Abstract:
BACKGROUND:Reliable data on the course and treatment of pediatric COVID-19 ("corona virus disease 2019") in immunosuppressed patients with rheumatic diseases are missing. AIM:Delineation of individual strategies of the members of the Society for Pediatric Rheumatology (GKJR) in cases of COVID-19. METHODS:In May 2020 all GKJR members were invited to take part in an online survey. Opinion data regarding an approach using disease-modifying anti-rheumatic drugs (DMARD) in cases of COVID-19 as well as the readiness to use new therapeutic agents in patients in different stages of the disease were collected. RESULTS:A total of 71 respondents (27.3% of all contacted pediatric rheumatologists) took part in the survey. Of these 28.2% had treated patients with COVID-19. Over 95% of the respondents did not support a preventive adaptation of the anti-rheumatic treatment during the SARS-CoV‑2 pandemic. In the case of outpatients under immunosuppression with proven COVID-19 more than 50% of the respondents would refrain from administering intravenous high-dose steroids, cyclophosphamide, anti-CD20 antibodies as well as BAFF, CTLA‑4 and TNF-alpha blockades. Conversely, >70% of the respondents would continue the treatment with nonsteroidal anti-inflammatory drugs, hydroxychloroquine (HCQ), oral steroids, mycophenolate, IL‑1 blockade and immunoglobulins (Ig). In the case of inpatients 74.6% of respondents would consider targeted COVID-19 treatment. In stable patients with oxygen treatment (stage I) HCQ (18.3%), azithromycin (16.9%) and Ig (9.9%) were most frequently used. In cases of early signs (stage II) or a manifest cytokine storm (stage III) anakinra (40.8% for stage II and 46.5% for stage III), tocilizumab (26.8% and 40.8%, respectively), steroids (25.4% and 33.8%, respectively) and remdesivir (29.6% and 38.0%, respectively) were most frequently used. The need for a personalized approach based on the current clinical situation was emphasized by many respondents. CONCLUSION:The currently low prevalence of COVID-19 in Germany limits the general clinical experience. Therefore, the presented results have to be interpreted with caution and mostly as hypothetical treatment considerations. It is to be expected that there will always be a limited amount of evidence on pediatric COVID-19; therefore, a continuous and critical exchange of expert opinions on the treatment strategies is important.
journal_name
Z Rheumatoljournal_title
Zeitschrift fur Rheumatologieauthors
Janda A,Schuetz C,Heeg M,Minden K,Hedrich CM,Kallinich T,Hinze C,Schulz A,Speth Fdoi
10.1007/s00393-020-00854-8subject
Has Abstractpub_date
2020-09-01 00:00:00pages
710-717issue
7eissn
0340-1855issn
1435-1250pii
10.1007/s00393-020-00854-8journal_volume
79pub_type
杂志文章abstract::Monocytes from patients with definite or classical rheumatoid arthritis show a significantly higher release of O2-radicals in the chemiluminescence assay (2925 X 10(3) cpm) than those of healthy volunteers (267 X 10(3) cpm) (p = 0.01). This difference does not appear in a similar test with granulocytes, which in both ...
journal_title:Zeitschrift fur Rheumatologie
pub_type: 杂志文章
doi:
更新日期:1985-01-01 00:00:00
abstract::Reactive arthritis is an inflammatory joint disease induced by a preceding, sometimes asymptomatic bacterial infection outside the joints. With an estimated prevalence of 40/100,000 inhabitants, the disease primarily affects adults between the ages of 20 and 40 years. The clinical presentation is typically characteriz...
journal_title:Zeitschrift fur Rheumatologie
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doi:10.1007/s00393-013-1281-z
更新日期:2013-12-01 00:00:00
abstract::Three new findings are reviewed that help to understand the mechanisms of action of anti-rheumatic gold drugs, such as disodium aurothiomalate (Na2Au(I)TM): i) We found that Na2Au(I)TM selectively inhibits T-cell receptor-mediated antigen recognition by murine CD4+ T-cell hybridomas specific for antigenic peptides con...
journal_title:Zeitschrift fur Rheumatologie
pub_type: 杂志文章,评审
doi:
更新日期:1996-09-01 00:00:00
abstract::Conventional radiography, ultrasonography (US), magnetic resonance imaging (MRI), computed tomography, and scintigraphy are imaging techniques in use for rheumatoid arthritis (RA). Conventional radiography of the hands and the forefeet should be performed every 6 to 12 months in the first two years, and every 12 to 24...
