Digital Public Defence: Håvard Fretheim Håvard Fretheim at Institute of Clinical Medicine will be defending the thesis "Aiming for better care – novel treatment strategies in Systemic Sclerosis" for the degree of PhD (Philosophiae Doctor).

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.

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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.

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Adjudication committee

  • First opponent: Professor Michael Kreuter, University Clinic Heidelberg, Germany
  • Second opponent: Professor Marie-Elise Truchetet, Bordeaux University Hospital, France
  • Third member and chair of the evaluation committee: Professor Michael Bretthauer, Institute of Health and Society, University of Oslo

Chair of defence

Professor II Per Olav Vandvik, Institute of Health and Society, University of Oslo 

Principal supervisor

Post.doc. Anna-Maria Hoffmann-Vold, Oslo University Hospital


Systemic sclerosis is an autoimmune disease with high morbidity and mortality. Lung fibrosis, pulmonary arterial hypertension, and gastrointestinal complications are the three most common disease-related causes of death. 

The overall aim of the thesis was to establish the first nationwide SSc cohort to acquire unselected data regarding organ involvement and to improve disease management, including screening and treatment of the three most lethal SSc complications. 

First, we used a stepwise approach to establish the nationwide SSc cohort (the NOR-SSc cohort), including all patients in Norway with an SSc diagnosis between 2000 and 2012. Second, we used the NOR-SSc cohort to gain information regarding interstitial lung disease (ILD), gathering computer tomography data and lung function tests. Third, we looked at how implementing the DETECT algorithm for detecting PAH influenced screening and early diagnosis in the Oslo SSc cohort. Last, we performed a pilot study to determine the feasibility of performing faecal microbiota transplantation (FMT) in patients with SSc.  We used ACHIM, an anaerobic standardized bacterial culture, to improve safety and enable improved tracking of the gut microbiota changes. 

In the NOR-SSc cohort, we included 815 patients with SSc.  Mortality was increased when ILD was present, even when the extent of lung fibrosis was mild, and lung function tests were normal. This warrants a change in how we are screening and treating ILD in SSc patients. The DETECT algorithm did not change the number of patients diagnosed with PAH. Still, it increased the number of identified borderline PH cases. It could potentially standardize the follow-up and screening of PAH in Norway. This could lead to the diagnosis of PAH at an earlier stage, enabling prompt initiation of treatment. 

Performing a pilot study, we found that it is feasible to perform an FMT study in SSc patients, but intervention-related adverse events could be a problem.

Additional information

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Published Sep. 17, 2021 9:00 AM - Last modified Sep. 30, 2021 12:29 PM