Digital Public Defence: Ulf Sundin
MD Ulf Sundin at Institute of Health and Society will be defending the thesis Magnetic resonance imaging in early rheumatoid arthritis – Evaluation of treatment response and prediction of future disease course for the degree of PhD (Philosophiae Doctor).
Photo: Nicolas Tourrenc.
The public defence will be held as a video conference over Zoom.
The defence will follow regular procedure as far as possible, hence it will be open to the public and the audience can ask ex auditorio questions when invited to do so.
Due to copyright reasons, an electronic copy of the thesis must be ordered from the faculty. In order for the faculty to have time to process the order, it must be received by the faculty no later than 2 days prior to the public defence. Orders received later than 2 days before the defence will not be processed. Inquiries regarding the thesis after the public defence must be addressed to the candidate.
Digital Trial Lecture – time and place
- First opponent: Professor Kay-Geert Hermann, Charité - Universitätsmedizin Berlin, Klinik für Radiologie, Germany
- Second opponent: Senior Researcher Susanne Juhl Pedersen, Copenhagen Center for Arthritis Research, Department of Spine Surgery, Rigshospitalet, Copenhagen, Denmark
- Third member and chair of the evaluation committee: Associate Professor Rune Bruhn Jakobsen, University of Oslo
Chair of the Defence
Professor Michael Bretthauer, Faculty of Medicine, University of Oslo
Siri Lillegraven, Researcher, Diakonhjemmet Hospital
Magnetic resonance imaging in early rheumatoid arthritis
Rheumatoid arthritis (RA) is a chronic inflammatory joint disease, prevalent in 0.5-1% of the population. Although medical therapy has advanced considerably over the last decades, current therapies are not always effective, and irreversible joint damage may continue to develop despite treatment. Magnetic resonance imaging (MRI) makes it is possible to detect structural lesions at an early stage of development, and visualize residual inflammation in clinically asymptomatic joints.
The aim of this thesis was to investigate MRI features as outcome measures in RA research, and the possible benefit of using MRI for assessment of treatment response and prediction of future disease course in patients with early RA. The analyses are based on clinical, laboratory, and imaging data from the randomized controlled ARCTIC trial, where participants were treated by a tight control treat-to-target DMARD escalation strategy corresponding to current international treatment recommendations.
Results show that MRI provide valid and responsive assessment of inflammatory and structural joint pathology in RA disease activity and joint damage, applicable as outcome measures in medical trials.
MRI joint inflammation at the time of diagnosis was predictive of subsequent progression of joint damage. In response to treatment, MRI inflammation decreased markedly, but remained detectable in a vast majority of patients, even in clinical remission. In patients in remission, residual inflammation was predictive of subsequent treatment failure and erosive progression. Despite this, the results do not indicate that MRI currently is superior to the combination of clinical examination, laboratory tests, and conventional radiography as a method to monitor disease, or predict future disease outcomes, and thus is of limited value in clinical management of early RA patients.
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