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Corte G, Atzinger A, Temiz SA, Noversa de Sousa R, Mutlu MY, Schoenau V, Raimondo MG, Kleyer A, Kuwert T, Ramming A, Simon D, Sticherling M, Schmidkonz C, Schett G, Fagni F. Anatomical pattern of entheseal and synovial fibroblast activation in patients with psoriasis and its risk of developing psoriatic arthritis. RMD Open 2024; 10:e004294. [PMID: 38862244 PMCID: PMC11168197 DOI: 10.1136/rmdopen-2024-004294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2024] [Accepted: 05/15/2024] [Indexed: 06/13/2024] Open
Abstract
OBJECTIVES To assess the presence and anatomical distribution of activated fibroblasts in the joints and entheses of patients with psoriasis with arthralgia and to test how fibroblast activation visualised by 68gallium-labelled fibroblast activation protein inhibitor-04 (68Ga-FAPI-04)-positron emission tomography (PET)/CT correlates with clinical tenderness, musculoskeletal ultrasound findings and progression to psoriatic arthritis (PsA). METHODS We conducted a prospective cohort study in patients with psoriasis and arthralgia who underwent clinical and ultrasound evaluation and whole-body PET/CT imaging with 68Ga-FAPI-04. 68Ga-FAPI-04 uptake at synovial and entheseal sites was assessed by maximal standardised uptake values (SUVmax) and PET/CT Joint Index (JI); logistic regression models were used to investigate its correlation with clinical and ultrasound findings. Survival analyses were performed on patients with at least 6 months of follow-up. RESULTS 36 patients with psoriasis were enrolled. 68Ga-FAPI-04 uptake was found in 318 (7.9%) joints and 369 (7.3%) entheses in 29 (80.6%) participants, with a mean SUVmax (SD) of 3.2 (1.8) for joints and 2.9 (1.6) for entheses. Large joints and the lower limbs were predominantly affected. A significant positive relationship was found between 68Ga-FAPI-04-PET/CT signal intensity and the 68 tender joint count (SUVmax: p<0.001; PET/CT-JI: p<0.001) and tender entheses count (SUVmax: p<0.001; PET/CT-JI: p=0.002). No correlations were found with ultrasound findings (SUVmax: p=0.969; PET/CT-JI: p=0.720). Patients with relevant synovio-entheseal 68Ga-FAPI-04 uptake showed a statistically significant higher risk of developing PsA (p=0.02), independent of ultrasound findings. CONCLUSIONS Patients with psoriasis presenting with arthralgia show localised signs of resident tissue activation in joints and entheses, which are associated with higher risk of developing PsA.
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Affiliation(s)
- Giulia Corte
- Department of Internal Medicine 3, Rheumatology and Immunology, Erlangen University Hospital, Erlangen, Germany
- Deutsches Zentrum fuer Immuntherapie (DZI), Erlangen University Hospital, Erlangen, Germany
| | - Armin Atzinger
- Department of Nuclear Medicine, Erlangen University Hospital, Erlangen, Germany
| | - Selahattin Alp Temiz
- Department of Internal Medicine 3, Rheumatology and Immunology, Erlangen University Hospital, Erlangen, Germany
- Deutsches Zentrum fuer Immuntherapie (DZI), Erlangen University Hospital, Erlangen, Germany
| | - Rita Noversa de Sousa
- Department of Internal Medicine 3, Rheumatology and Immunology, Erlangen University Hospital, Erlangen, Germany
- Serviço de Medicina Interna, Hospital Pedro Hispano, Hospital Pedro Hispano, Matosinhos, Porto, Portugal
| | - Melek Yalcin Mutlu
- Department of Internal Medicine 3, Rheumatology and Immunology, Erlangen University Hospital, Erlangen, Germany
