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Rheumatology International
Published in: Rheumatology International 3/2015

01-03-2015 | Original Article - Guidelines

Consensus statement on a framework for the management of comorbidity and extra-articular manifestations in rheumatoid arthritis

Authors: Estíbaliz Loza, Cristina Lajas, Jose Luis Andreu, Alejandro Balsa, Isidoro González-Álvaro, Oscar Illera, Juan Ángel Jover, Isabel Mateo, Javier Orte, Javier Rivera, José Manuel Rodríguez Heredia, Fredeswinda Romero, Juan Antonio Martínez-López, Ana María Ortiz, Esther Toledano, Virginia Villaverde, Loreto Carmona, Santos Castañeda

Published in: Rheumatology International | Issue 3/2015

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Abstract

The objective of the study was to develop evidence-based and practical recommendations for the detection and management of comorbidity in patients with rheumatoid arthritis (RA) in daily practice. We used a modified RAND/UCLA methodology and systematic review (SR). The process map and specific recommendations, based on the SR, were established in discussion groups. A two round Delphi survey permitted (1) to prioritize the recommendations, (2) to refine them, and (3) to evaluate their agreement by a large group of users. The recommendations cover: (1) which comorbidities should be investigated in clinical practice at the first and following visits (including treatments, risk factors and patient’s features that might interfere with RA management); (2) how and when should comorbidities and risk factors be investigated; (3) how to manage specific comorbidities, related or non-related to RA, including major adverse events of RA treatment, and to promote health (general and musculoskeletal health); and (4) specific recommendations to assure an integral care approach for RA patients with any comorbidity, such as health care models for chronic inflammatory patients, early arthritis units, relationships with primary care, specialized nursing care, and self-management. These recommendations are intended to guide rheumatologists, patients, and other stakeholders, on the early diagnosis and management of comorbidity in RA, in order to improve disease outcomes.
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Literature
1.
van den Akker M, Buntinx F, Roos S, Knottnerus JA (2001) Problems in determining occurrence rates of multimorbidity. J Clin Epidemiol 54(7):675–679CrossRefPubMed
2.
Michaud K, Wolfe F (2007) Comorbidities in rheumatoid arthritis. Best Pract Res Clin Rheumatol 21(5):885–906CrossRefPubMed
3.
Gabriel SE, Michaud K (2009) Epidemiological studies in incidence, prevalence, mortality, and comorbidity of the rheumatic diseases. Arthritis Res Ther 11(3):229CrossRefPubMedCentralPubMed
4.
Perez Edo L, Alonso Ruiz A, Roig Vilaseca D, Garcia Vadillo A, Guanabens Gay N, Peris P et al (2011) Up-date of the consensus statement of the Spanish Society of Rheumatology on osteoporosis. Reumatol Clin 7(6):357–379CrossRefPubMed
5.
Gomez Reino J, Loza E, Andreu JL, Balsa A, Batlle E, Canete JD et al (2011) Consensus statement of the Spanish Society of Rheumatology on risk management of biologic therapy in rheumatic patients. Reumatol Clin 7(5):284–298CrossRefPubMed
6.
Peters MJ, Symmons DP, McCarey D, Dijkmans BA, Nicola P, Kvien TK et al (2010) EULAR evidence-based recommendations for cardiovascular risk management in patients with rheumatoid arthritis and other forms of inflammatory arthritis. Ann Rheum Dis 69(2):325–331CrossRefPubMed
7.
Smolen JS, Landewe R, Breedveld FC, Dougados M, Emery P, Gaujoux-Viala C et al (2010) EULAR recommendations for the management of rheumatoid arthritis with synthetic and biological disease-modifying antirheumatic drugs. Ann Rheum Dis 69(6):964–975CrossRefPubMedCentralPubMed
8.
9.
Carmona L, Gonzalez-Alvaro I, Balsa A, Angel Belmonte M, Tena X, Sanmarti R (2003) Rheumatoid arthritis in Spain: occurrence of extra-articular manifestations and estimates of disease severity. Ann Rheum Dis 62(9):897–900CrossRefPubMedCentralPubMed
10.
Mikuls TR, Saag KG (2001) Comorbidity in rheumatoid arthritis. Rheum Dis Clin N Am 27(2):283–303CrossRef
11.
