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Yogeswaran A, Mamazhakypov A, Schermuly RT, Weiß A. Erratum to: Right ventricular failure in pulmonary hypertension: recent insights from experimental models. Herz 2023; 48:291. [PMID: 37160777 DOI: 10.1007/s00059-023-05190-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Affiliation(s)
- Athiththan Yogeswaran
- Department of Internal Medicine, Universities of Gießen and Marburg Lung Center (UGMLC), Member of the German Center for Lung Research (DZL), Justus-Liebig-University Giessen, Schubertstr. 81, 35392, Gießen, Germany
| | - Argen Mamazhakypov
- Department of Internal Medicine, Universities of Gießen and Marburg Lung Center (UGMLC), Member of the German Center for Lung Research (DZL), Justus-Liebig-University Giessen, Schubertstr. 81, 35392, Gießen, Germany
| | - Ralph T Schermuly
- Department of Internal Medicine, Universities of Gießen and Marburg Lung Center (UGMLC), Member of the German Center for Lung Research (DZL), Justus-Liebig-University Giessen, Schubertstr. 81, 35392, Gießen, Germany
| | - Astrid Weiß
- Department of Internal Medicine, Universities of Gießen and Marburg Lung Center (UGMLC), Member of the German Center for Lung Research (DZL), Justus-Liebig-University Giessen, Schubertstr. 81, 35392, Gießen, Germany.
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Yogeswaran A, Mamazhakypov A, Schermuly RT, Weiß A. Right ventricular failure in pulmonary hypertension: recent insights from experimental models. Herz 2023; 48:285-290. [PMID: 37079028 DOI: 10.1007/s00059-023-05180-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/20/2023] [Indexed: 04/21/2023]
Abstract
Right ventricular (RV) function is a critical determinant of the prognosis of patients with pulmonary hypertension (PH). Upon establishment of PH, RV dysfunction develops, leading to a gradual worsening of the condition over time, culminating in RV failure and premature mortality. Despite this understanding, the underlying mechanisms of RV failure remain obscure. As a result, there are currently no approved therapies specifically targeting the right ventricle. One contributing factor to the lack of RV-directed therapies is the complexity of the pathogenesis of RV failure as observed in animal models and clinical studies. In recent years, various research groups have begun utilizing multiple models, including both afterload-dependent and afterload-independent models, to investigate specific targets and pharmacological agents in RV failure. In this review, we examine various animal models of RV failure and the recent advancements made utilizing these models to study the mechanisms of RV failure and the potential efficacy of therapeutic interventions, with the ultimate goal of translating these findings into clinical practice to enhance the management of individuals with PH.
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Affiliation(s)
- Athiththan Yogeswaran
- Department of Internal Medicine, Universities of Gießen and Marburg Lung Center (UGMLC), Member of the German Center for Lung Research (DZL), Justus-Liebig-University Giessen, Schubertstr. 81, 35392, Gießen, Germany
| | - Argen Mamazhakypov
- Department of Internal Medicine, Universities of Gießen and Marburg Lung Center (UGMLC), Member of the German Center for Lung Research (DZL), Justus-Liebig-University Giessen, Schubertstr. 81, 35392, Gießen, Germany
| | - Ralph T Schermuly
- Department of Internal Medicine, Universities of Gießen and Marburg Lung Center (UGMLC), Member of the German Center for Lung Research (DZL), Justus-Liebig-University Giessen, Schubertstr. 81, 35392, Gießen, Germany
| | - Astrid Weiß
- Department of Internal Medicine, Universities of Gießen and Marburg Lung Center (UGMLC), Member of the German Center for Lung Research (DZL), Justus-Liebig-University Giessen, Schubertstr. 81, 35392, Gießen, Germany.
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Lindner L, Augustin M, Kühl L, Weiß A, Rustenbach SJ, Behrens F, Feuchtenberger M, Schwarze I, Mrowietz U, Thaçi D, Reich K, Strangfeld A, Regierer A. AB0952 Characterization of patients with psoriatic arthritis in dermatologic and rheumatologic care: an analysis of two disease registries. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.4317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundPsoriatic arthritis (PsA) is a chronic inflammatory disease affecting the musculoskeletal system, skin and nails. Therapeutic management in Germany is usually provided by a dermatologist or rheumatologist.ObjectivesThe aim is to characterize the socioeconomic and clinical patient profiles in dermatologic and rheumatologic settings.MethodsBaseline data of patients with PsA from [1] the dermatological German Psoriasis Registry PsoBest (PB) and [2] the rheumatological German disease register RABBIT-SpA (RS) [2] were analyzed. For this purpose, comparable anamnestic and clinical variables collected in the period 10/2017 to 12/2020 were identified and descriptively analyzed. The analysis was carried out in each of the data-holding registers.Results1066 RS patients and 704 PB patients were included in the analysis (Table 1). The proportion of women was higher in the rheumatology setting (RS) (60% vs. 49%). Disease duration of psoriasis was longer in the dermatology setting (PB). Cutaneous severity was higher in PB, including affected body surface area and nail psoriasis. However, more patients in RS had tender joints and swollen joints. The physician-reported global disease activity was higher in RS. The mean DLQI (Dermatology Life Quality Index) was higher in PB and the mean HAQ (Health Assessment Questionnaire) was higher in RS. Patient reported global disease activity and pain were lower in PB.Table 1.Baseline data of patients with PsA from the registers PsoBest and RABBIT-SpA included 10/2017 to 12/2020.RABBIT-SpA(Rheumatology setting)PsoBest(Dermatology setting)N1066704Age, mean (SD)51.9 (12.2)51.7 (13.2)Female, n (%)637 (60)346 (49)Disease duration skin, mean (SD)14.3 (13.9)21.6 (16.0)Body surface area, mean (SD)8.5 (15.0)20.8 (19.8)Nail psoriasis, n (%)434 (41)407 (58)Tender joints, n (%)905 (85)498 (71)Swollen joints, n (%)708 (67)387 (55)Physician reported disease activity, mean (SD)5.2 (1.9)4.6 (2.7)DLQI, mean (SD)5.6 (6.2)12.2 (7.6)HAQ, mean (SD)0.9 (0.7)0.7 (0.6)Patient reported disease activity, mean (SD)5.7 (2.4)4.9 (2.9)Patient reported pain, mean (SD)5.5 (2.4)5.2 (2.8)bDMARD, n (%)751 (71)514 (73)TNF, n (%)346 (46)117 (23)IL17, n (%)351 (47)246 (48)IL23, n (%)54 (7)151 (29)tsDMARD, n (%)109 (10)47 (7)csDMARD, n (%)195 (18)142 (20)Most of the patients received biologics at inclusion (RS: 71% and PB: 73%). In the dermatology setting IL23 inhibitors were used more frequently, whereas TNF inhibitors were used more frequently in the rheumatology setting.ConclusionThe clinical specialization of the treating physician was associated with a different treatment and clinical status of patients with PsA. Our analysis showed that patients in the rheumatology setting more frequently had joint affections and lower functional status, whereas skin severity was worse in the dermatology setting, indicating selection effects of health care access. We hypothesize out that these differences may be biased due to different diagnostic and therapeutic routines in the specialized health care settings. Psoriatic arthritis should be treated in a multidisciplinary approach to take into account all facets of this complex disease.References[1]PMID: 24393314[2]PMID: 30874933Disclosure of InterestsLisa Lindner Grant/research support from: RABBIT-SpA is supported by a joint, unconditional grant from AbbVie, Amgen, Biogen, Hexal, Janssen-Cilag, Lilly, MSD, Novartis, Pfizer, UCB and Viatris., Matthias Augustin Grant/research support from: The PsoBest registry is/was supported by AbbVie, Almirall Hermal, Amgen, Biogen, BMS, Celgene, Hexal, Janssen-Cilag, LEO Pharma, Eli Lilly, Medac, Novartis, Pfizer, UCB and Viatris. These companies do not have influence on the design of the registry, data collection, analyses, the publication decisions or development., Laura Kühl Grant/research support from: The PsoBest registry is/was supported by AbbVie, Almirall Hermal, Amgen, Biogen, BMS, Celgene, Hexal, Janssen-Cilag, LEO Pharma, Eli Lilly, Medac, Novartis, Pfizer, UCB and Viatris. These companies do not have influence on the design of the registry, data collection, analyses, the publication decisions or development., Anja Weiß Grant/research support from: RABBIT-SpA is supported by a joint, unconditional grant from AbbVie, Amgen, Biogen, Hexal, Janssen-Cilag, Lilly, MSD, Novartis, Pfizer, UCB and Viatris., Stephan Jeff Rustenbach Grant/research support from: The PsoBest registry is/was supported by AbbVie, Almirall Hermal, Amgen, Biogen, BMS, Celgene, Hexal, Janssen-Cilag, LEO Pharma, Eli Lilly, Medac, Novartis, Pfizer, UCB and Viatris. These companies do not have influence on the design of the registry, data collection, analyses, the publication decisions or development., Frank Behrens: None declared, Martin Feuchtenberger: None declared, Ilka Schwarze: None declared, Ulrich Mrowietz: None declared, Diamant Thaçi: None declared, Kristian Reich Grant/research support from: The PsoBest registry is/was supported by AbbVie, Almirall Hermal, Amgen, Biogen, BMS, Celgene, Hexal, Janssen-Cilag, LEO Pharma, Eli Lilly, Medac, Novartis, Pfizer, UCB and Viatris. These companies do not have influence on the design of the registry, data collection, analyses, the publication decisions or development., Anja Strangfeld Grant/research support from: RABBIT-SpA is supported by a joint, unconditional grant from AbbVie, Amgen, Biogen, Hexal, Janssen-Cilag, Lilly, MSD, Novartis, Pfizer, UCB and Viatris., Anne Regierer Grant/research support from: RABBIT-SpA is supported by a joint, unconditional grant from AbbVie, Amgen, Biogen, Hexal, Janssen-Cilag, Lilly, MSD, Novartis, Pfizer, UCB and Viatris.
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Liu L, Weiß A, Saul VV, Schermuly RT, Pleschka S, Schmitz ML. Comparative kinase activity profiling of pathogenic influenza A viruses reveals new anti- and pro-viral protein kinases. J Gen Virol 2022; 103. [PMID: 35771598 DOI: 10.1099/jgv.0.001762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Constant evolution of influenza A viruses (IAVs) leads to the occurrence of new virus strains, which can cause epidemics and occasional pandemics. Here we compared two medically relevant IAVs, namely A/Hamburg/4/09 (H1N1pdm09) of the 2009 pandemic and the highly pathogenic avian IAV human isolate A/Thailand/1(KAN-1)/2004 (H5N1), for their ability to trigger intracellular phosphorylation patterns using a highly sensitive peptide-based kinase activity profiling approach. Virus-dependent tyrosine phosphorylations of substrate peptides largely overlap between the two viruses and are also strongly overrepresented in comparison to serine/threonine peptide phosphorylations. Both viruses trigger phosphorylations with distinct kinetics by overlapping and different kinases from which many form highly interconnected networks. As approximately half of the kinases forming a signalling hub have no known function for the IAV life cycle, we interrogated selected members of this group for their ability to interfere with IAV replication. These experiments revealed negative regulation of H1N1pdm09 and H5N1 replication by NUAK [novel (nua) kinase] kinases and by redundant ephrin A (EphA) receptor tyrosine kinases.