- Deutsches Zentrum fuer Immuntherapie (DZI), Erlangen University Hospital, Erlangen, Germany
| | - Verena Schoenau
- Department of Internal Medicine 3, Rheumatology and Immunology, Erlangen University Hospital, Erlangen, Germany
- Deutsches Zentrum fuer Immuntherapie (DZI), Erlangen University Hospital, Erlangen, Germany
| | - Maria Gabriella Raimondo
- Department of Internal Medicine 3, Rheumatology and Immunology, Erlangen University Hospital, Erlangen, Germany
- Deutsches Zentrum fuer Immuntherapie (DZI), Erlangen University Hospital, Erlangen, Germany
| | - Arnd Kleyer
- Department of Internal Medicine 3, Rheumatology and Immunology, Erlangen University Hospital, Erlangen, Germany
- Department of Rheumatology and Clinical Immunology, Charite University Hospital Berlin, Berlin, Germany
| | - Torsten Kuwert
- Department of Nuclear Medicine, Erlangen University Hospital, Erlangen, Germany
| | - Andreas Ramming
- Department of Internal Medicine 3, Rheumatology and Immunology, Erlangen University Hospital, Erlangen, Germany
- Deutsches Zentrum fuer Immuntherapie (DZI), Erlangen University Hospital, Erlangen, Germany
| | - David Simon
- Department of Internal Medicine 3, Rheumatology and Immunology, Erlangen University Hospital, Erlangen, Germany
- Department of Rheumatology and Clinical Immunology, Charite University Hospital Berlin, Berlin, Germany
| | - Michael Sticherling
- Deutsches Zentrum fuer Immuntherapie (DZI), Erlangen University Hospital, Erlangen, Germany
- Department of Nuclear Medicine, Erlangen University Hospital, Erlangen, Germany
| | - Christian Schmidkonz
- Department of Nuclear Medicine, Erlangen University Hospital, Erlangen, Germany
- Institute for Medical Engineering, Ostbayerische Technische Hochschule Amberg-Weiden, Amberg, Germany
| | - Georg Schett
- Department of Internal Medicine 3, Rheumatology and Immunology, Erlangen University Hospital, Erlangen, Germany
- Deutsches Zentrum fuer Immuntherapie (DZI), Erlangen University Hospital, Erlangen, Germany
| | - Filippo Fagni
- Department of Internal Medicine 3, Rheumatology and Immunology, Erlangen University Hospital, Erlangen, Germany
- Deutsches Zentrum fuer Immuntherapie (DZI), Erlangen University Hospital, Erlangen, Germany
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Ruscitti P, Cataldi G, Gentile M, Dionisi A, Volpe P, Finucci A, Verardi L, Di Muzio C, Italiano N, Celletti E, Di Penta M, Di Cola I, Marrelli A, Alfonsi A, Delle Monache F, Cipollone F, Gabini M, Cipriani P. The Evaluation of Effectiveness and Safety of Guselkumab in Patients with Psoriatic Arthritis in a Prospective Multicentre "Real-Life" Cohort Study. Rheumatol Ther 2024; 11:539-551. [PMID: 38436915 PMCID: PMC11111644 DOI: 10.1007/s40744-024-00649-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Accepted: 02/06/2024] [Indexed: 03/05/2024] Open
Abstract
INTRODUCTION Guselkumab is an interleukin-23 (IL-23) inhibitor licensed for the treatment of psoriatic arthritis (PsA). This study aimed to evaluate the 6-month effectiveness of guselkumab in patients with PsA in a "real-life" multicentre patient cohort. We also estimated the drug retention rate (DRR) of gusulkumab, also assessing the impact of comorbidities and patient clinical characteristics, in a collective 18-month prospective follow-up. METHODS Between December 2021 and September 2023, consecutive patients with PsA were evaluated if treated at least for 6 months with guselkumab in a prospective multicentre study to evaluate the effectiveness of the drug by means of disease activity index for psoriatic