Sella Aarrestad Provan

• Bardan, Imane; Sundbakk, Lene Maria; Sexton, Joseph; Kvien, Tore Kristian Aaserud; Molberg, Øyvind & Kristianslund, Eirik [Vis alle 8 forfattere av denne artikkelen] (2026). Comorbidity and mortality in adults with juvenile idiopathic arthritis: a nationwide Norwegian register-based matched cohort study. Rheumatology. ISSN 1462-0324. doi: 10.1093/rheumatology/keag507. Fulltekst i vitenarkiv Vis sammendrag

  Abstract Objectives This population-based study assesses comorbidities, autoimmune conditions and all-cause mortality in (1) adults with juvenile idiopathic arthritis (JIA) against general population comparators and (2) adults with JIA with versus without recent disease-modifying anti-rheumatic drug (DMARD) exposure. Methods We included adults who, between 2009-2024, had ≥ 2 specialist health contacts with a JIA-specific ICD-10 code in the mandatory Norwegian Patient Registry (NPR). Each case was matched randomly, by age, gender and county of residence, to 10 general population comparators at the time of receiving the 2nd JIA diagnosis in adulthood. We compared 5-year retrospective comorbidity prevalences in descriptive analyses and prospective all-cause mortality in (1) adults with JIA versus comparators and (2) adult JIA with versus without recent DMARD exposure. Results Adults with JIA (N = 2932) had higher prevalence than comparators (N = 29 097) of ischemic heart disease excluding myocardial infarction (JIA vs. comparators (%): 1.0 vs. 0.6), hypertension (3.6 vs. 1.4), chronic kidney disease (0.5 vs. 0.2), type 1 diabetes (1.7 vs. 0.7), celiac disease (1.4 vs. 0.7), autoimmune thyroiditis (0.3 vs. 0.1) and autoimmune alopecia (0.4 vs. 0.1). Prospective all-cause mortality was higher in JIA than comparators (mortality rate 2.4 vs. 1.8 per 1000 person-years). In adult JIA, prevalences of comorbidities and autoimmune conditions as well as all-cause mortality, was similar in those with and without recent DMARD exposure. Conclusion In this study we found an increased 5-year retrospective prevalence of several comorbidities and increased all-cause mortality in adults with JIA compared to population controls.

• Ikdahl, Eirik; Døskeland, Benedikte; Bertelsen, Liv-Turid; Bakland, Gunnstein; Pedersen, Tina Therese & Hu, Yi [Vis alle 10 forfattere av denne artikkelen] (2026). Current Diagnostic Pathways for Rheumatoid Arthritis-Associated Interstitial Lung Disease Result in Substantial Underdiagnosis and Excess Mortality: A Multicenter Norwegian Quality Assurance Audit. Joint Bone Spine. ISSN 1297-319X. s. 106130–106130. doi: 10.1016/j.jbspin.2026.106130. Fulltekst i vitenarkiv
• Westermann, Rasmus; Delcoigne, Bénédicte; Cordtz, René Lindholm; Provan, Sella Aarrestad; Sexton, Joseph & Nordström, Dan [Vis alle 10 forfattere av denne artikkelen] (2026). Risk of nonmelanoma skin cancer in patients with psoriatic arthritis and according to bDMARD treatment—a cohort study from the Nordic Arthritis Research Collaboration. EULAR Rheumatology Open (ERO). 2(2), s. 100161–100161. doi: 10.1016/j.ero.2026.03.009. Fulltekst i vitenarkiv
• Nielung, Louise Majormoen; Giuseppe, Daniela Di; Hetland, Merete Lund; Askling, Johan; Nordström, Dan C. & Provan, Sella Aarrestad [Vis alle 13 forfattere av denne artikkelen] (2026). Difficult-to-manage and treatment-refractory psoriatic arthritis in patients treated with biological and targeted synthetic DMARDs: prevalence and characteristics in 5 Nordic registries. Annals of the Rheumatic Diseases. ISSN 0003-4967. doi: 10.1016/j.ard.2026.08.002. Fulltekst i vitenarkiv
• Michelsen, Brigitte; Polysopoulos, Christos; Nissen, Michael J.; Ciurea, Adrian; Möller, Burkhard & Ørnbjerg, Lykke Midtbøll [Vis alle 37 forfattere av denne artikkelen] (2026). Influence of national socioeconomic status on treatment retention and disease activity in psoriatic arthritis and axial spondyloarthritis: evidence over 2 years in 13 European countries. Annals of the Rheumatic Diseases. ISSN 0003-4967. doi: 10.1016/j.ard.2026.06.021. Fulltekst i vitenarkiv
• Hagen, Gunhild; Opheim, Anna K; Øverbø, Joakim; Aas, Eline & Provan, Sella A (2026). Cost-effectiveness of herpes zoster vaccination in patients with rheumatoid arthritis. Rheumatology. ISSN 1462-0324. 65(9). doi: 10.1093/rheumatology/keag448. Fulltekst i vitenarkiv Vis sammendrag

  Objectives To assess the cost-effectiveness of vaccinating patients with rheumatoid arthritis (RA) with the adjuvanted recombinant zoster vaccine (RZV), compared with no vaccination. Methods To predict health gains and costs from vaccination, we developed a decision-analytic Markov model with five health states: no herpes zoster, herpes zoster (HZ), postherpetic neuralgia (PHN), recovered from herpes zoster, and death. The model follows a hypothetical cohort of 10,000 patients with RA over a lifetime perspective and records events of HZ and PHN, along with quality-adjusted life years (QALYs) and costs from a healthcare perspective. Costs and health effects were discounted with 4% annually. Model inputs were collected from published literature and publicly available sources. Cost-effectiveness was evaluated using the incremental cost-effectiveness ratio (ICER), expressed as EUR per quality adjusted life year (QALY), compared with a cost-effectiveness threshold of EUR 23,650 per QALY. We performed one-way and probabilistic sensitivity analyses. Results Vaccination led to a reduction of 2,550 cases of HZ and 1,303 cases of PHN per 10,000 patients with RA vaccinated, resulting in an ICER of EUR 11,205/QALY. One-way sensitivity analyses revealed that the results were particularly sensitive to changes in the probability of developing PHN as a sequela of HZ. The probabilistic analysis indicated that the RZV had a 98% probability of being cost-effective at the assumed threshold value. Conclusions Vaccinating patients with RA using RZV results in better health at higher cost compared with no vaccination. Under the assumptions made, vaccination is likely to be considered cost-effective for patients with RA.

• Salis, Zubeyir; Mongin, Denis; Choquette, Denis; Coupal, Louis; Codreanu, Catalin & Iannone, Florenzo [Vis alle 23 forfattere av denne artikkelen] (2026). Machine Learning to Predict Remission Between 6 and 24 Months in Rheumatoid Arthritis: Insights From JAK, an International Registry Collaboration. Arthritis & Rheumatology. ISSN 2326-5191. doi: 10.1002/art.70165. Fulltekst i vitenarkiv
• Ahmadzay, Zohra Faizy; Ørnbjerg, Lykke Midtbøll; Østergaard, Mikkel; Jensen, Kasper Yde; Jørgensen, Jacob Brauner & Heberg, Jette [Vis alle 41 forfattere av denne artikkelen] (2026). Impact of cardiometabolic comorbidities on clinical characteristics, prescription patterns and retention rate of first b/tsDMARD treatment in 5299 European real-world patients with psoriatic arthritis. RMD Open. 12(2). doi: 10.1136/rmdopen-2025-006477. Fulltekst i vitenarkiv Vis sammendrag

  Objectives To investigate associations between cardiometabolic comorbidities and clinical characteristics, prescription patterns and retention of first biologic/targeted synthetic disease-modifying anti-rheumatic drug (b/tsDMARD) in patients with psoriatic arthritis (PsA). Methods Patients with PsA initiating a first b/tsDMARD treatment in 2015 or later were identified in eight European rheumatology registries. Patients with information on five cardiometabolic comorbidities (obesity, dyslipidaemia, diabetes, hypertension, ischaemic heart disease) at treatment start (baseline) were included. All analyses were conducted according to patients’ comorbidity burden (count: 0/1/≥2) and status (presence/absence of each comorbidity). Patient characteristics and prescription patterns were described. Twelve-month treatment retention rates were estimated and compared using Kaplan-Meier plots, log-rank tests and multivariable Cox regression analyses. Results Among 5299 patients, 36% had at least one cardiometabolic comorbidity. Patients with comorbidity were older, had higher disease activity and more disability. Regardless of comorbidity, most patients were prescribed a tumour necrosis factor inhibitor (76%). The use of interleukin-17 inhibitors increased with comorbidity burden (0/1/≥2 comorbidities: 13%/18%/19%), whereas Janus kinase inhibitor use declined (2.3%/1.6%/0.8%). Retention rates were marginally lower with higher comorbidity burden (80%/76%/78%) (log-rank, p=0.036) and obesity (absent 79% vs present 77%) (log-rank, p=0.04). The risk of treatment withdrawal was only marginally higher in patients with higher comorbidity burden (one comorbidity: HR 1.19; 95% CI 1.02 to 1.40; ≥2 comorbidities: HR 1.18; 0.98 to 1.42). Conclusion Patients with cardiometabolic comorbidities had higher disease activity at treatment initiation of the first b/tsDMARD. Prescription patterns varied with comorbidity burden. Cardiometabolic comorbidity burden, especially obesity, was associated with marginally lower treatment retention.

• Uhlig, Tillmann; Karoliussen, Lars Fridtjof; Sexton, Joseph; Haavardsholm, Espen Andre; Provan, Sella Aarrestad & Solomon, D. H. [Vis alle 7 forfattere av denne artikkelen] (2026). Duration and dose of allopurinol needed to attain the serum urate target in gout. Scandinavian Journal of Rheumatology. ISSN 0300-9742. doi: 10.1080/03009742.2026.2648357. Fulltekst i vitenarkiv Vis sammendrag

  Objective: To examine, in patients with gout using escalating urate-lowering therapy (ULT), the treatment durationand allopurinol dose required to attain the serum urate (SU) target (< 360 μmol/L; < 6 mg/dL). Method: We studied patients in the NOR-Gout prospective cohort with a recent gout flare and increased SU(> 360 μmol/L). Patients escalated allopurinol dosage until reaching the SU treatment target of <360 µmol/L,switching, if needed, to febuxostat. Results: Of 211 patients, 95.2% were male; mean ± sd age was 56.7 ± 13.7 years, disease duration 8.1 years, 16.6%had clinical tophi, and 12.8% used allopurinol at cohort entry. Mean SU (μmol/L) was reduced from 500 at baseline to312 at 1 year and 325 at 2 years. Target SU was attained at least once during year 1 by 197 patients (93.4%). Mediantime to attaining the treatment target was 2 months (mean 2.9 months), and median allopurinol dose was 200 mg(mean 243 mg). Eighty per cent of patients reached the treatment target by 3 months. Patients with SU >480 μmol/L atbaseline needed a median of 3 months to attain target SU versus 2 months for patients with SU <480 μmol/L (log-rankp < 0.001). A switch to febuxostat was seen in 12.4% at year 1 and 15.1% at year 2. Conclusion: Treat-to-target ULT using allopurinol leads to attainment of the SU target within 2–3 months at lowdoses for most patients. Very few patients did not achieve the treatment target at least once during year 1. Trial registration: ACTRN12618001372279

• Nellemann, Birgitte; Fongen, Birgit Camilla; Dagfinrud, Hanne Solveig; Berg, Inger Jorid; Kristianslund, Eirik & Sexton, Joseph [Vis alle 13 forfattere av denne artikkelen] (2026). Remote personalised exercise in axial spondyloarthritis: the SPARK trial – protocol for a 6-month randomised controlled trial. BMJ Open. 16(3). doi: 10.1136/bmjopen-2025-112420. Fulltekst i vitenarkiv
• Mongin, Denis; Aymon, Romain; Choquette, Denis; Coupal, Louis; Codreanu, Catalin & Iannone, Florenzo [Vis alle 23 forfattere av denne artikkelen] (2026). Evolution of Janus Kinase inhibitors (JAKi) prescriptions since 2015 in an international collaboration of rheumatoid arthritis registers (the 'JAK-pot' study): effect of regulatory warnings. Seminars in Arthritis & Rheumatism. ISSN 0049-0172. 77, s. 152946–152946. doi: 10.1016/j.semarthrit.2026.152946. Fulltekst i vitenarkiv
• Holly, Teresa; Brun, Marthe Kirkesæther; Jørgensen, Kristin Kaasen; Goll, Guro Løvik; Sexton, Joseph & Gehin, Johanna [Vis alle 15 forfattere av denne artikkelen] (2026). Cost-effectiveness of proactive therapeutic drug monitoring of maintenance infliximab treatment in patients with immune-mediated inflammatory diseases: results from a randomised controlled trial. RMD Open. 12(1), s. 11–11. doi: 10.1136/rmdopen-2025-006329. Fulltekst i vitenarkiv
• Kazemi, Amirhossein; Kristianslund, Eirik; Sexton, Joseph; Fagerli, Karen Minde; Provan, Sella Aarrestad & Olsen, Inge Christoffer (2026). A head-to-head comparison of TNF-α inhibitors as the first biologic treatment of rheumatoid arthritis. Rheumatology. ISSN 1462-0324. 65(2). doi: 10.1093/rheumatology/keag007. Fulltekst i vitenarkiv
• Provan, Sella Aarrestad; Hammer, Hilde Berner & Kleppang, Annette Løvheim (2025). Psychometric evaluation of the Norwegian version of the Revised Fibromyalgia Impact Questionnaire. Scandinavian Journal of Rheumatology. ISSN 0300-9742. s. 8–8. doi: 10.1080/03009742.2025.2573532. Fulltekst i vitenarkiv Vis sammendrag

  Objectives: The Revised Fibromyalgia Impact Questionnaire (FIQ-R) is a composite questionnaire covering key domains of fibromyalgia disease burden. This study aimed to translate the FIQ-R into Norwegian, to assess face, content, and criterion validity, and to evaluate the psychometric properties of the Norwegian FIQ-R using Rasch analysis, in a sample of adults with fibromyalgia. Method: The FIQ-R was translated into Norwegian following established methodology in collaboration with patient research partners. Participants attending a patient education session for people with chronic musculoskeletal pain were asked to complete, anonymously, the translated FIQ-R, Fibromyalgia Self-reported Diagnostic Criteria (FSDC), 36-item Short Form Health Survey (SF-36), and Modified Health Assessment Questionnaire (MHAQ). Fibromyalgia cases were identified according to the FSDC. Correlations between FIQ-R, MHAQ, and SF-36 were calculated. Rasch analysis was performed. Results: In total, 241 participants (96.3% female) were classified as having fibromyalgia according to the FSDC. The translated FIQ-R had acceptable face and content validity. The correlation coefficients were moderate between FIQ-R and SF-36, and strong between FIQ-R and MHAQ. The FIQ-R formed a multidimensional scale, indicating two subscales: FIQ-R function and FIQ-R symptoms. Both subscales showed reversed threshold ordering and were consequently collapsed into five and four response categories, respectively. The resulting subscales were found to have good reliability and targeting. Conclusion: Owing to the lack of unidimensionality in the FIQ-R, it is recommended that both clinical and research applications rely on subscale scores rather than a total score.