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Affiliation(s)
- Lu Liu
- Institute of Biochemistry, Justus-Liebig-University Giessen (Germany), Member of the German Center for Lung Research, Germany.,Institute of Medical Virology, Justus Liebig University Giessen, Germany
| | - Astrid Weiß
- Department of Internal Medicine, Cardio-Pulmonary Institute (CPI), Member of the German Center for Lung Research (DZL), Justus-Liebig-University Giessen, Germany
| | - Vera Vivian Saul
- Institute of Biochemistry, Justus-Liebig-University Giessen (Germany), Member of the German Center for Lung Research, Germany
| | - Ralph Theo Schermuly
- Department of Internal Medicine, Cardio-Pulmonary Institute (CPI), Member of the German Center for Lung Research (DZL), Justus-Liebig-University Giessen, Germany
| | - Stephan Pleschka
- Institute of Medical Virology, Justus Liebig University Giessen, Germany.,German Center for Infection Research (DZIF), partner site Giessen, Germany
| | - M Lienhard Schmitz
- Institute of Biochemistry, Justus-Liebig-University Giessen (Germany), Member of the German Center for Lung Research, Germany
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Regierer A, Weiß A, Baraliakos X, Behrens F, Poddubnyy D, Schett G, Lorenz HM, Worsch M, Strangfeld A. POS1078 COMPARISON OF PATIENTS WITH AXIAL PsA AND PATIENTS WITH axSpA AND CONCOMITANT PSORIASIS. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.2274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BackgroundPsoriatic arthritis (PsA) is a chronic inflammatory disease affecting the peripheral and axial musculoskeletal system as well as skin and nails. Diagnostic criteria of axial PsA (axPsA) are not well defined. Treatment strategy is mostly based on evidence generated for axial spondyloarthritis (axSpA), as only rare clinical trial data for axPsA exist. However, it is still unclear whether axSpA with concomitant psoriasis (axSpA/pso) is the same as axPsA.ObjectivesTo compare PsA patients with axial manifestations with axSpA patients with concomitant psoriasis.MethodsRABBIT-SpA is a prospective longitudinal cohort study including PsA and axSpA patients enrolled at start of a new conventional treatment or b/tsDMARD treatment. Two definitions of axPsA were used:Clinical definition: documentation of axial manifestation as diagnosed by a rheumatologistRadiographic definition: presence of sacroiliitis according to modified NY criteria (mNYc).axSpA patients were stratified into axPsA/pso (with psoriasis either in patient history or present) and axSpA.ResultsPsoriasis was documented in 182/1407 axSpA patients (13%). Of 1355 PsA patients, 295 (22%) fulfilled the clinical definition of axPsA. Using the radiographic definition, 127 (9%) PsA patients fulfilled mNYc, 230 (17%) did not fulfil mNYc and 998 (74%) did not undergo radiographic evaluation.AxSpA/pso patients differed from axPsA regardless of the definition (Table 1). axPsA patients were older, less often HLA-B27 positive, and peripheral manifestations were much more often present in axPsA than in axSpA/pso. Uveitis and inflammatory bowel disease were more common in axSpA/pso.Table 1.Baseline characteristics of axSpA/pso patients and clinical resp. radiographic defined axPsA.axSpA/psoaxPsA/clinaxPsA/radN182295127female gender, n (%)80 (44)178 (60.3)80 (63)age, mean (SD)47 (12.8)51.1 (11.3)51.6 (11.4)HLA-B27 positive, n (%)106 (67.1)44 (22.7)28 (32.9)CRP mg/l, mean (SD)8.7 (14.6)7.1 (11.8)6.9 (11.5)CRP ≥5 mg/l, n (%)70 (42.4)106 (40)50 (45.9)uveitis ever, n (%)26 (14.3)10 (3.4)7 (5.5)IBD ever, n (%)13 (7.1)14 (4.7)7 (5.5)≥3 comorbidities, n (%)48 (26.4)117 (39.7)48 (37.8)peripheral manifestations, n (%)65 (36.3)251 (85.1)109 (85.8)enthesitis, n (%)29 (16.2)77 (26.4)32 (25.4)number of sites with enthesitis, mean (SD)0.5 (1.6)0.9 (2.2)0.9 (1.9)affected joints, n (%)53 (29.6)234 (80.1)102 (80.3)number of affected joints, mean (SD)1.4 (3.7)6.8 (8.4)5 (5.9)physician global disease activity, mean (SD)5.6 (2.1)5.6 (1.9)5.6 (2)patient global disease activity, mean (SD)5.4 (2.6)5.9 (2.3)5.8 (2.2)patient pain, mean (SD)5.5 (2.6)5.7 (2.3)5.7 (2.2)sakroiliitis, n (%)124 (84.4)97 (56.1)127 (100)clinical axial definition, n (%)n.d.295 (100)97 (76.4)In contrast, disease activity measured by physician global as well as patient global, and patient pain were similar in axSpA/pso and axPsA.ConclusionRegardless whether clinical or radiographic definitions of axPsA were used, differences to axSpA/pso patients were identified. These data indicate a need for a specific diagnostic, and a potentially more targeted treatment approach for axPsA.Disclosure of InterestsAnne Regierer Grant/research support from: RABBIT-SpA is supported by a joint, unconditional grant from AbbVie, Amgen, Biogen, Hexal, Janssen-Cilag, Lilly, MSD, Novartis, Pfizer, UCB and Viatris., Anja Weiß Grant/research support from: RABBIT-SpA is supported by a joint, unconditional grant from AbbVie, Amgen, Biogen, Hexal, Janssen-Cilag, Lilly, MSD, Novartis, Pfizer, UCB and Viatris., Xenofon Baraliakos: None declared, Frank Behrens: None declared, Denis Poddubnyy: None declared, Georg Schett: None declared, Hanns-Martin Lorenz: None declared, Matthias Worsch: None declared, Anja Strangfeld Grant/research support from: RABBIT-SpA is supported by a joint, unconditional grant from AbbVie, Amgen, Biogen, Hexal, Janssen-Cilag, Lilly, MSD, Novartis, Pfizer, UCB and Viatris.
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Weiß A, Löck S, Xu T, Liao Z, Troost E. PD-0663 Do structural parameters of the dose distribution improve the prediction of RP in NSCLC patients? Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)02910-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Regierer A, Weiß A, Bohl-Buehler M, Baraliakos X, Behrens F, Schett G, Strangfeld A. OP0225 DEPRESSIVE SYMPTOMS IN PSA: A CROSS-SECTIONAL ANALYSIS FROM THE NATIONAL GERMAN RABBIT-SPA REGISTRY. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.2130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:Psoriatic arthritis (PsA) is a chronic inflammatory disease affecting the musculoskeletal system as well as skin and nails. The prevalence of depression in psoriasis and PsA is high and ranges from 7-40% [1]. Persistent depressive mood may influence disease activity outcome in PsA, especially patient-reported outcomes.Objectives:To assess the correlation of depressive symptoms with PsA-specific outcome parameters.Methods:RABBIT-SpA is a prospective longitudinal cohort study including PsA patients enrolled at start of a new conventional treatment or b/tsDMARD treatment. In regularly provided follow-up questionnaires, physician- and patient-reported information on the disease course including the depression screening tool WHO-5 to assess mental health is collected. For the current analysis, the WHO-5 score was categorised into 4 groups using validated cut-offs: severe depressive symptoms <13, moderate depressive symptoms 13-28, mild depressive symptoms 29-50, well-being >50. Spearman correlation coefficient was calculated to analyse the relationship between the WHO-5 score and various PsA related outcome parameters.Results:936 PsA patients were included. Baseline characteristics are shown in Table 1. In 411 patients (43.9%) the WHO-5 score indicated well-being, 249 (26.6%) had mild depressive, 203 (21.7%) moderate depressive and 73 patients (7.8%) severe depressive symptoms. WHO-5 results correlated with patient reported skin involvement (DLQI: -0.25, patient assessment skin: -0.17), and the composite scores DAPSA (-0.33) and DAS28 (-0.28) as well as with patient reported pain (-0.43) and patient global disease assessment (-0.42). The highest correlation was found for physician assessed global health status (-0.51) and PSAID (-0.62). No significant correlation was found with CRP, swollen joint count and physician assessed skin involvement including body surface area (BSA).Table 1.Baseline characteristics of patients included in the analysis stratified by WHO-5 categories.ParameterWHO-5 (<13) severeN=73WHO-5 (13-28) moderateN=203WHO-5 (29-50) mildN=249WHO-5 (>50) well-beingN=411TotalN=936Age, mean (SD)52.6 (11.4)51 (11.3)51.4 (12.5)52.8 (12.7)52 (12.2)Female, n (%)52 (71.2)127 (62.6)157 (63.1)227 (55.2)563 (60.1)Disease duration, years, mean (SD)8.3 (8.7)6 (7.9)6.2 (6.7)6.4 (7.5)6.4 (7.5)Dactylitis, n (%)14 (19.7)31 (15.5)46 (18.5)77 (18.8)168 (18.1)Axial involvement, n (%)14 (19.7)54 (26.9)49 (19.7)71 (17.3)188 (20.2)Nail involvement, n (%)34 (47.2)85 (42.3)106 (42.6)158 (38.6)383 (41.1)BMI>=30, n (%)37 (51.4)75 (37.1)98 (39.5)125 (30.9)335 (36.2)CRP of >=5 mg/L, n (%)33 (51.6)84 (45.4)99 (46.5)138 (39.1)354 (43.4)BSA (0-100), mean (SD)10.1 (18.3)9.5 (16.8)8.5 (14.9)8.1 (14.6)8.7 (15.5)Physician assessed global health (NRS 0-10), mean (SD)6.3 (1.5)5.6 (1.8)5.2 (1.7)4.9 (1.9)5.2 (1.9)TJC68, mean (SD)9.9 (7.1)8.6 (7.6)8.2 (7.6)7.3 (8.2)8 (7.8)SJC66, mean (SD)6 (5.2)4.8 (4.9)4.7 (4.4)4.3 (3.8)4.6 (4.4)DAPSA, mean (SD)29.3 (11.1)25.1 (12.9)23.4 (12.1)18.9 (12.4)22.3 (12.8)DAS28-CRP, mean (SD)4.1 (1)3.8 (1.2)3.7 (1.1)3.2 (1.1)3.6 (1.2)Patient assessed global health (NRS 0-10), mean (SD)7.9 (2.1)6.6 (2.1)5.9 (2)4.8 (2.3)5.7 (2.4)Patient assessed pain (NRS 0-10), mean (SD)7.8 (1.8)6.4 (2.1)5.8 (2)4.6 (2.4)5.5 (2.4)DLQI (0-30), mean (SD)8.5 (8.2)7.8 (7.2)5.4 (5.7)4.1 (4.9)5.6 (6.2)PSAID (0-10), mean (SD)6.9 (1.8)5.5 (1.8)4.4 (1.7)3 (1.7)4.2 (2.2)Conclusion:The impact of depressive symptoms on outcome parameters used in rheumatology is increasingly being recognised. Interestingly, direct measures of inflammatory disease activity of joint and skin disease such as BSA, CRP, and swollen joint count were not correlated with depressive symptoms. The highest correlation was found for broader assessments like global health status and PSAID.References:[1]Haugeberg et al. Arthritis research & Therapy, 2020, 22:198Acknowledgements:RABBIT-SpA is supported by a joint, unconditional grant from AbbVie, Amgen, Biogen, Hexal, Janssen-Cilag, Lilly, MSD, Novartis, Pfizer, UCB and Viatris.We thank all participating rheumatologists and patients.Disclosure of Interests:Anne Regierer Grant/research support from: AbbVie, Amgen, Biogen, Hexal, Janssen-Cilag, Lilly, MSD, Novartis, Pfizer, UCB and Viatris., Anja Weiß Grant/research support from: AbbVie, Amgen, Biogen, Hexal, Janssen-Cilag, Lilly, MSD, Novartis, Pfizer, UCB and Viatris., Martin Bohl-Buehler: None declared, Xenofon Baraliakos: None declared, Frank Behrens: None declared, Georg Schett: None declared, Anja Strangfeld Grant/research support from: AbbVie, Amgen, Biogen, Hexal, Janssen-Cilag, Lilly, MSD, Novartis, Pfizer, UCB and Viatris.
