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Erschienen in: Zeitschrift für Rheumatologie 6/2011

01.08.2011 | Leitthema

Kardiovaskuläre Komorbidität und ihre Risikofaktoren bei rheumatoider Arthritis

verfasst von: Dr. S. Kleinert, K. Krueger

Erschienen in: Zeitschrift für Rheumatologie | Ausgabe 6/2011

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Zusammenfassung

Die rheumatoide Arthritis (RA) ist mit einer erhöhten Mortalität assoziiert, die v. a. auf dem erhöhten kardiovaskulären Risiko basiert. Traditionelle kardiovaskuläre Risikofaktoren können dieses Risiko nicht ausreichend erklären. Dahingegen wurden Charakteristika der Erkrankung wie Inflammation, Rheumafaktorpositivität oder Nachweis von Antikörpern gegen zitrullinierte Peptide (ACPA) als RA-spezifische Risikofaktoren etabliert. Eine effektive Krankheitskontrolle mit Basistherapeutika („disease modifying drugs“, DMARDs) reduziert nachweislich das kardiovaskuläre Risiko bei RA-Patienten; nichtsteroidale Antirheumatika (NSAR) und Glukokortikoide sind vermutlich mit einem erhöhten Risiko assoziiert. EULAR-Empfehlungen zum Management des kardiovaskulären Risikos bei RA-Patienten wurden etabliert. Diese Empfehlungen basieren auf nationalen Richtlinien zur Kontrolle der traditionellen kardiovaskulären Risikofaktoren.
Literatur
1.
Zurück zum Zitat Baka Z, Buzas E, Nagy G (2009) Rheumatoid arthritis and smoking: putting the pieces together. Arthritis Res Ther 11:238PubMedCrossRef Baka Z, Buzas E, Nagy G (2009) Rheumatoid arthritis and smoking: putting the pieces together. Arthritis Res Ther 11:238PubMedCrossRef
2.
Zurück zum Zitat Banerjee S, Compton AP, Hooker RS et al (2008) Cardiovascular outcomes in male veterans with rheumatoid arthritis. Am J Cardiol 101:1201–1205PubMedCrossRef Banerjee S, Compton AP, Hooker RS et al (2008) Cardiovascular outcomes in male veterans with rheumatoid arthritis. Am J Cardiol 101:1201–1205PubMedCrossRef
3.
Zurück zum Zitat Böhm M, Laufs U, Hamm C et al (2007) Position paper on statin therapy. Clin Res Cardiol (Suppl 2):8–15 Böhm M, Laufs U, Hamm C et al (2007) Position paper on statin therapy. Clin Res Cardiol (Suppl 2):8–15
4.
Zurück zum Zitat Boyer JF, Gourraud PA, Cantagrel A et al (2011) Traditional cardiovascular risk factors in rheumatoid arthritis: a meta-analysis. Joint Bone Spine 78:179–183PubMedCrossRef Boyer JF, Gourraud PA, Cantagrel A et al (2011) Traditional cardiovascular risk factors in rheumatoid arthritis: a meta-analysis. Joint Bone Spine 78:179–183PubMedCrossRef
5.
Zurück zum Zitat Brady SR, De Courten B, Reid CM et al (2009) The role of traditional cardiovascular risk factors among patients with rheumatoid arthritis. J Rheumatol 36:34–40PubMed Brady SR, De Courten B, Reid CM et al (2009) The role of traditional cardiovascular risk factors among patients with rheumatoid arthritis. J Rheumatol 36:34–40PubMed
6.
Zurück zum Zitat Cannon CP, Curtis SP, Fitzgerald GA et al (2006) Cardiovascular outcomes with etoricoxib and diclofenac in patients with osteoarthritis and rheumatoid arthritis in the Multinational Etoricoxib and Diclofenac Arthritis Long-term (MEDAL) programme: a randomised comparison. Lancet 368:1771–1781PubMedCrossRef Cannon CP, Curtis SP, Fitzgerald GA et al (2006) Cardiovascular outcomes with etoricoxib and diclofenac in patients with osteoarthritis and rheumatoid arthritis in the Multinational Etoricoxib and Diclofenac Arthritis Long-term (MEDAL) programme: a randomised comparison. Lancet 368:1771–1781PubMedCrossRef
7.
