Research ArticleArticle
Response to Tumor Necrosis Factor Inhibition in Male and Female Patients with Ankylosing Spondylitis: Data from a Swiss Cohort
Monika Hebeisen, Regula Neuenschwander, Almut Scherer, Pascale Exer, Ulrich Weber, Giorgio Tamborrini, Raphael Micheroli, Lukas M. Wildi, Pascal Zufferey, Michael J. Nissen, Peter M. Villiger, Jürg Bernhard, Axel Finckh, Irene E. van der Horst-Bruinsma, Joachim Sieper, Robert Landewé, Désirée van der Heijde and Adrian Ciurea on behalf of the rheumatologists of the Swiss Clinical Quality Management Program
The Journal of Rheumatology February 2018, jrheum.170166; DOI: https://doi.org/10.3899/jrheum.170166
Monika Hebeisen
From the Swiss Clinical Quality Management Foundation; Department of Rheumatology, Zurich University Hospital, Zurich; Praxis Rheuma-Basel, Basel, Switzerland; King Christian 10th Hospital for Rheumatic Diseases, Gråsten; Institute of Regional Health Research, University of Southern Denmark, Odense, Denmark; Ultrasound Center Rheumatology, Basel; Department of Rheumatology, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne; Department of Rheumatology, University Hospital, Geneva; Department of Rheumatology and Clinical Immunology, Inselspital, Bern; Department of Rheumatology and Rehabilitation, Bürgerspital, Solothurn, Switzerland; Department of Rheumatology, VU University Medical Center, Amsterdam, the Netherlands; Department of Gastroenterology, Infectiology and Rheumatology, Charité Universitätsmedizin, Berlin, Germany; Department of Clinical Immunology and Rheumatology, University of Amsterdam; Department of Rheumatology, Zuyderland Hospital, Heerlen; Department of Rheumatology, Leiden University Medical Center, Leiden, the Netherlands. The Swiss Clinical Quality Management Foundation is supported by the Swiss Society of Rheumatology and by AbbVie, Bristol-Myers-Squibb, Janssen-Cilag, Merck Sharp & Dohme, Novartis, Pfizer, Roche, and UCB, and has received project-based financial supports from the Arco Foundation, Switzerland, as well as from the Swiss Balgrist Society, Switzerland. This study was supported by AbbVie through the AbbVie Rheumatology Grant 2013, intended to support clinically oriented research in rheumatology and clinical immunology in Switzerland and awarded to Dr. Ciurea. Additional financial support was obtained from the Stiftung für Rheumaforschung. M. Hebeisen, MSc, Swiss Clinical Quality Management Foundation; R. Neuenschwander, Department of Rheumatology, Zurich University Hospital; A. Scherer, PhD, Swiss Clinical Quality Management Foundation; P. Exer, MD, Praxis Rheuma-Basel; U. Weber, MD, King Christian 10th Hospital for Rheumatic Diseases, Gråsten, and South Jutland Hospital, Institute of Regional Health Research; G. Tamborrini, MD, Ultrasound Center Rheumatology; R. Micheroli, MD, Department of Rheumatology, Zurich University Hospital; L.M. Wildi, MD, Department of Rheumatology, Zurich University Hospital; P. Zufferey, MD, Department of Rheumatology, CHUV; M.J. Nissen, MD, Department of Rheumatology, University Hospital; P.M. Villiger, MD, Department of Rheumatology and Clinical Immunology, Inselspital; J. Bernhard, MD, Department of Rheumatology and Rehabilitation, Bürgerspital; A. Finckh, MD, PhD, Department of Rheumatology, University Hospital; I.E. van der Horst-Bruinsma, MD, PhD, Department of Rheumatology, VU University Medical Center; J. Sieper, MD, Department of Gastroenterology, Infectiology and Rheumatology, Charité Universitätsmedizin; R. Landewé, MD, PhD, Department of Clinical Immunology and Rheumatology, University of Amsterdam, and Department of Rheumatology, Zuyderland Hospital; D. van der Heijde, MD, PhD, Department of Rheumatology, Leiden University Medical Center; A. Ciurea, MD, Department of Rheumatology, Zurich University Hospital. Address correspondence to Dr. A. Ciurea, Department of Rheumatology, Zurich University Hospital, Gloriastrasse 25, CH-8091 Zurich, Switzerland. E-mail: adrian.ciurea@usz.ch. Accepted for publication November 6, 2017.
Regula Neuenschwander
From the Swiss Clinical Quality Management Foundation; Department of Rheumatology, Zurich University Hospital, Zurich; Praxis Rheuma-Basel, Basel, Switzerland; King Christian 10th Hospital for Rheumatic Diseases, Gråsten; Institute of Regional Health Research, University of Southern Denmark, Odense, Denmark; Ultrasound Center Rheumatology, Basel; Department of Rheumatology, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne; Department of Rheumatology, University Hospital, Geneva; Department of Rheumatology and Clinical Immunology, Inselspital, Bern; Department of Rheumatology and Rehabilitation, Bürgerspital, Solothurn, Switzerland; Department of Rheumatology, VU University Medical Center, Amsterdam, the Netherlands; Department of Gastroenterology, Infectiology and Rheumatology, Charité Universitätsmedizin, Berlin, Germany; Department of Clinical Immunology and Rheumatology, University of Amsterdam; Department of Rheumatology, Zuyderland Hospital, Heerlen; Department of Rheumatology, Leiden University Medical Center, Leiden, the Netherlands. The Swiss Clinical Quality Management Foundation is supported by the Swiss Society of Rheumatology and by AbbVie, Bristol-Myers-Squibb, Janssen-Cilag, Merck Sharp & Dohme, Novartis, Pfizer, Roche, and UCB, and has received project-based financial supports from the Arco Foundation, Switzerland, as well as from the Swiss Balgrist Society, Switzerland. This study was supported by AbbVie through the AbbVie Rheumatology Grant 2013, intended to support clinically oriented research in rheumatology and clinical immunology in Switzerland and awarded to Dr. Ciurea. Additional financial support was obtained from the Stiftung für Rheumaforschung. M. Hebeisen, MSc, Swiss Clinical Quality Management Foundation; R. Neuenschwander, Department of Rheumatology, Zurich University Hospital; A. Scherer, PhD, Swiss Clinical Quality Management Foundation; P. Exer, MD, Praxis Rheuma-Basel; U. Weber, MD, King Christian 10th Hospital for Rheumatic Diseases, Gråsten, and South Jutland Hospital, Institute of Regional Health Research; G. Tamborrini, MD, Ultrasound Center Rheumatology; R. Micheroli, MD, Department of Rheumatology, Zurich University Hospital; L.M. Wildi, MD, Department of Rheumatology, Zurich University Hospital; P. Zufferey, MD, Department of Rheumatology, CHUV; M.J. Nissen, MD, Department of Rheumatology, University Hospital; P.M. Villiger, MD, Department of Rheumatology and Clinical Immunology, Inselspital; J. Bernhard, MD, Department of Rheumatology and Rehabilitation, Bürgerspital; A. Finckh, MD, PhD, Department of Rheumatology, University Hospital; I.E. van der Horst-Bruinsma, MD, PhD, Department of Rheumatology, VU University Medical Center; J. Sieper, MD, Department of Gastroenterology, Infectiology and Rheumatology, Charité Universitätsmedizin; R. Landewé, MD, PhD, Department of Clinical Immunology and Rheumatology, University of Amsterdam, and Department of Rheumatology, Zuyderland Hospital; D. van der Heijde, MD, PhD, Department of Rheumatology, Leiden University Medical Center; A. Ciurea, MD, Department of Rheumatology, Zurich University Hospital. Address correspondence to Dr. A. Ciurea, Department of Rheumatology, Zurich University Hospital, Gloriastrasse 25, CH-8091 Zurich, Switzerland. E-mail: adrian.ciurea@usz.ch. Accepted for publication November 6, 2017.