12.
Descalzo MA, Carbonell J, Gonzalez-Alvaro I, Sanmarti R, Balsa A, Hernandez-Barrera V et al (2012) Effectiveness of a clinical practice intervention in early rheumatoid arthritis. Arthritis Care Res (Hoboken) 64(3):321–330CrossRef
13.
Baron M, Schieir O, Hudson M, Steele R, Janelle-Montcalm A, Bernstein J et al (2009) Evaluation of the clinimetric properties of the early inflammatory arthritis—self-administered comorbidity questionnaire. Rheumatology (Oxf) 48(4):390–394CrossRef
14.
Sarfati D (2012) Review of methods used to measure comorbidity in cancer populations: no gold standard exists. J Clin Epidemiol 65(9):924–933CrossRefPubMed
15.
Sangha O, Stucki G, Liang MH, Fossel AH, Katz JN (2003) The Self-Administered Comorbidity Questionnaire: a new method to assess comorbidity for clinical and health services research. Arthritis Rheum 49(2):156–163CrossRefPubMed
16.
17.
Norton S, Koduri G, Nikiphorou E, Dixey J, Williams P, Young A (2013) A study of baseline prevalence and cumulative incidence of comorbidity and extra-articular manifestations in RA and their impact on outcome. Rheumatology (Oxf) 52(1):99–110CrossRef
18.
Young A, Koduri G (2007) Extra-articular manifestations and complications of rheumatoid arthritis. Best Pract Res Clin Rheumatol 21(5):907–927CrossRefPubMed
19.
Nakamura Y, Suda T, Kaida Y, Kono M, Hozumi H, Hashimoto D et al (2012) Rheumatoid lung disease: prognostic analysis of 54 biopsy-proven cases. Respir Med 106(8):1164–1169CrossRefPubMed
20.
EULAR Textbook on Rheumatic Diseases. European League Against Rheumatism, editor: BMJ Group; 2012
21.
Haugeberg G, Uhlig T, Falch JA, Halse JI, Kvien TK (2000) Reduced bone mineral density in male rheumatoid arthritis patients: frequencies and associations with demographic and disease variables in ninety-four patients in the Oslo County Rheumatoid Arthritis Register. Arthritis Rheum 43(12):2776–2784CrossRefPubMed
22.
Coulson KA, Reed G, Gilliam BE, Kremer JM, Pepmueller PH (2009) Factors influencing fracture risk, T score, and management of osteoporosis in patients with rheumatoid arthritis in the Consortium of Rheumatology Researchers of North America (CORRONA) registry. J Clin Rheumatol 15(4):155–160CrossRefPubMed
23.
van Staa TP, Geusens P, Bijlsma JW, Leufkens HG, Cooper C (2006) Clinical assessment of the long-term risk of fracture in patients with rheumatoid arthritis. Arthritis Rheum 54(10):3104–3112CrossRefPubMed
24.
Mazzantini M, Talarico R, Doveri M, Consensi A, Cazzato M, Bazzichi L et al (2010) Incident comorbidity among patients with rheumatoid arthritis treated or not with low-dose glucocorticoids: a retrospective study. J Rheumatol 37(11):2232–2236CrossRefPubMed
25.
McKeown E, Bykerk VP, De Leon F, Bonner A, Thorne C, Hitchon CA et al (2012) Quality assurance study of the use of preventative therapies in glucocorticoid-induced osteoporosis in early inflammatory arthritis: results from the CATCH cohort. Rheumatology (Oxf) 51(9):1662–1669CrossRef
26.
Wolfe F, Hauser W, Hassett AL, Katz RS, Walitt BT (2011) The development of fibromyalgia—I: examination of rates and predictors in patients with rheumatoid arthritis (RA). Pain 152(2):291–299CrossRefPubMed
27.
Wolfe F, Michaud K (2004) Severe rheumatoid arthritis (RA), worse outcomes, comorbid illness, and sociodemographic disadvantage characterize ra patients with fibromyalgia. J Rheumatol 31(4):695–700PubMed
28.
Dhir V, Lawrence A, Aggarwal A, Misra R (2009) Fibromyalgia is common and adversely affects pain and fatigue perception in North Indian patients with rheumatoid arthritis. J Rheumatol 36(11):2443–2448CrossRefPubMed
29.
