beruflicher Werdegang | |
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1984 - 1991 | Medizinstudium in Erlangen, USA (Chicago, Houston) und Wien |
1991 | Zivildienst |
1991 - 1997 | Ausbildung zum Internisten Medizinische Klinik III der Universität Erlangen-Nürnberg, Klinische Immunologie und Hämato-Onkologie, Prof. Kalden |
1996 | Medizinische Klinik IV (Nephrologie) am Klinikum Nürnberg, Prof. Sterzel |
1997 | Anerkennung als Facharzt für Innere Medizin |
1999 | Rheumatologische Gemeinschaftspraxis Dres. de la Camp und Wendler, Erlangen |
2000 | Niedergelassener Internist in Einzelpraxis Schwerpunkte: hausärztliche internistische Versorgung und internistische Rheumatologie |
2001 | Rheumatologische Schwerpunktpraxis Erlangen Dres. de la Camp/Schuch/Wendler in Praxisgemeinschaft Rheumatologie-Nephrologie |
2006 | KV-Zulassung Blutreinigungsverfahren/Dialyse |
2006 | Erweiterung Rheumatologische Schwerpunktpraxis Erlangen Dres. de la Camp/Schuch/Wendler und Dr. Praxedis Rapp |
2012 | Rheumatologische Schwerpunktpraxis Erlangen Dres. Kleinert/ Rapp/Schuch/Wendler |
2018 | Praxisgemeinschaft Rheumatologie- Nephrologie PD Kleinert/ Dres. Rapp/Ronneberger/Schuch/Wendler und Dres. Horn/Wulff |
2020 | Praxisgemeinschaft Rheumatologie- Nephrologie PD Kleinert/ Dres. Rapp/Ronneberger/Schuch/Wendler und Dres. Broll/Horn/Wulff |
Mitgliedschaften | |
Deutsche Gesellschaft für Rheumatologie (DGRh) | |
Berufsverband der deutschen Rheumatologen (BDRh) | |
Dachverband Osteologie (DVO) | |
Arbeitskreis Ausbildung Fachassistenz Rheumatologie | |
Rheumaliga Deutschland e.V. | |
Deutsche Vereinigung Morbus Bechterew e.V. DVMB | |
Rheumazentrum Erlangen | |
Mitglied Zulassungsauschuß KV Mittelfranken | |
Mitglied Laborkommission KVB | |
Tätigkeiten und Funktionen | |
Mitautor und Referent „Rheumatologische Fachassistenz (DGRh-BDRh)“ und Aufbaukurse | |
Koordinator Jahresmotto 2008/2009 der Rheumazentren „Der informierte Patient als Partner“ | |
Koordinator und Mitautor „Strukturierte Patienteninformation StruPI“ – ein Projekt zur ambulanten Patienteninformation der AGRZ, Berufsverband Deutscher Rheumatologen (BDRh) und Rheumaliga | |
Mitautor „Aktiv leben - trotz Rheuma“ humboldt Gesundheitsratgeber 2015 | |
Teilnahme und PI (principle investigator ) bei mehr als 40 Phase II-IV Studien | |
1. Vorsitzender Berufsverband Deutscher Rheumatologen BDRh Bayern | |
BDRh Bundesvorstand Schriftführer | |
Mitglied im Beirat der Deutschen Gesellschaft für Rheumatologie DGRh 2012 bis 2015 und 2023 bis 2026 | |
Sprecher Kommission Rheumatologische Fachassistenz der Deutschen Gesellschaft für Rheumatologie | |
Mitglied im wissenschaftlichen Kuratorium der Rheumaakademie | |
Mitglied Vorstand der Rheumastiftung seit 2016, Vorsitzender seit 2021 | |
Mitglied Vorstand Rheumazentrum Erlangen | |
Mitglied des Vorstandes Ärztlicher Kreisverband Erlangen seit 2002, seit 2015 1.Vorsitzender | |
Delegierter zur Bayerischen Landesärztekammer (BLAEK) | |
Mitglied Temporärer Ausschuss zur Umsetzung der (Muster-)Weiterbildungsordnung der BLAEK | |
Mitglied der Akademie für Ärztliche Fortbildung der Landesärztekammer Bayern 2002 bis 2012 | |
KV Bayern Mitglied Laborkommission seit 2017 | |
Editorial Board „Zeitschrift für Rheumatologie“ | |
Gutachtertätigkeit für wissenschaftliche Fachzeitschriften | |
Zeitschrift für Rheumatologie | |
Aktuelle Rheumatologie | |
Preise und Auszeichnungen | |
2013 | Kussmaul Medaille der DGRh |
2015 | Erlanger Medizinpreis |
seit 2018 | TOP Ärzte FOCUS Magazin |
seit 2022 | Ärzteliste „Gute Ärzte für mich“ STERN-Magazin |
Publikationen und Kongressbeiträge (Auswahl) |
Kleinert, S.; Schuch, F.; Rapp, P.; Ronneberger, M.; Wendler, J.; Sternad, P.; Popp, F.; Bartz-Bazzanella, P.; von der Decken, C.; Karberg, K.; Gauler, G.; Wurth, P.; Spathling-Mestekemper, S.; Kuhn, C.; Englbrecht, M.; Vorbruggen, W.; Adler, G.; Welcker, M.: Impairment in cognitive function in patients with axial spondyloarthritis and psoriatic arthritis. In: Rheumatol Int, Bd. 43, Nr. 1, S. 89-97, 2023, ISSN: 1437-160X (Electronic)
0172-8172 (Linking). (Typ: Artikel | Links | BibTeX)@article{RN10032, |
