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Hagen M, Englbrecht M, Haschka J, Reiser M, Kleyer A, Hueber A, Manger B, Figueiredo C, Cobra JF, Tony HP, Finzel S, Kleinert S, Wendler J, Schuch F, Ronneberger M, Feuchtenberger M, Fleck M, Manger K, Ochs W, Lorenz HM, Nüsslein H, Alten R, Henes J, Krüger K, Schett G, Rech J. Cost-effective Tapering Algorithm in Patients with Rheumatoid Arthritis: Combination of Multibiomarker Disease Activity Score and Autoantibody Status. J Rheumatol 2018; 46:460-466. [PMID: 30504510 DOI: 10.3899/jrheum.180028] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/07/2018] [Indexed: 12/11/2022]
Abstract
OBJECTIVE To analyze the effect of a risk-stratified disease-modifying antirheumatic drug (DMARD)-tapering algorithm based on multibiomarker disease activity (MBDA) score and anticitrullinated protein antibodies (ACPA) on direct treatment costs for patients with rheumatoid arthritis (RA) in sustained remission. METHODS The study was a posthoc retrospective analysis of direct treatment costs for 146 patients with RA in sustained remission tapering and stopping DMARD treatment, in the prospective randomized RETRO study. MBDA scores and ACPA status were determined in baseline samples of patients continuing DMARD (arm 1), tapering their dose by 50% (arm 2), or stopping after tapering (arm 3). Patients were followed over 1 year, and direct treatment costs were evaluated every 3 months. MBDA and ACPA status were used as predictors creating a risk-stratified tapering algorithm based on relapse rates. RESULTS RA patients with a low MBDA score (< 30 units) and negative ACPA showed the lowest relapse risk (19%), while double-positive patients showed high relapse risk (61%). In ACPA-negative and MBDA-negative (< 30 units), and ACPA or MBDA single-positive (> 30 units) groups, DMARD tapering appears feasible. Considering only patients without flare, direct costs for synthetic and biologic DMARD in the ACPA/MBDA-negative and single positive groups (n = 41) would have been €372,245.16 for full-dose treatment over 1 year. Tapering and stopping DMARD in this low-risk relapse group allowed a reduction of €219,712.03 of DMARD costs. Average reduction of DMARD costs per patient was €5358.83. CONCLUSION Combining MBDA score and ACPA status at baseline may allow risk stratification for successful DMARD tapering and cost-effective use of biologic DMARD in patients in deep remission as defined by the 28-joint count Disease Activity Score using erythrocyte sedimentation rate.
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Affiliation(s)
- Melanie Hagen
- From the Friedrich-Alexander-University Erlangen-Nuremberg (FAU), Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen, Erlangen, Germany; St. Vincent Hospital, Vinforce Study Group, Medical University of Vienna, Vienna, Austria; Institutio de Rheumatologia, São Paolo, Brazil; University of Würzburg, Internal Medicine 2, Würzburg; University Medical Center Freiburg, Rheumatology and Clinical Immunology, Freiburg; Rheumatology Clinical Practice Erlangen, Erlangen; Rheumatology Practice and Department of Internal Medicine 2, Clinic Burghausen, Burghausen; Asklepios Medical Center, Department of Rheumatology and clinical Immunology, Bad Abbach; Rheumatology Practice Bamberg, Bamberg; Rheumatology Practice Bayreuth, Bayreuth; University of Heidelberg, Medicine 5, Heidelberg; Rheumatology Practice Nuremberg, Nuremberg; Schlosspark Klinik, Internal Medicine/Rheumatology, Berlin; University of Tübingen, Centre for Interdisciplinary Clinical Immunology, Tübingen; Praxiszentrum St. Bonifatius, Munich, Germany.,M. Hagen, BSc, CandMed, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen; M. Englbrecht, PhD, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen; J. Haschka, MD, St. Vincent Hospital, Vinforce Study Group, Medical University of Vienna; M. Reiser, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen; A. Kleyer, MD, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen; A. Hueber, MD, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen; B. Manger, MD, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen; C. Figueiredo, MD, Institutio de Rheumatologia; J. Fogagnolo Cobra, MD, Institutio de Rheumatologia; H.P. Tony, MD, University of Würzburg, Internal Medicine 2; S. Finzel, MD, University Medical Center Freiburg, Rheumatology and Clinical Immunology; S. Kleinert, MD, Rheumatology Clinical Practice Erlangen; J. Wendler, MD, Rheumatology Clinical Practice Erlangen; F. Schuch, MD, Rheumatology Clinical Practice Erlangen; M. Ronneberger, MD, Rheumatology Clinical Practice Erlangen; M. Feuchtenberger, MD, Rheumatology Practice and Department of Internal Medicine 2, Clinic Burghausen; M. Fleck, MD, Asklepios Medical Center, Department of Rheumatology and clinical Immunology; K. Manger, MD, Rheumatology Practice Bamberg; W. Ochs, MD, Rheumatology Practice Bayreuth; H.M. Lorenz, MD, University of Heidelberg, Medicine 5; H. Nüsslein, MD, Rheumatology Practice Nuremberg; R. Alten, MD, Schlosspark Klinik, Internal Medicine/Rheumatology; J. Henes, MD, University of Tübingen, Centre for Interdisciplinary Clinical Immunology; K. Krüger, MD, Praxiszentrum St. Bonifatius; G. Schett, MD, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen; J. Rech, MD, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen
| | - Matthias Englbrecht
- From the Friedrich-Alexander-University Erlangen-Nuremberg (FAU), Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen, Erlangen, Germany; St. Vincent Hospital, Vinforce Study Group, Medical University of Vienna, Vienna, Austria; Institutio de Rheumatologia, São Paolo, Brazil; University of Würzburg, Internal Medicine 2, Würzburg; University Medical Center Freiburg, Rheumatology and Clinical Immunology, Freiburg; Rheumatology Clinical Practice Erlangen, Erlangen; Rheumatology Practice and Department of Internal Medicine 2, Clinic Burghausen, Burghausen; Asklepios Medical Center, Department of Rheumatology and clinical Immunology, Bad Abbach; Rheumatology Practice Bamberg, Bamberg; Rheumatology Practice Bayreuth, Bayreuth; University of Heidelberg, Medicine 5, Heidelberg; Rheumatology Practice Nuremberg, Nuremberg; Schlosspark Klinik, Internal Medicine/Rheumatology, Berlin; University of Tübingen, Centre for Interdisciplinary Clinical Immunology, Tübingen; Praxiszentrum St. Bonifatius, Munich, Germany.,M. Hagen, BSc, CandMed, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen; M. Englbrecht, PhD, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen; J. Haschka, MD, St. Vincent Hospital, Vinforce Study Group, Medical University of Vienna; M. Reiser, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen; A. Kleyer, MD, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen; A. Hueber, MD, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen; B. Manger, MD, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen; C. Figueiredo, MD, Institutio de Rheumatologia; J. Fogagnolo Cobra, MD, Institutio de Rheumatologia; H.P. Tony, MD, University of Würzburg, Internal Medicine 2; S. Finzel, MD, University Medical Center Freiburg, Rheumatology and Clinical Immunology; S. Kleinert, MD, Rheumatology Clinical Practice Erlangen; J. Wendler, MD, Rheumatology Clinical Practice Erlangen; F. Schuch, MD, Rheumatology Clinical Practice Erlangen; M. Ronneberger, MD, Rheumatology Clinical Practice Erlangen; M. Feuchtenberger, MD, Rheumatology Practice and Department of Internal Medicine 2, Clinic Burghausen; M. Fleck, MD, Asklepios Medical Center, Department of Rheumatology and clinical Immunology; K. Manger, MD, Rheumatology Practice Bamberg; W. Ochs, MD, Rheumatology Practice Bayreuth; H.M. Lorenz, MD, University of Heidelberg, Medicine 5; H. Nüsslein, MD, Rheumatology Practice Nuremberg; R. Alten, MD, Schlosspark Klinik, Internal Medicine/Rheumatology; J. Henes, MD, University of Tübingen, Centre for Interdisciplinary Clinical Immunology; K. Krüger, MD, Praxiszentrum St. Bonifatius; G. Schett, MD, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen; J. Rech, MD, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen
| | - Judith Haschka