Almut Scherer
From the Swiss Clinical Quality Management Foundation; Department of Rheumatology, Zurich University Hospital, Zurich; Praxis Rheuma-Basel, Basel, Switzerland; King Christian 10th Hospital for Rheumatic Diseases, Gråsten; Institute of Regional Health Research, University of Southern Denmark, Odense, Denmark; Ultrasound Center Rheumatology, Basel; Department of Rheumatology, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne; Department of Rheumatology, University Hospital, Geneva; Department of Rheumatology and Clinical Immunology, Inselspital, Bern; Department of Rheumatology and Rehabilitation, Bürgerspital, Solothurn, Switzerland; Department of Rheumatology, VU University Medical Center, Amsterdam, the Netherlands; Department of Gastroenterology, Infectiology and Rheumatology, Charité Universitätsmedizin, Berlin, Germany; Department of Clinical Immunology and Rheumatology, University of Amsterdam; Department of Rheumatology, Zuyderland Hospital, Heerlen; Department of Rheumatology, Leiden University Medical Center, Leiden, the Netherlands. The Swiss Clinical Quality Management Foundation is supported by the Swiss Society of Rheumatology and by AbbVie, Bristol-Myers-Squibb, Janssen-Cilag, Merck Sharp & Dohme, Novartis, Pfizer, Roche, and UCB, and has received project-based financial supports from the Arco Foundation, Switzerland, as well as from the Swiss Balgrist Society, Switzerland. This study was supported by AbbVie through the AbbVie Rheumatology Grant 2013, intended to support clinically oriented research in rheumatology and clinical immunology in Switzerland and awarded to Dr. Ciurea. Additional financial support was obtained from the Stiftung für Rheumaforschung. M. Hebeisen, MSc, Swiss Clinical Quality Management Foundation; R. Neuenschwander, Department of Rheumatology, Zurich University Hospital; A. Scherer, PhD, Swiss Clinical Quality Management Foundation; P. Exer, MD, Praxis Rheuma-Basel; U. Weber, MD, King Christian 10th Hospital for Rheumatic Diseases, Gråsten, and South Jutland Hospital, Institute of Regional Health Research; G. Tamborrini, MD, Ultrasound Center Rheumatology; R. Micheroli, MD, Department of Rheumatology, Zurich University Hospital; L.M. Wildi, MD, Department of Rheumatology, Zurich University Hospital; P. Zufferey, MD, Department of Rheumatology, CHUV; M.J. Nissen, MD, Department of Rheumatology, University Hospital; P.M. Villiger, MD, Department of Rheumatology and Clinical Immunology, Inselspital; J. Bernhard, MD, Department of Rheumatology and Rehabilitation, Bürgerspital; A. Finckh, MD, PhD, Department of Rheumatology, University Hospital; I.E. van der Horst-Bruinsma, MD, PhD, Department of Rheumatology, VU University Medical Center; J. Sieper, MD, Department of Gastroenterology, Infectiology and Rheumatology, Charité Universitätsmedizin; R. Landewé, MD, PhD, Department of Clinical Immunology and Rheumatology, University of Amsterdam, and Department of Rheumatology, Zuyderland Hospital; D. van der Heijde, MD, PhD, Department of Rheumatology, Leiden University Medical Center; A. Ciurea, MD, Department of Rheumatology, Zurich University Hospital. Address correspondence to Dr. A. Ciurea, Department of Rheumatology, Zurich University Hospital, Gloriastrasse 25, CH-8091 Zurich, Switzerland. E-mail: adrian.ciurea@usz.ch. Accepted for publication November 6, 2017.
Pascale Exer
From the Swiss Clinical Quality Management Foundation; Department of Rheumatology, Zurich University Hospital, Zurich; Praxis Rheuma-Basel, Basel, Switzerland; King Christian 10th Hospital for Rheumatic Diseases, Gråsten; Institute of Regional Health Research, University of Southern Denmark, Odense, Denmark; Ultrasound Center Rheumatology, Basel; Department of Rheumatology, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne; Department of Rheumatology, University Hospital, Geneva; Department of Rheumatology and Clinical Immunology, Inselspital, Bern; Department of Rheumatology and Rehabilitation, Bürgerspital, Solothurn, Switzerland; Department of Rheumatology, VU University Medical Center, Amsterdam, the Netherlands; Department of Gastroenterology, Infectiology and Rheumatology, Charité Universitätsmedizin, Berlin, Germany; Department of Clinical Immunology and Rheumatology, University of Amsterdam; Department of Rheumatology, Zuyderland Hospital, Heerlen; Department of Rheumatology, Leiden University Medical Center, Leiden, the Netherlands. The Swiss Clinical Quality Management Foundation is supported by the Swiss Society of Rheumatology and by AbbVie, Bristol-Myers-Squibb, Janssen-Cilag, Merck Sharp & Dohme, Novartis, Pfizer, Roche, and UCB, and has received project-based financial supports from the Arco Foundation, Switzerland, as well as from the Swiss Balgrist Society, Switzerland. This study was supported by AbbVie through the AbbVie Rheumatology Grant 2013, intended to support clinically oriented research in rheumatology and clinical immunology in Switzerland and awarded to Dr. Ciurea. Additional financial support was obtained from the Stiftung für Rheumaforschung. M. Hebeisen, MSc, Swiss Clinical Quality Management Foundation; R. Neuenschwander, Department of Rheumatology, Zurich University Hospital; A. Scherer, PhD, Swiss Clinical Quality Management Foundation; P. Exer, MD, Praxis Rheuma-Basel; U. Weber, MD, King Christian 10th Hospital for Rheumatic Diseases, Gråsten, and South Jutland Hospital, Institute of Regional Health Research; G. Tamborrini, MD, Ultrasound Center Rheumatology; R. Micheroli, MD, Department of Rheumatology, Zurich University Hospital; L.M. Wildi, MD, Department of Rheumatology, Zurich University Hospital; P. Zufferey, MD, Department of Rheumatology, CHUV; M.J. Nissen, MD, Department of Rheumatology, University Hospital; P.M. Villiger, MD, Department of Rheumatology and Clinical Immunology, Inselspital; J. Bernhard, MD, Department of Rheumatology and Rehabilitation, Bürgerspital; A. Finckh, MD, PhD, Department of Rheumatology, University Hospital; I.E. van der Horst-Bruinsma, MD, PhD, Department of Rheumatology, VU University Medical Center; J. Sieper, MD, Department of Gastroenterology, Infectiology and Rheumatology, Charité Universitätsmedizin; R. Landewé, MD, PhD, Department of Clinical Immunology and Rheumatology, University of Amsterdam, and Department of Rheumatology, Zuyderland Hospital; D. van der Heijde, MD, PhD, Department of Rheumatology, Leiden University Medical Center; A. Ciurea, MD, Department of Rheumatology, Zurich University Hospital. Address correspondence to Dr. A. Ciurea, Department of Rheumatology, Zurich University Hospital, Gloriastrasse 25, CH-8091 Zurich, Switzerland. E-mail: adrian.ciurea@usz.ch. Accepted for publication November 6, 2017.
Ulrich Weber
From the Swiss Clinical Quality Management Foundation; Department of Rheumatology, Zurich University Hospital, Zurich; Praxis Rheuma-Basel, Basel, Switzerland; King Christian 10th Hospital for Rheumatic Diseases, Gråsten; Institute of Regional Health Research, University of Southern Denmark, Odense, Denmark; Ultrasound Center Rheumatology, Basel; Department of Rheumatology, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne; Department of Rheumatology, University Hospital, Geneva; Department of Rheumatology and Clinical Immunology, Inselspital, Bern; Department of Rheumatology and Rehabilitation, Bürgerspital, Solothurn, Switzerland; Department of Rheumatology, VU University Medical Center, Amsterdam, the Netherlands; Department of Gastroenterology, Infectiology and Rheumatology, Charité Universitätsmedizin, Berlin, Germany; Department of Clinical Immunology and Rheumatology, University of Amsterdam; Department of Rheumatology, Zuyderland Hospital, Heerlen; Department of Rheumatology, Leiden University Medical Center, Leiden, the Netherlands. The Swiss Clinical Quality Management Foundation is supported by the Swiss Society of Rheumatology and by AbbVie, Bristol-Myers-Squibb, Janssen-Cilag, Merck Sharp & Dohme, Novartis, Pfizer, Roche, and UCB, and has received project-based financial supports from the Arco Foundation, Switzerland, as well as from the Swiss Balgrist Society, Switzerland. This study was supported by AbbVie through the AbbVie Rheumatology Grant 2013, intended to support clinically oriented research in rheumatology and clinical immunology in Switzerland and awarded to Dr. Ciurea. Additional financial support was obtained from the Stiftung für Rheumaforschung. M. Hebeisen, MSc, Swiss Clinical Quality Management Foundation; R. Neuenschwander, Department of Rheumatology, Zurich University Hospital; A. Scherer, PhD, Swiss Clinical Quality Management Foundation; P. Exer, MD, Praxis Rheuma-Basel; U. Weber, MD, King Christian 10th Hospital for Rheumatic Diseases, Gråsten, and South Jutland Hospital, Institute of Regional Health Research; G. Tamborrini, MD, Ultrasound Center Rheumatology; R. Micheroli, MD, Department of Rheumatology, Zurich University Hospital; L.M. Wildi, MD, Department of Rheumatology, Zurich University Hospital; P. Zufferey, MD, Department of Rheumatology, CHUV; M.J. Nissen, MD, Department of Rheumatology, University Hospital; P.M. Villiger, MD, Department of Rheumatology and Clinical Immunology, Inselspital; J. Bernhard, MD, Department of Rheumatology and Rehabilitation, Bürgerspital; A. Finckh, MD, PhD, Department of Rheumatology, University Hospital; I.E. van der Horst-Bruinsma, MD, PhD, Department of Rheumatology, VU University Medical Center; J. Sieper, MD, Department of Gastroenterology, Infectiology and Rheumatology, Charité Universitätsmedizin; R. Landewé, MD, PhD, Department of Clinical Immunology and Rheumatology, University of Amsterdam, and Department of Rheumatology, Zuyderland Hospital; D. van der Heijde, MD, PhD, Department of Rheumatology, Leiden University Medical Center; A. Ciurea, MD, Department of Rheumatology, Zurich University Hospital. Address correspondence to Dr. A. Ciurea, Department of Rheumatology, Zurich University Hospital, Gloriastrasse 25, CH-8091 Zurich, Switzerland. E-mail: adrian.ciurea@usz.ch. Accepted for publication November 6, 2017.