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Regierer A, Weiß A, Poddubnyy D, Kellner H, Behrens F, Schett G, Braun J, Sieper J, Strangfeld A. POS0296 DOSING OF BDMARDS IN AXSPA AND PSA IN A REAL WORLD SETTING. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.2155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Background:The treatment of patients with axial spondyloarthritis (axSpA) and psoriatic arthritis (PsA) has been revolutionised by the introduction of biologic DMARDs targeting TNF, IL17, and IL23 inhibitors (i). In Germany, about 30-50% of axSpA and PsA patients receive treatment with bDMARDs. Although many patients benefit from these drugs, in some patients effectiveness of the standard dose may be insufficient and higher doses are used.Objectives:To describe dosing of TNFi and non-TNFi bDMARDs over a 2 year period in a real world cohort of patients with axSpA and PsA managed by rheumatologists.Methods:RABBIT-SpA is a prospective longitudinal cohort study including axSpA and PsA patients enrolled at the start of a new conventional treatment (including NSAID) or b/tsDMARD treatment. Description of dosing of TNFi (adalimumab bio-original (bo), adalimumab bio-similar (bs), etanercept bo, etanercept bs, golimumab, certolizumab) in comparison to nonTNFi-bDMARDs (secukinumab, ustekinumab, ixekizumab, guselkumab) in axSpA and PsA. Standard dosing was defined according to the current labels for axSpA and PsA.Results:1628 patients (axSpA: n=903, PsA: n=725) were included in this analysis. At inclusion mean age was 44 years in axSpA and 51 years in PsA. 44% of patients with axSpA and 58% of those with PsA were female. The mean disease duration of axSpA was 7.6 years, of PsA 6.4 years.Standard doses of TNFi were used during a 2 year period in > 90% of patients with axSpA and PsA (Figure 1). In contrast, standard doses of non-TNFi-bDMARDs were only used in 70-80% of patients. The percentage of documented higher doses in patients with axSpA ranged from 20-30% at different time points. In PsA, this percentage increased from 27% at baseline to 44% at 2 years. On the other hand, TNFi were used in lower doses than the label in up to 9% and 7 % of patients with axSpA and PsA, respectively, after 2 years.Figure 1.Percentages of patients with axSpA or PsA who received less than, equal to, or more than the approved doses of bDMARDs at baseline and at 5 follow-up visits.Conclusion:While TNFi are used in licensed doses in most patients, non-TNFi-bDMARDs were often used in higher doses, which corresponds to higher doses approved in other indications like psoriasis. The effectiveness of this treatment strategy in axSpA and PsA needs to be analysed further.Acknowledgements:RABBIT-SpA is supported by a joint, unconditional grant from AbbVie, Amgen, Biogen, Hexal, Janssen-Cilag, Lilly, MSD, Novartis, Pfizer, UCB, and Viatris.We thank all participating patients and rheumatologists.Disclosure of Interests:Anne Regierer Grant/research support from: AbbVie, Amgen, Biogen, Hexal, Janssen-Cilag, Lilly, MSD, Novartis, Pfizer, UCB, and Viatris., Anja Weiß Grant/research support from: AbbVie, Amgen, Biogen, Hexal, Janssen-Cilag, Lilly, MSD, Novartis, Pfizer, UCB, and Viatris., Denis Poddubnyy: None declared, Herbert Kellner: None declared, Frank Behrens: None declared, Georg Schett: None declared, Juergen Braun: None declared, Joachim Sieper: None declared, Anja Strangfeld Grant/research support from: AbbVie, Amgen, Biogen, Hexal, Janssen-Cilag, Lilly, MSD, Novartis, Pfizer, UCB, and Viatris
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Weiß A, Bungartz C, Richter J, Spaethling-Mestekemper S, Baraliakos X, Aries PM, Fischer-Betz R, Strangfeld A. AB0472 DISEASE ACTIVITY AND OUTCOME IN PREGNANCIES OF PATIENTS WITH SpA - DATA FROM THE GERMAN PREGNANCY REGISTER RHEKISS. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.2087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Background:Spondyloarthritis (SpA) is a severe chronic inflammatory disease, which affects quality of life and functional status. It frequently occurs in women of childbearing age. Active disease and TNFi discontinuation at early pregnancy were found to be risk factors for flares during pregnancy (1).Objectives:To compare disease activity during pregnancy in patients with or without bDMARD exposure at conception and during pregnancy and to assess pregnancy outcomes.Methods:RHEKISS is a prospective longitudinal cohort study including patients with confirmed diagnose of inflammatory rheumatic disease. Pregnant patients are eligible to be enrolled until the 20th week of gestation regardless of drug treatment. During observation, information on treatment, disease and pregnancy course, and outcome is collected from rheumatologists and patients. For this analysis, pregnancies of patients with SpA were selected and stratified into three groups according to their exposure to bDMARDs.Results:Of 140 SpA pregnancies included, 74 (53%) were not exposed to bDMARDs at conception (group 1), 38 (27%) were exposed to bDMARDs at conception, but not during pregnancy (group 2) and 28 (20%) were continuously exposed to bDMARDs at conception and during pregnancy (group 3). Certolizumab (50%), Adalimumab (20%), Etanercept (8%) and Infliximab (8%) were the most frequently prescribed bDMARDs at beginning of pregnancy. Baseline characteristics according to treatment exposure are shown in Table 1. Frequency of flares was highest in group 2: 21%, 38%, and 39% of patients flared during the 1st, 2nd, and 3rd trimester. These rates were 20%, 25%, and 21% in group 1 and 8%, 20%, and zero in group 3. The difference in flare rates was also mirrored in the course of physician assessed global disease activity (Figure 1). Whereas patients in group 1 seemed to have a quite stable disease activity during pregnancy, those who were in group 2 had an increasing activity of disease during pregnancy with an even higher increase of disease activity after giving birth. Patients in group 3 had the lowest disease activity.Of 137 singleton pregnancies, 130 (95%) ended in live birth. Of 6 spontaneous abortions 2 were in every of the three groups. One pregnancy in group 1 was terminated in gestational week 22 due to suspect malformation. One baby of the triple pregnancy was born and two aborted. All babies of the twin pregnancies were born healthy.Conclusion:SpA patients treated with bDMARDs at conception are not at higher risk for adverse pregnancy outcomes. Our results in a larger patient population confirmed that discontinuation of bDMARDs after conception is associated with increased disease activity during pregnancy and after birth and a higher risk of flares.References:[1]van den Brandt S et al., Arthritis Res Ther. 2017; 19(1):64.Table 1.Baseline characteristics; numbers are n (%) if not otherwise specified; * value at beginning of pregnancy: first 22 weeks after conceptionParameterno bDMARD at conception (group 1)n=74bDMARD at conception anddiscontinuedduring pregnancy(group 2)n=38bDMARD at conception andcontinuedduring pregnancy (group 3)n=28Totaln=140Singleton72 (97)37 (97.4)28 (100)137 (97.9)Twin1 (1.4)1 (2.6)02 (1.4)Triple1 (1.4)001 (0.7)New-York criteria fulfilled21 (33)17 (49)10 (48)48 (40)disease duration in years, mean (SD)6.4 (5.9)7 (4.1)5.8 (4)6.4 (5.1)age*, mean (SD)33.4 (4.9)32.3 (4)31.6 (3.4)32.7 (4.4)severity of illness*: asymptomatic4 (6)0 (0)3 (14)7 (6) mild31 (48)6 (17)4 (19)41 (34) moderate24 (38)21 (60)14 (67)59 (49) severe5 (8)8 (23)013 (11)HLA-B27 positive41 (62)24 (80)15 (75)80 (69)CRP in mg/l *, mean (SD)6.6 (8.2)5.4 (8.2)5.2 (4.9)6 (7.6)CRP >5mg/l *25 (41)9 (30)8 (35)42 (37)physician global* (NRS 0-10), mean (SD)2.6 (2)2.3 (2.5)1.7 (1.4)2.4 (2.1)BASDAI* (0-10), mean (SD)3.2 (2)2.9 (2.3)2.8 (1.5)3.1 (2)patient global* (NRS 0-10), mean (SD)3.3 (2.7)3 (2.8)3 (2.3)3.1 (2.6)Figure 1Course of physician assessed global disease activityDisclosure of Interests:None declared.
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Mamazhakypov A, Weiß A, Zukunft S, Sydykov A, Kojonazarov B, Wilhelm J, Vroom C, Petrovic A, Kosanovic D, Weissmann N, Seeger W, Fleming I, Iglarz M, Grimminger F, Ghofrani HA, Pullamsetti SS, Schermuly RT. Effects of macitentan and tadalafil monotherapy or their combination on the right ventricle and plasma metabolites in pulmonary hypertensive rats. Pulm Circ 2020; 10:2045894020947283. [PMID: 33240483 PMCID: PMC7672745 DOI: 10.1177/2045894020947283] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2020] [Accepted: 07/10/2020] [Indexed: 12/19/2022] Open
Abstract
Pulmonary arterial hypertension is a severe respiratory disease characterized by pulmonary artery remodeling. RV dysfunction and dysregulated circulating metabolomics are associated with adverse outcomes in pulmonary arterial hypertension. We investigated effects of tadalafil and macitentan alone or in combination on the RV and plasma metabolomics in SuHx and PAB models. For SuHx model, rats were injected with SU5416 and exposed to hypoxia for three weeks and then were returned to normoxia and treated with either tadalafil (10 mg/kg in chow) or macitentan (10 mg/kg in chow) or their combination (both 10 mg/kg in chow) for two weeks. For PAB model, rats were subjected to either sham or PAB surgery for three weeks and treated with above-mentioned drugs from week 1 to week 3. Following terminal echocardiographic and hemodynamic measurements, tissue samples were collected for metabolomic, histological and gene expression analysis. Both SuHx and PAB rats developed RV remodeling/dysfunction with severe and mild plasma metabolomic alterations, respectively. In SuHx rats, tadalafil and macitentan alone or in combination improved RV remodeling/function with the effects of macitentan and combination therapy being superior to tadalafil. All therapies similarly attenuated SuHx-induced changes in plasma metabolomics. In PAB rats, only macitentan improved RV remodeling/function, while only tadalafil attenuated PAB-induced changes in plasma metabolomics.
