142 results on '"Philipp Sewerin"'
Search Results
2. Performance of standardized patient reported outcomes developed for spondyloarthritis in primary and concomitant forms of fibromyalgia
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Styliani Tsiami, Piet Dukatz, Maria Gkelaki, Philipp Sewerin, Uta Kiltz, and Xenofon Baraliakos
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Axial spondyloarthritis ,Psoriatic arthritis ,Fibromyalgia ,Widespread pain ,Disease activity ,Diseases of the musculoskeletal system ,RC925-935 - Abstract
Abstract Background In spondyloarthritides (SpA) and fibromyalgia (FM), patients suffer from generalized pain. The impact of FM on PRO validated in SpA has not been systematically studied. Objective Study the performance of PROs developed for SpA in patients with primary (p) FM without chronic inflammatory-rheumatic disease vs. SpA without and with concomitant (c) FM. Methods Patients with pFM, axSpA or PsA and indication for treatment adaptation were prospectively included. Standardized PROs were assessed: BASDAI, ASDAS-CRP, DAPSA, patient´s global assessment, BASFI, LEI, MASES, SPARCC Enthesitis Score and FIQ. Results 300 patients were included (100/diagnosis). More males were found in axSpA vs. PsA and pFM group (67, 33 and 2/100, respectively), while 12 axSpA (axSpA+) and 16 PsA (PsA+) patients had cFM. pFM patients showed significantly higher scores in all assessments vs. axSpA or PsA, with exception of ASDAS-CRP (3.3 ± 0.6 in FM vs. 3.1 ± 1.0 in axSpA) and duration of low lumbar morning stiffness. Similar results were also found in the subanalysis of female patients only. In addition, patients with axSpA + or PsA + showed no differences to patients with pFM, while significantly higher scores were found for FM, axSpA + and PsA + for almost all FIQ items compared to axSpA- or PsA-. Conclusions PROs originally developed for axSpA or PsA need to be interpreted differently in the presence or absence of cFM. ASDAS-CRP and duration of lumbar morning stiffness were not affected by cFM. FM-specific questionnaires also showed high scores in patients with SpA with cFM but not in those without.
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- 2024
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3. Quantitative and Compositional MRI of the Articular Cartilage: A Narrative Review
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Domenico Albano, Umberto Viglino, Francesco Esposito, Aldo Rizzo, Carmelo Messina, Salvatore Gitto, Stefano Fusco, Francesca Serpi, Benedikt Kamp, Anja Müller-Lutz, Riccardo D’Ambrosi, Luca Maria Sconfienza, and Philipp Sewerin
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magnetic resonance imaging ,cartilage ,quantitative ,mapping ,osteoarthritis ,Computer applications to medicine. Medical informatics ,R858-859.7 - Abstract
This review examines the latest advancements in compositional and quantitative cartilage MRI techniques, addressing both their potential and challenges. The integration of these advancements promises to improve disease detection, treatment monitoring, and overall patient care. We want to highlight the pivotal task of translating these techniques into widespread clinical use, the transition of cartilage MRI from technical validation to clinical application, emphasizing its critical role in identifying early signs of degenerative and inflammatory joint diseases. Recognizing these changes early may enable informed treatment decisions, thereby facilitating personalized medicine approaches. The evolving landscape of cartilage MRI underscores its increasing importance in clinical practice, offering valuable insights for patient management and therapeutic interventions. This review aims to discuss the old evidence and new insights about the evaluation of articular cartilage through MRI, with an update on the most recent literature published on novel quantitative sequences.
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- 2024
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4. No difference in clinical parameters and drug retention in PsA patients receiving b/tsDMARD monotherapy versus combination with methotrexate: data from the RABBIT-SpA registry
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Philipp Sewerin, Georg Schett, Anja Strangfeld, David Kiefer, Anja Weiß, Andreas Krause, and Anne Constanze Regierer
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Medicine - Abstract
Background The potential benefit of methotrexate (MTX) in combination with biologic (b) and targeted synthetic (ts) disease modifying anti-rheumatic drugs (DMARDs) in psoriatic arthritis (PsA) is still a matter of debate.Objectives To compare clinical and patient reported characteristics as well as drug retention rates in PsA patients receiving b/tsDMARD monotherapy or in combination with MTX.Methods RABBIT-SpA is a prospective longitudinal cohort study including axSpA and PsA patients. In this analysis, PsA patients were stratified into two groups: starting b/tsDMARD as monotherapy or in combination with MTX. Treatment retention was compared by drug survival analysis.Results 69% of the patients (n=900) started b/tsDMARD as monotherapy while 31% were treated in combination with MTX (n=405). At baseline, clinical domains like skin, nail and joint affection, dactylitis, enthesitis and axial involvement were similar between the groups. Only the patients’ satisfaction concerning tolerability of the previous treatment was significantly better in the combination group at treatment start. Drug retention rates did not differ between the groups (p=0.4). At 6/12 months, 66%/48% of patients in monotherapy and 67%/48% in the combination group were still on their original treatment.Conclusions We did not identify any clinical parameters with notable influence on the choice of b/tsDMARD mono or MTX-combination therapy in PsA. Drug retention rates are similar between mono and combination therapy. It seems that the decision to continue MTX at initiation of b/tsDMARDs is mostly based on the subjective tolerability of MTX treatment.
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- 2024
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5. Impact of daily physical therapy over 2 weeks on spinal mobility including objective electronic measurements and function in patients with axial spondyloarthritis
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David Kiefer, Lucia Schneider, Juergen Braun, Uta Kiltz, Niklas Kolle, Ioana Andreica, Styliani Tsiami, Bjoern Buehring, Philipp Sewerin, Susanne Herbold, and Xenofon Baraliakos
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Diseases of the musculoskeletal system ,RC925-935 - Abstract
Background: Patients with axial spondyloarthritis (axSpA) are often compromised by impaired function and mobility. The standardized 2-week inpatient program ‘multimodal rheumatologic complex treatment’ (MRCT) was designed for patients with axSpA. The Epionics SPINE (ES) is an objective tool validated to assess mobility. Objective: To investigate the impact of MRCT on physical function and mobility including range of motion (RoM) and kinematics (RoK). Design: Single-center interventional, observational trial. Methods: Patients with axSpA presenting with high disease activity and impaired physical function were consecutively recruited to undergo MRCT. Assessments performed before (V1) and after (V2) the intervention included Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Bath Ankylosing Spondylitis functional index (BASFI), Bath Ankylosing Spondylitis Metrology Index (BASMI), the ankylosing spondylitis physical performance index (ASPI), the Short Physical Performance Battery (SPPB), and ES measurements. Results: At baseline, the 80 patients included had: BASDAI 5.5 ± 1.5, BASFI 5.6 ± 2.0, BASMI 4.2 ± 1.8, SPPB 13.8 ± 1.8, and ASPI 37.3 ± 18.1 s. Clinically relevant improvements between V1 versus V2 were noted for BASFI, BASMI, and all other assessments ( p 0.05). Conclusion: The 2-weeks MRCT was associated with definite improvements of function and mobility. Importantly, the effect of this extensive physical activity was confirmed by using the ES as an objective tool to assess spinal mobility. The ES demonstrated for the first time that the RoK of spinal mobility can significantly improve related to an exercise intervention. Trial registration: Ethical Committee: Ruhr-Universität (reference-number: 19-6735-BR).
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- 2024
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6. Clinically relevant differences in spinal mobility related to daytime performance in patients with axial spondyloarthritis
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Jürgen Braun, Xenofon Baraliakos, Uta Kiltz, Philipp Sewerin, David Kiefer, Ioana Andreica, Bjoern Buehring, Styliani Tsiami, Lucia Schneider, Niklas Kolle, and Susanne Herbold
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Medicine - Abstract
Objective Patients with axial spondyloarthritis (axSpA) suffer from clinical symptoms like morning stiffness and back pain. Mobility of patients with axSpA is often impaired. The aim of this study is to compare the performance of patients with axSpA regarding mobility measures including performance-based tests and objective electronic assessments with the Epionics SPINE device (ES) at different times of the day compared with healthy controls (HC).Methods Observational trial, consecutive inpatients with axSpA (n=100) and 20 HCs were examined in the morning (V1: before 10:00 am) and in the afternoon (V2: after 02:00 pm) by the Bath Ankylosing Spondylitis Metrology Index (BASMI), the AS physical performance index (ASPI), the Short Physical Performance Battery (SPPB) and ES measurements, including range of motion (RoM) and range of kinematics (RoK).Results The assessments of patients with axSpA performed in the morning clearly differed from those in the afternoon, especially regarding performance-based tests. Significant improvements were seen for BASMI (4.0±3.8 to 3.8±1.9; p
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- 2024
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7. Addressing the spread of health-related misinformation on social networks: an opinion article
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Maria Polyzou, David Kiefer, Xenofon Baraliakos, and Philipp Sewerin
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misinformation ,social networks ,health sector ,rheumatology ,COVID-19 ,Medicine (General) ,R5-920 - Abstract
This article deals with the spread of misinformation in a general context and specifically in the health sector. It presents a theoretical view of the problem and analyzes its characteristics with a focus on medicine and mainly rheumatology. Finally, conclusions from the previous analysis are formulated as well as suggestions for reducing the dimensions of the problem in the health sector.
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- 2023
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8. Musculoskeletal ultrasound as a screening-tool for rheumatoid arthritis: results of the 'Rheuma-Truck' screening and awareness initiative
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Alexander Lautwein, Benedikt Ostendorf, Stefan Vordenbäumen, Aiko Liedmann, Ralph Brinks, Mario Giulini, Sarah Ohrndorf, Marina Backhaus, Hasan Acar, Oliver Sander, Jutta G. Richter, Matthias Schneider, and Philipp Sewerin
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Musculoskeletal ultrasound ,Screening ,Rheumatoid arthritis ,Osteoarthritis ,Diseases of the musculoskeletal system ,RC925-935 ,Immunologic diseases. Allergy ,RC581-607 - Abstract
Abstract Objective To evaluate musculoskeletal ultrasound (MSUS) as a screening tool for rheumatoid arthritis (RA) and osteoarthritis (OA) patients in a rheumatology-screening program. Patients and methods To raise awareness for rheumatic diseases, a mobile rheumatology office was deployed in different cities of Germany (“Rheuma-Truck”). Standardized questionnaire assessment, testing for rheumatoid factor and citrullinated peptide antibodies and medical student driven MSUS of the clinically dominant hand/foot including wrist, MCP-II, -III, -V, PIP-II, -III, MTP-II and -V were offered free of charge to the population. In case of suspicious results, a rheumatologist was consulted. Results In MSUS, 192 of 560 selected volunteers (aged 18–89, mean 52.7 years; 72.9% female) had suspicious findings including synovitis or erosions primarily affecting the MTP-II (11.8%), dorsal wrist (8.9%), and MCP-II (7%). 354 of the 560 volunteers further visited a rheumatologist of whom 76 were diagnosed with RA. According to the ‘US7 Score’, a sum scores ≥ 5 was significantly predictive for RA (odds ratio (OR) 5.06; confidence interval (CI) 0.83–35.32). 313 volunteers displayed signs of OA including osteophytes, while MCP-II (36.2%), MCP-III (14.8%), and the wrist (10.5%) were mostly affected. Diagnosis of RA was favoured over OA if the wrist (OR 4.2; CI 1.28–13.95), MTP-II (OR 1.62; CI 1.0–2.6), and MCP-V (OR 2.0; CI 1.0–3.8) were involved. Conclusion Medical student driven MSUS by the ‘US7 Score’ can facilitate diagnosis of RA in rheumatology-screening programs due to the level of the score and the affected joints. A high rate of unknown OA signs was detected by MSUS. A mobile rheumatology office displays an opportunity to screen patients for RA and OA.