Zurück zum Zitat Choy E, Sattar N (2009) Interpreting lipid levels in the context of high-grade inflammatory states with a focus on rheumatoid arthritis: a challenge to conventional cardiovascular risk actions. Ann Rheum Dis 68:460–469PubMedCrossRef Choy E, Sattar N (2009) Interpreting lipid levels in the context of high-grade inflammatory states with a focus on rheumatoid arthritis: a challenge to conventional cardiovascular risk actions. Ann Rheum Dis 68:460–469PubMedCrossRef
8.
Zurück zum Zitat Chung ES, Packer M, Lo KH et al (2003) Randomized, double-blind, placebo-controlled, pilot trial of infliximab, a chimeric monoclonal antibody to tumor necrosis factor-alpha, in patients with moderate-to-severe heart failure: results of the anti-TNF Therapy Against Congestive Heart Failure (ATTACH) trial. Circulation 107:3133–3140PubMedCrossRef Chung ES, Packer M, Lo KH et al (2003) Randomized, double-blind, placebo-controlled, pilot trial of infliximab, a chimeric monoclonal antibody to tumor necrosis factor-alpha, in patients with moderate-to-severe heart failure: results of the anti-TNF Therapy Against Congestive Heart Failure (ATTACH) trial. Circulation 107:3133–3140PubMedCrossRef
9.
Zurück zum Zitat Davis JM 3rd, Maradit Kremers H, Crowson CS et al (2007) Glucocorticoids and cardiovascular events in rheumatoid arthritis: a population-based cohort study. Arthritis Rheum 56:820–830PubMedCrossRef Davis JM 3rd, Maradit Kremers H, Crowson CS et al (2007) Glucocorticoids and cardiovascular events in rheumatoid arthritis: a population-based cohort study. Arthritis Rheum 56:820–830PubMedCrossRef
10.
Zurück zum Zitat Deutsche Hochdruckliga e.V. DHL®, Deutsche Hypertonie Gesellschaft (2008) Leitlinien zur Behandlung der arteriellen Hypertonie. AWMF-Leitlinien-Register-Nr. 046/001 (Stand Juni 2008) Deutsche Hochdruckliga e.V. DHL®, Deutsche Hypertonie Gesellschaft (2008) Leitlinien zur Behandlung der arteriellen Hypertonie. AWMF-Leitlinien-Register-Nr. 046/001 (Stand Juni 2008)
11.
Zurück zum Zitat Deutsche Hochdruckliga e.V. DHL®, Deutsche Hypertonie Gesellschaft (2010) Zielblutdruckwerte bei Patienten mit Diabetes mellitus. Stellungnahme vom 07. September 2010 Deutsche Hochdruckliga e.V. DHL®, Deutsche Hypertonie Gesellschaft (2010) Zielblutdruckwerte bei Patienten mit Diabetes mellitus. Stellungnahme vom 07. September 2010
12.
Zurück zum Zitat Dixon WG, Watson KD, Lunt M et al (2007) Reduction in the incidence of myocardial infarction in patients with rheumatoid arthritis who respond to anti-tumor necrosis factor alpha therapy: results from the British Society for Rheumatology Biologics Register. Arthritis Rheum 56:2905–2912PubMedCrossRef Dixon WG, Watson KD, Lunt M et al (2007) Reduction in the incidence of myocardial infarction in patients with rheumatoid arthritis who respond to anti-tumor necrosis factor alpha therapy: results from the British Society for Rheumatology Biologics Register. Arthritis Rheum 56:2905–2912PubMedCrossRef
13.
Zurück zum Zitat Edwards CJ, Syddall H, Goswami R et al (2007) The autoantibody rheumatoid factor may be an independent risk factor for ischaemic heart disease in men. Heart 93:1263–1267PubMedCrossRef Edwards CJ, Syddall H, Goswami R et al (2007) The autoantibody rheumatoid factor may be an independent risk factor for ischaemic heart disease in men. Heart 93:1263–1267PubMedCrossRef
14.
Zurück zum Zitat Gohlke H, Von Schacky C (2005) Total risk for cardiovascular disease. At what point is medical prophylactic medication useful? Z Kardiol 94(Suppl 3):III/6–10 Gohlke H, Von Schacky C (2005) Total risk for cardiovascular disease. At what point is medical prophylactic medication useful? Z Kardiol 94(Suppl 3):III/6–10
15.