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Affiliation(s)
- Argen Mamazhakypov
- Cardio-Pulmonary Institute (CPI), Universities of Giessen and Marburg Lung Center, Member of the German Lung Center (DZL), Justus-Liebig-University Giessen, Giessen, Germany
| | - Astrid Weiß
- Cardio-Pulmonary Institute (CPI), Universities of Giessen and Marburg Lung Center, Member of the German Lung Center (DZL), Justus-Liebig-University Giessen, Giessen, Germany
| | - Sven Zukunft
- Institute for Vascular Signalling, Centre for Molecular Medicine, Goethe University, Frankfurt am Main, Germany & German Center of Cardiovascular Research (DZHK), Partner site RheinMain, Frankfurt am Main, Germany
| | - Akylbek Sydykov
- Cardio-Pulmonary Institute (CPI), Universities of Giessen and Marburg Lung Center, Member of the German Lung Center (DZL), Justus-Liebig-University Giessen, Giessen, Germany
| | - Baktybek Kojonazarov
- Cardio-Pulmonary Institute (CPI), Universities of Giessen and Marburg Lung Center, Member of the German Lung Center (DZL), Justus-Liebig-University Giessen, Giessen, Germany
| | - Jochen Wilhelm
- Cardio-Pulmonary Institute (CPI), Universities of Giessen and Marburg Lung Center, Member of the German Lung Center (DZL), Justus-Liebig-University Giessen, Giessen, Germany
| | - Christina Vroom
- Cardio-Pulmonary Institute (CPI), Universities of Giessen and Marburg Lung Center, Member of the German Lung Center (DZL), Justus-Liebig-University Giessen, Giessen, Germany
| | - Aleksandar Petrovic
- Cardio-Pulmonary Institute (CPI), Universities of Giessen and Marburg Lung Center, Member of the German Lung Center (DZL), Justus-Liebig-University Giessen, Giessen, Germany
| | - Djuro Kosanovic
- Cardio-Pulmonary Institute (CPI), Universities of Giessen and Marburg Lung Center, Member of the German Lung Center (DZL), Justus-Liebig-University Giessen, Giessen, Germany.,Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Norbert Weissmann
- Cardio-Pulmonary Institute (CPI), Universities of Giessen and Marburg Lung Center, Member of the German Lung Center (DZL), Justus-Liebig-University Giessen, Giessen, Germany
| | - Werner Seeger
- Cardio-Pulmonary Institute (CPI), Universities of Giessen and Marburg Lung Center, Member of the German Lung Center (DZL), Justus-Liebig-University Giessen, Giessen, Germany.,Department of Lung Development and Remodelling, Max-Planck Institute for Heart and Lung Research, Bad Nauheim, Germany
| | - Ingrid Fleming
- Institute for Vascular Signalling, Centre for Molecular Medicine, Goethe University, Frankfurt am Main, Germany & German Center of Cardiovascular Research (DZHK), Partner site RheinMain, Frankfurt am Main, Germany
| | - Marc Iglarz
- Actelion Pharmaceuticals Ltd, Allschwil, Switzerland
| | - Friedrich Grimminger
- Cardio-Pulmonary Institute (CPI), Universities of Giessen and Marburg Lung Center, Member of the German Lung Center (DZL), Justus-Liebig-University Giessen, Giessen, Germany
| | - Hossein A Ghofrani
- Cardio-Pulmonary Institute (CPI), Universities of Giessen and Marburg Lung Center, Member of the German Lung Center (DZL), Justus-Liebig-University Giessen, Giessen, Germany
| | - Soni S Pullamsetti
- Cardio-Pulmonary Institute (CPI), Universities of Giessen and Marburg Lung Center, Member of the German Lung Center (DZL), Justus-Liebig-University Giessen, Giessen, Germany.,Department of Lung Development and Remodelling, Max-Planck Institute for Heart and Lung Research, Bad Nauheim, Germany
| | - Ralph T Schermuly
- Cardio-Pulmonary Institute (CPI), Universities of Giessen and Marburg Lung Center, Member of the German Lung Center (DZL), Justus-Liebig-University Giessen, Giessen, Germany
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Hollatz-Galuschki E, Weiß A, Rensinghoff J, Hemmerlein E, Schwinger M, Kellermann P, Landsleitner B, Kainer F. Mitarbeitermotivation in der interdisziplinären geburtshilflichen Notfallsimulation. Geburtshilfe Frauenheilkd 2020. [DOI: 10.1055/s-0040-1717933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Affiliation(s)
| | - A Weiß
- Klinik Hallerwiese, Perinatalmedizin
| | | | | | | | | | | | - F Kainer
- Klinik Hallerwiese, Perinatalmedizin
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Hollatz-Galuschki E, Weiß A, Rensinghoff J, Hemmerlein E, Landsleitner B, Kainer F. Mitarbeitermotivation in der geburtshilflichen Notfallsimulation. Geburtshilfe Frauenheilkd 2020. [DOI: 10.1055/s-0040-1713990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Affiliation(s)
- E Hollatz-Galuschki
- Klinik Hallerwiese-Cnopfsche Kinderklinik, Abteilung für Geburtshilfe und Pränatalmedizin, Nürnberg
| | - A Weiß
- Klinik Hallerwiese-Cnopfsche Kinderklinik, Abteilung für Geburtshilfe und Pränatalmedizin, Nürnberg
| | - J Rensinghoff
- Klinik Hallerwiese-Cnopfsche Kinderklinik, Abteilung für Geburtshilfe und Pränatalmedizin, Nürnberg
| | - E Hemmerlein
- Klinik Hallerwiese-Cnopfsche Kinderklinik, Abteilung für Geburtshilfe und Pränatalmedizin, Nürnberg
| | - B Landsleitner
- Klinik Hallerwiese-Cnopfsche Kinderklinik, Abteilung für Anästhesie und Intensivmedizin, Nürnberg
| | - F Kainer
- Klinik Hallerwiese-Cnopfsche Kinderklinik, Abteilung für Geburtshilfe und Pränatalmedizin, Nürnberg
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Proft F, Torgutalp M, Weiß A, Protopopov M, Rios Rodriguez V, Haibel H, Behmer O, Sieper J, Poddubnyy D. AB0660 LONG-TERM CLINICAL OUTCOME OF ANTI-TNF TREATMENT IN PATIENTS WITH EARLY AXIAL SPONDYLOARTHRITIS: 10-YEAR DATA OF THE ETANERCEPT VS. SULFASALAZIN IN EARLY AXIAL SPONDYLOARTHRITIS TRIAL. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.3136] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:Long-term data on anti-TNF treatment in patients with early axial spondyloarthritis (SpA) is scarce.Objectives:The objective of this analysis was to assess the long-term clinical efficacy (up to 10 years of treatment) of a tumor necrosis factor (TNF) inhibitor etanercept (ETN) in patients with early axial spondyloarthritis, who participated in the long-term (until year 10) extension of the ESTHER (Etanercept vs. Sulfasalazine in Early Axial Spondyloarthritis Trial) trial.Methods:In the previously reported ESTHER trial, patients with early active axial SpA [including both non-radiographic axial SpA (nr-axSpA) and radiographic axial SpA (r-axSpA)/ankylosing spondylitis (AS)] with a symptom duration of <5 years and a positive MRI of the sacroiliac joints (SIJs) and/or the spine at baseline) were treated with ETN (n= 40) or sulfasalazine (SSZ) (n= 36) during the first year (1). At year 1, all patients who were not in remission continued with - or switched (in case of SSZ therapy) to – ETN for up to 10 years in total (1). Patients in remission discontinued their therapy and were followed-up until end of year 2; in case of remission loss, ETN was (re)-introduced and continued till the end of year 10.Results:Out of 76 initial patients, 25% (n=19, 12 with r-axSpA and 7 with nr-axSpA) completed year 10 of the study. At baseline, completers were significantly more often male and showed lower values of patient (PGA) and physician global assessments of disease activity (PhGA), ASDAS (Ankylosing Spondylitis Disease Activity Score), BASMI (Bath Ankylosing Spondylitis Metrology Index), and AS-QoL (Ankylosing Spondylitis Quality of Life Questionnaire) as compared to non-completers (Table 1). When analyzing clinical data of the completers, mean BASDAI, BASFI and ASDAS values were constantly <2 during the follow up with no statistically significant differences between the r-axSpA and nr-axSpA sub-groups (Table 2, Figure 1B). In the entire group, a sustained clinical response was observed over 10 years of follow up (Figure 1A). A total of 39 serious adverse events were documented over the 10 years of the study, while six of them were seen as possibly associated with ETN treatment, which lead in five patients (one lymphoma, one sarcoidosis, one demyelinating neurological disease, one elevated liver enzymes and one recurrent minor infections) to an ETN discontinuation.Conclusion:A sustained clinical response was shown over the 10 years of the study for the completers with comparable rates between r-axSpA and nr-axSpA. ETN was well tolerated across the entire treatment period and showed a good safety profile with no new safety signals.Table 1.Baseline characteristics of patients with axial spondyloarthritis who completed the study as compared to patients who dropped out.Completer(n=19)Non-Completer(n=57)p valueAge, years32.5 (7.4)32.8 (8.9)0.91Male patients, n (%)15 (78.9)29 (50.9)0.034Symptomduration, years1.1 (1.2)1 (1.7)0.81HLA-B27 positivity, n (%)18 (94.7)44 (77.2)0.091Elevated CRP (CRP>5mg/l), n (%)7 (38.9)33 (62.3)0.088Fulfilled New York criteria, n (%)12 (63.2)27 (47.4)0.24Patient global (0-10)6.1 (1.9)7.2 (1.7)0.025Physician global (0-10)5.5 (1.5)6.5 (1.2)0.007ASDAS3 (0.7)3.5 (0.8)0.042BASDAI (0-10)5.4 (1.1)5.8 (1.3)0.27BASFI (0-10)4 (2.1)4.4 (2)0.41BASMI (0-10)1.2 (1.3)2 (1.6)0.039AS-QoL (0-18)7.6 (3.9)10.1 (3.9)0.019Acknowledgments:The ESTHER study was supported by an unrestricted research grant from Pfizer.Murat Torgutalp’s work at Charité was supported by an award from the Scientific and Technological Research Council of Turkey.Disclosure of Interests:Fabian Proft Grant/research support from: Novartis Pharma GmbH, Consultant of: Consultancy / speaker fees from: Abbvie, BMS, Celgene, Lilly, MSD, Novartis, Pfizer, Roche, UCB, Speakers bureau: Consultancy / speaker fees from: Abbvie, BMS, Celgene, Lilly, MSD, Novartis, Pfizer, Roche, UCB, Murat Torgutalp: None declared, Anja Weiß: None declared, Mikhail Protopopov Consultant of: Novartis, Valeria Rios Rodriguez Consultant of: Abbvie, Novartis, Hildrun Haibel Consultant of: Abbvie, Jansen, MSD, and Novartis, Speakers bureau: Abbvie, Jansen, MSD, and Novartis, Olaf Behmer Employee of: Pfizer Pharma GmbH, Joachim Sieper Consultant of: AbbVie, Boehringer Ingelheim, Eli Lilly and Company, Janssen, Merck, Novartis, Pfizer, Roche, and UCB Pharma, Speakers bureau: AbbVie, Boehringer Ingelheim, Eli Lilly and Company, Janssen, Merck, Novartis, Pfizer, Roche, and UCB Pharma, Denis Poddubnyy Grant/research support from: AbbVie, MSD, Novartis, and Pfizer, Consultant of: AbbVie, Bristol-Myers Squibb, Eli Lilly, MSD, Novartis, Pfizer, Roche, UCB, Speakers bureau: AbbVie, Bristol-Myers Squibb, Eli Lilly, MSD, Novartis, Pfizer, Roche, UCB
