Zeitschrift fur Rheumatologie最新文献

{"title":"[Diagnosis and treatment of ANCA-associated vasculitis : SHORT VERSION of the S3 guideline of the German Society for Rheumatology and Clinical Immunology e. V. (DGRh) and German Society for Internal Medicine e. V. (DGIM), German Society for Nephrology e. V. (DGfN), German Society for Otorhinolaryngology and Head and Neck Surgery e. V. (DGHNO-KHC), German Ophthalmological Society e. V. (DOG), German Society for Neurology e. V. (DGN), German Society for Pneumology and Respiratory Medicine e. V. (DGP), German Society for Pathology e. V. (DGP), German Radiological Society, Society for Medical Radiology e. V. (DRG), Federal Association of German Pathologists, Federal Kidney Association e. V., German Rheumatism League Federal Association e. V.]","authors":"J U Holle, T Kubacki, P Aries, B Hellmich, A Kernder, C Kneitz, P Lamprecht, J H Schirmer, A Schreiber, P Berlit, T A Bley, S Blödt, L Decker, K de Groot, S Engel, I Jordans, B Frye, M Haubitz, K Holl-Ulrich, I Kötter, M Laudien, K Milger-Kneidinger, C Muche-Borowski, U Müller-Ladner, T Neß, B Nölle, E Reinhold-Keller, N Ruffer, K Scheuermann, N Venhoff, S von Vietinghoff, T Wiech, M Zänker, F Moosig","doi":"10.1007/s00393-024-01596-7","DOIUrl":"https://doi.org/10.1007/s00393-024-01596-7","url":null,"abstract":"<p><p>Vasculitis associated with anti-neutrophil cytoplasmic antibodies (ANCA) is a rare disease with a potentially severe course. Affected patients should be diagnosed as quickly as possible and given suitable treatment according to the current study situation. Considerable progress has been made in the treatment of this disease in recent years, so that a largely evidence-based therapy with immunosuppressants and biologics is now possible. The guideline on the diagnosis and treatment of ANCA-associated vasculitis was raised from S1 level (2017) to S3 level. This guideline is the first German guideline on the diagnosis and treatment of ANCA-associated vasculitis at S3 level.</p>","PeriodicalId":23834,"journal":{"name":"Zeitschrift fur Rheumatologie","volume":"84 3","pages":"225-251"},"PeriodicalIF":0.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143765254","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 DGRh - Veranstaltungen der Rheumaakademie.","authors":"","doi":"10.1007/s00393-025-01642-y","DOIUrl":"https://doi.org/10.1007/s00393-025-01642-y","url":null,"abstract":"","PeriodicalId":23834,"journal":{"name":"Zeitschrift fur Rheumatologie","volume":"84 3","pages":"254"},"PeriodicalIF":0.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143765255","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":"[Comments of the German Society for Orthopaedic Rheumatology on the article \"Rheumatological care in Germany\" : Memorandum of the German Society for Rheumatology and Clinical Immunology 2024].","authors":"Hans-Dieter Carl, Martin Arbogast, Ralph Gaulke","doi":"10.1007/s00393-025-01638-8","DOIUrl":"https://doi.org/10.1007/s00393-025-01638-8","url":null,"abstract":"<p><p>The following comment from the German Society of Orthopedic Rheumatology refers to the Memorandum from The German Society of Rheumatology as pubsished in 2024.</p>","PeriodicalId":23834,"journal":{"name":"Zeitschrift fur Rheumatologie","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143754734","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":"[Lung involvement in connective tissue diseases].","authors":"Elena Heinze Martinez, Nicole Dietze, Sabine Mewes, Jens Schreiber, Eugen Feist","doi":"10.1007/s00393-025-01635-x","DOIUrl":"10.1007/s00393-025-01635-x","url":null,"abstract":"<p><p>Connective tissue diseases as systemic autoimmune diseases are frequently associated with lung involvement. The diagnostics are often delayed by initially mild and unspecific symptoms. As lung involvement in these diseases can be chronically progressive and sometimes rapidly progressive, early and regular screening and monitoring are essential. This article focuses on typical findings and the diagnostic value of useful examination methods. Ideally, the diagnostics and treatment of lung involvement in connective tissue disease should be performed on an interdisciplinary basis in collaboration between pulmonology and rheumatology.</p>","PeriodicalId":23834,"journal":{"name":"Zeitschrift fur Rheumatologie","volume":" ","pages":"198-209"},"PeriodicalIF":0.