• Feldhaus, Chiara; Vedøy, Ingeborg Barth; Kleppang, Annette Løvheim; Sveaas, Silje Halvorsen; Danielsen, Kjersti Karoline & Litleskare, Sigbjørn [Vis alle 7 forfattere av denne artikkelen] (2025). The aftermath of the pandemic: how the COVID-19 pandemic affected physical activity, fitness, health, and body fat in first-year students in Norway. Frontiers in Sports and Active Living. 7. doi: 10.3389/fspor.2025.1719951. Fulltekst i vitenarkiv Vis sammendrag

  Public health measures to limit the spread of COVID-19 included restricting physical activity (PA). Here we described the impact of pandemic restrictions and reduction in PA on physical fitness and health and body composition amongst first-year students, and the associations to body fat and total PA at the end of their first year. “ On your own feet” is a longitudinal study exploring changes in lifestyle habits amongst first-year students. Questionnaires for assessment of perceived restriction, PA behaviour and fitness and health were administered at the start and end of the first year at university. Body composition (bioelectrical impedance analysis) and total PA (Actigraph®) were recorded at both time-points. In multivariable models we identified factors associated to body fat and total PA. We included 150 students aged 18-22 years, 53% of whom reported restrictions and 34% a reduction in PA due to the COVID-19 pandemic. Students reporting restrictions had comparable fitness, health, body composition and PA level at baseline and follow-up, compared to those without restrictions. Students with reduced PA less often reported “good” fitness (30% vs. 56%, p  &lt; 0.001) and health (54% vs. 70%, p  = 0.046) and had higher mean body fat percentage (27% vs. 23%, p  = 0.009) and lower total PA (314 vs. 420 cpm, p  &lt; 0.001) at baseline, compared to those without reduction in PA. At follow-up, they less often reported “good” physical fitness (26% vs. 54%, p  = 0.005), while body composition and total PA were comparable. We concluded that students who report pandemic reduction in PA may need targeted interventions to improve fitness.

• Moe, Sigrid Reppe; Haukeland, Hilde; Brunborg, Cathrine; Botea, Antonela; Damjanic, Nenad & Wivestad, Gro Årthun [Vis alle 13 forfattere av denne artikkelen] (2025). Accrual of thromboembolic events and antiphospholipid syndrome in new-onset systemic lupus erythematosus: a population-based inception cohort study. RMD Open. 11(3), s. 005795–005795. doi: 10.1136/rmdopen-2025-005795. Fulltekst i vitenarkiv Vis sammendrag

  Objective This population-based study aimed to determine timing and incidence of arterial and venous thromboembolic events (TE) and antiphospholipid syndrome (APS) relative to systemic lupus erythematosus (SLE) onset and assess relationships between TE, APS and anti-phospholipid antibodies (aPL) during follow-up. Methods We included all medical-record confirmed new-onset SLE patients in Southeast Norway (population 2.9 million) 2000–2017 who fulfilled the 2019 European Alliance of Rheumatology Associations/American College of Rheumatology classification criteria. APS was defined by the 2006 Sydney classification criteria, and aPL positivity was determined following international guidelines. Key outcomes were APS, TE and death. We estimated outcome-free survival using Kaplan-Meier methods. Results Among 700 new-onset SLE patients followed for a mean of 8 years (SD 5.0), 13% (89/700) experienced a new TE. TE incidence peaked at 59 per 100 person-years (95% CI 38 to 87) in the first year of SLE among aPL positive patients diagnosed with APS, falling to 12 (95% CI 6.2 to 21) in the subsequent 4 years. In patients without APS, corresponding TE incidences were 2.6 (95% CI 1.4 to 4.3) and 0.9 (95% CI 0.5 to 1.4), respectively. The lowest TE incidence was in aPL-negative patients aged <50 years, with 1-year TE-free survival of 0.99 (95% CI 0.97 to 1.0). Beyond the first year, TE-free survival rates did not differ between SLE patients positive and negative for aPL. Standardised mortality rate in patients with and without APS was 4.7 (95% CI 1.8 to 10.7 and 1.7 (95% CI 1.2 to 2.3). Conclusions This population-level study reveals high risk of TE, particularly for aPL positive patients around the time of SLE diagnosis. The elevated TE risk requires attention and early preventive strategies in newly diagnosed SLE.

• Christensen, Ingrid Egeland; Lillegraven, Siri; Sexton, Joseph; Kvien, Tore Kristian Aaserud; Uhlig, Till & Provan, Sella Aarrestad (2025). Longitudinal risk of serious infections in patients with inflammatory arthritis on immunomodulating therapy compared to controls. Rheumatology - Advances in Practice (Rheumap). 9(1). doi: 10.1093/rap/rkaf017. Fulltekst i vitenarkiv
• Aymon, Romain; Mongin, Denis; Guemara, Romain; Salis, Zubeyir; Askling, Johan & Choquette, Denis [Vis alle 29 forfattere av denne artikkelen] (2025). Incidence of Major Adverse Cardiovascular Events in Patients With Rheumatoid Arthritis Treated With JAK Inhibitors Compared With Biologic Disease-Modifying Antirheumatic Drugs: Data From an International Collaboration of Registries. Arthritis & Rheumatology. ISSN 2326-5191. doi: 10.1002/art.43188. Fulltekst i vitenarkiv Vis sammendrag

  Objective. Our objective was to assess the incidence of major adverse cardiovascular events (MACEs) in patients withrheumatoid arthritis (RA) treated with JAK inhibitors (JAKi), tumor necrosis factor inhibitors (TNFi), or biologic disease-modifying antirheumatic drugs with other modes of action (bDMARD-OMA) in a multicountry, real-world population. Methods. Patients with RA from 15 registries in the JAK-pot collaboration were included. MACE incidence wasanalyzed using two approaches: a within-registry analysis aggregating country-specific estimates from registers with>25 incident MACEs through meta-analysis and an individual-level data combined analysis. We used adjusted linearmixed Poisson regression to obtain incidence rate ratios (IRRs) of MACEs between treatment groups, accounting formultiple treatment courses. Results. The study included 73,008 treatment courses (16,417 JAKi, 35,373 TNFi, and 21,218 bDMARD-OMA) and828 incident MACEs among 51,233 patients. Median follow-up time was 1.3 years, with most of the follow-up concen-trated in the first two years of treatment. Incidence rates were 7.0, 7.6, and 11.8 per 1,000 person-years for JAKi, TNFi,and bDMARD-OMA, respectively. Compared to TNFi, JAKi (within-registry adjusted IRR 0.89, 95% confidence interval[CI] 0.63–1.25) had similar incidence rates of MACEs and bDMARD-OMA had higher rates (within-registry adjusted IRR1.35, 95% CI 1.10–1.66). Combined analysis showed similar results. Conclusion. Observational data from the JAK-pot collaboration show no evidence of an increase in cardiovascularevents during the first two years of use with JAKi compared to TNFi in the general RA population.

• Berg, Inger Jorid; Kristianslund, Eirik; Tveter, Anne Therese; Sexton, Joseph; Bakland, Gunnstein & Gossec, Laure [Vis alle 15 forfattere av denne artikkelen] (2025). Remote monitoring or patient-initiated care in axial spondyloarthritis: a 3-armed randomised controlled noninferiority trial. Annals of the Rheumatic Diseases. ISSN 0003-4967. doi: 10.1016/j.ard.2025.04.019. Fulltekst i vitenarkiv
• Georgiadis, Stylianos; Pons, Marion; Rasmussen, Simon; Hetland, Merete Lund; Linde, Louise & Giuseppe, Daniela di [Vis alle 30 forfattere av denne artikkelen] (2025). Challenge of missing data in observational studies: investigating cross-sectional imputation methods for assessing disease activity in axial spondyloarthritis. RMD Open. 11(1). doi: 10.1136/rmdopen-2024-004844. Fulltekst i vitenarkiv Vis sammendrag

  Objectives We aimed to compare various methods for imputing disease activity in longitudinally collected observational data of patients with axial spondyloarthritis (axSpA). Methods We conducted a simulation study on data from 8583 axSpA patients from ten European registries. Disease activity was assessed by the Axial Spondyloarthritis Disease Activity Score (ASDAS) and the corresponding low disease activity (LDA; ASDAS<2.1) state at baseline, 6 and 12 months. We focused on cross-sectional methods which impute missing values of an individual at a particular time point based on the available information from other individuals at that time point. We applied nine single and five multiple imputation methods, covering mean, regression and hot deck methods. The performance of each imputation method was evaluated via relative bias and coverage of 95% confidence intervals for the mean ASDAS and the derived proportion of patients in LDA. Results Hot deck imputation methods outperformed mean and regression methods, particularly when assessing LDA. Multiple imputation procedures provided better coverage than the corresponding single imputation ones. However, none of the evaluated methods produced unbiased estimates with adequate coverage across all time points, with performance for missing baseline data being worse than for missing follow-up data. Predictive mean and weighted predictive mean hot deck imputation procedures consistently provided results with low bias. Conclusions This study contributes to the available methods for imputing disease activity in observational research. Hot deck imputation using predictive mean matching exhibited the highest robustness and is thus our suggested approach.

• Zangi, Heidi Andersen; Haugmark, Trond & Provan, Sella Aarrestad (2025). Can mindfulness have long-term impact on patients with fibromyalgia? A two-year prospective follow-up study of a mindfulness-based intervention. Rheumatology International. ISSN 0172-8172. 45(1). doi: 10.1007/s00296-024-05778-z. Fulltekst i vitenarkiv Vis sammendrag

  To examine changes in symptoms and health status in patients with fibromyalgia (FM) 24 months after participating in the mindfulness-based group-program, the Vitality Training (VTP), followed by physical exercise counselling. Seventysix participants, mean age (range) 43 (26–52), females 69 (91%), diagnosed with FM according to the ACR 2011-criteria received the VTP in a previous randomised controlled trial. Control group participants could receive the VTP after a 12-month observation period, therefore only data from the intervention group were analysed in the present study. Selfreported data were collected electronically at baseline, 3, 12 and 24 months. Outcomes were patient global impression of change (PGIC), FM-severity, i.e. widespread pain (WPI) and symptom severity (SSS), pain, fatigue, sleep quality, psychological distress, motivation and barriers for physical activity, mindfulness and work participation. Trends across timepoints were analysed using mixed models for repeated measurements. At 24-months, 48 (56.5%) participants responded, 94% female, median (range) age 46 (28–54), symptom duration 12 (5–33) years. Seven participants reported much/very much better on the PGIC; 21 (44%) reported no change/minimal improvement. Improvements were observed in WPI (-1.9, ES 0.4), SSS (-1.2, ES 0.6), fatigue (-0.8, p=.014) and self-efficacy for physical activity (1.4, ES 0.4). There was a significant trend of reduced WPI, SSS, pain and fatigue across the four time-points, but no additional improvements from 12 to 24-month follow-up. Participants who had completed the VTP demonstrated small to moderate improvements in symptom burden and FM-severity from baseline to 24-month follow-up. Trial registration number: ISRCTN96836577

• Uhlig, Till; Stjärne, Johan Folke Håkan; Karoliussen, Lars Fridtjof; Sexton, Joseph; Eskild, Tron Hovind & Provan, Sella Aarrestad [Vis alle 8 forfattere av denne artikkelen] (2025). Remission in gout is possible: 5-year follow-up in the NOR-Gout study. Seminars in Arthritis & Rheumatism. ISSN 0049-0172. 72. doi: 10.1016/j.semarthrit.2025.152698. Fulltekst i vitenarkiv
• Provan, Sella Aarrestad; Calogiuri, Giovanna; Røset, Linda; Mariussen, Maren; Rosøy, Ingeborg & Johnsen, Tonje Jossie [Vis alle 9 forfattere av denne artikkelen] (2025). VR-guided exercise and mindfulness program for people with chronic pain: a randomised controlled cross-over pilot trial. BMC sports science, medicine and rehabilitation. 17(1), s. 1–8. doi: 10.1186/s13102-025-01102-9. Fulltekst i vitenarkiv Vis sammendrag

  Background Physical exercises and mindfulness are important components in the management of chronic pain, but pain may reduce exercise adherence. Virtual reality (VR) can provide cognitive inhibition of the ascending pain signal and may thus be a tool for the delivery of pain management during exercise interventions. In this study we assessed a VR-guided intervention seeking to improve physical fitness in individuals with chronic pain. Methods Participants in rehabilitation for chronic pain were included in a randomised controlled pilot trial with a cross-over design. In counter-balanced order participants were asked to perform, five minutes of aerobic exercise following identical instructions given through either a VR headset or television (TV) screen. The procedures were then repeated with mindfulness exercises. Heart rate (HR) was monitored throughout all four sessions and participants self-reported perceived exercise intensity, benefit, relaxation, and reward. Paired Student’s t-test, Wilcoxon signed rank test and McNemar’s test were performed to compare the outcome variables across sessions for individuals, as appropriate. (Clinical trial registration NCT06611566 09.09.24, retrospectively registered). Results Twenty-seven participants were included in the study. The mean age (SD) was 40.4 (11.3) years, and 17 (63%) were men. Mean HR, the proportion of time spent at moderate-vigorous exercise intensity levels, and all self-reported measurements were comparable between the VR vs. TV sessions. No major adverse events were reported. The physiological and perceived exercise outputs of aerobic exercises were thus similar across modes of delivery (VR vs. TV) in individuals with chronic pain. Conclusions This study confirms the possibilities of VR-guided interventions in the pain management of individuals with chronic pain with comparable levels of exertion to TV-guided exercise and few adverse events. The promise of VR-guided mindfulness in the rehabilitation of patients with chronic pain conditions is also confirmed.

