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2. Twelve-Week Internet-Based Individualized Exercise Program in Adults With Systemic Lupus Erythematosus: Protocol for a Randomized Controlled Trial

Author

Boedecker, Simone Cosima, Philippi, Keito Finn Akanby, Neuberger, Elmo, Schmidt, Sebastian, Pfirrmann, Daniel, Haller, Nils, Schwarting, Andreas, Simon, Perikles, and Weinmann-Menke, Julia

Subjects
Medicine, Computer applications to medicine. Medical informatics, R858-859.7
Abstract

BackgroundSystemic lupus erythematosus is a systemic autoimmune disease, which is associated with high cardiovascular risk, a predisposition to metabolic disorders, muscle wasting, and fatigue. Exercise therapy has become an important part of the long-term treatment of comorbidities in systemic lupus erythematosus. Exercise can lead to various benefits in patients with systemic lupus erythematosus such as increased aerobic capacity and exercise tolerance, resulting in an increased quality of life, decreased depression, and decreased fatigue. At the moment, no evidence-based treatment guidelines that recommend exercise for patients with systemic lupus erythematosus exist. Also, the efficacy of different training programs requires further investigation. ObjectiveThis study focuses on the feasibility, efficacy, and safety of an internet-based exercise program in patients with systemic lupus erythematosus. Furthermore, we investigate the feasibility and efficiency of anaerobic training compared to aerobic training. MethodsOverall, patients with systemic lupus erythematosus from the Division of Nephrology, Rheumatology, and Immunology outpatient clinic of the University Medical Center Mainz who are clinically stable status are included and randomized in an aerobic exercise group (n=10), anaerobic exercise group (n=10), or treatment as usual group (n=10). After completing initial clinical testing and physical fitness tests, patients undergo supervised 12-week online exercise programs, receiving weekly individualized training plans adapted to their physical performance. The primary outcome is change in physical fitness (VO2 peak) after 12 weeks compared to baseline. Secondary outcomes are disease activity measured via laboratory results (complement, autoantibodies) and questionnaires, as well as changes in muscle mass (anaerobic exercise group), results of the Chair-Stand test, and measurements of circulating cell-free DNA and extracellular vesicles. ResultsThe study was registered in May 2019. Enrollment began in May 2019. Of 40 patients who were initially screened, 30 patients fulfilled the inclusion criteria and were included in the study; 1 participant withdrew prior to the start of the exercise program. Among the 25 patients who completed the study, no serious adverse events have been reported; 3 participants withdrew during the program (due to frequent colds, n=1; Crohn relapse, n=1; physical strain, n=1), and 1 participant has not yet completed the program. Data analysis is ongoing, and results are expected to be submitted for publication in January 2021. ConclusionsWe expect the online exercise intervention to be a feasible and efficient tool to provide regular individualized exercise for patients with systemic lupus erythematosus. Trial RegistrationClinicalTrials.gov NCT03942718; http://clinicaltrials.gov/ct2/show/NCT03942718. International Registered Report Identifier (IRRID)DERR1-10.2196/18291

Published
2020
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9. Fachspezifische Beurteilung des Berichts der Deutschen Gesellschaft für Innere Medizin (DGIM) zur Darstellung der Versorgungslandschaft im Bereich der Inneren Medizin in Deutschland durch die Deutsche Gesellschaft für Rheumatologie e.V. (DGRh)

Author

Braun, Jürgen, Krause, Andreas, Schulze-Koops, Hendrik, Haase, Isabell, Kötter, Ina, Hoyer, Bimba Franziska, Aringer, Martin, Krusche, Martin, Voormann, Anna Julia, Wagner, Ulf, Schwarting, Andreas, and Specker, Christof

Published
2023
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22. Disease-modifying therapies in systemic lupus erythematosus for extrarenal manifestations

