Zeitschrift fur Rheumatologie最新文献

{"title":"[First approved rheumatological digital health application for axial spondyloarthritis].","authors":"Martin Krusche","doi":"10.1007/s00393-026-01826-0","DOIUrl":"https://doi.org/10.1007/s00393-026-01826-0","url":null,"abstract":"","PeriodicalId":23834,"journal":{"name":"Zeitschrift fur Rheumatologie","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147843468","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Filgotinib treatment of calcinosis in centromere-antibody-positive systemic sclerosis].","authors":"Ottar Gadeholt","doi":"10.1007/s00393-025-01765-2","DOIUrl":"10.1007/s00393-025-01765-2","url":null,"abstract":"<p><p>Centromere-antibody-positive limited cutaneous systemic sclerosis (LCSSc) is a common disease. It generally takes a benign course, but can still considerably reduce quality of life. Our patient-a woman born in 1987 who was first diagnosis 2017-suffered from pain and declining hand function due to sclerodactyly and calcinosis. Methotrexate (MTX) and analgesics were not effective. After commencing off-label treatment with filgotinib, the patient reported rapid improvement. An X-ray after 8 months showed a reduction in calcinosis load. Filgotinib is well tolerated. Sclerodactyly has resolved, and hand function continues to improve. The clinical and radiological response merit further enquiry of Janus kinase (JAK) inhibitors in centromere-antibody-positive LCSSc.</p>","PeriodicalId":23834,"journal":{"name":"Zeitschrift fur Rheumatologie","volume":" ","pages":"317-319"},"PeriodicalIF":1.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146107466","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Consequences of late access to specialist care-effect on medication costs in rheumatoid arthritis].","authors":"Luisa V Licker, Nicolas Pardey, Kristine Kreis, Jona T Stahmeyer, Silke Zinke, Dirk Meyer-Olson, Torsten Witte, Kirsten Hoeper, Jan Zeidler","doi":"10.1007/s00393-026-01785-6","DOIUrl":"10.1007/s00393-026-01785-6","url":null,"abstract":"<p><strong>Background: </strong>Insufficient access to specialist rheumatology services in Germany results in prolonged waiting times and delayed diagnostic confirmation, which impedes timely and effective initiation of therapy.</p><p><strong>Objectives: </strong>This study examines the impact of early versus delayed access to specialist care on medication prescribing patterns and associated costs.</p><p><strong>Materials and methods: </strong>A cost analysis was conducted within the Deliver-Care study using health insurance claims data from 2015-2020. Patients with a confirmed rheumatoid arthritis diagnosis (ICD-10 M05/M06) were stratified by the timing of their initial specialist consultation: early access (within the diagnosis quarter, Q1) versus late access (Q2-Q4). Medication costs were compared across these groups.</p><p><strong>Results: </strong>More than half (57.4%) of M05 patients and about one quarter (24.4%) of M06 patients had no access to a specialist during the first year after the initial suspected diagnosis. Among patients who did have specialist contact (n = 3781), 82.7% obtained early specialist access. Patients with delayed specialist access incurred higher medication costs (€ 4343 in Q4 vs. € 1763 in Q1; p < 0.0001). A sensitivity analysis showed that patients with delayed specialist access were switched to high-cost medications earlier than those with early access.</p><p><strong>Conclusion: </strong>Early specialist access is associated with reduced biologic prescribing and lower medication costs. These findings highlight that timely diagnosis and treatment not only lessen patient disease burden but also generate substantial cost savings in the management of rheumatoid arthritis.</p>","PeriodicalId":23834,"journal":{"name":"Zeitschrift fur Rheumatologie","volume":" ","pages":"272-279"},"PeriodicalIF":1.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13124890/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146126442","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Flexible working time models in rheumatology : Results of a Germany-wide survey].","authors":"Ann-Christin Pecher, Katinka Albrecht, Xenofon Baraliakos, Johanna Callhoff, Eugen Feist, Isabell Haase, Michaela Koehm, Martin Krusche, Philipp Sewerin, Anna Voormann, Sarah Ohrndorf, Johanna Mucke","doi":"10.1007/s00393-025-01761-6","DOIUrl":"10.1007/s00393-025-01761-6","url":null,"abstract":"<p><strong>Background: </strong>Demographic change and a growing shortage of healthcare professionals pose significant challenges to the German healthcare system. Rheumatology is particularly affected due to increasing patient demand and evolving societal expectations regarding work-life balance, family compatibility, and gender equity. As a result, flexible working time models are gaining importance.</p><p><strong>Objective: </strong>This study aimed to assess existing and desired working time models in rheumatology, their feasibility, and perceived barriers from the perspectives of both employees and leadership.