• Wolf, Asia-Sophia Fumika Michaela; Hammersbøen, Kristin Reine; Ørbo, Hilde Sofie Sager; Bhandari, Sabin; Solum, Guri & Kjønstad, Ingrid Fadum [Vis alle 30 forfattere av denne artikkelen] (2024). T cell responses to repeated SARS-CoV-2 vaccination and breakthrough infections in patients on TNF inhibitor treatment: a prospective cohort study. EBioMedicine. 108. doi: 10.1016/j.ebiom.2024.105317. Fulltekst i vitenarkiv Vis sammendrag

  Background Understanding cellular responses to SARS-CoV-2 immunisations is important for informing vaccine recommendations in patients with inflammatory bowel disease (IBD) and other vulnerable patients on immunosuppressive therapies. This study investigated the magnitude and quality of T cell responses after multiple SARS-CoV-2 vaccine doses and COVID-19 breakthrough infection. Methods This prospective, observational study included patients with IBD and arthritis on tumour necrosis factor inhibitors (TNFi) receiving up to four SARS-CoV-2 vaccine doses. T cell responses to SARS-CoV-2 peptides were measured by flow cytometry before and 2–4 weeks after vaccinations and breakthrough infection to assess the frequency and polyfunctionality of responding cells, along with receptor-binding domain (anti-RBD) antibodies. Findings Between March 2, 2021, and December 20, 2022, 143 patients (118 IBD, 25 arthritis) and 73 healthy controls were included. In patients with either IBD or arthritis, humoral immunity was attenuated compared to healthy controls (median anti-RBD levels 3391 vs. 6280 BAU/ml, p = 0.008) after three SARS-CoV-2 vaccine doses. Patients with IBD had comparable quantities (median CD4 0.11% vs. 0.11%, p = 0.26, CD8 0.031% vs. 0.047%, p = 0.33) and quality (polyfunctionality score: 0.403 vs. 0.371, p = 0.39; 0.105 vs. 0.101, p = 0.87) of spike-specific T cells to healthy controls. Patients with arthritis had lower frequencies but comparable quality of responding T cells to controls. Breakthrough infection increased spike-specific CD8 T cell quality and T cell responses against non-spike peptides. Interpretation Patients with IBD on TNFi have T cell responses comparable to healthy controls despite attenuated humoral responses following three vaccine doses. Repeated vaccination and breakthrough infection increased the quality of T cell responses. Our study adds evidence that, in the absence of other risk factors, this group may in future be able to follow the general recommendations for COVID-19 vaccines.

• Christiansen, Sara Nysom; Rasmussen, Simon Horskjær; Pons, Marion; Michelsen, Brigitte; Glintborg, Bente & Gudbjornsson, Bjorn [Vis alle 33 forfattere av denne artikkelen] (2024). Patient-reported outcomes in axial spondyloarthritis and psoriatic arthritis patients treated with secukinumab for 24 months in daily clinical practice. Seminars in Arthritis & Rheumatism. ISSN 0049-0172. 65. doi: 10.1016/j.semarthrit.2024.152388. Fulltekst i vitenarkiv Vis sammendrag

  Objectives In patients with axial spondyloarthritis (axSpA) or psoriatic arthritis (PsA) initiating secukinumab, we aimed to assess and compare the proportion of patients achieving 6-, 12- and 24-month patient-reported outcomes (PRO) remission and the 24-month retention rates. Patients and methods Patients with axSpA or PsA from 16 European registries, who initiated secukinumab in routine care were included. PRO remission rates were defined as pain, fatigue, Patient Global Assessment (PGA) ≤2 (Numeric Rating Scale (NRS) 0–10) and Health Assessment Questionnaire (HAQ) ≤0.5, for both axSpA and PsA, and were calculated as crude values and adjusted for drug adherence (LUNDEX). Comparisons of axSpA and PsA remission rates were performed using logistic regression analyses (unadjusted and adjusted for multiple confounders). Kaplan-Meier plots with log-rank test and Cox regression analyses were conducted to assess and compare secukinumab retention rates. Results We included 3087 axSpA and 3246 PsA patients initiating secukinumab. Crude pain, fatigue, PGA and HAQ remission rates were higher in axSpA than in PsA patients, whereas LUNDEX-adjusted remission rates were similar. No differences were found between the patient groups after adjustment for confounders. The 24-month retention rates were similar in axSpA vs. PsA in fully adjusted analyses (HR [95 %CI] = 0.92 [0.84–1.02]). Conclusion In this large European real-world study of axSpA and PsA patients treated with secukinumab, we demonstrate for the first time a comparable effectiveness in PRO remission and treatment retention rates between these two conditions when adjusted for confounders.

• Kared, Hassen; Jyssum, Ingrid; Alirezaylavasani, Amin; Egner, Ingrid Marie; Tran, Trung & Tietze, Lisa [Vis alle 17 forfattere av denne artikkelen] (2024). Dynamics of SARS-CoV-2 immunity after vaccination and breakthrough infection in rituximab-treated rheumatoid arthritis patients: a prospective cohort study. Frontiers in Immunology. 15:1296273, s. 1–12. doi: 10.3389/fimmu.2024.1296273. Fulltekst i vitenarkiv Vis sammendrag

  Background: SARS-CoV-2 vaccination in rheumatoid arthritis (RA) patients treated with B cell-depleting drugs induced limited seroconversion but robust cellular response. We aimed to document specific T and B cell immunity in response to vaccine booster doses and breakthrough infection (BTI). Methods: We included 76 RA patients treated with rituximab who received up to four SARS-CoV-2 vaccine doses or three doses plus BTI, in addition to vaccinated healthy donors (HD) and control patients treated with tumor necrosis factor inhibitor (TNFi). We quantified anti-SARS-CoV-2 receptor-binding domain (RBD) Spike IgG, anti-nucleocapsid (NC) IgG, 92 circulating inflammatory proteins, Spike-binding B cells, and Spike-specific T cells along with comprehensive high-dimensional phenotyping and functional assays. Findings: The time since the last rituximab infusion, persistent inflammation, and age were associated with the anti-SARS-CoV-2 RBD IgG seroconversion. The vaccine-elicited serological response was accompanied by an incomplete induction of peripheral Spike-specific memory B cells but occurred independently of T cell responses. Vaccine- and BTI-elicited cellular immunity was similar between RA and HD ex vivo in terms of frequency or phenotype of Spike-specific cytotoxic T cells and in vitro in terms of the functionality and differentiation profile of Spike-specific T cells. Interpretation: SARS-CoV-2 vaccination in RA can induce persistent effector T-cell responses that are reactivated by BTI. Paused rituximab medication allowed serological responses after a booster dose (D4), especially in RA with lower inflammation, enabling efficient humoral and cellular immunity after BTI, and contributed overall to the development of potential durable immunity.

• Gehringer, Celina K.; Martin, Glen P.; Hyrich, Kimme L.; Verstappen, Suzanne M.M.; Sexton, Joseph & Kristianslund, Eirik [Vis alle 9 forfattere av denne artikkelen] (2024). Developing and externally validating multinomial prediction models for methotrexate treatment outcomes in patients with rheumatoid arthritis: results from an international collaboration. Journal of Clinical Epidemiology. ISSN 0895-4356. 166. doi: 10.1016/j.jclinepi.2023.111239. Fulltekst i vitenarkiv
• Provan, Sella Aarrestad; Ahlfors, F.; Bakland, Gunnstein; Hu, Yi; Kristianslund, Eirik & Ikdahl, Eirik [Vis alle 9 forfattere av denne artikkelen] (2024). A validation of register-derived diagnoses of interstitial lung disease in patients with inflammatory arthritis: data from the NOR-DMARD study. Scandinavian Journal of Rheumatology. ISSN 0300-9742. s. 173–179. doi: 10.1080/03009742.2024.2306716. Fulltekst i vitenarkiv Vis sammendrag

  Objective There is a lack of knowledge concerning the validity of the interstitial lung disease (ILD) diagnoses used in epidemiological studies on rheumatic diseases. This paper seeks to verify register-derived ILD diagnoses using chest computed tomography (CT) and medical records as a gold standard. Method The Norwegian Anti-Rheumatic Drug Register (NOR-DMARD) is a multicentre prospective observational study of patients with inflammatory arthritis who start treatment with disease-modifying anti-rheumatic drugs. NOR-DMARD is linked to the Norwegian Patient Registry (NPR) and Cause of Death Registry. We searched registers for ILD coded by ICD-10 J84 or J99 among patients with rheumatoid arthritis, psoriatic arthritis, or spondyloarthritis. We extracted chest CT reports and medical records from participating hospitals. Two expert thoracic radiologists scored examinations to confirm the ILD diagnosis. We also searched medical records to find justifications for the diagnosis following multidisciplinary evaluations. We calculated the positive predictive values (PPVs) for ILD across subsets. Results We identified 71 cases with an ILD diagnosis. CT examinations were available in 65/71 patients (91.5%), of whom ILD was confirmed on CT in 29/65 (44.6%). In a further 10 patients, medical records confirmed the diagnosis, giving a total of 39/71 verified cases. The PPV of a register-derived ILD diagnosis was thus 54.9%. In a subset of patients who had received an ILD code at two or more time-points and had a CT scan taken within a relevant period, the PPV was 72.2%. Conclusion The validity of register-based diagnoses of ILD must be carefully considered in epidemiological studies.

• Ahmadzay, Zohra F; Heberg, Jette; Jørgensen, Jacob B; Ørnbjerg, Lykke M; Østergaard, Mikkel & Møller-Bisgaard, Signe [Vis alle 45 forfattere av denne artikkelen] (2024). Recording of non-musculoskeletal manifestations, comorbidities and safety outcomes in European spondyloarthritis registries: A survey. Rheumatology - Advances in Practice (Rheumap). 8(4). doi: 10.1093/rap/rkae135. Fulltekst i vitenarkiv Vis sammendrag

  Objectives Real-world evidence is needed to inform treatment strategies for patients with PsA and axial SpA (axSpA) who have non-musculoskeletal manifestations (NMMs), various risk factors and comorbidities. International collaboration is required to ensure statistical power and to enhance generalizability. The first step forward is identifying which data are currently being collected. Across 17 registries participating in the European Spondyloarthritis Research Collaboration (EuroSpA), we aimed to map recording practices for NMMs, comorbidities and safety outcomes in patients with PsA and axSpA. Methods Through a survey with 4,420 questionnaire items, we explored the recording practices of 58 pre-defined conditions (i.e. NMMs, comorbidities and safety outcomes) covering 10 disease areas. In all registries we mapped for each condition whether it was recorded, the recording procedure and the potential to identify it through linkage to other national registries. Results Conditions were generally recorded at entry into the registry and clinical follow-up visits using a pre-specified list or a coding system. Most registries recorded conditions within the following disease areas: NMMs (number of registries, n = 15–16), cardiovascular diseases (n = 10–14), gastrointestinal diseases (n = 12–13), infections (n = 10–13) and death (n = 14). Nordic countries had the potential for data linkage and generally had limited recording of conditions in their registry, while other countries had comprehensive recording practices. Conclusion A wide range of conditions were consistently recorded across the registries. The recording practices of many conditions and disease areas were comparable across the registries. Our findings support the potential for future collaborative research.

• Provan, Sella Aarrestad; Kristianslund, Eirik Klami; Michelsen, Brigitte; Uhlig, Tillmann; Sexton, Joseph & Kvien, Tore Kristian Aaserud (2024). Interstitial Lung Disease in Patients With Rheumatoid Arthritis or Psoriatic Arthritis Initiating Biologics and Controls: Data From 5 Nordic Registries. Journal of Rheumatology. ISSN 0315-162X. 51(11), s. 1111–1118. doi: 10.3899/jrheum.2024-0252. Fulltekst i vitenarkiv
• Ørbo, Hilde Sofie Sager; Kasahara, Taissa de Matos; Wolf, Asia-Sophia Fumika Michaela; Bjørlykke, Kristin Hammersbøen; Sexton, Joseph & Jyssum, Ingrid [Vis alle 24 forfattere av denne artikkelen] (2024). Humoral and cellular responses to a fifth bivalent SARS-CoV-2 vaccine dose in patients with immune-mediated inflammatory diseases on tumour necrosis factor inhibitors: a prospective cohort study. The Lancet Regional Health - Europe. 48. doi: 10.1016/j.lanepe.2024.101121. Fulltekst i vitenarkiv Vis sammendrag

  Background As most people now have established hybrid immunity, the need for regular, updated SARS-CoV-2 vaccine boosters in patients with immune-mediated inflammatory diseases (IMIDs) is unclear. The study aim was to assess humoral and cellular immunogenicity of a fifth bivalent vaccine dose in patients with IMID on tumour necrosis factor inhibitors (TNFi). Methods In the longitudinal, observational Nor-vaC study, we assessed anti-spike and neutralising antibodies against Wuhan, Omicron BA.1 and BA.4, as well as frequency and polyfunctionality of responding T cells, following a fourth monovalent and a fifth bivalent (BA.1 or BA.4/5) vaccine dose in patients with or without hybrid immunity using TNFi. Findings Between December 17, 2021, and June 20, 2023, 456 infection-naïve patients with IMIDs using TNFi received a fourth vaccine dose and were otherwise eligible for inclusion. A total of 373/456 (82%) received a fifth vaccine dose, of these 190/373 (51%) had hybrid immunity defined as having had COVID-19 between the fourth and fifth dose. In patients with hybrid immunity, the fifth dose did not induce improved humoral responses compared to infection, neither with BA.1 (median anti-spike antibody concentrations 23,244 IU/ml (IQR 15,138–45,233) vs 36,341 IU/ml (11,887–53,710), p = 0.52) nor BA.4/5 (31,693 IU/ml (15,176–54,186), p = 0.30). Comparison of neutralising antibodies yielded similar results. In infection-naïve patients, a fifth BA.4/5 vaccine, but not the BA.1, induced slightly higher humoral responses (18,890 IU/ml (6494–50,211)) compared to the fourth dose (7304 IU/ml (3245–17,260), p < 0.0001). CD8 T cell responses remained stable following a fourth dose (median frequency of spike-specific cells 0.039% (IQR 0.010–0.14)), infection (0.058% (0.026–0.17)) and a fifth dose (0.058% (0.013–0.20). Interpretation In patients on TNFi with hybrid immunity, there was no immunological benefit of an updated fifth SARS-CoV-2 booster dose. Stable CD8 cellular responses following four doses indicate established protective immunity. Patients whose only risk factor is TNFi may in future follow vaccine recommendations for the general population.