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Regierer A, Weiß A, Baraliakos X, Poddubnyy D, Schwarze I, Braun J, Sieper J, Zink A, Strangfeld A. SAT0391 DEPRESSIVE SYMPTOMS ARE ASSOCIATED WITH HIGHER DISEASE ACTIVITY AND WORSE FUNCTIONAL STATUS IN AXSPA: A CROSS-SECTIONAL ANALYSIS FROM RABBIT-SPA. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.2767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Background:Axial spondyloarthritis (axSpA) is a potentially severe chronic inflammatory disease with impact on function and quality of life. About 20-30% of axSpA patients show symptoms of depression or are diagnosed with depression [1]. Depression may influence outcome, especially patient reported outcomes.Objectives:To assess differences in baseline characteristics and outcome parameters between patients with and without symptoms of depression using WHO-5 score.Methods:RABBIT-SpA is a prospective longitudinal cohort study including axSpA patients enrolled at start of a new conventional treatment (including NSAID) or bDMARD. WHO-5 score was used to identify depressive symptoms categorised into 3 groups using validated cut-offs: moderate to severe depressive symptoms <=28, mild depressive symptoms 29-50, good well-being >50. Baseline values of patients categorised as having moderate to severe depressive symptoms were compared with the rest of the patients using t-test. Spearman correlation coefficient was calculated to analyse the relationship between WHO-5 score and other outcome parameters.Results:A total of 848 axSpA patients were included in this analysis (table 1). Moderate to severe depressive symptoms were found in 221 patients (30%), 226 (31%) had mild depressive symptoms and 285 (39%) reported a good well-being. Percentages of patients with inflammatory back pain, peripheral arthritis or enthesitis as well as the number of affected joints (44 JC) and entheseal sites (using SPARCC) were higher in the group of patients with moderate to severe depressive symptoms.Table 1.ParameterWHO-5 (<=28)Moderate severeN=221WHO-5 (29-50/>50)Mild/well-beingN=511Age, mean43.844.1Female, n (%)100 (45.2)229 (44.8)Disease duration, years, mean6.86.5Inflammatory back pain, n (%)195 (88.6)416 (81.6)Enthesitis, n (%)49 (22.3)78 (15.4)Peripheral arthritis (44 JC), n (%)64 (29.1)134 (26.3)Uveitis, n (%)45 (20.4)76 (15)IBD, n (%)13 (5.9)31 (6.1)Psoriasis, n (%)35 (15.8)58 (11.4)CRP positive (≥5mg/l), n (%)115 (59)243 (55.1)HLA-B27, n (%)151 (72.6)354 (74.2)BMI≥30, n (%)66 (30)117 (23.6)Comorbidities ≥3, n (%)50 (22.6)89 (17.4)Current smoking, n (%)102 (47.2)185 (36.7)All analysed outcome parameters (e.g. ASDAS, ASAS-HI, BASDAI, BASFI, patient global, physician global, pain, sleep) were significantly worse in the group of patients with moderate to severe depressive symptoms versus the other patients (table 2). This includes physician-reported, patient-reported and composite scores.Table 2.ParameterWHO-5 (<=28)Moderate severeN=221WHO-5 (29-50/>50)Mild/well-beingN=511p-valuePhysGA (NRS 0-10)6.2 (1.6)5.4 (1.9)0.0001ASDAS6.1 (1.6)4.2 (1.8)0.0001BASDAI (NRS 0-10)3.5 (0.8)2.9 (0.9)0.0001BASFI (NRS 0-10)5.5 (2.2)3.2 (2.2)0.0001ASAS-HI (0-17)9.8 (3.1)5.8 (3.1)0.0001PatGA (NRS 0-10)7 (1.8)5.4 (2.3)0.0001PatPain (NRS 0-10)6.9 (1.9)5.2 (2.3)0.0001PatSleep (NRS 0-10)7.2 (2.4)4.6 (2.9)0.0001Results are presented as mean ± SD.WHO-5 was highly correlated with all outcome parameters regardless of gender. Figure 1 shows the correlation of BASDAI and WHO-5 stratified for gender.Figure 1.Conclusion:Almost one third (30%) of axSpA patients in this analysis reported scores indicative of depressive symptoms and depression. The strong correlation of WHO-5 scores with patient and physician reported outcomes may be relevant for the management of patients with axSpA.References:[1]Redeker I, et al. Ann Rheum Dis 2018;0:1–8. doi:10.1136Acknowledgments:RABBIT-SpA is supported by a joint, unconditional grant from AbbVie, Amgen, Janssen-Cilag, Lilly, MSD, Mylan, Novartis, Pfizer, and UCB.Disclosure of Interests:Anne Regierer Speakers bureau: Novartis, Celgene, Janssen-Cilag, Anja Weiß: None declared, Xenofon Baraliakos Grant/research support from: Grant/research support from: AbbVie, BMS, Celgene, Chugai, Merck, Novartis, Pfizer, UCB and Werfen, Consultant of: AbbVie, BMS, Celgene, Chugai, Merck, Novartis, Pfizer, UCB and Werfen, Speakers bureau: AbbVie, BMS, Celgene, Chugai, Merck, Novartis, Pfizer, UCB and Werfen, Denis Poddubnyy Grant/research support from: AbbVie, MSD, Novartis, and Pfizer, Consultant of: AbbVie, Bristol-Myers Squibb, Eli Lilly, MSD, Novartis, Pfizer, Roche, UCB, Speakers bureau: AbbVie, Bristol-Myers Squibb, Eli Lilly, MSD, Novartis, Pfizer, Roche, UCB, Ilka Schwarze: None declared, Juergen Braun Grant/research support from: Abbvie (Abbott), Amgen, BMS, Boehringer, Celgene, Celltrion, Centocor, Chugai, Eli Lilly and Company, Medac, MSD (Schering Plough), Mundipharma, Novartis, Pfizer (Wyeth), Roche, Sanofi- Aventis, and UCB Pharma, Consultant of: Abbvie (Abbott), Amgen, BMS, Boehringer, Celgene, Celltrion, Centocor, Chugai, EBEWE Pharma, Eli Lilly and Company, Medac, MSD (Schering-Plough), Mundipharma, Novartis, Pfizer (Wyeth), Roche, Sanofi-Aventis, and UCB Pharma, Speakers bureau: Abbvie (Abbott), Amgen, BMS, Boehringer, Celgene, Celltrion, Centocor, Chugai, EBEWE Pharma, Eli Lilly and Company, Medac, MSD (Schering-Plough), Mundipharma, Novartis, Pfizer (Wyeth), Roche, Sanofi-Aventis, and UCB Pharma, Joachim Sieper Consultant of: AbbVie, Boehringer Ingelheim, Eli Lilly and Company, Janssen, Merck, Novartis, Pfizer, Roche, and UCB Pharma, Speakers bureau: AbbVie, Boehringer Ingelheim, Eli Lilly and Company, Janssen, Merck, Novartis, Pfizer, Roche, and UCB Pharma, Angela Zink Speakers bureau: AbbVie, Amgen, BMS, Gilead, Hexal, Janssen, Lilly, MSD, Pfizer, Roche, Sanofi Aventis, UCB, Anja Strangfeld Speakers bureau: AbbVie, BMS, Pfizer, Roche, Sanofi-Aventis
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Proft F, Torgutalp M, Weiß A, Protopopov M, Rios Rodriguez V, Haibel H, Hermann K, Althoff C, Behmer O, Sieper J, Poddubnyy D. SAT0389 FREQUENCY OF DISEASE FLARES UNDER LONG-TERM ANTI-TNF THERAPY IN PATIENTS WITH EARLY AXIAL SPONDYLOARTHRITIS: RESULTS FROM THE ETANERCEPT VERSUS SULFASALAZINE IN EARLY AXIAL SPONDYLOARTHRITIS TRIAL. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.3148] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Background:Disease flares in axial spondyloarthritis (axSpA) might occur even in patients with otherwise stable disease receiving highly effective anti-inflammatory therapy such as TNF inhibitors. The frequency of disease flares, especially in patients with axSpA receiving long-term stable therapy, and factors associated with flares are not sufficiently investigated.Objectives:The objective was to assess the frequency of disease flares and to identify factors associated with flares in patients with early axSpA receiving continuous long-tem (up to 10 years) treatment with a TNF inhibitor etanercept.Methods:In the ESTHER (etanercept versus sulfasalazine in early axial spondyloarthritis trial), patients with early axSpA (symptom duration ≤5 years) were treated with ETN (n=40) versus sulfasalazine (n=36) for 48 weeks [2]. After one year all patients were treated continuously with etanercept (n=17 patients temporarily interrupted treatment in the 2nd year to assess time to flare and were then (re-)treated with etanercept, except 4 patients who completed the study in sustained remission) for up to 10 years in total. Only patients who were continuously treated with etanercept for at least 6 months were included in the current analysis. The disease flare was defined as a worsening of the ASDAS by ≥0.9 as compared to the value obtained at the previous visit. Univariate and multivariable cox-regression analyses were performed to analyze the predictors of flares.Results:Out of 76 patients who entered the study at baseline, 62 patients (n=32 with radiographic (r-) axSpA and n=30 with non-radiographic (nr-) axSpA) fulfilled the criterion of the continuous etanercept treatment. A total of 22 patients (35%) experienced at least one flare over the entire treatment period 10 patients (31.3%) in the r-axSpA and 12 patients (40%) in the nr-axSpA subgroup) - figure. A total of 81 flares occurred (33 and 48 in the r- and nr-axSpA subgroups, respectively) in the 10 years of follow-up. None of the documented disease flares resulted in a direct study withdrawal. The majority of flares occurred within first 4 years of treatment (figure). There were also no statistically significant differences between nr- and r-axSpA in the time until the first flare (p=0.4, Log-rank test). In the multivariable Cox regression analysis normal CRP values (≤5mg/l), HLA-B27 negativity, higher physician global assessment, a longer symptom duration at study entry, higher spinal ankylosis and higher fatty degeneration in the sacroiliac joints but lower spinal osteitis scores and lower ankylosis scores in the sacroiliac joints at baseline MRI were associated with a higher risk for flares.Conclusion:Disease flares according to the ASAS definition of clinically important worsening in axSpA based on ASDAS occurred ~1/3 of patients with early axSpA who received a treatment with etanercept for up to 10 years without major differences between r- and nr- forms of axSpA. HLA-B27 negativity, normal CRP, higher spinal ankylosis scores, higher fatty degeneration scores but lower ankylosis scores in the SIJ´s at baseline MRI were associated with a higher risk for flares.Figure 1.Baseline characteristics of all patients with with continous ETC treatment.all≥1 flareno flarepatientsn (%)62 (100)22 (35.5)40 (64.5)malen (%)38 (61.3)16 (72.7)22 (55)agemean (SD)34.1 (8.3)32.6 (7.8)35 (8.6)BASDAImean (SD)2.7 (2)1.8 (1.8)3.2 (1.9)ASDASmean (SD)1.6 (0.8)1.3 (0.7)1.7 (0.8)Figure 2.Kaplan-Meier curves indicating time to first flare and flare free survival propability.Acknowledgments:The ESTHER study was supported by an unrestricted research grant from Pfizer. Murat Torgutalp’s (MT) work at Charité - Universitätsmedizin was supported by an award from the Scientific and Technological Research Council of Turkey (TUBITAK).Disclosure of Interests:Fabian Proft Grant/research support from: Novartis Pharma GmbH, Consultant of: Consultancy / speaker fees from: Abbvie, BMS, Celgene, Lilly, MSD, Novartis, Pfizer, Roche, UCB, Speakers bureau: Consultancy / speaker fees from: Abbvie, BMS, Celgene, Lilly, MSD, Novartis, Pfizer, Roche, UCB, Murat Torgutalp: None declared, Anja Weiß: None declared, Mikhail Protopopov Consultant of: Novartis, Valeria Rios Rodriguez Consultant of: Abbvie, Novartis, Hildrun Haibel Consultant of: Abbvie, Jansen, MSD, and Novartis, Speakers bureau: Abbvie, Jansen, MSD, and Novartis, Kay Hermann: None declared, Christian Althoff: None declared, Olaf Behmer Employee of: Pfizer Pharma GmbH, Joachim Sieper Consultant of: AbbVie, Boehringer Ingelheim, Eli Lilly and Company, Janssen, Merck, Novartis, Pfizer, Roche, and UCB Pharma, Speakers bureau: AbbVie, Boehringer Ingelheim, Eli Lilly and Company, Janssen, Merck, Novartis, Pfizer, Roche, and UCB Pharma, Denis Poddubnyy Grant/research support from: AbbVie, MSD, Novartis, and Pfizer, Consultant of: AbbVie, Bristol-Myers Squibb, Eli Lilly, MSD, Novartis, Pfizer, Roche, UCB, Speakers bureau: AbbVie, Bristol-Myers Squibb, Eli Lilly, MSD, Novartis, Pfizer, Roche, UCB