Kiltz, U; Buschhorn-Milberger, V; Albrecht, K; Lakomek, H-J; Lorenz, H-M; Rudwaleit, M; Schneider, M; Schulze-Koops, H; Aringer, M; Hasenbring, M I; Herzer, P; von Hinüber, U; Krüger, K; Lauterbach, A; Manger, B; Oltman, R; Schuch, F; Schmale-Grede, R; Späthling-Mestekemper, S; Zinke, S; Braun, J: Entwicklung von Qualitätsstandards für die Versorgung von Patient*innen mit rheumatoider Arthritis zur Anwendung in Deutschland. In: Z. Rheumatol., Bd. 81, Nr. 9, S. 744–759, 2022. (Typ: Artikel | Abstract | Links | BibTeX)@article{Kiltz2022-nt, ZusammenfassungTrotz einer qualitativ und strukturell guten Versorgung von Patient*innen mit rheumatoider Arthritis (RA) in Deutschland bestehen weiterhin potenziell behebbare Defizite in der Qualität der Versorgung. Aus diesem Grund hat die Deutsche Gesellschaft für Rheumatologie (DGRh) eine Expert*innengruppe, in der verschiedene Interessengruppen vertreten waren, beauftragt, nationale Qualitätsstandards (QS) mit dem Ziel zu entwickeln, die rheumatologische Versorgung von Patient*innen mit RA in Deutschland qualitativ zu verbessern. QS dienen der Festlegung und quantitativen Messung guter Versorgungsqualität unter dem Vorbehalt von Relevanz und Realisierbarkeit. Als Grundlage für die Entwicklung dienten die kürzlich publizierten Standards von NICE und ASAS und eine systematische Literatursuche. Insgesamt wurden 8 hiermit erstmals veröffentlichte QS konsentiert, die als Grundlage dienen können, die Versorgungsqualität von Patient*innen mit RA in Deutschland zu messen und weiter zu optimieren. |
Pfeil, Alexander; Krusche, Martin; Proft, Fabian; Vossen, Diana; Braun, Jürgen; Baraliakos, Xenofon; Berliner, Michael N; Keyßer, Gernot; Krause, Andreas; Lorenz, Hanns-Martin; Manger, Bernhard; Schuch, Florian; Specker, Christof; Wollenhaupt, Jürgen; Voormann, Anna; Fleck, Martin: Rheumatology training positions in Germany. In: Z. Rheumatol., 2022. (Typ: Artikel | Abstract | BibTeX)@article{Pfeil2022-yp, BACKGROUND: In the next few years many general practitioners and specialists will retire. As in other disciplines the question arises in rheumatology whether sufficient training positions are available to maintain or expand the supply of care according to demand. Therefore, the German Society of Rheumatology (DGRh) has assigned its committee for education and training to review the currently available training opportunities in Germany. The aim of this work is the quantitative survey of the training capacity to become a specialist in internal medicine and rheumatology. METHODS: Within the framework of this study, a survey was conducted via the homepages of the 17 state medical associations to determine the postgraduate medical officers, their place of work and the duration of their postgraduate training capabilities. Based on the data, a nationwide survey of training positions was conducted. RESULTS: Specialized rheumatology training is established at 229 training centers in Germany, whereby data from 187 training sites were available for analysis. The training locations are distributed as followed: 52.4% clinical sector and 47.6% outpatient sector. In total, 478.4 training positions are available in Germany (clinical sector: 391.4 and outpatient sector: 87) and 17.2% of the positions (clinical sector: 11.4% and outpatient sector: 43.1%) are not occupied. CONCLUSION: Based on this study, it can be shown that most of the continuing education positions are available in the clinical sector. In contrast, half of the training positions in the outpatient area are not filled. In order to improve the training situation, it is essential to integrate outpatient colleagues into the training program. This presupposes that further training is supported or financed by the healthcare system. In this context, optimal rheumatological care must be permanently guaranteed throughout Germany in order to provide sufficient care for the approximately 2 million patients with inflammatory rheumatic diseases. |
Hörbrand, Franziska; Schuch, Florian; Bleß, Hans-Holger; Messinger, David; Bretthauer, Bork; Killian, Peter: PHARAO-Studie: Arzneimittelversorgung entzündlich
rheumatischer Erkrankungen. In: Z. Rheumatol., 2022. (Typ: Artikel | Abstract | BibTeX)@article{Horbrand2022-jn, Zusammenfassung Hintergrund Mit Einführung der Tumornekrosefaktor(TNF)-$alpha$-Blocker hat die Behandlung entzündlich rheumatischer Erkrankungen (ERE) einen grundlegenden Wandel erfahren. Etliche der ursprünglich hochpreisigen Biologika verloren im Verlauf der Studie ihren Patentschutz und standen seitdem als kostengünstigere Biosimilars zur Verfügung, sodass ein bedeutsames Verordnungshemmnis entfallen ist. Fragestellung In der vorliegenden Studie wurde untersucht, ob die Verfügbarkeit von Biosimilars mit einer Verbesserung der Versorgung von ERE einhergeht. Zugleich wurde die subjektive Akzeptanz von Biosimilars bei Ärzten und Patienten untersucht und mit standardisierten Scores abgeglichen. Material und Methoden Als Datengrundlage dienten pseudonymisierte Abrechnungsdaten der Kassenärztlichen Vereinigung Bayerns von 2014 bis 2019 sowie eine Paper-Pencil-Befragung von Patienten und Rheumatologen. Ergebnisse Im Beobachtungszeitraum stieg der Anteil an diagnostizierten Patienten, die eine Arzneimitteltherapie erhielten, von 38,5 % auf 43,2 % an. Deren Versorgung veränderte sich auch in Bezug auf die verordneten Wirkstoffe. Die konventionelle medikamentöse Therapie war insgesamt rückläufig. Insbesondere die Verordnung