1
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Ünal A, Leventoğlu E, Bakkaloğlu SA. Rituximab use in paediatric nephrology practice in Türkiye: TRTX. Nephrology (Carlton) 2024; 29:259-267. [PMID: 38113869 DOI: 10.1111/nep.14265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2023] [Revised: 12/09/2023] [Accepted: 12/12/2023] [Indexed: 12/21/2023]
Abstract
AIM Rituximab (RTX) is a genetically engineered chimeric monoclonal antibody which binds directly to CD20 antigen and mediates inhibition of B cell development. Although RTX has been widely used in paediatric nephrology, there is no routine protocol for its use. In this study, paediatric nephrologists in Türkiye were asked to fill out a questionnaire to understand their practice in using RTX. This study aimed to determine common practices and clarify the uncertainties regarding the use of RTX in paediatric nephrology. METHODS This was a nationwide, multicenter, retrospective cohort study based on data evaluating the use of RTX in paediatric nephrology practice. An online questionnaire was sent to all paediatric nephrology centers in Türkiye. The questionnaire forms included information about how many patients in total applied RTX treatment, for which indications they use RTX, and whether they made any preparations before using RTX. RESULTS According to this survey on RTX use in Türkiye, paediatric nephrologists use it most commonly in SSNS and followed by SRNS, ABMR, SLE and AAV, respectively. Dosing was highly standard but there is significant heterogeneity in pre-exposure tests and patient monitoring in the clinical practice of RTX. Also, the rate of encountering RTX-related allergic and infectious side effects at least once during the professional experience of our physicians can be quite high. CONCLUSION There is an increasing need for the preparation of a guideline on the indications for RTX use for each diagnosis, posology, and the practices to be performed before and after infusion.
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Affiliation(s)
- Ahmet Ünal
- Department of Pediatrics, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Emre Leventoğlu
- Department of Pediatric Nephrology, Gazi University, Ankara, Turkey
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2
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Priora M, Parisi S, Benedetti V, Fusaro E. How immunosuppressive therapy impaires on COVID-19 mRNA-vaccine response in rheumatic diseases. Minerva Med 2022; 113:763-765. [PMID: 36475533 DOI: 10.23736/s0026-4806.22.08046-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- Marta Priora
- Department of General and Specialistic Medicine, Clinic of Rheumatology, Regina Montis Regalis Hospital, Mondovì, Cuneo, Italy -
| | - Simone Parisi
- Unit of Rheumatology, Department of General and Specialistic Medicine, Città della Salute e della Scienza, Turin, Italy
| | - Valentina Benedetti
- Department of General and Specialistic Medicine, Clinic of Rheumatology, Regina Montis Regalis Hospital, Mondovì, Cuneo, Italy
| | - Enrico Fusaro
- Unit of Rheumatology, Department of General and Specialistic Medicine, Città della Salute e della Scienza, Turin, Italy
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3
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Vulvar Aphthous Ulcers in an Adolescent After Coronavirus Disease 2019 (COVID-19) Vaccination. Obstet Gynecol 2022; 140:514-517. [PMID: 35930388 PMCID: PMC9377366 DOI: 10.1097/aog.0000000000004885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Accepted: 05/19/2022] [Indexed: 01/05/2023]
Abstract
BACKGROUND Nonsexually acquired genital ulcers have been described among girls who are prepubertal after various viral illnesses due to mucosal inflammation from an immunologic response. Until recently, nonsexually acquired genital ulcers have only been associated with viral infections. CASE We present a case of an adolescent girl developing nonsexually acquired genital ulcers after both her first and second coronavirus disease 2019 (COVID-19) vaccine doses. Her course followed an expected timeline for severity and resolution of ulcers. CONCLUSIONS Aphthous ulcers may arise from inflammatory effects of COVID-19 vaccination. Clinical monitoring after COVID-19 vaccination from all formulations should include assessment for nonsexually acquired genital ulcers if vaginal pain is reported.