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Kedor C, Listing J, Zernicke J, Weiß A, Behrens F, Blank N, Henes J, Kekow J, Rubbert-Roth A, Schulze-Koops H, Seipelt E, Specker C, Feist E. AB1037 CANAKINUMAB FOR TREATMENT OF ADULT ONSET STILL‘S DISEASE-RESULTS OF THE 24 WEEKS TREATMENT AND BEYOND: A MULTI-CENTRE, PLACEBO-CONTROLLED STUDY (CONSIDER). Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:Inhibition of interleukin-1 (IL-1) represents a promising treatment option in adult-onset Still’s disease (AOSD). Canakinumab is approved for treatment of systemic juvenile idiopathic arthritis and has a marked impact on systemic as well as articular activity of the disease.Objectives:To investigate the efficacy and safety of canakinumab in patients with AOSD and active joint involvement by means of a multi-centre, double-blinded, randomized, placebo controlled trial over a period of 24 weeks with the option of a long-term extension.Methods:Patients with AOSD and active joint involvement (tender and swollen joint count ≥4 each) were stratified by pre-treatment status with biologic DMARDs to canakinumab (4 mg/kg, maximum 300 mg s.c. q4w) or placebo. After approval of canakinumab for AOSD by the European Medicines Agency, recruitment was stopped prematurely with enrollment of 35 out of 68 planned patients. The primary endpoint was the proportion of patients with a clinically-relevant reduction in disease activity at week 12 as determined by the change in disease activity score (ΔDAS28 >1.2).Results:At enrollment, patients had high active disease with a mean DAS28(ESR) of 5.4 in the canakinumab group (n=18, [CI 43.1; 85.2]) and 5·3 in the placebo group (n=17, [CI 20.1; 65.0]). In the intention-to-treat analysis, 12 (67%) canakinumab and 7 (41%) placebo patients fulfilled the primary outcome criterion (p=0.18). Figure 2 shows the DAS28-ESR disease activity by treatment groups and visits with imputation. In the per-protocol analysis, significantly higher ACR30 (61% vs. 33% p=0.033), ACR50 (50% vs. 6.7% p= 0.009) and ACR70 (28% vs. 0% p=0.049) response rates were observed in the canakinumab group compared with placebo (Figure 1). Two patients in the canakinumab group experienced an SAE.Figure 1.Response rates (PP)Figure 2.DAS28-ESR disease activity by treatment groups and visits with imputationConclusion:Although the study was terminated prematurely and the primary endpoint was not achieved, treatment with canakinumab led to an improvement of several outcome measures in AOSD. The overall safety findings were consistent with the known profile of canakinumab. Thus, our data support indication for IL-1 inhibition with canakinumab in AOSD.References:[1]Nirmala N et al. Gene-expression analysis of AOSD and SJIA is consistent with a continuum of a single disease entity. Pediatr Rheumatol Online J. 2015P-values are shown above each pair of bars; P-values in red are significant ACR, American College of Rheumatology; CRP, C-reactive protein; DAS, disease activity score; EULAR, European League Against Rheumatism; PP, per-protocolDisclosure of Interests:Claudia Kedor Consultant of: Advisory Board for Novartis Pharma GmbH, Joachim Listing: None declared, Jan Zernicke: None declared, Anja Weiß: None declared, Frank Behrens Grant/research support from: Abbvie, Pfizer, Roche, Chugai, Janssen, Consultant of: Abbvie, Pfizer, Roche, Chugai, UCB, BMS, Celgene, MSD, Novartis, Biotest, Janssen, Genzyme, Lilly; Boehringer; Sandoz, Speakers bureau: Abbvie, Pfizer, Roche, Chugai, UCB, BMS, Celgene, MSD, Novartis, Biotest, Janssen, Genzyme, Lilly; Boehringer; Sandoz, Norbert Blank Grant/research support from: Novartis, Sobi, Consultant of: Novartis, Sobi, Lilly, Pfizer, Abbvie, BMS, MSD, Actelion, UCB, Boehringer-Ingelheim, Roche, Jörg Henes Grant/research support from: Novartis, Roche-Chugai, Consultant of: Novartis, Roche, Celgene, Pfizer, Abbvie, Sanofi, Boehringer-Ingelheim,, Jörn Kekow Speakers bureau: BMS, MSD, Pfizer, Roche, Andrea Rubbert-Roth Consultant of: Abbvie, BMS, Chugai, Pfizer, Roche, Janssen, Lilly, Sanofi, Amgen, Novartis, Hendrik Schulze-Koops Grant/research support from: Pfizer Inc, Eva Seipelt: None declared, Christof Specker Consultant of: Abbvie, Boehringer Ingelheim, Chugai, Lilly, Novartis, Sobi, UCB, Celgene, Janssen-Cilag, MSD, Pfizer, Roche, UCB, Toshiba, Eugen Feist Consultant of: Novartis, Roche, Sobi, Lilly, Pfizer, Abbvie, BMS, MSD, Sanofi, Speakers bureau: Novartis, Roche, Sobi, Lilly, Pfizer, Abbvie, BMS, MSD, Sanofi
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Regierer A, Weiß A, Behrens F, Feuchtenberger M, Schett G, Baraliakos X, Zink A, Strangfeld A. SAT0437 GENDER DIFFERENCES IN PsA OUTCOME PARAMETERS AND THEIR CORRELATION WITH SKIN INVOLVEMENT: A CROSS-SECTIONAL ANALYSIS OF RABBIT-SpA PAtients. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.1210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:PsA is a complex disease characterised by a heterogeneous pattern including different clinical symptoms of musculoskeletal (MSK) inflammation like arthritis, enthesitis, dactylitis and axial involvement as well as skin and nail involvement. There are differences in these disease patterns between female and male patients which need to be taken into account.Objectives:To assess the differences between female and male PsA patients in the extent of psoriatic skin (body surface area, BSA) and joint (tender joint count 68, TJC68; swollen joint count 66, SJC66;) disease, composite scores (disease activity in PsA, DAPSA; disease activity score 28, DAS28), and patient-reported outcomes (PROs) and to correlate the extent of skin disease with PROs.Methods:RABBIT-SpA is a prospective longitudinal cohort study including PsA patients enrolled at start of a new csDMARD, bDMARD or tsDMARD. Gender specific differences in outcome parameters are compared using Wilcoxon resp. t-test at baseline visit. Spearman correlation coefficient was calculated to analyse the relationship between BSA and outcome parameters.Results:722 PsA patients were included in this analysis. Women were slightly older (52 vs 50 yrs), had longer disease duration (7 vs 5.8 yrs), more comorbidities and were more often obese. Men had a significantly higher skin involvement than women measured by BSA and physician skin assessment (physSk, table 1). Women had significantly higher joint involvement as measured by TJC68, DAPSA, DAS28, and patient muskuloskeletal assessment (patMSK). Impact of disease as measured by PSAID and patient global assessment (patGA) was more severe in women than in men and also physical function (HAQ) was lower in women than in men (table 1). Despite the higher skin involvement in men, the DLQI was equally high in women and men with more than 50% of patients in reduced quality of life state (table 1).Table 1.ParameterFemaleN=424MaleN=298SJC663.4 (5)2.7 (3.8)TJC687.9 (8.7)5.7 (7)BSA (0-100)6.6 (13)10.8 (16.5)physGA (NRS 0-10)5.3 (1.9)5.2 (2)physSk (NRS 0-10)3.1 (2.7)3.7 (2.6)physMSK (NRS 0-10)5.2 (2.1)4.9 (2.3)DAPSA24.2 (13.8)20.1 (12.3)DAS28-CRP3.7 (1.2)3.4 (1.2)patGA (NRS 0-10)5.5 (2.1)4.9 (2)patSk (NRS 0-10)3.9 (3.1)3.9 (2.8)patMSK (NRS 0-10)5.8 (2.2)5 (2.5)DLQI (0-30)6.1 (6.8)5.3 (5.7)HAQ (0-3)1.1 (0.6)0.7 (0.6)PSAID (0-10)4.8 (2.3)3.9 (2.2)Results are presented as mean ± SD.BSA was not correlated with SJC66 or TJC68, DAPSA, DAS28, phys MSK, patGA and patMSK neither in men nor in women. BSA was however positive correlated with DLQI, patSk, and physSK and slightly with physGA in both genders. The PSAID is correlated to BSA in women only.Conclusion:Women and men show differences regarding many PsA criteria. Men have a more severe skin involvement, while women have higher burden of joint involvement. In addition in the patient reported parameters women show significantly higher values than men except for the skin specific parameters. Notably, although skin involvement is not correlated with most PsA activity parameters, around 50% of patients in specialised rheumatologic care are negatively affected in their quality of life by psoriatic skin disease. Therapeutic decisions need to take into account the complexity of the patients’ symptoms as well as gender differences.Acknowledgments:RABBIT-SpA is supported by a joint, unconditional grant from AbbVie, Amgen, Janssen-Cilag, Lilly, MSD, Mylan, Novartis, Pfizer, and UCB.Disclosure of Interests:Anne Regierer Speakers bureau: Novartis, Celgene, Janssen-Cilag, Anja Weiß: None declared, Frank Behrens Grant/research support from: Pfizer, Janssen, Chugai, Celgene, Lilly and Roche, Consultant of: Pfizer, AbbVie, Sanofi, Lilly, Novartis, Genzyme, Boehringer, Janssen, MSD, Celgene, Roche and Chugai, Martin Feuchtenberger Consultant of: Abbvie, BMS, Chugai, Sanofi, Speakers bureau: Abbvie, BMS, Celgene, Chugai, Jansen-Cilag, Lilly, Pfizer, Roche, Sanofi, UCB, Georg Schett Speakers bureau: AbbVie, BMS, Celgene, Janssen, Eli Lilly, Novartis, Roche and UCB, Xenofon Baraliakos Grant/research support from: Grant/research support from: AbbVie, BMS, Celgene, Chugai, Merck, Novartis, Pfizer, UCB and Werfen, Consultant of: AbbVie, BMS, Celgene, Chugai, Merck, Novartis, Pfizer, UCB and Werfen, Speakers bureau: AbbVie, BMS, Celgene, Chugai, Merck, Novartis, Pfizer, UCB and Werfen, Angela Zink Speakers bureau: AbbVie, Amgen, BMS, Gilead, Hexal, Janssen, Lilly, MSD, Pfizer, Roche, Sanofi Aventis, UCB, Anja Strangfeld Speakers bureau: AbbVie, BMS, Pfizer, Roche, Sanofi-Aventis
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Spilker JS, Aravena M, Béthermin M, Chapman SC, Chen CC, Cunningham DJM, De Breuck C, Dong C, Gonzalez AH, Hayward CC, Hezaveh YD, Litke KC, Ma J, Malkan M, Marrone DP, Miller TB, Morningstar WR, Narayanan D, Phadke KA, Sreevani J, Stark AA, Vieira JD, Weiß A. Fast molecular outflow from a dusty star-forming galaxy in the early Universe. Science 2018; 361:1016-1019. [PMID: 30190403 DOI: 10.1126/science.aap8900] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2017] [Accepted: 07/13/2018] [Indexed: 11/02/2022]
Abstract
Galaxies grow inefficiently, with only a small percentage of the available gas converted into stars each free-fall time. Feedback processes, such as outflowing winds driven by radiation pressure, supernovae, or supermassive black hole accretion, can act to halt star formation if they heat or expel the gas supply. We report a molecular outflow launched from a dust-rich star-forming galaxy at redshift 5.3, 1 billion years after the Big Bang. The outflow reaches velocities up to 800 kilometers per second relative to the galaxy, is resolved into multiple clumps, and carries mass at a rate within a factor of 2 of the star formation rate. Our results show that molecular outflows can remove a large fraction of the gas available for star formation from galaxies at high redshift.