von Glukokortikoiden sank von 39,3 % in 2014 auf 34,3 % in 2019. Zugleich stieg der Anteil zielgerichteter Behandlungen von 12,3 % auf 20,4 %. Die mediane Dauer der Basistherapie vor erstmaligem bDMARD-Einsatz verkürzte sich von 3,15 Jahren in 2014 auf 2,17 Jahre in 2019. Diskussion Über den Beobachtungszeitraum, in den auch der Markteintritt von 3 Biosimilars fällt, verbesserte sich die Versorgung von Patienten mit ERE quantitativ wie qualitativ. Der Versorgungsanteil von Biosimilars nahm parallel zu der aufgezeigten Entwicklung zu. Bei insgesamt hoher Akzeptanz von Biosimilars verweist die Einschätzung des Krankheitsverlaufes von Ärzten und Patienten auf einen leichten, subjektiv wahrgenommenen Vorteil der Therapie mit Originalen im Vergleich zur Biosimilar-Therapie, der sich bei Anwendung standardisierter Scores jedoch nicht bestätigt. Eine mögliche Erklärung hierfür könnte ein Nocebo-Effekt sein, der durch geeignete Kommunikationsstrategien minimiert werden könnte. |
Pfeil, Alexander; Schuch, Florian; Fleck, Martin: Further training in rheumatology-Current status 2022. In: Z. Rheumatol., Bd. 81, Nr. 6, S. 482–486, 2022. (Typ: Artikel | Abstract | BibTeX)@article{Pfeil2022-md, For the continued existence of the specialty of internal medicine and rheumatology and the assurance of a qualitative patient care, attractive further education for motivated resident physicians is of central importance. Continuing training in rheumatology takes place primarily in the inpatient setting, although reliable figures on outpatient and inpatient further education positions are not yet available. Further training in rheumatology is predefined by the model further training regulations (Musterweiterbildungsverordnung; MWBO) 2018, which have now been implemented by most state medical associations, in some cases with state-specific changes. Based on the MWBO of 2018, a model curriculum was developed by the German Society of Rheumatology (DGRh) for further training in the specialty of internal medicine and rheumatology. This model curriculum is intended to provide orientation for trainees and trainers as well as to facilitate structured rheumatology training in inpatient and outpatient settings. |
Simon, David; Tascilar, Koray; Kleyer, Arnd; Fagni, Filippo; Krönke, Gerhard; Meder, Christine; Dietrich, Peter; Orlemann, Till; Kliem, Thorsten; Mößner, Johanna; Liphardt, Anna-Maria; Schönau, Verena; Bohr, Daniela; Schuster, Louis; Hartmann, Fabian; Leppkes, Moritz; Ramming, Andreas; Pachowsky, Milena; Schuch, Florian; Ronneberger, Monika; Kleinert, Stefan; Hueber, Axel J; Manger, Karin; Manger, Bernhard; Atreya, Raja; Berking, Carola; Sticherling, Michael; Neurath, Markus F; Schett, Georg: Impact of cytokine inhibitor therapy on the prevalence, seroconversion rate, and longevity of the humoral immune response against SARS-CoV-2 in an unvaccinated cohort. In: Arthritis Rheumatol., Bd. 74, Nr. 5, S. 783–790, 2022. (Typ: Artikel | Abstract | Links | BibTeX)@article{Simon2022-wz, ÖBJECTIVE: To investigate the impact of biologic disease-modifying antirheumatic drug (bDMARD) treatment on the prevalence, seroconversion rate, and longevity of the humoral immune response against SARS-CoV-2 in patients with immune-mediated inflammatory diseases (IMIDs). METHODS: Anti-SARS-CoV-2 IgG antibodies were measured in a prospective cohort of health care professional controls and non-health care controls and IMID patients receiving no treatment or receiving treatment with conventional or biologic DMARDs during the first and second COVID-19 waves. Regression models adjusting for age, sex, sampling time, and exposure risk behavior were used to calculate relative risks (RRs) of seropositivity. Seroconversion rates were assessed in participants with polymerase chain reaction (PCR)-positive SARS-CoV-2 infection. Antibody response longevity was evaluated by reassessing participants who tested positive during the first wave. RESULTS: In this study, 4,508 participants (2,869 IMID patients and 1,639 controls) were analyzed. The unadjusted RR (0.44 [95% confidence interval (95% CI) 0.31-0.62]) and adjusted RR (0.50 [95% CI 0.34-0.73]) for SARS-CoV-2 IgG antibodies were significantly lower in IMID patients treated with bDMARDs compared to non-health care controls (P < 0.001), primarily driven by treatment with tumor necrosis factor inhibitors, interleukin-17 (IL-17) inhibitors, and IL-23 inhibitors. Adjusted RRs for untreated IMID patients (1.12 [95% CI 0.75-1.67]) and IMID patients receiving conventional synthetic DMARDs (0.70 [95% CI 0.45-1.08]) were not significantly different from non-health care controls. Lack of seroconversion in PCR-positive participants was more common among bDMARD-treated patients (38.7%) than in non-health care controls (16%). Overall, 44% of positive participants lost SARS-CoV-2 antibodies by follow-up, with higher rates in IMID patients treated with bDMARDs (RR 2.86 [95% CI 1.43-5.74]). CONCLUSION: IMID patients treated with bDMARDs have a lower prevalence of SARS-CoV-2 antibodies, seroconvert less frequently after SARS-CoV-2 infection, and may exhibit a reduced longevity of their humoral immune response." |
