Due to copyright issues, an electronic copy of the thesis must be ordered from the faculty. For the faculty to have time to process the order, the order must be received by the faculty at the latest 2 days before the public defence. Orders received later than 2 days before the defence will not be processed. After the public defence, please address any inquiries regarding the thesis to the candidate.
Trial Lecture – time and place
See Trial Lecture.
Adjudication committee
- First opponent: Associate Professor Mwidimi Ndosi, University Hospitals Bristol and Weston NHS Trust and University of the West of England, UK
- Second opponent: Professor Jette Primdahl, Danish Hospital for Rheumatic Diseases, University of Southern Denmark,
- Third member and chair of the evaluation committee: Associate Professor Christine Råheim Borge, University of Oslo
Chair of the Defence
Professor John-Anker Zwart, University of Oslo
Principal Supervisor
Senior Researcher Anna-Birgitte Aga, Oslo University Hospital and Diakonhjemmet Hospital
Summary
Rheumatoid arthritis (RA) is one of the most prevalent chronic inflammatory diseases and carries a substantial burden for the individual and society. Clinical and radiographic outcomes in RA have improved significantly over the last two decades owing to increased availability of effective therapeutic agents and modern management principles building on treating early, intensively and to target. Patient-reported outcomes provide valuable insight regarding the effect of modern treatment strategies on important aspects of disease beyond inflammatory disease activity outcomes. In this doctoral thesis, RN Karen Holten examines patient-reported fatigue and flare in rheumatoid arthritis patients.
Fatigue is a common and disabling condition experienced by up to 70% of RA patients. Yet the association between fatigue and disease activity is unclear. This thesis demonstrates an association between disease activity and fatigue, highlighting that early disease remission can reduce the risk of long-term fatigue. Additionally, this thesis provides potential risk factors for long-term fatigue, which could help identify at-risk patients.
Flares in disease activity are common in RA and associated with increased risk of poorer long-term outcomes. Detection of disease activity flares is important for the patient to receive timely clinical evaluation and adjustment of treatment to regain control of the disease. Patient-reported outcomes may facilitate detection of flares. Results from this thesis suggest that patient-reported outcomes such as the Rheumatoid Arthritis Flare Questionnaire and Rheumatoid Arthritis Impact of Disease can contribute to identify clinically significant flares.
The findings have implications for identifying patients at risk of developing long-term fatigue, as well as identifying disease activity flares and underline the value of patient-reported outcomes as supplement to clinical assessment in modern treatment strategies in RA management.
Additional information
Contact the research support staff.