Author

Askanase, Anca D, primary, Furie, Richard A, additional, Dall'Era, Maria, additional, Bomback, Andrew S, additional, Schwarting, Andreas, additional, Zhao, Ming-Hui, additional, Bruce, Ian N, additional, Khamashta, Munther, additional, Rubin, Bernie, additional, Carroll, Angela, additional, Daniels, Mark, additional, Levy, Roger Abramino, additional, van Vollenhoven, Ronald, additional, and Urowitz, Murray B, additional

Published
2024
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24. P39 Analysis of nailfold capillaroscopy findings and clinical features of patients with systemic lupus erythematosus and pulmonary arterial hypertension

Author

Marasco, Emiliano, primary, Duesing, Christina, additional, Keymel, Stephanie, additional, Zanframundo, Giovanni, additional, Codullo, Veronica, additional, Sander, Oliver, additional, Chehab, Gamal, additional, Richter, Jutta, additional, Fischer-Betz, Rebecca, additional, Bracaglia, Claudia, additional, Sahin, Sezgin, additional, Triantafyllias, Konstantinos, additional, Schwarting, Andreas, additional, Keller, Lisa, additional, Meyer, Alain, additional, Canuet, Matthieu, additional, Riou, Marianne, additional, Cavazzana, Ilaria, additional, Fredi, Micaela, additional, Franceschini, Franco, additional, Silvagni, Ettore, additional, Bortoluzzi, Alessandra, additional, Scirè, Carlo Alberto, additional, Montecucco, Carlomaurizio, additional, Cavagna, Lorenzo, additional, and Schneider, Matthias, additional

Published
2024
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25. P89 IL-28 as potential therapeutic target for LN

Author

Meineck, Myriam, primary, Kommer, Andreas, additional, Linsel, Sebastian, additional, Saurin, Sabrina, additional, Möckel, Tamara, additional, Pautz, Andrea, additional, Schwarting, Andreas, additional, and Weinmann-Menke, Julia, additional

Published
2024
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31. Autoantibodies against the chemokine receptor 3 predict cardiovascular risk

Author

Müller, Felix S, primary, Aherrahrou, Zouhair, additional, Grasshoff, Hanna, additional, Heidorn, Marc W, additional, Humrich, Jens Y, additional, Johanson, Laurence, additional, Aherrahrou, Redouane, additional, Reinberger, Tobias, additional, Schulz, Andreas, additional, ten Cate, Vincent, additional, Robles, Alejandro Pallares, additional, Koeck, Thomas, additional, Rapp, Steffen, additional, Lange, Tanja, additional, Brachaczek, Lukas, additional, Luebber, Finn, additional, Erdmann, Jeanette, additional, Heidecke, Harald, additional, Schulze-Forster, Kai, additional, Dechend, Ralf, additional, Lackner, Karl J, additional, Pfeiffer, Norbert, additional, Ghaemi Kerahrodi, Jasmin, additional, Tüscher, Oliver, additional, Schwarting, Andreas, additional, Strauch, Konstantin, additional, Münzel, Thomas, additional, Prochaska, Jürgen H, additional, Riemekasten, Gabriela, additional, and Wild, Philipp S, additional

Published
2023
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32. Rheuma-VOR study: optimising healthcare of rheumatic diseases by multiprofessional coordinating centres

Author

Dreher, Matthias, primary, Witte, Torsten, additional, Hoeper, Kirsten, additional, Assmann, Gunter, additional, Proft, Fabian, additional, Poddubnyy, Denis, additional, Murawski, Niels, additional, Triantafyllias, Konstantinos, additional, Grodd, Marlon, additional, Graf, Erika, additional, Fichtner, Urs A, additional, Binder, Harald, additional, Zeidler, Jan, additional, Hoeper, Juliana Rachel, additional, Callhoff, Johanna, additional, Karberg, Kirsten, additional, Trautwein, Anna, additional, Tibyampansha, Dativa, additional, Wojnowski, Leszek, additional, Schmidt, Reinhold E, additional, and Schwarting, Andreas, additional

Published
2023
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35. Clinical follow-up predictors of disease pattern change in anti-Jo1 positive anti-synthetase syndrome: Results from a multicenter, international and retrospective study

