in a leave-one-out cross-validation and reported as the area under the receiver operating characteristic (ROC) curve (AUC). Results: 117 patients provided a macroscopically inflamed colonic/rectal biopsy at diagnosis of UC. Basic demographics and clinical characteristics are presented in Table 1. Relative protein levels of WFdc2 and CCL20 were significantly lower in lysates from patients developing an aggressive course vs patients developing an indolent course, while estimates of MM

Background: Studies from mainly before the wide use of targeted therapies and guidelines for thromboprophylaxis indicate that patients with inflammatory bowel disease (IBD) are at a doubled risk of venous thromboembolism (VTE). We studied the risk of VTE in a modern-day cohort of patients with IBD, overall and in subgroups of disease characteristics. Methods: Using Swedish healthcare registers, we identified a nationwide population-based cohort of 55,252 patients with incident IBD between 2007 and 2021 with a median follow-up time of 6.5 years. Patients were matched by age, sex, calendar year and county of residence with up to ten reference individuals from the general population (N=536,067). The primary outcome was VTE, including pulmonary embolism and deep vein thrombosis. Incidence rates per 1,000 person-years and hazard ratios (HR) were calculated for IBD in general and according to disease subtype, sex, age and disease characteristics at diagnosis. HRs stratified by matching variables (model 1) and additionally adjusted for comorbidities and socioeconomic factors (model 2) were estimated by using Cox regression. Results: The incidence rate of VTE among patients with IBD was 5.03 per 1,000 person-years compared with 2.34 per 1,000 person-years among reference individuals (Table 1). This corresponded to a doubled incidence of VTE (HR=2.18, 95% confidence interval (CI)=2.07-2.29, model 1). Adjusting further for covariates in model 2 had only minor effects on the HR. The HR was consistent across IBD subtypes and sex. The relative risk was higher for those with younger age (18-39 years) at IBD diagnosis (HR 2.52, 95% CI: 2.22-2.83) with a risk difference of 1.25 per 1,000 person-years. The IR, 10.64 per 1,000 person-years, and risk difference, 5.42 per 1,000 person-years, was the highest for those with elderly onset (≥60 years) IBD. There was a stronger association for those with extensive ulcerative colitis (E3), primary sclerosing cholangitis, extraintestinal mani

Background: We aimed to identify protein signatures predictive of a future diagnosis of inflammatory bowel disease (IBD). Methods: We conducted a case-control study, nested within large population-based cohorts with biorepositories. Samples were obtained from individuals who later in life were diagnosed with IBD (preclinical cases) and compared with age and sex-matched individuals who remained free from IBD during follow-up (controls). Using proximity extension assays (Olink, Uppsala), we measured 176 proteins. We applied regularized logistic regression to identify protein signatures of preclinical disease in serum from the discovery cohort (n=312). Their performance was validated in an external preclinical cohort (n=222). The biological relevance of identified proteins was further assessed in an inception cohort (n=144). Finally, we used an IBD twin cohort (n=327) to examine the impact of genetic and shared environmental factors on identified proteins. Results: We identified 34 proteins associated with preclinical Crohn’s disease (CD) in the discovery cohort (Pfalse discovery rate <0.10), with 9 confirmed in the validation cohort (Pfalse discovery rate <0.05). For preclinical ulcerative colitis (UC), 45 proteins were identified and 12 validated (Fig. 1A-B). In the discovery cohort, a signature of 29 proteins differentiated preclinical CD cases from controls with an AUC of 0.85 (Fig. 1G). Its performance was confirmed when applied to the preclinical validation cohort (AUC=0.84, Fig. 1H). Moreover, the signature had excellent capacity to differentiate newly diagnosed CD from healthy controls in the inception cohort (AUC = 0.99, Fig. 1I). The preclinical UC signature had a significant, but albeit lower, predictive capacity in the discovery (AUC=0.77), validation (AUC=0.67) and inception cohort (AUC=0.90, Fig. 1G-I).15 of 17 proteins associated with preclinical IBD demonstrated significantly higher intra-pair correlation coefficients in healthy monozygotic- compa