</p><p><strong>Methods: </strong>The Commission of Equal Opportunities of the German Society for Rheumatology (DGRh) developed two online questionnaires targeting rheumatology healthcare professionals in employee and leadership roles asking about their current employment situation, existing flexible working time models, and preferences and feasibility of various working time models. The survey was distributed between September 2024 and March 2025 via the mailing lists of the DGRh and the Association of Rheumatological Acute Clinics (VRA), and via personal contacts by email, and subsequently evaluated descriptively.</p><p><strong>Results: </strong>A total of 151 individuals participated (111 employees, 40 leaders). Part-time work, especially in outpatient care, was common and frequently desired. The 4‑day workweek and hybrid models (e.g., home office) were considered attractive but posed organizational challenges. Of the employees, 24% reported having changed jobs due to a lack of flexible options; 30% of leaders had lost staff for the same reason. Most respondents prioritized flexibility over reduced working hours.</p><p><strong>Conclusion: </strong>Flexible working time models are generally desired and often feasible in rheumatology but require tailored implementation and structural support. They are essential for improving job satisfaction and staff retention and should be strategically promoted to ensure sustainable rheumatologic care.</p>","PeriodicalId":23834,"journal":{"name":"Zeitschrift fur Rheumatologie","volume":" ","pages":"262-271"},"PeriodicalIF":1.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13144166/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145702113","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Patient satisfaction in patients with rheumatoid arthritis : Effects of delegation to rheumatological specialist assistants].","authors":"Birte Luise Hägermann, Juliana Rachel Hoeper, Sara Eileen Meyer, Patricia Steffens-Korbanka, Torsten Witte, Dirk Meyer-Olson, Kirsten Hoeper","doi":"10.1007/s00393-025-01747-4","DOIUrl":"10.1007/s00393-025-01747-4","url":null,"abstract":"<p><strong>Background: </strong>The satisfaction of patients with rheumatoid arthritis (RA) influences disease control, treatment adherence and both physical and psychological well-being, which are key factors for long-term treatment success. However, due to limited physician resources, guideline-based patient-centered care cannot be universally implemented. As a response, the integration of trained rheumatological specialist assistants (RFA) into the care is evaluated as a complementary approach.</p><p><strong>Objective: </strong>This study aimed to assess the impact of team-based care on patient satisfaction among individuals with seropositive RA during flares.</p><p><strong>Material and methods: </strong>In this 12-month multicenter, pragmatic randomized controlled trial, 224 patients were enrolled. Following baseline assessment, five follow-up visits were scheduled. In the intervention group (IG), three of these visits were conducted by RFAs, while the control group (CG) received standard rheumatologist-led care. After 12 months participants were stratified by disease activity (DAS28 < 2.6 vs. ≥ 2.6). A secondary outcome was patient satisfaction, assessed using the ZAP questionnaire.</p><p><strong>Results: </strong>After 12 months the IG reported significantly higher satisfaction in the domains of interaction (p = 0.023), information (p = 0.014), cooperation (p = 0.021), quality of care (p = 0.005) and trust in the healthcare provider (p = 0.028). No significant differences were found for practice organization (p = 0.515) or overall satisfaction (p = 0.084). Similar patterns were observed in the subgroup with active disease but not in patients in remission.</p><p><strong>Conclusion: </strong>Team-based care showed a positive impact on multiple dimensions of patient satisfaction in active RA.</p>","PeriodicalId":23834,"journal":{"name":"Zeitschrift fur Rheumatologie","volume":" ","pages":"280-288"},"PeriodicalIF":1.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13124916/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145439119","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Revisiting James Joyce's disease: insights into reactive arthritis vs. tertiary syphilis.","authors":"Luca Ventura","doi":"10.1007/s00393-026-01806-4","DOIUrl":"10.1007/s00393-026-01806-4","url":null,"abstract":"","PeriodicalId":23834,"journal":{"name":"Zeitschrift fur Rheumatologie","volume":" ","pages":"329-330"},"PeriodicalIF":1.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147391110","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evidenz und klinische Rolle der transarteriellen periartikulären Embolisation (TAPE).","authors":"Alexander Pfeil, Carolin Pflug, Gunter Wolf, René Aschenbach, Ulf Teichgräber","doi":"10.1007/s00393-026-01792-7","DOIUrl":"10.1007/s00393-026-01792-7","url":null,"abstract":"","PeriodicalId":23834,"journal":{"name":"Zeitschrift fur Rheumatologie","volume":" ","pages":"333-335"},"PeriodicalIF":1.