- From the Friedrich-Alexander-University Erlangen-Nuremberg (FAU), Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen, Erlangen, Germany; St. Vincent Hospital, Vinforce Study Group, Medical University of Vienna, Vienna, Austria; Institutio de Rheumatologia, São Paolo, Brazil; University of Würzburg, Internal Medicine 2, Würzburg; University Medical Center Freiburg, Rheumatology and Clinical Immunology, Freiburg; Rheumatology Clinical Practice Erlangen, Erlangen; Rheumatology Practice and Department of Internal Medicine 2, Clinic Burghausen, Burghausen; Asklepios Medical Center, Department of Rheumatology and clinical Immunology, Bad Abbach; Rheumatology Practice Bamberg, Bamberg; Rheumatology Practice Bayreuth, Bayreuth; University of Heidelberg, Medicine 5, Heidelberg; Rheumatology Practice Nuremberg, Nuremberg; Schlosspark Klinik, Internal Medicine/Rheumatology, Berlin; University of Tübingen, Centre for Interdisciplinary Clinical Immunology, Tübingen; Praxiszentrum St. Bonifatius, Munich, Germany.,M. Hagen, BSc, CandMed, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen; M. Englbrecht, PhD, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen; J. Haschka, MD, St. Vincent Hospital, Vinforce Study Group, Medical University of Vienna; M. Reiser, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen; A. Kleyer, MD, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen; A. Hueber, MD, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen; B. Manger, MD, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen; C. Figueiredo, MD, Institutio de Rheumatologia; J. Fogagnolo Cobra, MD, Institutio de Rheumatologia; H.P. Tony, MD, University of Würzburg, Internal Medicine 2; S. Finzel, MD, University Medical Center Freiburg, Rheumatology and Clinical Immunology; S. Kleinert, MD, Rheumatology Clinical Practice Erlangen; J. Wendler, MD, Rheumatology Clinical Practice Erlangen; F. Schuch, MD, Rheumatology Clinical Practice Erlangen; M. Ronneberger, MD, Rheumatology Clinical Practice Erlangen; M. Feuchtenberger, MD, Rheumatology Practice and Department of Internal Medicine 2, Clinic Burghausen; M. Fleck, MD, Asklepios Medical Center, Department of Rheumatology and clinical Immunology; K. Manger, MD, Rheumatology Practice Bamberg; W. Ochs, MD, Rheumatology Practice Bayreuth; H.M. Lorenz, MD, University of Heidelberg, Medicine 5; H. Nüsslein, MD, Rheumatology Practice Nuremberg; R. Alten, MD, Schlosspark Klinik, Internal Medicine/Rheumatology; J. Henes, MD, University of Tübingen, Centre for Interdisciplinary Clinical Immunology; K. Krüger, MD, Praxiszentrum St. Bonifatius; G. Schett, MD, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen; J. Rech, MD, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen
| | - Michaela Reiser
- From the Friedrich-Alexander-University Erlangen-Nuremberg (FAU), Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen, Erlangen, Germany; St. Vincent Hospital, Vinforce Study Group, Medical University of Vienna, Vienna, Austria; Institutio de Rheumatologia, São Paolo, Brazil; University of Würzburg, Internal Medicine 2, Würzburg; University Medical Center Freiburg, Rheumatology and Clinical Immunology, Freiburg; Rheumatology Clinical Practice Erlangen, Erlangen; Rheumatology Practice and Department of Internal Medicine 2, Clinic Burghausen, Burghausen; Asklepios Medical Center, Department of Rheumatology and clinical Immunology, Bad Abbach; Rheumatology Practice Bamberg, Bamberg; Rheumatology Practice Bayreuth, Bayreuth; University of Heidelberg, Medicine 5, Heidelberg; Rheumatology Practice Nuremberg, Nuremberg; Schlosspark Klinik, Internal Medicine/Rheumatology, Berlin; University of Tübingen, Centre for Interdisciplinary Clinical Immunology, Tübingen; Praxiszentrum St. Bonifatius, Munich, Germany.,M. Hagen, BSc, CandMed, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen; M. Englbrecht, PhD, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen; J. Haschka, MD, St. Vincent Hospital, Vinforce Study Group, Medical University of Vienna; M. Reiser, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen; A. Kleyer, MD, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen; A. Hueber, MD, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen; B. Manger, MD, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen; C. Figueiredo, MD, Institutio de Rheumatologia; J. Fogagnolo Cobra, MD, Institutio de Rheumatologia; H.P. Tony, MD, University of Würzburg, Internal Medicine 2; S. Finzel, MD, University Medical Center Freiburg, Rheumatology and Clinical Immunology; S. Kleinert, MD, Rheumatology Clinical Practice Erlangen; J. Wendler, MD, Rheumatology Clinical Practice Erlangen; F. Schuch, MD, Rheumatology Clinical Practice Erlangen; M. Ronneberger, MD, Rheumatology Clinical Practice Erlangen; M. Feuchtenberger, MD, Rheumatology Practice and Department of Internal Medicine 2, Clinic Burghausen; M. Fleck, MD, Asklepios Medical Center, Department of Rheumatology and clinical Immunology; K. Manger, MD, Rheumatology Practice Bamberg; W. Ochs, MD, Rheumatology Practice Bayreuth; H.M. Lorenz, MD, University of Heidelberg, Medicine 5; H. Nüsslein, MD, Rheumatology Practice Nuremberg; R. Alten, MD, Schlosspark Klinik, Internal Medicine/Rheumatology; J. Henes, MD, University of Tübingen, Centre for Interdisciplinary Clinical Immunology; K. Krüger, MD, Praxiszentrum St. Bonifatius; G. Schett, MD, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen; J. Rech, MD, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen
| | - Arnd Kleyer
- From the Friedrich-Alexander-University Erlangen-Nuremberg (FAU), Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen, Erlangen, Germany; St. Vincent Hospital, Vinforce Study Group, Medical University of Vienna, Vienna, Austria; Institutio de Rheumatologia, São Paolo, Brazil; University of Würzburg, Internal Medicine 2, Würzburg; University Medical Center Freiburg, Rheumatology and Clinical Immunology, Freiburg; Rheumatology Clinical Practice Erlangen, Erlangen; Rheumatology Practice and Department of Internal Medicine 2, Clinic Burghausen, Burghausen; Asklepios Medical Center, Department of Rheumatology and clinical Immunology, Bad Abbach; Rheumatology Practice Bamberg, Bamberg; Rheumatology Practice Bayreuth, Bayreuth; University of Heidelberg, Medicine 5, Heidelberg; Rheumatology Practice Nuremberg, Nuremberg; Schlosspark Klinik, Internal Medicine/Rheumatology, Berlin; University of Tübingen, Centre for Interdisciplinary Clinical Immunology, Tübingen; Praxiszentrum St. Bonifatius, Munich, Germany.,M. Hagen, BSc, CandMed, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen; M. Englbrecht, PhD, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen; J. Haschka, MD, St. Vincent Hospital, Vinforce Study Group, Medical University of Vienna; M. Reiser, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen; A. Kleyer, MD, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen; A. Hueber, MD, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen; B. Manger, MD, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen; C. Figueiredo, MD, Institutio de Rheumatologia; J. Fogagnolo Cobra, MD, Institutio de Rheumatologia; H.P. Tony, MD, University of Würzburg, Internal Medicine 2; S. Finzel, MD, University Medical Center Freiburg, Rheumatology and Clinical Immunology; S. Kleinert, MD, Rheumatology Clinical Practice Erlangen; J. Wendler, MD, Rheumatology Clinical Practice Erlangen; F. Schuch, MD, Rheumatology Clinical Practice Erlangen; M. Ronneberger, MD, Rheumatology Clinical Practice Erlangen; M. Feuchtenberger, MD, Rheumatology Practice and Department of Internal Medicine 2, Clinic Burghausen; M. Fleck, MD, Asklepios Medical Center, Department of Rheumatology and clinical Immunology; K. Manger, MD, Rheumatology Practice Bamberg; W. Ochs, MD, Rheumatology Practice Bayreuth; H.M. Lorenz, MD, University of Heidelberg, Medicine 5; H. Nüsslein, MD, Rheumatology Practice Nuremberg; R. Alten, MD, Schlosspark Klinik, Internal Medicine/Rheumatology; J. Henes, MD, University of Tübingen, Centre for Interdisciplinary Clinical Immunology; K. Krüger, MD, Praxiszentrum St. Bonifatius; G. Schett, MD, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen; J. Rech, MD, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen
| | - Axel Hueber
- From the Friedrich-Alexander-University Erlangen-Nuremberg (FAU), Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen, Erlangen, Germany; St. Vincent Hospital, Vinforce Study Group, Medical University of Vienna, Vienna, Austria; Institutio de Rheumatologia, São Paolo, Brazil; University of Würzburg, Internal Medicine 2, Würzburg; University Medical Center Freiburg, Rheumatology and Clinical Immunology, Freiburg; Rheumatology Clinical Practice Erlangen, Erlangen; Rheumatology Practice and Department of Internal Medicine 2, Clinic Burghausen, Burghausen; Asklepios Medical Center, Department of Rheumatology and clinical Immunology, Bad Abbach; Rheumatology Practice Bamberg, Bamberg; Rheumatology Practice Bayreuth, Bayreuth; University of Heidelberg, Medicine 5, Heidelberg; Rheumatology Practice Nuremberg, Nuremberg; Schlosspark Klinik, Internal Medicine/Rheumatology, Berlin; University of Tübingen, Centre for Interdisciplinary Clinical Immunology, Tübingen; Praxiszentrum St. Bonifatius, Munich, Germany.,M. Hagen, BSc, CandMed, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen; M. Englbrecht, PhD, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen; J. Haschka, MD, St. Vincent Hospital, Vinforce Study Group, Medical University of Vienna; M. Reiser, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen; A. Kleyer, MD, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen; A. Hueber, MD, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen; B. Manger, MD, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen; C. Figueiredo, MD, Institutio de Rheumatologia; J. Fogagnolo Cobra, MD, Institutio de Rheumatologia; H.P. Tony, MD, University of Würzburg, Internal Medicine 2; S. Finzel, MD, University Medical Center Freiburg, Rheumatology and Clinical Immunology; S. Kleinert, MD, Rheumatology Clinical Practice Erlangen; J. Wendler, MD, Rheumatology Clinical Practice Erlangen; F. Schuch, MD, Rheumatology Clinical Practice Erlangen; M. Ronneberger, MD, Rheumatology Clinical Practice Erlangen; M. Feuchtenberger, MD, Rheumatology Practice and Department of Internal Medicine 2, Clinic Burghausen; M. Fleck, MD, Asklepios Medical Center, Department of Rheumatology and clinical Immunology; K. Manger, MD, Rheumatology Practice Bamberg; W. Ochs, MD, Rheumatology Practice Bayreuth; H.M. Lorenz, MD, University of Heidelberg, Medicine 5; H. Nüsslein, MD, Rheumatology Practice Nuremberg; R. Alten, MD, Schlosspark Klinik, Internal Medicine/Rheumatology; J. Henes, MD, University of Tübingen, Centre for Interdisciplinary Clinical Immunology; K. Krüger, MD, Praxiszentrum St. Bonifatius; G. Schett, MD, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen; J. Rech, MD, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen
| | - Bernhard Manger
- From the Friedrich-Alexander-University Erlangen-Nuremberg (FAU), Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen, Erlangen, Germany; St. Vincent Hospital, Vinforce Study Group, Medical University of Vienna, Vienna, Austria; Institutio de Rheumatologia, São Paolo, Brazil; University of Würzburg, Internal Medicine 2, Würzburg; University Medical Center Freiburg, Rheumatology and Clinical Immunology, Freiburg; Rheumatology Clinical Practice Erlangen, Erlangen; Rheumatology Practice and Department of Internal Medicine 2, Clinic Burghausen, Burghausen; Asklepios Medical Center, Department of Rheumatology and clinical Immunology, Bad Abbach; Rheumatology Practice Bamberg, Bamberg; Rheumatology Practice Bayreuth, Bayreuth; University of Heidelberg, Medicine 5, Heidelberg; Rheumatology Practice Nuremberg, Nuremberg; Schlosspark Klinik, Internal Medicine/Rheumatology, Berlin; University of Tübingen, Centre for Interdisciplinary Clinical Immunology, Tübingen; Praxiszentrum St. Bonifatius, Munich, Germany.,M. Hagen, BSc, CandMed, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen; M. Englbrecht, PhD, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen; J. Haschka, MD, St. Vincent Hospital, Vinforce Study Group, Medical University of Vienna; M. Reiser, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen; A. Kleyer, MD, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen; A. Hueber, MD, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen; B. Manger, MD, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen; C. Figueiredo, MD, Institutio de Rheumatologia; J. Fogagnolo Cobra, MD, Institutio de Rheumatologia; H.P. Tony, MD, University of Würzburg, Internal Medicine 2; S. Finzel, MD, University Medical Center Freiburg, Rheumatology and Clinical Immunology; S. Kleinert, MD, Rheumatology Clinical Practice Erlangen; J. Wendler, MD, Rheumatology Clinical Practice Erlangen; F. Schuch, MD, Rheumatology Clinical Practice Erlangen; M. Ronneberger, MD, Rheumatology Clinical Practice Erlangen; M. Feuchtenberger, MD, Rheumatology Practice and Department of Internal Medicine 2, Clinic Burghausen; M. Fleck, MD, Asklepios Medical Center, Department of Rheumatology and clinical Immunology; K. Manger, MD, Rheumatology Practice Bamberg; W. Ochs, MD, Rheumatology Practice Bayreuth; H.M. Lorenz, MD, University of Heidelberg, Medicine 5; H. Nüsslein, MD, Rheumatology Practice Nuremberg; R. Alten, MD, Schlosspark Klinik, Internal Medicine/Rheumatology; J. Henes, MD, University of Tübingen, Centre for Interdisciplinary Clinical Immunology; K. Krüger, MD, Praxiszentrum St. Bonifatius; G. Schett, MD, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen; J. Rech, MD, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen
| | - Camille Figueiredo
- From the Friedrich-Alexander-University Erlangen-Nuremberg (FAU), Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen, Erlangen, Germany; St. Vincent Hospital, Vinforce Study Group, Medical University of Vienna, Vienna, Austria; Institutio de Rheumatologia, São Paolo, Brazil; University of Würzburg, Internal Medicine 2, Würzburg; University Medical Center Freiburg, Rheumatology and Clinical Immunology, Freiburg; Rheumatology Clinical Practice Erlangen, Erlangen; Rheumatology Practice and Department of Internal Medicine 2, Clinic Burghausen, Burghausen; Asklepios Medical Center, Department of Rheumatology and clinical Immunology, Bad Abbach; Rheumatology Practice Bamberg, Bamberg; Rheumatology Practice Bayreuth, Bayreuth; University of Heidelberg, Medicine 5, Heidelberg; Rheumatology Practice Nuremberg, Nuremberg; Schlosspark Klinik, Internal Medicine/Rheumatology, Berlin; University of Tübingen, Centre for Interdisciplinary Clinical Immunology, Tübingen; Praxiszentrum St. Bonifatius, Munich, Germany.,M. Hagen, BSc, CandMed, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen; M. Englbrecht, PhD, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen; J. Haschka, MD, St. Vincent Hospital, Vinforce Study Group, Medical University of Vienna; M. Reiser, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen; A. Kleyer, MD, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen; A. Hueber, MD, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen; B. Manger, MD, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen; C. Figueiredo, MD, Institutio de Rheumatologia; J. Fogagnolo Cobra, MD, Institutio de Rheumatologia; H.P. Tony, MD, University of Würzburg, Internal Medicine 2; S. Finzel, MD, University Medical Center Freiburg, Rheumatology and Clinical Immunology; S. Kleinert, MD, Rheumatology Clinical Practice Erlangen; J. Wendler, MD, Rheumatology Clinical Practice Erlangen; F. Schuch, MD, Rheumatology Clinical Practice Erlangen; M. Ronneberger, MD, Rheumatology Clinical Practice Erlangen; M. Feuchtenberger, MD, Rheumatology Practice and Department of Internal Medicine 2, Clinic Burghausen; M. Fleck, MD, Asklepios Medical Center, Department of Rheumatology and clinical Immunology; K. Manger, MD, Rheumatology Practice Bamberg; W. Ochs, MD, Rheumatology Practice Bayreuth; H.M. Lorenz, MD, University of Heidelberg, Medicine 5; H. Nüsslein, MD, Rheumatology Practice Nuremberg; R. Alten, MD, Schlosspark Klinik, Internal Medicine/Rheumatology; J. Henes, MD, University of Tübingen, Centre for Interdisciplinary Clinical Immunology; K. Krüger, MD, Praxiszentrum St. Bonifatius; G. Schett, MD, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen; J. Rech, MD, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen
| | - Jayme Fogagnolo Cobra
- From the Friedrich-Alexander-University Erlangen-Nuremberg (FAU), Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen, Erlangen, Germany; St. Vincent Hospital, Vinforce Study Group, Medical University of Vienna, Vienna, Austria; Institutio de Rheumatologia, São Paolo, Brazil; University of Würzburg, Internal Medicine 2, Würzburg; University Medical Center Freiburg, Rheumatology and Clinical Immunology, Freiburg; Rheumatology Clinical Practice Erlangen, Erlangen; Rheumatology Practice and Department of Internal Medicine 2, Clinic Burghausen, Burghausen; Asklepios Medical Center, Department of Rheumatology and clinical Immunology, Bad Abbach; Rheumatology Practice Bamberg, Bamberg; Rheumatology Practice Bayreuth, Bayreuth; University of Heidelberg, Medicine 5, Heidelberg; Rheumatology Practice Nuremberg, Nuremberg; Schlosspark Klinik, Internal Medicine/Rheumatology, Berlin; University of Tübingen, Centre for Interdisciplinary Clinical Immunology, Tübingen; Praxiszentrum St. Bonifatius, Munich, Germany.,M. Hagen, BSc, CandMed, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen; M. Englbrecht, PhD, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen; J. Haschka, MD, St. Vincent Hospital, Vinforce Study Group, Medical University of Vienna; M. Reiser, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen; A. Kleyer, MD, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen; A. Hueber, MD, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen; B. Manger, MD, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen; C. Figueiredo, MD, Institutio de Rheumatologia; J. Fogagnolo Cobra, MD, Institutio de Rheumatologia; H.P. Tony, MD, University of Würzburg, Internal Medicine 2; S. Finzel, MD, University Medical Center Freiburg, Rheumatology and Clinical Immunology; S. Kleinert, MD, Rheumatology Clinical Practice Erlangen; J. Wendler, MD, Rheumatology Clinical Practice Erlangen; F. Schuch, MD, Rheumatology Clinical Practice Erlangen; M. Ronneberger, MD, Rheumatology Clinical Practice Erlangen; M. Feuchtenberger, MD, Rheumatology Practice and Department of Internal Medicine 2, Clinic Burghausen; M. Fleck, MD, Asklepios Medical Center, Department of Rheumatology and clinical Immunology; K. Manger, MD, Rheumatology Practice Bamberg; W. Ochs, MD, Rheumatology Practice Bayreuth; H.M. Lorenz, MD, University of Heidelberg, Medicine 5; H. Nüsslein, MD, Rheumatology Practice Nuremberg; R. Alten, MD, Schlosspark Klinik, Internal Medicine/Rheumatology; J. Henes, MD, University of Tübingen, Centre for Interdisciplinary Clinical Immunology; K. Krüger, MD, Praxiszentrum St. Bonifatius; G. Schett, MD, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen; J. Rech, MD, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen
| | - Hans-Peter Tony