Background: The real-world comparative safety of vedolizumab in inflammatory bowel disease (IBD) remains uncertain. We aimed to assess the risk of serious infection in IBD patients treated with vedolizumab, compared to (i) those treated with anti-tumour necrosis factor (TNF) treatment and (ii) the general population. Methods: In this nationwide cohort study, treatment episodes were identified from Swedish health registers (from 1 May 2014 – 31 December 2020). Patients were considered exposed from initiation of treatment until 90 days after discontinuation of treatment. We used Cox regression with propensity score-matched cohorts to estimate hazard ratios (HRs) for incident serious infection, defined as infection requiring hospital admission. Results: After propensity score matching, the cohorts were not materially different at baseline with regard to demographic, disease and treatment characteristics (Table 1). During 1376 treatment-episodes in patients with Crohn’s disease, there were 5.18 (95%CI: 3.98-6.63) serious infections per 100 person-years (PY) with vedolizumab vs 3.54 (95%CI: 2.50-4.85) per 100 PY with anti-TNF; HR 1.72 (95%CI: 1.12-2.65; Figure 1A). When examining site-specific infections in Crohn’s disease, vedolizumab was associated with an HR of 2.47 (95% CI: 0.96-6.39) for serious gastrointestinal infections. Compared to the rate of 0.75 (95%CI: 0.59-0.92) serious infections per 100 PY in the general population, vedolizumab demonstrated an increased HR of 7.00 (95%CI: 5.04-9.72). Across 1294 episodes among patients with ulcerative colitis there were 3.74 (95%CI: 2.66-5.11) serious infections per 100 PY with vedolizumab vs 3.42 (95%CI: 2.31-4.89) per 100 PY with anti-TNF, corresponding to HRs of 0.80 (95%CI: 0.47-1.36, Figure 1B) within the initial 1.1 years of treatment and 2.03 (95%CI: 0.65-6.32) after 1.1 years (follow-up truncated due to non-proportional hazards). In ulcerative colitis, there was no statistically significant association between ved

I strävan efter en effektiviserad och optimerad produktion har conveyorsystem blivit en betydande del av många industrier. Med ett stort utbud av tillgängliga conveyorsystem uppstår behovet av standarder för dessa system. Den svenska standarden SS-EN 619:2022 är ett exempel på en standard som skapats genom ett gemensamt arbete av företag som tillverkar conveyorsystem för att ge riktlinjer gällande effektivitet och kvalitet. Ett av ämnena i denna standard är ljudemission. När man designar maskiner som människor kommer arbeta i närheten av är det viktigt att vidta åtgärder för att minska ljudemissionen. Exponering av höga ljudnivåer kan vara skadligt, både fysiskt och psykiskt och därför är det viktigt att mäta och deklarera ljudemissionen från ett conveyorsystem. Svensk standard SS-EN-ISO 11201:2010 innehåller riktlinjer för hur sådana tester ska utföras. I detta projekt gjordes mätningar enligt SS-EN-ISO 11201:2010 och en deklaration upprättades enligt SS-EN 619:2022 för conveyorsystemen OCS-150 och OCS-500. Vidare användes mätdatan från undersökningarna för att identifiera faktorer med stor påverkan på ljudemissionen, med syfte att i framtiden kunna utgöra en grund gällande förbättringsarbete. Projektet inleddes med en grundlig analys av de två standarderna. En litteraturstudie genomfördes också i ämnet för att få mer kunskap inom området ljudemission. Därefter genomfördes tester i produktionsanläggningen hos OCS AB. Slutligen analyserades mätvärdena med hjälp av program som SE324 och Audacity för att upptäcka påverkande faktorer för ljudemissionen. Deklarationen visade att alla mätningar låg väl inom det tillåtna intervallet för ljudemission, och borde inte ha en negativ påverkan på arbetsmiljön när det kommer till ljudnivån. Två krav för SS-EN 619 kunde dock inte uppfyllas, klassificeringen av mätinstrumentet och drivhastigheten under testerna för systemen. Resultaten ger däremot en god approximation av ljudemissionen från de båda systemen OCS-150 och OCS-500. Tv, In the pursuit of a more efficient and optimized production, conveyor systems have become an important part of many industries. With a large variety of conveyor systems available, the need for standards regarding these systems arised. The Swedish standard SS-EN 619:2022 is an example of a standard which was created through the joint effort of companies producing conveyor systems in order to provide guidelines regarding efficiency and quality. One of the topics in this standard is noise emission. When designing machines where humans will be working in close proximity, it is important to take steps to reduce the sound emission. The exposure to excessive noise can be harmful, both physically and mentally and therefore it is important to measure and declare the noise emission of a conveyor system. Swedish standard SS-EN-ISO 11201:2010 contains guidelines for how such tests should be carried out. In this project, measurements were made according to SS-EN-ISO 11201:2010 and a declaration was made in accordance with SS-EN 619:2022 for the conveyor systems OCS-150 and OCS-500. Furthermore, the measurements were used to identify driving factors regarding the noise emission. The project began with a thorough analysis of these standards. A literature study was also performed on the subject in order to gain more knowledge in the field of sound emission. Afterwards, tests were performed in the production facility at OCS AB in order to declare the noise emission of the systems. Lastly, the measurements were analyzed through the utilization of softwares such as SE324 in order to detect driving factors for the noise. The declaration showed that all measurements were well within the allowed range for noise emission and should not have a negative impact on the work environment regarding noise. However, two requirements for SS-EN 619 could not be satisfied. These were the classification of the sound meter and the operational speed of the source during the tests. The results are nevert

