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Biologicals in der frühen Behandlung des M. Bechterew und verwandter Spondyloarthritiden

Biologics in the early treatment of ankylosing spondylitis and related forms of spondyloarthritis

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Summary

New pathogenetic insights have identified the key role of TNF-alpha in inflammatory rheumatic diseases and have revolutionized the therapy of spondyloarthritides. TNF-alpha-antagonists specifically inhibit the pro-inflammatory effects of TNF-alpha. Clinical studies with infliximab (Remicade), Etanercept (Enbrel) or Adalimumab (Humira) in ankylosing spondylitis or related diseases demonstrate superior efficacy to conventional drugs like non-steroidal antirheumatic drugs or traditional disease modifying antirheumatic drugs.

Zusammenfassung

Neue Erkenntnisse in der Pathogenese haben die Therapie der Spondyloarthritiden revolutioniert und die Schlüsselrolle des Zytokins TNF-alpha für die chronischen Entzündungsprozesse auch an der Wirbelsäule aufgezeigt. Mit dem therapeutischen Einsatz von biotechnologisch hergestellten Substanzen ("Biologicals") ist es heute möglich, TNF-alpha spezifisch zu inhibieren und damit in seiner pro-inflammatorischen Wirkung zu hemmen. Klinische Studien zeigen bei M. Bechterew und verwandten Spondyloarthritiden die überlegene Wirksamkeit der TNF-alpha-blockierenden Medikamente Infliximab (Remicade), Etanercept (Enbrel) und Adalimumab (Humira) gegenüber der konventionellen Therapie mit NSAR und traditionellen langwirksamen Antirheumatika.

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Literatur

  • Braun J, Bollow M, Remlinger G, Eggens U, Rudwaleit M, Distler A, Sieper J (1998) Prevalence of spondylarthropathies in HLA B27-positive and -negative blood donors. Arthritis Rheum 4158–4167

  • Ward MM (1999) Health-related quality of life in ankylosing spondylitis: a survey of 175 patients. Arthritis Care Res 12: 247–255

    Article  PubMed  CAS  Google Scholar 

  • Zink A, Listing J, Klindworth C, Zeidler H (2001) The national database of the German Collaborative Arthritis Centres: I. Structure, aims, and patients. Ann Rheum Dis 60: 199–206

    Article  PubMed  CAS  Google Scholar 

  • Boonen A (2002) Socioeconomic consequences of ankylosing spondylitis. Clin Exp Rheumatol 20: S23–S26

    PubMed  CAS  Google Scholar 

  • Lehtinen K (1993) Mortality and causes of death in 398 patients admitted to hospital with ankylosing spondylitis. Ann Rheum Dis 52: 174–176

    Article  PubMed  CAS  Google Scholar 

  • Braun J, Pincus T (2002) Mortality, course of disease, and prognosis of patients with ankylosing spondylitis. Clin Exp Rheumatol 20: S16–S22

    PubMed  CAS  Google Scholar 

  • Haibel H, Rudwaleit M, Braun J, Sieper J (2002) Epidemiologie und Versorgung im Bereich der Spondylarthropathien. Z. Rheumatol 61: 30–38

    Article  PubMed  CAS  Google Scholar 

  • Creemers MCW, Franssen MJAM, van De Putte LBA, Gribnau FWJ, van Riel PLCM (1995) Methotrexate in severe ankylosing spondylitis: an open study. J Rheumatol 22: 1104–1107

    PubMed  CAS  Google Scholar 

  • Marshall RW, Kirwan JR (2001) Methotrexate in the treatment of ankylosing spondylitis. Scandinavian J Rheumatol 30: 313–314

    Article  CAS  Google Scholar 

  • Biasi D, Carletto A, Caramaschi P, Pacor ML, Maleknia T, Bambara L M (2000) Efficacy of methotrexate in the treatment of ankylosing spondylitis: a three-year open study. Clin Rheumatol 19: 114–117

    Article  PubMed  CAS  Google Scholar 

  • Roychowdhury B, Bintley-Bagot S, Bulgen DY, Thompson RN, Tunn EJ, Moots RJ (2002) Is methotrexate effective in ankylosing spondylitis? Rheumatology (Oxford) 41: 1330–1332