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4
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Current Take on Systemic Sclerosis Patients' Vaccination Recommendations. Vaccines (Basel) 2021; 9:vaccines9121426. [PMID: 34960174 PMCID: PMC8708328 DOI: 10.3390/vaccines9121426] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 11/26/2021] [Accepted: 11/30/2021] [Indexed: 12/14/2022] Open
Abstract
Systemic sclerosis (SSc) is a rare autoimmune inflammatory rheumatic disease. The prevalence of SSc ranges from 7 to 700 cases per million worldwide. Due to multiple organ involvement and constant inflammatory state, this group of patients presents an increased risk of infectious diseases. This paper aimed to gather the up-to-date evidence on vaccination strategies for patients with SSc and to be a useful tool for the prevention and management of infectious diseases. The authors conducted a scoping review in which each paragraph presents data on a specific vaccine’s safety, immunogenicity, and efficacy. The work deals with the following topics: SARS-CoV-2, seasonal influenza, S. pneumoniae, HAV, HBV, HZV, N. meningitidis, H. influenzae, HPV, and diphtheria-tetanus-pertussis.
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5
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Specker C, Aries P, Braun J, Burmester G, Fischer-Betz R, Hasseli R, Holle J, Hoyer BF, Iking-Konert C, Krause A, Krüger K, Krusche M, Leipe J, Lorenz HM, Moosig F, Schmale-Grede R, Schneider M, Strangfeld A, Voll R, Voormann A, Wagner U, Schulze-Koops H. Updated recommendations of the German Society for Rheumatology for the care of patients with inflammatory rheumatic diseases in the context of the SARS-CoV-2/COVID-19 pandemic, including recommendations for COVID-19 vaccination. Z Rheumatol 2021; 80:33-48. [PMID: 34491403 PMCID: PMC8422376 DOI: 10.1007/s00393-021-01055-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/06/2021] [Indexed: 01/13/2023]
Affiliation(s)
- Christof Specker
- German Society for Rheumatology (Deutsche Gesellschaft für Rheumatologie e. V., DGRh), Berlin, Germany.
- Klinik für Rheumatologie & Klinische Immunologie, Kliniken Essen-Mitte, Pattbergstr. 2, 45239, Essen, Germany.
| | - Peer Aries
- German Society for Rheumatology (Deutsche Gesellschaft für Rheumatologie e. V., DGRh), Berlin, Germany
- Rheumatologie im Struenseehaus, Hamburg, Germany
| | - Jürgen Braun
- German Society for Rheumatology (Deutsche Gesellschaft für Rheumatologie e. V., DGRh), Berlin, Germany
- Rheumazentrum Ruhrgebiet, Ruhr Universität Bochum, Bochum, Germany
| | - Gerd Burmester
- German Society for Rheumatology (Deutsche Gesellschaft für Rheumatologie e. V., DGRh), Berlin, Germany
- Medizinische Klinik mit Schwerpunkt Rheumatologie und Klinische Immunologie, Charité - Universitätsmedizin Berlin, Freie Universität und Humboldt Universität zu Berlin, Berlin, Germany
| | - Rebecca Fischer-Betz
- German Society for Rheumatology (Deutsche Gesellschaft für Rheumatologie e. V., DGRh), Berlin, Germany
- Poliklinik, Funktionsbereich und Hiller Forschungszentrum für Rheumatologie, Universitätsklinikum Düsseldorf, Heinrich-Heine-Universität Düsseldorf, Düsseldorf, Germany
| | - Rebecca Hasseli
- German Society for Rheumatology (Deutsche Gesellschaft für Rheumatologie e. V., DGRh), Berlin, Germany
- Abteilung für Rheumatologie und Klinische Immunologie, Justus-Liebig-Universität Gießen, Campus Kerckhoff, Bad Nauheim, Germany
| | - Julia Holle