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143469111","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":"[Diagnosis and treatment of ANCA-associated vasculitis : S3 guideline of the German Society for Rheumatology and Clinical Immunology e. V. (DGRh) and German Society for Internal Medicine e. V. (DGIM), German Society for Nephrology e. V. (DGfN), German Society for ENT Medicine and Head and Neck Surgery e. V. (DGHNO-KHC), German Ophthalmological Society e. V. (DOG), German Society for Neurology e. V. (DGN), German Society for Pneumology and Respiratory Medicine e. V. (DGP), German Society for Pathology e. V. (DGP), German Radiological Society, Society for Medical Radiology e. V. (DRG), Federal Association of German Pathologists, Federal Kidney Association e. V., German Rheumatism League Federal Association e. V.]","authors":"J U Holle, T Kubacki, P Aries, B Hellmich, A Kernder, C Kneitz, P Lamprecht, J H Schirmer, A Schreiber, P Berlit, T A Bley, S Blödt, L Decker, K de Groot, S Engel, I Jordans, B Frye, M Haubitz, K Holl-Ulrich, I Kötter, M Laudien, K Milger-Kneidinger, C Muche-Borowski, U Müller-Ladner, T Neß, B Nölle, E Reinhold-Keller, N Ruffer, K Scheuermann, N Venhoff, S von Vietinghoff, T Wiech, M Zänker, F Moosig","doi":"10.1007/s00393-024-01597-6","DOIUrl":"https://doi.org/10.1007/s00393-024-01597-6","url":null,"abstract":"","PeriodicalId":23834,"journal":{"name":"Zeitschrift fur Rheumatologie","volume":"84 Suppl 1","pages":"1-49"},"PeriodicalIF":0.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143773591","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":"[Regional differences in the distance to rheumatological specialist care in Germany].","authors":"Carlo Veltri, Nora Baer, Martin Aringer, Thorsten Eidner, Jörg Henes, Katja Thiele, Johanna Callhoff, Katinka Albrecht","doi":"10.1007/s00393-025-01641-z","DOIUrl":"https://doi.org/10.1007/s00393-025-01641-z","url":null,"abstract":"<p><strong>Background: </strong>Rheumatological care should be available for people with inflammatory rheumatic diseases in all regions of Germany. In this article the distance to rheumatological specialist care is mapped.</p><p><strong>Methodology: </strong>Specialists in rheumatology listed in the German Federal Medical Register as of 31 December 2023 were assigned to postal code regions. The mean linear distance from a postal code region to the nearest region with a rheumatology practice was calculated. The mean distance from the places of residence of patients was calculated for the rheumatology centers participating in the German national database.</p><p><strong>Results: </strong>Of the postal code regions 25% are > 20 km linear distance away from a postal code district with a rheumatological practice. Especially in Mecklenburg-Western Pomerania, Lower Saxony and Schleswig-Holstein there are larger areas with a low density of care. In the German national database, the median distance between the patient's place of residence and the rheumatological facility is between 10 km (Berlin) and 40 km (Tübingen).</p><p><strong>Conclusion: </strong>In rural areas and for specialized rheumatology centers patients must travel long distances to reach a specialized rheumatological care.</p>","PeriodicalId":23834,"journal":{"name":"Zeitschrift fur Rheumatologie","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143710673","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":"Diagnostic accuracy of IgG 4/IgG and IgG 4 in patients with IgG 4-related disease: a meta-analysis.","authors":"Young Ho Lee, Gwan Gyu Song","doi":"10.1007/s00393-025-01637-9","DOIUrl":"https://doi.org/10.1007/s00393-025-01637-9","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to evaluate and compare the diagnostic performance of immunoglobulin G4/Immunoglobulin G (IgG 4/IgG) and immunoglobulin G4 (IgG 4) alone in identifying immunoglobulin G4-related disease (IgG 4-RD).</p><p><strong>Methods: </strong>A systematic review and meta-analysis were conducted using data from Medline, Embase, and the Cochrane Library from inception to November 2024. Two meta-analyses were performed to assess the diagnostic accuracies of IgG 4/IgG and IgG 4 in IgG 4-RD patients.