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- 2022
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9. Tofacitinib downregulates antiviral immune defence in keratinocytes and reduces T cell activation
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Heike C. Hawerkamp, Alina Domdey, Lisa Radau, Philipp Sewerin, Péter Oláh, Bernhard Homey, and Stephan Meller
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Janus kinase inhibitor ,Antiviral immunity ,Keratinocyte ,T cell ,Diseases of the musculoskeletal system ,RC925-935 - Abstract
Abstract Background Tofacitinib is a novel Janus kinase (JAK) inhibitor approved for the treatment of rheumatoid arthritis, psoriatic arthritis, and ulcerative colitis. In clinical trials, the most common adverse events observed were nasopharyngitis, upper respiratory tract infections, and zoster. JAKs are found downstream of the type II cytokine receptor family used by a number of TH17 cell-associated cytokines for signal transduction. These cytokines lead to the secretion of antiviral and antimicrobial peptides (AMPs) by keratinocytes or synoviocytes. Blocking the JAK pathway might result in a diminished secretion of antimicrobial and antiviral peptides causing higher susceptibility to infections in patients treated with JAK inhibitors. Methods We treated primary human keratinocytes and synoviocytes with tofacitinib and subsequently added various cytokines and bacterial surface proteins before evaluation of the response via RT-qPCR. CD69 expression on tofacitinib-treated PBMCs was investigated via flow cytometry. Results We found a markedly reduced gene expression of all tested antiviral peptides such as MX1 or ISG15 in keratinocytes and synoviocytes in the presence of tofacitinib in vitro. Additionally, we found that JAK inhibition reduced activation of T cells after stimulation with bacterial LPS or viral VZV gE. Conclusions The antiviral immunity is strongly inhibited in the presence of tofacitinib in vitro, while the antimicrobial immunity does not seem to be affected. In T cells, the overall activation process seems to be influenced by tofacitinib. These findings suggest that tofacitinib has an impact on antiviral immunity such as patients treated with tofacitinib often show adverse events like herpes zoster. Graphical abstract
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- 2021
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10. Editorial: Opportunities and Challenges of Digitization in Rheumatology
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Philipp Sewerin
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digitization/digitisation ,rheumatoid arthritis ,psoriatic arthritis ,systemic lupus erythematosus ,telemedical applications ,Medicine (General) ,R5-920 - Published
- 2022
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11. Achilles tendon enthesitis evaluated by MRI assessments in patients with axial spondyloarthritis and psoriatic arthritis: a report of the methodology of the ACHILLES trial
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Xenofon Baraliakos, Philipp Sewerin, Eugenio de Miguel, Effie Pournara, Christine Kleinmond, Annette Wiedon, and Frank Behrens
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Achilles tendon ,Enthesitis ,Spondyloarthritis ,PsAMRIS ,Bone erosion ,Bone oedema ,Diseases of the musculoskeletal system ,RC925-935 - Abstract
Abstract Background The currently available scoring methods for enthesitis are often measures of pain but not of inflammation at entheseal sites. The Outcome Measures in Rheumatology Clinical Trials (OMERACT) psoriatic arthritis (PsA) magnetic resonance imaging (MRI) scoring system (PsAMRIS) assesses inflammation and damage in PsA and was particularly developed for the hands. The ACHILLES trial used clinical measures for heel enthesitis in combination with MRI scoring based on PsAMRIS. Methods Patients (age ≥ 18 years) with spondyloarthritis (SpA) and PsA were included in the trial if they presented with clinical and MRI-positive heel enthesitis. MRI of the affected heel was performed at three time points: screening, Week 24 and Week 52. Inflammatory MRI findings (tendinitis, bursitis and bone marrow oedema [BME]) in the area of the Achilles tendon and/or plantar aponeurosis, periarticular inflammation of the ankle joint and heel erosion were assessed qualitatively (absent/present). In addition, BME and bone erosion were quantitatively assessed based on PsAMRIS, where their proportion was compared to the volume of the affected bone. Mean scores of BME and bone erosion quantification were calculated, and the mean composite score (based on PsAMRIS) was calculated based on the individual score of each subject for periarticular inflammation, BME and bone erosion and further extended for bursitis and tendinitis. Modifications to PsAMRIS were introduced by categorising oedema length as ≤/> 0.5 cm and locating bone erosion. Conclusions In ACHILLES, MRI was used to assess and evaluate heel enthesitis. Due to the lack of a validated scoring system for heel enthesitis at the time of ACHILLES initiation, this trial applied quantitative scoring based on PsAMRIS, with specific adaptations for the heel. Trial registration National Clinical Trial Registry, NCT02771210 . Registered 13 May 2016.
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- 2020
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12. Functional MR imaging beyond structure and inflammation—radiographic axial spondyloarthritis is associated with proteoglycan depletion of the lumbar spine
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Daniel B. Abrar, Christoph Schleich, Styliani Tsiami, Anja Müller-Lutz, Karl Ludger Radke, Neela Holthausen, Miriam Frenken, Matthias Boschheidgen, Gerald Antoch, Johanna Mucke, Philipp Sewerin, Juergen Braun, Sven Nebelung, and Xenofon Baraliakos
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Ankylosing spondylitis ,Magnetic resonance imaging ,gagCEST ,Spine ,Rheumatic diseases ,Spondyloarthropathy ,Diseases of the musculoskeletal system ,RC925-935 - Abstract
Abstract Background To compare the glycosaminoglycan (GAG) content of lumbar intervertebral disks (IVDs) of patients with ankylosing spondylitis (AS) and healthy volunteers and to investigate the association of GAG depletion and disease-related clinical and imaging features. Methods Lumbar spines of 50 AS patients (mean age 50 ± 10.5 years) and 30 age-matched volunteers were studied with 3-T magnetic resonance imaging (MRI) and conventional radiographs (CR). The MRI protocol included high-resolution morphological sequences and the compositional GAG chemical exchange saturation transfer imaging technique (gagCEST). Morphological images were analyzed by three raters for inflammatory activity, fat deposition, disk degeneration, and structural changes on CR. Clinical and serological measures included the Bath AS Disease Activity (BASDAI) and Bath AS Function (BASFI) Indices and C-reactive protein (CRP) levels. GagCEST values of both groups were compared using a linear mixed model. Kendall-Tau correlation analyses were performed. Results GagCEST values were significantly lower in AS patients (2.0 ± 1.7%) vs. healthy volunteers (2.4 ± 1.8%), p = 0.001. Small, yet significant correlations were found between gagCEST values and CRP levels (τ = − 0.14, p = 0.007), BASFI (τ = − 0.18, p
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- 2020
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13. Proteoglycan loss in the articular cartilage is associated with severity of joint inflammation in psoriatic arthritis—a compositional magnetic resonance imaging study
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Daniel B. Abrar, Christoph Schleich, Sven Nebelung, Miriam Frenken, Tim Ullrich, Karl Ludger Radke, Gerald Antoch, Stefan Vordenbäumen, Ralph Brinks, Matthias Schneider, Benedikt Ostendorf, and Philipp Sewerin
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Psoriatic arthritis ,Arthritis ,Cartilage ,Magnetic resonance imaging ,dGEMRIC ,Compositional imaging ,Diseases of the musculoskeletal system ,RC925-935 - Abstract
Abstract Background Even though cartilage loss is a known feature of psoriatic arthritis (PsA), little is known about its role in the pathogenesis of PsA. Using delayed gadolinium-enhanced magnetic resonance imaging of cartilage (dGEMRIC) as a non-invasive marker of the tissue’s proteoglycan content, such early (i.e., pre-morphological) changes have been associated with inflammation in rheumatoid arthritis (RA). Yet, this association has not been studied before in PsA. Methods The metacarpophalangeal (MCP), proximal interphalangeal (PIP), and distal interphalangeal (DIP) joints of 17 patients with active PsA were evaluated by high-resolution clinical standard morphological and dGEMRIC sequences using a 3T MRI scanner (Magnetom Skyra, Siemens) and a dedicated 16-channel hand coil. Images were analyzed by two independent raters for dGEMRIC indices, PsA MRI scores (PsAMRIS), and total cartilage thickness (TCT). Kendall tau correlation coefficients (τ) were calculated. Results We found significant negative correlations between dGEMRIC indices and total PsAMRIS (τ = − 0.5, p = 0.012), synovitis (τ = − 0.56, p = 0.006), flexor tenosynovitis (τ = − 0.4, p = 0.049), and periarticular inflammation (τ = − 0.72, p
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- 2020
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14. High-resolution MRI of flexor tendon pulleys using a 16-channel hand coil: disease detection and differentiation of psoriatic and rheumatoid arthritis
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Daniel B. Abrar, Christoph Schleich, Sven Nebelung, Miriam Frenken, Karl Ludger Radke, Stefan Vordenbäumen, Ralph Brinks, Matthias Schneider, Benedikt Ostendorf, Dennis McGonagle, and Philipp Sewerin
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Psoriatic arthritis ,Pulley ,PsAMRIS ,Enthesitis ,Rheumatoid arthritis ,Synovio-entheseal-complex ,Diseases of the musculoskeletal system ,RC925-935 - Abstract
Abstract Background To evaluate the value of 3 Tesla (T) magnetic resonance imaging (MRI) changes of flexor tendon pulleys for the differentiation of psoriatic (PsA) and rheumatoid arthritis (RA), using a novel 16-channel high-resolution hand coil. Methods Seventeen patients with active PsA, 20 patients with active RA, and 16 healthy controls (HC) underwent high-resolution 3 T MRI using the dedicated 16-channel hand coil. Images were analyzed by three independent readers for the degree of inflammatory changes, thickness of flexor tendon pulleys, and comparison to the outcome measures for RA clinical trials (OMERACT) PsA MRI score (PsAMRIS) and to its sub-scores. For correlation analyses, Spearman rho correlation was calculated. Results Flexor tendon pulleys were thicker in PsA than in RA patients (mean difference 0.16 mm, p
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- 2020
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15. Risk of psoriatic arthritis depending on age: analysis of data from 65 million people on statutory insurance in Germany
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Matthias Schneider, Ralph Brinks, Philipp Sewerin, Madeline Deike, and Stephan Meller
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Medicine - Published
- 2021
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16. Adaptive IoU Thresholding for Improving Small Object Detection: A Proof-of-Concept Study of Hand Erosions Classification of Patients with Rheumatic Arthritis on X-ray Images
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Karl Ludger Radke, Matthias Kors, Anja Müller-Lutz, Miriam Frenken, Lena Marie Wilms, Xenofon Baraliakos, Hans-Jörg Wittsack, Jörg H. W. Distler, Daniel B. Abrar, Gerald Antoch, and Philipp Sewerin
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X-ray ,imaging ,deep learning ,AI ,RetinaNet ,rheumatic arthritis ,Medicine (General) ,R5-920 - Abstract
In recent years, much research evaluating the radiographic destruction of finger joints in patients with rheumatoid arthritis (RA) using deep learning models was conducted. Unfortunately, most previous models were not clinically applicable due to the small object regions as well as the close spatial relationship. In recent years, a new network structure called RetinaNets, in combination with the focal loss function, proved reliable for detecting even small objects. Therefore, the study aimed to increase the recognition performance to a clinically valuable level by proposing an innovative approach with adaptive changes in intersection over union (IoU) values during training of Retina Networks using the focal loss error function. To this end, the erosion score was determined using the Sharp van der Heijde (SvH) metric on 300 conventional radiographs from 119 patients with RA. Subsequently, a standard RetinaNet with different IoU values as well as adaptively modified IoU values were trained and compared in terms of accuracy, mean average accuracy (mAP), and IoU. With the proposed approach of adaptive IoU values during training, erosion detection accuracy could be improved to 94% and an mAP of 0.81 ± 0.18. In contrast Retina networks with static IoU values achieved only an accuracy of 80% and an mAP of 0.43 ± 0.24. Thus, adaptive adjustment of IoU values during training is a simple and effective method to increase the recognition accuracy of small objects such as finger and wrist joints.