Coury F, Rossat A, Tebib A, Letroublon MC, Gagnard A, Fantino B et al (2009) Rheumatoid arthritis and fibromyalgia: a frequent unrelated association complicating disease management. J Rheumatol 36(1):58–62PubMed
30.
Roig Vilaseca D, Hoces Otero C (2008) Effect of the coexistence of fibromyalgia in the DAS28 Index in women with rheumatoid arthritis. Reumatol Clin 4(3):96–99CrossRefPubMed
31.
Bori Segura G, Hernandez Cruz B, Gobbo M, Lanas Arbeloa A, Salazar Paramo M, Teran Estrada L et al (2009) Appropriate use of non-steroidal anti-inflammatory drugs in rheumatology: guidelines from the Spanish Society of Rheumatology and the Mexican College of Rheumatology. Reumatol Clin 5(1):3–12CrossRefPubMed
32.
Ranzolin A, Brenol JC, Bredemeier M, Guarienti J, Rizzatti M, Feldman D et al (2009) Association of concomitant fibromyalgia with worse disease activity score in 28 joints, health assessment questionnaire, and short form 36 scores in patients with rheumatoid arthritis. Arthritis Rheum 61(6):794–800CrossRefPubMed
33.
Carville SF, Arendt-Nielsen S, Bliddal H, Blotman F, Branco JC, Buskila D et al (2008) EULAR evidence-based recommendations for the management of fibromyalgia syndrome. Ann Rheum Dis 67(4):536–541CrossRefPubMed
34.
Zhang W, Doherty M, Leeb BF, Alekseeva L, Arden NK, Bijlsma JW et al (2007) EULAR evidence based recommendations for the management of hand osteoarthritis: report of a Task Force of the EULAR Standing Committee for International Clinical Studies Including Therapeutics (ESCISIT). Ann Rheum Dis 66(3):377–388CrossRefPubMedCentralPubMed
35.
Zhang W, Doherty M, Arden N, Bannwarth B, Bijlsma J, Gunther KP et al (2005) EULAR evidence based recommendations for the management of hip osteoarthritis: report of a task force of the EULAR Standing Committee for International Clinical Studies Including Therapeutics (ESCISIT). Ann Rheum Dis 64(5):669–681CrossRefPubMedCentralPubMed
36.
Jordan KM, Arden NK, Doherty M, Bannwarth B, Bijlsma JW, Dieppe P et al (2003) EULAR Recommendations 2003: an evidence based approach to the management of knee osteoarthritis: Report of a Task Force of the Standing Committee for International Clinical Studies Including Therapeutic Trials (ESCISIT). Ann Rheum Dis 62(12):1145–1155CrossRefPubMedCentralPubMed
37.
Del Olmo L, Hernandez B, Galindo-Izquierdo M, Tebar D, Balsa A, Carmona L (2012) Peri-operative management of disease modifying anti-rheumatic drugs: recommendations based on a meta-analysis. Rev Esp Cir Ortop Traumatol 56(5):393–412PubMed
38.
Cramp F, Berry J, Gardiner M, Smith F, Stephens D (2013) Health behaviour change interventions for the promotion of physical activity in rheumatoid arthritis: a systematic review. Musculoskelet Care 11(4):238–247
39.
Cramp F, Hewlett S, Almeida C, Kirwan JR, Choy EH, Chalder T et al (2013) Non-pharmacological interventions for fatigue in rheumatoid arthritis. Cochrane Database Syst Rev 8:CD008322PubMed
40.
Gordon MM, Thomson EA, Madhok R, Capell HA (2002) Can intervention modify adverse lifestyle variables in a rheumatoid population? Results of a pilot study. Ann Rheum Dis 61(1):66–69CrossRefPubMedCentralPubMed
41.
Mody GM, Brooks PM (2012) Improving musculoskeletal health: global issues. Best Pract Res Clin Rheumatol 26(2):237–249CrossRefPubMed
42.
Desai SS, Myles JD, Kaplan MJ (2012) Suboptimal cardiovascular risk factor identification and management in patients with rheumatoid arthritis: a cohort analysis. Arthritis Res Ther 14(6):R270CrossRefPubMedCentralPubMed
43.