Simon, David; Tascilar, Koray; Schmidt, Katja; Manger, Bernhard; Weckwerth, Leonie; Sokolova, Maria; Bucci, Laura; Fagni, Filippo; Manger, Karin; Schuch, Florian; Ronneberger, Monika; Hueber, Axel; Steffen, Ulrike; Mielenz, Dirk; Herrmann, Martin; Harrer, Thomas; Kleyer, Arnd; Krönke, Gerhard; Schett, Georg: Humoral and cellular immune responses to SARS-CoV-2 infection
and vaccination in autoimmune disease patients with B cell
depletion. In: Ärthritis Rheumatol.", Bd. 74, Nr. 1, S. 33–37, 2022. (Typ: Artikel | Abstract | BibTeX)@article{Simon2022-nf, ÖBJECTIVE: B cell depletion is an established therapeutic principle in a wide range of autoimmune diseases. However, B cells are also critical for inducing protective immunity after infection and vaccination. We undertook this study to assess humoral and cellular immune responses after infection with or vaccination against SARS-CoV-2 in patients with B cell depletion and controls who are B cell-competent. METHODS: Antibody responses (tested using enzyme-linked immunosorbent assay) and T cell responses (tested using interferon-$gamma$ enzyme-linked immunospot assay) against the SARS-CoV-2 spike S1 and nucleocapsid proteins were assessed in a limited number of previously infected (n = 6) and vaccinated (n = 8) autoimmune disease patients with B cell depletion, as well as previously infected (n = 30) and vaccinated (n = 30) healthy controls. RESULTS: As expected, B cell and T cell responses to the nucleocapsid protein were observed only after infection, while respective responses to SARS-CoV-2 spike S1 were found after both infection and vaccination. A SARS-CoV-2 antibody response was observed in all vaccinated controls (30 of 30 [100%]) but in none of the vaccinated patients with B cell depletion (0 of 8). In contrast, after SARS-CoV-2 infection, both the patients with B cell depletion (spike S1, 5 of 6 [83%]; nucleocapsid, 3 of 6 [50%]) and healthy controls (spike S1, 28 of 30 [93%]; nucleocapsid, 28 of 30 [93%]) developed antibodies. T cell responses against the spike S1 and nucleocapsid proteins were found in both infected and vaccinated patients with B cell depletion and in the controls. CONCLUSION: These data show that B cell depletion completely blocks humoral but not T cell SARS-CoV-2 vaccination response. Furthermore, limited humoral immune responses are found after SARS-CoV-2 infection in patients with B cell depletion." |
Pfeil, Alexander; Krusche, Martin; Vossen, Diana; Berliner, Michael N; Keyßer, Gernot; Krause, Andreas; Lorenz, Hanns-Martin; Manger, Bernhard; Schuch, Florian; Specker, Christof; Wollenhaupt, Jürgen; Baraliakos, Xenofon; Fleck, Martin; Proft, Fabian: Model curriculum of the German society for Rheumatology for
advanced training in the discipline internal medicine and
rheumatology. English version. In: Z. Rheumatol., Bd. 80, Nr. Suppl 2, S. 64–67, 2021. (Typ: Artikel | BibTeX)@article{Pfeil2021-hh, |
Schuch, Florian; Aries, Peer: Rheumatology in practice. In: Z. Rheumatol., Bd. 80, Nr. 9, S. 793–794, 2021. (Typ: Artikel | BibTeX)@article{Schuch2021-tw, |
Edelmann, Edmund; Schuch, Florian: Rheumatology in private practice: yesterday-today-tomorrow. In: Z. Rheumatol., Bd. 80, Nr. 9, S. 801–818, 2021. (Typ: Artikel | Abstract | BibTeX)@article{Edelmann2021-cs, Rheumatologic practices were still rare in the early 1990s and rheumatologic treatment took place mainly in the rheumatology clinics and university rheumatology clinics. In the following decades, the number of the rheumatologists in private practices increased and in the year 2004 about two thirds of the outpatient care were already carried out in private practices. In 2020 a total of 597 rheumatologists out of 1106 nationwide worked in private practices, including 203 who were employed. Since 2008, the number of rheumatologists in medical care centers increased more than the number of rheumatologists in private practice. In 2020 only 75% of panel rheumatologists in private practice were in full-time employment. This development to an altered work mentality of the incoming generation and an age structure in which approximately 30% of panel rheumatologists are older than 60 years, threatens a further deterioration of the anyway insufficient outpatient care. In contrast, there are developments that strengthen the outpatient care especially in practices, such as the outpatient specialist medical care and quality-oriented selective contracts as well as rheumatological and immunological laboratory diagnostics. These cornerstones give rheumatology a special position in the panel medical care within the group of specialties in internal medicine and an attractive economic basis. In addition to the medically and scientifically interesting discipline, this could be a further incentive for young trainees to choose rheumatology as a specialty and working in a private practice. |
