Nina Paulshu's Sundliseater

Education
- Cand.med at the University of Bergen
- Specialist in rheumatology
- Doctoral degree (PhD) at the Department of Clinical Medicine, University of Oslo
Position
- Senior physician at the Department of Rheumatology, Outpatient Clinic and Research, Diakonhjemmet Hospital
- Post doc, Clinic for rheumatology, outpatient clinic and research, Diakonhjemmet Hospital
Field of interest
- Rheumatology
- Outcome measures
- Prediction
- Follow-up and treatment
- Randomized controlled trials
visiting address
Diakonhjemmet hospital
Forstanderboligen
Reidar Kobros vei 8
0370 Oslo
Postal address
Diakohjemmet hospital
PO Box 23 Vinderen
0319 Oslo
Projects
ARCTIC
Remission in patients with rheumatoid arthritis: a randomized controlled trial investigating the use of ultrasound in clinical follow-up
Project Manager:
Espen A. HaavardsholmARCTIC REWIND
Project managers
Post doc
PhD fellow
ABOUT THE PROJECT
Rheumatoid arthritis is an inflammatory disease affecting 0.5-1% of the population. The disease is characterized by joint lifts and joint pain, which can lead to joint damage and reduced functional level. Using modern treatment strategies, which include disease -modifying drugs, good disease control without signs of inflammation has become an achievable measure of an ever -increasing number of people. However, there has been no professional agreement or clear guidelines for how this group should be treated further; Should one continue with a stable dose of medication, or step down and possibly end treatment?
Arctic Rewind is a randomized controlled multi -center study where the main goal is to investigate whether a strategy in which the disease -modifying treatment is reduced and possibly discontinued is not inferior to still stable treatment when it comes to taking care of good disease control. In addition, the study will provide sought -after data for research on more personalized treatment.
WHO CAN JOIN?
The study included adults with rheumatoid arthritis where there had been no signs of activity in the disease last 12 months. Both recruitment and follow -up of the included have been completed.
WHAT DOES THE STUDY INCLUDE?
In one study arm, the treatment was stepped down and possibly discontinued, in the other, participants continued unchanged treatment. Both groups were followed with regular checks every 4 months for 3 years with thorough mapping of signs of flare -up of activity in the disease (clinical examination, blood tests and patient -reported outcome measures), as well as registration and handling of potential side effects. In addition, ultrasound examination, x -ray of hands and feet, was carried out by dominant hand and biobank.
The study was divided into two; One part included people who used synthetic disease-modifying treatment, the other included people who used biological drugs (TNF inhibitors).
MENTION
Arctic Rewind: New Norwegian study can change how we treat arthritis (Healthtalk.no)
The Marie Spångberg Prize 2022 (medical federingen.no)
PUBLICATIONS
Project Manager:
Espen A. HaavardsholmNOR Flare
Distance follow-up of patients with rheumatoid arthritis
Project Manager:
Anne Therese TveterProject Manager:
Silje Watterdal SyversenPublications
Publications taken from the National Science Archive (NVA):
Effects of tapering conventional synthetic disease-modifying antirheumatic drugs to drug-free remission versus stable treatment in rheumatoid arthritis (ARCTIC REWIND): 3-year results from an open-label, randomized controlled, non-inferiority trial
The Lancet Rheumatology
Agreement between patient-reported flares and clinically significant flare status in patients with rheumatoid arthritis in sustained remission: data from the ARCTIC REWIND trials
RMD Open
Effect of tapered versus stable treatment with tumor necrosis factor inhibitors on disease flares in patients with rheumatoid arthritis in remission: a randomised, open label, non-inferiority trial
Annals of the Rheumatic Diseases
Discontinuation of Conventional Synthetic Disease-Modifying Antirheumatic Drugs in Patients with Rheumatoid Arthritis and Excellent Disease Control
Journal of the American Medical Association (JAMA)
Effect of Half-Dose vs Stable-Dose Conventional Synthetic Disease-Modifying Antirheumatic Drugs on Disease Flares in Patients with Rheumatoid Arthritis in Remission: The ARCTIC REWIND Randomized Clinical Trial
Journal of the American Medical Association (JAMA)
Value of MRI and ultrasound for prediction of therapeutic response and erosive progression in patients with early rheumatoid arthritis managed by an aggressive treat-to-target strategy
RMD Open
Clinical and ultrasound remission after 6 months of treat-to-target therapy in early rheumatoid arthritis: Associations to future good radiographic and physical outcomes
Annals of the Rheumatic Diseases