Giorgio Tamborrini
From the Swiss Clinical Quality Management Foundation; Department of Rheumatology, Zurich University Hospital, Zurich; Praxis Rheuma-Basel, Basel, Switzerland; King Christian 10th Hospital for Rheumatic Diseases, Gråsten; Institute of Regional Health Research, University of Southern Denmark, Odense, Denmark; Ultrasound Center Rheumatology, Basel; Department of Rheumatology, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne; Department of Rheumatology, University Hospital, Geneva; Department of Rheumatology and Clinical Immunology, Inselspital, Bern; Department of Rheumatology and Rehabilitation, Bürgerspital, Solothurn, Switzerland; Department of Rheumatology, VU University Medical Center, Amsterdam, the Netherlands; Department of Gastroenterology, Infectiology and Rheumatology, Charité Universitätsmedizin, Berlin, Germany; Department of Clinical Immunology and Rheumatology, University of Amsterdam; Department of Rheumatology, Zuyderland Hospital, Heerlen; Department of Rheumatology, Leiden University Medical Center, Leiden, the Netherlands. The Swiss Clinical Quality Management Foundation is supported by the Swiss Society of Rheumatology and by AbbVie, Bristol-Myers-Squibb, Janssen-Cilag, Merck Sharp & Dohme, Novartis, Pfizer, Roche, and UCB, and has received project-based financial supports from the Arco Foundation, Switzerland, as well as from the Swiss Balgrist Society, Switzerland. This study was supported by AbbVie through the AbbVie Rheumatology Grant 2013, intended to support clinically oriented research in rheumatology and clinical immunology in Switzerland and awarded to Dr. Ciurea. Additional financial support was obtained from the Stiftung für Rheumaforschung. M. Hebeisen, MSc, Swiss Clinical Quality Management Foundation; R. Neuenschwander, Department of Rheumatology, Zurich University Hospital; A. Scherer, PhD, Swiss Clinical Quality Management Foundation; P. Exer, MD, Praxis Rheuma-Basel; U. Weber, MD, King Christian 10th Hospital for Rheumatic Diseases, Gråsten, and South Jutland Hospital, Institute of Regional Health Research; G. Tamborrini, MD, Ultrasound Center Rheumatology; R. Micheroli, MD, Department of Rheumatology, Zurich University Hospital; L.M. Wildi, MD, Department of Rheumatology, Zurich University Hospital; P. Zufferey, MD, Department of Rheumatology, CHUV; M.J. Nissen, MD, Department of Rheumatology, University Hospital; P.M. Villiger, MD, Department of Rheumatology and Clinical Immunology, Inselspital; J. Bernhard, MD, Department of Rheumatology and Rehabilitation, Bürgerspital; A. Finckh, MD, PhD, Department of Rheumatology, University Hospital; I.E. van der Horst-Bruinsma, MD, PhD, Department of Rheumatology, VU University Medical Center; J. Sieper, MD, Department of Gastroenterology, Infectiology and Rheumatology, Charité Universitätsmedizin; R. Landewé, MD, PhD, Department of Clinical Immunology and Rheumatology, University of Amsterdam, and Department of Rheumatology, Zuyderland Hospital; D. van der Heijde, MD, PhD, Department of Rheumatology, Leiden University Medical Center; A. Ciurea, MD, Department of Rheumatology, Zurich University Hospital. Address correspondence to Dr. A. Ciurea, Department of Rheumatology, Zurich University Hospital, Gloriastrasse 25, CH-8091 Zurich, Switzerland. E-mail: adrian.ciurea@usz.ch. Accepted for publication November 6, 2017.
Raphael Micheroli
From the Swiss Clinical Quality Management Foundation; Department of Rheumatology, Zurich University Hospital, Zurich; Praxis Rheuma-Basel, Basel, Switzerland; King Christian 10th Hospital for Rheumatic Diseases, Gråsten; Institute of Regional Health Research, University of Southern Denmark, Odense, Denmark; Ultrasound Center Rheumatology, Basel; Department of Rheumatology, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne; Department of Rheumatology, University Hospital, Geneva; Department of Rheumatology and Clinical Immunology, Inselspital, Bern; Department of Rheumatology and Rehabilitation, Bürgerspital, Solothurn, Switzerland; Department of Rheumatology, VU University Medical Center, Amsterdam, the Netherlands; Department of Gastroenterology, Infectiology and Rheumatology, Charité Universitätsmedizin, Berlin, Germany; Department of Clinical Immunology and Rheumatology, University of Amsterdam; Department of Rheumatology, Zuyderland Hospital, Heerlen; Department of Rheumatology, Leiden University Medical Center, Leiden, the Netherlands. The Swiss Clinical Quality Management Foundation is supported by the Swiss Society of Rheumatology and by AbbVie, Bristol-Myers-Squibb, Janssen-Cilag, Merck Sharp & Dohme, Novartis, Pfizer, Roche, and UCB, and has received project-based financial supports from the Arco Foundation, Switzerland, as well as from the Swiss Balgrist Society, Switzerland. This study was supported by AbbVie through the AbbVie Rheumatology Grant 2013, intended to support clinically oriented research in rheumatology and clinical immunology in Switzerland and awarded to Dr. Ciurea. Additional financial support was obtained from the Stiftung für Rheumaforschung. M. Hebeisen, MSc, Swiss Clinical Quality Management Foundation; R. Neuenschwander, Department of Rheumatology, Zurich University Hospital; A. Scherer, PhD, Swiss Clinical Quality Management Foundation; P. Exer, MD, Praxis Rheuma-Basel; U. Weber, MD, King Christian 10th Hospital for Rheumatic Diseases, Gråsten, and South Jutland Hospital, Institute of Regional Health Research; G. Tamborrini, MD, Ultrasound Center Rheumatology; R. Micheroli, MD, Department of Rheumatology, Zurich University Hospital; L.M. Wildi, MD, Department of Rheumatology, Zurich University Hospital; P. Zufferey, MD, Department of Rheumatology, CHUV; M.J. Nissen, MD, Department of Rheumatology, University Hospital; P.M. Villiger, MD, Department of Rheumatology and Clinical Immunology, Inselspital; J. Bernhard, MD, Department of Rheumatology and Rehabilitation, Bürgerspital; A. Finckh, MD, PhD, Department of Rheumatology, University Hospital; I.E. van der Horst-Bruinsma, MD, PhD, Department of Rheumatology, VU University Medical Center; J. Sieper, MD, Department of Gastroenterology, Infectiology and Rheumatology, Charité Universitätsmedizin; R. Landewé, MD, PhD, Department of Clinical Immunology and Rheumatology, University of Amsterdam, and Department of Rheumatology, Zuyderland Hospital; D. van der Heijde, MD, PhD, Department of Rheumatology, Leiden University Medical Center; A. Ciurea, MD, Department of Rheumatology, Zurich University Hospital. Address correspondence to Dr. A. Ciurea, Department of Rheumatology, Zurich University Hospital, Gloriastrasse 25, CH-8091 Zurich, Switzerland. E-mail: adrian.ciurea@usz.ch. Accepted for publication November 6, 2017.