• Pettersen, Pernille; Haugmark, Trond; Berg, Inger Jorid; Hammer, Hilde Berner; Neogi, Tuhina & Zangi, Heidi Andersen [Vis alle 8 forfattere av denne artikkelen] (2024). Pain sensitization in fibromyalgia. Cross-sectional associations between quantitative sensory testing of pain sensitization and fibromyalgia disease burden. European Journal of Pain. ISSN 1090-3801. 29(1). doi: 10.1002/ejp.4771. Fulltekst i vitenarkiv
• Christiansen, Sara Nysom; Rasmussen, Simon Horskjær; Ostergaard, Mikkel; Pons, Marion; Michelsen, Brigitte & Pavelka, Karel [Vis alle 39 forfattere av denne artikkelen] (2024). Effectiveness of secukinumab in radiographic and non-radiographic axial spondyloarthritis: a European routine-care observational study. RMD Open. 10(3). doi: 10.1136/rmdopen-2024-004166. Fulltekst i vitenarkiv Vis sammendrag

  Objectives To compare the treatment effectiveness of secukinumab in radiographic (r) versus non-radiographic (nr) axial spondyloarthritis (axSpA) patients treated in routine care across Europe. Methods Prospectively collected data on secukinumab-treated axSpA patients with known radiographic status were pooled from nine countries. Remission rates based on patient-reported outcomes (PROs; Numeric Rating Scale (0–10), for example, pain ≤2/Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) ≤2 and Ankylosing Spondylitis Disease Activity Score (ASDAS) inactive disease (ID) <1.3 after 6/12/24 months of secukinumab treatment were calculated. Remission and drug retention rates in r-axSpA versus nr-axSpA patients were compared by logistic and Cox regression models (unadjusted/adjusted for age+sex/adjusted for multiple confounders). Results Overall, 1161 secukinumab-treated patients were included (r-axSpA/nr-axSpA: 922/239). At baseline, r-axSpA patients had longer disease duration and higher C reactive protein, were more often male and HLA-B27 positive and had received fewer prior biological or targeted synthetic disease-modifying antirheumatic drugs compared with nr-axSpA patients, whereas PROs were largely similar. During follow-up, crude PRO remission rates were significantly higher in r-axSpA compared with nr-axSpA patients (6 months: pain≤2: 40%/28%, OR=1.7; BASDAI≤2: 37%/25%, OR=1.8), as were drug retention rates (24 months: 66%/58%, HR 0.73 (ref: r-axSpA)). Proportions of patients achieving ASDAS ID were low for both groups, particularly nr-axSpA (6 months: 11%/8%). However, when adjusting for age+sex, these differences diminished, and after adjusting for multiple confounders, no significant between-group differences remained for either remission or drug retention rates. Conclusion Crude remission/drug retention rates in European secukinumab-treated patients were higher in r-axSpA compared with nr-axSpA patients. In adjusted analyses, secukinumab effectiveness was similar in both groups, suggesting that observed differences were related to factors other than radiographic status.

• Georgiadis, Stylianos; Ørnbjerg, Lykke Midtbøll; Michelsen, Brigitte; Kvien, Tore Kristian Aaserud; Giuseppe, Daniela Di & Wallman, Johan K. [Vis alle 20 forfattere av denne artikkelen] (2024). Cut-Offs for Disease Activity States in Axial Spondyloarthritis With Ankylosing Spondylitis Disease Activity Score (ASDAS) Based on C-Reactive Protein and ASDAS Based on Erythrocyte Sedimentation Rate: Are They Interchangeable? Journal of Rheumatology. ISSN 0315-162X. 51(7), s. 673–677. doi: 10.3899/jrheum.2023-1217. Fulltekst i vitenarkiv
• Ørbo, Hilde Sofie Sager; Hammersbøen, Kristin Reine; Sexton, Joseph; Jyssum, Ingrid; Tveter, Anne Therese & Christensen, Ingrid Egeland [Vis alle 18 forfattere av denne artikkelen] (2024). Incidence and outcome of COVID-19 following vaccine and hybrid immunity in patients on immunosuppressive therapy: identification of protective post-immunisation anti-RBD antibody levels in a prospective cohort study. RMD Open. 10(2). doi: 10.1136/rmdopen-2023-003545. Fulltekst i vitenarkiv Vis sammendrag

  Objectives To assess incidence, severity and predictors of COVID-19, including protective post-vaccination levels of antibodies to the receptor-binding domain of SARS-CoV-2 spike protein (anti-RBD), informing further vaccine strategies for patients with immune-mediated inflammatory diseases (IMIDs) on immunosuppressive medication. Methods IMIDs on immunosuppressives and healthy controls (HC) receiving SARS-CoV-2 vaccines were included in this prospective observational study. COVID-19 and outcome were registered and anti-RBD antibodies measured 2–5 weeks post-immunisation. Results Between 15 February 2021 and 15 February 2023, 1729 IMIDs and 350 HC provided blood samples and self-reported COVID-19. The incidence of COVID-19 was 66% in patients and 67% in HC, with re-infection occurring in 12% of patients. Severe COVID-19 was recorded in 22 (2%) patients and no HC. No COVID-19-related deaths occurred. Vaccine-induced immunity gave higher risk of COVID-19 (HR 5.89 (95% CI 4.45 to 7.80)) than hybrid immunity. Post-immunisation anti-RBD levels <6000 binding antibody units/mL were associated with an increased risk of COVID-19 following three (HR 1.37 (95% CI 1.08 to 1.74)) and four doses (HR 1.28 (95% CI 1.02 to 1.62)), and of COVID-19 re-infection (HR 4.47 (95% CI 1.87 to 10.67)). Conclusion Vaccinated patients with IMID have a low risk of severe COVID-19. Hybrid immunity lowers the risk of infection. High post-immunisation anti-RBD levels protect against COVID-19. These results suggest that knowledge on COVID-19 history, and assessment of antibody levels post-immunisation can help individualise vaccination programme series in high-risk individuals. Trial registration number NCT04798625.

• Provan, Sella Aarrestad; Litleskare, Sigbjørn; Flaten, Ole E.; Pettersen, Henning; Røset, Linda & Calogiuri, Giovanna (2024). Participatory Development of a Virtual Reality Exercise Program for People with Chronic Pain. Games for Health Journal. ISSN 2161-783X. 13(4), s. 1–3. doi: 10.1089/g4h.2023.0229. Fulltekst i vitenarkiv Vis sammendrag

  Background: By describing how a participatory process led to changes in the design of a study of a virtual reality (VR)-guided exercise and mindfulness intervention tailored to people with chronic musculoskeletal pain, this article makes the case for including end user at an early stage when planning research within this field. Methods: A multidisciplinary panel including end-user representatives, researcher, clinicians, and VR developers participated in a 1-day workshop to design a randomized study and a VR-guided intervention. Results: Through the participatory process, changes were made to the original study design with respect to experimental design, duration, content of VR interventions and mode of delivery. Conclusion: This case exemplifies the importance of including end-user participants in the early phases of planning VR interventions for people with chronic pain.

• Uhlig, Tillmann; Karoliussen, Lars Fridtjof; Sexton, Joseph; Provan, Sella Aarrestad; Haavardsholm, Espen Andre & Hammer, Hilde Berner (2024). Non-adherence to urate lowering therapy in gout after 5 years is related to poor outcomes: results from the NOR-Gout study. Rheumatology. ISSN 1462-0324. 64(4), s. 1799–1806. doi: 10.1093/rheumatology/keae514. Fulltekst i vitenarkiv Vis sammendrag

  Objectives Patients with gout need to adhere to medication over time to achieve good outcomes. We assessed self-reported adherence to medication with urate lowering therapy (ULT) 5 years after a treat-to-target intervention and studied how non-adherence was related to baseline demographic and disease variables. Methods Patients in the NOR-Gout observational study were included after a recent gout flare and serum urate >360 µmol/l. Patients [mean age 56.2 (S.D. 13.6), 94.5% males, 17.2% with tophi] attended tight-control visits over one year with escalating urate lowering therapy using a treat-to-target strategy. Five-year follow-up included the Medication Adherence Report Scale (MARS-5) questionnaire (range 5–25) for adherence. Flares and SUA target achievement were compared for 5-year adherence to medication. Results At 5 years most of the 163 patients used ULT (95.1%). MARS-5 adherence scores after 5 years were high (median 24, interquartile range 22–25). Patients in the lowest MARS-5 quartile had, compared with the highest quartile, more often a flare during the last year of follow-up (33.3% vs 9.5%, P = 0.004) and reached the 5-yr serum urate treatment target less frequently (45.2% vs 87.5%, P < 0.001). Baseline lower age (OR 0.56, 95%CI 0.39–0.79), non-European origin (OR 0.22, 95%CI 0.06–0.80), lower SF-36 mental health scores (OR 0.94, 95%CI 0.91–0.98) and less joint pain during last flare (OR 0.73, 95%CI 0.58–0.92) were independent risk factors for non-adherence to medication. Conclusions Patients reported high adherence to medication after 5 years. Non-adherence was related to more flares and less urate target achievement. Younger age and non-European origin were associated with non-adherence.

• Michelsen, Brigitte; Sexton, Joseph; Kvien, Tore Kristian Aaserud; Provan, Sella Aarrestad & Hammer, Hilde Berner (2024). Ultrasound evaluation contrasts clinical disease activity evaluation in rheumatoid arthritis patients with concomitant anxiety or depression. Seminars in Arthritis & Rheumatism. ISSN 0049-0172. 68, s. 1–6. doi: 10.1016/j.semarthrit.2024.152502. Fulltekst i vitenarkiv Vis sammendrag

  Objectives To compare disease activity as assessed by ultrasonography (US) between rheumatoid arthritis (RA) patients with and without anxiety or depression, and to compare clinical disease activity and sociodemographic measures between these patient groups. Methods Anxious or depressed patients were identified by EuroQoL-5D-3L question “I am not/moderately/extremely anxious or depressed.” US assessments of 36 joints and 4 tendons were performed and power Doppler (PD) and grey scale (GS) sum scores calculated (both range 0–120). Comparisons between anxious/depressed and not anxious/depressed patients were performed in unadjusted analyses, adjusted logistic regression, and sensitivity analyses. Results A total of 201 RA patients starting biological disease-modifying antirheumatic drugs were included (82 % women, mean age 52 years, disease duration 10 years). Hundred-and-nine patients (54.2 %) were moderately or extremely anxious/depressed. Median (IQR) PD (13 (4, 21) vs. 10 (3, 20), p = 0.53) and GS (28 (18, 42) vs. 25 (14, 41), p = 0.51) sum scores were similar between anxious/depressed and not anxious/depressed patients, respectively, whereas composite scores of disease activity were significantly worse in the anxious/depressed patients (p < 0.001), as were also patient-reported outcomes, ESR, CRP and plasma calprotectin (all p ≤ 0.02). Sensitivity analyses confirmed these findings, except for CRP. Self-reported economy and sleep difficulties were also worse in the anxious/depressed patients and a higher proportion were not working (all p < 0.001). Conclusion This study highlights the negative impact of anxiety and depression on RA patients in standard care, and underscores the challenges in disease activity assessment. US examination may be a valuable objective tool in the evaluation of these patients.

• Delcoigne, Benedicte; Kopp, Tine Iskov; Arkema, Elizabeth V.; Hellgren, Karin; Provan, Sella Aarrestad & Relas, Heikki [Vis alle 14 forfattere av denne artikkelen] (2023). Exposure to specific tumour necrosis factor inhibitors and risk of demyelinating and inflammatory neuropathy in cohorts of patients with inflammatory arthritis: a collaborative observational study across five Nordic rheumatology registers. RMD Open. 9(1). doi: 10.1136/rmdopen-2022-002924. Fulltekst i vitenarkiv Vis sammendrag

  Objective To compare incidences of neuroinflammatory events, including demyelinating disease (DML), inflammatory polyneuropathies (IPN) and multiple sclerosis (MS), in patients with rheumatoid arthritis (RA) or spondyloarthritis (SpA; including psoriatic arthritis) starting a tumour necrosis factor inhibitor (TNFi), investigating whether monoclonal TNFi antibodies (other TNFis (oTNFis)) confer higher risk than etanercept. Methods This is an observational cohort study including patients from the five Nordic countries starting a TNFi in 2001–2020. Time to first neuroinflammatory event was identified through register linkages. We calculated crude incidence rates (cIR) per 1000 person-years and used multivariable-adjusted Cox regression to compare incidences of neuroinflammatory events overall and for DML, IPN and MS with oTNFi versus etanercept. We further examined individual TNFis and indications. Results 33 883 patients with RA and 28 772 patients with SpA were included, initiating 52 704 and 46 572 treatment courses, respectively. In RA, we observed 135 neuroinflammatory events (65% DML) with cIR of 0.38 with oTNFi and 0.34 with etanercept. The HR of oTNFi versus etanercept was 1.07 (95% CI 0.74 to 1.54) for any neuroinflammatory event, 0.79 (95% CI 0.51 to 1.22) for DML, 2.20 (95% CI 1.05 to 4.63) for IPN and 0.73 (95% CI 0.34 to 1.56) for MS. In SpA, we observed 179 events (78% DML) with cIR of 0.68 with oTNFi and 0.65 with etanercept. The HR for any neuroinflammatory event, DML, IPN and MS was 1.06 (95% CI 0.75 to 1.50), 1.01 (95% CI 0.68 to 1.50), 1.28 (95% CI 0.61 to 2.69) and 0.94 (95% CI0.53 to 1.69), respectively. Conclusion The cIRs of neuroinflammatory events are higher in SpA than in RA, but the choice of specific TNFi does not seem to play an important role in the risk of neuroinflammatory events.