Kaur S, White S, Bartold PM (2013) Periodontal disease and rheumatoid arthritis: a systematic review. J Dent Res 92(5):399–408CrossRefPubMed
44.
Mangani I, Cesari M, Kritchevsky SB, Maraldi C, Carter CS, Atkinson HH et al (2006) Physical exercise and comorbidity. Results from the fitness and arthritis in seniors trial (FAST). Aging Clin Exp Res 18(5):374–380CrossRefPubMed
45.
Reckner Olsson A, Skogh T, Wingren G (2001) Comorbidity and lifestyle, reproductive factors, and environmental exposures associated with rheumatoid arthritis. Ann Rheum Dis 60(10):934–939CrossRefPubMed
46.
Ribeiro J, Leao A, Novaes AB (2005) Periodontal infection as a possible severity factor for rheumatoid arthritis. J Clin Periodontol 32(4):412–416CrossRefPubMed
47.
Pasma A, Van’t Spijker A, Hazes JM, Busschbach JJ, Luime JJ (2013) Factors associated with adherence to pharmaceutical treatment for rheumatoid arthritis patients: A systematic review. Semin Arthritis Rheum 43(1):18–28CrossRefPubMed
48.
Knittle K, De Gucht V, Maes S (2012) Lifestyle- and behaviour-change interventions in musculoskeletal conditions. Best Pract Res Clin Rheumatol 26(3):293–304CrossRefPubMed
49.
Savioli C, Ribeiro AC, Fabri GM, Calich AL, Carvalho J, Silva CA et al (2012) Persistent periodontal disease hampers anti-tumor necrosis factor treatment response in rheumatoid arthritis. J Clin Rheumatol 18(4):180–184PubMed
50.
Carmona Ortells L, Laffon Roca A (1994) Local therapy in Sjögren’s syndrome. A practical review. Rev Esp Reumatol 21:259–262
51.
Vescovi P, Meleti M, Merigo E, Manfredi M, Fornaini C, Guidotti R et al (2013) Case series of 589 tooth extractions in patients under bisphosphonates therapy. Proposal of a clinical protocol supported by Nd:YAG low-level laser therapy. Med Oral Patol Oral Cir Bucal 18(4):e680–e685CrossRefPubMedCentralPubMed
52.
Blake DJ, Maisiak R, Koplan A, Alarcon GS, Brown S (1988) Sexual dysfunction among patients with arthritis. Clin Rheumatol 7(1):50–60CrossRefPubMed
53.
Aguirre MA, Velez A, Romero M, Collantes E (2002) Gynecomastia and sexual impotence associated with methotrexate treatment. J Rheumatol 29(8):1793–1794PubMed
54.
Yilmaz H, Polat HA, Yilmaz SD, Erkin G, Kucuksen S, Salli A et al (2012) Evaluation of sexual dysfunction in women with rheumatoid arthritis: a controlled study. J Sex Med 9(10):2664–2670CrossRefPubMed
55.
Hill J, Bird H, Thorpe R (2003) Effects of rheumatoid arthritis on sexual activity and relationships. Rheumatology (Oxf) 42(2):280–286CrossRef
56.
Gossec L, Solano C, Paternotte S, Beauvais C, Gaudin P, von Krause G et al (2012) Elaboration and validation of a questionnaire (Qualisex) to assess the impact of rheumatoid arthritis on sexuality with patient involvement. Clin Exp Rheumatol 30(4):505–513PubMed
57.
Singh JA, Christensen R, Wells GA, Suarez-Almazor ME, Buchbinder R, Lopez-Olivo MA et al (2009) Biologics for rheumatoid arthritis: an overview of Cochrane reviews. Cochrane Database Syst Rev 4(4):CD007848PubMed
58.
Marks JL, van der Heijde DM, Colebatch AN, Buchbinder R, Edwards CJ (2012) Pain pharmacotherapy in patients with inflammatory arthritis and concurrent cardiovascular or renal disease: a Cochrane systematic review. J Rheumatol Suppl 90:81–84CrossRefPubMed
59.
Shea B, Swinden MV, Tanjong Ghogomu E, Ortiz Z, Katchamart W, Rader T et al (2013) Folic acid and folinic acid for reducing side effects in patients receiving methotrexate for rheumatoid arthritis. Cochrane Database Syst Rev 5:CD000951PubMed
60.