Background: Proactive therapeutic drug monitoring (TDM) is often challenged by long turnaround time when using enzyme-linked immunosorbent assays (ELISAs), especially when analyses are centralised. Point-of-care tests (POCTs) allow rapid assessments, but data on their agreement with existing in-house methodologies are scarce.Objective: To examine the agreement between a POCT by ProciseDx (San Diego, CA) and the most frequently used in-house ELISA for infliximab (IFX) quantification in Sweden.Methods: Serum samples were analysed using the in-house ELISA, Karolinska University Hospital, Stockholm, Sweden and a POCT by ProciseDx (San Diego, CA). Agreement was assessed and differences were examined.Results: Samples from 61 inflammatory bowel disease (IBD) patients were analysed with a median IFX concentration of 7.9 mu g/mL (interquartile range (IQR) 5.5-13) for the POCT and 7.9 mu g/mL (IQR 5.2-12) for the ELISA (Pearsons correlation coefficient = 0.95 (95% CI 0.92-0.97, p < .01)). A Passing-Bablok regression yielded an intercept of -0.44 and a slope of 1.09. The Bland-Altman plot showed a systemic bias of -0.77 mu g/mL (95% CI -0.18 to -1.4) between the methods. The upper limit of agreement was 3.7 (95% CI 2.7-4.8) (mu g/mL), whereas the lower limit agreement was -5.3 (95% CI -6.3 to -4.3) (mu g/mL). An excellent reliability was observed, intraclass correlation showed = 0.94 (95% CI 0.89-0.96, p < .0001). When defining IFX concentration as subtherapeutic (<3.0 mu g/mL), therapeutic (3.0-7.0 mu g/mL) or supratherapeutic (>7.0 mu g/mL) drug levels, Kappa statistics showed a substantial agreement (0.79).Conclusions: The POCT by ProciseDx (San Diego, CA) demonstrated a good agreement with the in-house ELISA, supporting its use for rapid IFX quantification., Funding Agencies|Rui Rodrigues, MD, Clinical Immunology and Transfusion Medicine, Karolinska University Hospital is acknowledged for providing support regarding method description of in-house IFX analysis.; Karolinska University Hospital