Schuch, Florian: Corona pandemic in the practice : A flashback and reflection
from the rheumatological practice. In: Z. Rheumatol., Bd. 80, Nr. 9, S. 795–800, 2021. (Typ: Artikel | Abstract | BibTeX)@article{Schuch2021-hd, The corona pandemic changed the lives of people in Germany in 2020. Completely new challenges had to be met in outpatient care and of course also in rheumatology practices. The rapid development, the constant changes, the readjustment, the accompaniment of patients and staff team in this global catastrophe are described. The influence on the daily work and the implementation of new scientific knowledge, e.g. the recommendations of the German Society of Rheumatology (DGRh), are reported. Experiences and insights into what can be learned and taken away from crisis situations are outlined. A detailed chronology of the events, taking the special rheumatological features into account, completes this report of experiences. |
Pfeil, Alexander; Krusche, Martin; Vossen, Diana; Berliner, Michael N; Keyßer, Gernot; Krause, Andreas; Lorenz, Hanns-Martin; Manger, Bernhard; Schuch, Florian; Specker, Christof; Wollenhaupt, Jürgen; Baraliakos, Xenofon; Fleck, Martin; Proft, Fabian: Mustercurriculum der Deutschen Gesellschaft für
Rheumatologie für die Weiterbildung im Fachgebiet Innere
Medizin und Rheumatologie. In: Z. Rheumatol., Bd. 80, Nr. 7, S. 688–691, 2021. (Typ: Artikel | BibTeX)@article{Pfeil2021-ka, |
Schwarze, M; Fieguth, V; Schuch, F; Sandner, P; Edelmann, E; Händel, A; Kettler, M; Hanke, A; Kück, M; Stein, L; Stille, C; Fellner, M; Angelis, V De; Touissant, S; Specker, C: Disease-related knowledge acquisition through structured patient
information in rheumatoid arthritis (StruPI-RA) : First
results of the StruPI-RA study in Germany. In: Z. Rheumatol., Bd. 80, Nr. 4, S. 364–372, 2021. (Typ: Artikel | Abstract | BibTeX)@article{Schwarze2021-ul, Zusammenfassung Hintergrund/Ziel Mit der strukturierten Patienteninformation für Rheumatoide Arthritis (StruPi-RA) liegt das erste standardisierte ambulante Patientenschulungsprogramm für Rheumatoide Arthritis (RA) in Deutschland vor. Das Hauptziel der vorliegenden Studie ist die Erfassung der Wirksamkeit von StruPI-RA in Bezug auf den krankheitsspezifischen Wissenserwerb bei Patienten mit früher RA oder nach Therapiewechsel. Methoden Insgesamt wurden 61 Patienten eingeschlossen: n = 32 in die Interventionsgruppe (IG) und n = 29 in die Kontrollgruppe (KG). Die Intervention umfasste ein strukturiertes Patienteninformationsprogramm (StruPi-RA) zu den Themen Diagnostik, Therapie und Leben mit RA, welches drei 90-minütige Module beinhaltet. Die KG erhielt nur einen Patientenratgeber der Deutschen Rheumaliga zur Information über die Erkrankung. Primäres Zielkriterium war der krankheitsbezogene Wissenserwerb, der anhand des Patient Knowledge Questionnaire (PKQ) sowie Erweiterungsfragen zu 2 Messzeitpunkten, einmal unmittelbar vor und dann nach Durchführung von StruPI-RA, erhoben wurde. Ergebnisse Die Teilnahme an StruPI-RA führte zu einer signifikanten Verbesserung des krankheitsspezifischen Wissens im Gruppen- und Zeitvergleich zur ungeschulten Gruppe im Original-PKQ sowie in der Fragebogenerweiterung. Ein Einfluss der Krankheitsdauer oder des Bildungsstands wurde nicht beobachtet. Allein in der Subskala Therapie zeigte sich ein signifikanter Unterscheid im Gruppen- und Zeitvergleich. Diskussion Die Teilnehmer am StruPI-RA-Programm hatten im Vergleich zu ungeschulten Patienten einen nachweisbaren krankheitsspezifischen Wissenszuwachs. Dadurch kann sich die Arzt-Patienten-Kommunikation verbessern und eine fundierte Entscheidungsfindung hinsichtlich der Therapie befördert werden. Mittelfristig können sich darüber hinaus eine erhöhte Selbstmanagementkompetenz der Patienten und langfristig auch eine Verbesserung der Lebensqualität sowie der Therapieadhärenz ergeben. |
Hoeper, Juliana Rachel; Zeidler, Jan; Meyer, Sara Eileen; Gauler, Georg; Steffens-Korbanka, Patricia; Welcker, Martin; Wendler, Jörg; Schuch, Florian; von Hinüber, Ulrich; Schwarting, Andreas; Witte, Torsten; Meyer-Olson, Dirk; Hoeper, Kirsten: Effect of nurse-led care on outcomes in patients with
ACPA/RF-positive rheumatoid arthritis with active disease
undergoing treat-to-target: a multicentre randomised controlled