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147445322","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Cardiovascular risk in inflammatory rheumatic diseases : Evidence-based strategies for risk reduction in rheumatologic practice].","authors":"Stefan Kleinert","doi":"10.1007/s00393-026-01800-w","DOIUrl":"10.1007/s00393-026-01800-w","url":null,"abstract":"<p><p>Patients with rheumatoid arthritis (RA), psoriatic arthritis (PsA), and axial spondyloarthritis (axSpA) have a persistently increased cardiovascular (CV) risk and higher mortality, independently of traditional CV risk factors. Effective control of inflammation reduces CV events, whereas glucocorticoids increase the risk in a dose- and duration-dependent manner, even at ≤ 5 mg prednisolone/day. Disease-modifying antirheumatic drugs especially tumor necrosis factor (TNF) inhibitors, are largely protective through the reduction of systemic inflammation. For patients receiving Janus kinase (JAK) inhibitors or long-term glucocorticoid therapy, a structured CV risk assessment and guideline-based management of modifiable risk factors (including lipid optimization/statin therapy) are essential. Primary prevention should be based on the cardiovascular prevention guidelines of the European Society of Cardiology (ESC). Vaccinations (influenza, COVID-19, pneumococcus, respiratory syncytial virus, zoster) represent an effective pillar of CV prevention in populations at cardiovascular risk; however, evidence in patients with inflammatory rheumatic diseases is still lacking. The main challenge for CV prevention remains implementation: digital clinical reminders/decision support systems and multicomponent strategies can improve the implementation of recommendations.</p>","PeriodicalId":23834,"journal":{"name":"Zeitschrift fur Rheumatologie","volume":" ","pages":"307-316"},"PeriodicalIF":1.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147634423","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mitteilungen der DRL.","authors":"","doi":"10.1007/s00393-026-01819-z","DOIUrl":"https://doi.org/10.1007/s00393-026-01819-z","url":null,"abstract":"","PeriodicalId":23834,"journal":{"name":"Zeitschrift fur Rheumatologie","volume":"85 4","pages":"339"},"PeriodicalIF":1.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147783101","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Professional situation of rheumatological specialist assistants (RFA, DGRh-BDRh) after training : Results of a nationwide survey in 2024].","authors":"Florian Schuch, Klaus Krüger, Anna Voormann, Dorothea John, Luisa Martens, Kirsten Hoeper","doi":"10.1007/s00393-026-01777-6","DOIUrl":"10.1007/s00393-026-01777-6","url":null,"abstract":"<p><p>Since the introduction of the qualification for rheumatological specialist assistants (RFA) by the German Society for Rheumatology (DGRh) and the Professional Association of German Rheumatologists (BDRh) in 2006, this advanced training has become an established component of rheumatological care. Although more than 2000 medical assistants have since completed the RFA qualification, only limited data have been available on their professional situation after completion of the program. The aim of the present nationwide online survey was to assess the current professional situation, areas of activity, job satisfaction and career paths of RFAs in Germany.In October 2024 all graduates from 2006-2024 known to the Rheumatism Academy (Rheumaakademie, n = 677) were invited via email. A total of 263 individuals completed the questionnaire (response rate 39%), of whom 243 provided complete responses.At the time of the survey 81% (n = 199/245) of respondents were still working as RFAs, mostly in rheumatology practices (71%). Independent RFA consultation hours were conducted by 44% (n = 86) of participants, with most offering their own appointments, using defined procedures and having separate consultation rooms available. The main reasons cited for leaving RFA work were high workload, lack of development opportunities, and insufficient recognition. Nevertheless, 96% of those who had left the RFA role remained employed in the medical field.The results show that the RFA has become firmly established as a key component of rheumatological care in Germany; however, due to voluntary participation and limited reachability of all graduates, selection bias is likely and particularly RFAs no longer working in the profession may be underrepresented.To sustainably strengthen and retain this professional group, structural improvements are necessary, especially legal clarification of delegable tasks, the establishment of reimbursement options for RFA consultation hours and the development of advanced qualifications and career pathways.</p>","PeriodicalId":23834,"journal":{"name":"Zeitschrift fur Rheumatologie","volume":" ","pages":"324-328"},"PeriodicalIF":1.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146067530","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}