Background:Real-world data on long-term outcomes of vedolizumab (VDZ) are scarce. Objective:To assess long-term outcomes (up to 3 years) of VDZ in treating inflammatory bowel disease (IBD). Design:A nationwide, prospective multicentre extension of a Swedish observational study on VDZ assessing Effectiveness And Healthcare resource utilization in patients with IBD (SVEAH). Methods:After re-consent, data of patients with Crohns disease (CD) (n = 68) and ulcerative colitis (UC) (n = 46) treated with VDZ were prospectively recorded using an electronic case report form integrated with the Swedish IBD Register (SWIBREG). The primary outcome was clinical remission (defined as Harvey-Bradshaw Index <= 4 in CD and partial Mayo score <= 2 in UC) at 104 and 156 weeks in patients with a response and/or remission 12 weeks after starting VDZ. Secondary outcomes included health-related quality of life (HRQoL) and biochemical outcomes. Results:VDZ continuation rates were high at weeks 104 and 156, 88% and 84%, respectively, for CD and 87% and 78%, respectively, for UC. Of the 53 CD patients with a response/remission at 12 weeks, 40 (75%) patients were in remission at 104 weeks and 42 (79%) patients at 156 weeks. For UC, these numbers were 25/31 (81%) and 22/31 (71%), respectively. Improvements were seen in the Short Health Scale (p < 0.01 for each dimension; CD, n = 51; UC, n = 33) and the EuroQol 5-Dimensions, 5-levels index value (p < 0.01; CD, n = 39; UC, n = 30). Median plasma-C-reactive protein concentrations (mg/L) decreased from 5 at baseline to 4 in CD (p = 0.01, n = 53) and from 5 to 4 in UC (p = 0.03, n = 34) at 156 weeks. Correspondingly, median faecal-calprotectin (mu g/g) decreased from 641 to 114 in CD patients (p < 0.01, n = 26) and from 387 to 37 in UC patients (p = 0.02, n = 17). Conclusion:VDZ demonstrated high continuation rates and was associated with improvements in clinical outcomes, HRQoL measures and inflammatory markers at, Funding Agencies|Takeda [EUPAS22735]; Swedish governments agreement on medical training and research [OLL-836791, OLL-934569, OLL-929900, OLL-960775]

Syftet med denna studie var att finna strategier för att identifiera nya riskkemikalier som vi människor kan bli exponerade för, baserat på den information som finns i Svenska produktregistret (SE-PR). En kombination av information om den registrerade användningen av kemikalier, och modellerade egenskaper som kan förutspå persistens och huruvida kemikalierna är benägna att bioackumuleras i mänskligt blod och urin användes. Med denna strategi kunde olika listor av prioriterade kemikalier som kunde potentiellt vara riskkemikalier i blod och urin hos människa presenteras. Kort summerat: Kemikalier som är lätt biologiskt nedbrytbara bör övervakas i urin och icke biologiskt nedbrytbara bör analyseras i blod. Kemikalier med hög fördelningskoefficient för oktanol-luft (log KOA> 8) bör prioriteras för analys både i blod och urin. Fördelningskoefficienten för oktanol-vatten delar upp de prioriterade kemikalierna i tre grupper; opolära (log KOW> 6) och polära (log KOW 3,5-6) kemikalier för analys i blod, och polära (log KOW <4) kemikalier för analys i urin. Med denna strategi prioriterades syntetiska antioxidanter som potentiella riskkemikalier både i blod. Med riktad kemisk analys kunde sex antioxidanter detekteras i en pool av blodprover från människor som bor i Stockholmsregionen.