Zurück zum Zitat Gonzalez-Gay MA, Gonzalez-Juanatey C, Lopez-Diaz MJ et al (2007) HLA-DRB1 and persistent chronic inflammation contribute to cardiovascular events and cardiovascular mortality in patients with rheumatoid arthritis. Arthritis Rheum 57:125–132PubMedCrossRef Gonzalez-Gay MA, Gonzalez-Juanatey C, Lopez-Diaz MJ et al (2007) HLA-DRB1 and persistent chronic inflammation contribute to cardiovascular events and cardiovascular mortality in patients with rheumatoid arthritis. Arthritis Rheum 57:125–132PubMedCrossRef
16.
Zurück zum Zitat Goodson NJ, Brookhart AM, Symmons DP et al (2009) Non-steroidal anti-inflammatory drug use does not appear to be associated with increased cardiovascular mortality in patients with inflammatory polyarthritis: results from a primary care based inception cohort of patients. Ann Rheum Dis 68:367–372PubMedCrossRef Goodson NJ, Brookhart AM, Symmons DP et al (2009) Non-steroidal anti-inflammatory drug use does not appear to be associated with increased cardiovascular mortality in patients with inflammatory polyarthritis: results from a primary care based inception cohort of patients. Ann Rheum Dis 68:367–372PubMedCrossRef
17.
Zurück zum Zitat Greenberg JD, Kremer JM, Curtis JR et al (2011) Tumour necrosis factor antagonist use and associated risk reduction of cardiovascular events among patients with rheumatoid arthritis. Ann Rheum Dis 70:576–582PubMedCrossRef Greenberg JD, Kremer JM, Curtis JR et al (2011) Tumour necrosis factor antagonist use and associated risk reduction of cardiovascular events among patients with rheumatoid arthritis. Ann Rheum Dis 70:576–582PubMedCrossRef
18.
Zurück zum Zitat Holmqvist ME, Wedren S, Jacobsson LT et al (2009) No increased occurrence of ischemic heart disease prior to the onset of rheumatoid arthritis: results from two Swedish population-based rheumatoid arthritis cohorts. Arthritis Rheum 60:2861–2869PubMedCrossRef Holmqvist ME, Wedren S, Jacobsson LT et al (2009) No increased occurrence of ischemic heart disease prior to the onset of rheumatoid arthritis: results from two Swedish population-based rheumatoid arthritis cohorts. Arthritis Rheum 60:2861–2869PubMedCrossRef
19.
Zurück zum Zitat Holmqvist ME, Wedren S, Jacobsson LT et al (2010) Rapid increase in myocardial infarction risk following diagnosis of rheumatoid arthritis amongst patients diagnosed between 1995 and 2006. J Intern Med 268:578–585PubMedCrossRef Holmqvist ME, Wedren S, Jacobsson LT et al (2010) Rapid increase in myocardial infarction risk following diagnosis of rheumatoid arthritis amongst patients diagnosed between 1995 and 2006. J Intern Med 268:578–585PubMedCrossRef
20.
Zurück zum Zitat Jacobsson LT, Turesson C, Gulfe A et al (2005) Treatment with tumor necrosis factor blockers is associated with a lower incidence of first cardiovascular events in patients with rheumatoid arthritis. J Rheumatol 32:1213–1218PubMed Jacobsson LT, Turesson C, Gulfe A et al (2005) Treatment with tumor necrosis factor blockers is associated with a lower incidence of first cardiovascular events in patients with rheumatoid arthritis. J Rheumatol 32:1213–1218PubMed
21.
Zurück zum Zitat Keil U, Fitzgerald AP, Gohlke H et al (2005) Risikoabschätzung tödlicher Herz-Kreislauf-Erkrankungen. Die neuen SCORE-Deutschland-Tabellen für die Primärprävention. Dtsch Arztebl 102:A1808–A1812 Keil U, Fitzgerald AP, Gohlke H et al (2005) Risikoabschätzung tödlicher Herz-Kreislauf-Erkrankungen. Die neuen SCORE-Deutschland-Tabellen für die Primärprävention. Dtsch Arztebl 102:A1808–A1812
22.