arthritis (DAPSA) and cumulative DRR. RESULTS A total of 111 patients with PsA were evaluated and treated with guselkumab (age 56.8 ± 9.9, male sex 20.7%). These patients were mainly characterised by active and long-standing PsA with median disease duration of 6.0 (7.0) years (55.9% disease duration ≥ 5 years), 55.0% showed comorbidities, 78.4% of patients were previously treated with biologic disease-modifying anti-rheumatic drugs (bDMARDs), and 60.4% concomitantly with conventional synthetic DMARDs (csDMARDs). After 6 months, a significant reduction of DAPSA was observed (β - 15.47, p = 0.001, 95% CI - 23.15 to - 9.79) with 39.6% of patients achieving a DAPSA ≤ 14. At the end of cumulative follow-up, 71.2% of patients were still treated with guselkumab whereas 24.3% discontinued the drug because of inefficacy. An 18-month DRR of guselkumab of 66.7% was estimated with a mean time of administration of 9.8 ± 4.1 months. The results of the DRR were stratified according to patient clinical characteristics. The DRR of guselkumab appeared to be not influenced by long disease duration, comorbidities, obesity, concomitant csDMARDs, and previous bDMARDs. CONCLUSION The "real-life" 6-month effectiveness of guselkumab was shown in patients with PsA, mainly characterised by active long-standing disease, previously treated with bDMARDs, and with comorbidities. Furthermore, a good DRR of guselkumab was estimated in the cumulative 18 months of follow-up and appeared to be not influenced by long disease duration, comorbidities, obesity, and previous bDMARDs.
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Affiliation(s)
- Piero Ruscitti
- Rheumatology Unit, Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, Delta 6 Building, P.O. box 67100, L'Aquila, Italy.
| | - Giulia Cataldi
- Rheumatology Unit, Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, Delta 6 Building, P.O. box 67100, L'Aquila, Italy
| | - Martina Gentile
- Rheumatology Unit, Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, Delta 6 Building, P.O. box 67100, L'Aquila, Italy
| | - Alice Dionisi
- Rheumatology Unit, Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, Delta 6 Building, P.O. box 67100, L'Aquila, Italy
| | - Paola Volpe
- Rheumatology Unit, "Santo Spirito" Hospital, Pescara, Italy
| | | | | | - Claudia Di Muzio
- Rheumatology Unit, Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, Delta 6 Building, P.O. box 67100, L'Aquila, Italy
| | - Noemi Italiano
- Rheumatology Unit, Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, Delta 6 Building, P.O. box 67100, L'Aquila, Italy
| | - Eleonora Celletti
- Department of Medicine and Science of Aging, Medical Clinic, SS. Annunziata Hospital of Chieti, "G. D'Annunzio" University of Chieti-Pescara, Chieti, Italy
| | - Myriam Di Penta
- Department of Medicine and Science of Aging, Medical Clinic, SS. Annunziata Hospital of Chieti, "G. D'Annunzio" University of Chieti-Pescara, Chieti, Italy
| | - Ilenia Di Cola
- Rheumatology Unit, Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, Delta 6 Building, P.O. box 67100, L'Aquila, Italy
| | | | - Alessia Alfonsi
- Internal Medicine Unit, "Giuseppe Mazzini" Hospital, Teramo, Italy
| | | | - Francesco Cipollone
- Department of Medicine and Science of Aging, Medical Clinic, SS. Annunziata Hospital of Chieti, "G. D'Annunzio" University of Chieti-Pescara, Chieti, Italy
| | - Marco Gabini
- Rheumatology Unit, "Santo Spirito" Hospital, Pescara, Italy
| | - Paola Cipriani
