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.
Order a digital copy of the thesis here
Trial Lecture – time and place
See Trial Lecture.
Adjudication committee
- First opponent: Associate professor Filipa Oliveira Ramos, University of Lisbon, Portugal
- Second opponent: Senior consultant Stefan Berg, University of Gothenburg, Sweden
- Third member and chair of the evaluation committee: Professor Anne Cathrine Staff, University of Oslo
Chair of the Defence
Professor II Erik Harald Øie, University of Oslo
Principal Supervisor
Senior consultant Anna-Birgitte Aga, OUS - Oslo University Hospital
Summary
Adults with juvenile idiopathic arthritis (JIA) respond well to disease-modifying antirheumatic drugs (DMARDs) but experience lower physical health-related quality of life (HRQoL) and increased risks of comorbidities and mortality. A doctoral thesis in rheumatology investigated treatment effectiveness and long-term disease burden in adult JIA patients.
The project consists of three studies based on national observational and registry data. Paper I utilized register data from the Norwegian DMARD (NOR-DMARD) study to compare the effectiveness of two treatment regimens (TNF inhibitors and methotrexate monotherapy) in adults with JIA compared to patients with rheumatoid arthritis (RA). Changes in disease activity measures, remission rates, and treatment survival were evaluated 3, 6, and 12 months after treatment initiation. Paper II used NOR-DMARD data and normative data from the general Norwegian population to evaluate HRQoL measured by Short-Form 36 (SF-36), physical component score (PCS), mental component score (MCS) and Short Form 6 Dimensions (SF-6D) utility score. Paper III compared adult JIA patients with matched population controls to assess the 5-year retrospective prevalence of 10 important comorbidities and overall all-cause mortality.
The results indicate that treatment with TNF inhibitors or methotrexate monotherapy is as effective in adults with JIA as in RA patients. Furthermore, adults with JIA experience significantly reduced physical health compared to RA patients and the general population but maintain comparable mental health. Finally, adults with JIA have a higher prevalence of common comorbidities and autoimmune diseases and an increased rate of all-cause mortality compared to controls.
Overall, the results support current treatment practices in adults with JIA and contribute to an enhanced understanding of the disease burden of JIA in adulthood, highlighting the need for integrated care throughout adulthood.
Additional information
Contact the research support staff.