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- 2022
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17. Evaluation of Sodium Relaxation Times and Concentrations in the Achilles Tendon Using MRI
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Benedikt Kamp, Miriam Frenken, Lena Klein-Schmeink, Armin M. Nagel, Lena M. Wilms, Karl Ludger Radke, Styliani Tsiami, Philipp Sewerin, Xenofon Baraliakos, Gerald Antoch, Daniel B. Abrar, Hans-Jörg Wittsack, and Anja Müller-Lutz
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sodium MRI ,23Na MRI ,sodium relaxation time ,sodium concentration ,Achilles tendon ,tendon ,Biology (General) ,QH301-705.5 ,Chemistry ,QD1-999 - Abstract
Sodium magnetic resonance imaging (MRI) can be used to evaluate the change in the proteoglycan content in Achilles tendons (ATs) of patients with different AT pathologies by measuring the 23Na signal-to-noise ratio (SNR). As 23Na SNR alone is difficult to compare between different studies, because of the high influence of hardware configurations and sequence settings on the SNR, we further set out to measure the apparent tissue sodium content (aTSC) in the AT as a better comparable parameter. Ten healthy controls and one patient with tendinopathy in the AT were examined using a clinical 3 Tesla (T) MRI scanner in conjunction with a dual tuned 1H/23Na surface coil to measure 23Na SNR and aTSC in their ATs. 23Na T1 and T2* of the AT were also measured for three controls to correct for different relaxation behavior. The results were as follows: 23Na SNR = 11.7 ± 2.2, aTSC = 82.2 ± 13.9 mM, 23Na T1 = 20.4 ± 2.4 ms, 23Na T2s* = 1.4 ± 0.4 ms, and 23Na T2l* = 13.9 ± 0.8 ms for the whole AT of healthy controls with significant regional differences. These are the first reported aTSCs and 23Na relaxation times for the AT using sodium MRI and may serve for future comparability in different studies regarding examinations of diseased ATs with sodium MRI.
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- 2022
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18. The value of the simplified RAMRIS-5 in early RA patients under methotrexate therapy using high-field MRI
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Miriam Frenken, Christoph Schleich, Ralph Brinks, Daniel Benjamin Abrar, Christine Goertz, Matthias Schneider, Benedikt Ostendorf, and Philipp Sewerin
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High-field magnetic resonance imaging ,Early rheumatoid arthritis ,Prediction ,RAMRIS-5 ,RAMRIS ,Diseases of the musculoskeletal system ,RC925-935 - Abstract
Abstract Background The aim of the study was to evaluate a simplified version of the Rheumatoid Arthritis Magnetic Resonance Imaging Score (RAMRIS) for five joints of the hand (RAMRIS-5) in patients with early rheumatoid arthritis (RA) before and after the initiation of methotrexate (MTX) therapy using high-resolution, 3-T magnetic resonance imaging (MRI). Methods Twenty-eight patients with a seropositive, early RA (disease duration of less than 6 months (range 2–23 weeks)) according to 2010 American College of Rheumatology/European League Against Rheumatism (ACR/EULAR) criteria (mean age 56.8 years, range 39–74) were prospectively assessed with a baseline investigation including clinical assessment (disease activity score of 28 joints (DAS-28) and C-reactive protein (CRP)) and 3-T MRI of the clinically dominant hand. Follow-up visits were performed 3 and 6 months after initiation of a MTX therapy at baseline. MRI scans were analyzed in accordance with RAMRIS and the simplified RAMRIS-5. Results DAS-28 and CRP decreased significantly after initiation of MTX therapy. Even though erosion scores increased over time, RAMRIS and RAMRIS-5 also decreased significantly after the start of therapy. There was a strong correlation between the total RAMRIS-5 and RAMRIS at baseline (r = 0.838; P
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- 2019
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19. Digital rheumatology in the era of COVID-19: results of a national patient and physician survey
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Philipp Sewerin, Isabell Haase, Johannes Knitza, Martin Krusche, Johanna Mucke, Anna Kernder, Arnd Kleyer, Gerlinde Bendzuck, Harriet Morf, Philipp Klemm, Diana Vossen, Marco Meyer, and Sabine Eis
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Medicine - Abstract
Objective To analyse the impact of the COVID-19 pandemic on rheumatic patients’ and rheumatologists’ usage, preferences and perception of digital health applications (DHAs).Methods A web-based national survey was developed by the Working Group Young Rheumatology of the German Society for Rheumatology and the German League against Rheumatism. The prospective survey was distributed via social media (Twitter, Instagram and Facebook), QR code and email. Descriptive statistics were calculated, and regression analyses were performed to show correlations.Results We analysed the responses of 299 patients and 129 rheumatologists. Most patients (74%) and rheumatologists (76%) believed that DHAs are useful in the management of rheumatic and musculoskeletal diseases (RMDs) and felt confident in their own usage thereof (90%; 86%). 38% of patients and 71% of rheumatologists reported that their attitude had changed positively towards DHAs and that their usage had increased due to COVID-19 (29%; 48%). The majority in both groups agreed on implementing virtual visits for follow-up appointments in stable disease conditions. The most reported advantages of DHAs were usage independent of time and place (76.6%; 77.5%). The main barriers were a lack of information on suitable, available DHAs (58.5%; 41.9%), poor usability (42.1% of patients) and a lack of evidence supporting the effectiveness of DHAs (23.2% of rheumatologists). Only a minority (
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- 2021
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20. To Contrast or Not to Contrast? On the Role of Contrast Enhancement in Hand MRI Studies of Patients with Rheumatoid Arthritis
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Miriam Frenken, Gesa Rübsam, Alexander Mewes, Karl Ludger Radke, Lien Li, Lena M. Wilms, Sven Nebelung, Daniel B. Abrar, and Philipp Sewerin
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MRI ,gadolinium ,gadolinium-based MRI contrast agent ,rheumatoid arthritis ,RAMRIS ,synovitis ,Medicine (General) ,R5-920 - Abstract
Currently, clinical indications for the application of gadolinium-based contrast agents (GBCA) in magnetic resonance imaging (MRI) are increasingly being questioned. Consequently, this study aimed to evaluate the additional diagnostic value of contrast enhancement in MRI of the hand in patients with rheumatoid arthritis (RA). Thirty-one patients with RA (mean age, 50 ± 14 years (range, 18–72 years)) underwent morphologic MRI scans on a clinical 3 T scanner. MRI studies were analyzed based on (1) the Rheumatoid Arthritis Magnetic Resonance Imaging Score (RAMRIS) and (2) the GBCA-free RAMRIS version, termed RAMRIS Sine-Gadolinium-For-Experts (RAMRIS-SAFE), in which synovitis and tenosynovitis were assessed using the short-tau inversion-recovery sequence instead of the post-contrast T1-weighted sequence. The synovitis subscores in terms of Spearman’s ρ, as based on RAMRIS and RAMRIS-SAFE, were almost perfect (ρ = 0.937; p < 0.001), while the tenosynovitis subscores were less strongly correlated (ρ = 0.380 p = 0.035). Correlation between the total RAMRIS and RAMRIS-SAFE was also almost perfect (ρ = 0.976; p < 0.001). Inter-rater reliability in terms of Cohen’s κ was high (0.963 ≤ κ ≤ 0.925). In conclusion, RAMRIS-SAFE as the GBCA-free version of the well-established RAMRIS is a patient-friendly and resource-efficient alternative for assessing disease-related joint changes in RA. As patients with RA are subject to repetitive GBCA applications, non-contrast imaging protocols should be considered.