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Affiliation(s)
- J S Spilker
- Department of Astronomy, University of Texas at Austin, 2515 Speedway Stop C1400, Austin, TX 78712, USA. .,Steward Observatory, University of Arizona, 933 North Cherry Avenue, Tucson, AZ 85721, USA
| | - M Aravena
- Núcleo de Astronomía, Facultad de Ingeniería, Universidad Diego Portales, Av. Ejército 441, Santiago, Chile
| | - M Béthermin
- Aix Marseille Univ., Centre National de la Recherche Scientifique, Laboratoire d'Astrophysique de Marseille, Marseille, France
| | - S C Chapman
- Department of Physics and Atmospheric Science, Dalhousie University, Halifax, Nova Scotia, Canada
| | - C-C Chen
- European Southern Observatory, Karl Schwarzschild Straße 2, 85748 Garching, Germany
| | - D J M Cunningham
- Department of Physics and Atmospheric Science, Dalhousie University, Halifax, Nova Scotia, Canada.,Department of Astronomy and Physics, Saint Mary's University, Halifax, Nova Scotia, Canada
| | - C De Breuck
- European Southern Observatory, Karl Schwarzschild Straße 2, 85748 Garching, Germany
| | - C Dong
- Department of Astronomy, University of Florida, Bryant Space Sciences Center, Gainesville, FL 32611, USA
| | - A H Gonzalez
- Department of Astronomy, University of Florida, Bryant Space Sciences Center, Gainesville, FL 32611, USA
| | - C C Hayward
- Center for Computational Astrophysics, Flatiron Institute, 162 Fifth Avenue, New York, NY 10010, USA.,Harvard-Smithsonian Center for Astrophysics, 60 Garden St., Cambridge, MA 02138, USA
| | - Y D Hezaveh
- Kavli Institute for Particle Astrophysics and Cosmology, Stanford University, Stanford, CA 94305, USA
| | - K C Litke
- Steward Observatory, University of Arizona, 933 North Cherry Avenue, Tucson, AZ 85721, USA
| | - J Ma
- Department of Physics and Astronomy, University of California, Irvine, CA 92697, USA
| | - M Malkan
- Department of Physics and Astronomy, University of California, Los Angeles, CA 90095, USA
| | - D P Marrone
- Steward Observatory, University of Arizona, 933 North Cherry Avenue, Tucson, AZ 85721, USA
| | - T B Miller
- Department of Physics and Atmospheric Science, Dalhousie University, Halifax, Nova Scotia, Canada.,Department of Astronomy, Yale University, 52 Hillhouse Avenue, New Haven, CT 06511, USA
| | - W R Morningstar
- Kavli Institute for Particle Astrophysics and Cosmology, Stanford University, Stanford, CA 94305, USA
| | - D Narayanan
- Department of Astronomy, University of Florida, Bryant Space Sciences Center, Gainesville, FL 32611, USA
| | - K A Phadke
- Department of Astronomy, University of Illinois, 1002 West Green Street, Urbana, IL 61801, USA
| | - J Sreevani
- Department of Astronomy, University of Illinois, 1002 West Green Street, Urbana, IL 61801, USA
| | - A A Stark
- Harvard-Smithsonian Center for Astrophysics, 60 Garden St., Cambridge, MA 02138, USA
| | - J D Vieira
- Department of Astronomy, University of Illinois, 1002 West Green Street, Urbana, IL 61801, USA
| | - A Weiß
- Max-Planck-Institut für Radioastronomie, Auf dem Hügel 69, D-53121 Bonn, Germany
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Bernardi C, Weiß A, Brandstetter S, Brandl M, Blecha S, Bein T, Apfelbacher C. Perspektiven von Patienten nach einem prolongierten Aufenthalt auf Intensivstation bezüglich einer Intensiv-Nachsorgeambulanz: eine qualitative Interviewstudie. Das Gesundheitswesen 2018. [DOI: 10.1055/s-0038-1667792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- C Bernardi
- Universität Regensburg, Institut für Epidemiologie und Präventivmedizin, Medizinische Soziologie, Regensburg, Deutschland
| | - A Weiß
- Universität Regensburg, Institut für Epidemiologie und Präventivmedizin, Medizinische Soziologie, Regensburg, Deutschland
| | - S Brandstetter
- Universität Regensburg, Institut für Epidemiologie und Präventivmedizin, Medizinische Soziologie, Regensburg, Deutschland
| | - M Brandl
- Universität Regensburg, Institut für Epidemiologie und Präventivmedizin, Medizinische Soziologie, Regensburg, Deutschland
| | - S Blecha
- Universitätsklinikum Regensburg, Klinik für Anästhesiologie, Regensburg, Deutschland
| | - T Bein
- Universitätsklinikum Regensburg, Klinik für Anästhesiologie, Regensburg, Deutschland
| | - C Apfelbacher
- Universität Regensburg, Institut für Epidemiologie und Präventivmedizin, Medizinische Soziologie, Regensburg, Deutschland
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Miller TB, Chapman SC, Aravena M, Ashby MLN, Hayward CC, Vieira JD, Weiß A, Babul A, Béthermin M, Bradford CM, Brodwin M, Carlstrom JE, Chen CC, Cunningham DJM, De Breuck C, Gonzalez AH, Greve TR, Harnett J, Hezaveh Y, Lacaille K, Litke KC, Ma J, Malkan M, Marrone DP, Morningstar W, Murphy EJ, Narayanan D, Pass E, Perry R, Phadke KA, Rennehan D, Rotermund KM, Simpson J, Spilker JS, Sreevani J, Stark AA, Strandet ML, Strom AL. A massive core for a cluster of galaxies at a redshift of 4.3. Nature 2018; 556:469-472. [PMID: 29695849 DOI: 10.1038/s41586-018-0025-2] [Citation(s) in RCA: 93] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2017] [Accepted: 01/24/2018] [Indexed: 11/09/2022]
Abstract
Massive galaxy clusters have been found that date to times as early as three billion years after the Big Bang, containing stars that formed at even earlier epochs1-3. The high-redshift progenitors of these galaxy clusters-termed 'protoclusters'-can be identified in cosmological simulations that have the highest overdensities (greater-than-average densities) of dark matter4-6. Protoclusters are expected to contain extremely massive galaxies that can be observed as luminous starbursts 7 . However, recent detections of possible protoclusters hosting such starbursts8-11 do not support the kind of rapid cluster-core formation expected from simulations 12 : the structures observed contain only a handful of starbursting galaxies spread throughout a broad region, with poor evidence for eventual collapse into a protocluster. Here we report observations of carbon monoxide and ionized carbon emission from the source SPT2349-56. We find that this source consists of at least 14 gas-rich galaxies, all lying at redshifts of 4.31. We demonstrate that each of these galaxies is forming stars between 50 and 1,000 times more quickly than our own Milky Way, and that all are located within a projected region that is only around 130 kiloparsecs in diameter. This galaxy surface density is more than ten times the average blank-field value (integrated over all redshifts), and more than 1,000 times the average field volume density. The velocity dispersion (approximately 410 kilometres per second) of these galaxies and the enormous gas and star-formation densities suggest that this system represents the core of a cluster of galaxies that was already at an advanced stage of formation when the Universe was only 1.4 billion years old. A comparison with other known protoclusters at high redshifts shows that SPT2349-56 could be building one of the most massive structures in the Universe today.
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Affiliation(s)
- T B Miller
- Department of Physics and Atmospheric Science, Dalhousie University, Halifax, Nova Scotia, Canada. .,Department of Astronomy, Yale University, New Haven, CT, USA.
| | - S C Chapman
- Department of Physics and Atmospheric Science, Dalhousie University, Halifax, Nova Scotia, Canada.,Department of Physics and Astronomy, University of British Columbia, Vancouver, British Columbia, Canada.,National Research Council, Herzberg Astronomy and Astrophysics, Victoria, British Columbia, Canada
| | - M Aravena
- Núcleo de Astronomía, Facultad de Ingeniería y Ciencias, Universidad Diego Portales, Santiago, Chile
| | - M L N Ashby
- Harvard-Smithsonian Center for Astrophysics, Cambridge, MA, USA
| | - C C Hayward
- Harvard-Smithsonian Center for Astrophysics, Cambridge, MA, USA.,Center for Computational Astrophysics, Flatiron Institute, New York, NY, USA
| | - J D Vieira
- Department of Astronomy, University of Illinois, Urbana, IL, USA
| | - A Weiß
- Max-Planck-Institut für Radioastronomie, Bonn, Germany
| | - A Babul
- Department of Physics and Astronomy, University of Victoria, Victoria, British Columbia, Canada
| | - M Béthermin
- Aix-Marseille Université, CNRS, LAM, Laboratoire d'Astrophysique de Marseille, Marseille, France
| | - C M Bradford
- California Institute of Technology, Pasadena, CA, USA.,Jet Propulsion Laboratory, Pasadena, CA, USA
| | - M Brodwin
- Department of Physics and Astronomy, University of Missouri, Kansas City, MO, USA
| | - J E Carlstrom
- Kavli Institute for Cosmological Physics, University of Chicago, Chicago, IL, USA.,Department of Physics, University of Chicago, Chicago, IL, USA.,Enrico Fermi Institute, University of Chicago, Chicago, IL, USA.,Department of Astronomy and Astrophysics, University of Chicago, Chicago, IL, USA
| | | | - D J M Cunningham
- Department of Physics and Atmospheric Science, Dalhousie University, Halifax, Nova Scotia, Canada.,Department of Astronomy and Physics, Saint Mary's University, Halifax, Nova Scotia, Canada
| | - C De Breuck
- European Southern Observatory, Garching, Germany
| | - A H Gonzalez
- Department of Astronomy, University of Florida, Gainesville, FL, USA
| | - T R Greve
- Department of Physics and Astronomy, University College London, London, UK
| | - J Harnett
- School of Physics, University of Sydney, Sydney, New South Wales, Australia
| | - Y Hezaveh
- Kavli Institute for Particle Astrophysics and Cosmology, Stanford University, Stanford, CA, USA
| | - K Lacaille
- Department of Physics and Atmospheric Science, Dalhousie University, Halifax, Nova Scotia, Canada.,Department of Physics and Astronomy, McMaster University, Hamilton, Ontario, Canada
| | - K C Litke
- Steward Observatory, University of Arizona, Tucson, AZ, USA
| | - J Ma
- Department of Astronomy, University of Florida, Gainesville, FL, USA
| | - M Malkan
- Department of Physics and Astronomy, University of California, Los Angeles, CA, USA
| | - D P Marrone
- Steward Observatory, University of Arizona, Tucson, AZ, USA
| | - W Morningstar
- Kavli Institute for Particle Astrophysics and Cosmology, Stanford University, Stanford, CA, USA
| | - E J Murphy
- National Radio Astronomy Observatory, Charlottesville, VA, USA
| | - D Narayanan
- Department of Astronomy, University of Florida, Gainesville, FL, USA
| | - E Pass
- Department of Physics and Atmospheric Science, Dalhousie University, Halifax, Nova Scotia, Canada.,Department of Physics and Astronomy, University of Waterloo, Waterloo, Ontario, Canada
| | - R Perry
- Department of Physics and Atmospheric Science, Dalhousie University, Halifax, Nova Scotia, Canada
| | - K A Phadke
- Department of Astronomy, University of Illinois, Urbana, IL, USA
| | - D Rennehan
- Department of Physics and Astronomy, University of Victoria, Victoria, British Columbia, Canada
| | - K M Rotermund
- Department of Physics and Atmospheric Science, Dalhousie University, Halifax, Nova Scotia, Canada
| | - J Simpson
- Institute for Astronomy, Royal Observatory, University of Edinburgh, Edinburgh, UK.,Centre for Extragalactic Astronomy, Department of Physics, Durham University, Durham, UK
| | - J S Spilker
- Steward Observatory, University of Arizona, Tucson, AZ, USA
| | - J Sreevani
- Department of Astronomy, University of Illinois, Urbana, IL, USA
| | - A A Stark
- Harvard-Smithsonian Center for Astrophysics, Cambridge, MA, USA
| | - M L Strandet
- Max-Planck-Institut für Radioastronomie, Bonn, Germany.,International Max Planck Research School (IMPRS) for Astronomy and Astrophysics, Bonn, Germany
| | - A L Strom
- Observatories of The Carnegie Institution for Science, Pasadena, CA, USA
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Marrone DP, Spilker JS, Hayward CC, Vieira JD, Aravena M, Ashby MLN, Bayliss MB, Béthermin M, Brodwin M, Bothwell MS, Carlstrom JE, Chapman SC, Chen CC, Crawford TM, Cunningham DJM, De Breuck C, Fassnacht CD, Gonzalez AH, Greve TR, Hezaveh YD, Lacaille K, Litke KC, Lower S, Ma J, Malkan M, Miller TB, Morningstar WR, Murphy EJ, Narayanan D, Phadke KA, Rotermund KM, Sreevani J, Stalder B, Stark AA, Strandet ML, Tang M, Weiß A. Galaxy growth in a massive halo in the first billion years of cosmic history. Nature 2018; 553:51-54. [PMID: 29211721 DOI: 10.1038/nature24629] [Citation(s) in RCA: 130] [Impact Index Per Article: 21.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2017] [Accepted: 10/06/2017] [Indexed: 11/09/2022]
Abstract
According to the current understanding of cosmic structure formation, the precursors of the most massive structures in the Universe began to form shortly after the Big Bang, in regions corresponding to the largest fluctuations in the cosmic density field. Observing these structures during their period of active growth and assembly-the first few hundred million years of the Universe-is challenging because it requires surveys that are sensitive enough to detect the distant galaxies that act as signposts for these structures and wide enough to capture the rarest objects. As a result, very few such objects have been detected so far. Here we report observations of a far-infrared-luminous object at redshift 6.900 (less than 800 million years after the Big Bang) that was discovered in a wide-field survey. High-resolution imaging shows it to be a pair of extremely massive star-forming galaxies. The larger is forming stars at a rate of 2,900 solar masses per year, contains 270 billion solar masses of gas and 2.5 billion solar masses of dust, and is more massive than any other known object at a redshift of more than 6. Its rapid star formation is probably triggered by its companion galaxy at a projected separation of 8 kiloparsecs. This merging companion hosts 35 billion solar masses of stars and has a star-formation rate of 540 solar masses per year, but has an order of magnitude less gas and dust than its neighbour and physical conditions akin to those observed in lower-metallicity galaxies in the nearby Universe. These objects suggest the presence of a dark-matter halo with a mass of more than 100 billion solar masses, making it among the rarest dark-matter haloes that should exist in the Universe at this epoch.