trial. In: RMD Open, Bd. 7, Nr. 1, S. e001627, 2021. (Typ: Artikel | Abstract | BibTeX)@article{Hoeper2021-nl, ÖBJECTIVE: To determine the non-inferiority of nurse-led care (NLC) in patients with anticitrullinated protein antibody (ACPA)-positive and/or rheumatoid factor (RF)-positive rheumatoid arthritis (RA) with active disease who are starting disease-modifying antirheumatic drug therapy, following treat-to-target (T2T) recommendations. METHODS: A multicentre, pragmatic randomised controlled trial was conducted to assess clinical effectiveness, anxiety, depression and patient satisfaction following a non-inferiority design. The participants were 224 adults with ACPA/RF-positive RA who were randomly assigned to either NLC or rheumatologist-led care (RLC). The primary outcome was the Disease Activity Score in 28 Joints measured with C reactive protein (DAS28-CRP) assessed at baseline and after 3, 6, 9 and 12 months. A DAS28-CRP difference of 0.6 was set as the non-inferiority margin. Mean differences between the groups were assessed following per-protocol and intention-to-treat strategies. RESULTS: Demographic data and baseline characteristics of patients in the NLC group (n=111) were comparable to those of patients in the RLC group (n=113). The improvement in disease activity (change in DAS28-CRP, primary outcome) over the course of 12 months was significant in both groups (p<0.001). No significant differences were observed between the NLC and RLC groups (p=0.317). Non-inferiority of NLC was shown for the primary outcome and all secondary outcomes. CONCLUSION: This study supported the non-inferiority of NLC in managing T2T and follow-up care of patients with RA with moderate to high disease activity and poor prognostic factors in addition to RLC. TRIAL REGISTRATION NUMBER: DRKS00013055." |
Englbrecht, M.; Bartz-Bazzanella, P.; von der Decken, C.; Gauler, G.; Wurth, P.; Aries, P.; Karberg, K.; Kuhn, C.; Schuch, F.; Spathling-Mestekemper, S.; Vorbruggen, W.; Wendler, J.; Welcker, M.; Kleinert, S.: Prevalence of Depressive Symptoms in Patients With Psoriatic Arthritis: Have Numbers Changed During the COVID-19 Pandemic?. In: Front Med (Lausanne), Bd. 8, S. 748262, 2021, ISSN: 2296-858X (Print)
2296-858X (Linking). (Typ: Artikel | Links | BibTeX)@article{RN9958, |
Kleinert, S.; Bartz-Bazzanella, P.; von der Decken, C.; Knitza, J.; Witte, T.; Fekete, S. P.; Konitzny, M.; Zink, A.; Gauler, G.; Wurth, P.; Aries, P.; Karberg, K.; Kuhn, C.; Schuch, F.; Spathling-Mestekemper, S.; Vorbruggen, W.; Englbrecht, M.; Welcker, M.; Group, Rhadar: A Real-World Rheumatology Registry and Research Consortium: The German RheumaDatenRhePort (RHADAR) Registry. In: J Med Internet Res, Bd. 23, Nr. 5, S. e28164, 2021, ISSN: 1438-8871 (Electronic)
1438-8871 (Linking). (Typ: Artikel | Links | BibTeX)@article{RN9809, |
Kleinert, S.; Rapp, P.; Schuch, F.; Ronneberger, M.; Wendler, J.; Sternad, P.; Popp, F.; Bartz-Bazzanella, P.; der Decken, C. B. Von; Karberg, K.; Gauler, G.; Wurth, P.; Spaethling-Mestekemper, S.; Kuhn, C.; Englbrecht, M.; Vorbrüggen, W.; Adler, G.; Welcker, M.: Cognitive Impairment in axial spondyloarthritis? [abstract]. In: Annals of the Rheumatic Diseases, Bd. 80, Nr. Suppl 1, S. 1274, 2021. (Typ: Artikel | Links | BibTeX)@article{RN9667, |
Simon, D.; Tascilar, K.; Fagni, F.; Kronke, G.; Kleyer, A.; Meder, C.; Atreya, R.; Leppkes, M.; Kremer, A. E.; Ramming, A.; Pachowsky, M. L.; Schuch, F.; Ronneberger, M.; Kleinert, S.; Hueber, A. J.; Manger, K.; Manger, B.; Berking, C.; Sticherling, M.; Neurath, M. F.; Schett, G.: SARS-CoV-2 vaccination responses in untreated, conventionally treated and anticytokine-treated patients with immune-mediated inflammatory diseases. In: Ann Rheum Dis, 2021, ISSN: 1468-2060 (Electronic)
0003-4967 (Linking). (Typ: Artikel | Links | BibTeX)@article{RN9669, |
Krause, A; Krüger, K; Braun, J; Gauler, G; Hoeper, K; Schuch, F; Voormann, A J: Delegation ärztlicher Leistungen in der Rheumatologie. In: Z. Rheumatol., Bd. 79, Nr. Suppl 2, S. 47–48, 2020. (Typ: Artikel | BibTeX)@article{Krause2020-es, |
Schuch, F: Die Weiterentwicklung des Curriculums Rheumatologische
Fachassistenz DGRh-BDRh -- Medizinische Fachangestellte
für Rheumatologie. In: Z. Rheumatol., Bd. 79, Nr. Suppl 2, S. 45–46, 2020. (Typ: Artikel | BibTeX)@article{Schuch2020-jq, |