Lukas M. Wildi
From the Swiss Clinical Quality Management Foundation; Department of Rheumatology, Zurich University Hospital, Zurich; Praxis Rheuma-Basel, Basel, Switzerland; King Christian 10th Hospital for Rheumatic Diseases, Gråsten; Institute of Regional Health Research, University of Southern Denmark, Odense, Denmark; Ultrasound Center Rheumatology, Basel; Department of Rheumatology, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne; Department of Rheumatology, University Hospital, Geneva; Department of Rheumatology and Clinical Immunology, Inselspital, Bern; Department of Rheumatology and Rehabilitation, Bürgerspital, Solothurn, Switzerland; Department of Rheumatology, VU University Medical Center, Amsterdam, the Netherlands; Department of Gastroenterology, Infectiology and Rheumatology, Charité Universitätsmedizin, Berlin, Germany; Department of Clinical Immunology and Rheumatology, University of Amsterdam; Department of Rheumatology, Zuyderland Hospital, Heerlen; Department of Rheumatology, Leiden University Medical Center, Leiden, the Netherlands. The Swiss Clinical Quality Management Foundation is supported by the Swiss Society of Rheumatology and by AbbVie, Bristol-Myers-Squibb, Janssen-Cilag, Merck Sharp & Dohme, Novartis, Pfizer, Roche, and UCB, and has received project-based financial supports from the Arco Foundation, Switzerland, as well as from the Swiss Balgrist Society, Switzerland. This study was supported by AbbVie through the AbbVie Rheumatology Grant 2013, intended to support clinically oriented research in rheumatology and clinical immunology in Switzerland and awarded to Dr. Ciurea. Additional financial support was obtained from the Stiftung für Rheumaforschung. M. Hebeisen, MSc, Swiss Clinical Quality Management Foundation; R. Neuenschwander, Department of Rheumatology, Zurich University Hospital; A. Scherer, PhD, Swiss Clinical Quality Management Foundation; P. Exer, MD, Praxis Rheuma-Basel; U. Weber, MD, King Christian 10th Hospital for Rheumatic Diseases, Gråsten, and South Jutland Hospital, Institute of Regional Health Research; G. Tamborrini, MD, Ultrasound Center Rheumatology; R. Micheroli, MD, Department of Rheumatology, Zurich University Hospital; L.M. Wildi, MD, Department of Rheumatology, Zurich University Hospital; P. Zufferey, MD, Department of Rheumatology, CHUV; M.J. Nissen, MD, Department of Rheumatology, University Hospital; P.M. Villiger, MD, Department of Rheumatology and Clinical Immunology, Inselspital; J. Bernhard, MD, Department of Rheumatology and Rehabilitation, Bürgerspital; A. Finckh, MD, PhD, Department of Rheumatology, University Hospital; I.E. van der Horst-Bruinsma, MD, PhD, Department of Rheumatology, VU University Medical Center; J. Sieper, MD, Department of Gastroenterology, Infectiology and Rheumatology, Charité Universitätsmedizin; R. Landewé, MD, PhD, Department of Clinical Immunology and Rheumatology, University of Amsterdam, and Department of Rheumatology, Zuyderland Hospital; D. van der Heijde, MD, PhD, Department of Rheumatology, Leiden University Medical Center; A. Ciurea, MD, Department of Rheumatology, Zurich University Hospital. Address correspondence to Dr. A. Ciurea, Department of Rheumatology, Zurich University Hospital, Gloriastrasse 25, CH-8091 Zurich, Switzerland. E-mail: adrian.ciurea@usz.ch. Accepted for publication November 6, 2017.
Pascal Zufferey
From the Swiss Clinical Quality Management Foundation; Department of Rheumatology, Zurich University Hospital, Zurich; Praxis Rheuma-Basel, Basel, Switzerland; King Christian 10th Hospital for Rheumatic Diseases, Gråsten; Institute of Regional Health Research, University of Southern Denmark, Odense, Denmark; Ultrasound Center Rheumatology, Basel; Department of Rheumatology, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne; Department of Rheumatology, University Hospital, Geneva; Department of Rheumatology and Clinical Immunology, Inselspital, Bern; Department of Rheumatology and Rehabilitation, Bürgerspital, Solothurn, Switzerland; Department of Rheumatology, VU University Medical Center, Amsterdam, the Netherlands; Department of Gastroenterology, Infectiology and Rheumatology, Charité Universitätsmedizin, Berlin, Germany; Department of Clinical Immunology and Rheumatology, University of Amsterdam; Department of Rheumatology, Zuyderland Hospital, Heerlen; Department of Rheumatology, Leiden University Medical Center, Leiden, the Netherlands. The Swiss Clinical Quality Management Foundation is supported by the Swiss Society of Rheumatology and by AbbVie, Bristol-Myers-Squibb, Janssen-Cilag, Merck Sharp & Dohme, Novartis, Pfizer, Roche, and UCB, and has received project-based financial supports from the Arco Foundation, Switzerland, as well as from the Swiss Balgrist Society, Switzerland. This study was supported by AbbVie through the AbbVie Rheumatology Grant 2013, intended to support clinically oriented research in rheumatology and clinical immunology in Switzerland and awarded to Dr. Ciurea. Additional financial support was obtained from the Stiftung für Rheumaforschung. M. Hebeisen, MSc, Swiss Clinical Quality Management Foundation; R. Neuenschwander, Department of Rheumatology, Zurich University Hospital; A. Scherer, PhD, Swiss Clinical Quality Management Foundation; P. Exer, MD, Praxis Rheuma-Basel; U. Weber, MD, King Christian 10th Hospital for Rheumatic Diseases, Gråsten, and South Jutland Hospital, Institute of Regional Health Research; G. Tamborrini, MD, Ultrasound Center Rheumatology; R. Micheroli, MD, Department of Rheumatology, Zurich University Hospital; L.M. Wildi, MD, Department of Rheumatology, Zurich University Hospital; P. Zufferey, MD, Department of Rheumatology, CHUV; M.J. Nissen, MD, Department of Rheumatology, University Hospital; P.M. Villiger, MD, Department of Rheumatology and Clinical Immunology, Inselspital; J. Bernhard, MD, Department of Rheumatology and Rehabilitation, Bürgerspital; A. Finckh, MD, PhD, Department of Rheumatology, University Hospital; I.E. van der Horst-Bruinsma, MD, PhD, Department of Rheumatology, VU University Medical Center; J. Sieper, MD, Department of Gastroenterology, Infectiology and Rheumatology, Charité Universitätsmedizin; R. Landewé, MD, PhD, Department of Clinical Immunology and Rheumatology, University of Amsterdam, and Department of Rheumatology, Zuyderland Hospital; D. van der Heijde, MD, PhD, Department of Rheumatology, Leiden University Medical Center; A. Ciurea, MD, Department of Rheumatology, Zurich University Hospital. Address correspondence to Dr. A. Ciurea, Department of Rheumatology, Zurich University Hospital, Gloriastrasse 25, CH-8091 Zurich, Switzerland. E-mail: adrian.ciurea@usz.ch. Accepted for publication November 6, 2017.