journal_title:Zeitschrift fur Rheumatologie
pub_type: 杂志文章,评审
doi:10.1007/s00393-005-0720-x
更新日期:2005-11-01 00:00:00
abstract::Progressive multifocal leukoencephalopathy (PML) is a rare but often fatal demyelinating disease of the central nervous system induced by the JC virus. It mainly occurs in immunocompromised patients. Growing interest in rheumatology has arisen from reports of patients with rheumatic diseases suffering from PML. A dire...
journal_title:Zeitschrift fur Rheumatologie
pub_type: 杂志文章,评审
doi:10.1007/s00393-008-0297-2
更新日期:2008-07-01 00:00:00
abstract:AIM:The aim of this study was to compare demographic characteristics, disease activity, functional status, and quality of life between ankylosing spondylitis (AS) with neuropatic pain (NP) and AS without NP (Non-NP). METHODS:The MEDLINE via PubMed, Cochrane, Scopus, and Embase database, from the earliest available dat...
journal_title:Zeitschrift fur Rheumatologie
pub_type: 杂志文章,meta分析
doi:10.1007/s00393-019-0654-3
更新日期:2020-02-01 00:00:00
abstract::Up to now stratified therapy concepts have not played an important role in the treatment of patients with rheumatoid arthritis; however, a high heterogeneity regarding the effectiveness of therapies and occurrence of side effects in patients with the same indications provokes research efforts aiming at identifying and...
journal_title:Zeitschrift fur Rheumatologie
pub_type: 杂志文章
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abstract::Five to 9 months after a comparative study of 2 groups of patients with coxarthrosis and gonarthrosis, 69 individuals (group 1) receiving Arteparon forte injections and physical therapy and 46 persons (group 2) with physical therapy only, questioneer with specific questions was sent out. From 72 questioneers mailed 55...
journal_title:Zeitschrift fur Rheumatologie
pub_type: 杂志文章
doi:
更新日期:1977-07-01 00:00:00
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journal_title:Zeitschrift fur Rheumatologie
pub_type: 杂志文章
doi:10.1007/s003930050048
更新日期:1997-12-01 00:00:00
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journal_title:Zeitschrift fur Rheumatologie
pub_type: 杂志文章,评审
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journal_title:Zeitschrift fur Rheumatologie
pub_type: 杂志文章
doi:10.1007/s00393-006-0045-4
更新日期:2006-10-01 00:00:00
abstract::Within the group of inflammatory rheumatic diseases, spondyloarthropathy is the most common diagnosis after rheumatoid arthritis. Its prevalence was long underestimated. Ankylosing spondylitis (AS) and undifferentiated spondyloathropathy (uSpA) are the most common subgroups in western countries. There are still diffic...
journal_title:Zeitschrift fur Rheumatologie
pub_type: 杂志文章,评审
doi:10.1007/s003930200004
更新日期:2002-02-01 00:00:00
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journal_title:Zeitschrift fur Rheumatologie
pub_type: 杂志文章,评审
doi:10.1007/s00393-014-1357-4
更新日期:2014-09-01 00:00:00
abstract::A multicentric post-marketing surveillance study over 7 years including 5,124 patients is presented. According to clinical and laboratory data, the drug D-penicillamine was effective, with a tendency of loss of efficacy after therapy of 5 years or longer. Response was better in the early stage of the disease. Side eff...
journal_title:Zeitschrift fur Rheumatologie
pub_type: 杂志文章
doi:
更新日期:1988-01-01 00:00:00
abstract::The author describes the information gained from anamnesis which points to a psychogenetic cause of rheumatic complaints. These symptoms are part of the diagnostically important criteria which must be supplemented still further by means of a personal discussion with the patient. A great deal depends on the skill of th...
journal_title:Zeitschrift fur Rheumatologie
pub_type: 杂志文章
doi:
更新日期:1993-07-01 00:00:00
abstract::Fiftythree patients with progressive systemic sclerosis were studied. Four of them (3 males) had the diffuse form of the disease. The skin manifestation of this clinical picture is characterized by diffuse progression of the cutaneous sclerosis over almost the whole body surface, except for the hands where it eventual...
journal_title:Zeitschrift fur Rheumatologie
pub_type: 杂志文章
doi:
更新日期:1976-07-01 00:00:00
abstract::Due to the wide range of positive effects and the clear evidence of effectiveness, physical activity is one of the most important treatments for inflammatory rheumatic diseases. Because of the frequent overlap of disease and age-related aspects in older patients, the implementation of the German national physical acti...