- From the Friedrich-Alexander-University Erlangen-Nuremberg (FAU), Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen, Erlangen, Germany; St. Vincent Hospital, Vinforce Study Group, Medical University of Vienna, Vienna, Austria; Institutio de Rheumatologia, São Paolo, Brazil; University of Würzburg, Internal Medicine 2, Würzburg; University Medical Center Freiburg, Rheumatology and Clinical Immunology, Freiburg; Rheumatology Clinical Practice Erlangen, Erlangen; Rheumatology Practice and Department of Internal Medicine 2, Clinic Burghausen, Burghausen; Asklepios Medical Center, Department of Rheumatology and clinical Immunology, Bad Abbach; Rheumatology Practice Bamberg, Bamberg; Rheumatology Practice Bayreuth, Bayreuth; University of Heidelberg, Medicine 5, Heidelberg; Rheumatology Practice Nuremberg, Nuremberg; Schlosspark Klinik, Internal Medicine/Rheumatology, Berlin; University of Tübingen, Centre for Interdisciplinary Clinical Immunology, Tübingen; Praxiszentrum St. Bonifatius, Munich, Germany.,M. Hagen, BSc, CandMed, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen; M. Englbrecht, PhD, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen; J. Haschka, MD, St. Vincent Hospital, Vinforce Study Group, Medical University of Vienna; M. Reiser, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen; A. Kleyer, MD, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen; A. Hueber, MD, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen; B. Manger, MD, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen; C. Figueiredo, MD, Institutio de Rheumatologia; J. Fogagnolo Cobra, MD, Institutio de Rheumatologia; H.P. Tony, MD, University of Würzburg, Internal Medicine 2; S. Finzel, MD, University Medical Center Freiburg, Rheumatology and Clinical Immunology; S. Kleinert, MD, Rheumatology Clinical Practice Erlangen; J. Wendler, MD, Rheumatology Clinical Practice Erlangen; F. Schuch, MD, Rheumatology Clinical Practice Erlangen; M. Ronneberger, MD, Rheumatology Clinical Practice Erlangen; M. Feuchtenberger, MD, Rheumatology Practice and Department of Internal Medicine 2, Clinic Burghausen; M. Fleck, MD, Asklepios Medical Center, Department of Rheumatology and clinical Immunology; K. Manger, MD, Rheumatology Practice Bamberg; W. Ochs, MD, Rheumatology Practice Bayreuth; H.M. Lorenz, MD, University of Heidelberg, Medicine 5; H. Nüsslein, MD, Rheumatology Practice Nuremberg; R. Alten, MD, Schlosspark Klinik, Internal Medicine/Rheumatology; J. Henes, MD, University of Tübingen, Centre for Interdisciplinary Clinical Immunology; K. Krüger, MD, Praxiszentrum St. Bonifatius; G. Schett, MD, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen; J. Rech, MD, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen
| | - Stephanie Finzel
- From the Friedrich-Alexander-University Erlangen-Nuremberg (FAU), Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen, Erlangen, Germany; St. Vincent Hospital, Vinforce Study Group, Medical University of Vienna, Vienna, Austria; Institutio de Rheumatologia, São Paolo, Brazil; University of Würzburg, Internal Medicine 2, Würzburg; University Medical Center Freiburg, Rheumatology and Clinical Immunology, Freiburg; Rheumatology Clinical Practice Erlangen, Erlangen; Rheumatology Practice and Department of Internal Medicine 2, Clinic Burghausen, Burghausen; Asklepios Medical Center, Department of Rheumatology and clinical Immunology, Bad Abbach; Rheumatology Practice Bamberg, Bamberg; Rheumatology Practice Bayreuth, Bayreuth; University of Heidelberg, Medicine 5, Heidelberg; Rheumatology Practice Nuremberg, Nuremberg; Schlosspark Klinik, Internal Medicine/Rheumatology, Berlin; University of Tübingen, Centre for Interdisciplinary Clinical Immunology, Tübingen; Praxiszentrum St. Bonifatius, Munich, Germany.,M. Hagen, BSc, CandMed, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen; M. Englbrecht, PhD, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen; J. Haschka, MD, St. Vincent Hospital, Vinforce Study Group, Medical University of Vienna; M. Reiser, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen; A. Kleyer, MD, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen; A. Hueber, MD, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen; B. Manger, MD, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen; C. Figueiredo, MD, Institutio de Rheumatologia; J. Fogagnolo Cobra, MD, Institutio de Rheumatologia; H.P. Tony, MD, University of Würzburg, Internal Medicine 2; S. Finzel, MD, University Medical Center Freiburg, Rheumatology and Clinical Immunology; S. Kleinert, MD, Rheumatology Clinical Practice Erlangen; J. Wendler, MD, Rheumatology Clinical Practice Erlangen; F. Schuch, MD, Rheumatology Clinical Practice Erlangen; M. Ronneberger, MD, Rheumatology Clinical Practice Erlangen; M. Feuchtenberger, MD, Rheumatology Practice and Department of Internal Medicine 2, Clinic Burghausen; M. Fleck, MD, Asklepios Medical Center, Department of Rheumatology and clinical Immunology; K. Manger, MD, Rheumatology Practice Bamberg; W. Ochs, MD, Rheumatology Practice Bayreuth; H.M. Lorenz, MD, University of Heidelberg, Medicine 5; H. Nüsslein, MD, Rheumatology Practice Nuremberg; R. Alten, MD, Schlosspark Klinik, Internal Medicine/Rheumatology; J. Henes, MD, University of Tübingen, Centre for Interdisciplinary Clinical Immunology; K. Krüger, MD, Praxiszentrum St. Bonifatius; G. Schett, MD, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen; J. Rech, MD, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen
| | - Stefan Kleinert
- From the Friedrich-Alexander-University Erlangen-Nuremberg (FAU), Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen, Erlangen, Germany; St. Vincent Hospital, Vinforce Study Group, Medical University of Vienna, Vienna, Austria; Institutio de Rheumatologia, São Paolo, Brazil; University of Würzburg, Internal Medicine 2, Würzburg; University Medical Center Freiburg, Rheumatology and Clinical Immunology, Freiburg; Rheumatology Clinical Practice Erlangen, Erlangen; Rheumatology Practice and Department of Internal Medicine 2, Clinic Burghausen, Burghausen; Asklepios Medical Center, Department of Rheumatology and clinical Immunology, Bad Abbach; Rheumatology Practice Bamberg, Bamberg; Rheumatology Practice Bayreuth, Bayreuth; University of Heidelberg, Medicine 5, Heidelberg; Rheumatology Practice Nuremberg, Nuremberg; Schlosspark Klinik, Internal Medicine/Rheumatology, Berlin; University of Tübingen, Centre for Interdisciplinary Clinical Immunology, Tübingen; Praxiszentrum St. Bonifatius, Munich, Germany.,M. Hagen, BSc, CandMed, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen; M. Englbrecht, PhD, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen; J. Haschka, MD, St. Vincent Hospital, Vinforce Study Group, Medical University of Vienna; M. Reiser, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen; A. Kleyer, MD, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen; A. Hueber, MD, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen; B. Manger, MD, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen; C. Figueiredo, MD, Institutio de Rheumatologia; J. Fogagnolo Cobra, MD, Institutio de Rheumatologia; H.P. Tony, MD, University of Würzburg, Internal Medicine 2; S. Finzel, MD, University Medical Center Freiburg, Rheumatology and Clinical Immunology; S. Kleinert, MD, Rheumatology Clinical Practice Erlangen; J. Wendler, MD, Rheumatology Clinical Practice Erlangen; F. Schuch, MD, Rheumatology Clinical Practice Erlangen; M. Ronneberger, MD, Rheumatology Clinical Practice Erlangen; M. Feuchtenberger, MD, Rheumatology Practice and Department of Internal Medicine 2, Clinic Burghausen; M. Fleck, MD, Asklepios Medical Center, Department of Rheumatology and clinical Immunology; K. Manger, MD, Rheumatology Practice Bamberg; W. Ochs, MD, Rheumatology Practice Bayreuth; H.M. Lorenz, MD, University of Heidelberg, Medicine 5; H. Nüsslein, MD, Rheumatology Practice Nuremberg; R. Alten, MD, Schlosspark Klinik, Internal Medicine/Rheumatology; J. Henes, MD, University of Tübingen, Centre for Interdisciplinary Clinical Immunology; K. Krüger, MD, Praxiszentrum St. Bonifatius; G. Schett, MD, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen; J. Rech, MD, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen
| | - Jörg Wendler
- From the Friedrich-Alexander-University Erlangen-Nuremberg (FAU), Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen, Erlangen, Germany; St. Vincent Hospital, Vinforce Study Group, Medical University of Vienna, Vienna, Austria; Institutio de Rheumatologia, São Paolo, Brazil; University of Würzburg, Internal Medicine 2, Würzburg; University Medical Center Freiburg, Rheumatology and Clinical Immunology, Freiburg; Rheumatology Clinical Practice Erlangen, Erlangen; Rheumatology Practice and Department of Internal Medicine 2, Clinic Burghausen, Burghausen; Asklepios Medical Center, Department of Rheumatology and clinical Immunology, Bad Abbach; Rheumatology Practice Bamberg, Bamberg; Rheumatology Practice Bayreuth, Bayreuth; University of Heidelberg, Medicine 5, Heidelberg; Rheumatology Practice Nuremberg, Nuremberg; Schlosspark Klinik, Internal Medicine/Rheumatology, Berlin; University of Tübingen, Centre for Interdisciplinary Clinical Immunology, Tübingen; Praxiszentrum St. Bonifatius, Munich, Germany.,M. Hagen, BSc, CandMed, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen; M. Englbrecht, PhD, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen; J. Haschka, MD, St. Vincent Hospital, Vinforce Study Group, Medical University of Vienna; M. Reiser, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen; A. Kleyer, MD, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen; A. Hueber, MD, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen; B. Manger, MD, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen; C. Figueiredo, MD, Institutio de Rheumatologia; J. Fogagnolo Cobra, MD, Institutio de Rheumatologia; H.P. Tony, MD, University of Würzburg, Internal Medicine 2; S. Finzel, MD, University Medical Center Freiburg, Rheumatology and Clinical Immunology; S. Kleinert, MD, Rheumatology Clinical Practice Erlangen; J. Wendler, MD, Rheumatology Clinical Practice Erlangen; F. Schuch, MD, Rheumatology Clinical Practice Erlangen; M. Ronneberger, MD, Rheumatology Clinical Practice Erlangen; M. Feuchtenberger, MD, Rheumatology Practice and Department of Internal Medicine 2, Clinic Burghausen; M. Fleck, MD, Asklepios Medical Center, Department of Rheumatology and clinical Immunology; K. Manger, MD, Rheumatology Practice Bamberg; W. Ochs, MD, Rheumatology Practice Bayreuth; H.M. Lorenz, MD, University of Heidelberg, Medicine 5; H. Nüsslein, MD, Rheumatology Practice Nuremberg; R. Alten, MD, Schlosspark Klinik, Internal Medicine/Rheumatology; J. Henes, MD, University of Tübingen, Centre for Interdisciplinary Clinical Immunology; K. Krüger, MD, Praxiszentrum St. Bonifatius; G. Schett, MD, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen; J. Rech, MD, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen
| | - Florian Schuch
- From the Friedrich-Alexander-University Erlangen-Nuremberg (FAU), Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen, Erlangen, Germany; St. Vincent Hospital, Vinforce Study Group, Medical University of Vienna, Vienna, Austria; Institutio de Rheumatologia, São Paolo, Brazil; University of Würzburg, Internal Medicine 2, Würzburg; University Medical Center Freiburg, Rheumatology and Clinical Immunology, Freiburg; Rheumatology Clinical Practice Erlangen, Erlangen; Rheumatology Practice and Department of Internal Medicine 2, Clinic Burghausen, Burghausen; Asklepios Medical Center, Department of Rheumatology and clinical Immunology, Bad Abbach; Rheumatology Practice Bamberg, Bamberg; Rheumatology Practice Bayreuth, Bayreuth; University of Heidelberg, Medicine 5, Heidelberg; Rheumatology Practice Nuremberg, Nuremberg; Schlosspark Klinik, Internal Medicine/Rheumatology, Berlin; University of Tübingen, Centre for Interdisciplinary Clinical Immunology, Tübingen; Praxiszentrum St. Bonifatius, Munich, Germany.,M. Hagen, BSc, CandMed, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen; M. Englbrecht, PhD, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen; J. Haschka, MD, St. Vincent Hospital, Vinforce Study Group, Medical University of Vienna; M. Reiser, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen; A. Kleyer, MD, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen; A. Hueber, MD, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen; B. Manger, MD, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen; C. Figueiredo, MD, Institutio de Rheumatologia; J. Fogagnolo Cobra, MD, Institutio de Rheumatologia; H.P. Tony, MD, University of Würzburg, Internal Medicine 2; S. Finzel, MD, University Medical Center Freiburg, Rheumatology and Clinical Immunology; S. Kleinert, MD, Rheumatology Clinical Practice Erlangen; J. Wendler, MD, Rheumatology Clinical Practice Erlangen; F. Schuch, MD, Rheumatology Clinical Practice Erlangen; M. Ronneberger, MD, Rheumatology Clinical Practice Erlangen; M. Feuchtenberger, MD, Rheumatology Practice and Department of Internal Medicine 2, Clinic Burghausen; M. Fleck, MD, Asklepios Medical Center, Department of Rheumatology and clinical Immunology; K. Manger, MD, Rheumatology Practice Bamberg; W. Ochs, MD, Rheumatology Practice Bayreuth; H.M. Lorenz, MD, University of Heidelberg, Medicine 5; H. Nüsslein, MD, Rheumatology Practice Nuremberg; R. Alten, MD, Schlosspark Klinik, Internal Medicine/Rheumatology; J. Henes, MD, University of Tübingen, Centre for Interdisciplinary Clinical Immunology; K. Krüger, MD, Praxiszentrum St. Bonifatius; G. Schett, MD, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen; J. Rech, MD, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen
| | - Monika Ronneberger
- From the Friedrich-Alexander-University Erlangen-Nuremberg (FAU), Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen, Erlangen, Germany; St. Vincent Hospital, Vinforce Study Group, Medical University of Vienna, Vienna, Austria; Institutio de Rheumatologia, São Paolo, Brazil; University of Würzburg, Internal Medicine 2, Würzburg; University Medical Center Freiburg, Rheumatology and Clinical Immunology, Freiburg; Rheumatology Clinical Practice Erlangen, Erlangen; Rheumatology Practice and Department of Internal Medicine 2, Clinic Burghausen, Burghausen; Asklepios Medical Center, Department of Rheumatology and clinical Immunology, Bad Abbach; Rheumatology Practice Bamberg, Bamberg; Rheumatology Practice Bayreuth, Bayreuth; University of Heidelberg, Medicine 5, Heidelberg; Rheumatology Practice Nuremberg, Nuremberg; Schlosspark Klinik, Internal Medicine/Rheumatology, Berlin; University of Tübingen, Centre for Interdisciplinary Clinical Immunology, Tübingen; Praxiszentrum St. Bonifatius, Munich, Germany.,M. Hagen, BSc, CandMed, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen; M. Englbrecht, PhD, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen; J. Haschka, MD, St. Vincent Hospital, Vinforce Study Group, Medical University of Vienna; M. Reiser, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen; A. Kleyer, MD, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen; A. Hueber, MD, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen; B. Manger, MD, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen; C. Figueiredo, MD, Institutio de Rheumatologia; J. Fogagnolo Cobra, MD, Institutio de Rheumatologia; H.P. Tony, MD, University of Würzburg, Internal Medicine 2; S. Finzel, MD, University Medical Center Freiburg, Rheumatology and Clinical Immunology; S. Kleinert, MD, Rheumatology Clinical Practice Erlangen; J. Wendler, MD, Rheumatology Clinical Practice Erlangen; F. Schuch, MD, Rheumatology Clinical Practice Erlangen; M. Ronneberger, MD, Rheumatology Clinical Practice Erlangen; M. Feuchtenberger, MD, Rheumatology Practice and Department of Internal Medicine 2, Clinic Burghausen; M. Fleck, MD, Asklepios Medical Center, Department of Rheumatology and clinical Immunology; K. Manger, MD, Rheumatology Practice Bamberg; W. Ochs, MD, Rheumatology Practice Bayreuth; H.M. Lorenz, MD, University of Heidelberg, Medicine 5; H. Nüsslein, MD, Rheumatology Practice Nuremberg; R. Alten, MD, Schlosspark Klinik, Internal Medicine/Rheumatology; J. Henes, MD, University of Tübingen, Centre for Interdisciplinary Clinical Immunology; K. Krüger, MD, Praxiszentrum St. Bonifatius; G. Schett, MD, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen; J. Rech, MD, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen
| | - Martin Feuchtenberger
- From the Friedrich-Alexander-University Erlangen-Nuremberg (FAU), Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen, Erlangen, Germany; St. Vincent Hospital, Vinforce Study Group, Medical University of Vienna, Vienna, Austria; Institutio de Rheumatologia, São Paolo, Brazil; University of Würzburg, Internal Medicine 2, Würzburg; University Medical Center Freiburg, Rheumatology and Clinical Immunology, Freiburg; Rheumatology Clinical Practice Erlangen, Erlangen; Rheumatology Practice and Department of Internal Medicine 2, Clinic Burghausen, Burghausen; Asklepios Medical Center, Department of Rheumatology and clinical Immunology, Bad Abbach; Rheumatology Practice Bamberg, Bamberg; Rheumatology Practice Bayreuth, Bayreuth; University of Heidelberg, Medicine 5, Heidelberg; Rheumatology Practice Nuremberg, Nuremberg; Schlosspark Klinik, Internal Medicine/Rheumatology, Berlin; University of Tübingen, Centre for Interdisciplinary Clinical Immunology, Tübingen; Praxiszentrum St. Bonifatius, Munich, Germany.,M. Hagen, BSc, CandMed, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen; M. Englbrecht, PhD, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen; J. Haschka, MD, St. Vincent Hospital, Vinforce Study Group, Medical University of Vienna; M. Reiser, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen; A. Kleyer, MD, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen; A. Hueber, MD, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen; B. Manger, MD, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen; C. Figueiredo, MD, Institutio de Rheumatologia; J. Fogagnolo Cobra, MD, Institutio de Rheumatologia; H.P. Tony, MD, University of Würzburg, Internal Medicine 2; S. Finzel, MD, University Medical Center Freiburg, Rheumatology and Clinical Immunology; S. Kleinert, MD, Rheumatology Clinical Practice Erlangen; J. Wendler, MD, Rheumatology Clinical Practice Erlangen; F. Schuch, MD, Rheumatology Clinical Practice Erlangen; M. Ronneberger, MD, Rheumatology Clinical Practice Erlangen; M. Feuchtenberger, MD, Rheumatology Practice and Department of Internal Medicine 2, Clinic Burghausen; M. Fleck, MD, Asklepios Medical Center, Department of Rheumatology and clinical Immunology; K. Manger, MD, Rheumatology Practice Bamberg; W. Ochs, MD, Rheumatology Practice Bayreuth; H.M. Lorenz, MD, University of Heidelberg, Medicine 5; H. Nüsslein, MD, Rheumatology Practice Nuremberg; R. Alten, MD, Schlosspark Klinik, Internal Medicine/Rheumatology; J. Henes, MD, University of Tübingen, Centre for Interdisciplinary Clinical Immunology; K. Krüger, MD, Praxiszentrum St. Bonifatius; G. Schett, MD, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen; J. Rech, MD, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen
| | - Martin Fleck
- From the Friedrich-Alexander-University Erlangen-Nuremberg (FAU), Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen, Erlangen, Germany; St. Vincent Hospital, Vinforce Study Group, Medical University of Vienna, Vienna, Austria; Institutio de Rheumatologia, São Paolo, Brazil; University of Würzburg, Internal Medicine 2, Würzburg; University Medical Center Freiburg, Rheumatology and Clinical Immunology, Freiburg; Rheumatology Clinical Practice Erlangen, Erlangen; Rheumatology Practice and Department of Internal Medicine 2, Clinic Burghausen, Burghausen; Asklepios Medical Center, Department of Rheumatology and clinical Immunology, Bad Abbach; Rheumatology Practice Bamberg, Bamberg; Rheumatology Practice Bayreuth, Bayreuth; University of Heidelberg, Medicine 5, Heidelberg; Rheumatology Practice Nuremberg, Nuremberg; Schlosspark Klinik, Internal Medicine/Rheumatology, Berlin; University of Tübingen, Centre for Interdisciplinary Clinical Immunology, Tübingen; Praxiszentrum St. Bonifatius, Munich, Germany.,M. Hagen, BSc, CandMed, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen; M. Englbrecht, PhD, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen; J. Haschka, MD, St. Vincent Hospital, Vinforce Study Group, Medical University of Vienna; M. Reiser, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen; A. Kleyer, MD, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen; A. Hueber, MD, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen; B. Manger, MD, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen; C. Figueiredo, MD, Institutio de Rheumatologia; J. Fogagnolo Cobra, MD, Institutio de Rheumatologia; H.P. Tony, MD, University of Würzburg, Internal Medicine 2; S. Finzel, MD, University Medical Center Freiburg, Rheumatology and Clinical Immunology; S. Kleinert, MD, Rheumatology Clinical Practice Erlangen; J. Wendler, MD, Rheumatology Clinical Practice Erlangen; F. Schuch, MD, Rheumatology Clinical Practice Erlangen; M. Ronneberger, MD, Rheumatology Clinical Practice Erlangen; M. Feuchtenberger, MD, Rheumatology Practice and Department of Internal Medicine 2, Clinic Burghausen; M. Fleck, MD, Asklepios Medical Center, Department of Rheumatology and clinical Immunology; K. Manger, MD, Rheumatology Practice Bamberg; W. Ochs, MD, Rheumatology Practice Bayreuth; H.M. Lorenz, MD, University of Heidelberg, Medicine 5; H. Nüsslein, MD, Rheumatology Practice Nuremberg; R. Alten, MD, Schlosspark Klinik, Internal Medicine/Rheumatology; J. Henes, MD, University of Tübingen, Centre for Interdisciplinary Clinical Immunology; K. Krüger, MD, Praxiszentrum St. Bonifatius; G. Schett, MD, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen; J. Rech, MD, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen
| | - Karin Manger
- From the Friedrich-Alexander-University Erlangen-Nuremberg (FAU), Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen, Erlangen, Germany; St. Vincent Hospital, Vinforce Study Group, Medical University of Vienna, Vienna, Austria; Institutio de Rheumatologia, São Paolo, Brazil; University of Würzburg, Internal Medicine 2, Würzburg; University Medical Center Freiburg, Rheumatology and Clinical Immunology, Freiburg; Rheumatology Clinical Practice Erlangen, Erlangen; Rheumatology Practice and Department of Internal Medicine 2, Clinic Burghausen, Burghausen; Asklepios Medical Center, Department of Rheumatology and clinical Immunology, Bad Abbach; Rheumatology Practice Bamberg, Bamberg; Rheumatology Practice Bayreuth, Bayreuth; University of Heidelberg, Medicine 5, Heidelberg; Rheumatology Practice Nuremberg, Nuremberg; Schlosspark Klinik, Internal Medicine/Rheumatology, Berlin; University of Tübingen, Centre for Interdisciplinary Clinical Immunology, Tübingen; Praxiszentrum St. Bonifatius, Munich, Germany.,M. Hagen, BSc, CandMed, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen; M. Englbrecht, PhD, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen; J. Haschka, MD, St. Vincent Hospital, Vinforce Study Group, Medical University of Vienna; M. Reiser, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen; A. Kleyer, MD, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen; A. Hueber, MD, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen; B. Manger, MD, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen; C. Figueiredo, MD, Institutio de Rheumatologia; J. Fogagnolo Cobra, MD, Institutio de Rheumatologia; H.P. Tony, MD, University of Würzburg, Internal Medicine 2; S. Finzel, MD, University Medical Center Freiburg, Rheumatology and Clinical Immunology; S. Kleinert, MD, Rheumatology Clinical Practice Erlangen; J. Wendler, MD, Rheumatology Clinical Practice Erlangen; F. Schuch, MD, Rheumatology Clinical Practice Erlangen; M. Ronneberger, MD, Rheumatology Clinical Practice Erlangen; M. Feuchtenberger, MD, Rheumatology Practice and Department of Internal Medicine 2, Clinic Burghausen; M. Fleck, MD, Asklepios Medical Center, Department of Rheumatology and clinical Immunology; K. Manger, MD, Rheumatology Practice Bamberg; W. Ochs, MD, Rheumatology Practice Bayreuth; H.M. Lorenz, MD, University of Heidelberg, Medicine 5; H. Nüsslein, MD, Rheumatology Practice Nuremberg; R. Alten, MD, Schlosspark Klinik, Internal Medicine/Rheumatology; J. Henes, MD, University of Tübingen, Centre for Interdisciplinary Clinical Immunology; K. Krüger, MD, Praxiszentrum St. Bonifatius; G. Schett, MD, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen; J. Rech, MD, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen
| | - Wolfgang Ochs
- From the Friedrich-Alexander-University Erlangen-Nuremberg (FAU), Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen, Erlangen, Germany; St. Vincent Hospital, Vinforce Study Group, Medical University of Vienna, Vienna, Austria; Institutio de Rheumatologia, São Paolo, Brazil; University of Würzburg, Internal Medicine 2, Würzburg; University Medical Center Freiburg, Rheumatology and Clinical Immunology, Freiburg; Rheumatology Clinical Practice Erlangen, Erlangen; Rheumatology Practice and Department of Internal Medicine 2, Clinic Burghausen, Burghausen; Asklepios Medical Center, Department of Rheumatology and clinical Immunology, Bad Abbach; Rheumatology Practice Bamberg, Bamberg; Rheumatology Practice Bayreuth, Bayreuth; University of Heidelberg, Medicine 5, Heidelberg; Rheumatology Practice Nuremberg, Nuremberg; Schlosspark Klinik, Internal Medicine/Rheumatology, Berlin; University of Tübingen, Centre for Interdisciplinary Clinical Immunology, Tübingen; Praxiszentrum St. Bonifatius, Munich, Germany.,M. Hagen, BSc, CandMed, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen; M. Englbrecht, PhD, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen; J. Haschka, MD, St. Vincent Hospital, Vinforce Study Group, Medical University of Vienna; M. Reiser, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen; A. Kleyer, MD, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen; A. Hueber, MD, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen; B. Manger, MD, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen; C. Figueiredo, MD, Institutio de Rheumatologia; J. Fogagnolo Cobra, MD, Institutio de Rheumatologia; H.P. Tony, MD, University of Würzburg, Internal Medicine 2; S. Finzel, MD, University Medical Center Freiburg, Rheumatology and Clinical Immunology; S. Kleinert, MD, Rheumatology Clinical Practice Erlangen; J. Wendler, MD, Rheumatology Clinical Practice Erlangen; F. Schuch, MD, Rheumatology Clinical Practice Erlangen; M. Ronneberger, MD, Rheumatology Clinical Practice Erlangen; M. Feuchtenberger, MD, Rheumatology Practice and Department of Internal Medicine 2, Clinic Burghausen; M. Fleck, MD, Asklepios Medical Center, Department of Rheumatology and clinical Immunology; K. Manger, MD, Rheumatology Practice Bamberg; W. Ochs, MD, Rheumatology Practice Bayreuth; H.M. Lorenz, MD, University of Heidelberg, Medicine 5; H. Nüsslein, MD, Rheumatology Practice Nuremberg; R. Alten, MD, Schlosspark Klinik, Internal Medicine/Rheumatology; J. Henes, MD, University of Tübingen, Centre for Interdisciplinary Clinical Immunology; K. Krüger, MD, Praxiszentrum St. Bonifatius; G. Schett, MD, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen; J. Rech, MD, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen
| | - Hans-Martin Lorenz