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- 2022
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21. Cartilage Degradation in Psoriatic Arthritis Is Associated With Increased Synovial Perfusion as Detected by Magnetic Resonance Imaging
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Daniel B. Abrar, Christoph Schleich, Anja Müller-Lutz, Miriam Frenken, K. Ludger Radke, Stefan Vordenbäumen, Matthias Schneider, Benedikt Ostendorf, and Philipp Sewerin
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psoriatic arthritis ,magnetic resonance imaging ,dGEMRIC ,cartilage ,compositional imaging ,Medicine (General) ,R5-920 - Abstract
Objective: Even though cartilage loss is a known feature of psoriatic arthritis (PsA), research is sparse on its role in the pathogenesis of PsA and its potential use for disease detection and monitoring. Using delayed gadolinium-enhanced magnetic resonance imaging of cartilage (dGEMRIC) and dynamic contrast-enhanced MRI (DCE MRI), research has shown that early cartilage loss is strongly associated with synovial inflammation in rheumatoid arthritis (RA). The aim of this study was to determine if acute inflammation is associated with early cartilage loss in small finger joints of patients with PsA.Methods: Metacarpophalangeal (MCP), proximal interphalangeal (PIP), and distal interphalangeal (DIP) joints of 17 patients with active PsA were evaluated by high-resolution 3 Tesla dGEMRIC and DCE MRI using a dedicated 16-channel hand coil. Semi-quantitative and quantitative perfusion parameters were calculated. Images were analyzed by two independent raters for dGEMRIC indices, PsA MRI scores (PsAMRIS), total cartilage thickness (TCT), and joint space width (JSW).Results: We found significant negative correlations between perfusion parameters (except Kep) and dGEMRIC indices, with the highest value at the MCP joints (KTrans: τ = −0.54, p = 0.01; Kep: τ = −0.02, p = 0.90; IAUC: τ = −0.51, p = 0.015; Initial Slope: τ = −0.54, p = 0.01; Peak: τ = −0.67, p = 0.002). Heterogeneous correlations were detected between perfusion parameters and both, total PsAMRIS and PsAMRIS synovitis sub-scores. No significant correlation was seen between any perfusion parameter and JSW and/or TCT.Conclusion: As examined by DCE MRI and dGEMRIC, there is a potential association between early cartilage loss and acute synovial inflammation in small finger joints of PsA patients.
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- 2020
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22. Silent progression in patients with rheumatoid arthritis: is DAS28 remission an insufficient goal in RA? Results from the German Remission-plus cohort
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Philipp Sewerin, Stefan Vordenbaeumen, Annika Hoyer, Ralph Brinks, Christian Buchbender, Falk Miese, Christoph Schleich, Sabine Klein, Matthias Schneider, and Benedikt Ostendorf
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Magnetic resonance imaging ,Rheumatoid arthritis ,RAMRIS ,Therapy monitoring ,Remission ,Silent progression ,Diseases of the musculoskeletal system ,RC925-935 - Abstract
Abstract Background Remission is arguably the ultimate therapeutic goal in rheumatoid arthritis (RA). Applying modern strategies, clinical remission can be achieved in a substantial number of patients with early RA (ERA). Even in those patients, the number and scope of erosions can increase. We, therefore, investigated the value of MRI for the detection of radiological progression in patients with DAS28 improvement and/or clinical remission of the German Remission-plus cohort. Methods Data-sets of 80 RA patients (according to 2010 ACR/EULAR criteria) from the Remission-plus study cohort, who fulfilled the following criteria, were retrospectively analysed: availability of two consecutive MRI scans (low-field MRI, follow-up interval 1 year) of the clinically dominant hand and wrist, and the presence of DAS28 (CRP) scores at both time points, which was used to assess disease activity. Results Seventy-one of the 80 investigated patients presented a numerical improvement of the DAS28 (CRP) after 12 months (DAS28(CRP) T0 average (Ø) 4.96, SD 1.2; DAS28 T4 (12 month) Ø 2.6, SD 1.0), 73% of them also improved in the RAMRIS-Score, while 24% demonstrated an increase despite DAS28 improvement and 3% showed equal values. 48% of patients who improved in the DAS28 reached EULAR remission. 41% of these patients had an increase in the RAMRIS Erosion-subscore after 12 months. When considering EULAR response criteria (non-response (n = 7), moderate response (n = 19), good response (n = 45)), an increase of erosions was found in 71.4% of non-responders, 52.6% of moderate responders, and 31.1% of good responders after 12 months, all compared to baseline. Conclusion Up to 40% of patients in this study demonstrated a progressive erosive disease detected by MRI despite DAS28 improvement or EULAR remission. Future studies are needed to determine the prognostic clinical impact of disease progression in MRI despite clinical remission, and to investigate if DAS28 remission may be an insufficient therapeutic goal and should be accompanied by MRI remission criteria.
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- 2017
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23. DGEMRIC in the Assessment of Pre-Morphological Cartilage Degeneration in Rheumatic Disease: Rheumatoid Arthritis vs. Psoriatic Arthritis
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Daniel B. Abrar, Christoph Schleich, Miriam Frenken, Stefan Vordenbäumen, Jutta Richter, Matthias Schneider, Benedikt Ostendorf, Sven Nebelung, and Philipp Sewerin
- Subjects
psoriatic arthritis ,rheumatoid arthritis ,cartilage ,magnetic resonance imaging ,dGEMRIC ,compositional imaging ,Medicine (General) ,R5-920 - Abstract
Background: Even though cartilage loss is a known feature of psoriatic (PsA) and rheumatoid arthritis (RA), research is sparse on its role in the pathogenesis of PsA, its potential use for disease monitoring and for differentiation from RA. We therefore assessed the use of delayed gadolinium-enhanced magnetic resonance imaging of cartilage (dGEMRIC) to evaluate biochemical cartilage changes in metacarpophalangeal (MCP) and proximal interphalangeal (PIP) joints in PsA patients and compared these to RA patients. Materials and Methods: A total of 17 patients with active PsA and 20 patients with active RA were evaluated by high-resolution 3 Tesla dGEMRIC using a dedicated 16-channel hand coil. Images were analyzed by two independent raters for dGEMRIC indices and joint space width (JSW) at MCP and PIP joint levels. Results: No significant differences of dGEMRIC values could be found between both study populations (PsA 472.25 ms, RA 461.11 ms; p = 0.763). In all RA and most PsA patients, PIP joints showed significantly lower dGEMRIC indices than MCP joints (RA: D2: p = 0.009, D3: p = 0.008, D4: p = 0.002, D5: p = 0.002; PsA: D3: p = 0.001, D4: p = 0.004). Most joint spaces had similar widths in both disease entities and no significant differences were found. Conclusions: As evaluated by dGEMRIC, the molecular composition of the MCP and PIP joint cartilage of PsA patients is similar to that of RA patients, demonstrating the scientific and clinical feasibility of compositional magnetic resonance (MR) imaging in these disease entities. Patterns and severity of compositional cartilage degradation of the finger joints may therefore be assessed beyond mere morphology in PsA and RA patients.
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- 2021
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24. Introduction of a Simplified Psoriatic Arthritis Magnetic Resonance Imaging Score (sPsAMRIS): A Potential Tool for Treatment Monitoring in Peripheral Psoriatic Arthritis
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Daniel B. Abrar, Christoph Schleich, Ralph Brinks, Christine Goertz, Miriam Frenken, Matthias Schneider, Sven Nebelung, and Philipp Sewerin
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psoriatic arthritis ,PsAMRIS ,magnetic resonance imaging ,OMERACT ,Medicine (General) ,R5-920 - Abstract
Background: To evaluate whether a simplified (s) version of the psoriatic arthritis magnetic resonance imaging score (PsAMRIS), sPsAMRIS, is a potential tool for therapy monitoring in psoriatic arthritis (PsA). Methods: Seventeen patients with active psoriatic arthritis (PsA) underwent magnetic resonance imaging (MRI) at 3 T of the clinically dominant hand at baseline and after 6 months. Scoring was performed by two musculoskeletal radiologists in terms of the PsAMRIS and sPsAMRIS, which is a simplified version with reduced item numbers based on prior evaluation of responsiveness to change by standardized response means (SRMs). Both scores were compared by calculation of overall and each sub-score’s SRMs and relative efficacy (RE) after bootstrapping. Results: PsAMRIS sub-scores of MCP joints 3 and 4, and proximal interphalangeal (PIP) joint 4 had the highest SRM (−0.07 each), indicating highest responsiveness to change, and were, therefore, included in sPsAMRIS. Compared to PsAMRIS, sPsAMRIS was characterized by higher SRMs (sPsAMRIS: −0.13 vs. PsAMRIS: −0.02) and higher RE (29.46). sPsAMRIS and PsAMRIS were highly correlated at baseline (r = 0.75, p < 0.01 (Pearson’s correlation)) and at 6-month follow-up (r = 0.64, p = 0.01). Mean time burden for completion of scoring per MRI study was significantly reduced when using PsAMRIS (469 ± 87.03 s) as compared to sPsAMRIS (140.1 ± 21.25 s) (p < 0.001). Conclusion: Due to its similar responsiveness to change compared to standard PsAMRIS, and time efficiency, sPsAMRIS might be a potential diagnostic tool to quantitatively assess and monitor therapy in PsA.
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- 2020
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25. Praktikable Sjögren-Diagnostik bei interstitieller Lungenerkrankung – ein Diskussionsbeitrag
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Martin Aringer, Dirk Koschel, Thomas Dörner, Philipp Sewerin, Antje Prasse, and Torsten Witte
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Rheumatology - Abstract
ZusammenfassungDas Sjögren-Syndrom (SjS) stellt eine mögliche autoimmune Ursache einer interstitiellen Lungenerkrankung dar. Die Abklärung in Richtung SjS ist aber im Vergleich zu anderen systemischen Autoimmunerkrankungen bisher kaum standardisiert. Die subjektive Sicca-Symptomatik, die Anti-SS-A/Ro-Antikörper und selbst die ANA-Diagnostik als Suchtest haben alle relevante Einschränkungen in ihrer Sensitivität und/oder Spezifität. Vor diesem Hintergrund haben wir in einer interdisziplinären Diskussion einen Konsens für die SjS-Abklärung entwickelt, den wir hier für die breitere Diskussion vorstellen. Neben ANA sollten sowohl Anti-SS-A/Ro-Antikörper als auch Antikörper gegen α‑Fodrin bestimmt werden. Wichtig ist die Objektivierung der Trockenheit mittels Schirmer- und Saxon-Test und bei fehlenden typischen Autoantikörpern die Speicheldrüsenbiopsie.