Zurück zum Zitat Kitas GD, Gabriel SE (2011) Cardiovascular disease in rheumatoid arthritis: state of the art and future perspectives. Ann Rheum Dis 70:8–14PubMedCrossRef Kitas GD, Gabriel SE (2011) Cardiovascular disease in rheumatoid arthritis: state of the art and future perspectives. Ann Rheum Dis 70:8–14PubMedCrossRef
23.
Zurück zum Zitat Klarenbeek NB, Van Der Kooij SM, Huizinga TJ et al (2010) Blood pressure changes in patients with recent-onset rheumatoid arthritis treated with four different treatment strategies: a post hoc analysis from the BeSt trial. Ann Rheum Dis 69:1342–1345PubMedCrossRef Klarenbeek NB, Van Der Kooij SM, Huizinga TJ et al (2010) Blood pressure changes in patients with recent-onset rheumatoid arthritis treated with four different treatment strategies: a post hoc analysis from the BeSt trial. Ann Rheum Dis 69:1342–1345PubMedCrossRef
24.
Zurück zum Zitat Kramer HR, Giles JT (2011) Cardiovascular disease risk in rheumatoid arthritis: progress, debate, and opportunity. Arthritis Care Res (Hoboken) 63:484–499CrossRef Kramer HR, Giles JT (2011) Cardiovascular disease risk in rheumatoid arthritis: progress, debate, and opportunity. Arthritis Care Res (Hoboken) 63:484–499CrossRef
25.
Zurück zum Zitat Liang KP, Kremers HM, Crowson CS et al (2009) Autoantibodies and the risk of cardiovascular events. J Rheumatol 36:2462–2469PubMedCrossRef Liang KP, Kremers HM, Crowson CS et al (2009) Autoantibodies and the risk of cardiovascular events. J Rheumatol 36:2462–2469PubMedCrossRef
26.
Zurück zum Zitat Listing J, Strangfeld A, Kekow J et al (2008) Does tumor necrosis factor alpha inhibition promote or prevent heart failure in patients with rheumatoid arthritis? Arthritis Rheum 58:667–677PubMedCrossRef Listing J, Strangfeld A, Kekow J et al (2008) Does tumor necrosis factor alpha inhibition promote or prevent heart failure in patients with rheumatoid arthritis? Arthritis Rheum 58:667–677PubMedCrossRef
27.
Zurück zum Zitat Lopez-Longo FJ, Oliver-Minarro D, De La Torre I et al (2009) Association between anti-cyclic citrullinated peptide antibodies and ischemic heart disease in patients with rheumatoid arthritis. Arthritis Rheum 61:419–424PubMedCrossRef Lopez-Longo FJ, Oliver-Minarro D, De La Torre I et al (2009) Association between anti-cyclic citrullinated peptide antibodies and ischemic heart disease in patients with rheumatoid arthritis. Arthritis Rheum 61:419–424PubMedCrossRef
28.
Zurück zum Zitat Mancia G, De Backer G, Dominiczak A et al (2007) 2007 Guidelines for the management of arterial hypertension: The Task Force for the Management of Arterial Hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). Eur Heart J 28:1462–1536PubMed Mancia G, De Backer G, Dominiczak A et al (2007) 2007 Guidelines for the management of arterial hypertension: The Task Force for the Management of Arterial Hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). Eur Heart J 28:1462–1536PubMed
29.
Zurück zum Zitat Mancia G, Laurent S, Agabiti-Rosei E et al (2009) Reappraisal of European guidelines on hypertension management: a European Society of Hypertension Task Force document. J Hypertens 27:2121–2158PubMedCrossRef Mancia G, Laurent S, Agabiti-Rosei E et al (2009) Reappraisal of European guidelines on hypertension management: a European Society of Hypertension Task Force document. J Hypertens 27:2121–2158PubMedCrossRef
30.
Zurück zum Zitat Maradit-Kremers H, Crowson CS, Nicola PJ et al (2005) Increased unrecognized coronary heart disease and sudden deaths in rheumatoid arthritis: a population-based cohort study. Arthritis Rheum 52:402–411PubMedCrossRef Maradit-Kremers H, Crowson CS, Nicola PJ et al (2005) Increased unrecognized coronary heart disease and sudden deaths in rheumatoid arthritis: a population-based cohort study. Arthritis Rheum 52:402–411PubMedCrossRef
31.