- Rheumatology Unit, Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, Delta 6 Building, P.O. box 67100, L'Aquila, Italy
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Gossec L, Siebert S, Bergmans P, de Vlam K, Gremese E, Joven-Ibáñez B, Korotaeva TV, Lavie F, Noël W, Nurmohamed MT, Sfikakis PP, Sharaf M, Theander E, Smolen JS. Long-term effectiveness and persistence of ustekinumab and TNF inhibitors in patients with psoriatic arthritis: final 3-year results from the PsABio real-world study. Ann Rheum Dis 2023; 82:496-506. [PMID: 36600178 PMCID: PMC10086293 DOI: 10.1136/ard-2022-222879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Accepted: 11/25/2022] [Indexed: 12/15/2022]
Abstract
OBJECTIVES To evaluate real-world persistence and effectiveness of the IL-12/23 inhibitor, ustekinumab or a tumour necrosis factor inhibitor (TNFi) for psoriatic arthritis over 3 years. METHODS PsABio (NCT02627768), a prospective, observational study, followed patients with PsA prescribed first-line to third-line ustekinumab or a TNFi. Persistence and effectiveness (achievement of clinical Disease Activity for PSA (cDAPSA) low disease activity (LDA)/remission and minimal disease activity/very LDA (MDA/VLDA)) were assessed every 6 months. Safety data were collected over 3 years. Analyses to compare the modes of action were adjusted on baseline differences by propensity scores (PS). RESULTS In 895 patients (mean age 49.8 years, 44.7% males), at 3 years, the proportion of patients still on their initial treatments was similar with ustekinumab (49.9%) and TNFi (47.8%). No difference was seen in the risk of stopping/switching; PS-adjusted hazard ratio (95% CI) for stopping/switching ustekinumab versus TNFi was 0.87 (0.68 to 1.11). In the overall population, cDAPSA LDA/remission was achieved in 58.6%/31.4% ustekinumab-treated and 69.8%/45.0% TNFi-treated patients; PS-adjusted ORs (95% CI) were 0.89 (0.63 to 1.26) for cDAPSA LDA; 0.72 (0.50 to 1.05) for remission. MDA/VLDA was achieved in 41.4%/19.2% of ustekinumab-treated and 54.2%/26.9% of TNFi-treated patients with overlapping PS-adjusted ORs. A greater percentage of TNFi-treated patients achieved effectiveness outcomes. Both treatments exhibited good long-term safety profiles, although ustekinumab-treated patients had a lower rate of adverse events (AEs) versus TNFi. CONCLUSION At 3 years, there was generally comparable persistence after ustekinumab or TNFi treatment, but AE rates were lower with ustekinumab.
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Affiliation(s)
- Laure Gossec
- INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Sorbonne Université, Paris, France
- Rheumatology Department, Pitié-Salpêtrière Hospital, AP-HP, Paris, France
| | | | | | | | - Elisa Gremese
- Fondazione Policlinico A Gemelli-IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | | | | | - Frederic Lavie
- The Janssen Pharmaceutical Companies of Johnson & Johnson, Paris, France
| | - Wim Noël
- Janssen Pharmaceutica NV, Beerse, Belgium
| | | | - Petros P Sfikakis
- National and Kapodistrian University of Athens Medical School, Athens, Greece
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Coates L, Gossec L. The updated GRAPPA and EULAR recommendations for the management of psoriatic arthritis: Similarities and differences. Joint Bone Spine 2023; 90:105469. [PMID: 36184036 DOI: 10.1016/j.jbspin.2022.105469] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 09/07/2022] [Accepted: 09/21/2022] [Indexed: 01/19/2023]
Affiliation(s)
- Laura Coates
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK.