Michael J. Nissen
From the Swiss Clinical Quality Management Foundation; Department of Rheumatology, Zurich University Hospital, Zurich; Praxis Rheuma-Basel, Basel, Switzerland; King Christian 10th Hospital for Rheumatic Diseases, Gråsten; Institute of Regional Health Research, University of Southern Denmark, Odense, Denmark; Ultrasound Center Rheumatology, Basel; Department of Rheumatology, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne; Department of Rheumatology, University Hospital, Geneva; Department of Rheumatology and Clinical Immunology, Inselspital, Bern; Department of Rheumatology and Rehabilitation, Bürgerspital, Solothurn, Switzerland; Department of Rheumatology, VU University Medical Center, Amsterdam, the Netherlands; Department of Gastroenterology, Infectiology and Rheumatology, Charité Universitätsmedizin, Berlin, Germany; Department of Clinical Immunology and Rheumatology, University of Amsterdam; Department of Rheumatology, Zuyderland Hospital, Heerlen; Department of Rheumatology, Leiden University Medical Center, Leiden, the Netherlands. The Swiss Clinical Quality Management Foundation is supported by the Swiss Society of Rheumatology and by AbbVie, Bristol-Myers-Squibb, Janssen-Cilag, Merck Sharp & Dohme, Novartis, Pfizer, Roche, and UCB, and has received project-based financial supports from the Arco Foundation, Switzerland, as well as from the Swiss Balgrist Society, Switzerland. This study was supported by AbbVie through the AbbVie Rheumatology Grant 2013, intended to support clinically oriented research in rheumatology and clinical immunology in Switzerland and awarded to Dr. Ciurea. Additional financial support was obtained from the Stiftung für Rheumaforschung. M. Hebeisen, MSc, Swiss Clinical Quality Management Foundation; R. Neuenschwander, Department of Rheumatology, Zurich University Hospital; A. Scherer, PhD, Swiss Clinical Quality Management Foundation; P. Exer, MD, Praxis Rheuma-Basel; U. Weber, MD, King Christian 10th Hospital for Rheumatic Diseases, Gråsten, and South Jutland Hospital, Institute of Regional Health Research; G. Tamborrini, MD, Ultrasound Center Rheumatology; R. Micheroli, MD, Department of Rheumatology, Zurich University Hospital; L.M. Wildi, MD, Department of Rheumatology, Zurich University Hospital; P. Zufferey, MD, Department of Rheumatology, CHUV; M.J. Nissen, MD, Department of Rheumatology, University Hospital; P.M. Villiger, MD, Department of Rheumatology and Clinical Immunology, Inselspital; J. Bernhard, MD, Department of Rheumatology and Rehabilitation, Bürgerspital; A. Finckh, MD, PhD, Department of Rheumatology, University Hospital; I.E. van der Horst-Bruinsma, MD, PhD, Department of Rheumatology, VU University Medical Center; J. Sieper, MD, Department of Gastroenterology, Infectiology and Rheumatology, Charité Universitätsmedizin; R. Landewé, MD, PhD, Department of Clinical Immunology and Rheumatology, University of Amsterdam, and Department of Rheumatology, Zuyderland Hospital; D. van der Heijde, MD, PhD, Department of Rheumatology, Leiden University Medical Center; A. Ciurea, MD, Department of Rheumatology, Zurich University Hospital. Address correspondence to Dr. A. Ciurea, Department of Rheumatology, Zurich University Hospital, Gloriastrasse 25, CH-8091 Zurich, Switzerland. E-mail: adrian.ciurea@usz.ch. Accepted for publication November 6, 2017.
Peter M. Villiger
From the Swiss Clinical Quality Management Foundation; Department of Rheumatology, Zurich University Hospital, Zurich; Praxis Rheuma-Basel, Basel, Switzerland; King Christian 10th Hospital for Rheumatic Diseases, Gråsten; Institute of Regional Health Research, University of Southern Denmark, Odense, Denmark; Ultrasound Center Rheumatology, Basel; Department of Rheumatology, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne; Department of Rheumatology, University Hospital, Geneva; Department of Rheumatology and Clinical Immunology, Inselspital, Bern; Department of Rheumatology and Rehabilitation, Bürgerspital, Solothurn, Switzerland; Department of Rheumatology, VU University Medical Center, Amsterdam, the Netherlands; Department of Gastroenterology, Infectiology and Rheumatology, Charité Universitätsmedizin, Berlin, Germany; Department of Clinical Immunology and Rheumatology, University of Amsterdam; Department of Rheumatology, Zuyderland Hospital, Heerlen; Department of Rheumatology, Leiden University Medical Center, Leiden, the Netherlands. The Swiss Clinical Quality Management Foundation is supported by the Swiss Society of Rheumatology and by AbbVie, Bristol-Myers-Squibb, Janssen-Cilag, Merck Sharp & Dohme, Novartis, Pfizer, Roche, and UCB, and has received project-based financial supports from the Arco Foundation, Switzerland, as well as from the Swiss Balgrist Society, Switzerland. This study was supported by AbbVie through the AbbVie Rheumatology Grant 2013, intended to support clinically oriented research in rheumatology and clinical immunology in Switzerland and awarded to Dr. Ciurea. Additional financial support was obtained from the Stiftung für Rheumaforschung. M. Hebeisen, MSc, Swiss Clinical Quality Management Foundation; R. Neuenschwander, Department of Rheumatology, Zurich University Hospital; A. Scherer, PhD, Swiss Clinical Quality Management Foundation; P. Exer, MD, Praxis Rheuma-Basel; U. Weber, MD, King Christian 10th Hospital for Rheumatic Diseases, Gråsten, and South Jutland Hospital, Institute of Regional Health Research; G. Tamborrini, MD, Ultrasound Center Rheumatology; R. Micheroli, MD, Department of Rheumatology, Zurich University Hospital; L.M. Wildi, MD, Department of Rheumatology, Zurich University Hospital; P. Zufferey, MD, Department of Rheumatology, CHUV; M.J. Nissen, MD, Department of Rheumatology, University Hospital; P.M. Villiger, MD, Department of Rheumatology and Clinical Immunology, Inselspital; J. Bernhard, MD, Department of Rheumatology and Rehabilitation, Bürgerspital; A. Finckh, MD, PhD, Department of Rheumatology, University Hospital; I.E. van der Horst-Bruinsma, MD, PhD, Department of Rheumatology, VU University Medical Center; J. Sieper, MD, Department of Gastroenterology, Infectiology and Rheumatology, Charité Universitätsmedizin; R. Landewé, MD, PhD, Department of Clinical Immunology and Rheumatology, University of Amsterdam, and Department of Rheumatology, Zuyderland Hospital; D. van der Heijde, MD, PhD, Department of Rheumatology, Leiden University Medical Center; A. Ciurea, MD, Department of Rheumatology, Zurich University Hospital. Address correspondence to Dr. A. Ciurea, Department of Rheumatology, Zurich University Hospital, Gloriastrasse 25, CH-8091 Zurich, Switzerland. E-mail: adrian.ciurea@usz.ch. Accepted for publication November 6, 2017.
Jürg Bernhard
From the Swiss Clinical Quality Management Foundation; Department of Rheumatology, Zurich University Hospital, Zurich; Praxis Rheuma-Basel, Basel, Switzerland; King Christian 10th Hospital for Rheumatic Diseases, Gråsten; Institute of Regional Health Research, University of Southern Denmark, Odense, Denmark; Ultrasound Center Rheumatology, Basel; Department of Rheumatology, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne; Department of Rheumatology, University Hospital, Geneva; Department of Rheumatology and Clinical Immunology, Inselspital, Bern; Department of Rheumatology and Rehabilitation, Bürgerspital, Solothurn, Switzerland; Department of Rheumatology, VU University Medical Center, Amsterdam, the Netherlands; Department of Gastroenterology, Infectiology and Rheumatology, Charité Universitätsmedizin, Berlin, Germany; Department of Clinical Immunology and Rheumatology, University of Amsterdam; Department of Rheumatology, Zuyderland Hospital, Heerlen; Department of Rheumatology, Leiden University Medical Center, Leiden, the Netherlands. The Swiss Clinical Quality Management Foundation is supported by the Swiss Society of Rheumatology and by AbbVie, Bristol-Myers-Squibb, Janssen-Cilag, Merck Sharp & Dohme, Novartis, Pfizer, Roche, and UCB, and has received project-based financial supports from the Arco Foundation, Switzerland, as well as from the Swiss Balgrist Society, Switzerland. This study was supported by AbbVie through the AbbVie Rheumatology Grant 2013, intended to support clinically oriented research in rheumatology and clinical immunology in Switzerland and awarded to Dr. Ciurea. Additional financial support was obtained from the Stiftung für Rheumaforschung. M. Hebeisen, MSc, Swiss Clinical Quality Management Foundation; R. Neuenschwander, Department of Rheumatology, Zurich University Hospital; A. Scherer, PhD, Swiss Clinical Quality Management Foundation; P. Exer, MD, Praxis Rheuma-Basel; U. Weber, MD, King Christian 10th Hospital for Rheumatic Diseases, Gråsten, and South Jutland Hospital, Institute of Regional Health Research; G. Tamborrini, MD, Ultrasound Center Rheumatology; R. Micheroli, MD, Department of Rheumatology, Zurich University Hospital; L.M. Wildi, MD, Department of Rheumatology, Zurich University Hospital; P. Zufferey, MD, Department of Rheumatology, CHUV; M.J. Nissen, MD, Department of Rheumatology, University Hospital; P.M. Villiger, MD, Department of Rheumatology and Clinical Immunology, Inselspital; J. Bernhard, MD, Department of Rheumatology and Rehabilitation, Bürgerspital; A. Finckh, MD, PhD, Department of Rheumatology, University Hospital; I.E. van der Horst-Bruinsma, MD, PhD, Department of Rheumatology, VU University Medical Center; J. Sieper, MD, Department of Gastroenterology, Infectiology and Rheumatology, Charité Universitätsmedizin; R. Landewé, MD, PhD, Department of Clinical Immunology and Rheumatology, University of Amsterdam, and Department of Rheumatology, Zuyderland Hospital; D. van der Heijde, MD, PhD, Department of Rheumatology, Leiden University Medical Center; A. Ciurea, MD, Department of Rheumatology, Zurich University Hospital. Address correspondence to Dr. A. Ciurea, Department of Rheumatology, Zurich University Hospital, Gloriastrasse 25, CH-8091 Zurich, Switzerland. E-mail: adrian.ciurea@usz.ch. Accepted for publication November 6, 2017.