    Article  CAS  Google Scholar 

  • Gonzalez-Lopez L, Garcia-Gonzalez A, Vazquez-Del-Mercado M, Muñoz-Valle JF, Gamez-Nava JI (2004) Efficacy of methotrexate in ankylosing spondylitis – a randomized, double blind, placebo controlled trial. J Rheumatol 31: 1568–1574

    PubMed  CAS  Google Scholar 

  • Haibel H, Brandt HC, Song IH, Brandt A, Listing J, Rudwaleit M, Sieper J (2007) Efficacy of subcutaneous methotrexate in active ankylosing spondylitis: a 16-week open-label trial. Ann Rheum Dis 66: 419–421

    Article  PubMed  CAS  Google Scholar 

  • Chen J, Liu C, Lin J (2006) Methotrexate for ankylosing spondylitis. Cochrane Database Syst Rev CD004524

  • Dougados M, van der Linden S, Leirisalo-Repo M, Huitfeldt B, Juhlin R, Veys E (1995) Sulfasalazine in the treatment of spondylarthropathy: a randomized, multicenter, double-blind, placebo-controlled study. Arthritis Rheum 38: 618–627

    Article  PubMed  CAS  Google Scholar 

  • Clegg DO, Reda DJ, Weisman MH, Blackburn WD, Cush JJ, Cannon GW (1996) Comparison of sulfasalazine and placebo in the treatment of ankylosing spondylitis: a Department of Veterans Affairs cooperative study. Arthritis Rheum 39: 2004–2012

    Article  PubMed  CAS  Google Scholar 

  • Clegg DO, Reda DJ, Abdellatif M (1999) Comparison of sulfasalazine and placebo for the treatment of axial and peripheral articular manifestations of the seronegative spondylarthropathies: a Department of Veterans Affairs Cooperative Study. Arthritis Rheum 42: 2325–2329

    Article  PubMed  CAS  Google Scholar 

  • Chen J, Liu C (2005) Sulfasalazine for ankylosing spondylitis. Cochrane Database Syst Rev CD004800

  • Darmawan J, Nasution AR, Chen SL, Haq SA, Zhao D, Zeng Q, Davatchi F (2006) Excellent endpoints from step-down bridge combination therapy of 5 immunosuppressants in NSAID-refractory ankylosing spondylitis: 6 year international study in Asia – WHO-ILAR COPCORD stage II treatment of the autoimmune diseases. J Rheumatol 33: 2484–2492

    PubMed  CAS  Google Scholar 

  • Haibel H, Rudwaleit M, Braun J, Sieper J (2005) Six months open label trial of leflunomide in active ank. spondylitis. Ann Rheum Dis 64: 124–126

    Article  PubMed  CAS  Google Scholar 

  • van Denderen JC, van der Paardt M, Nurmohamed MT, de Ryck YM, Dijkmans BA, van der Horst-Bruinsma IE (2005) Double blind, randomised, placebo controlled study of leflunomide in the treatment of active ankylosing spondylitis. Ann Rheum Dis 64: 1761–1764

    Article  PubMed  CAS  Google Scholar 

  • Hermann J, Müller T, Yazdani-Biuki B, Aringer M, Herold M, Ebner W, Ofner P, Graninger W (2007) High disease activity of ankylosing spondylitis in the community before the introduction of tumour necrosis factor blockers. Ann Rheum Dis 66: 561–562

    Article  PubMed  Google Scholar 

  • Dougados M, Dijkmans D, Khan M, Maksymowych W, van der Linden Sj, Brandt J (2002) Conventional treatments for ankylosing spondylitis. Ann Rheum Dis 61(Suppl III): iii40–iii50

    PubMed  CAS  Google Scholar 

  • Braun J, Bollow M, Neure L, Seipelt E, Seyrekbasan F, Herbst H (1995) Use of immunohistologic and in situ hybridization techniques in the examination of sacroiliac joint biopsy specimens from patients with ankylosing spondylitis. Arthritis Rheum 38: 499–505

    Article  PubMed  CAS  Google Scholar 

  • Braun J, Sieper J (2000) Anti-TNF: a new dimension in the pharmacotherapy of the spondyloarthropathies? Ann Rheum Dis 59: 404–407