Background Real-world data on clinical outcomes of ustekinumab in ulcerative colitis are lacking. Objective To assess short- and long-term clinical outcomes of ustekinumab in ulcerative colitis. Methods Adult ulcerative colitis patients without previous colectomy starting ustekinumab treatment up until 11 December 2020 were identified through the Swedish Inflammatory Bowel Disease Register (SWIBREG). Prospectively recorded data were extracted from the SWIBREG. The primary outcome was persistence to ustekinumab 16 weeks after treatment initiation. Secondary outcomes included drug persistence beyond week 16, clinical remission (defined as a patient-reported Mayo rectal bleeding subscore = 0 and stool frequency subscore <= 1), biochemical remission (defined as faecal-calprotectin <250 mu g/g) and changes in health-related quality of life (HRQoL), as measured by the Short Health Scale (SHS). Logistic regression was used to identify potential predictors of ustekinumab persistence at 16 weeks. Results Of the 133 patients with ulcerative colitis, only three were naive to biologics and tofacitinib. The persistence rates of ustekinumab were 115/133 (86%) at 16 weeks and 89/133 (67%) at last follow-up, that is, after a median follow-up of 32 (interquartile range 19-56) weeks. The clinical remission rates were 17% at 16 weeks and 32% at the last follow-up. The corresponding rates for biochemical remission were 14% and 23%. The median faecal-calprotectin concentration decreased from 740 mu g/g at baseline to 98 mu g/g at the last follow-up (p < 0.01, n = 37). Improvement was seen in each dimension of the SHS between baseline and last follow-up (p < 0.01 for each dimension, n = 46). Male sex was associated with ustekinumab persistence at 16 weeks (adjusted odds ratio = 4.00, 95% confidence interval: 1.35-11.83). Conclusion In this nationwide real-world cohort of ulcerative colitis patients with prior drug failures, including other biologics and tofaci, Funding Agencies|Janssen Pharmaceuticals [CNTO1275UCO0001]

För att underlätta skapandet av spelbanor i spel så används ofta Procedural Content Generation (PCG). Det finns dock en stor mängd PCG-algoritmer med olika tillämpningar. Detta arbete undersöker och jämför tre algoritmer vid skapandet av 2D grottsystem utifrån kriterierna; tidseffektivitet, tillgänglighet och variation. Algoritmerna som jämförs är cellular automata, Perlin noise och Voronoi. Syftet med jämförelsen är att ge en bättre förståelse förde tre algoritmernas för- och nackdelar, med förhoppning om att underlätta valet av PCGal-goritmer i framtiden. Arbetet implementerades i spelmotorn Unity (2022a) och skrevs i C#. Kriteriet tidseffektivitet testades med hjälp av en tidtagarursklass, tillgänglighet med hjälp av en flood fill algoritm och variation med hjälp av en algoritm från Alwidian, Abu-Mansour och Ali (2012). Resultaten visade att Voronoi presterade bäst vid kriteriet tillgänglighet och variation (4x4), (8x8). Cellular automata presterade bäst vid kriteriet tidseffektivitet och variation (16x16). Perlin noise presterade varken bra eller dåligt på något test. Sammanfattningsvis presterade Voronoi bäst, därefter Perlin noise och slutligen cellular automata., Det finns övrigt digitalt material (t.ex. film-, bild- eller ljudfiler) eller modeller/artefakter tillhörande examensarbetet som ska skickas till arkivet.

Bakgrund: Smärta är komplext och individuellt. På grund av den kognitiva nedsättningen är det svårt för demenssjuka patienter att smärtskatta sig själva. Det är alltid sjuksköterskans ansvar att smärtbedöma patienter. Det uppstår en utmaning när patienten inte kan föra sin egen talan på grund av demenssjukdom. Som sjuksköterska krävs kompetens om såväl smärtbedömning som vilket sorts smärtskattningsinstrument som lämpar sig för den individuella patienten. Syfte: Att beskriva sjuksköterskans erfarenheter av att smärtbedöma patienter med demenssjukdom inom slutenvården. Metod: Kvalitativ litteraturöversikt där tolv artiklar från 2010 till 2022 inkluderades som berörde syftet. Artiklarna hittades genom Cinahl, Medline samt genom manuella sökningar. Resultat: Resultatet gav tre huvudteman: erfarenheter av hinder, erfarenheter av smärtskattningsinstrument samt sjuksköterskans professionella roll. Vidare identifierades sex subteman: arbetsmiljöns hinder, kommunikativa hinder, effektiviteten av smärtskattningsinstrument, pålitligheten av smärtskattningsinstrument, interprofessionellt arbetets betydelse samt sjuksköterskors kunskap. Slutsats: Studien visar att kommunikativa barriärer är svåra att överkomma inom smärtbedömning. Då befintliga smärtskattningsinstrument kan upplevas bristfälliga, tenderar sjuksköterskor att förlita sig på tidigare erfarenheter. Det finns resurser för att underlätta smärtbedömningen av dementa patienter. Smärtbedömning av dementa patienter inom slutenvården är ett relativt outforskat ämne som kräver vidare forskning