Axel Finckh
From the Swiss Clinical Quality Management Foundation; Department of Rheumatology, Zurich University Hospital, Zurich; Praxis Rheuma-Basel, Basel, Switzerland; King Christian 10th Hospital for Rheumatic Diseases, Gråsten; Institute of Regional Health Research, University of Southern Denmark, Odense, Denmark; Ultrasound Center Rheumatology, Basel; Department of Rheumatology, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne; Department of Rheumatology, University Hospital, Geneva; Department of Rheumatology and Clinical Immunology, Inselspital, Bern; Department of Rheumatology and Rehabilitation, Bürgerspital, Solothurn, Switzerland; Department of Rheumatology, VU University Medical Center, Amsterdam, the Netherlands; Department of Gastroenterology, Infectiology and Rheumatology, Charité Universitätsmedizin, Berlin, Germany; Department of Clinical Immunology and Rheumatology, University of Amsterdam; Department of Rheumatology, Zuyderland Hospital, Heerlen; Department of Rheumatology, Leiden University Medical Center, Leiden, the Netherlands. The Swiss Clinical Quality Management Foundation is supported by the Swiss Society of Rheumatology and by AbbVie, Bristol-Myers-Squibb, Janssen-Cilag, Merck Sharp & Dohme, Novartis, Pfizer, Roche, and UCB, and has received project-based financial supports from the Arco Foundation, Switzerland, as well as from the Swiss Balgrist Society, Switzerland. This study was supported by AbbVie through the AbbVie Rheumatology Grant 2013, intended to support clinically oriented research in rheumatology and clinical immunology in Switzerland and awarded to Dr. Ciurea. Additional financial support was obtained from the Stiftung für Rheumaforschung. M. Hebeisen, MSc, Swiss Clinical Quality Management Foundation; R. Neuenschwander, Department of Rheumatology, Zurich University Hospital; A. Scherer, PhD, Swiss Clinical Quality Management Foundation; P. Exer, MD, Praxis Rheuma-Basel; U. Weber, MD, King Christian 10th Hospital for Rheumatic Diseases, Gråsten, and South Jutland Hospital, Institute of Regional Health Research; G. Tamborrini, MD, Ultrasound Center Rheumatology; R. Micheroli, MD, Department of Rheumatology, Zurich University Hospital; L.M. Wildi, MD, Department of Rheumatology, Zurich University Hospital; P. Zufferey, MD, Department of Rheumatology, CHUV; M.J. Nissen, MD, Department of Rheumatology, University Hospital; P.M. Villiger, MD, Department of Rheumatology and Clinical Immunology, Inselspital; J. Bernhard, MD, Department of Rheumatology and Rehabilitation, Bürgerspital; A. Finckh, MD, PhD, Department of Rheumatology, University Hospital; I.E. van der Horst-Bruinsma, MD, PhD, Department of Rheumatology, VU University Medical Center; J. Sieper, MD, Department of Gastroenterology, Infectiology and Rheumatology, Charité Universitätsmedizin; R. Landewé, MD, PhD, Department of Clinical Immunology and Rheumatology, University of Amsterdam, and Department of Rheumatology, Zuyderland Hospital; D. van der Heijde, MD, PhD, Department of Rheumatology, Leiden University Medical Center; A. Ciurea, MD, Department of Rheumatology, Zurich University Hospital. Address correspondence to Dr. A. Ciurea, Department of Rheumatology, Zurich University Hospital, Gloriastrasse 25, CH-8091 Zurich, Switzerland. E-mail: adrian.ciurea@usz.ch. Accepted for publication November 6, 2017.
Irene E. van der Horst-Bruinsma
From the Swiss Clinical Quality Management Foundation; Department of Rheumatology, Zurich University Hospital, Zurich; Praxis Rheuma-Basel, Basel, Switzerland; King Christian 10th Hospital for Rheumatic Diseases, Gråsten; Institute of Regional Health Research, University of Southern Denmark, Odense, Denmark; Ultrasound Center Rheumatology, Basel; Department of Rheumatology, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne; Department of Rheumatology, University Hospital, Geneva; Department of Rheumatology and Clinical Immunology, Inselspital, Bern; Department of Rheumatology and Rehabilitation, Bürgerspital, Solothurn, Switzerland; Department of Rheumatology, VU University Medical Center, Amsterdam, the Netherlands; Department of Gastroenterology, Infectiology and Rheumatology, Charité Universitätsmedizin, Berlin, Germany; Department of Clinical Immunology and Rheumatology, University of Amsterdam; Department of Rheumatology, Zuyderland Hospital, Heerlen; Department of Rheumatology, Leiden University Medical Center, Leiden, the Netherlands. The Swiss Clinical Quality Management Foundation is supported by the Swiss Society of Rheumatology and by AbbVie, Bristol-Myers-Squibb, Janssen-Cilag, Merck Sharp & Dohme, Novartis, Pfizer, Roche, and UCB, and has received project-based financial supports from the Arco Foundation, Switzerland, as well as from the Swiss Balgrist Society, Switzerland. This study was supported by AbbVie through the AbbVie Rheumatology Grant 2013, intended to support clinically oriented research in rheumatology and clinical immunology in Switzerland and awarded to Dr. Ciurea. Additional financial support was obtained from the Stiftung für Rheumaforschung. M. Hebeisen, MSc, Swiss Clinical Quality Management Foundation; R. Neuenschwander, Department of Rheumatology, Zurich University Hospital; A. Scherer, PhD, Swiss Clinical Quality Management Foundation; P. Exer, MD, Praxis Rheuma-Basel; U. Weber, MD, King Christian 10th Hospital for Rheumatic Diseases, Gråsten, and South Jutland Hospital, Institute of Regional Health Research; G. Tamborrini, MD, Ultrasound Center Rheumatology; R. Micheroli, MD, Department of Rheumatology, Zurich University Hospital; L.M. Wildi, MD, Department of Rheumatology, Zurich University Hospital; P. Zufferey, MD, Department of Rheumatology, CHUV; M.J. Nissen, MD, Department of Rheumatology, University Hospital; P.M. Villiger, MD, Department of Rheumatology and Clinical Immunology, Inselspital; J. Bernhard, MD, Department of Rheumatology and Rehabilitation, Bürgerspital; A. Finckh, MD, PhD, Department of Rheumatology, University Hospital; I.E. van der Horst-Bruinsma, MD, PhD, Department of Rheumatology, VU University Medical Center; J. Sieper, MD, Department of Gastroenterology, Infectiology and Rheumatology, Charité Universitätsmedizin; R. Landewé, MD, PhD, Department of Clinical Immunology and Rheumatology, University of Amsterdam, and Department of Rheumatology, Zuyderland Hospital; D. van der Heijde, MD, PhD, Department of Rheumatology, Leiden University Medical Center; A. Ciurea, MD, Department of Rheumatology, Zurich University Hospital. Address correspondence to Dr. A. Ciurea, Department of Rheumatology, Zurich University Hospital, Gloriastrasse 25, CH-8091 Zurich, Switzerland. E-mail: adrian.ciurea@usz.ch. Accepted for publication November 6, 2017.