Zurück zum Zitat Maradit-Kremers H, Nicola PJ, Crowson CS et al (2005) Cardiovascular death in rheumatoid arthritis: a population-based study. Arthritis Rheum 52:722–732PubMedCrossRef Maradit-Kremers H, Nicola PJ, Crowson CS et al (2005) Cardiovascular death in rheumatoid arthritis: a population-based study. Arthritis Rheum 52:722–732PubMedCrossRef
32.
Zurück zum Zitat Mathes P, Thiery J (2005) The role of lipid metabolism in the prevention of coronary heart disease. Z Kardiol 94(Suppl 3):III/43–55CrossRef Mathes P, Thiery J (2005) The role of lipid metabolism in the prevention of coronary heart disease. Z Kardiol 94(Suppl 3):III/43–55CrossRef
33.
Zurück zum Zitat Matthaei S, Bierwirth R, Fritsche A et al (2010) Behandlung des Diabetes mellitus Typ 2. Diabetes Metab 5(Suppl 2):127–132 Matthaei S, Bierwirth R, Fritsche A et al (2010) Behandlung des Diabetes mellitus Typ 2. Diabetes Metab 5(Suppl 2):127–132
34.
Zurück zum Zitat Myasoedova E, Crowson CS, Kremers HM et al (2011) Lipid paradox in rheumatoid arthritis: the impact of serum lipid measures and systemic inflammation on the risk of cardiovascular disease. Ann Rheum Dis 70:482–487PubMedCrossRef Myasoedova E, Crowson CS, Kremers HM et al (2011) Lipid paradox in rheumatoid arthritis: the impact of serum lipid measures and systemic inflammation on the risk of cardiovascular disease. Ann Rheum Dis 70:482–487PubMedCrossRef
35.
Zurück zum Zitat Naranjo A, Sokka T, Descalzo MA et al (2008) Cardiovascular disease in patients with rheumatoid arthritis: results from the QUEST-RA study. Arthritis Res Ther 10:R30PubMedCrossRef Naranjo A, Sokka T, Descalzo MA et al (2008) Cardiovascular disease in patients with rheumatoid arthritis: results from the QUEST-RA study. Arthritis Res Ther 10:R30PubMedCrossRef
36.
Zurück zum Zitat Panoulas VF, Metsios GS, Pace AV et al (2008) Hypertension in rheumatoid arthritis. Rheumatology (Oxford) 47:1286–1298 Panoulas VF, Metsios GS, Pace AV et al (2008) Hypertension in rheumatoid arthritis. Rheumatology (Oxford) 47:1286–1298
37.
Zurück zum Zitat Peters MJL, Symmons DPM, Mccarey D et al (2010) EULAR evidence-based recommendations for cardiovascular risk management in patients with rheumatoid arthritis and other forms of inflammatory arthritis. Ann Rheum Dis 69:325–331PubMedCrossRef Peters MJL, Symmons DPM, Mccarey D et al (2010) EULAR evidence-based recommendations for cardiovascular risk management in patients with rheumatoid arthritis and other forms of inflammatory arthritis. Ann Rheum Dis 69:325–331PubMedCrossRef
38.
Zurück zum Zitat Semb AG, Kvien TK, Aastveit AH et al (2010) Lipids, myocardial infarction and ischaemic stroke in patients with rheumatoid arthritis in the Apolipoprotein-related Mortality RISk (AMORIS) Study. Ann Rheum Dis 69:1996–2001PubMedCrossRef Semb AG, Kvien TK, Aastveit AH et al (2010) Lipids, myocardial infarction and ischaemic stroke in patients with rheumatoid arthritis in the Apolipoprotein-related Mortality RISk (AMORIS) Study. Ann Rheum Dis 69:1996–2001PubMedCrossRef
39.
Zurück zum Zitat Solomon DH, Avorn J, Katz JN et al (2006) Immunosuppressive medications and hospitalization for cardiovascular events in patients with rheumatoid arthritis. Arthritis Rheum 54:3790–3798PubMedCrossRef Solomon DH, Avorn J, Katz JN et al (2006) Immunosuppressive medications and hospitalization for cardiovascular events in patients with rheumatoid arthritis. Arthritis Rheum 54:3790–3798PubMedCrossRef
40.