- German Society for Rheumatology (Deutsche Gesellschaft für Rheumatologie e. V., DGRh), Berlin, Germany
- Rheumazentrum Schleswig-Holstein Mitte, Neumünster, Germany
| | - Bimba Franziska Hoyer
- German Society for Rheumatology (Deutsche Gesellschaft für Rheumatologie e. V., DGRh), Berlin, Germany
- Abteilung für Rheumatologie, 1. Medizinische Klinik, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Christof Iking-Konert
- German Society for Rheumatology (Deutsche Gesellschaft für Rheumatologie e. V., DGRh), Berlin, Germany
- III. Medizinische Klinik und Poliklinik Sektion Rheumatologie, Universitätsklinikum Hamburg-Eppendorf, Hamburg-Eppendorf, Germany
| | - Andreas Krause
- German Society for Rheumatology (Deutsche Gesellschaft für Rheumatologie e. V., DGRh), Berlin, Germany
- Abteilung für Rheumatologie, Osteologie und Klinische Immunologie, Immanuel Krankenhaus Berlin, Berlin, Germany
| | - Klaus Krüger
- German Society for Rheumatology (Deutsche Gesellschaft für Rheumatologie e. V., DGRh), Berlin, Germany
- Rheumatologisches Praxiszentrum München, Munich, Germany
| | - Martin Krusche
- German Society for Rheumatology (Deutsche Gesellschaft für Rheumatologie e. V., DGRh), Berlin, Germany
- Medizinische Klinik mit Schwerpunkt Rheumatologie und Klinische Immunologie, Charité - Universitätsmedizin Berlin, Freie Universität und Humboldt Universität zu Berlin, Berlin, Germany
| | - Jan Leipe
- German Society for Rheumatology (Deutsche Gesellschaft für Rheumatologie e. V., DGRh), Berlin, Germany
- Abteilung für Rheumatologie, Medizinische Klinik V, Universitätskrankenhaus Mannheim, Mannheim, Germany
| | - Hanns-Martin Lorenz
- German Society for Rheumatology (Deutsche Gesellschaft für Rheumatologie e. V., DGRh), Berlin, Germany
- Sektion Rheumatologie, Medizinische Klinik V, Universitätsklinikum Heidelberg, Heidelberg, Germany
| | - Frank Moosig
- German Society for Rheumatology (Deutsche Gesellschaft für Rheumatologie e. V., DGRh), Berlin, Germany
- Rheumazentrum Schleswig-Holstein Mitte, Neumünster, Germany
| | | | - Matthias Schneider
- German Society for Rheumatology (Deutsche Gesellschaft für Rheumatologie e. V., DGRh), Berlin, Germany
- Poliklinik, Funktionsbereich und Hiller Forschungszentrum für Rheumatologie, Universitätsklinikum Düsseldorf, Heinrich-Heine-Universität Düsseldorf, Düsseldorf, Germany
| | - Anja Strangfeld
- German Society for Rheumatology (Deutsche Gesellschaft für Rheumatologie e. V., DGRh), Berlin, Germany
- Programmbereich Epidemiologie und Versorgungsforschung, Deutsches Rheumaforschungszentrum Berlin, Berlin, Germany
| | - Reinhard Voll
- German Society for Rheumatology (Deutsche Gesellschaft für Rheumatologie e. V., DGRh), Berlin, Germany
- Klinik für Rheumatologie und Klinische Immunologie, Universitätsklinikum Freiburg, Medizinische Fakultät, Universität Freiburg, Freiburg, Germany
| | - Anna Voormann
- German Society for Rheumatology (Deutsche Gesellschaft für Rheumatologie e. V., DGRh), Berlin, Germany
| | - Ulf Wagner
- German Society for Rheumatology (Deutsche Gesellschaft für Rheumatologie e. V., DGRh), Berlin, Germany
- Abteilung für Rheumatologie, Klinik und Poliklinik für Endokrinologie, Nephrologie, Rheumatologie, Universitätsklinikum Leipzig, Leipzig, Germany
| | - Hendrik Schulze-Koops
- German Society for Rheumatology (Deutsche Gesellschaft für Rheumatologie e. V., DGRh), Berlin, Germany.
- Sektion Rheumatologie und Klinische Immunologie, Medizinische Klinik IV, Ludwig-Maximilians-Universität München, Pettenkoferstraße 8a, Munich, Germany.