Fiehn, C; Baraliakos, X; Edelmann, E; Froschauer, S; Feist, E; Karberg, K; Ruehlmann, J M; Schuch, F; Welcker, M; Zinke, S: Aktueller Stand, Ziele und Qualitätsstandards der ambulanten Versorgung in der Rheumatologie: Positionspapier des Berufsverbandes der deutschen Rheumatologen (BDRh). In: Z. Rheumatol., Bd. 79, Nr. 8, S. 770–779, 2020. (Typ: Artikel | Abstract | BibTeX)@article{Fiehn2020-bw, Even in the era of modern guidelines, the treatment of rheumatic diseases is only as good as the framework of rheumatological care within which the treatment is carried out. The access to high-quality medical treatment for all patients is therefore essentially decisive for the prognosis of the patients. This article describes the current state of outpatient treatment in rheumatology and demonstrates which quality projects, such as treatment contracts, outpatient specialized medical treatment (ASV), digitalization and training as specialized rheumatological assistant (RFA), have been created in order to ensure the treatment of our patients. Furthermore, standards are defined that can guarantee a contemporary and guideline-conform treatment in outpatient rheumatological units. As an example it is an affirmation of the Professional Association of German Rheumatologists (BDRh) for ensuring optimal care for all rheumatology patients through early or emergency rheumatology clinics, treat to target, appropriate delegation of medical duties and diversification of treatment, thus an assurance of the quality and comprehensive treatment in rheumatology. The important topic of safeguarding the next generation of rheumatologists, which is indispensable for this, is also discussed. |
Krause, A; Schuch, F; Braun, J; Gauler, G; Hoeper, K; Krüger, K; Wallhäuser, M; Voormann, A J: Delegation ärztlicher Leistungen in der Rheumatologie. In: Z. Rheumatol., Bd. 79, Nr. 2, S. 123–131, 2020. (Typ: Artikel | Abstract | BibTeX)@article{Krause2020-wu, Modern rheumatology enables better and earlier diagnosis and therapy of inflammatory rheumatic system diseases. At the same time, the requirements for the care of rheumatologic patients have risen considerably for non-medical assistant professions and specialists for nursing professions. Since 2006 there has been established an education curriculum ``Rheumatological Specialist Assistant DGRh-BDRh'' (RFA) with the training to become a ``Rheumatological Specialist Assistant (DGRh-BDRh)''. In Europe and in parallel in Germany, assistant professions are increasingly involved in the early detection and care of patients with rheumatic diseases and entrusted with tasks.In this work, the overarching principles for delegation of medical tasks to RFA and recommendations for the delegation are published by the Commission for Delegation of the German Society for Rheumatology (DGRh). These recommendations are based on the requirements of the German Medical Association and have been legally evaluated. With the extension of the training of the RFA board certification is aimed for ``MFA for Rheumatology''. These recommendations enable more transparency and security for delegating doctors and the delegated RFA's. |
Simon, D.; Tascilar, K.; Kronke, G.; Kleyer, A.; Zaiss, M. M.; Heppt, F.; Meder, C.; Atreya, R.; Klenske, E.; Dietrich, P.; Abdullah, A.; Kliem, T.; Corte, G.; Morf, H.; Leppkes, M.; Kremer, A. E.; Ramming, A.; Pachowsky, M.; Schuch, F.; Ronneberger, M.; Kleinert, S.; Maier, C.; Hueber, A. J.; Manger, K.; Manger, B.; Berking, C.; Tenbusch, M.; Uberla, K.; Sticherling, M.; Neurath, M. F.; Schett, G.: Patients with immune-mediated inflammatory diseases receiving cytokine inhibitors have low prevalence of SARS-CoV-2 seroconversion. In: Nat Commun, Bd. 11, Nr. 1, S. 3774, 2020, ISSN: 2041-1723 (Electronic)
2041-1723 (Linking). (Typ: Artikel | Links | BibTeX)@article{RN9673, |
S, Kleinert; P, Bartz-Bazzanella; von der Decken C,; K, Karberg; F, Schuch; G, Gauler; P, Wurth; S, Spaethling-Mestekemper; C, Kuhn; M, Englbrecht; W, Vorbrueggen; M., Welcker: Chronic Kidney Disease Is Underestimated in Patients with Rheumatoid Arthritis – Real World Data Gathered from a Network of Rheumatologists [abstract]. In: Arthritis Rheumatol., Bd. 72 (suppl 10)., 2020. (Typ: Artikel | BibTeX)@article{RN9624, |
Kleinert, Stefan; Schuch, Florian; Rapp, Praxedis; Ronneberger, Monika; Wendler, Joerg; Englbrecht, Matthias: How many of your patients have depressive symptoms? How to assess during routine clinical practice?. In: Ann Rheum Dis, Bd. 78, S. A638, 2019. (Typ: Artikel | BibTeX)@article{RN9615, |
Kleinert, Stefan; Rapp, Praxedis; Ronneberger, Monika; Wendler, Joerg; Schuch, Florian: Dealing with comorbidities in rheumatoid arthritis with medical assistants. The patients’ opinion on assessment and education by medical assistants during routine clinical practice [abstract]. In: Ann Rheum Dis, Bd. 78, supplement 2, 2019. (Typ: Artikel | BibTeX)@article{RN9625, |