• Nordberg, Lena Bugge; Schrumpf, Marte; Kristianslund, Eirik; Lillejordet, Even; Provan, Sella Aarrestad & Lillegraven, Siri (2023). Rheumatology congresses post COVID-19: we cannot regress. The Lancet Rheumatology. doi: 10.1016/S2665-9913(23)00153-4. Fulltekst i vitenarkiv
• Ullensvang, Gyda; Kringeland, Ester Anne; Ikdahl, Eirik; Provan, Sella Aarrestad; Berg, Inger Jorid & Rollefstad, Silvia Christin Hellerud [Vis alle 10 forfattere av denne artikkelen] (2023). Cardiovascular organ damage in relation to hypertension status in patients with ankylosing spondylitis. Blood Pressure. ISSN 0803-7051. 32(1). doi: 10.1080/08037051.2023.2205956. Fulltekst i vitenarkiv Vis sammendrag

  Purpose Hypertension is a major cardiovascular (CV) risk factor in ankylosing spondylitis (AS) patients. Less is known about the prevalence of CV organ damage in relation to hypertension status in AS patients. Materials and Methods CV organ damage was assessed by echocardiography, carotid ultrasound and pulse wave velocity (PWV) by applanation tonometry in 126 AS patients (mean age 49 ± 12 years, 39% women) and 71 normotensive controls (mean age 47 ± 11 years, 52% women). CV organ damage was defined as presence of abnormal left ventricular (LV) geometry, LV diastolic dysfunction, left atrial (LA) dilatation, carotid plaque or high pulse wave velocity (PWV). Results Thirty-four percent of AS patients had hypertension. AS patients with hypertension were older and had higher C-reactive protein (CRP) levels compared to AS patients without hypertension and controls (p < 0.05). The prevalence of CV organ damage was 84% in AS patients with hypertension, 29% in AS patients without hypertension and 30% in controls (p < 0.001). In multivariable logistic regression analyses, having hypertension was associated with a fourfold increased risk of CV organ damage independent of age, presence of AS, gender, body mass index, CRP, and cholesterol (odds ratio (OR) 4.57, 95% confidence interval (CI) 1.53 to 13.61, p = 0.006). In AS patients, presence of hypertension was the only covariable significantly associated with presence of CV organ damage (OR 4.40, 95% CI 1.40 to 13.84, p = 0.011). Conclusions CV organ damage in AS was strongly associated with hypertension, pointing to the importance of guideline-based hypertension management in AS patients.

• Ikdahl, Eirik; Rollefstad, Silvia Christin Hellerud; Kazemi, Amirhossein; Provan, Sella Aarrestad; Larsen, Trine-Lise & Semb, Anne Grete (2023). Non-steroidal anti-inflammatory drugs and risk of pulmonary embolism in patients with inflammatory joint disease—results from the nationwide Norwegian Cardio-rheuma registry. European Heart Journal (EHJ) - Cardiovascular Pharmacotherapy. ISSN 2055-6837. 10(1), s. 27–34. doi: 10.1093/ehjcvp/pvad078. Fulltekst i vitenarkiv Vis sammendrag

  Aims Patients with inflammatory joint diseases (IJD), including rheumatoid arthritis (RA), psoriatic arthritis (PsA), and axial spondyloarthritis (axSpA) have increased rates of pulmonary embolism (PE). Non-steroidal anti-inflammatory drugs (NSAIDs) use is associated with PE in the general population. Our aim was to evaluate the association between NSAIDs use and PE in IJD patients. Methods and results Using individual-level registry data from the whole Norwegian population, including data from the Norwegian Patient Registry and the Norwegian Prescription Database, we: (1) evaluated PE risk in IJD compared to non-IJD individuals, (2) applied the self-controlled case series method to evaluate if PE risks were associated with use of traditional NSAIDs (tNSAIDs) and selective cox-2 inhibitors (coxibs). After a one-year wash-out period, we followed 4 660 475 adults, including 74 001 with IJD (RA: 39 050, PsA: 20 803, and axSpA: 18 591) for a median of 9.0 years. Crude PE incidence rates per 1000 patient years were 2.02 in IJD and 1.01 in non-IJD individuals. Age and sex adjusted hazard ratios for PE events were 1.57 for IJD patients compared to non-IJD. Incidence rate ratios (IRR) [95% confidence interval (CI)] for PE during tNSAIDs use were 0.78 (0.64–0.94, P = 0.010) in IJD and 1.68 (1.61–1.76, P < 0.001) in non-IJD. IRR (95% CI) for PE during coxibs use was 1.75 (1.10–2.79, P = 0.018) in IJD and 2.80 (2.47–3.18, P < 0.001) for non-IJD. Conclusion Pulmonary embolism rates appeared to be higher in IJD than among non-IJD subjects in our study. Traditional NSAIDs may protect against PE in IJD patients, while coxibs may associated with increased PE risk.

• Berg, Inger Jorid; Tveter, Anne Therese; Bakland, Gunnstein; Hakim, Sarah; Kristianslund, Eirik & Lillegraven, Siri [Vis alle 15 forfattere av denne artikkelen] (2023). Follow-Up of Patients With Axial Spondyloarthritis in Specialist Health Care With Remote Monitoring and Self-Monitoring Compared With Regular Face-to-Face Follow-Up Visits (the ReMonit Study): Protocol for a Randomized, Controlled Open-Label Noninferiority Trial. JMIR Research Protocols. 12(1), s. e52872–e52872. doi: 10.2196/52872. Fulltekst i vitenarkiv Vis sammendrag

  Background: Patients with chronic inflammatory joint diseases such as axial spondyloarthritis have traditionally received regular follow-up in specialist health care to maintain low disease activity. The follow-up has been organized as prescheduled face-to-face visits, which are time-consuming for both patients and health care professionals. Technology has enabled the remote monitoring of disease activity, allowing patients to self-monitor their disease and contact health care professionals when needed. Remote monitoring or self-monitoring may provide a more personalized follow-up, but there is limited research on how these follow-up strategies perform in maintaining low disease activity, patient satisfaction, safety, and cost-effectiveness.<p> <p>Objective: The Remote Monitoring in Axial Spondyloarthritis (ReMonit) study aimed to assess the effectiveness of digital remote monitoring and self-monitoring in maintaining low disease activity in patients with axial spondyloarthritis.<p> <p>Methods: The ReMonit study is a 3-armed, single-site, randomized, controlled, open-label noninferiority trial including patients with axial spondyloarthritis with low disease activity (Ankylosing Spondylitis Disease Activity Score <2.1) and on stable treatment with a tumor necrosis factor inhibitor. Participants were randomized 1:1:1 to arm A (usual care, face-to-face visits every sixth month), arm B (remote monitoring, monthly digital registration of patient-reported outcomes), or arm C (patient-initiated care, self-monitoring, no planned visits during the study period). The primary end point was disease activity measured with the Ankylosing Spondylitis Disease Activity Score, evaluated at 6, 12, and 18 months. We aimed to include 240 patients, 80 in each arm. Secondary end points included other measures of disease activity, patient satisfaction, safety, and cost-effectiveness.<p> <p>Results: The project is funded by the South-Eastern Norway Regional Health Authority and Centre for the treatment of Rheumatic and Musculoskeletal Diseases (REMEDY), Diakonhjemmet Hospital, Norway. Enrollment started in September 2021 and was completed with 242 patients by June 2022. The data collection will be completed in December 2023.<p> <p>Conclusions: To our knowledge, this trial will be among the first to evaluate the effectiveness, safety, and cost-effectiveness of remote digital monitoring and self-monitoring of patients with axial spondyloarthritis compared with usual care. Hence, the ReMonit study will contribute important knowledge to personalized follow-up strategies for patients with axial spondyloarthritis. These results may also be relevant for other patient groups with inflammatory joint diseases.

• Uhlig, Till; Karoliussen, Lars Fridtjof; Sexton, Joseph; Provan, Sella Aarrestad; Kvien, Tore Kristian Aaserud & Haavardsholm, Espen A. [Vis alle 7 forfattere av denne artikkelen] (2023). Course and predictors of work productivity in gout - results from the NOR-Gout longitudinal 2-year treat-to-target study. Rheumatology. ISSN 1462-0324. 62(12), s. 3886–3892. doi: 10.1093/rheumatology/kead124. Fulltekst i vitenarkiv Vis sammendrag

  Objectives In patients with gout there is a lack of longitudinal studies on the course of work productivity. We explored longitudinal changes in and predictors of work productivity over 2 years. Methods Patients in the NOR-Gout observational study with a recent gout flare and serum urate (sUA) >360 µmol/l attended tight-control visits during escalating urate lowering therapy according to a treat-to-target strategy. From the Work Productivity and Activity Impairment (WPAI) questionnaire, scores for work productivity and activity impairment were assessed over 2 years together with the Beliefs about Medicines Questionnaire and a variety of demographic and clinical variables. Results At baseline patients had a mean age of 56.4 years and 95% were males. WPAI scores at baseline were 5.0% work missed (absenteeism), 19.1% work impairment (presenteeism), 21.4% overall work impairment and 32.1% activity impairment. Work productivity and activity impairment improved during the first months, and remained stable at 1 and 2 years. Comorbidities were not cross-sectionally associated with WPAI scores at baseline, but predicted worse work impairment and activity impairment at year 1. The Beliefs about Medicines Questionnaire subscale with concerns about medicines at baseline independently predicted worse overall work impairment and worse activity impairment at year 1. Conclusions In patients with gout who were intensively treated to the sUA target, work productivity and activity impairment were largely unchanged and at 1 year predicted by comorbidities and patient concerns about medication.

• Glintborg, Bente; Giuseppe, Daniela Di; Wallman, Johan K.; Provan, Sella Aarrestad; Nordström, Dan & Hokkanen, Anna-Mari [Vis alle 15 forfattere av denne artikkelen] (2023). Is the risk of infection higher during treatment with secukinumab than with TNF inhibitors? An observational study from the Nordic countries. Rheumatology. ISSN 1462-0324. 62(2), s. 647–658. doi: 10.1093/rheumatology/keac358. Fulltekst i vitenarkiv
• Konzett, Victoria; Kerschbaumer, Andreas; Smolen, Josef S.; Kristianslund, Eirik Klami; Provan, Sella Aarrestad & Kvien, Tore Kristian Aaserud [Vis alle 7 forfattere av denne artikkelen] (2023). Definition of rheumatoid arthritis flare based on SDAI and CDAI. Annals of the Rheumatic Diseases. ISSN 0003-4967. 83(2), s. 169–176. doi: 10.1136/ard-2023-224742. Fulltekst i vitenarkiv
• Glintborg, Bente; Giuseppe, Daniela Di; Wallman, Johan Karlsson; Nordström, Dan C; Gudbjornsson, Bjorn & Hetland, Merete Lund [Vis alle 15 forfattere av denne artikkelen] (2023). Uptake and effectiveness of newer biologic and targeted synthetic disease-modifying antirheumatic drugs in psoriatic arthritis: results from five Nordic biologics registries. Annals of the Rheumatic Diseases. ISSN 0003-4967. 82(6), s. 820–828. doi: 10.1136/ard-2022-223650. Fulltekst i vitenarkiv
• Delcoigne, Bénédicte; Provan, Sella Aarrestad; Kristianslund, Eirik; Askling, Johan & Ljung, Lotta (2023). How does current disease activity in rheumatoid arthritis affect the short-term risk of acute coronary syndrome? A clinical register based study from Sweden and Norway. European journal of internal medicine. ISSN 0953-6205. doi: 10.1016/j.ejim.2023.06.013. Fulltekst i vitenarkiv
• Moe, Sigrid Reppe; Haukeland, Hilde; Brunborg, Cathrine; Botea, Antonela; Damjanic, Nenad & Wivestad, Gro Årthun [Vis alle 14 forfattere av denne artikkelen] (2023). Persisting mortality gap in systemic lupus erythematosus; a population-based study on juvenile- and adult-onset SLE in Norway 1999–2022. Rheumatology. ISSN 1462-0324. 63(8), s. 2109–2117. doi: 10.1093/rheumatology/kead519. Fulltekst i vitenarkiv Vis sammendrag

  Objective: To estimate mortality and survival rates of systemic lupus erythematosus (SLE) in a contemporary, population-based setting and assess potential influences by time, sex, ethnicity, classification criteria and age at diagnosis. Methods: We assessed mortality and survival in the Nor-SLE cohort, which includes all chart-review confirmed SLE cases resident in Southeast Norway (population 2.9 million) 1999-2017. Study end was at death, emigration, or 1 October 2022. We defined juvenile SLE by age <16 years at diagnosis. For standardized mortality rate (SMR) estimates, we applied 15 population controls per case, all matched for age, sex, residency, and ethnicity. We analyzed survival by Kaplan-Meier and risk factors by cox regression. Results: The Nor-SLE cohort included 1558 SLE cases, of whom 749 were incident and met the 2019 European Alliance of Associations for Rheumatology and American College of Rheumatology (2019-EA) classification criteria. SMR was increased to 1.8 (95% CI 1.6-2.2) in incident adult-onset SLE but did not differ between females and males. Survival rates at 5-, 10-, 15 and 20-years were lower in incident adult-onset SLE than in matched controls. In multivariable analysis, lupus nephritis associated with decreased survival, while sex did not. Separate, long-term mortality analyses in the total Nor-SLE cohort showed that SMR peaked at 7.2 (95% CI 3.3-14) in juvenile-onset SLE (n = 93) and fell gradually by increasing age at SLE diagnosis. Conclusion: This study shows persistence of a mortality gap between adult-onset SLE and controls at population level and provides indications of worryingly high mortality in juvenile-onset SLE.