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6
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Hasseli R, Pfeil A, Krause A, Schulze-Koops H, Müller-Ladner U, Specker C. A survey to evaluate knowledge, perceptions and attitudes toward COVID-19 vaccinations among rheumatologists in Germany. Rheumatol Int 2021; 41:1949-1956. [PMID: 34498112 PMCID: PMC8425463 DOI: 10.1007/s00296-021-04986-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Accepted: 08/30/2021] [Indexed: 12/12/2022]
Abstract
The objective is to evaluate the attitude of rheumatologists regarding the use of COVID-19 vaccination in patients with inflammatory rheumatic diseases (IRDs). From February 2nd until March 15th, 2021, rheumatologists from Germany were asked to participate anonymously in a survey addressing their attitude with respect to COVID-19 vaccinations of IRD patients. The survey was completed by 214 participants (107 men, 103 women, 4 unspecified). More than half of the physicians (61%) were working in rheumatologic private practices and 62% had more than 20 years of experience in rheumatology. 90% reported to be at least confidential in handling issues of COVID-19 vaccination and 99% would recommend COVID-19 vaccination for IRD patients. The majority would not recommend to stop or reduce immunomodulatory drugs for vaccination except for rituximab. More than 70% would prefer vaccination with a mRNA vaccine for their IRD patients. This study shows that almost all rheumatologists in Germany support the COVID-19 vaccination for their IRD patients without reducing or terminating the actual immunomodulatory medication to potentially improve the response to the vaccine. This attitude is in accordance with the current recommendations of the German Society of Rheumatology regarding COVID-19 vaccination in IRD patients, and indicates that these have been well accepted and work in everyday clinical practice.
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Affiliation(s)
- Rebecca Hasseli
- Department of Rheumatology and Clinical Immunology, Campus Kerckhoff, Justus-Liebig-University Giessen, Bad Nauheim, Germany.
| | - Alexander Pfeil
- Department of Internal Medicine III, University Hospital Jena, Jena, Germany
| | - Andreas Krause
- Department of Rheumatology, Clinical Immunology and Osteology, Immanuel Hospital, Berlin, Germany
| | - Hendrik Schulze-Koops
- Division of Rheumatology and Clinical Immunology, Department of Internal Medicine IV, University of Munich, Munich, Germany
| | - Ulf Müller-Ladner
- Department of Rheumatology and Clinical Immunology, Campus Kerckhoff, Justus-Liebig-University Giessen, Bad Nauheim, Germany
| | - Christof Specker
- Department of Rheumatology and Clinical Immunology, Kliniken Essen-Mitte, Essen, Germany
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7
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Friedman MA, Curtis JR, Winthrop KL. Impact of disease-modifying antirheumatic drugs on vaccine immunogenicity in patients with inflammatory rheumatic and musculoskeletal diseases. Ann Rheum Dis 2021; 80:1255-1265. [PMID: 34493491 DOI: 10.1136/annrheumdis-2021-221244] [Citation(s) in RCA: 57] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Accepted: 08/25/2021] [Indexed: 12/14/2022]
Abstract
Patients with rheumatic diseases are at increased risk of infectious complications; vaccinations are a critical component of their care. Disease-modifying antirheumatic drugs may reduce the immunogenicity of common vaccines. We will review here available data regarding the effect of these medications on influenza, pneumococcal, herpes zoster, SARS-CoV-2, hepatitis B, human papilloma virus and yellow fever vaccines. Rituximab has the most substantial impact on vaccine immunogenicity, which is most profound when vaccinations are given at shorter intervals after rituximab dosing. Methotrexate has less substantial effect but appears to adversely impact most vaccine immunogenicity. Abatacept likely decrease vaccine immunogenicity, although these studies are limited by the lack of adequate control groups. Janus kinase and tumour necrosis factor inhibitors decrease absolute antibody titres for many vaccines, but do not seem to significantly impact the proportions of patients achieving seroprotection. Other biologics (interleukin-6R (IL-6R), IL-12/IL-23 and IL-17 inhibitors) have little observed impact on vaccine immunogenicity. Data regarding the effect of these medications on the SARS-CoV-2 vaccine immunogenicity are just now emerging, and early glimpses appear similar to our experience with other vaccines. In this review, we summarise the most recent data regarding vaccine response and efficacy in this setting, particularly in light of current vaccination recommendations for immunocompromised patients.