Figueiredo, Camille P; Bang, Holger; Cobra, Jayme Fogagnolo; Englbrecht, Matthias; Hueber, Axel J; Haschka, Judith; Manger, Bernhard; Kleyer, Arnd; Reiser, Michaela; Finzel, Stephanie; Tony, Hans-Peter; Kleinert, Stefan; Wendler, Joerg; Schuch, Florian; Ronneberger, Monika; Feuchtenberger, Martin; Fleck, Martin; Manger, Karin; Ochs, Wolfgang; Schmitt-Haendle, Matthias; Lorenz, Hanns-Martin; Nuesslein, Hubert; Alten, Rieke; Henes, Joerg; Krueger, Klaus; Rech, Jürgen; Schett, Georg: Antimodified protein antibody response pattern influences the risk for disease relapse in patients with rheumatoid arthritis tapering disease modifying antirheumatic drugs. In: Ann. Rheum. Dis., Bd. 76, Nr. 2, S. 399–407, 2017. (Typ: Artikel | Abstract | BibTeX)@article{Figueiredo2017-hw, ÖBJECTIVE: To perform a detailed analysis of the autoantibody response against post-translationally modified proteins in patients with rheumatoid arthritis (RA) in sustained remission and to explore whether its composition influences the risk for disease relapse when tapering disease modifying antirheumatic drug (DMARD) therapy. METHODS: Immune responses against 10 citrullinated, homocitrullinated/carbamylated and acetylated peptides, as well as unmodified vimentin (control) and cyclic citrullinated peptide 2 (CCP2) were tested in baseline serum samples from 94 patients of the RETRO study. Patients were classified according to the number of autoantibody reactivities (0-1/10, 2-5/10 and >5/10) or specificity groups (citrullination, carbamylation and acetylation; 0-3) and tested for their risk to develop relapses after DMARD tapering. Demographic and disease-specific parameters were included in multivariate logistic regression analysis for defining the role of autoantibodies in predicting relapse. RESULTS: Patients varied in their antimodified protein antibody response with the extremes from recognition of no (0/10) to all antigens (10/10). Antibodies against citrullinated vimentin (51%), acetylated ornithine (46%) and acetylated lysine (37%) were the most frequently observed subspecificities. Relapse risk significantly (p=0.011) increased from 18% (0-1/10 reactivities) to 34% (2-5/10) and 55% (>5/10). With respect to specificity groups (0-3), relapse risk significantly (p=0.021) increased from 18% (no reactivity) to 28%, 36% and finally to 52% with one, two or three antibody specificity groups, respectively. CONCLUSIONS: The data suggest that the pattern of antimodified protein antibody response determines the risk of disease relapse in patients with RA tapering DMARD therapy. TRIAL REGISTRATION NUMBER: 2009-015740-42; Results." |
Figueiredo, C. P.; Bang, H.; Cobra, J. F.; Englbrecht, M.; Hueber, A. J.; Haschka, J.; Manger, B.; Kleyer, A.; Reiser, M.; Finzel, S.; Tony, H. P.; Kleinert, S.; Wendler, J.; Schuch, F.; Ronneberger, M.; Feuchtenberger, M.; Fleck, M.; Manger, K.; Ochs, W.; Schmitt-Haendle, M.; Lorenz, H. M.; Nuesslein, H.; Alten, R.; Henes, J.; Krueger, K.; Rech, J.; Schett, G.: Antimodified protein antibody response pattern influences the risk for disease relapse in patients with rheumatoid arthritis tapering disease modifying antirheumatic drugs. In: Ann Rheum Dis, Bd. 76, Nr. 2, S. 399-407, 2017, ISSN: 1468-2060 (Electronic)
0003-4967 (Linking). (Typ: Artikel | Links | BibTeX)@article{RN8609, |
Haschka, J.; Englbrecht, M.; Hueber, A. J.; Manger, B.; Kleyer, A.; Reiser, M.; Finzel, S.; Tony, H. P.; Kleinert, S.; Feuchtenberger, M.; Fleck, M.; Manger, K.; Ochs, W.; Schmitt-Haendle, M.; Wendler, J.; Schuch, F.; Ronneberger, M.; Lorenz, H. M.; Nuesslein, H.; Alten, R.; Demary, W.; Henes, J.; Schett, G.; Rech, J.: Relapse rates in patients with rheumatoid arthritis in stable remission tapering or stopping antirheumatic therapy: interim results from the prospective randomised controlled RETRO study. In: Ann Rheum Dis, Bd. 75, Nr. 1, S. 45-51, 2016, ISSN: 1468-2060 (Electronic)
0003-4967 (Linking). (Typ: Artikel | Links | BibTeX)@article{RN7751, |
Rech, J.; Hueber, A. J.; Finzel, S.; Englbrecht, M.; Haschka, J.; Manger, B.; Kleyer, A.; Reiser, M.; Cobra, J. F.; Figueiredo, C.; Tony, H. P.; Kleinert, S.; Wendler, J.; Schuch, F.; Ronneberger, M.; Feuchtenberger, M.; Fleck, M.; Manger, K.; Ochs, W.; Schmitt-Haendle, M.; Lorenz, H. M.; Nuesslein, H.; Alten, R.; Henes, J.; Krueger, K.; Schett, G.: Prediction of disease relapses by multibiomarker disease activity and autoantibody status in patients with rheumatoid arthritis on tapering DMARD treatment. In: Ann Rheum Dis, Bd. 75, Nr. 9, S. 1637-44, 2016, ISSN: 1468-2060 (Electronic)
0003-4967 (Linking). (Typ: Artikel | Links | BibTeX)@article{RN8206, |
Haschka, J.; Englbrecht, M.; Hueber, A. J.; Manger, B.; Kleyer, A.; Reiser, M.; Finzel, S.; Tony, H. P.; Kleinert, S.; Feuchtenberger, M.; Fleck, M.; Manger, K.; Ochs, W.; Schmitt-Haendle, M.; Wendler, J.; Schuch, F.; Ronneberger, M.; Lorenz, H. M.; Nuesslein, H.; Alten, R.; Demary, W.; Henes, J.; Schett, G.; Rech, J.: Relapse rates in patients with rheumatoid arthritis in stable remission tapering or stopping antirheumatic therapy: interim results from the prospective randomised controlled RETRO study. In: Ann Rheum Dis, 2015, ISSN: 0003-4967. (Typ: Artikel | Links | BibTeX)@article{RN9102, |