About me

  • Specialized in the methodological aspects of clinical epidemiology, I have a passion for teaching and for making cutting edge methodologies known and used by the research community. The overarching aim of my work is to, using epidemiological studies, provide information that will help patients and caregivers better understand chronic disease and disease course, and to make informed choices about therapeutic options.

    My research interests include study design, biostatistical methods, and how to make the most of registers and other secondary data sources for pharmacoepidemiological studies. During 2020 to 2022 I worked part time at the National Board of Health and Welfare on issues concerning data quality in the national healthcare and social service registries. Starting in March 2023, I am working on issues linked to using healthcare data for research through the Clinicum initiative - organized methods support for clinical and translational research funded by KI and Region Stockholm.

Research

  • As part of Johan Askling's research group on chronic inflammatory disease epidemiology, my team's work can broadly be divided in pharmaco-
    epidemiological projects on treatments for rheumatic diseases and multiple sclerosis, and etiological studies with a focus on the familial
    aggregation of chronic inflammatory joint diseases. My research is funded by research grants from US-based Patient Centered Outcomes Institute (PCORI), the Swedish Research Council, patient organizations in Neurology and Rheumatology, and the MS Research Foundation (MS-forskningsfonden). My work in the Anti-Rheumatic Therapies In Sweden (ARTIS) project has been funded by post-authorization safety studies contracted between the Kaorlinska Institutet and several pharmaceutical companies.

Articles

All other publications

Grants

  • Swedish Research Council
    1 January 2025 - 31 December 2029
    Multiple sclerosis (MS), a chronic inflammatory and neurodegenerative condition, is a major driver of disability and healthcare costs among young to middle-aged adults. Access to disease-modifying treatments (DMTs) early in the disease course is thought to have improved prognosis, but outcomes vary greatly between patients. Major knowledge gaps remain on prognostic markers and on the benefit-risk balance of specific DMTs strategies in real world populations, with little evidence to guide the choice of DMT for individual patients. This prompted us to establish Combat-MS: a nationwide study following 3500 participants to answer which initial or secondary DMT strategy that, at the group level, best preserves quality of life and neurological functions. This unique cohort combined prospective serum samples and clinical evaluations with rich data from national registers, resulting in a series of influential publications. With this proposal, the cohort will be expanded further with promising biomarkers, imaging and electronic medical record data, covering patients’ trajectories from first healthcare contacts to long-term treatment outcomes. Analyzing this rich data with state-of-the art biostatistics and machine learning, my team will build a framework for a precision medicine approach to MS, providing individualized risk predictions at different clinical stages and evaluating the benefit-risk of distinct DMT strategies across diverse MS populations.
  • Swedish Research Council
    1 January 2024 - 31 December 2028
    Multiple sclerosis (MS) features aberrant adaptive immune reaction towards central nervous system antigens leading to myelin and neuron/axon damage. Disease modulatory therapies (DMTs) are highly effective in the initial inflammatory phase, but much less so in later progressive disease phases. We have recently invested 8.6 MUSD in the largest real-world study of MS in a nationwide population-based material, providing a unique basis for advancing our knowledge how MS evolves from a first triggering event to late progressive stages. We hypothesize that chronic infection of memory B cell clones with Epstein-Barr virus (EBV) drives the early inflammatory component of MS, and that innate immune mechanisms and accelerated aging explain progressive MS. The first aim will be addressed using advanced immunophenotyping of our unique MS cohort with full B cell repletion following antiCD20 therapy and a treatment trial with antivirals (collaboration Bergen). We will address the second aim with epidemiological techniques and large-scale soluble biomarker and brain imaging profiling (collaboration Oslo, Basel), supplemented with deep brain imaging and molecular cerebrospinal fluid characterization in smaller clinical materials. Our previous research has transformed treatment of MS in Sweden in a unique way. With this 5-year program we will make considerable progress towards implementation of precision medicine and further improve long-term outcomes for those affected by MS.
  • Swedish Research Council
    1 January 2022 - 31 December 2025
    Multiple sclerosis (MS), a chronic inflammatory and neurodegenerative condition, is a major cause of disability and driver of healthcare costs among young and middle aged adults. Access to a range of disease-modifying treatments (DMTs) have improved outlooks for most patients. Major knowledge gaps remain on the benefit-risk balance of specific DMTs strategies in real world populations, however, with little evidence to guide the choice of DMT for individual patients. This prompted us to launch Combat-MS, a nationwide observational drug trial following 3500 participants from 2017 to 2022 to answer which initial or secondary DMT strategy that, at the group level, best preserves quality of life and neurological functions. Nearing its end, the study has generated important insights on safety/effectiveness of major DMTs, also gaining major international interest. With this proposal, we wish to expand the cohort with further national registry and biomarker data and implement new prediction techniques to move from the group level to more individualized prognostication, including how DMT switches or extended dosing intervals interact with patient characteristics to predict treatment outcomes, and with a special focus on off-label use of rituximab. Analyzing this rich data with state-of-the art biostatistics and machine learning, we will build a framework for a precision medicine approach to MS, evaluating the benefit-risk of distinct DMT strategies across diverse MS populations.
  • Swedish Research Council for Health Working Life and Welfare
    1 December 2021 - 30 November 2024
  • Swedish Research Council for Health Working Life and Welfare
    1 January 2018 - 31 December 2019
  • Swedish Research Council
    1 January 2018 - 31 December 2020
  • Swedish Research Council
    1 January 2015 - 31 December 2017

Employments

  • Senior Lecturer, Department of Medicine, Karolinska Institutet, 2025-
  • Principal Researcher, Department of Medicine, Karolinska Institutet, 2022-2025

Degrees and Education

  • Docent, Karolinska Institutet, 2017
  • Degree Of Doctor Of Philosophy, Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, 2012

News from KI

Events from KI