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- 2023
26. Leitfaden soll Unterstützung bei Verwendung von gendergerechter Sprache bieten
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Isabell Haase, Sarah Ohrndorf, Xenofon Baraliakos, Eugen Feist, Bimba Hoyer, Uta Kiltz, Michaela Köhm, Martin Krusche, Philipp Sewerin, Anna Voormann, and Johanna Mucke
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Rheumatology - Published
- 2023
27. High Frequency of Osteophytes Detected by High Resolution Ul-Trasound at the Finger Joints of Asymptomatic Factory Workers
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Mario Giulini, Ralph Brinks, Stefan Vordenbäumen, Hasan Acar, Jutta G Richter, Christian Feldhaus, Xenofon Baraliakos, Benedikt Ostendorf, Matthias Schneider, Oliver Sander, and Philipp Sewerin
- Abstract
Osteoarthritis of the hand (HOA) is one of the most common musculoskeletal diseases affecting health. Osteophytes, documented by imaging procedures are often used as diagnostic criteria. The gold standard is the radiographic image, however, more sensitive and saver methods such as ultrasound are gaining in importance. We investigated the prevalence, grade and pattern of osteophytes by high resolution ultrasound investigation (US) in a population-based cross-sectional study. Factory workers were recruited at work. 26 finger joints of each participant were examined with US with grading the occurrence of osteophytes in a semiquantitative score ranging 0-3, increasing scores indicated larger osteophytes. 427 participants (mean age 53.5 years, range. 20-79 years) were investigated, resulting in 11,000 scored joints. At least one osteophyte was found in 4,546/11,000 (41.3%) joints or 426/427 (99.8%) participants but grade 2 or 3 osteophytes were seen in only 553 (5.0%) joints. The number of os-teophyte sum score increased with age (0.18/year of age increase, p
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- 2023
28. Digital Rheumatology
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Johannes Knitza, Martin Krusche, and Philipp Sewerin
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- 2023
29. Nutzung und Adhärenz digitaler Angebote durch Patienten und Ärzte – unter Berücksichtigung des Alters
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Manuel Grahammer and Philipp Sewerin
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General Medicine - Abstract
ZUSAMMENFASSUNGDie Digitalisierung des deutschen Gesundheitswesens schreitet stetig voran. Vielfältige digitale Gesundheitsangebote stehen dabei für verschiedene Indikationen und immer mehr Gruppen an Nutzer*innen zur Verfügung. Vermehrt wird sich daher mit der Adhärenz bei solchen digitalen Technologien auseinandergesetzt, die man als effektive Nutzung einer digitalen Anwendung oder Technologie gemäß den Vorgaben und Anleitungen der Hersteller*innen definieren kann. Diese digitale Adhärenz wird von einer Vielzahl an Faktoren beeinflusst. Betrachtet man insbesondere das Alter der Nutzer*innen, so zeigt sich, dass dieser Faktor weder einen generell-negativen noch generell-positiven signifikanten Einfluss auf die Adhärenz hat. Für eine hohe Adhärenz ist es wichtig, dass Entwickler*innen digitale Technologien nutzerorientiert konzipieren und die individuellen Bedürfnisse einzelner Nutzer*innen berücksichtigen. Aktuelle Forschung in der Rheumatologie beschäftigt sich ebenfalls mit digitalen Gesundheitsangeboten, in denen großes Potenzial für eine bessere und effizientere Versorgung liegt, sowie mit der Adhärenz dieser Angebote. Dabei zeigt sich eine große Bereitschaft zur Nutzung digitaler Technologien, unter anderem auch bei älteren Nutzer*innen. Dieser Artikel gibt einen Überblick über Nutzung und Adhärenz digitaler Gesundheitsangebote unter besonderer Berücksichtigung des Alters der Nutzer*innen und betrachtet die Implikationen für die Rheumatologie als Fachbereich.
- Published
- 2022
30. Patients’ awareness towards physical activity in the treatment of axial spondyloarthritis
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David Kiefer, Juergen Braun, Uta Kiltz, Niklas Kolle, Lucia Schneider, Ioana Andreica, Bjoern Buehring, Philipp Sewerin, Susanne Herbold, and Xenofon Baraliakos
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Rheumatology - Published
- 2023
31. Perioperativer Umgang mit der Therapie von Patienten mit entzündlich rheumatischen Erkrankungen
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Katinka Albrecht, Denis Poddubnyy, Jan Leipe, Philipp Sewerin, Christof Iking-Konert, Roger Scholz, and Klaus Krüger
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Rheumatology - Published
- 2021
32. Akzeptanz der Videosprechstunde unter Patienten/innen mit entzündlich rheumatischen Erkrankungen ist geschlechts- und ortsabhängig – Ergebnisse einer Online-Umfrage unter Patienten/innen und Ärzten/innen
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Sabine Eis, Anna Kernder, Philipp Sewerin, Arnd Kleyer, Johanna Mucke, Philipp Klemm, Diana Vossen, Isabell Haase, Marco Meyer, Harriet Morf, Johannes Knitza, Martin Krusche, and Gerlinde Bendzuck
- Subjects
Gynecology ,medicine.medical_specialty ,Rheumatology ,business.industry ,Medicine ,business - Abstract
Um die Telemedizin erfolgreich in den rheumatologischen Alltag zu integrieren, sind sowohl die Patienten- als auch Arztperspektive wichtig. Hierzu wurde eine ausfuhrliche Studie mittels webbasierter Umfrage durch die Arbeitsgemeinschaft Junge Rheumatologie der Deutschen Gesellschaft fur Rheumatologie (DGRh) und die Deutsche Rheuma-Liga Bundesverband e. V. durchgefuhrt. Mittels Subgruppenanalyse der Daten im Hinblick auf die Videosprechstunde galt es nun herauszufinden, welche Anforderungen und Wunsche unter den Patienten/innen und Arzte/innen an die Videosprechstunde gestellt wurden. Die prospektive Umfrage wurde uber die sozialen Medien, QR-Code und E‑Mail verteilt. Es wurden deskriptive Statistiken und Regressionsanalysen in Bezug auf die Videosprechstunde durchgefuhrt und Korrelationen aufgezeigt. Die Daten zeigen eine positive Einstellung zur Videosprechstunde sowohl aufseiten der Patienten/innen (n = 299) als auch der Rheumatologen/innen (n = 129) auf. Eine Korrelation zwischen Alter und positiver Meinung zur Videosprechstunde zeigte sich unter den Patienten/innen (r = 0,161, p = 0,006), insbesondere bei den weiblichen Patienten fand sich mit zunehmendem Alter ein positiver Zuspruch fur die Videosprechstunde (r = 0,244, p
- Published
- 2021
33. [Guidelines 'Gender-neutral language in the German Society for Rheumatology (DGRh e.V.)']
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Isabell, Haase, Sarah, Ohrndorf, Xenofon, Baraliakos, Eugen, Feist, Bimba, Hoyer, Uta, Kiltz, Michaela, Köhm, Martin, Krusche, Philipp, Sewerin, Anna, Voormann, and Johanna, Mucke
- Subjects
Rheumatology ,Germany ,Humans ,Societies, Medical ,Language - Published
- 2022
34. Wichtige Differenzialdiagnosen von Mon- und Oligoarthritiden
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Anna Kernder and Philipp Sewerin
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Anamnesis ,medicine.medical_specialty ,Oligoarthritis ,medicine.diagnostic_test ,business.industry ,Physical examination ,General Medicine ,medicine.disease ,Crystal arthropathy ,Medicine ,Synovial fluid ,Reactive arthritis ,Septic arthritis ,Radiology ,Differential diagnosis ,business - Abstract
Reasons of mon- and oligoarthritis are heterogeneous. The diagnostic approach includes a detailed medical anamnesis, physical examination and imaging (conventional X-ray, sonography, MRI and, CT). Analysis of the synovial fluid is required in suspected septic arthritis and frequently helps in diagnosis and differential diagnosis of crystal arthropathies. Dual-energy-CT (DECT) detects sodium urate crystals and can replace joint puncture in some cases. In addition to crystal arthropathies and septic arthritis, differential diagnosis of mon-/oligoarthritis includes reactive arthritis, arthrosis and monarthritic courses of SpA/PsA. A rheumatologist should be consulted particularly in the case of persistent monarthritides, in order to initiate a specific therapy to prevent secondary damage.
- Published
- 2021
35. Real-World Treatment Persistence with Biologic Disease-Modifying Antirheumatic Drugs Among German Patients with Psoriatic Arthritis—A Retrospective Database Study
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Matthias Schneider, K. Borchert, Dominic Meise, Philipp Sewerin, and Jörg Mahlich
- Subjects
medicine.medical_specialty ,business.industry ,Hazard ratio ,medicine.disease ,Lower risk ,Golimumab ,Infliximab ,Discontinuation ,Persistence ,Regimen ,Psoriatic arthritis ,Rheumatology ,Biologic disease-modifying antirheumatic drugs ,Germany ,Internal medicine ,Ustekinumab ,medicine ,Immunology and Allergy ,business ,Original Research ,medicine.drug - Abstract
Introduction To investigate drug survival for biologic disease-modifying antirheumatic drugs (bDMARDs) in a real-world cohort of German adult biologic-naïve patients with psoriatic arthritis (PsA). Methods Claims data for patients with a diagnosis of PsA, a bDMARD claims record (index date) between 1 January 2014 and 31 December 2017, and no bDMARD prescription for 365 days before the index date were retrospectively analyzed. The primary outcomes were the overall and individual bDMARD persistence rates over 12 months. Nonpersistence was defined as a treatment gap exceeding the days of supply plus 60 days or switching to a bDMARD other than the index therapy. Sensitivity analysis was performed, wherein the treatment gap was found to vary depending on the bDMARD regimen. Kaplan–Meier curves were plotted to determine persistence; the log-rank test was used to evaluate differences in the persistence rate. Factors associated with treatment discontinuation were evaluated using Cox regression analysis. Results Among 10,954 patients with a PsA diagnosis, 348 were eligible. The overall bDMARD persistence rate was 57.5%; individual bDMARD persistence rates were 81.3% for ustekinumab, 66.7% for infliximab, and 60.0% for golimumab. The mean (SD) overall persistence with bDMARDs was 289 (103) days; the mean persistence was 334 (72) days for ustekinumab, 309 (82) days for golimumab, and 305 (92) days for infliximab. The main reasons for nonpersistence were switching to another bDMARD (15.8%) and treatment discontinuation (26.7%). Male gender was significantly associated with a lower risk of treatment discontinuation (hazard ratio 0.54, 95% confidence interval 0.39–0.77; P
- Published
- 2021
36. Leitbild der Rheumatologinnen und Rheumatologen in der Deutschen Gesellschaft für Rheumatologie e. V. (DGRh e. V.)
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Jörg Wendler, Martin Aringer, D. Meyer‑Olson, Philipp Sewerin, Bimba F. Hoyer, Andreas Krause, J. Braun, Ch. Specker, H.-M. Lorenz, Matthias F. Schneider, Johanna Mucke, M. Rudwaleit, Hendrik Schulze-Koops, S. Späthling-Mestekemper, A. Voormann, and Ulf Wagner