Joachim Sieper
From the Swiss Clinical Quality Management Foundation; Department of Rheumatology, Zurich University Hospital, Zurich; Praxis Rheuma-Basel, Basel, Switzerland; King Christian 10th Hospital for Rheumatic Diseases, Gråsten; Institute of Regional Health Research, University of Southern Denmark, Odense, Denmark; Ultrasound Center Rheumatology, Basel; Department of Rheumatology, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne; Department of Rheumatology, University Hospital, Geneva; Department of Rheumatology and Clinical Immunology, Inselspital, Bern; Department of Rheumatology and Rehabilitation, Bürgerspital, Solothurn, Switzerland; Department of Rheumatology, VU University Medical Center, Amsterdam, the Netherlands; Department of Gastroenterology, Infectiology and Rheumatology, Charité Universitätsmedizin, Berlin, Germany; Department of Clinical Immunology and Rheumatology, University of Amsterdam; Department of Rheumatology, Zuyderland Hospital, Heerlen; Department of Rheumatology, Leiden University Medical Center, Leiden, the Netherlands. The Swiss Clinical Quality Management Foundation is supported by the Swiss Society of Rheumatology and by AbbVie, Bristol-Myers-Squibb, Janssen-Cilag, Merck Sharp & Dohme, Novartis, Pfizer, Roche, and UCB, and has received project-based financial supports from the Arco Foundation, Switzerland, as well as from the Swiss Balgrist Society, Switzerland. This study was supported by AbbVie through the AbbVie Rheumatology Grant 2013, intended to support clinically oriented research in rheumatology and clinical immunology in Switzerland and awarded to Dr. Ciurea. Additional financial support was obtained from the Stiftung für Rheumaforschung. M. Hebeisen, MSc, Swiss Clinical Quality Management Foundation; R. Neuenschwander, Department of Rheumatology, Zurich University Hospital; A. Scherer, PhD, Swiss Clinical Quality Management Foundation; P. Exer, MD, Praxis Rheuma-Basel; U. Weber, MD, King Christian 10th Hospital for Rheumatic Diseases, Gråsten, and South Jutland Hospital, Institute of Regional Health Research; G. Tamborrini, MD, Ultrasound Center Rheumatology; R. Micheroli, MD, Department of Rheumatology, Zurich University Hospital; L.M. Wildi, MD, Department of Rheumatology, Zurich University Hospital; P. Zufferey, MD, Department of Rheumatology, CHUV; M.J. Nissen, MD, Department of Rheumatology, University Hospital; P.M. Villiger, MD, Department of Rheumatology and Clinical Immunology, Inselspital; J. Bernhard, MD, Department of Rheumatology and Rehabilitation, Bürgerspital; A. Finckh, MD, PhD, Department of Rheumatology, University Hospital; I.E. van der Horst-Bruinsma, MD, PhD, Department of Rheumatology, VU University Medical Center; J. Sieper, MD, Department of Gastroenterology, Infectiology and Rheumatology, Charité Universitätsmedizin; R. Landewé, MD, PhD, Department of Clinical Immunology and Rheumatology, University of Amsterdam, and Department of Rheumatology, Zuyderland Hospital; D. van der Heijde, MD, PhD, Department of Rheumatology, Leiden University Medical Center; A. Ciurea, MD, Department of Rheumatology, Zurich University Hospital. Address correspondence to Dr. A. Ciurea, Department of Rheumatology, Zurich University Hospital, Gloriastrasse 25, CH-8091 Zurich, Switzerland. E-mail: adrian.ciurea@usz.ch. Accepted for publication November 6, 2017.
Robert Landewé
From the Swiss Clinical Quality Management Foundation; Department of Rheumatology, Zurich University Hospital, Zurich; Praxis Rheuma-Basel, Basel, Switzerland; King Christian 10th Hospital for Rheumatic Diseases, Gråsten; Institute of Regional Health Research, University of Southern Denmark, Odense, Denmark; Ultrasound Center Rheumatology, Basel; Department of Rheumatology, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne; Department of Rheumatology, University Hospital, Geneva; Department of Rheumatology and Clinical Immunology, Inselspital, Bern; Department of Rheumatology and Rehabilitation, Bürgerspital, Solothurn, Switzerland; Department of Rheumatology, VU University Medical Center, Amsterdam, the Netherlands; Department of Gastroenterology, Infectiology and Rheumatology, Charité Universitätsmedizin, Berlin, Germany; Department of Clinical Immunology and Rheumatology, University of Amsterdam; Department of Rheumatology, Zuyderland Hospital, Heerlen; Department of Rheumatology, Leiden University Medical Center, Leiden, the Netherlands. The Swiss Clinical Quality Management Foundation is supported by the Swiss Society of Rheumatology and by AbbVie, Bristol-Myers-Squibb, Janssen-Cilag, Merck Sharp & Dohme, Novartis, Pfizer, Roche, and UCB, and has received project-based financial supports from the Arco Foundation, Switzerland, as well as from the Swiss Balgrist Society, Switzerland. This study was supported by AbbVie through the AbbVie Rheumatology Grant 2013, intended to support clinically oriented research in rheumatology and clinical immunology in Switzerland and awarded to Dr. Ciurea. Additional financial support was obtained from the Stiftung für Rheumaforschung. M. Hebeisen, MSc, Swiss Clinical Quality Management Foundation; R. Neuenschwander, Department of Rheumatology, Zurich University Hospital; A. Scherer, PhD, Swiss Clinical Quality Management Foundation; P. Exer, MD, Praxis Rheuma-Basel; U. Weber, MD, King Christian 10th Hospital for Rheumatic Diseases, Gråsten, and South Jutland Hospital, Institute of Regional Health Research; G. Tamborrini, MD, Ultrasound Center Rheumatology; R. Micheroli, MD, Department of Rheumatology, Zurich University Hospital; L.M. Wildi, MD, Department of Rheumatology, Zurich University Hospital; P. Zufferey, MD, Department of Rheumatology, CHUV; M.J. Nissen, MD, Department of Rheumatology, University Hospital; P.M. Villiger, MD, Department of Rheumatology and Clinical Immunology, Inselspital; J. Bernhard, MD, Department of Rheumatology and Rehabilitation, Bürgerspital; A. Finckh, MD, PhD, Department of Rheumatology, University Hospital; I.E. van der Horst-Bruinsma, MD, PhD, Department of Rheumatology, VU University Medical Center; J. Sieper, MD, Department of Gastroenterology, Infectiology and Rheumatology, Charité Universitätsmedizin; R. Landewé, MD, PhD, Department of Clinical Immunology and Rheumatology, University of Amsterdam, and Department of Rheumatology, Zuyderland Hospital; D. van der Heijde, MD, PhD, Department of Rheumatology, Leiden University Medical Center; A. Ciurea, MD, Department of Rheumatology, Zurich University Hospital. Address correspondence to Dr. A. Ciurea, Department of Rheumatology, Zurich University Hospital, Gloriastrasse 25, CH-8091 Zurich, Switzerland. E-mail: adrian.ciurea@usz.ch. Accepted for publication November 6, 2017.