• Bjørlykke, Kristin H.; Ørbo, Hilde Sofie Sager; Tveter, Anne Therese; Jyssum, Ingrid; Sexton, Joseph & Tran, Trung [Vis alle 21 forfattere av denne artikkelen] (2022). Four SARS-CoV-2 vaccine doses or hybrid immunity in patients on immunosuppressive therapies: a Norwegian cohort study. The Lancet Rheumatology. 5(1), s. e36–e46. doi: 10.1016/S2665-9913(22)00330-7. Fulltekst i vitenarkiv Vis sammendrag

  Background Data on response and safety of repeated vaccinations and hybrid immunity in patients with immune-mediated inflammatory diseases on immunosuppressive therapy is needed to further develop vaccination strategies in this vulnerable population. This study aimed to evaluate hybrid immunity and humoral immune response and safety of four SARS-CoV-2 vaccine doses in patients with immune-mediated inflammatory diseases on immunosuppressive therapy. Methods This prospective observational Norwegian study of vaccine response to COVID-19 (Nor-vaC) included adult patients aged 18 years and older with immune-mediated inflammatory diseases (rheumatoid arthritis, spondyloarthritis, psoriatic arthritis, Crohn's disease, or ulcerative colitis) on immunosuppressive therapy, who had received four SARS-CoV-2 vaccine doses (vaccine group) or three vaccine doses followed by COVID-19 (hybrid group), and healthy controls receiving three vaccine doses (control group). Patients were recruited from the Division of Rheumatology at Diakonhjemmet Hospital, Oslo, and the Department of Gastroenterology at Akershus University Hospital, Lørenskog. Patients who had COVID-19 before the third vaccine dose, and patients with allergies or intolerances to elements of the vaccine were excluded. Antibodies to the receptor-binding domain of SARS-CoV-2 spike protein (anti-RBD antibodies) were assessed 2–4 weeks following vaccination or COVID-19. This study is registered at Clinialtrials.gov, NCT04798625. Findings Between Nov 12, 2021, and April 19, 2022, 1458 participants with immune-mediated inflammatory diseases provided post-vaccination samples at 2–4 weeks following a third vaccine dose. After 544 participants were excluded, 715 (78%) of the remaining 914 participants received the fourth dose of the vaccine, and of these, 536 (75%) provided post-vaccination samples 2–4 weeks after their fourth vaccination (vaccine group). 199 (22%) of the 914 had COVID-19 after their third dose of the vaccine and of these, 167 (84%) provided samples (hybrid group). 256 of the eligible 703 patients had rheumatoid arthritis, 107 had spondyloarthritis, 115 had psoriatic arthritis, 130 had Crohn's disease, and 95 had ulcerative colitis). Median age was 56 years [IQR 45–65], 398 (57%) were women, and 305 (43%) were men. Patients in the vaccine group had higher anti-RBD antibody concentrations following the fourth vaccine dose (median 6192 BAU/ml [IQR 2878–11 243]) than after the third dose (median 5087 BAU/ml [1250–9081]; p< 0·0001), but lower antibody concentrations than the control group following the third dose (median 7595 BAU/ml [5916–12 001]; p< 0·0001). Antibody concentrations were higher in the patients in the hybrid group (23 548 BAU/ml [IQR 11 440–35 935]) than in the vaccine group (p<0·0001). No difference was found in antibody concentrations between the fourth dose of BNT162b2 (full-dose) and mRNA-1273 (half-dose). Patients and controls had a comparable safety profile after both three and four vaccine doses. Interpretation Vaccine boosters improve humoral immune responses and are safe in patients with immune-mediated inflammatory diseases on immunosuppressive therapy, and administration should be considered regularly in this patient group. Hybrid immunity with omicron induces a strong humoral response suggesting longer intervals between booster doses in this patient group.

• Giuseppe, Daniela Di; Lindström, Ulf; Aaltonen, Kalle; Relas, Heikki; Provan, Sella Aarrestad & Gudbjornsson, Bjorn [Vis alle 16 forfattere av denne artikkelen] (2022). The occurrence of multiple treatment switches in axial spondyloarthritis. Results from five Nordic rheumatology registries. Rheumatology. ISSN 1462-0324. 61(9), s. 3647–3656. doi: 10.1093/rheumatology/keab946. Fulltekst i vitenarkiv
• Delcoigne, Benedicte; Ljung, Lotta; Provan, Sella Aarrestad; Glintborg, Bente; Hetland, Merete Lund & Grøn, Kathrine Lederballe [Vis alle 12 forfattere av denne artikkelen] (2022). Short-term, intermediate-term and long-term risks of acute coronary syndrome in cohorts of patients with RA starting biologic DMARDs: Results from four Nordic countries. Annals of the Rheumatic Diseases. ISSN 0003-4967. 81, s. 789–797. doi: 10.1136/annrheumdis-2021-221996. Fulltekst i vitenarkiv
• Glintborg, Bente; Lindström, Ulf; Giuseppe, Daniela Di; Provan, Sella Aarrestad; Gudbjornsson, Bjorn & Hetland, Merete Lund [Vis alle 19 forfattere av denne artikkelen] (2022). One-Year Treatment Outcomes of Secukinumab Versus Tumor Necrosis Factor Inhibitors in Spondyloarthritis: Results From Five Nordic Biologic Registries Including More Than 10,000 Treatment Courses. Arthritis care & research. ISSN 2151-464X. 74(5), s. 748–758. doi: 10.1002/acr.24523. Fulltekst i vitenarkiv
• Loza, Estibaliz; Carmona, Loreto; Woolf, Anthony; Fautrel, Bruno; Courvoisier, Delphine S & Verstappen, Suzanne [Vis alle 15 forfattere av denne artikkelen] (2022). Implementation of recommendations in rheumatic and musculoskeletal diseases: Considerations for development and uptake. Annals of the Rheumatic Diseases. ISSN 0003-4967. 81(10). doi: 10.1136/ard-2022-223016. Fulltekst i vitenarkiv
• Cordtz, Rene Lindholm; Askling, Johan; Delcoigne, Benedicte; Smedby, Karin E.; Baecklund, Eva & Ballegaard, Christine [Vis alle 15 forfattere av denne artikkelen] (2022). Haematological malignancies in patients with psoriatic arthritis overall and treated with TNF inhibitors: a Nordic cohort study. RMD Open. 8(2). doi: 10.1136/rmdopen-2022-002776. Fulltekst i vitenarkiv
• Syversen, Silje Watterdal; Jyssum, Ingrid; Tveter, Anne Therese; Tran, Trung; Sexton, Joseph & Provan, Sella Aarrestad [Vis alle 22 forfattere av denne artikkelen] (2022). Immunogenicity and Safety of Standard and Third-Dose SARS-CoV-2 Vaccination in Patients Receiving Immunosuppressive Therapy. Arthritis & Rheumatology. ISSN 2326-5191. 74(8), s. 1321–1332. doi: 10.1002/art.42153. Fulltekst i vitenarkiv Vis sammendrag

  Objective Immunogenicity and safety following receipt of the standard SARS–CoV-2 vaccination regimen in patients with immune-mediated inflammatory diseases (IMIDs) are poorly characterized, and data after receipt of the third vaccine dose are lacking. The aim of the study was to evaluate serologic responses and adverse events following the standard 2-dose regimen and a third dose of SARS–CoV-2 vaccine in IMID patients receiving immunosuppressive therapy. Methods Adult patients receiving immunosuppressive therapy for rheumatoid arthritis, spondyloarthritis, psoriatic arthritis, Crohn's disease, or ulcerative colitis, as well as healthy adult controls, who received the standard 2-dose SARS–CoV-2 vaccination regimen were included in this prospective observational study. Analyses of antibodies to the receptor-binding domain (RBD) of the SARS–CoV-2 spike protein were performed prior to and 2–4 weeks after vaccination. Patients with a weak serologic response, defined as an IgG antibody titer of ≤100 arbitrary units per milliliter (AU/ml) against the receptor-binding domain of the full-length SARS–Cov-2 spike protein, were allotted a third vaccine dose. Results A total of 1,505 patients (91%) and 1,096 healthy controls (98%) had a serologic response to the standard regimen (P < 0.001). Anti-RBD antibody levels were lower in patients (median 619 AU/ml interquartile range [IQR] 192–4,191) than in controls (median 3,355 AU/ml [IQR 896–7,849]) (P < 0.001). The proportion of responders was lowest among patients receiving tumor necrosis factor inhibitor combination therapy, JAK inhibitors, or abatacept. Younger age and receipt of messenger RNA–1273 vaccine were predictors of serologic response. Of 153 patients who had a weak response to the standard regimen and received a third dose, 129 (84%) became responders. The vaccine safety profile among patients and controls was comparable. Conclusion IMID patients had an attenuated response to the standard vaccination regimen as compared to healthy controls. A third vaccine dose was safe and resulted in serologic response in most patients. These data facilitate identification of patient groups at risk of an attenuated vaccine response, and they support administering a third vaccine dose to IMID patients with a weak serologic response to the standard regimen.

• Syversen, Silje Watterdal; Jyssum, Ingrid; Tveter, Anne Therese; Sexton, Joseph; Christensen, Ingrid Egeland & Tran, Trung [Vis alle 20 forfattere av denne artikkelen] (2022). Immunogenicity and safety of a three-dose SARS-CoV-2 vaccination strategy in patients with immune-mediated inflammatory diseases on immunosuppressive therapy. RMD Open. 8(2). doi: 10.1136/rmdopen-2022-002417. Fulltekst i vitenarkiv Vis sammendrag

  Objectives Humoral vaccine responses to SARS-CoV-2 vaccines are impaired and short lasting in patients with immune-mediated inflammatory diseases (IMID) following two vaccine doses. To protect these vulnerable patients against severe COVID-19 disease, a three-dose primary vaccination strategy has been implemented in many countries. The aim of this study was to evaluate humoral response and safety of primary vaccination with three doses in patients with IMID. Methods Patients with IMID on immunosuppressive therapy and healthy controls receiving three-dose and two-dose primary SARS-CoV-2 vaccination, respectively, were included in this prospective observational cohort study. Anti-Spike antibodies were assessed 2–4 weeks, and 12 weeks following each dose. The main outcome was anti-Spike antibody levels 2–4 weeks following three doses in patients with IMID and two doses in controls. Additional outcomes were the antibody decline rate and adverse events. Results 1100 patients and 303 controls were included. Following three-dose vaccination, patients achieved median (IQR) antibody levels of 5720 BAU/mL (2138–8732) compared with 4495 (1591–6639) in controls receiving two doses, p=0.27. Anti-Spike antibody levels increased with median 1932 BAU/mL (IQR 150–4978) after the third dose. The interval between the vaccine doses and vaccination with mRNA-1273 or a combination of vaccines were associated with antibody levels following the third dose. Antibody levels had a slower decline-rate following the third than the second vaccine dose, p<0.001. Adverse events were reported by 464 (47%) patients and by 196 (78%) controls. Disease flares were reported by 70 (7%) patients. Conclusions This study shows that additional vaccine doses to patients with IMID contribute to strong and sustained immune-responses comparable to healthy persons vaccinated twice, and supports repeated vaccination of patients with IMID. Trial registration number NCT04798625.

• Delcoigne, Bénédicte; Provan, Sella Aarrestad; Hammer, Hilde Berner; Giuseppe, Daniela Di; Frisell, Thomas & Glintborg, Bente [Vis alle 13 forfattere av denne artikkelen] (2022). Do patient-reported measures of disease activity in rheumatoid arthritis vary between countries? Results from a Nordic collaboration. Rheumatology. ISSN 1462-0324. 61(11), s. 4286–4296. doi: 10.1093/rheumatology/keac081. Fulltekst i vitenarkiv Vis sammendrag

  Abstract Objectives To investigate whether patient-reported outcomes vary across countries and are influenced by cultural/contextual factors. Specifically, we aimed to assess inter-country differences in tender joint count (TJC), pain and patient’s global health assessment (PGA), and their impact on disease activity (DAS28-CRP) in RA patients from five Nordic countries. Methods We collected data (baseline, 3- and 12-months) from rheumatology registers in the five countries comprising RA patients starting a first ever MTX or a first ever TNF inhibitor (TNFi). In order to assess the role of context (=country), we separately modelled TJC, pain and PGA as functions of objective variables (CRP, swollen joint count, age, sex, calendar period and disease duration) with linear models. Analyses were performed at each time point and for both treatments. We further assessed the impact of inter-country differences on DAS28-CRP. Results A total of 27 645 RA patients started MTX and 19 733 started a TNFi. Crude inter-country differences at MTX start amounted to up to 4 points (28 points scale) for TJC, 10 and 27 points (0–100 scale) for pain and PGA, respectively. Corresponding numbers at TNFi start were 3 (TJC), 27 (pain) and 24 (PGA) points. All differences were reduced at 3- and 12-months, and attenuated when adjusting for the objective variables. The variation in predicted DAS28-CRP across countries amounted to &amp;lt;0.5 units. Conclusions Inter-country differences in TJC, pain and PGA are greater than expected based on differences in objective measures, but have a small clinical impact on DAS28-CRP across countries.

• Christensen, Ingrid Egeland; Jyssum, Ingrid; Tveter, Anne Therese; Sexton, Joseph; Tran, Trung & Mjaaland, Siri [Vis alle 19 forfattere av denne artikkelen] (2022). The persistence of anti-Spike antibodies following two SARS-CoV-2 vaccine doses in patients on immunosuppressive therapy compared to healthy controls—a prospective cohort study. BMC Medicine. 20(1), s. 1–13. doi: 10.1186/s12916-022-02587-8. Fulltekst i vitenarkiv Vis sammendrag

  Background The durability of vaccine-induced humoral immunity against SARS-CoV-2 in patients with immune-mediated inflammatory diseases (IMIDs) on immunosuppressive therapy is not known. The aim of this study was to compare the persistence of anti-Spike antibodies following two-dose SARS-CoV-2 vaccination between IMID patients and healthy controls and to identify factors associated with antibody decline. Methods IMID patients on immunosuppressive medication enrolled in the prospective observational Nor-vaC study were included. Participants received two-dose SARS-CoV-2 vaccination. Serum collected at two time points following vaccination (first assessment within 6–48 days, second within 49–123 days) were analyzed for antibodies binding the receptor-binding domain (RBD) of the SARS-CoV-2 Spike protein. Multivariable regression models estimated percent reduction in anti-RBD over 30 days and factors associated with reduction. Results A total of 1108 patients (403 rheumatoid arthritis, 195 psoriatic arthritis, 195 spondyloarthritis, 124 ulcerative colitis, 191 Crohn’s disease) and 134 controls provided blood samples within the defined intervals (median 19 days [IQR 15–24] and 97 days [87–105] after second vaccine dose). Antibody levels were lower in patients compared to controls at both time points, with median anti-RBD 2806 BAU/ml [IQR 1018–6068] in patients and 6187 BAU/ml [4105–7496] in controls (p<0.001) at first assessment, and 608 BAU/ml [IQR 58–1053] in patients and 1520 BAU/ml [979–3766] in controls (p<0.001) at second assessment. At second assessment, low anti-RBD antibody levels (defined as <200 BAU/ml) were found in 449 (41%) patients, and 6 (5%) controls (p<0.001). The change was − 83% in patients and − 66% in controls (p<0.001). Patients had a greater estimated 30 days percent reduction in anti-RBD levels compared to controls − 4.9 (95% CI − 7.4 to − 2.4), (p<0.05). Among therapies, mono- or combination treatment with tumor necrosis factor inhibitors was associated with the greatest decline. Conclusions Within 4 months after vaccination, antibody levels declined considerably in both IMID patients and controls. Patients had lower initial antibody levels and a more pronounced decline compared to healthy controls and were therefore more likely to decline to low antibody levels. These results support that IMID patients need additional vaccine doses at an earlier stage than healthy individuals.