Gotzsche PC, Johansen HK (2004) Short-term low-dose corticosteroids vs placebo and nonsteroidal antiinflammatory drugs in rheumatoid arthritis. Cochrane Database Syst Rev. 3:CD000189PubMed
61.
Adams K, Bombardier C, van der Heijde DM (2012) Safety of pain therapy during pregnancy and lactation in patients with inflammatory arthritis: a systematic literature review. J Rheumatol Suppl 90:59–61CrossRefPubMed
62.
Loza E, Jover JA, Rodriguez L, Carmona L (2009) Multimorbidity: prevalence, effect on quality of life and daily functioning, and variation of this effect when one condition is a rheumatic disease. Semin Arthritis Rheum 38(4):312–319CrossRefPubMed
63.
Wijlhuizen GJ, Perenboom RJ, Garre FG, Heerkens YF, van Meeteren N (2012) Impact of multimorbidity on functioning: evaluating the ICF core set approach in an empirical study of people with rheumatic diseases. J Rehabil Med 44(8):664–668CrossRefPubMed
64.
McDaid O, Hanly MJ, Richardson K, Kee F, Kenny RA, Savva GM (2013) The effect of multiple chronic conditions on self-rated health, disability and quality of life among the older populations of Northern Ireland and the Republic of Ireland: a comparison of two nationally representative cross-sectional surveys. BMJ Open 3(6). doi:10.​1136/​bmjopen-2013-002571
65.
Burt J, Rick J, Blakeman T, Protheroe J, Roland M, Bower P (2014) Care plans and care planning in long-term conditions: a conceptual model. Prim Health Care Res Dev 5(4):342–354
66.
Newbould J, Burt J, Bower P, Blakeman T, Kennedy A, Rogers A et al (2012) Experiences of care planning in England: interviews with patients with long term conditions. BMC Fam Pract 13:71CrossRefPubMedCentralPubMed
67.
Villaverde V, Descalzo MA, Carmona L, Bascones M, Carbonell J (2011) Characteristics of early arthritis units that may be associated with better referral efficiency: survey of SERAP units. Reumatol Clin 7(4):236–240CrossRefPubMed
68.
Villaverde V, Carmona L, Lopez Robledillo JC, Serrano S, Gobbo M (2013) Motivations and objections to implement a spondyloarthritis integrated care pathway. A qualitative study with primary care physicians. Rheumatol Clin 9(2):85–89
69.
van Eijk-Hustings Y, van Tubergen A, Bostrom C, Braychenko E, Buss B, Felix J et al (2012) EULAR recommendations for the role of the nurse in the management of chronic inflammatory arthritis. Ann Rheum Dis 71(1):13–19CrossRefPubMed
70.
Bonavita V, De Simone R (2008) Towards a definition of comorbidity in the light of clinical complexity. Neurol Sci 29(Suppl 1):S99–S102CrossRefPubMed
71.
Gullick NJ, Scott DL (2011) Co-morbidities in established rheumatoid arthritis. Best Pract Res Clin Rheumatol 25(4):469–483CrossRefPubMed
72.
Hyrich K, Symmons D, Watson K, Silman A (2006) Baseline comorbidity levels in biologic and standard DMARD treated patients with rheumatoid arthritis: results from a national patient register. Ann Rheum Dis 65(7):895–898CrossRefPubMedCentralPubMed
73.
Radner H, Smolen JS, Aletaha D (2011) Comorbidity affects all domains of physical function and quality of life in patients with rheumatoid arthritis. Rheumatology (Oxf) 50(2):381–388CrossRef
74.
Rupp I, Boshuizen HC, Roorda LD, Dinant HJ, Jacobi CE, van den Bos G (2006) Poor and good health outcomes in rheumatoid arthritis: the role of comorbidity. J Rheumatol 33(8):1488–1495PubMed
75.
Pereira IA, Mota LM, Cruz BA, Brenol CV, Fronza LS, Bertolo MB et al (2012) 2012 Brazilian Society of Rheumatology Consensus on the management of comorbidities in patients with rheumatoid arthritis. Rev Bras Reumatol 52(4):474–495PubMed
76.
Esselens G, Westhovens R, Verschueren P (2009) Effectiveness of an integrated outpatient care programme compared with present-day standard care in early rheumatoid arthritis. Musculoskelet Care 7(1):1–16CrossRef
77.