</p><p><strong>Results: </strong>Eight studies encompassing 754 IgG 4-RD patients and 9496 non-IgG 4-RD controls were included in the analysis. IgG 4/IgG demonstrated a sensitivity of 89% and a specificity of 91.6%, accurately detecting IgG 4-RD in 89% of cases and correctly identifying non-IgG 4-RD in 91.6% of cases. IgG 4 alone exhibited a higher sensitivity (94.9%) and a similar specificity (91%), indicating a slightly improved ability to identify IgG 4-RD cases. The positive likelihood ratio (PLR) and the negative likelihood ratio (NLR) for IgG 4/IgG were 7580 and 0.132, respectively, while IgG 4 alone had a PLR of 6403 and a lower NLR of 0.066, confirming the high diagnostic reliability. The diagnostic odds ratio (DOR) was 62.97 for IgG 4/IgG compared to 105.6 for IgG 4 alone, reflecting enhanced accuracy. The area under the curve (AUC) was 0.949 for IgG 4/IgG and 0.986 for IgG 4. The Q* index was 0.889 for IgG 4/IgG and 0.949 for IgG 4, further underscoring the diagnostic effectiveness of IgG 4 alone.</p><p><strong>Conclusion: </strong>Both IgG 4/IgG and IgG 4 are highly accurate markers for diagnosing IgG 4-RD, with IgG 4 alone showing marginally higher sensitivity, DOR, and AUC. This suggests that IgG 4 alone may offer a slight advantage as a diagnostic marker for IgG 4-RD.</p>","PeriodicalId":23834,"journal":{"name":"Zeitschrift fur Rheumatologie","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143617337","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":"[Influencing fracture healing by specific osteoporosis medications].","authors":"Ulla Stumpf, Ralf Schmidmaier, Hanna Taipaleenmäki, Wolfgang Böcker, Andreas Kurth, Eric Hesse","doi":"10.1007/s00393-024-01610-y","DOIUrl":"10.1007/s00393-024-01610-y","url":null,"abstract":"<p><strong>Background: </strong>Osteoporosis is a widespread disease defined by a reduction in bone mass and structure, thereby increasing the risk of fragility fractures. Treatment typically involves specific medications, which either inhibit bone resorption (antiresorptive) or stimulate bone formation (anabolic) and may potentially influence the healing of osteoporotic fractures. On the other hand, metabolic disorders, immune system dysfunctions or circulatory problems can impair fracture healing. Therefore, the targeted use of osteoporosis medications could be a strategy to promote the healing of impaired fractures.</p><p><strong>Objective: </strong>The aim of this study is to provide a current overview of the effects of osteoporosis medications approved in Germany on fracture healing. The focus is on the potential influence of these medications in the context of osteoporosis treatment. Additionally, the current state of research is examined to explore to what extent the targeted use of these medications could improve fracture healing.</p><p><strong>Material and methods: </strong>A literature search was conducted in the PubMed database using topic-specific keywords. Preclinical studies, clinical trials, review articles and meta-analyses were considered to present the current scientific knowledge with clinical relevance.</p><p><strong>Results: </strong>Preclinical and clinical studies suggest that specific osteoporosis medications do not have a clinically relevant negative impact on the healing of fragility fractures. Osteoanabolic substances even tend to have a positive effect on fracture healing in both normal and impaired healing processes; however, the available studies are limited and none of the medications have been approved for this specific use.</p><p><strong>Discussion: </strong>Osteoporosis medications with antiresorptive or osteoanabolic effects are primarily used to treat osteoporosis, especially after fragility fractures, to reduce the risk of further fractures. There is no clinically relevant impairment of fracture healing due to these medications. Further studies would be required to obtain approval for these medications specifically to improve fracture healing.</p>","PeriodicalId":23834,"journal":{"name":"Zeitschrift fur Rheumatologie","volume":" ","pages":"107-112"},"PeriodicalIF":0.