• Hellgren, Karin; Ballegaard, Christine; Delcoigne, Bénédicte; Cordtz, René; Nordström, Dan C. & Aaltonen, Kalle [Vis alle 14 forfattere av denne artikkelen] (2021). Risk of solid cancers overall and by subtypes in patients with psoriatic arthritis treated with TNF inhibitors - a Nordic cohort study. Rheumatology. ISSN 1462-0324. 60(8), s. 3656–3668. doi: 10.1093/rheumatology/keaa828. Fulltekst i vitenarkiv
• Jyssum, Ingrid; Kared, Hassen; Tran, Trung; Tveter, Anne Therese; Provan, Sella Aarrestad & Sexton, Joseph [Vis alle 22 forfattere av denne artikkelen] (2021). Humoral and cellular immune responses to two and three doses of SARS-CoV-2 vaccines in rituximab-treated patients with rheumatoid arthritis: a prospective, cohort study. The Lancet Rheumatology. 00. doi: 10.1016/S2665-9913(21)00394-5. Fulltekst i vitenarkiv Vis sammendrag

  Background In rituximab-treated patients with rheumatoid arthritis, humoral and cellular immune responses after two or three doses of SARS-CoV-2 vaccines are not well characterised. We aimed to address this knowledge gap. Methods This prospective, cohort study (Nor-vaC) was done at two hospitals in Norway. For this sub-study, we enrolled patients with rheumatoid arthritis on rituximab treatment and healthy controls who received SARS-CoV-2 vaccines according to the Norwegian national vaccination programme. Patients with insufficient serological responses to two doses (antibody to the receptor-binding domain [RBD] of the SARS-CoV-2 spike protein concentration <100 arbitrary units [AU]/mL) were allotted a third vaccine dose. Antibodies to the RBD of the SARS-CoV-2 spike protein were measured in serum 2–4 weeks after the second and third doses. Vaccine-elicited T-cell responses were assessed in vitro using blood samples taken before and 7–10 days after the second dose and 3 weeks after the third dose from a subset of patients by stimulating cryopreserved peripheral blood mononuclear cells with spike protein peptides. The main outcomes were the proportions of participants with serological responses (anti-RBD antibody concentrations of ≥70 AU/mL) and T-cell responses to spike peptides following two and three doses of SARS-CoV-2 vaccines. The study is registered at ClinicalTrials.gov, NCT04798625, and is ongoing. Findings Between Feb 9, 2021, and May 27, 2021, 90 patients were enrolled, 87 of whom donated serum and were included in our analyses (69 [79·3%] women and 18 [20·7%] men). 1114 healthy controls were included (854 [76·7%] women and 260 [23·3%] men). 49 patients were allotted a third vaccine dose. 19 (21·8%) of 87 patients, compared with 1096 (98·4%) of 1114 healthy controls, had a serological response after two doses (p<0·0001). Time since last rituximab infusion (median 267 days [IQR 222–324] in responders vs 107 days [80–152] in non-responders) and vaccine type (mRNA-1273 vs BNT162b2) were significantly associated with serological response (adjusting for age and sex). After two doses, 10 (53%) of 19 patients had CD4+ T-cell responses and 14 (74%) had CD8+ T-cell responses. A third vaccine dose induced serological responses in eight (16·3%) of 49 patients, but induced CD4+ and CD8+ T-cell responses in all patients assessed (n=12), including responses to the SARS-CoV-2 delta variant (B.1.617.2). Adverse events were reported in 32 (48%) of 67 patients and in 191 (78%) of 244 healthy controls after two doses, with the frequency not increasing after the third dose. There were no serious adverse events or deaths. Interpretation This study provides important insight into the divergent humoral and cellular responses to two and three doses of SARS-CoV-2 vaccines in rituximab-treated patients with rheumatoid arthritis. A third vaccine dose given 6–9 months after a rituximab infusion might not induce a serological response, but could be considered to boost the cellular immune response.

• Haugmark, Trond; Hagen, Kåre Birger; Provan, Sella Aarrestad; Smedslund, Geir & Zangi, Heidi A (2021). Effects of a mindfulness-based and acceptance-based group programme followed by physical activity for patients with fibromyalgia: a randomised controlled trial. BMJ Open. 11(6). doi: 10.1136/bmjopen-2020-046943. Fulltekst i vitenarkiv Vis sammendrag

  Introduction: Non-pharmacological approaches are recommended as first-line treatment for patients with fibromyalgia. This randomised controlled trial investigated the effects of a multicomponent rehabilitation programme for patients with recently diagnosed fibromyalgia in primary and secondary healthcare. Methods: Patients with widespread pain ≥3 months were referred to rheumatologists for diagnostic clarification and assessment of study eligibility. Inclusion criteria were age 20–50 years, engaged in work or studies at present or during the past 2 years, and fibromyalgia diagnosed according to the American College of Rheumatology 2010 criteria. All eligible patients participated in a short patient education programme before inclusion and randomisation. The multicomponent programme, a 10-session mindfulness-based and acceptance-based group programme followed by 12 weeks of physical activity counselling was evaluated in comparison with treatment as usual, that is, no treatment or any other treatment of their choice. The primary outcome was the Patient Global Impression of Change (PGIC). Secondary outcomes were self-reported pain, fatigue, sleep quality, psychological distress, physical activity, health-related quality of life and work ability at 12-month follow-up. Results: In total, 170 patients were randomised, 1:1, intervention:control. Overall, the multicomponent rehabilitation programme was not more effective than treatment as usual; 13% in the intervention group and 8% in the control group reported clinically relevant improvement in PGIC (p=0.28). No statistically significant between-group differences were found in any diseaserelated secondary outcomes. There were significant between-group differences in patient’s tendency to be mindful (p=0.016) and perceived benefits of exercise (p=0.033) in favour of the intervention group. Conclusions: A multicomponent rehabilitation programme combining patient education with a mindfulness-based and acceptance-based group programme followed by physical activity counselling was not more effective than patient education and treatment as usual for patients with recently diagnosed fibromyalgia at 12-month follow-up

• Chatzidionysiou, Katerina; Hetland, Merete Lund; Frisell, Thomas; Giuseppe, Daniela Di; Hellgren, Karin & Glintborg, Bente [Vis alle 20 forfattere av denne artikkelen] (2021). Effectiveness of a Second Biologic After Failure of a Non–tumor Necrosis Factor Inhibitor As First Biologic in Rheumatoid Arthritis. Journal of Rheumatology. ISSN 0315-162X. 48. doi: 10.3899/jrheum.201467. Fulltekst i vitenarkiv Vis sammendrag

  Objective: In rheumatoid arthritis (RA), evidence regarding the effectiveness of a second biologic disease-modifying antirheumatic drug (bDMARD) in patients whose first-ever bDMARD was a non-tumor necrosis factor inhibitor (TNFi) bDMARD is limited. The objective of this study was therefore to assess the outcome of a second bDMARD (non-TNFi: rituximab [RTX], abatacept [ABA], or tocilizumab [TCZ], separately; and TNFi) after failure of a non-TNFi bDMARD as first bDMARD. Methods: We identified patients with RA from the 5 Nordic biologics registers who started treatment with a non-TNFi as first-ever bDMARD but switched to a second bDMARD. For the second bDMARD, we assessed drug survival (at 6 and 12 months) and primary response (at 6 months). Results: We included 620 patients starting a second bDMARD (ABA 86, RTX 40, TCZ 67, and TNFi 427) following failure of a first non-TNFi bDMARD. At 6 and 12 months after start of their second bDMARD, approximately 70% and 60%, respectively, remained on treatment, and at 6 months, less than one-third of patients were still on their second bDMARD and had reached low disease activity or remission according to the Disease Activity Score in 28 joints. For those patients whose second bMDARD was a TNFi, the corresponding proportion was slightly higher (40%). Conclusion: The drug survival and primary response of a second bDMARD in patients with RA switching due to failure of a non-TNFi bDMARD as first bDMARD is modest. Some patients may benefit from TNFi when used after failure of a non-TNFi as first bDMARD.

• Haugmark, Trond; Hagen, Kåre Birger; Provan, Sella Aarrestad; Sexton, Joseph & Zangi, Heidi Andersen (2021). Trajectories of change in symptom severity in patients with fibromyalgia: exploratory analyses of a randomised controlled trial. Rheumatology International. ISSN 0172-8172. 41(4), s. 691–697. doi: 10.1007/s00296-021-04801-x. Fulltekst i vitenarkiv
• Tveter, Anne Therese; Provan, Sella Aarrestad; Moholt, Ellen; Bergsmark, Kjetil & Østerås, Nina (2021). Use of video consultations in an outpatient rheumatology clinic. Tidsskrift for Den norske legeforening (Tidsskriftet). ISSN 0029-2001. 141(8), s. 737–742. doi: 10.4045/tidsskr.20.0882. Fulltekst i vitenarkiv
• Provan, Sella A.; Dean, Linda E.; Jones, Gareth & Macfarlane, Gary J. (2021). The changing states of fibromyalgia in patients with axial spondyloarthritis: results from the British Society of Rheumatology Biologics Register for Ankylosing Spondylitis. Rheumatology. ISSN 1462-0324. 60(9), s. 4121–4129. doi: 10.1093/rheumatology/keaa888. Fulltekst i vitenarkiv
• Hansen, Rebekka Lund; Jørgensen, Tanja Schoedt; Dreyer, Lene; Hetland, Merete Lund; Glintborg, Bente & Askling, Johan [Vis alle 17 forfattere av denne artikkelen] (2021). Inflammatory hallmarks of lesser prominence in psoriatic arthritis patients starting biologics: A Nordic population-based cohort study. Rheumatology. ISSN 1462-0324. 60(1), s. 140–146. doi: 10.1093/rheumatology/keaa237. Fulltekst i vitenarkiv
• Christensen, Ingrid Egeland; Lillegraven, Siri; Pawel, Mielnik; Bakland, Gunnstein; Loli, Liz Paucar & Sexton, Joseph [Vis alle 9 forfattere av denne artikkelen] (2021). Serious infections in patients with rheumatoid arthritis and psoriatic arthritis treated with tumour necrosis factor inhibitors: data from register linkage of the NOR-DMARD study. Annals of the Rheumatic Diseases. ISSN 0003-4967. s. 1–4. doi: 10.1136/annrheumdis-2021-221007. Fulltekst i vitenarkiv Vis sammendrag

  Objectives To estimate the incidence of serious infections (SIs) in patients with rheumatoid arthritis (RA) and psoriatic arthritis (PsA) treated with tumour necrosis factor inhibitor (TNFi), and compare risk of SIs between patients with RA and PsA. Methods We included patients with RA and PsA from the NORwegian-Disease Modifying Anti-Rheumatic Drug registry starting TNFi treatment. Crude incidence rates (IRs) and IR ratio for SIs were calculated. The risk of SIs in patients with RA and PsA was compared using adjusted Cox-regression models. Results A total of 3169 TNFi treatment courses (RA/PsA: 1778/1391) were identified in 2359 patients. Patients with RA were significantly older with more extensive use of co-medication. The crude IRs for SIs were 4.17 (95% CI 3.52 to 4.95) in patients with RA and 2.16 (95% CI 1.66 to 2.81) in patients with PsA. Compared with the patients with RA, patients with PsA had a lower risk of SIs (HR 0.59, 95% CI 0.41 to 0.85, p=0.004) in complete set analysis. The reduced risk in PsA versus RA remained significant after multiple adjustments and consistent across strata based on age, gender and disease status. Conclusions Compared with patients with RA, the risk of SIs was significantly lower in patients with PsA during TNFi exposure.

• Provan, Sella Aarrestad; Michelsen, Brigitte; Sexton, Joseph; Uhlig, Till & Hammer, Hilde Berner (2020). Trajectories of fatigue in actively treated patients with established rheumatoid arthritis starting biologic DMARD therapy. RMD Open. 6(3). doi: 10.1136/rmdopen-2020-001372. Fulltekst i vitenarkiv
• Lindström, Ulf; Glintborg, Bente; Giuseppe, Daniela Di; Jørgensen, Tanja Schjødt; Gudbjornsson, Bjorn & Grøn, Kathrine Lederballe [Vis alle 17 forfattere av denne artikkelen] (2020). Comparison of treatment retention and response to secukinumab versus tumour necrosis factor inhibitors in psoriatic arthritis. Rheumatology. ISSN 1462-0324. doi: 10.1093/rheumatology/keaa825. Fulltekst i vitenarkiv
• Sveaas, Silje Halvorsen; Dagfinrud, Hanne; Berg, Inger Jorid; Provan, Sella Aarrestad; Johansen, Melissa Woll & Pedersen, Elisabeth Alexandersen [Vis alle 7 forfattere av denne artikkelen] (2020). High-Intensity Exercise Improves Fatigue, Sleep, and Mood in Patients With Axial Spondyloarthritis: Secondary Analysis of a Randomized Controlled Trial. Physical Therapy. ISSN 0031-9023. 100(8), s. 1323–1332. doi: 10.1093/ptj/pzaa086. Fulltekst i vitenarkiv Vis sammendrag

  <i>Objective</i> - Although exercise is recommended in the treatment of axial spondyloarthritis (axSpa), the focus has been on flexibility, and the effect of high-intensity exercises is unknown. The purpose of this study was to investigate the effect of high-intensity exercises on fatigue, sleep, and mood in patients with axSpA.<br><br> <i>Methods</i> - In this secondary analysis of a randomized controlled trial, participants were recruited from outpatient clinics at 4 hospitals in Scandinavia. A total of 100 patients with axSpA were randomized to either an exercise group (n = 50) or a control group (n = 50). High-intensity exercise was provided 3 times per week for 3 months and supervised by a physical therapist. The controls received no intervention. Measurements were self-reported at baseline, 3 months, and 12 months: fatigue, using the Fatigue Severity Scale (range = 0–7, 7 = worst, ≥5 = severe); vitality, using the RAND 36-item short-form health survey (SF-36, range = 0–100, 100 = best); sleep, using the Pittsburgh Sleep Quality Index (range = 0–21, 21 = worst, >5 = poor quality); mood, using the General Health Questionnaire 12 (range = 0–36, 36 = worst); and general health, using the EUROQoL (range = 0–100, 100 = best).<br><br> <i>Results</i> - A total of 38 participants (76%) in the exercise group followed ≥80% of the exercise protocol. At 3 months, there was a significant beneficial effect on fatigue (mean group differences = −0.4, 95% CI = −0.7 to −0.1), vitality (5.0, 95% CI = 1.1 to 10.5), mood (−2, 95% CI = −3.7 to −0.04), and general health (9.0, 95% CI = 3.3 to 14.7) but no effect on sleep (−1.1, 95% CI = −2.1 to 0.2). Compared with the control group, the exercise group had a reduced rate of severe fatigue and poor sleep. No differences were seen between the groups at 12 months.<br><br> <i>Conclusions</i> - A 3-month exercise program had a beneficial effect on fatigue, sleep, mood, and general health in patients with axSpA at the end of the intervention; however, no long-term effects were seen.<br><br> <i>Impact</i> - High-intensity cardiorespiratory and strength exercises should be considered as important in exercise programs for patients with axSpA.