- From the Friedrich-Alexander-University Erlangen-Nuremberg (FAU), Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen, Erlangen, Germany; St. Vincent Hospital, Vinforce Study Group, Medical University of Vienna, Vienna, Austria; Institutio de Rheumatologia, São Paolo, Brazil; University of Würzburg, Internal Medicine 2, Würzburg; University Medical Center Freiburg, Rheumatology and Clinical Immunology, Freiburg; Rheumatology Clinical Practice Erlangen, Erlangen; Rheumatology Practice and Department of Internal Medicine 2, Clinic Burghausen, Burghausen; Asklepios Medical Center, Department of Rheumatology and clinical Immunology, Bad Abbach; Rheumatology Practice Bamberg, Bamberg; Rheumatology Practice Bayreuth, Bayreuth; University of Heidelberg, Medicine 5, Heidelberg; Rheumatology Practice Nuremberg, Nuremberg; Schlosspark Klinik, Internal Medicine/Rheumatology, Berlin; University of Tübingen, Centre for Interdisciplinary Clinical Immunology, Tübingen; Praxiszentrum St. Bonifatius, Munich, Germany.,M. Hagen, BSc, CandMed, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen; M. Englbrecht, PhD, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen; J. Haschka, MD, St. Vincent Hospital, Vinforce Study Group, Medical University of Vienna; M. Reiser, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen; A. Kleyer, MD, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen; A. Hueber, MD, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen; B. Manger, MD, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen; C. Figueiredo, MD, Institutio de Rheumatologia; J. Fogagnolo Cobra, MD, Institutio de Rheumatologia; H.P. Tony, MD, University of Würzburg, Internal Medicine 2; S. Finzel, MD, University Medical Center Freiburg, Rheumatology and Clinical Immunology; S. Kleinert, MD, Rheumatology Clinical Practice Erlangen; J. Wendler, MD, Rheumatology Clinical Practice Erlangen; F. Schuch, MD, Rheumatology Clinical Practice Erlangen; M. Ronneberger, MD, Rheumatology Clinical Practice Erlangen; M. Feuchtenberger, MD, Rheumatology Practice and Department of Internal Medicine 2, Clinic Burghausen; M. Fleck, MD, Asklepios Medical Center, Department of Rheumatology and clinical Immunology; K. Manger, MD, Rheumatology Practice Bamberg; W. Ochs, MD, Rheumatology Practice Bayreuth; H.M. Lorenz, MD, University of Heidelberg, Medicine 5; H. Nüsslein, MD, Rheumatology Practice Nuremberg; R. Alten, MD, Schlosspark Klinik, Internal Medicine/Rheumatology; J. Henes, MD, University of Tübingen, Centre for Interdisciplinary Clinical Immunology; K. Krüger, MD, Praxiszentrum St. Bonifatius; G. Schett, MD, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen; J. Rech, MD, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen
| | - Hubert Nüsslein
- From the Friedrich-Alexander-University Erlangen-Nuremberg (FAU), Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen, Erlangen, Germany; St. Vincent Hospital, Vinforce Study Group, Medical University of Vienna, Vienna, Austria; Institutio de Rheumatologia, São Paolo, Brazil; University of Würzburg, Internal Medicine 2, Würzburg; University Medical Center Freiburg, Rheumatology and Clinical Immunology, Freiburg; Rheumatology Clinical Practice Erlangen, Erlangen; Rheumatology Practice and Department of Internal Medicine 2, Clinic Burghausen, Burghausen; Asklepios Medical Center, Department of Rheumatology and clinical Immunology, Bad Abbach; Rheumatology Practice Bamberg, Bamberg; Rheumatology Practice Bayreuth, Bayreuth; University of Heidelberg, Medicine 5, Heidelberg; Rheumatology Practice Nuremberg, Nuremberg; Schlosspark Klinik, Internal Medicine/Rheumatology, Berlin; University of Tübingen, Centre for Interdisciplinary Clinical Immunology, Tübingen; Praxiszentrum St. Bonifatius, Munich, Germany.,M. Hagen, BSc, CandMed, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen; M. Englbrecht, PhD, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen; J. Haschka, MD, St. Vincent Hospital, Vinforce Study Group, Medical University of Vienna; M. Reiser, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen; A. Kleyer, MD, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen; A. Hueber, MD, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen; B. Manger, MD, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen; C. Figueiredo, MD, Institutio de Rheumatologia; J. Fogagnolo Cobra, MD, Institutio de Rheumatologia; H.P. Tony, MD, University of Würzburg, Internal Medicine 2; S. Finzel, MD, University Medical Center Freiburg, Rheumatology and Clinical Immunology; S. Kleinert, MD, Rheumatology Clinical Practice Erlangen; J. Wendler, MD, Rheumatology Clinical Practice Erlangen; F. Schuch, MD, Rheumatology Clinical Practice Erlangen; M. Ronneberger, MD, Rheumatology Clinical Practice Erlangen; M. Feuchtenberger, MD, Rheumatology Practice and Department of Internal Medicine 2, Clinic Burghausen; M. Fleck, MD, Asklepios Medical Center, Department of Rheumatology and clinical Immunology; K. Manger, MD, Rheumatology Practice Bamberg; W. Ochs, MD, Rheumatology Practice Bayreuth; H.M. Lorenz, MD, University of Heidelberg, Medicine 5; H. Nüsslein, MD, Rheumatology Practice Nuremberg; R. Alten, MD, Schlosspark Klinik, Internal Medicine/Rheumatology; J. Henes, MD, University of Tübingen, Centre for Interdisciplinary Clinical Immunology; K. Krüger, MD, Praxiszentrum St. Bonifatius; G. Schett, MD, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen; J. Rech, MD, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen
| | - Rieke Alten
- From the Friedrich-Alexander-University Erlangen-Nuremberg (FAU), Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen, Erlangen, Germany; St. Vincent Hospital, Vinforce Study Group, Medical University of Vienna, Vienna, Austria; Institutio de Rheumatologia, São Paolo, Brazil; University of Würzburg, Internal Medicine 2, Würzburg; University Medical Center Freiburg, Rheumatology and Clinical Immunology, Freiburg; Rheumatology Clinical Practice Erlangen, Erlangen; Rheumatology Practice and Department of Internal Medicine 2, Clinic Burghausen, Burghausen; Asklepios Medical Center, Department of Rheumatology and clinical Immunology, Bad Abbach; Rheumatology Practice Bamberg, Bamberg; Rheumatology Practice Bayreuth, Bayreuth; University of Heidelberg, Medicine 5, Heidelberg; Rheumatology Practice Nuremberg, Nuremberg; Schlosspark Klinik, Internal Medicine/Rheumatology, Berlin; University of Tübingen, Centre for Interdisciplinary Clinical Immunology, Tübingen; Praxiszentrum St. Bonifatius, Munich, Germany.,M. Hagen, BSc, CandMed, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen; M. Englbrecht, PhD, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen; J. Haschka, MD, St. Vincent Hospital, Vinforce Study Group, Medical University of Vienna; M. Reiser, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen; A. Kleyer, MD, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen; A. Hueber, MD, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen; B. Manger, MD, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen; C. Figueiredo, MD, Institutio de Rheumatologia; J. Fogagnolo Cobra, MD, Institutio de Rheumatologia; H.P. Tony, MD, University of Würzburg, Internal Medicine 2; S. Finzel, MD, University Medical Center Freiburg, Rheumatology and Clinical Immunology; S. Kleinert, MD, Rheumatology Clinical Practice Erlangen; J. Wendler, MD, Rheumatology Clinical Practice Erlangen; F. Schuch, MD, Rheumatology Clinical Practice Erlangen; M. Ronneberger, MD, Rheumatology Clinical Practice Erlangen; M. Feuchtenberger, MD, Rheumatology Practice and Department of Internal Medicine 2, Clinic Burghausen; M. Fleck, MD, Asklepios Medical Center, Department of Rheumatology and clinical Immunology; K. Manger, MD, Rheumatology Practice Bamberg; W. Ochs, MD, Rheumatology Practice Bayreuth; H.M. Lorenz, MD, University of Heidelberg, Medicine 5; H. Nüsslein, MD, Rheumatology Practice Nuremberg; R. Alten, MD, Schlosspark Klinik, Internal Medicine/Rheumatology; J. Henes, MD, University of Tübingen, Centre for Interdisciplinary Clinical Immunology; K. Krüger, MD, Praxiszentrum St. Bonifatius; G. Schett, MD, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen; J. Rech, MD, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen
| | - Jörg Henes
- From the Friedrich-Alexander-University Erlangen-Nuremberg (FAU), Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen, Erlangen, Germany; St. Vincent Hospital, Vinforce Study Group, Medical University of Vienna, Vienna, Austria; Institutio de Rheumatologia, São Paolo, Brazil; University of Würzburg, Internal Medicine 2, Würzburg; University Medical Center Freiburg, Rheumatology and Clinical Immunology, Freiburg; Rheumatology Clinical Practice Erlangen, Erlangen; Rheumatology Practice and Department of Internal Medicine 2, Clinic Burghausen, Burghausen; Asklepios Medical Center, Department of Rheumatology and clinical Immunology, Bad Abbach; Rheumatology Practice Bamberg, Bamberg; Rheumatology Practice Bayreuth, Bayreuth; University of Heidelberg, Medicine 5, Heidelberg; Rheumatology Practice Nuremberg, Nuremberg; Schlosspark Klinik, Internal Medicine/Rheumatology, Berlin; University of Tübingen, Centre for Interdisciplinary Clinical Immunology, Tübingen; Praxiszentrum St. Bonifatius, Munich, Germany.,M. Hagen, BSc, CandMed, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen; M. Englbrecht, PhD, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen; J. Haschka, MD, St. Vincent Hospital, Vinforce Study Group, Medical University of Vienna; M. Reiser, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen; A. Kleyer, MD, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen; A. Hueber, MD, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen; B. Manger, MD, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen; C. Figueiredo, MD, Institutio de Rheumatologia; J. Fogagnolo Cobra, MD, Institutio de Rheumatologia; H.P. Tony, MD, University of Würzburg, Internal Medicine 2; S. Finzel, MD, University Medical Center Freiburg, Rheumatology and Clinical Immunology; S. Kleinert, MD, Rheumatology Clinical Practice Erlangen; J. Wendler, MD, Rheumatology Clinical Practice Erlangen; F. Schuch, MD, Rheumatology Clinical Practice Erlangen; M. Ronneberger, MD, Rheumatology Clinical Practice Erlangen; M. Feuchtenberger, MD, Rheumatology Practice and Department of Internal Medicine 2, Clinic Burghausen; M. Fleck, MD, Asklepios Medical Center, Department of Rheumatology and clinical Immunology; K. Manger, MD, Rheumatology Practice Bamberg; W. Ochs, MD, Rheumatology Practice Bayreuth; H.M. Lorenz, MD, University of Heidelberg, Medicine 5; H. Nüsslein, MD, Rheumatology Practice Nuremberg; R. Alten, MD, Schlosspark Klinik, Internal Medicine/Rheumatology; J. Henes, MD, University of Tübingen, Centre for Interdisciplinary Clinical Immunology; K. Krüger, MD, Praxiszentrum St. Bonifatius; G. Schett, MD, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen; J. Rech, MD, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen
| | - Klaus Krüger
- From the Friedrich-Alexander-University Erlangen-Nuremberg (FAU), Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen, Erlangen, Germany; St. Vincent Hospital, Vinforce Study Group, Medical University of Vienna, Vienna, Austria; Institutio de Rheumatologia, São Paolo, Brazil; University of Würzburg, Internal Medicine 2, Würzburg; University Medical Center Freiburg, Rheumatology and Clinical Immunology, Freiburg; Rheumatology Clinical Practice Erlangen, Erlangen; Rheumatology Practice and Department of Internal Medicine 2, Clinic Burghausen, Burghausen; Asklepios Medical Center, Department of Rheumatology and clinical Immunology, Bad Abbach; Rheumatology Practice Bamberg, Bamberg; Rheumatology Practice Bayreuth, Bayreuth; University of Heidelberg, Medicine 5, Heidelberg; Rheumatology Practice Nuremberg, Nuremberg; Schlosspark Klinik, Internal Medicine/Rheumatology, Berlin; University of Tübingen, Centre for Interdisciplinary Clinical Immunology, Tübingen; Praxiszentrum St. Bonifatius, Munich, Germany.,M. Hagen, BSc, CandMed, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen; M. Englbrecht, PhD, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen; J. Haschka, MD, St. Vincent Hospital, Vinforce Study Group, Medical University of Vienna; M. Reiser, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen; A. Kleyer, MD, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen; A. Hueber, MD, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen; B. Manger, MD, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen; C. Figueiredo, MD, Institutio de Rheumatologia; J. Fogagnolo Cobra, MD, Institutio de Rheumatologia; H.P. Tony, MD, University of Würzburg, Internal Medicine 2; S. Finzel, MD, University Medical Center Freiburg, Rheumatology and Clinical Immunology; S. Kleinert, MD, Rheumatology Clinical Practice Erlangen; J. Wendler, MD, Rheumatology Clinical Practice Erlangen; F. Schuch, MD, Rheumatology Clinical Practice Erlangen; M. Ronneberger, MD, Rheumatology Clinical Practice Erlangen; M. Feuchtenberger, MD, Rheumatology Practice and Department of Internal Medicine 2, Clinic Burghausen; M. Fleck, MD, Asklepios Medical Center, Department of Rheumatology and clinical Immunology; K. Manger, MD, Rheumatology Practice Bamberg; W. Ochs, MD, Rheumatology Practice Bayreuth; H.M. Lorenz, MD, University of Heidelberg, Medicine 5; H. Nüsslein, MD, Rheumatology Practice Nuremberg; R. Alten, MD, Schlosspark Klinik, Internal Medicine/Rheumatology; J. Henes, MD, University of Tübingen, Centre for Interdisciplinary Clinical Immunology; K. Krüger, MD, Praxiszentrum St. Bonifatius; G. Schett, MD, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen; J. Rech, MD, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen
| | - Georg Schett
- From the Friedrich-Alexander-University Erlangen-Nuremberg (FAU), Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen, Erlangen, Germany; St. Vincent Hospital, Vinforce Study Group, Medical University of Vienna, Vienna, Austria; Institutio de Rheumatologia, São Paolo, Brazil; University of Würzburg, Internal Medicine 2, Würzburg; University Medical Center Freiburg, Rheumatology and Clinical Immunology, Freiburg; Rheumatology Clinical Practice Erlangen, Erlangen; Rheumatology Practice and Department of Internal Medicine 2, Clinic Burghausen, Burghausen; Asklepios Medical Center, Department of Rheumatology and clinical Immunology, Bad Abbach; Rheumatology Practice Bamberg, Bamberg; Rheumatology Practice Bayreuth, Bayreuth; University of Heidelberg, Medicine 5, Heidelberg; Rheumatology Practice Nuremberg, Nuremberg; Schlosspark Klinik, Internal Medicine/Rheumatology, Berlin; University of Tübingen, Centre for Interdisciplinary Clinical Immunology, Tübingen; Praxiszentrum St. Bonifatius, Munich, Germany.,M. Hagen, BSc, CandMed, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen; M. Englbrecht, PhD, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen; J. Haschka, MD, St. Vincent Hospital, Vinforce Study Group, Medical University of Vienna; M. Reiser, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen; A. Kleyer, MD, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen; A. Hueber, MD, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen; B. Manger, MD, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen; C. Figueiredo, MD, Institutio de Rheumatologia; J. Fogagnolo Cobra, MD, Institutio de Rheumatologia; H.P. Tony, MD, University of Würzburg, Internal Medicine 2; S. Finzel, MD, University Medical Center Freiburg, Rheumatology and Clinical Immunology; S. Kleinert, MD, Rheumatology Clinical Practice Erlangen; J. Wendler, MD, Rheumatology Clinical Practice Erlangen; F. Schuch, MD, Rheumatology Clinical Practice Erlangen; M. Ronneberger, MD, Rheumatology Clinical Practice Erlangen; M. Feuchtenberger, MD, Rheumatology Practice and Department of Internal Medicine 2, Clinic Burghausen; M. Fleck, MD, Asklepios Medical Center, Department of Rheumatology and clinical Immunology; K. Manger, MD, Rheumatology Practice Bamberg; W. Ochs, MD, Rheumatology Practice Bayreuth; H.M. Lorenz, MD, University of Heidelberg, Medicine 5; H. Nüsslein, MD, Rheumatology Practice Nuremberg; R. Alten, MD, Schlosspark Klinik, Internal Medicine/Rheumatology; J. Henes, MD, University of Tübingen, Centre for Interdisciplinary Clinical Immunology; K. Krüger, MD, Praxiszentrum St. Bonifatius; G. Schett, MD, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen; J. Rech, MD, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen
| | - Jürgen Rech
- From the Friedrich-Alexander-University Erlangen-Nuremberg (FAU), Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen, Erlangen, Germany; St. Vincent Hospital, Vinforce Study Group, Medical University of Vienna, Vienna, Austria; Institutio de Rheumatologia, São Paolo, Brazil; University of Würzburg, Internal Medicine 2, Würzburg; University Medical Center Freiburg, Rheumatology and Clinical Immunology, Freiburg; Rheumatology Clinical Practice Erlangen, Erlangen; Rheumatology Practice and Department of Internal Medicine 2, Clinic Burghausen, Burghausen; Asklepios Medical Center, Department of Rheumatology and clinical Immunology, Bad Abbach; Rheumatology Practice Bamberg, Bamberg; Rheumatology Practice Bayreuth, Bayreuth; University of Heidelberg, Medicine 5, Heidelberg; Rheumatology Practice Nuremberg, Nuremberg; Schlosspark Klinik, Internal Medicine/Rheumatology, Berlin; University of Tübingen, Centre for Interdisciplinary Clinical Immunology, Tübingen; Praxiszentrum St. Bonifatius, Munich, Germany. .,M. Hagen, BSc, CandMed, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen; M. Englbrecht, PhD, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen; J. Haschka, MD, St. Vincent Hospital, Vinforce Study Group, Medical University of Vienna; M. Reiser, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen; A. Kleyer, MD, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen; A. Hueber, MD, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen; B. Manger, MD, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen; C. Figueiredo, MD, Institutio de Rheumatologia; J. Fogagnolo Cobra, MD, Institutio de Rheumatologia; H.P. Tony, MD, University of Würzburg, Internal Medicine 2; S. Finzel, MD, University Medical Center Freiburg, Rheumatology and Clinical Immunology; S. Kleinert, MD, Rheumatology Clinical Practice Erlangen; J. Wendler, MD, Rheumatology Clinical Practice Erlangen; F. Schuch, MD, Rheumatology Clinical Practice Erlangen; M. Ronneberger, MD, Rheumatology Clinical Practice Erlangen; M. Feuchtenberger, MD, Rheumatology Practice and Department of Internal Medicine 2, Clinic Burghausen; M. Fleck, MD, Asklepios Medical Center, Department of Rheumatology and clinical Immunology; K. Manger, MD, Rheumatology Practice Bamberg; W. Ochs, MD, Rheumatology Practice Bayreuth; H.M. Lorenz, MD, University of Heidelberg, Medicine 5; H. Nüsslein, MD, Rheumatology Practice Nuremberg; R. Alten, MD, Schlosspark Klinik, Internal Medicine/Rheumatology; J. Henes, MD, University of Tübingen, Centre for Interdisciplinary Clinical Immunology; K. Krüger, MD, Praxiszentrum St. Bonifatius; G. Schett, MD, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen; J. Rech, MD, FAU, Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen.
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