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Trial Lecture – time and place
See Trial Lecture.
Adjudication committee
- First opponent: Professor Kevin Winthrop, Oregon Health and Science University, United States
- Second opponent: Professor Mari Hoff, NTNU: Norwegian University of Science and Technology,
- Third member and chair of the evaluation committee: Professor II Berit Flatø, University of Oslo
Chair of the Defence
Professor Erik Øie, University of Oslo
Principal Supervisor
Sella Aarrestad Provan, Diakonhjemmet Hospital
Summary
Immunosuppressive therapies used in the treatment of inflammatory joint diseases are associated with an increased risk of infections. Several of these infections are vaccine-preventable, but many of the immunosuppressive drugs may, to different degrees, impair the immunogenicity of vaccines.
In this thesis data from two prospective observational studies; The NORwegian Disease-Modifying AntiRheumatic Drug (NOR-DMARD) and the Norwegian study of vaccine response to Covid-19 (Nor-vaC) were used, aiming to explore the risk of serious infections in patients with inflammatory joint diseases on immunosuppressive therapies, and assess the persistency of the humoral immune response to SARS-CoV-2 vaccinations in patients with inflammatory joint- and bowel diseases treated with a wide range of immunosuppressants.
Patients with inflammatory joint disease treated with biologic or targeted synthetic disease-modifying antirheumatic drugs have an approximately two-fold higher risk of serious infection compared to the general population, during the first year of treatment. Risk differences across joint diseases were found, with the risk being highest among patients with rheumatoid arthritis as compared to patients with spondyloarthritis and psoriatic arthritis.
SARS-CoV-2 vaccination has been crucial in pandemic management by reducing the incidence, morbidity and mortality of SARS-CoV-2. In the roll-out of the vaccines, concerns were raised regarding the vaccine efficacy in patients using immunosuppressive therapies. Christensen and co-workers therefore assessed the persistency of the humoral response to SARS-CoV-2 vaccination in patients with inflammatory joint- and bowel disease, and found that patients had a more profound and rapid antibody clearance than healthy controls after two vaccine doses. These findings supported the need for repeated vaccination and implied a shorter time-interval between vaccine doses in this patient population.
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