• Chatzidionysiou, Katerina; Delcoigne, Bénédicte; Frisell, Thomas; Hetland, Merete L.; Glintborg, Bente & Dreyer, Lene [Vis alle 15 forfattere av denne artikkelen] (2020). How do we use biologics in rheumatoid arthritis patients with a history of malignancy? An assessment of treatment patterns using Scandinavian registers. RMD Open. 6(2). doi: 10.1136/rmdopen-2020-001363. Fulltekst i vitenarkiv
• Hammer, Hilde Berner; Michelsen, Brigitte; Sexton, Joe; Uhlig, Till & Provan, Sella Aarrestad (2020). Fatigue is cross-sectionally not associated with objective assessments of inflammation, but changes in fatigue are associated with changes of disease activity assessments during biologic treatment of patients with established rheumatoid arthritis. Clinical Rheumatology. ISSN 0770-3198. s. 1–11. doi: 10.1007/s10067-020-05402-y. Fulltekst i vitenarkiv Vis sammendrag

  Objective The associations between fatigue and disease activity in patients with rheumatoid arthritis (RA) have not been defined. The present objectives were to explore in RA patients the cross-sectional and longitudinal relation of fatigue with subjective as well as objective assessments of disease activity. Methods RA patients were consecutively included when initiating biologic disease-modifying anti-rheumatic drugs (DMARDs) and assessed at baseline, 1, 2, 3, 6, and 12 months with investigation of fatigue, patient-reported outcome measures (PROMs; joint pain and patient’s global disease activity, MHAQ, pain catastrophizing, Mental Health score), clinical examinations (examiner’s global disease activity, 28 tender and swollen joint counts), and laboratory variables (ESR, CRP, calprotectin). Ultrasound examinations (semi-quantitative scoring (0–3)) with grey scale and power Doppler were performed of 36 joints and 4 tendons. Statistics included one-way analysis of variance, Pearson’s correlations, and multiple linear and logistic regression analysis. Results A total of 208 RA patients (mean (SD) age 53.2 (13.2) years, disease duration 9.8 (8.5) years) were included. Fatigue levels diminished during follow-up (mean (SD) baseline/12 months; 4.8 (2.8)/3.0 (2.5) (p < 0.001)). Substantial correlations were cross-sectionally found between fatigue and PROMs (median (IQR) r=0.61 (0.52-0.71)) but not with the objective inflammatory assessments. During follow-up, baseline fatigue was associated with PROMs (p < 0.001) but not with objective inflammatory assessments. However, change of fatigue was associated with change in all variables. Higher baseline fatigue levels were associated with lower clinical composite score remission rates. Conclusion Fatigue was cross-sectionally associated to subjective but not to objective disease assessments. However, change of fatigue during treatment was associated to all assessments of disease activity.

• Provan, Sella Aarrestad; Rollefstad, Silvia Christin Hellerud; Ikdahl, Eirik; Mathiessen, Alexander; Berg, Inger Jorid & Wilkinson, I. B. [Vis alle 12 forfattere av denne artikkelen] (2019). Biomarkers of cardiovascular risk across phenotypes of osteoarthritis. BMC Rheumatology. 3(33). doi: 10.1186/s41927-019-0081-8. Fulltekst i vitenarkiv
• Hammer, Hilde Berner; Michelsen, Brigitte; Sexton, Joseph; Haugen, Ida Kristin; Provan, Sella Aarrestad & Haavardsholm, Espen A. [Vis alle 8 forfattere av denne artikkelen] (2019). Swollen, but not tender joints, are independently associated with ultrasound synovitis: Results from a longitudinal observational study of patients with established rheumatoid arthritis. Annals of the Rheumatic Diseases. ISSN 0003-4967. 78, s. 1179–1185. doi: 10.1136/annrheumdis-2019-215321. Fulltekst i vitenarkiv
• Joseph, Kenth-Louis Hansen; Hagen, Kåre Birger; Tveter, Anne Therese; Magnusson, Karin; Provan, Sella Aarrestad & Dagfinrud, Hanne (2019). Osteoarthritis-Related Walking Disability and Arterial Stiffness: Results From a Cross-Sectional Study. Arthritis care & research. ISSN 2151-464X. 71(2), s. 252–258. doi: 10.1002/acr.23697. Fulltekst i vitenarkiv
• Provan, Sella Aarrestad; Austad, Cathrine; Halsaa, Vera; Hammer, Hilde Berner; Kvien, Tore Kristian & Uhlig, Till (2019). Fibromyalgia in patients with rheumatoid arthritis. A 10-year follow-up study, results from the Oslo Rheumatoid Arthritis Register. Clinical and Experimental Rheumatology. ISSN 0392-856X. 37(Supplement 116), s. S58–S62. Fulltekst i vitenarkiv
• Sveaas, Silje Halvorsen; Bilberg, Annelie; Berg, Inger Jorid; Provan, Sella Aarrestad; Rollefstad, Silvia Christin Hellerud & Semb, Anne Grete [Vis alle 10 forfattere av denne artikkelen] (2019). High intensity exercise for 3 months reduces disease activity in axial spondyloarthritis (axSpA): A multicentre randomised trial of 100 patients. British Journal of Sports Medicine. ISSN 0306-3674. doi: 10.1136/bjsports-2018-099943. Fulltekst i vitenarkiv

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• Michelsen, Brigitte; Kvien, Tore Kristian Aaserud & Provan, Sella Aarrestad (2026). National Socioeconomic Status Influences Disease Severity at Treatment Start and Duration of Treatment in Patients with Psoriatic Arthritis and Axial Spondyloarthritis - TheSynapse. [Internet]. The Synapse. Fulltekst i vitenarkiv Vis sammendrag

  Differences in how long patients remain on treatment may reflect not only how well treatment works but may also reflect healthcare policies influenced by a country’s wealth, according to a new study in the Annals of the Rheumatic Diseases. August 11, 2026 – A study initiated by the European Spondyloarthritis Research Collaboration Network (EuroSpA) examined

• Berg, Inger Jorid; Asphaug, Lars; Kristianslund, Eirik; Tveter, Anne Therese; Gossec, Laure & Macfarlane, Gary J [Vis alle 12 forfattere av denne artikkelen] (2026). Patient-initiated follow-up is more cost-effective than remote monitoring or usual care in axial spondyloarthritis, results from the ReMonit randomized controlled trial. Fulltekst i vitenarkiv
• Alvino, Miryam; Provan, Sella Aarrestad; Aas, Eline & Hagen, Gunhild (2026). COST-EFFECTIVENESS OF PNEUMOCOCCAL VACCINATION IN IN 50-YEAR-OLD PATIENTS WITH RHEUMATOID ARTHRITIS IN NORWAY-A MARKOV MODELLING ANALYSIS. doi: https:/scientific.sparx-ip.net/archiveeular/?c=a&searchfor=gunhild%20hagen&view=1&item=2026POS0422. Fulltekst i vitenarkiv
• Hagen, Gunhild; Opheim, Anna K; Øverbø, Joakim; Aas, Eline & Provan, Sella Aarrestad (2026). COST-EFFECTIVENESS OF HERPES ZOSTER VACCINATION IN PATIENTS WITH RHEUMATOID ARTHRITIS. doi: https:/scientific.sparx-ip.net/archiveeular/?c=a&searchfor=gunhild%20hagen&view=1&item=2026POS0036. Fulltekst i vitenarkiv
• Pavia, Fabiola; Provan, Sella Aarrestad; Aas, Eline; Dagfinrud, Hanne; Sveaas, Silje Halvorsen & Berg, Inger Jorid [Vis alle 8 forfattere av denne artikkelen] (2026). COST-EFFECTIVENESS OF A HIGH-INTENSITY EXERCISE PROGRAM FOR AXIAL SPONDYLOARTHRITIS: A MODELLING STUDY. doi: https:/scientific.sparx-ip.net/archiveeular/?c=a&searchfor=gunhild%20hagen&view=1&item=2026POS0192. Fulltekst i vitenarkiv
• Provan, Sella Aarrestad & Håskjold, Sissel Egset (2025). Fibromyalgi- Bevegelse er som medisin. [Journal]. Norsk Ukeblad. Fulltekst i vitenarkiv
• Provan, Sella Aarrestad (2025). På agendaen: KVINNEHELSE. [Journal]. Revmatiker.no og R, et magasin fra Norsk Revmatikerforbund. doi: https:/revmatiker.prenly.com/. Fulltekst i vitenarkiv
• Ørbo, Hilde Sofie Sager; Fukui, S.; Sundbakk, L.M.; Tedeschi, S.K.; Kvien, Tore Kristian Aaserud & Goll, Guro Løvik [Vis alle 8 forfattere av denne artikkelen] (2025). OP0183 CANCER MORTALITY IN FEMALE ARTHRITIS PATIENTS: 20 YEARS FOLLOW-UP FROM THE PROSPECTIVE NOR-DMARD STUDY. doi: 10.1016/j.ard.2025.05.196. Fulltekst i vitenarkiv
• Holly, T.; Brun, Marthe Kirkesæther; Jørgensen, K.K.; Goll, Guro Løvik; Sexton, Joseph & Gehin, Johanna [Vis alle 15 forfattere av denne artikkelen] (2025). POS1077 Cost-effectiveness of proactive terapeutic drug monitoring (TDM) in patients with inflmmatory disease-results from the Nor-Drum trial. doi: 10.1016/j.ard.2025.06.431. Fulltekst i vitenarkiv
• Uhlig, Till; Provan, Sella Aarrestad & Fryxelius, Anna (2025). Langtidsstudier. [Internet]. Revmatiker.no. doi: https:/www.revmatiker.no/forskningswebinar-hvordan-gar-det-med-revmatikere-pa-sikt/#%3A%7E%3Atext=Norsk%20Revmatikerforbund%20og%20REMEDY%20inviterer%20til%20forskningswebinar%20med%2Cog%20ledes%20av%20fagsjef%20i%20NRF%2C%20Anna%20Fryxelius.. Fulltekst i vitenarkiv
• Holly, Teresa; Brun, Marthe Kirkesæther; Jørgensen, Kristin Kaasen; Goll, Guro Løvik; Sexton, Joseph & Gehin, Johanna [Vis alle 16 forfattere av denne artikkelen] (2025). Cost-effectiveness of proactive therapeutic drug monitoring (TDM) in patients with inflmmatory disease-results from the Nor-Drum trial. Fulltekst i vitenarkiv
• Hagen, Gunhild; Arif, Sonia; Karoliussen, Lars Fridtjof; Sexton, Joseph; Haavardsholm, Espen Andre & Provan, Sella Aarrestad [Vis alle 8 forfattere av denne artikkelen] (2025). Treating gout to target serum urate improves health-related quality of life and utility over five years. Fulltekst i vitenarkiv
• Christensen, Ingrid Egeland; Lillegraven, Siri; Uhlig, Till & Provan, Sella Aarrestad (2025). Comment on: Longitudinal risk of serious infections in patients with inflammatory arthritis on immunomodulating therapy compared to controls: Reply. Rheumatology - Advances in Practice (Rheumap). 9(3). doi: 10.1093/rap/rkaf069. Fulltekst i vitenarkiv
• Ikdahl, Eirik; Provan, Sella Aarrestad & Borgen, Tove (2024). Komorbide tilstander. I Vikse, Jens; Haavardsholm, Espen A. & Molberg, Øyvind (Red.), Revmatologi. Universitetsforlaget. ISSN 9788215068589. Fulltekst i vitenarkiv
• Provan, Sella Aarrestad (2024). Informasjon om SPARK. Fulltekst i vitenarkiv
• Provan, Sella Aarrestad (2023). P-pille kan gi leddgiktbeskyttelse. [Journal]. VG online og papirutgave. Fulltekst i vitenarkiv
• Zangi, Heidi Andersen; Haugmark, Trond; Provan, Sella Aarrestad & Hagen, Kåre Birger (2022). High symptom burden and limited changes in fibromyalgia patients’ health status two years after participation in a multicomponent rehabilitation programme. Fulltekst i vitenarkiv
• Provan, Sella Aarrestad & Litleskare, Sigbjørn (2022). Skal finne ut om studenter endrer vekt og livsstil. [Internet]. NRK. Fulltekst i vitenarkiv
• Delcoigne, Bénédicte; Provan, Sella Aarrestad; Hammer, Hilde Berner; Giuseppe, Daniela Di; Frisell, Thomas & Glintborg, Bente [Vis alle 13 forfattere av denne artikkelen] (2022). Erratum: Correction to: Do patient-reported measures of disease activity in rheumatoid arthritis vary between countries? Results from a Nordic collaboration (Rheumatology (Oxford, England) (2022) 61 11 (4286-4296)). Rheumatology. ISSN 1462-0324. 61(12), s. 4998–4998. doi: 10.1093/rheumatology/keac151. Fulltekst i vitenarkiv
• Provan, Sella Aarrestad & Litleskare, Sigbjørn (2022). Forsker på om førsteårsstudenter legger på seg. [Radio]. NRK. Fulltekst i vitenarkiv
• Berg, Inger Jorid & Provan, Sella A. (2021). Inflammatory joint diseases and risk of cardiovascular disease in modern rheumatology. Journal of Rheumatology. ISSN 0315-162X. 48(3), s. 311–313. doi: 10.3899/JRHEUM.201134. Fulltekst i vitenarkiv
• Provan, Sella Aarrestad; Berg, Inger Jorid; Haugmark, Trond & Zangi, Heidi Andersen (2021). The referral of patients with fibromyalgia to a rheumatological specialist care unit. Is it necessary? Clinical and Experimental Rheumatology. ISSN 0392-856X. 39(3), s. S194–S194. Fulltekst i vitenarkiv

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