    Article  PubMed  CAS  Google Scholar 

  • Brandt J, Haibel H, Cornely D, Golder W, Gonzalez J, Reddig J (2000) Successful treatment of active ankylosing spondylitis with the anti-tumor necrosis factor monoclonal antibody infliximab. Arthritis Rheum 43: 1346–1352

    Article  PubMed  CAS  Google Scholar 

  • Braun J, Brandt J, Listing J, Zink A, Alten R, Krause A (2002) Treatment of active ankylosing spondylitis with infliximab: a double-blind placebo controlled multicenter trial. Lancet 359: 1187–1193

    Article  PubMed  CAS  Google Scholar 

  • Brandt J, Haibel H, Sieper J, Reddig J, Braun J (2001) Infliximab treatment of severe ankylosing spondylitis: one-year followup [letter]. Arthritis Rheum 44: 2936–2937

    Article  PubMed  CAS  Google Scholar 

  • Braun J, Brandt J, Listing J, Zink A, Alten R, Burmester G, Gromnica-Ihle E, Kellner H, Schneider M, Sörensen H, Zeidler H, Sieper J (2005) Two year maintenance of efficacy and safety of infliximab in the treatment of ankylosing spondylitis. Ann Rheum Dis 64: 229–234

    Article  PubMed  CAS  Google Scholar 

  • Braun J, Baraliakos X, Brandt J, Listing J, Zink A, Alten R, Burmester G, Gromnica-Ihle E, Kellner H, Schneider M, Sorensen H, Zeidler H, Sieper J (2005) Persistent clinical response to the anti-TNF-alpha antibody infliximab in patients with ankylosing spondylitis over 3 years. Rheumatology (Oxford) 44: 670–676

    Article  CAS  Google Scholar 

  • van der Heijde D, Dijkmans B, Geusens P, Sieper J, DeWoody K, Williamson P, Braun J (2005) Ankylosing Spondylitis Study for the Evaluation of Recombinant Infliximab Therapy Study Group. Efficacy and safety of infliximab in patients with ankylosing spondylitis: results of a randomized, placebo-controlled trial (ASSERT). Arthritis Rheum 52: 582–591

    Article  PubMed  CAS  Google Scholar 

  • Stone M, Salonen D, Lax M, Payne U, Lapp V, Inman R (2001) Clinical and imaging correlates of response to treatment with infliximab in patients with ankylosing spondylitis. J Rheumatol 28: 1605–1614

    PubMed  CAS  Google Scholar 

  • Breban M, Vignon E, Claudepierre P, Devauchelle V, Wendling D, Lespessailles E, Euller-Ziegler L, Sibilia J, Perdriger A, Mezières M, Alexandre C, Dougados M (2002) Efficacy of infliximab in refractory ankylosing spondylitis: results of a six-month open-label study. Rheumatology (Oxford) 41: 1280–1285

    Article  CAS  Google Scholar 

  • Maksymowych WP, Jhangri GS, Lambert RG, Mallon C, Buenviaje H, Pedrycz E, Luongo R, Russell AS (2002) Infliximab in ankylosing spondylitis: a prospective observational inception cohort analysis of efficacy and safety. J Rheumatol 29: 959–965

    PubMed  CAS  Google Scholar 

  • Munoz-Villanueva MC, Collantes E, Gratacos J, Sanmarti R, Canete JD, Gratacos J, Zarco P, Gonzalez C, Torre-Alanso JC (2002) Successful treatment of active and refractory spondyloarthritis with the anti-TNFa monoclonal antibody infliximab. Ann Rheum Dis 61(Suppl 1): 300

    Google Scholar 

  • Keeling S, Oswald A, Russell AS, Maksymowych WP (2006) Prospective observational analysis of the efficacy and safety of low-dose (3 mg/kg) infliximab in ankylosing spondylitis: 4-year follow up. J Rheumatol 33: 558–561

    PubMed  CAS  Google Scholar 

  • Venetsanopoulou AI, Voulgari PV, Alamanos Y, Papadopoulos CG, Markatseli TE, Drosos AA (2007) Persistent clinical response of infliximab treatment, over a 4-year period in ankylosing spondylitis. Rheumatol Int 27: 935–939