Désirée van der Heijde
From the Swiss Clinical Quality Management Foundation; Department of Rheumatology, Zurich University Hospital, Zurich; Praxis Rheuma-Basel, Basel, Switzerland; King Christian 10th Hospital for Rheumatic Diseases, Gråsten; Institute of Regional Health Research, University of Southern Denmark, Odense, Denmark; Ultrasound Center Rheumatology, Basel; Department of Rheumatology, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne; Department of Rheumatology, University Hospital, Geneva; Department of Rheumatology and Clinical Immunology, Inselspital, Bern; Department of Rheumatology and Rehabilitation, Bürgerspital, Solothurn, Switzerland; Department of Rheumatology, VU University Medical Center, Amsterdam, the Netherlands; Department of Gastroenterology, Infectiology and Rheumatology, Charité Universitätsmedizin, Berlin, Germany; Department of Clinical Immunology and Rheumatology, University of Amsterdam; Department of Rheumatology, Zuyderland Hospital, Heerlen; Department of Rheumatology, Leiden University Medical Center, Leiden, the Netherlands. The Swiss Clinical Quality Management Foundation is supported by the Swiss Society of Rheumatology and by AbbVie, Bristol-Myers-Squibb, Janssen-Cilag, Merck Sharp & Dohme, Novartis, Pfizer, Roche, and UCB, and has received project-based financial supports from the Arco Foundation, Switzerland, as well as from the Swiss Balgrist Society, Switzerland. This study was supported by AbbVie through the AbbVie Rheumatology Grant 2013, intended to support clinically oriented research in rheumatology and clinical immunology in Switzerland and awarded to Dr. Ciurea. Additional financial support was obtained from the Stiftung für Rheumaforschung. M. Hebeisen, MSc, Swiss Clinical Quality Management Foundation; R. Neuenschwander, Department of Rheumatology, Zurich University Hospital; A. Scherer, PhD, Swiss Clinical Quality Management Foundation; P. Exer, MD, Praxis Rheuma-Basel; U. Weber, MD, King Christian 10th Hospital for Rheumatic Diseases, Gråsten, and South Jutland Hospital, Institute of Regional Health Research; G. Tamborrini, MD, Ultrasound Center Rheumatology; R. Micheroli, MD, Department of Rheumatology, Zurich University Hospital; L.M. Wildi, MD, Department of Rheumatology, Zurich University Hospital; P. Zufferey, MD, Department of Rheumatology, CHUV; M.J. Nissen, MD, Department of Rheumatology, University Hospital; P.M. Villiger, MD, Department of Rheumatology and Clinical Immunology, Inselspital; J. Bernhard, MD, Department of Rheumatology and Rehabilitation, Bürgerspital; A. Finckh, MD, PhD, Department of Rheumatology, University Hospital; I.E. van der Horst-Bruinsma, MD, PhD, Department of Rheumatology, VU University Medical Center; J. Sieper, MD, Department of Gastroenterology, Infectiology and Rheumatology, Charité Universitätsmedizin; R. Landewé, MD, PhD, Department of Clinical Immunology and Rheumatology, University of Amsterdam, and Department of Rheumatology, Zuyderland Hospital; D. van der Heijde, MD, PhD, Department of Rheumatology, Leiden University Medical Center; A. Ciurea, MD, Department of Rheumatology, Zurich University Hospital. Address correspondence to Dr. A. Ciurea, Department of Rheumatology, Zurich University Hospital, Gloriastrasse 25, CH-8091 Zurich, Switzerland. E-mail: adrian.ciurea@usz.ch. Accepted for publication November 6, 2017.
Adrian Ciurea
From the Swiss Clinical Quality Management Foundation; Department of Rheumatology, Zurich University Hospital, Zurich; Praxis Rheuma-Basel, Basel, Switzerland; King Christian 10th Hospital for Rheumatic Diseases, Gråsten; Institute of Regional Health Research, University of Southern Denmark, Odense, Denmark; Ultrasound Center Rheumatology, Basel; Department of Rheumatology, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne; Department of Rheumatology, University Hospital, Geneva; Department of Rheumatology and Clinical Immunology, Inselspital, Bern; Department of Rheumatology and Rehabilitation, Bürgerspital, Solothurn, Switzerland; Department of Rheumatology, VU University Medical Center, Amsterdam, the Netherlands; Department of Gastroenterology, Infectiology and Rheumatology, Charité Universitätsmedizin, Berlin, Germany; Department of Clinical Immunology and Rheumatology, University of Amsterdam; Department of Rheumatology, Zuyderland Hospital, Heerlen; Department of Rheumatology, Leiden University Medical Center, Leiden, the Netherlands. The Swiss Clinical Quality Management Foundation is supported by the Swiss Society of Rheumatology and by AbbVie, Bristol-Myers-Squibb, Janssen-Cilag, Merck Sharp & Dohme, Novartis, Pfizer, Roche, and UCB, and has received project-based financial supports from the Arco Foundation, Switzerland, as well as from the Swiss Balgrist Society, Switzerland. This study was supported by AbbVie through the AbbVie Rheumatology Grant 2013, intended to support clinically oriented research in rheumatology and clinical immunology in Switzerland and awarded to Dr. Ciurea. Additional financial support was obtained from the Stiftung für Rheumaforschung. M. Hebeisen, MSc, Swiss Clinical Quality Management Foundation; R. Neuenschwander, Department of Rheumatology, Zurich University Hospital; A. Scherer, PhD, Swiss Clinical Quality Management Foundation; P. Exer, MD, Praxis Rheuma-Basel; U. Weber, MD, King Christian 10th Hospital for Rheumatic Diseases, Gråsten, and South Jutland Hospital, Institute of Regional Health Research; G. Tamborrini, MD, Ultrasound Center Rheumatology; R. Micheroli, MD, Department of Rheumatology, Zurich University Hospital; L.M. Wildi, MD, Department of Rheumatology, Zurich University Hospital; P. Zufferey, MD, Department of Rheumatology, CHUV; M.J. Nissen, MD, Department of Rheumatology, University Hospital; P.M. Villiger, MD, Department of Rheumatology and Clinical Immunology, Inselspital; J. Bernhard, MD, Department of Rheumatology and Rehabilitation, Bürgerspital; A. Finckh, MD, PhD, Department of Rheumatology, University Hospital; I.E. van der Horst-Bruinsma, MD, PhD, Department of Rheumatology, VU University Medical Center; J. Sieper, MD, Department of Gastroenterology, Infectiology and Rheumatology, Charité Universitätsmedizin; R. Landewé, MD, PhD, Department of Clinical Immunology and Rheumatology, University of Amsterdam, and Department of Rheumatology, Zuyderland Hospital; D. van der Heijde, MD, PhD, Department of Rheumatology, Leiden University Medical Center; A. Ciurea, MD, Department of Rheumatology, Zurich University Hospital. Address correspondence to Dr. A. Ciurea, Department of Rheumatology, Zurich University Hospital, Gloriastrasse 25, CH-8091 Zurich, Switzerland. E-mail: adrian.ciurea@usz.ch. Accepted for publication November 6, 2017.
Abstract
Objective To investigate sex differences in connection with the effectiveness of tumor necrosis factor inhibitors (TNFi) in patients with ankylosing spondylitis (AS).
Methods A total of 440 patients with AS (294 men; 146 women) initiating a first TNFi in the prospective Swiss Clinical Quality Management Cohort were included. We evaluated the proportion of patients achieving the 20% and 40% improvement in the Assessment of Spondyloarthritis international Society criteria (ASAS20 and ASAS40) as well as Ankylosing Spondylitis Disease Activity Score (ASDAS) improvement and status scores at 1 year. Patients having discontinued TNFi were considered nonresponders. Logistic regression analyses were performed to adjust for important predictors of response.
Results Compared to men, female patients had lower mean C-reactive protein levels, better spinal mobility, and more peripheral disease at the start. There was no sex disparity with regard to the ASDAS, the Bath Ankylosing Spondylitis Disease Activity and Functional indices, and the quality of life. At 1 year, 52% of women and 63% of men achieved an ASAS20 response (OR 0.63, 95% CI 0.37–1.07, p = 0.09). An inactive disease status (ASDAS < 1.3) was reached by 18% of women and 26% of men (OR 0.65, 95% CI 0.32–1.27, p = 0.22). These sex differences in response to TNFi were more pronounced in adjusted analyses (OR 0.34, 95% CI 0.16–0.71, p = 0.005 for ASAS20 and OR 0.10, 95% CI 0.03–0.31, p < 0.001 for ASDAS < 1.3) and confirmed for all the other outcomes assessed.
Conclusion In AS, fewer women respond to TNFi and women show a reduced response in comparison to men.
In this issue
The Journal of Rheumatology
Vol. 52, Issue 5
1 May 2025
Response to Tumor Necrosis Factor Inhibition in Male and Female Patients with Ankylosing Spondylitis: Data from a Swiss Cohort
Monika Hebeisen, Regula Neuenschwander, Almut Scherer, Pascale Exer, Ulrich Weber, Giorgio Tamborrini, Raphael Micheroli, Lukas M. Wildi, Pascal Zufferey, Michael J. Nissen, Peter M. Villiger, Jürg Bernhard, Axel Finckh, Irene E. van der Horst-Bruinsma, Joachim Sieper, Robert Landewé, Désirée van der Heijde, Adrian Ciurea
The Journal of Rheumatology Feb 2018, jrheum.170166; DOI: 10.3899/jrheum.170166
Response to Tumor Necrosis Factor Inhibition in Male and Female Patients with Ankylosing Spondylitis: Data from a Swiss Cohort
Monika Hebeisen, Regula Neuenschwander, Almut Scherer, Pascale Exer, Ulrich Weber, Giorgio Tamborrini, Raphael Micheroli, Lukas M. Wildi, Pascal Zufferey, Michael J. Nissen, Peter M. Villiger, Jürg Bernhard, Axel Finckh, Irene E. van der Horst-Bruinsma, Joachim Sieper, Robert Landewé, Désirée van der Heijde, Adrian Ciurea
The Journal of Rheumatology Feb 2018, jrheum.170166; DOI: 10.3899/jrheum.170166