Author

Bartoloni, Elena, Gonzalez-Gay, Miguel A., Scirè, Carlo, Castaneda, Santos, Gerli, Roberto, Lopez-Longo, Francisco Javier, Martinez-Barrio, Julia, Govoni, Marcello, Furini, Federica, Pina, Trinitario, Iannone, Florenzo, Giannini, Margherita, Nuño, Laura, Quartuccio, Luca, Ortego-Centeno, Norberto, Alunno, Alessia, Specker, Christopher, Montecucco, Carlomaurizio, Triantafyllias, Konstantinos, Balduzzi, Silvia, Sifuentes-Giraldo, Walter Alberto, Paolazzi, Giuseppe, Bravi, Elena, Schwarting, Andreas, Pellerito, Raffaele, Russo, Alessandra, Selmi, Carlo, Saketkoo, Lesley-Ann, Fusaro, Enrico, Parisi, Simone, Pipitone, Nicolò, Franceschini, Franco, Cavazzana, Ilaria, Neri, Rossella, Barsotti, Simone, Codullo, Veronica, and Cavagna, Lorenzo

Published
2017
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37. Transcriptome Analysis of BAFF/BAFF-R System in Murine Nephrotoxic Serum Nephritis.

Author

Möckel, Tamara, Boegel, Sebastian, and Schwarting, Andreas

Subjects
NEPHRITIS, CHRONIC kidney failure, ACUTE kidney failure, PROGNOSIS, BASAL lamina, TALL-1 (Protein), B cells
Abstract

Chronic kidney disease (CKD) is an emerging cause for morbidity and mortality worldwide. Acute kidney injury (AKI) can transition to CKD and finally to end-stage renal disease (ESRD). Targeted treatment is still unavailable. NF-κB signaling is associated with CKD and activated by B cell activating factor (BAFF) via BAFF-R binding. In turn, renal tubular epithelial cells (TECs) are critical for the progression of fibrosis and producing BAFF. Therefore, the direct involvement of the BAFF/BAFF-R system to the pathogenesis of CKD is conceivable. We performed non-accelerated nephrotoxic serum nephritis (NTN) as the CKD model in BAFF KO (B6.129S2-Tnfsf13btm1Msc/J), BAFF-R KO (B6(Cg)-Tnfrsf13ctm1Mass/J) and wildtype (C57BL/6J) mice to analyze the BAFF/BAFF-R system in anti-glomerular basement membrane (GBM) disease using high throughput RNA sequencing. We found that BAFF signaling is directly involved in the upregulation of collagen III as BAFF ko mice showed a reduced expression. However, these effects were not mediated via BAFF-R. We identified several upregulated genes that could explain the effects of BAFF in chronic kidney injury such as Txnip, Gpx3, Igfbp7, Ccn2, Kap, Umod and Ren1. Thus, we conclude that targeted treatment with anti-BAFF drugs such as belimumab may reduce chronic kidney damage. Furthermore, upregulated genes may be useful prognostic CKD biomarkers. [ABSTRACT FROM AUTHOR]

Published
2024
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40. Delegation ärztlicher Leistungen an rheumatologische Fachassistenten

Author

Hoeper, Juliana Rachel, primary, Schuch, Florian, additional, Steffens-Korbanka, Patricia, additional, Gauler, Georg, additional, Welcker, Martin, additional, Wendler, Jörg, additional, von Hinüber, Ulrich, additional, Meyer, Sara Eileen, additional, Schwarting, Andreas, additional, Zeidler, Jan, additional, Witte, Torsten, additional, Meyer-Olson, Dirk, additional, and Hoeper, Kirsten, additional

Published
2023
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45. Delegation ärztlicher Leistungen an rheumatologische Fachassistenten: Effekte auf Depression und Angst bei Patienten mit rheumatoider Arthritis