    Article  PubMed  CAS  Google Scholar 

  • van der Heijde D, Dijkmans B, Geusens P, Sieper J, DeWoody K, Williamson P, Braun J (2005) Ankylosing Spondylitis Study for the Evaluation of Recombinant Infliximab Therapy Study Group. Efficacy and safety of infliximab in patients with ankylosing spondylitis: results of a randomized, placebo-controlled trial (ASSERT). Arthritis Rheum 52: 582–591

    Article  PubMed  CAS  Google Scholar 

  • Gorman JD, Sack KE, Davis JC (2002) Treatment of ankylosing spondylitis by inhibition of tumor necrosis factor. N Engl J Med 346: 1349–1356

    Article  PubMed  CAS  Google Scholar 

  • Brandt J, Khariouzov A, Listing J, Haibel H, Sorensen H, Grassnickel L (2003) Six-month results of a double-blind, placebo-controlled trial of etanercept treatment in patients with active ankylosing spondylitis. Arthritis Rheum 48: 1667–1675

    Article  PubMed  CAS  Google Scholar 

  • Davis JC Jr, van der Heijde D, Braun J, Dougados M, Cush J, Clegg DO (2003) for the Enbrel Ankylosing Spondylitis Study Group. Recombinant human tumor necrosis factor receptor (etanercept) for treating ankylosing spondylitis: a randomized, controlled trial. Arthritis Rheum 48: 3230–3236

    Article  PubMed  CAS  Google Scholar 

  • Calin A, Dijkmans BA, Emery P, Hakala M, Kalden J, Leirisalo-Repo M, Mola EM, Salvarani C, Sanmartí R, Sany J, Sibilia J, Sieper J, van der Linden S, Veys E, Appel AM, Fatenejad S (2004) Outcomes of a multicentre randomised clinical trial of etanercept to treat ankylosing spondylitis. Annals of the Rheumatic Diseases 63: 1594–1600

    Article  PubMed  CAS  Google Scholar 

  • Davis J Jr, Webb A, Lund S, Sack K (2004) Results from an open-label extension study of etanercept in ankylosing spondylitis. Arthritis Rheum 51: 302–304

    Article  PubMed  Google Scholar 

  • Davis JC, van der Heijde DM, Braun J, Dougados M, Cush J, Clegg D, Inman RD, Kivitz A, Zhou L, Solinger A, Tsuji W (2005) Sustained durability and tolerability of etanercept in ankylosing spondylitis for 96 weeks. Ann Rheum Dis 64: 1557–1562

    Article  PubMed  CAS  Google Scholar 

  • Brandt J, Listing J, Haibel H, Sorensen H, Schwebig A, Rudwaleit M (2005) Long-term efficacy and safety of etanercept after readministration in patients with active ankylosing spondylitis. Rheumatology (Oxford) 44: 342–348

    Article  CAS  Google Scholar 

  • Baraliakos X, Brandt J, Listing J, Haibel H, Sörensen H, Rudwaleit M, Sieper J, Braun J (2005) Outcome of patients with active ankylosing spondylitis after two years of therapy with etanercept: Clinical and magnetic resonance imaging data. Arthritis Rheum 53: 856–863

    Article  PubMed  CAS  Google Scholar 

  • Braun J, McHugh N, Singh A, Wajdula JS, Sato R (2007) Improvement in patient-reported outcomes for patients with ankylosing spondylitis treated with etanercept 50 mg once-weekly and 25 mg twice-weekly. Rheumatology (Oxford) 46: 999–1004

    Article  CAS  Google Scholar 

  • Delaunay C, Farrenq V, Marini-Portugal A, Cohen JD, Chevalier X, Claudepierre P (2005) Infliximab to etanercept switch in patients with spondyloarthropathies and psoriatic arthritis: preliminary data. J Rheumatol 32: 2183–2185

    PubMed  CAS  Google Scholar 

  • Haibel H, Rudwaleit M, Brandt HC, Grozdanovic Z, Listing J, Kupper H, Braun J, Sieper J (2006) Adalimumab reduces spinal symptoms in active ankylosing spondylitis: clinical and magnetic resonance imaging results of a fifty-two-week open-label trial. Arthritis Rheum 54: 678–681