Background & Aim: The main focus of this thesis was on the education for children with special needs in western Värmland's region during the period 1946 - 1951. Reports by the school inspector describing the organisation, and the work by different disciplines in the school were studied. The aim of the investigation was to simplify and clarify the picture of the complex activities regarding work on establishing ways to handle these children, described as having lower educational ability, within the school system. Methods: The underlying theory used the concepts of classification and framing to examine the conditions that the school system established for students with special needs. A qualitative research methodology has been leading the work with the source material. Results & Conclusions: The most important finding in the reports by the school inspector is that we can clearly distinguish how the presence of students described as having low educational ability was considered a serious problem, both for themselves but mainly for the other children. The idea that students with "low educational ability" were considered a hindrance originates from the 1932 seminary experts’ advice and references, where several common positions are possible to make visible in the school inspector's annual reports and the experts' texts. However, I would argue that a more inclusive approach is taken through the later 1940 school investigation and the 1946 school commission, which explicitly show the advantages of a unitary school. I believe this is reflected in the inspectors later reports and recommendations. The study’s results show that the work with special education is developed to be less strongly classified with a strong framework of control.

BACKGROUND: Endoscopic-post-operative-recurrence (ePOR) in Crohn's disease (CD) after ileocecal resection (ICR) is a major concern. We aimed to evaluate the effectiveness of early prophylaxis with biologics and to compare anti-TNF therapy to vedolizumab (VDZ) and ustekinumab (UST) in a real-world setting. METHODS: A retrospective multicenter study of CD-adults after curative ICR on early prophylaxis. ePOR was defined as a Rutgeerts score [RS]≥i2 or colonic-segmental-SES-CD≥6. Multivariable logistic regression was used to evaluate risk factors, and inverse probability treatment weighting (IPTW) was applied to compare the effectiveness between agents. RESULTS: Included 297 patients (53.9% males, age at diagnosis 24y[19-32], age at ICR-34y[26-43], 18.5% smokers, 27.6% biologic-naïve, 65.7% anti-TNF experienced, 28.6%≥2 biologics, and 17.2% previous surgery). Overall, 224, 39 and 34 patients received anti-TNF, VDZ or UST, respectively. Patients treated with VDZ and UST were more biologic experienced with higher rates of previous surgery. ePOR rates within 1-year were: 41.8%. ePOR rates by treatment groups: anti-TNF 40.2%, VDZ 33% and UST 61.8%. Risk factors for ePOR at 1-year: past-infliximab (adj.OR=1.73[95%CI:1.01-2.97]), past-adalimumab (adj.OR=2.32[95% CI:1.35-4.01) and surgical aspects. After IPTW, the risk of ePOR within 1-year of VDZ vs. anti-TNF or UST vs. anti-TNF was comparable (OR=0.55[95%CI:0.25-1.19], OR=1.86[95%CI:0.79-4.38]), respectively. CONCLUSION: Prevention of ePOR within 1-year after surgery was successful in ~60% of patients. Patients treated with VDZ or UST consisted of a more refractory group. After controlling for confounders, no differences in ePOR risk were seen between anti-TNF prophylaxis and other groups.