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Affiliation(s)
| | - Jeffrey R Curtis
- Division of Clinical Immunology and Rheumatology, University of Alabama at Birmingham Department of Medicine, Birmingham, Alabama, USA
| | - Kevin L Winthrop
- Medicine, Oregon Health & Science University, Portland, Oregon, USA.,School of Public Health, Oregon Health & Science University, Portland, Oregon, USA
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8
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Arnold J, Winthrop K, Emery P. COVID-19 vaccination and antirheumatic therapy. Rheumatology (Oxford) 2021; 60:3496-3502. [PMID: 33710296 PMCID: PMC7989162 DOI: 10.1093/rheumatology/keab223] [Citation(s) in RCA: 82] [Impact Index Per Article: 27.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Revised: 02/18/2021] [Accepted: 03/01/2021] [Indexed: 12/27/2022] Open
Abstract
The coronavirus disease 2019 (COVID-19) vaccination will be the largest vaccination programme in the history of the NHS. Patients on immunosuppressive therapy will be among the earliest to be vaccinated. Some evidence indicates immunosuppressive therapy inhibits humoral response to the influenza, pneumococcal and hepatitis B vaccines. The degree to which this will translate to impaired COVID-19 vaccine responses is unclear. Other evidence suggests withholding MTX for 2 weeks post-vaccination may improve responses. Rituximab has been shown to impair humoral responses for 6 months or longer post-administration. Decisions on withholding or interrupting immunosuppressive therapy around COVID-19 vaccination will need to be made prior to the availability of data on specific COVID-19 vaccine response in these patients. With this in mind, this article outlines the existing data on the effect of antirheumatic therapy on vaccine responses in patients with inflammatory arthritis and formulates a possible pragmatic management strategy for COVID-19 vaccination.
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Affiliation(s)
- Jack Arnold
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Chapel Allerton Hospital, Leeds, UK
| | - Kevin Winthrop
- Division of Infectious Diseases, Oregon Health and Science University, Portland, OR, USA
| | - Paul Emery
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Chapel Allerton Hospital, Leeds, UK.,NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals NHS Trust, Leeds, UK
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9
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Specker C, Aries P, Braun J, Burmester G, Fischer-Betz R, Hasseli R, Holle J, Hoyer BF, Iking-Konert C, Krause A, Krüger K, Krusche M, Leipe J, Lorenz HM, Moosig F, Schmale-Grede R, Schneider M, Strangfeld A, Voll R, Voormann A, Wagner U, Schulze-Koops H. [Updated recommendations of the German Society for Rheumatology for the care of patients with inflammatory rheumatic diseases in the context of the SARS-CoV‑2/COVID‑19 pandemic, including recommendations for COVID‑19 vaccination]. Z Rheumatol 2021; 80:570-587. [PMID: 34309739 PMCID: PMC8311067 DOI: 10.1007/s00393-021-01056-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Affiliation(s)
- Christof Specker
- Deutsche Gesellschaft für Rheumatologie e. V., Berlin, Deutschland.
- Klinik für Rheumatologie und Klinische Immunologie, Kliniken Essen-Mitte, Pattbergstr. 2, 45239, Essen, Deutschland.