Zurück zum Zitat Solomon DH, Kremer J, Curtis JR et al (2010) Explaining the cardiovascular risk associated with rheumatoid arthritis: traditional risk factors versus markers of rheumatoid arthritis severity. Ann Rheum Dis 69:1920–1925PubMedCrossRef Solomon DH, Kremer J, Curtis JR et al (2010) Explaining the cardiovascular risk associated with rheumatoid arthritis: traditional risk factors versus markers of rheumatoid arthritis severity. Ann Rheum Dis 69:1920–1925PubMedCrossRef
41.
Zurück zum Zitat Suissa S, Bernatsky S, Hudson M (2006) Antirheumatic drug use and the risk of acute myocardial infarction. Arthritis Rheum 55:531–536PubMedCrossRef Suissa S, Bernatsky S, Hudson M (2006) Antirheumatic drug use and the risk of acute myocardial infarction. Arthritis Rheum 55:531–536PubMedCrossRef
42.
Zurück zum Zitat Taylor F, Ward K, Moore TH et al (2011) Statins for the primary prevention of cardiovascular disease. Cochrane database Syst Rev:CD004816 Taylor F, Ward K, Moore TH et al (2011) Statins for the primary prevention of cardiovascular disease. Cochrane database Syst Rev:CD004816
43.
Zurück zum Zitat Tomasson G, Aspelund T, Jonsson T et al (2010) Effect of rheumatoid factor on mortality and coronary heart disease. Ann Rheum Dis 69:1649–1654PubMedCrossRef Tomasson G, Aspelund T, Jonsson T et al (2010) Effect of rheumatoid factor on mortality and coronary heart disease. Ann Rheum Dis 69:1649–1654PubMedCrossRef
44.
Zurück zum Zitat Trelle S, Reichenbach S, Wandel S et al (2011) Cardiovascular safety of non-steroidal anti-inflammatory drugs: network meta-analysis. BMJ 342:c7086PubMedCrossRef Trelle S, Reichenbach S, Wandel S et al (2011) Cardiovascular safety of non-steroidal anti-inflammatory drugs: network meta-analysis. BMJ 342:c7086PubMedCrossRef
45.
Zurück zum Zitat Van Halm VP, Peters MJ, Voskuyl AE et al (2009) Rheumatoid arthritis versus diabetes as a risk factor for cardiovascular disease: a cross-sectional study, the CARRE Investigation. Ann Rheum Dis 68:1395–1400CrossRef Van Halm VP, Peters MJ, Voskuyl AE et al (2009) Rheumatoid arthritis versus diabetes as a risk factor for cardiovascular disease: a cross-sectional study, the CARRE Investigation. Ann Rheum Dis 68:1395–1400CrossRef
46.
Zurück zum Zitat Westlake SL, Colebatch AN, Baird J et al (2010) The effect of methotrexate on cardiovascular disease in patients with rheumatoid arthritis: a systematic literature review. Rheumatology (Oxford) 49:295–307 Westlake SL, Colebatch AN, Baird J et al (2010) The effect of methotrexate on cardiovascular disease in patients with rheumatoid arthritis: a systematic literature review. Rheumatology (Oxford) 49:295–307
47.
Zurück zum Zitat Wolfe F, Michaud K (2008) The risk of myocardial infarction and pharmacologic and nonpharmacologic myocardial infarction predictors in rheumatoid arthritis: a cohort and nested case-control analysis. Arthritis Rheum 58:2612–2621PubMedCrossRef Wolfe F, Michaud K (2008) The risk of myocardial infarction and pharmacologic and nonpharmacologic myocardial infarction predictors in rheumatoid arthritis: a cohort and nested case-control analysis. Arthritis Rheum 58:2612–2621PubMedCrossRef
Metadaten
Titel
Kardiovaskuläre Komorbidität und ihre Risikofaktoren bei rheumatoider Arthritis
verfasst von
Dr. S. Kleinert
K. Krueger
Publikationsdatum
01.08.2011
Verlag
Springer-Verlag
Erschienen in
Zeitschrift für Rheumatologie / Ausgabe 6/2011
Print ISSN: 0340-1855
Elektronische ISSN: 1435-1250
DOI
https://doi.org/10.1007/s00393-011-0755-0

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