Author

Hoeper, Juliana Rachel, Schuch, Florian, Steffens-Korbanka, Patricia, Gauler, Georg, Welcker, Martin, Wendler, Jörg, von Hinüber, Ulrich, Meyer, Sara Eileen, Schwarting, Andreas, Zeidler, Jan, Witte, Torsten, Meyer-Olson, Dirk, Hoeper, Kirsten, Hoeper, Juliana Rachel, Schuch, Florian, Steffens-Korbanka, Patricia, Gauler, Georg, Welcker, Martin, Wendler, Jörg, von Hinüber, Ulrich, Meyer, Sara Eileen, Schwarting, Andreas, Zeidler, Jan, Witte, Torsten, Meyer-Olson, Dirk, and Hoeper, Kirsten

Abstract

Background: At least 1 comorbidity occurs in 80% of patients with rheumatoid arthritis (RA). In addition to cardiovascular comorbidities psychological comorbid conditions are common. The prevalence of depression and anxiety is higher in patients than in the general population. Screening for comorbidities is crucial. A shortage of outpatient specialist care barely allows resources for this. The implementation of team-based care holds the potential to improve the standard of care while simultaneously working against the shortage of care. Objective: The aim of the study was to examine the effects of care on the course of depression and anxiety in patients with seropositive RA and active disease. Material and methods: A multicenter pragmatic randomized controlled trial was conducted over the course of 1 year with 224 patients. After baseline, five more visits followed. In the intervention group (IG), three were initially carried out by qualified rheumatological assistants. Depression, anxiety and patient satisfaction with outpatient care were looked at in detail. Results: In the IG the anxiety symptoms significantly improved over 12 months (p = 0.036). The proportions of patients with anxiety also significantly changed in the IG (p < 0.001), while there was no change in the control group between baseline and month 12. The values of the depression scale did not differ significantly (p = 0.866). In terms of the information dimension of the satisfaction questionnaire, patients in the IG felt significantly better informed after 6 months (p = 0.013) and 12 months (p = 0.003). Conclusion: A positive effect of team-based care on the course of depression and anxiety in patients with seropositive RA and active disease could be shown., Hintergrund: Bei 80 % der Patienten mit einer rheumatoiden Arthritis (RA) tritt mindestens eine Komorbidität auf. Neben kardiovaskulären Komorbiditäten sind psychische Erkrankungen häufig. Die Prävalenz von Depression und Angst ist bei Betroffenen höher als in der Allgemeinbevölkerung. Ein Screening auf Komorbidität ist hoch relevant. Die Unterversorgung im fachärztlichen Bereich lässt dies kaum zu. Die Implementierung einer Visite durch die rheumatologische Fachassistenz (RFA) bietet Potenzial, die Versorgung zu verbessern und der Unterversorgung zu begegnen. Fragestellung: Ziel ist, Auswirkungen einer teambasierten Versorgung auf den Verlauf von Depression und Angst bei Patienten mit einer seropositiven RA im Krankheitsschub zu untersuchen. Material und Methoden: Es handelt sich um eine multizentrische, pragmatische, randomisierte, kontrollierte Studie über 1 Jahr mit 224 Patienten. Nach Baseline folgen 5 Visiten. In der Interventionsgruppe (IG) fanden 3 zunächst bei der RFA statt. Depression, Angst und Behandlungszufriedenheit werden genauer betrachtet. Ergebnisse: In der IG hat sich die ängstliche Symptomatik über 12 Monate signifikant verbessert (p = 0,036). Auch die Anteile der Patienten mit Ängstlichkeit verändern sich signifikant in der Interventionsgruppe (p < 0,001), während es in der Kontrollgruppe im Vergleich zwischen Baseline und Monat 12 zu keiner Veränderung kam. Die Werte der Depressionsskala unterschieden sich nicht signifikant (p = 0,866). Bei der Dimension „Information“ des Zufriedenheitsfragebogens haben sich die Patienten in der IG nach 6 (p = 0,013) und 12 Monaten (p = 0,003) signifikant besser informiert gefühlt. Diskussion: Ein positiver Effekt der teambasierten Versorgung auf den Verlauf von Depression und Angst bei Patienten mit einer seropositiven RA im Krankheitsschub konnte gezeigt werden.

Published
2023

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