    Article  PubMed  CAS  Google Scholar 

  • van der Heijde D, Kivitz A, Schiff MH, Sieper J, Dijkmans BA, Braun J, Dougados M, Reveille JD, Wong RL, Kupper H, Davis JC Jr (2006) ATLAS Study Group. Efficacy and safety of adalimumab in patients with ankylosing spondylitis: results of a multicenter, randomized, double-blind, placebo-controlled trial. Arthritis Rheum 54: 2136–2146

    Article  PubMed  CAS  Google Scholar 

  • Davis JC Jr, Revicki D, van der Heijde DM, Rentz AM, Wong RL, Kupper H, Luo MP (2007) Health-related quality of life outcomes in patients with active ankylosing spondylitis treated with adalimumab: Results from a randomized controlled study. Arthritis Rheum 57: 1050–1057

    Article  PubMed  Google Scholar 

  • Van den Bosch F, Kruithof E, Baeten D, de Keyser F, Mielants H, Veys EM (2000) Effects of a loading dose regimen of three infusions of chimeric monoclonal antibody to tumour necrosis factor (infliximab) in spondyloarthropathy: an open pilot study. Ann Rheum Dis 59: 428–433

    Article  PubMed  CAS  Google Scholar 

  • Van den Bosch F, Kruithof E, Baeten D, Herssens A, de Keyser F, Mielants H (2002) Randomized double-blind comparison of chimeric monoclonal antibody to tumor necrosis factor (infliximab) versus placebo in active spondylarthropathy. Arthritis Rheum 46: 755–765

    Article  PubMed  CAS  Google Scholar 

  • Brandt J, Haibel H, Reddig J, Sieper J, Braun J (2002) Successful short term treatment of severe undifferentiated spondyloarthropathy with the anti-tumor necrosis factor monoclonal antibody infliximab. J Rheumatol 29: 118–122

    PubMed  CAS  Google Scholar 

  • Kruithof E, van den Bosch F, Baeten D, Herssens A, de Keyser F, Mielants H (2002) Repeated infusions of infliximab, a chimeric anti-TNF monoclonal antibody, in patients with active spondyloarthropathy: one year follow up. Ann Rheum Dis 61: 207–212

    Article  PubMed  CAS  Google Scholar 

  • Baeten D, Kruithof E, van den Bosch F, van den Bossche N, Herssens A, Mielants H (2003) Systemic safety follow up in a cohort of 107 patients with spondyl-arthropathy treated with infliximab: a new perspective on the role of host defense in the pathogenesis of the disease. Ann Rheum Dis 62: 829–834

    Article  PubMed  CAS  Google Scholar 

  • Brandt J, Khariouzov A, Listing J, Haibel H, Sorensen H, Rudwaleit M, Sieper J, Braun J (2004) Successful short term treatment of patients with severe undifferentiated spondyloarthritis with the anti-tumor necrosis factor-alpha fusion receptor protein etanercept. J Rheumatol 31: 531–538

    PubMed  CAS  Google Scholar 

  • Braun J, Baraliakos X, Golder W, Brandt J, Rudwaleit M, Listing J (2003) Magnetic resonance imaging examinations of the spine in patients with ankylosing spondylitis, before and after successful therapy with infliximab: evaluation of a new scoring system. Arthritis Rheum 48: 1126–1136

    Article  PubMed  CAS  Google Scholar 

  • Braun J, Landewe R, Hermann KG, Han J, Yan S, Williamson P, van der Heijde D (2006) ASSERT Study Group. Major reduction in spinal inflammation in patients with ankylosing spondylitis after treatment with infliximab: results of a multicenter, randomized, double-blind, placebo-controlled magnetic resonance imaging study. Arthritis Rheum 54: 1646–1652

    Article  PubMed  CAS  Google Scholar 

  • Sieper J, Baraliakos X, Listing J, Brandt J, Haibel H, Rudwaleit M, Braun J (2005) Persistent reduction of spinal inflammation as assessed by magnetic resonance imaging in patients with ankylosing spondylitis after 2 yrs of treatment with the anti-tumour necrosis factor agent infliximab. Rheumatology (Oxford) 44: 1525–1530

    Article  CAS  Google Scholar 

  • Baraliakos X, Davis J, Tsuji W, Braun J (2005) Magnetic resonance imaging examinations of the spine in patients with ankylosing spondylitis before and after therapy with the tumor necrosis factor alpha receptor fusion protein etanercept. Arthritis Rheum 52: 1216–1223