Development group of the stroke prevention Guideline (2008) Iberoamerican Cochrane Centre—coordinator. Clinical practice guideline for primary and secondary prevention of stroke. Quality Plan for the National Health System of the Ministry of Health and Consumer Affairs; Catalan Agency for Health Technology Assessment and Research, Madrid (2008)
78.
Martín-Martínez MA, González-Juanatey C, Castañeda S, Llorca J, Ferraz-Amaro I, Fernández-Gutiérrez B et al (2014) Recommendations for the management of cardiovascular risk in patients with rheumatoid arthritis. Scientific evidence and expert opinion. Semin Arthritis Rheum 44(1):1–8
79.
80.
81.
Working group of the Clinical Practice Guideline for type 2 Diabetes (2008) Clinical Practice Guideline on type 2 Diabetes. Madrid: Health Technologies Assessment Agency of the Basque Country
82.
83.
Duru N, van der Goes MC, Jacobs JW, Andrews T, Boers M, Buttgereit F et al (2013) EULAR evidence-based and consensus-based recommendations on the management of medium to high-dose glucocorticoid therapy in rheumatic diseases. Ann Rheum Dis 72(12):1905–1913CrossRefPubMed
84.
85.
National Institute for Health and Care Excellence (NICE) (2008) Early identification and management of chronic kidney disease in adults in primary and secondary care. National Institute for Health and Care Excellence, UK (Jan 22, 14); NICE clinical guideline 73. http://​guidance.​nice.​org.​uk/​cg73
86.
87.
88.
89.
U.S. Preventive Services Task Force recommendation statement (2009) Screening for impaired visual acuity in older adults. Ann Intern Med 151(1):37–43CrossRef
90.
Nelson AE, Allen KD, Golightly YM, Goode AP, Jordan JM (2014) A systematic review of recommendations and guidelines for the management of osteoarthritis: the chronic osteoarthritis management initiative of the U.S. Bone and Joint Initiative. Semin Arthritis Rheum 43(6):701–712
91.
Lanas A, Benito P, Alonso J, Hernández-Cruz B, Barón-Esquivias G, Perez-Aísa A et al (2014) Safe prescription recommendations for non steroidal anti-inflammatory drugs: consensus document ellaborated by nominated experts of three scientific associations (SER-SEC-AEG). Gastroenterol Hepatol 37(3):107–127
92.
van der Goes MC, Jacobs JW, Boers M, Andrews T, Blom-Bakkers MA, Buttgereit F et al (2010) Monitoring adverse events of low-dose glucocorticoid therapy: EULAR recommendations for clinical trials and daily practice. Ann Rheum Dis 69(11):1913–1919CrossRefPubMed
93.
Grossman JM, Gordon R, Ranganath VK, Deal C, Caplan L, Chen W et al (2010) American College of Rheumatology 2010 recommendations for the prevention and treatment of glucocorticoid-induced osteoporosis. Arthritis Care Res (Hoboken) 62(11):1515–1526CrossRef
94.
Singh JA, Furst DE, Bharat A, Curtis JR, Kavanaugh AF, Kremer JM et al (2012) 2012 update of the 2008 American College of Rheumatology recommendations for the use of disease-modifying antirheumatic drugs and biologic agents in the treatment of rheumatoid arthritis. Arthritis Care Res (Hoboken) 64(5):625–639CrossRef
Metadata
Title
Consensus statement on a framework for the management of comorbidity and extra-articular manifestations in rheumatoid arthritis
Authors
Estíbaliz Loza
Cristina Lajas
Jose Luis Andreu
Alejandro Balsa
Isidoro González-Álvaro
Oscar Illera
Juan Ángel Jover
Isabel Mateo
Javier Orte
Javier Rivera
José Manuel Rodríguez Heredia
Fredeswinda Romero
Juan Antonio Martínez-López
Ana María Ortiz
Esther Toledano
Virginia Villaverde
Loreto Carmona
Santos Castañeda
Publication date
01-03-2015
Publisher
Springer Berlin Heidelberg
Published in
Rheumatology International / Issue 3/2015
Print ISSN: 0172-8172
Electronic ISSN: 1437-160X
DOI
https://doi.org/10.1007/s00296-014-3196-7

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