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Affiliation(s)
- D P Marrone
- Steward Observatory, University of Arizona, 933 North Cherry Avenue, Tucson, Arizona 85721, USA
| | - J S Spilker
- Steward Observatory, University of Arizona, 933 North Cherry Avenue, Tucson, Arizona 85721, USA
| | - C C Hayward
- Center for Computational Astrophysics, Flatiron Institute, 162 Fifth Avenue, New York, New York 10010, USA.,Harvard-Smithsonian Center for Astrophysics, 60 Garden Street, Cambridge, Massachusetts 02138, USA
| | - J D Vieira
- Department of Astronomy, University of Illinois, 1002 West Green Street, Urbana, Illinois 61801, USA
| | - M Aravena
- Núcleo de Astronomía, Facultad de Ingeniería, Universidad Diego Portales, Avenida Ejército 441, Santiago, Chile
| | - M L N Ashby
- Harvard-Smithsonian Center for Astrophysics, 60 Garden Street, Cambridge, Massachusetts 02138, USA
| | - M B Bayliss
- Kavli Institute for Astrophysics and Space Research, Massachusetts Institute of Technology, 77 Massachusetts Avenue, Cambridge, Massachusetts 02139, USA
| | - M Béthermin
- Aix Marseille Université, CNRS, LAM, Laboratoire d'Astrophysique de Marseille, Marseille, France
| | - M Brodwin
- Department of Physics and Astronomy, University of Missouri, 5110 Rockhill Road, Kansas City, Missouri 64110, USA
| | - M S Bothwell
- Cavendish Laboratory, University of Cambridge, 19 J. J. Thomson Avenue, Cambridge CB3 0HE, UK.,Kavli Institute for Cosmology, University of Cambridge, Madingley Road, Cambridge CB3 0HA, UK
| | - J E Carlstrom
- Kavli Institute for Cosmological Physics, University of Chicago, 5640 South Ellis Avenue, Chicago, Illinois 60637, USA.,Department of Physics, University of Chicago, 5640 South Ellis Avenue, Chicago, Illinois 60637, USA.,Enrico Fermi Institute, University of Chicago, 5640 South Ellis Avenue, Chicago, Illinois 60637, USA.,Department of Astronomy and Astrophysics, University of Chicago, 5640 South Ellis Avenue, Chicago, Illinois 60637, USA
| | - S C Chapman
- Dalhousie University, Halifax, Nova Scotia, Canada
| | - Chian-Chou Chen
- European Southern Observatory, Karl Schwarzschild Straße 2, 85748 Garching, Germany
| | - T M Crawford
- Kavli Institute for Cosmological Physics, University of Chicago, 5640 South Ellis Avenue, Chicago, Illinois 60637, USA.,Department of Astronomy and Astrophysics, University of Chicago, 5640 South Ellis Avenue, Chicago, Illinois 60637, USA
| | - D J M Cunningham
- Dalhousie University, Halifax, Nova Scotia, Canada.,Department of Astronomy and Physics, Saint Mary's University, Halifax, Nova Scotia, Canada
| | - C De Breuck
- European Southern Observatory, Karl Schwarzschild Straße 2, 85748 Garching, Germany
| | - C D Fassnacht
- Department of Physics, University of California, One Shields Avenue, Davis, California 95616, USA
| | - A H Gonzalez
- Department of Astronomy, University of Florida, Bryant Space Sciences Center, Gainesville, Florida 32611 USA
| | - T R Greve
- Department of Physics and Astronomy, University College London, Gower Street, London WC1E 6BT, UK
| | - Y D Hezaveh
- Kavli Institute for Particle Astrophysics and Cosmology, Stanford University, Stanford, California 94305, USA
| | - K Lacaille
- Department of Physics and Astronomy, McMaster University, Hamilton, Ontario L8S 4M1, Canada
| | - K C Litke
- Steward Observatory, University of Arizona, 933 North Cherry Avenue, Tucson, Arizona 85721, USA
| | - S Lower
- Department of Astronomy, University of Illinois, 1002 West Green Street, Urbana, Illinois 61801, USA
| | - J Ma
- Department of Astronomy, University of Florida, Bryant Space Sciences Center, Gainesville, Florida 32611 USA
| | - M Malkan
- Department of Physics and Astronomy, University of California, Los Angeles, California 90095-1547, USA
| | - T B Miller
- Dalhousie University, Halifax, Nova Scotia, Canada
| | - W R Morningstar
- Kavli Institute for Particle Astrophysics and Cosmology, Stanford University, Stanford, California 94305, USA
| | - E J Murphy
- National Radio Astronomy Observatory, 520 Edgemont Road, Charlottesville, Virginia 22903, USA
| | - D Narayanan
- Department of Astronomy, University of Florida, Bryant Space Sciences Center, Gainesville, Florida 32611 USA
| | - K A Phadke
- Department of Astronomy, University of Illinois, 1002 West Green Street, Urbana, Illinois 61801, USA
| | | | - J Sreevani
- Department of Astronomy, University of Illinois, 1002 West Green Street, Urbana, Illinois 61801, USA
| | - B Stalder
- Large Synoptic Survey Telescope, 950 North Cherry Avenue, Tucson, Arizona 85719, USA
| | - A A Stark
- Harvard-Smithsonian Center for Astrophysics, 60 Garden Street, Cambridge, Massachusetts 02138, USA
| | - M L Strandet
- Max-Planck-Institut für Radioastronomie, Auf dem Hügel 69, D-53121 Bonn, Germany.,International Max Planck Research School (IMPRS) for Astronomy and Astrophysics, Universities of Bonn and Cologne, Bonn, Germany
| | - M Tang
- Steward Observatory, University of Arizona, 933 North Cherry Avenue, Tucson, Arizona 85721, USA
| | - A Weiß
- Max-Planck-Institut für Radioastronomie, Auf dem Hügel 69, D-53121 Bonn, Germany
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Song IH, Hermann KG, Haibel H, Althoff C, Poddubnyy D, Listing J, Weiß A, Lange E, Freundlich B, Rudwaleit M, Sieper J. THU0273 Similar response rates in patients with ankylosing spondylitis and non-radiographic axial spondyloarthritis after one year of treatment with etanercept - results of the esther trial:. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2012-eular.2238] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Song IH, Hermann KG, Haibel H, Althoff CE, Poddubnyy D, Listing J, Weiß A, Lange E, Freundlich B, Rudwaleit M, Sieper J. THU0358 Constant Clinical Response in Patients with Early Axial Spondyloarthritis after Continuous Treatment with Etanercept - 4 Year Data of the Esther Trial. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2013-eular.886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Weiß A, Song IH, Haibel H, Listing J, Sieper J. AB0847 Comparison of treatment responses to TNF-blockers in axial spondyloarthritis patients with short vs long symptom duration:. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2012-eular.847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Song IH, Hermann KG, Haibel H, Althoff CE, Poddubnyy D, Listing J, Weiß A, Lange E, Freundlich B, Rudwaleit M, Sieper J. FRI0423 Effective prevention of new inflammatory bony lesions on magnetic resonance imaging in patients with early axial spondyloarthritis during treatment with etanercept over 2 years - data of the esther trial. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2013-eular.1550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Song IH, Heldmann F, Rudwaleit M, Haibel H, Weiß A, Braun J, Sieper J. Treatment of active ankylosing spondylitis with abatacept: an open-label, 24-week pilot study. Ann Rheum Dis 2011; 70:1108-10. [DOI: 10.1136/ard.2010.145946] [Citation(s) in RCA: 132] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
ObjectiveTo prospectively explore the short-term efficacy and safety of abatacept in patients with ankylosing spondylitis (AS).MethodsIn this prospective open-label pilot study, abatacept (10 mg/kg) was administered intravenously on days 1, 15, 29 and every 28 days thereafter up to week 24 in 15 tumour necrosis factor α (TNFα)-inhibitor naive patients (group 1) and 15 patients with inadequate response to TNFα inhibitors (group 2) with active AS. The primary end point was the proportion of patients with 40% improvement according to the Assessment of SpondyloArthritis international Society criteria (ASAS40) in both groups at week 24.ResultsAt week 24, ASAS40 was reached by 13% of group 1 and 0% of group 2; 20% improvement (ASAS20) was reached by 27% and 20%, respectively. There was no significant change of Bath Ankylosing Spondylitis Disease Activity Index score, patient global assessment or C reactive protein. Overall, abatacept was well tolerated.ConclusionsIn this pilot open-label AS study a major response was not observed.
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Krüger L, Wolf S, Martin U, Martin S, Scheller PR, Jahn A, Weiß A. The influence of martensitic transformation on mechanical properties of cast high alloyed CrMnNi-steel under various strain rates and temperatures. ACTA ACUST UNITED AC 2010. [DOI: 10.1088/1742-6596/240/1/012098] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Schartel B, Weiß A, Sturm H, Kleemeier M, Hartwig A, Vogt C, Fischer RX. Layered silicate epoxy nanocomposites: formation of the inorganic-carbonaceous fire protection layer. POLYM ADVAN TECHNOL 2010. [DOI: 10.1002/pat.1644] [Citation(s) in RCA: 93] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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Schartel B, Weiß A, Mohr F, Kleemeier M, Hartwig A, Braun U. Flame retarded epoxy resins by adding layered silicate in combination with the conventional protection-layer-building flame retardants melamine borate and ammonium polyphosphate. J Appl Polym Sci 2010. [DOI: 10.1002/app.32512] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Handhziev S, Lützkendorf L, Weiß A, Stiller O, Peschke A, Höffken G, Koschel D. Nicht-invasive Heimbeatmung bei interstitiellen Lungenerkrankungen. Pneumologie 2007. [DOI: 10.1055/s-2007-988777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Peschke A, Weiß A, Höffken G, Holotiuk O, Sturm U. Malignes Mesotheliom der Tunica vaginalis testis mit pleuraler und pulmonaler Metastasierung. Pneumologie 2006. [DOI: 10.1055/s-2006-958861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Abstract
Atmospheric mixing ratios of chlorinated C1 and C2 hydrocarbons (CHCs) were measured at the mountain Wank (Garmisch-Partenkirchen, Bavarian Alps) in autumn 1992. The data lead to the assumption that at least part of the observed CC14 originates from a source different to the other CHCs measured (C2HCL3, C2C14, CHCl3 and CH3CCl3). The nature of this source is discussed.
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Affiliation(s)
- A Weiß
- Fraunhofer Institute for Atmospheric Environmental Research, D-82467, Garmisch-Partenkirchen, Germany
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Graichen H, Oertel G, Sommer H, Weiß A, Voigtmann R, Oswald S. Kombinierter Einsatz von REM/EDS - AES - ESCA - SIMS zur Untersuchung von Korrosionsdeckschichten auf Kontaktwerkstoffen. Z PHYS CHEM 1990. [DOI: 10.1515/zpch-1990-271118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Graichen H, Oertel G, Sommer H, Weiß A, Voigtmann R, Oswald S. Kombinierter Einsatz von REM/EDS - AES - ESCA - SIMS zur Untersuchung von Korrosionsdeckschichten auf Kontaktwerkstoffen. Z PHYS CHEM 1990. [DOI: 10.1515/zpch-1990-01118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Deeg T, Weiß A. Ladungsverteilung und Donatoreigenschaften in den Komplexen L·MeIIIX3 (L=ArCOAr, ArCOCl, ArOH; MeIII = Al, Ga; X = Cl, Br) und (ArOAlBr2)x Eine NQR-(35Cl,81Br,69Ga)- und Ir-ν (C-O), ν (C-Cl)-Untersuchung. Colloid Polym Sci 1978. [DOI: 10.1007/bf01746718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Meyer H, Nagorsen G, Weiß A. Tris(o-arylendioxo)- und Bis(o-arylendioxo)-organokieselsäuren mit sechs- und fünffach koordiniertem Silicum. Angew Chem Int Ed Engl 1968. [DOI: 10.1002/ange.19680802015] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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Nagorsen G, Weiß A. Strukturelle Beziehungen zwischen dem basischen Quecksilberchlorid HgCl2·4HgO und den Modifikationen des Quecksilberoxyds HgO. Angew Chem Int Ed Engl 1965. [DOI: 10.1002/ange.19650771649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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