- Subjects
Rheumatology ,business.industry ,Medicine ,business ,Humanities - Published
- 2020
37. Leitfaden 'Geschlechtergerechte Sprache in der DGRh e. V.'
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Isabell Haase, Sarah Ohrndorf, Xenofon Baraliakos, Eugen Feist, Bimba Hoyer, Uta Kiltz, Michaela Köhm, Martin Krusche, Philipp Sewerin, Anna Voormann, and Johanna Mucke
- Subjects
Rheumatology - Published
- 2022
38. A serial multiparametric quantitative magnetic resonance imaging study to assess proteoglycan depletion of human articular cartilage and its effects on functionality
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Tobias, Hafner, Justus, Schock, Manuel, Post, Daniel Benjamin, Abrar, Philipp, Sewerin, Kevin, Linka, Matthias, Knobe, Christiane, Kuhl, Daniel, Truhn, and Sven, Nebelung
- Subjects
Cartilage, Articular ,Male ,Knee Joint ,Functional magnetic resonance imaging ,lcsh:Medicine ,Article ,Biomaterials ,Medical research ,Magnetic resonance imaging ,Image Processing, Computer-Assisted ,Humans ,Arthroplasty, Replacement, Knee ,lcsh:Science ,Technik [600] ,Aged ,Aged, 80 and over ,Musculoskeletal system ,lcsh:R ,Middle Aged ,Osteoarthritis, Knee ,Biomechanical Phenomena ,Experimental models of disease ,Female ,Proteoglycans ,lcsh:Q ,Collagen ,ddc:600 - Abstract
Scientific reports 10, 15106 (2020). doi:10.1038/s41598-020-72208-y, Published by Macmillan Publishers Limited, part of Springer Nature, [London]
- Published
- 2020
39. Differentiating rheumatoid and psoriatic arthritis: a systematic analysis of high-resolution magnetic resonance imaging features—preliminary findings
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Daniel Benjamin Abrar, Ralph Brinks, Philipp Sewerin, Christine Goertz, Sven Nebelung, Christoph Schleich, and Matthias Schneider
- Subjects
medicine.medical_specialty ,030218 nuclear medicine & medical imaging ,Arthritis, Rheumatoid ,Metacarpophalangeal Joint ,03 medical and health sciences ,Psoriatic arthritis ,0302 clinical medicine ,Synovitis ,Internal medicine ,medicine ,Humans ,Scientific Article ,Radiology, Nuclear Medicine and imaging ,Rheumatoid arthritis ,PsAMRIS ,030203 arthritis & rheumatology ,medicine.diagnostic_test ,business.industry ,Arthritis, Psoriatic ,Magnetic resonance imaging ,Metacarpophalangeal joint ,Odds ratio ,medicine.disease ,Magnetic Resonance Imaging ,Rheumatology ,medicine.anatomical_structure ,Orthopedic surgery ,Radiology ,RAMRIS ,business ,MRI - Abstract
Background Because of overlapping phenotypical presentations, the diagnostic differentiation of rheumatoid arthritis (RA) and psoriatic arthritis (PsA) remains challenging. Thus, this study aimed to examine the diagnostic value of distinct imaging features obtained by high-resolution 3-T MRI for the diagnostic differentiation. Materials and methods Seventeen patients with PsA and 28 patients with RA were imaged at high resolution using 3-T MRI scanners and a dedicated 16-channel hand coil. All images were analyzed according to the outcome measures in rheumatology clinical trials’ (OMERACT) RAMRIS (Rheumatoid Arthritis Magnetic Resonance Imaging Score) and PsAMRIS (Psoriatic Arthritis Magnetic Resonance Imaging Score) for the presence and intensity of synovitis, flexor tenosynovitis, bone edema, bone erosion, periarticular inflammation, bone proliferation, and joint space narrowing. Next, odds ratios (OR) were calculated to determine the strength of the associations between these imaging features, demographic characteristics, and the outcome RA vs. PsA. Results PsA could be differentiated from RA by extracapsular inflammatory changes (PsAMRIS sub-score “periarticular inflammation”), with low odds for the presence of RA (OR of 0.06, p Conclusion High-resolution imaging is beneficial for the identification of relevant imaging features that may assist the clinical differentiation of inflammatory conditions of the hand. At the MCP level, extracapsular inflammatory changes were strongly associated with PsA and may consequently allow the imaging differentiation of PsA and RA.
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- 2020
40. Management der frühen rheumatoiden Arthritis
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S Heberger, Uta Kiltz, Matthias Schneider, C. Weseloh, Ch. Specker, Philipp Sewerin, O Funken, J Langhorst, S. Seitz, R Tholen, G Baseler, P Klose, B Richter, R. Oltman, Wilfried Mau, Klaus Krüger, and Michael Witthöft
- Subjects
medicine.medical_specialty ,Rheumatology ,business.industry ,medicine ,MEDLINE ,Arthritis ,Guideline ,Early rheumatoid arthritis ,medicine.disease ,Intensive care medicine ,business - Published
- 2020
41. Aktuelle Handlungsempfehlungen der Deutschen Gesellschaft für Rheumatologie für die Betreuung von Patienten mit rheumatischen Erkrankungen während der SARS-CoV‑2/Covid 19-Pandemie
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Jan Leipe, Philipp Sewerin, Andreas Krause, H.-M. Lorenz, Klaus Krüger, Julia U Holle, Matthias Schneider, Gerd-Rüdiger Burmester, U. Wager, Frank Moosig, C. Iking-Konert, P. M. Aries, Bimba F. Hoyer, Ch. Specker, C. Fiehn, A. Voormann, and Hendrik Schulze-Koops
- Subjects
030203 arthritis & rheumatology ,Gynecology ,03 medical and health sciences ,medicine.medical_specialty ,0302 clinical medicine ,Rheumatology ,business.industry ,medicine ,030212 general & internal medicine ,business - Abstract
In der aktuellen SARS-CoV-2 Pandemie bestehen viele Fragen mit Blick auf die sichere Behandlung von Patienten mit entzundlich-rheumatischen Erkrankungen. Auf viele dieser Fragen gibt es zur Zeit noch keine evidenzbasierte Antwort und das macht die Betreuung der Patienten nicht leicht. Die Deutsche Gesellschaft fur Rheumatologie e. V. (DGRh) will mit diesen ersten Empfehlungen Hilfestellung fur spezielle Belange in der Betreuung von Rheumapatienten angesichts der aktuellen Bedrohung durch SARS-CoV-2 geben. Um den dynamischen weltweiten Erkenntnisgewinn fur unsere Patienten zu nutzen, werden die Empfehlungen regelmasig aktualisiert. Die aktualisierten Versionen der Empfehlungen werden auf der Homepage der DGRh hinterlegt.
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- 2020
42. Kardinalsymptome entzündlich-rheumatischer Erkrankungen
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Johanna Mucke, Hendrik Schulze-Koops, Philipp Sewerin, and Matthias Schneider
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Gynecology ,03 medical and health sciences ,medicine.medical_specialty ,0302 clinical medicine ,business.industry ,Medicine ,030212 general & internal medicine ,General Medicine ,030204 cardiovascular system & hematology ,business - Abstract
Fur die Prognose entzundlich-rheumatischer Erkrankungen ist es wichtig, diese fruhzeitig zu erkennen und zu behandeln. In der nachfolgenden Ubersicht werden Symptome aufgelistet, die auf diese Erkrankungen hinweisen. Die Auswahl erfolgt dabei nach dem Kriterium „was wird haufig ubersehen“.