| | - Laure Gossec
- Sorbonne Université, Inserm, Institut Pierre Louis d'Epidémiologie et de Santé Publique, 75013 Paris, France; Rheumatology department, AP-HP, Pitié-Salpêtrière hospital, 75013 Paris, France
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Gossec L, Siebert S, Bergmans P, de Vlam K, Gremese E, Joven-Ibáñez B, Korotaeva TV, Lavie F, Noël W, Nurmohamed MT, Sfikakis PP, Theander E, Smolen JS. Persistence and effectiveness of the IL-12/23 pathway inhibitor ustekinumab or tumour necrosis factor inhibitor treatment in patients with psoriatic arthritis: 1-year results from the real-world PsABio Study. Ann Rheum Dis 2022; 81:823-830. [PMID: 35210262 PMCID: PMC9120383 DOI: 10.1136/annrheumdis-2021-221640] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Accepted: 02/01/2022] [Indexed: 11/03/2022]
Abstract
OBJECTIVE We evaluated real-world treatment persistence and effectiveness at 1 year following initiation of IL-12/23 inhibitor ustekinumab or a tumour necrosis factor inhibitor (TNFi) for psoriatic arthritis (PsA). METHODS PsABio (NCT02627768), a prospective, observational study, followed patients with PsA prescribed first-line to third-line ustekinumab or TNFi. Drug persistence, effectiveness (achievement of clinical Disease Activity Index for Psoriatic Arthritis (cDAPSA) low disease activity (LDA)/remission and minimal disease activity/very low disease activity (MDA/VLDA)), and safety were assessed every 6 months. In addition to descriptive statistics, propensity score (PS)-adjusted comparisons across cohorts were performed. RESULTS At 1 year, overall persistence was similar in the ustekinumab (n=317/438, 72.4%) and TNFi (n=321/455, 70.5%) groups. PS-adjusted HR (95% CI) for stopping/switching ustekinumab versus TNFi was 0.82 (0.60; 1.13). cDAPSA LDA (including remission)/remission was achieved in 55.9%/22.1% of ustekinumab-treated and 67.1%/31.7% of TNFi-treated patients; PS-adjusted ORs (95% CI) were 0.80 (0.57; 1.10) for cDAPSA LDA and 0.73 (0.49; 1.07) for remission. MDA/VLDA was achieved in 34.2%/11.9% of ustekinumab-treated and 43.1%/12.6% of TNFi-treated patients; PS-adjusted ORs (95% CI) were 0.89 (0.63; 1.26) for MDA and 0.90 (0.54; 1.49) for VLDA. The safety profiles were similar in both groups. CONCLUSION In the real-world PsABio Study, after 1 year of treatment, although unadjusted persistence was numerically slightly higher for ustekinumab versus TNFi and unadjusted effectiveness was numerically slightly higher for TNFi versus ustekinumab, the PS-adjusted comparisons demonstrated comparable overall persistence, effectiveness and safety for both modes of action in PsA.
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Affiliation(s)
- Laure Gossec
- INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Sorbonne Université, Paris, France
- Rheumatology Department, AP-HP, University Hospital Pitié Salpêtrière, Paris, France
| | - Stefan Siebert
- Institute of Infection, Immunity and Inflammation, University of Glasgow, Glasgow, Glasgow, UK
| | - Paul Bergmans
- Biostatistics, Janssen-Cilag BV, Breda, The Netherlands
| | - Kurt de Vlam
- Department of Rheumatology, Universitair Ziekenhuis Leuven, Leuven, Flanders, Belgium
| | - Elisa Gremese
- Division of Rheumatology, Fondazione Policlinico Agostino Gemelli-IRCCS, Università Cattolica del Sacro Cuore, Roma, Italy
| | | | - Tatiana V Korotaeva
- Department of Spondyloarthritis and Psoriatic Arthritis, VA Nasonova Research Institute of Rheumatology, Moscow, Russian Federation
| | - Frederic Lavie
- Medical Affairs, The Janssen Pharmaceutical Companies of Johnson & Johnson, Paris, France
| | - Wim Noël
- Medical Affairs, Janssen Pharmaceutica NV, Beerse, Belgium
| | - Michael T Nurmohamed
- Department of Rheumatology, Reade and VU University Medical Center, Amsterdam, The Netherlands
| | - Petros P Sfikakis
- 1st Department of Propedeutic Internal Medicine, National and Kapodistrian University of Athens Medical School, Athens, Greece
| | | | - Josef S Smolen
- Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria
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Kokolakis G, Sabat R, Fischer I, Gomis-Kleindienst S, Fritz B, Burmester GR, Ghoreschi K, Ohrndorf S. The Effect of TNF-α Inhibitors on Nail Psoriasis and Psoriatic Arthritis-Real-World Data from Dermatology Practice. J Pers Med 2021; 11:jpm11111083. [PMID: 34834435 PMCID: PMC8620057 DOI: 10.3390/jpm11111083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Revised: 10/19/2021] [Accepted: 10/22/2021] [Indexed: 12/02/2022] Open
Abstract
Patients with psoriatic arthritis (PsA) often develop joint symptoms years after their initial diagnosis of psoriasis disease; therefore, dermatologists should test for and detect PsA early. In this study, we focused on patients with psoriasis with both nail and joint disease being treated with tumor necrosis factor-α inhibitors by dermatologists. We performed a noninterventional, prospective, multicenter, and open-label study to evaluate the effectiveness of adalimumab, etanercept, or infliximab over 24 months of continuous therapy in patients with moderate to severe plaque-type psoriasis (Pso) and PsA. Disease assessments with the Psoriasis Area and Severity Index, Nail Psoriasis Severity Index (NAPSI), joint assessment, Dermatology Life Quality Index (DLQI), and Health Assessment Questionnaire (HAQ) instruments were performed every 3 months for the first year and twice annually thereafter. The cohort included 100 patients with Pso, nail psoriasis, and PsA. A significant reduction of NAPSI was observed 3 months after therapy initiation compared with the baseline (mean ± SD, 22.9 ± 17.8 vs. 33.8 ± 21.4; p < 0.001). Similarly, the mean ± SD number of both tender and swollen joints decreased significantly within the first 3 months of treatment, from 10.8 ± 11.5 to 6.4 ± 10.3 (p < 0.001) and from 6.4 ± 9.5 to 3.1 ± 7.2 (p < 0.001), respectively. Additionally, the distal interphalangeal joint involvement improved throughout the observation time, and DLQI and HAQ scores decreased. Improvements in control of skin, nail, and joint symptoms were seen, as well as in patients’ quality of life and functionality. Dermatologists have an important role not only in PsA diagnosis but also in PsA long-term care.
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Affiliation(s)
- Georgios Kokolakis
- Psoriasis Research and Treatment Center, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117 Berlin, Germany;
- Department of Dermatology, Venereology and Allergology, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117 Berlin, Germany;
- Correspondence: ; Tel.: +49-30-450618333; Fax: +49-30-450518908
| | - Robert Sabat
- Psoriasis Research and Treatment Center, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117 Berlin, Germany;
- Interdisciplinary Group of Molecular Immunopathology, Dermatology/Medical Immunology, Charité—Universitätsmedizin Berlin, 10117 Berlin, Germany
| | - Imma Fischer
- Biostatistik—Tübingen, 72070 Tuebingen, Germany;
| | | | - Björn Fritz
- AbbVie Deutschland GmbH & Co. KG, 65189 Wiesbaden, Germany; (S.G.-K.); (B.F.)
| | - Gerd-Rüdiger Burmester
- Department of Rheumatology and Clinical Immunology, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117 Berlin, Germany; (G.-R.B.); (S.O.)
| | - Kamran Ghoreschi
- Department of Dermatology, Venereology and Allergology, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117 Berlin, Germany;
| | - Sarah Ohrndorf
- Department of Rheumatology and Clinical Immunology, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117 Berlin, Germany; (G.-R.B.); (S.O.)
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Haroon N, Inman RD. Recent advances in spondyloarthritis: positive developments in the seronegative domain. Semin Immunopathol 2021; 43:159-161. [PMID: 33763750 DOI: 10.1007/s00281-021-00839-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Nigil Haroon
- Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, Toronto, Canada. .,Department of Medicine, University of Toronto, Toronto, Canada. .,Toronto Western Hospital, 399 Bathurst Street, Toronto, ON, M5T2S8, Canada.
| | - Robert D Inman
- Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, Toronto, Canada. .,Department of Medicine, University of Toronto, Toronto, Canada. .,Toronto Western Hospital, 399 Bathurst Street, Toronto, ON, M5T2S8, Canada.
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