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142980110","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":"[Recommendations of the DGRh Committee on Complementary Medicine and Nutrition on the application of selected phytotherapeutic drugs and herbal medicines in rheumatology].","authors":"Gernot Keyßer, Olga Seifert, Inna Frohne, Andreas Michalsen, Alexander Pfeil, Monika Reuß-Borst, Oliver Sander","doi":"10.1007/s00393-024-01612-w","DOIUrl":"10.1007/s00393-024-01612-w","url":null,"abstract":"<p><strong>Background: </strong>Herbal preparations and phytotherapeutic substances are offered for symptoms and diseases of the rheumatic spectrum and are often intensively advertised in the lay press. The German Society for Rheumatology and Clinical Immunology (DGRh) Committee on Complementary Medicine and Nutrition reviewed the scientific literature on selected over the counter preparations and prescription phytotherapeutic substances and examined the possibilities for their use in rheumatology.</p><p><strong>Methods: </strong>In an online meeting of the Committee on 8 February 2023 a list of herbal preparations that are frequently used in rheumatology (mostly as self-medication) was drawn up. Each member of the committee then carried out a literature search on one or two substances and summarized the results according to a defined matrix. Research was carried out on borage oil, stinging nettle preparations, cannabis preparations and preparations of dog rose, rosemary, saffron and willow bark. The data on the mixed preparation Phytodolor® (Bayer Vital GmbH, Germany) were also examined. The results were reviewed by a circulation procedure and approved in two further online meetings of the Committee. After review by the DGRh board, the recommendations were transferred to the professional organization's website.</p><p><strong>Results: </strong>Even though there are reports of anti-inflammatory or immunological effects in vitro and/or in animal models for all the plant substances examined, the evidence for a clinically relevant benefit is sparse. None of the preparations investigated has a therapeutic efficacy that justifies its use in inflammatory joint diseases. Herbal preparations based on saffron and rosemary are generally not recommended. Borage oil from seeds can be taken in standardized form as part of a health-conscious diet but is not expected to have any significant anti-inflammatory effect. Rheumatologists need not advise against Phytodolor® or preparations based on stinging nettle, willow bark or dog rose, which are taken on the patient's initiative for degenerative joint diseases, if a sensible therapy concept is otherwise adhered to. There is insufficient evidence to prescribe medicinal cannabis for inflammatory rheumatic diseases for disease modification or symptomatic therapy. In individual cases, however, its use to reduce chronic pain, particularly neuropathic pain and sleep disorders and to reduce opiate consumption may be justified.</p><p><strong>Conclusion: </strong>Even if the herbal preparations presented here must be considered in a differentiated manner for rheumatology practice, the value of phytotherapy for the discipline is low.</p>","PeriodicalId":23834,"journal":{"name":"Zeitschrift fur Rheumatologie","volume":" ","pages":"152-163"},"PeriodicalIF":0.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11865164/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143123768","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":"[\"Paradoxical fractures\": pathological fractures under anti-osteoporotic and antirheumatic treatment].","authors":"Edgar Wiebe, Paula Hoff, Frank Buttgereit","doi":"10.1007/s00393-025-01620-4","DOIUrl":"10.1007/s00393-025-01620-4","url":null,"abstract":"<p><p>Pathological fractures under anti-osteoporotic and antirheumatic treatment are very rare events. Nevertheless, atypical femoral fractures occur during antiresorptive treatment with bisphosphonates or denosumab, the latter especially in patients previously treated with bisphosphonates. Treatment with teriparatide can be helpful. While glucocorticoids have a well-known influence on the development of osteoporosis and thus also fractures, the probably unproblematic use in the low-dose range has so far found little acceptance. Methotrexate-induced osteopathy is also a rare phenomenon but is now well accepted and known. There are several approved medications for the treatment of glucocorticoid-induced osteoporosis and for methotrexate-induced osteopathy, discontinuation of methotrexate is particularly essential.</p>","PeriodicalId":23834,"journal":{"name":"Zeitschrift fur Rheumatologie","volume":" ","pages":"113-120"},"PeriodicalIF":0.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143459661","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}