- Published
- 2020
43. Efficacy and safety of secukinumab in patients with spondyloarthritis and enthesitis at the Achilles tendon: Results from a phase 3b trial
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Y. Patel, Eva Dokoupilova, Eugenio de Miguel, A. Wiedon, Anastas Batalov, Xenofon Baraliakos, Philipp Sewerin, Claudia Jentzsch, Ankita Shekhawat, Frank Behrens, Christine Kleinmond, Effie Pournara, and Publica
- Subjects
Adult ,medicine.medical_specialty ,IL-17 inhibitor ,Heel ,Adolescent ,Enthesopathy ,Antibodies, Monoclonal, Humanized ,Placebo ,Achilles Tendon ,03 medical and health sciences ,Psoriatic arthritis ,0302 clinical medicine ,Rheumatology ,Tendinitis ,Internal medicine ,Spondylarthritis ,medicine ,Clinical endpoint ,Humans ,Pharmacology (medical) ,biologics ,pain ,030212 general & internal medicine ,Inflammation ,030203 arthritis & rheumatology ,Achilles tendon ,bone marrow oedema ,business.industry ,Enthesitis ,spondyloarthritis ,medicine.disease ,heel enthesitis ,3. Good health ,medicine.anatomical_structure ,Achilles tendon enthesitis ,Secukinumab ,imaging outcomes ,medicine.symptom ,business - Abstract
Objective ACHILLES aimed to demonstrate efficacy of secukinumab on Achilles’ tendon enthesitis in spondyloarthritis (SpA) patients. Methods Patients ≥18 years (n = 204) with active PsA or axial SpA and heel enthesitis were randomized 1:1 to secukinumab 150/300 mg or placebo up to week 24, and thereafter placebo patients were switched to secukinumab. Results At week 24, a higher, yet statistically non-significant (P = 0.136), proportion of patients in secukinumab vs placebo reported resolution of Achilles tendon enthesitis in affected foot (42.2% vs 31.4%; odds ratio [OR] = 1.63; 95% CI: 0.87, 3.08). Proportion of patients reporting resolution of enthesitis based on Leeds Enthesitis Index was higher with secukinumab vs placebo (33.3% vs 23.5%; OR = 1.65; 95% CI: 0.85, 3.25) at week 24. Mean change from baseline in heel pain at week 24 was higher in secukinumab patients vs placebo (−2.8 [3.0] vs −1.9 [2.7]). Greater improvements with secukinumab were observed in heel enthesopathy activity and global assessment of disease activity. Imaging evaluation by local reading confirmed heel enthesitis on MRI at screening for all patients. Based on central reading, 56% presented with bone marrow oedema and/or tendinitis; according to Heel Enthesitis MRI Scoring System (HEMRIS) post hoc analysis, 76% had signs of entheseal inflammation while 86% had entheseal inflammation and/or structural changes. Conclusion A substantial proportion of patients showed no signs of inflammation on the centrally read MRIs despite a clinical diagnosis of heel enthesitis, thus highlighting that the discrepancy between the clinical and imaging assessments of enthesitis requires further investigation. Although ACHILLES did not meet the primary end point, the study reported clinically meaningful improvements in patient-related outcomes. Trial registration clinicaltrials.gov, NCT02771210
- Published
- 2022
44. Perioperative management of patients with inflammatory rheumatic diseases : Updated recommendations of the German Society for Rheumatology
- Author
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Katinka Albrecht, Denis Poddubnyy, Jan Leipe, Philipp Sewerin, Christof Iking-Konert, Roger Scholz, and Klaus Krüger
- Subjects
Rheumatology - Abstract
Prior to surgical interventions physicians and patients with inflammatory rheumatic diseases remain concerned about interrupting or continuing anti-inflammatory medication. For this reason, the German Society for Rheumatology has updated its recommendations from 2014.After a systematic literature search including publications up to 31 August 2021, the recommendations on the use of of glucocorticoids, conventional synthetic disease-modifying antirheumatic drugs (csDMARDs) and biologics (bDMARDs) were revised and recommendations on newer drugs and targeted synthetic (ts)DMARDs were added.The glucocorticoid dose should be reduced to as low as possible 2-3 months before elective surgery (in any case10 mg/day) but should be kept stable 1-2 weeks before and on the day of surgery. In many cases csDMARDs can be continued, exceptions being a reduction of high methotrexate doses to ≤15 mg/week and wash-out of leflunomide if there is a high risk of infection. Azathioprine, mycophenolate and ciclosporin should be paused 1-2 days prior to surgery. Under bDMARDs surgery can be scheduled for the end of each treatment interval. For major interventions Janus kinase (JAK) inhibitors should be paused for 3-4 days. Apremilast can be continued. If interruption is necessary, treatment should be restarted as soon as possible for all substances, depending on wound healing.Whether bDMARDs increase the perioperative risk of infection and the benefits and risks of discontinuation remain unclear based on the currently available evidence. To minimize the risk of a disease relapse under longer treatment pauses, in the updated recommendations the perioperative interruption of bDMARDs was reduced from at least two half-lives to one treatment interval.HINTERGRUND: Vor operativen Eingriffen stellt sich Ärzten und Patienten mit entzündlich rheumatischen Erkrankungen weiterhin die Frage nach einer Unterbrechung oder Fortsetzung der entzündungshemmenden Medikation. Die Deutsche Gesellschaft für Rheumatologie hat hierfür ihre Empfehlungen von 2014 aktualisiert.Nach einer systematischen Literaturrecherche mit Einschluss von Publikationen bis zum 31.08.2021 wurden die Empfehlungen zum Umgang mit Glukokortikoiden, konventionell synthetischen „disease-modifying antirheumatic drugs“ (csDMARDs) und Biologika (bDMARDs) überarbeitet und Empfehlungen zu neueren Substanzen und „targeted synthetic (ts) DMARDs“ ergänzt.Die Glukokortikoiddosis sollte 2 bis 3 Monate vor elektiven Eingriffen so niedrig wie möglich reduziert (in jedem Fall10 mg/Tag), 1 bis 2 Wochen vor und am Operationstag jedoch stabil gehalten werden. csDMARDs können in vielen Fällen fortgeführt werden, Ausnahmen sind eine Reduktion hoher Methotrexat-Dosierungen auf ≤15 mg/Woche und Auswaschen des Leflunomid bei hohem Infektionsrisiko. Azathioprin, Mycophenolat und Ciclosporin sollten 1 bis 2 Tage vor der Operation pausiert werden. Unter bDMARDs können Operationen zum Ende des jeweiligen Therapieintervalls geplant werden. Januskinase(JAK)-Inhibitoren sollten bei größeren Eingriffen für 3 bis 4 Tage pausiert werden. Apremilast kann fortgeführt werden. Bei notwendiger Unterbrechung gilt für alle Substanzen, die Therapie in Abhängigkeit der Wundheilung baldmöglichst wieder zu beginnen.Ob bDMARDs das Infektionsrisiko perioperativ erhöhen und welche Rolle die Absetzzeit dabei spielt, bleibt bei gegenwärtiger Evidenz noch unklar. Um das Risiko eines Krankheitsschubs unter längerer Therapiepause zu minimieren, wurde in den aktualisierten Empfehlungen die perioperative Pausierung von bDMARDs von mindestens 2 Halbwertszeiten auf ein Therapieintervall reduziert.
- Published
- 2021
45. Rheumatology in 2049: the age of all data
- Author
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Johanna Mucke, Philipp Sewerin, and Matthias Schneider
- Subjects
030203 arthritis & rheumatology ,0301 basic medicine ,Favourite ,Health professionals ,business.industry ,Immunology ,Health services research ,Disease ,medicine.disease ,General Biochemistry, Genetics and Molecular Biology ,Every Morning ,03 medical and health sciences ,030104 developmental biology ,0302 clinical medicine ,Rheumatology ,Health care ,medicine ,Immunology and Allergy ,Medical emergency ,business ,Disease manifestation - Abstract
> If you think about the unthinkable long enough it becomes quite reasonable. > > Josephine Tey (1896–1952)British author Have you ever thought about what our life as specialists for rheumatic diseases will look like in 2049? The amount of data gathered from us and our patients is increasing exponentially, and eventually, these data will be used to improve and facilitate patient’s care. We, that means primarily rheumatologists and—as the responsibilities will also change with all data —all other health professionals involved in the care of patients with rheumatic diseases, should know what to expect and actively contribute to this process. It is 10:00 on a sunny 21 July in 2049 and you are currently at your most favourite place in the world: a small cottage in the mountains, a vineyard in France or your house with a breath-taking view of the sea. You just finished your morning round on your virtual ward and a glimpse at your computer shows that 99% of the 50 000 customers in your virtual practice do not have any complaints and are enjoying their life without health-related limitations. In fact, most of them have never even had any symptoms as they were diagnosed before disease manifestation and preventive measures have successfully been applied. Like every morning, the system reports a few patients that deviate from their normal status. In some patients, the system has already adapted or changed therapy or has given behavioural advice. Most patients do not need any further adjustments. The system has identified two customers who need personal assessment in your virtual clinic, and therefore, an appointment has already been made. Other patients are still on your agenda for the virtual expert meeting this afternoon, as they do not fit into the known disease entities or treatment standards. Your avatar will present these complex cases to the other …
- Published
- 2021
46. [Perioperative management of treatment of patients with inflammatory rheumatic diseases : Updated recommendations of the German Society of Rheumatology]
- Author
-
Katinka, Albrecht, Denis, Poddubnyy, Jan, Leipe, Philipp, Sewerin, Christof, Iking-Konert, Roger, Scholz, and Klaus, Krüger
- Subjects
Biological Products ,Methotrexate ,Rheumatology ,Antirheumatic Agents ,Rheumatic Diseases ,Practice Guidelines as Topic ,Humans - Abstract
Prior to surgical interventions physicians and patients with inflammatory rheumatic diseases remain concerned about interrupting or continuing anti-inflammatory medication. For this reason, the German Society for Rheumatology has updated its recommendations from 2014.After a systematic literature search including publications up to 31 August 2021, the recommendations on the use of of glucocorticoids, conventional synthetic disease-modifying antirheumatic drugs (csDMARDs) and biologics (bDMARDs) were revised and recommendations on newer drugs and targeted synthetic (ts)DMARDs were added.The glucocorticoid dose should be reduced to as low as possible 2-3 months before elective surgery (in any case10 mg/day) but should be kept stable 1-2 weeks before and on the day of surgery. In many cases csDMARDs can be continued, exceptions being a reduction of high methotrexate doses to ≤15 mg/week and wash-out of leflunomide if there is a high risk of infection. Azathioprine, mycophenolate and ciclosporin should be paused 1-2 days prior to surgery. Under bDMARDs surgery can be scheduled for the end of each treatment interval. For major interventions Janus kinase (JAK) inhibitors should be paused for 3-4 days. Apremilast can be continued. If interruption is necessary, treatment should be restarted as soon as possible for all substances, depending on wound healing.Whether bDMARDs increase the perioperative risk of infection and the benefits and risks of discontinuation remain unclear based on the currently available evidence. To minimize the risk of a disease relapse under longer treatment pauses, in the updated recommendations the perioperative interruption of bDMARDs was reduced from at least two half-lives to one treatment interval.HINTERGRUND: Vor operativen Eingriffen stellt sich Ärzten und Patienten mit entzündlich rheumatischen Erkrankungen weiterhin die Frage nach einer Unterbrechung oder Fortsetzung der entzündungshemmenden Medikation. Die Deutsche Gesellschaft für Rheumatologie hat hierfür ihre Empfehlungen von 2014 aktualisiert.Nach einer systematischen Literaturrecherche mit Einschluss von Publikationen bis zum 31.08.2021 wurden die Empfehlungen zum Umgang mit Glukokortikoiden, konventionell synthetischen „disease-modifying antirheumatic drugs“ (csDMARDs) und Biologika (bDMARDs) überarbeitet und Empfehlungen zu neueren Substanzen und „targeted synthetic (ts) DMARDs“ ergänzt.Die Glukokortikoiddosis sollte 2 bis 3 Monate vor elektiven Eingriffen so niedrig wie möglich reduziert (in jedem Fall10 mg/Tag), 1 bis 2 Wochen vor und am Operationstag jedoch stabil gehalten werden. csDMARDs können in vielen Fällen fortgeführt werden, Ausnahmen sind eine Reduktion hoher Methotrexat-Dosierungen auf ≤15 mg/Woche und Auswaschen des Leflunomid bei hohem Infektionsrisiko. Azathioprin, Mycophenolat und Ciclosporin sollten 1 bis 2 Tage vor der Operation pausiert werden. Unter bDMARDs können Operationen zum Ende des jeweiligen Therapieintervalls geplant werden. Januskinase(JAK)-Inhibitoren sollten bei größeren Eingriffen für 3 bis 4 Tage pausiert werden. Apremilast kann fortgeführt werden. Bei notwendiger Unterbrechung gilt für alle Substanzen, die Therapie in Abhängigkeit der Wundheilung baldmöglichst wieder zu beginnen.Ob bDMARDs das Infektionsrisiko perioperativ erhöhen und welche Rolle die Absetzzeit dabei spielt, bleibt bei gegenwärtiger Evidenz noch unklar. Um das Risiko eines Krankheitsschubs unter längerer Therapiepause zu minimieren, wurde in den aktualisierten Empfehlungen die perioperative Pausierung von bDMARDs von mindestens 2 Halbwertszeiten auf ein Therapieintervall reduziert.