| | - Peer Aries
- Deutsche Gesellschaft für Rheumatologie e. V., Berlin, Deutschland
- Rheumatologie im Struenseehaus, Hamburg, Deutschland
| | - Jürgen Braun
- Deutsche Gesellschaft für Rheumatologie e. V., Berlin, Deutschland
- Rheumazentrum Ruhrgebiet, Ruhr Universität Bochum, Bochum, Deutschland
| | - Gerd Burmester
- Deutsche Gesellschaft für Rheumatologie e. V., Berlin, Deutschland
- Medizinische Klinik mit Schwerpunkt Rheumatologie und Klinische Immunologie, Charité - Universitätsmedizin Berlin, Freie Universität und Humboldt Universität zu Berlin, Berlin, Deutschland
| | - Rebecca Fischer-Betz
- Deutsche Gesellschaft für Rheumatologie e. V., Berlin, Deutschland
- Poliklinik, Funktionsbereich und Hiller Forschungszentrum für Rheumatologie, Universitätsklinikum Düsseldorf, , Heinrich-Heine-Universität Düsseldorf, Düsseldorf, Deutschland
| | - Rebecca Hasseli
- Deutsche Gesellschaft für Rheumatologie e. V., Berlin, Deutschland
- Abteilung für Rheumatologie und Klinische Immunologie, Justus-Liebig-Universität Gießen, Campus Kerckhoff, Bad Nauheim, Deutschland
| | - Julia Holle
- Deutsche Gesellschaft für Rheumatologie e. V., Berlin, Deutschland
- Rheumazentrum Schleswig-Holstein Mitte, Neumünster, Deutschland
| | - Bimba Franziska Hoyer
- Deutsche Gesellschaft für Rheumatologie e. V., Berlin, Deutschland
- Abteilung für Rheumatologie, 1. Medizinische Klinik, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Kiel, Deutschland
| | - Christof Iking-Konert
- Deutsche Gesellschaft für Rheumatologie e. V., Berlin, Deutschland
- III. Medizinische Klinik und Poliklinik Sektion Rheumatologie, Universitätsklinikum Hamburg-Eppendorf, Hamburg-Eppendorf, Deutschland
| | - Andreas Krause
- Deutsche Gesellschaft für Rheumatologie e. V., Berlin, Deutschland
- Abteilung für Rheumatologie, Osteologie und Klinische Immunologie, Immanuel Krankenhaus Berlin, Berlin, Deutschland
| | - Klaus Krüger
- Deutsche Gesellschaft für Rheumatologie e. V., Berlin, Deutschland
- Rheumatologisches Praxiszentrum München, München, Deutschland
| | - Martin Krusche
- Deutsche Gesellschaft für Rheumatologie e. V., Berlin, Deutschland
- Medizinische Klinik mit Schwerpunkt Rheumatologie und Klinische Immunologie, Charité - Universitätsmedizin Berlin, Freie Universität und Humboldt Universität zu Berlin, Berlin, Deutschland
| | - Jan Leipe
- Deutsche Gesellschaft für Rheumatologie e. V., Berlin, Deutschland
- Abteilung für Rheumatologie, Medizinische Klinik V, Universitätskrankenhaus Mannheim, Mannheim, Deutschland
| | - Hanns-Martin Lorenz
- Deutsche Gesellschaft für Rheumatologie e. V., Berlin, Deutschland
- Sektion Rheumatologie, Medizinische Klinik V, Universitätsklinikum Heidelberg, Heidelberg, Deutschland
| | - Frank Moosig
- Deutsche Gesellschaft für Rheumatologie e. V., Berlin, Deutschland
- Rheumazentrum Schleswig-Holstein Mitte, Neumünster, Deutschland
| | | | - Matthias Schneider
- Deutsche Gesellschaft für Rheumatologie e. V., Berlin, Deutschland
- Poliklinik, Funktionsbereich und Hiller Forschungszentrum für Rheumatologie, Universitätsklinikum Düsseldorf, , Heinrich-Heine-Universität Düsseldorf, Düsseldorf, Deutschland
| | - Anja Strangfeld
- Deutsche Gesellschaft für Rheumatologie e. V., Berlin, Deutschland
- Programmbereich Epidemiologie und Versorgungsforschung, Deutsches Rheumaforschungszentrum Berlin, Berlin, Deutschland
| | - Reinhard Voll
- Deutsche Gesellschaft für Rheumatologie e. V., Berlin, Deutschland
- Klinik für Rheumatologie und Klinische Immunologie, Universitätsklinikum Freiburg, Medizinische Fakultät, Universität Freiburg, Freiburg, Deutschland
| | - Anna Voormann
- Deutsche Gesellschaft für Rheumatologie e. V., Berlin, Deutschland
| | - Ulf Wagner
- Deutsche Gesellschaft für Rheumatologie e. V., Berlin, Deutschland
- Abteilung für Rheumatologie, Klinik und Poliklinik für Endokrinologie, Nephrologie, Rheumatologie, Universitätsklinikum Leipzig, Leipzig, Deutschland
| | - Hendrik Schulze-Koops
- Deutsche Gesellschaft für Rheumatologie e. V., Berlin, Deutschland.
- Sektion Rheumatologie und Klinische Immunologie, Medizinische Klinik IV, Ludwig-Maximilians-Universität München, Pettenkoferstr. 8a, 80336, München, Deutschland.
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