    Article  PubMed  CAS  Google Scholar 

  • Rudwaleit M, Baraliakos X, Listing J, Brandt J, Sieper J, Braun J (2005) Magnetic resonance imaging of the spine and the sacroiliac joints in ankylosing spondylitis and undifferentiated spondyloarthritis treatment with etanercept. Ann Rheum Dis 64: 1305–1310

    Article  PubMed  CAS  Google Scholar 

  • Baraliakos X, Listing J, Rudwaleit M, Brandt J, Sieper J, Braun J (2005) Radiographic progression in patients with ankylosing spondylitis after 2 years of treatment with the tumour necrosis factor alpha antibody infliximab. Ann Rheum Dis 64: 1462–1466

    Article  PubMed  CAS  Google Scholar 

  • Baraliakos X, Listing J, Brandt J, Haibel H, Rudwaleit M, Sieper J, Braun J (2007) Radiographic progression in patients with ankylosing spondylitis after 4 yrs of treatment with the anti-TNF-{alpha} antibody infliximab. Rheumatology (Oxford) Jul 10 [Epub ahead of print] http://rheumatology.oxfordjournals.org/cgi/content/full/kem166v1

  • van der Heide D, Landewe R, Deoadar A (2007) Radiographic progression in patients with ankylosing spondylitis after 2 years of treatment not inhibited with infliximab. Ann Rheum Dis 66(Suppl II): 85–86 (abstract OP0111)

    Google Scholar 

  • van der Heijde D, Landewe R, Ory P (2006) Two-year etanercept therapy does not inhibit radiographic progression in patients with anklyosing spondylitis. Ann Rheum Dis 65: 81 (abstract OP0090)

    Article  Google Scholar 

  • Rudwaleit M, Listing J, Brandt J, Braun J, Sieper J (2004) Prediction of a major clinical response (BASDAI 50) to tumour necrosis factor alpha blockers in ankylosing spondylitis. Ann Rheum Dis 63: 665–670

    Article  PubMed  CAS  Google Scholar 

  • Davis JC Jr, Van der Heijde DM, Dougados M, Braun J, Cush JJ, Clegg DO, Inman RD, de Vries T, Tsuji WH (2005) Baseline factors that influence ASAS 20 response in patients with ankylosing spondylitis treated with etanercept. J Rheumatol 32: 1751–1754

    PubMed  CAS  Google Scholar 

  • Pham T, Landewé R, van der Linden S, Dougados M, Sieper J, Braun J, Davis J, Rudwaleit M, Collantes E, Burgos-Vargas R, Edmonds J, Olivieri I, van der Horst-Bruinsma I, Mielants H, Stone M, Emery P, van der Heijde D (2006) An international study on starting tumour necrosis factor-blocking agents in ankylosing spondylitis. Ann Rheum Dis 65: 1620–1625

    Article  PubMed  CAS  Google Scholar 

  • Braun J, Pham T, Sieper J, Davis J, van der Linden S, Dougados M, van der Heijde D (2003) ASAS Working Group. International ASAS consensus statement for the use of anti-tumour necrosis factor agents in patients with ankylosing spondylitis. Ann Rheum Dis 62: 817–824

    Article  PubMed  CAS  Google Scholar 

  • Braun J, Davis J, Dougados M, Sieper J, van der Linden S, van der Heijde D (2006) ASAS Working Group. First update of the international ASAS consensus statement for the use of anti-TNF agents in patients with ankylosing spondylitis. Ann Rheum Dis 65: 316–320

    Article  PubMed  CAS  Google Scholar 

  • Kavanaugh A, Tutuncu Z, Catalan-Sanchez T (2006) Update in anti tumor necrosis factor therapy in the spondyloarthropathies including psoriatic arthritis. Curr Opin Rheumatol 18: 347–353

    Article  PubMed  CAS  Google Scholar 

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  1. Schwerpunkt für Rheumatologie, klinische Immunologie und Osteologie am Evangelischen Krankenhaus Düsseldorf, Düsseldorf, Germany

    Hans-Eckhard Langer

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Langer, HE. Biologicals in der frühen Behandlung des M. Bechterew und verwandter Spondyloarthritiden. Wien Med Wochenschr 158, 200–205 (2008). https://doi.org/10.1007/s10354-008-0522-2

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