- Published
- 2021
47. Mission statement from rheumatologists in the German Society of Rheumatology (DGRh e. V.)
- Author
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Philipp Sewerin, A. Voormann, Jörg Wendler, M. Rudwaleit, J. Braun, Andreas Krause, Hendrik Schulze-Koops, Bimba F. Hoyer, H.-M. Lorenz, Ulf Wagner, Dirk Meyer-Olson, Matthias Schneider, S. Späthling-Mestekemper, Johanna Mucke, Ch. Specker, and Martin Aringer
- Subjects
Physician-Patient Relations ,medicine.medical_specialty ,business.industry ,education ,Medical laboratory ,language.human_language ,Rheumatology ,German ,Family medicine ,Internal medicine ,Quality of Life ,medicine ,language ,Humans ,Mission statement ,Rheumatologists ,business ,Societies, Medical - Abstract
Systemic disease demands systemic thinkers. In this mission statement we define rheumatology, describe the role of the German Society of Rheumatology and the rheumatologist's spirit to their discipline. Rheumatologists are dedicated to improving the quality of life of their acute, chronic, and rehabilitative patients on the basis of up to date evidence and strong physician-patient relations. We think, act and interact systemically, scientifically, consistently, transparently, reliably, inclusively, innovatively and enthusiastically.Bei einer systemischen Erkrankung ist systemisches Denken erforderlich. In diesem Leitbild definieren wir Rheumatologie, beschreiben die Rolle der Deutschen Gesellschaft für Rheumatologie und umschreiben den rheumatologischen „Geist“, der uns für und in unserem Fach antreibt. Rheumatologen widmen sich der Verbesserung der Lebensqualität ihrer Patienten im akuten, chronischen und Rehabilitationsstadium auf Basis der aktuellen Datenlage und einer tragfähigen Arzt-Patienten-Beziehung. Wir denken, handeln und interagieren systemisch, wissenschaftlich, konsequent, transparent, verlässlich, integrativ, innovativ und begeistert.
- Published
- 2020
48. [Acceptance of video consultation among patients with inflammatory rheumatic diseases depends on gender and location-Results of an online survey among patients and physicians]
- Author
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Diana, Vossen, Johannes, Knitza, Philipp, Klemm, Isabell, Haase, Johanna, Mucke, Anna, Kernder, Marco, Meyer, Arnd, Kleyer, Philipp, Sewerin, Gerlinde, Bendzuck, Sabine, Eis, Martin, Krusche, and Harriet, Morf
- Subjects
COVID-19-Pandemie ,Video consultation ,Rheumatisch entzündliche Systemerkrankungen ,COVID-19 pandemic ,Rheumatic inflammatory systemic diseases ,Online survey ,Patientenversorgung ,Patient care ,Originalien ,Online-Umfrage ,Videosprechstunde - Abstract
In order to successfully integrate telemedicine into the daily routine of rheumatology, both the patient's and the physician's perspective are important. For this purpose, a detailed study by means of a web-based survey was conducted by the Working Group Young Rheumatology (AGJR) of the German Society for Rheumatology (DGRh) and the German Rheumatism League National Association. By means of subgroup analysis of the data regarding video consultation, the aim was now to find out which requirements and wishes patients and physicians have for video consultations.The prospective survey was distributed via social media, QR code and email. Descriptive statistics and regression analysis related to video consultation were performed and correlations were shown.The data indicated positive attitudes toward video consultation on the part of both patients (n = 299) and rheumatologists (n = 129). A correlation between age and positive opinion of the video consultation was found among the patients (r = 0.161, p = 0.006), especially among female patients a positive approval of the video consultation was found with increasing age (r = 0.244, p 0.001 to male patients: r = -0.190, p = 0.145). Regarding the travelling time to the treating rheumatologist, male patients found the video consultation more attractive with increasing travelling time (r = 0.229, p = 0.078). With respect to the wishes of patients and physicians, video consultation should be used primarily for follow-up or emergency appointments. Video consultation for initial appointments, on the other hand, was very rarely mentioned.During the COVID 19 pandemic, video consultation was increasingly popular among rheumatology patients as well as among rheumatologists.EINLEITUNG: Um die Telemedizin erfolgreich in den rheumatologischen Alltag zu integrieren, sind sowohl die Patienten- als auch Arztperspektive wichtig. Hierzu wurde eine ausführliche Studie mittels webbasierter Umfrage durch die Arbeitsgemeinschaft Junge Rheumatologie der Deutschen Gesellschaft für Rheumatologie (DGRh) und die Deutsche Rheuma-Liga Bundesverband e. V. durchgeführt. Mittels Subgruppenanalyse der Daten im Hinblick auf die Videosprechstunde galt es nun herauszufinden, welche Anforderungen und Wünsche unter den Patienten/innen und Ärzte/innen an die Videosprechstunde gestellt wurden.Die prospektive Umfrage wurde über die sozialen Medien, QR-Code und E‑Mail verteilt. Es wurden deskriptive Statistiken und Regressionsanalysen in Bezug auf die Videosprechstunde durchgeführt und Korrelationen aufgezeigt.Die Daten zeigen eine positive Einstellung zur Videosprechstunde sowohl aufseiten der Patienten/innen (n = 299) als auch der Rheumatologen/innen (n = 129) auf. Eine Korrelation zwischen Alter und positiver Meinung zur Videosprechstunde zeigte sich unter den Patienten/innen (r = 0,161, p = 0,006), insbesondere bei den weiblichen Patienten fand sich mit zunehmendem Alter ein positiver Zuspruch für die Videosprechstunde (r = 0,244, p 0,001 zu männlichen Patienten: r = −0,190, p = 0,145). Bezüglich der Fahrtzeit bis zum behandelnden Rheumatologen tendierten die männlichen Patienten mit zunehmender Fahrzeit zur Videosprechstunde (r = 0,229, p = 0,078), dies war jedoch nur schwach positiv. Hinsichtlich der Wünsche von Patienten/innen und Ärzten/innen sollte die Videosprechstunde v. a. für Folge- oder Notfalltermine genutzt werden. Eine Videosprechstunde für die Erstvorstellungen war hingegen nur sehr selten gewünscht.Während der COVID-19-Pandemie hat die Videosprechstunde zunehmenden Zuspruch unter den rheumatologischen Patienten/innen als auch unter den behandelnden Rheumatologen/innen erhalten.
- Published
- 2021
49. A Virtual Reality–Based App to Educate Health Care Professionals and Medical Students About Inflammatory Arthritis: Feasibility Study
- Author
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Georg Schett, Fabian Hartmann, Philipp Klemm, David Simon, Koray Tascilar, Timo Meinderink, Johannes Knitza, Alexander Pfeil, Philipp Sewerin, Axel J. Hueber, Louis Schuster, Johanna Mucke, Uwe Lange, Arnd Kleyer, Florian Steiger, and Ulf Müller-Ladner
- Subjects
rheumatoid arthritis ,medicine.medical_specialty ,Inflammatory arthritis ,Biomedical Engineering ,Physical Therapy, Sports Therapy and Rehabilitation ,Information technology ,Computer-assisted web interviewing ,Disease ,Virtual reality ,03 medical and health sciences ,symbols.namesake ,Psoriatic arthritis ,0302 clinical medicine ,Internal medicine ,Health care ,medicine ,030212 general & internal medicine ,Fisher's exact test ,inflammatory arthritis ,030203 arthritis & rheumatology ,psoriatic arthritis ,Original Paper ,business.industry ,Rehabilitation ,T58.5-58.64 ,medicine.disease ,Rheumatology ,3. Good health ,Computer Science Applications ,Psychiatry and Mental health ,Family medicine ,symbols ,virtual reality ,Public aspects of medicine ,RA1-1270 ,business ,feasibility - Abstract
Background Inflammatory arthritides (IA) such as rheumatoid arthritis or psoriatic arthritis are disorders that can be difficult to comprehend for health professionals and students in terms of the heterogeneity of clinical symptoms and pathologies. New didactic approaches using innovative technologies such as virtual reality (VR) apps could be helpful to demonstrate disease manifestations as well as joint pathologies in a more comprehensive manner. However, the potential of using a VR education concept in IA has not yet been evaluated. Objective We evaluated the feasibility of a VR app to educate health care professionals and medical students about IA. Methods We developed a VR app using data from IA patients as well as 2D and 3D-visualized pathological joints from X-ray and computed tomography–generated images. This VR app (Rheumality) allows the user to interact with representative arthritic joint and bone pathologies of patients with IA. In a consensus meeting, an online questionnaire was designed to collect basic demographic data (age, sex); profession of the participants; and their feedback on the general impression, knowledge gain, and potential areas of application of the VR app. The VR app was subsequently tested and evaluated by health care professionals (physicians, researchers, and other professionals) and medical students at predefined events (two annual rheumatology conferences and academic teaching seminars at two sites in Germany). To explore associations between categorical variables, the χ2 or Fisher test was used as appropriate. Two-sided P values ≤.05 were regarded as significant. Results A total of 125 individuals participated in this study. Among them, 56% of the participants identified as female, 43% identified as male, and 1% identified as nonbinary; 59% of the participants were 18-30 years of age, 18% were 31-40 years old, 10% were 41-50 years old, 8% were 51-60 years old, and 5% were 61-70 years old. The participants (N=125) rated the VR app as excellent, with a mean rating of 9.0 (SD 1.2) out of 10, and many participants would recommend use of the app, with a mean recommendation score of 3.2 (SD 1.1) out of 4. A large majority (120/125, 96.0%) stated that the presentation of pathological bone formation improves understanding of the disease. We did not find any association between participant characteristics and evaluation of the VR experience or recommendation scores. Conclusions The data show that IA-targeting innovative teaching approaches based on VR technology are feasible.
- Published
- 2021
50. [Diagnostic approach and differential diagnosis of mon- and oligoarthritis]
- Author
-
Anna, Kernder and Philipp, Sewerin
- Subjects
Diagnosis, Differential ,Diagnostic Imaging ,Crystal Arthropathies ,Arthritis ,Humans - Abstract
Reasons of mon- and oligoarthritis are heterogeneous. The diagnostic approach includes a detailed medical anamnesis, physical examination and imaging (conventional X-ray, sonography, MRI and, CT). Analysis of the synovial fluid is required in suspected septic arthritis and frequently helps in diagnosis and differential diagnosis of crystal arthropathies. Dual-energy-CT (DECT) detects sodium urate crystals and can replace joint puncture in some cases. In addition to crystal arthropathies and septic arthritis, differential diagnosis of mon-/oligoarthritis includes reactive arthritis, arthrosis and monarthritic courses of SpA/PsA. A rheumatologist should be consulted particularly in the case of persistent monarthritides, in order to initiate a specific therapy to prevent secondary damage.
- Published
- 2021
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