journal_title:Zeitschrift fur Rheumatologie
pub_type: 杂志文章,评审
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更新日期:2019-03-01 00:00:00
abstract:: ...
journal_title:Zeitschrift fur Rheumatologie
pub_type: 新闻
doi:10.1007/s00393-018-0509-3
更新日期:2018-11-01 00:00:00
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journal_title:Zeitschrift fur Rheumatologie
pub_type: 杂志文章
doi:
更新日期:1985-01-01 00:00:00
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journal_title:Zeitschrift fur Rheumatologie
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:1992-07-01 00:00:00
abstract::Many rheumatological diseases are either caused by specific known proteins, such as antibodies or mediated by a plethora of cytokines. Both the unspecific immunosuppressive therapy and the specific action of biologics usually require time to be effective; therefore, extracorporeal forms of treatment are increasingly b...
journal_title:Zeitschrift fur Rheumatologie
pub_type: 杂志文章,评审
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更新日期:2016-12-01 00:00:00
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journal_title:Zeitschrift fur Rheumatologie
pub_type: 杂志文章
doi:
更新日期:1979-11-01 00:00:00
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journal_title:Zeitschrift fur Rheumatologie
pub_type: 杂志文章
doi:
更新日期:1994-09-01 00:00:00
abstract::Blastocysts hominis, a protozoon considered to be a nonpathogen intestinal commensal, is now discussed to be a cause of intestinal infection under certain circumstances, e.g., immunosuppression. There are two published cases of Blastocysts infection complicated by arthritis which was classified as "reactive" in one ca...
journal_title:Zeitschrift fur Rheumatologie
pub_type: 杂志文章
doi:
更新日期:1994-03-01 00:00:00
abstract::Eight human femoral heads, surgically removed from patients with the clinical diagnosis: coxarthrosis or necrosis, were examined. In six of these we found severe arthrosis combined with synovitis and pannus formation. The pannus appeared as granulation tissue or fibrous connective tissue covering the surface of the ca...
journal_title:Zeitschrift fur Rheumatologie
pub_type: 杂志文章
doi:
更新日期:1983-11-01 00:00:00
abstract::The international treat-to-target initiative including rheumatoid arthritis (RA) patients has defined remission or alternatively low disease activity as treatment goals. In Germany representatives of the medical profession, such as doctors, nurses and including the Deutsche Rheuma-Liga, are deliberating how to adapt a...
journal_title:Zeitschrift fur Rheumatologie
pub_type: 杂志文章,评审
doi:10.1007/s00393-011-0773-y
更新日期:2011-10-01 00:00:00
abstract::In a double-blind study, glycosaminoglycan polysulfate (GAGPS, Arteparon) was compared to saline solution: both preparations were applied intramuscularly in two groups of 70 patients, each over a period of 8 weeks. The patients were suffering from pain and impaired function of the knee and hip joints. To assess the th...
journal_title:Zeitschrift fur Rheumatologie
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:1983-07-01 00:00:00
abstract::Systemic lupus erythematosus (SLE) results from loss of immunological tolerance. Regulatory T‑cells (Treg) are major gatekeepers of peripheral tolerance by suppression of autoreactive lymphocytes. Defects in Treg function are therefore possible pathogenetic mechanisms of SLE. Despite this fact published work about num...
journal_title:Zeitschrift fur Rheumatologie
pub_type: 杂志文章,评审
doi:10.1007/s00393-016-0060-z
更新日期:2016-04-01 00:00:00
abstract:BACKGROUND:Recent data provided evidence on the implication of the adipocytokines adiponectin, visfatin, and resistin in inflammation, immune response, and tissue destruction and revealed several links between them and arthritis. AIM OF THE STUDY:The purpose of this study was to assess the levels of adiponectin, visfa...
journal_title:Zeitschrift fur Rheumatologie
pub_type: 杂志文章
doi:10.1007/s00393-011-0834-2
更新日期:2011-09-01 00:00:00
abstract::Personalized healthcare tries to predict the effectiveness and safety in individual therapeutic approaches by defining individual patient characteristics (biomarkers), while stratification uses diagnostic patterns for groups of patients for prediction of therapeutic response with less adverse reactions caused by the d...
journal_title:Zeitschrift fur Rheumatologie
pub_type: 杂志文章
doi:10.1007/s00393-011-0886-3
更新日期:2013-02-01 00:00:00