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Strangfeld group

Assessing benefits and risks of new treatments in rheumatology

Introduction
Members
Cooperation partners
Research Networks
Selected Publications

Pharmacoepidemiology

Within large clinical-epidemiological cohort studies, the Pharmacoepidemiology Working Group comparatively examines the long-term safety and effectiveness of new antiinflammatory rheumatic drugs. Our goal is to provide physicians and patients with reliable evidence of the safety profile under everyday conditions and thus to increase the safety of therapy for risk groups.

Since 2001, patients with rheumatoid arthritis have been included in the Biologics Register RABBIT. These patients start therapy with a biological, biosimilar, JAK inhibitor or, as a comparison group, a conventional synthetic DMARD after failure of a previous DMARD. They are monitored for at least 5 and up to 10 years. About 450 institutions throughout Germany have documented almost 20,000 patients so far.

Numerous new and clinically significant insights have been gained, e.g. on the risk of infection, mortality, rare adverse events and their risk factors, efficacy under everyday conditions or quality of life (see drug safety). RABBIT is one of the world’s largest biologics registries in rheumatology and cooperates closely with other European registries.

In 2017, RABBIT-SpA was launched as a further disease registry for patients with axial spondyloarthritis and psoriatic arthritis, whose disease progression is observed under conventional or new therapies similar to RABBIT. As of September 2020, 2,000 patients are included. For the analysis of biomarkers we cooperate with the Fraunhofer Institute for Molecular Biology in Frankfurt (IME).

Within the framework of the BMBF funding of musculoskeletal research networks, we have been coordinating the TARISMA (Targeted Risk Management in Musculoskeletal Diseases) network since May 2020, in which a total of 6 network partners from Berlin, Bremen and Greifswald are involved. Using data from RABBIT, we are investigating the significance of chronic comorbidities such as interstitial lung disease, heart failure or depression for disease progression and mortality. In RABBIT-SpA detailed data on medication, adherence and patient-reported outcomes are collected with the help of a medical app and linked to existing clinical data.

There is a large evidence gap regarding the drug therapy of pregnant women with rheumatic diseases. Since 2015, in cooperation with the Heinrich-Heine-University of Düsseldorf we have therefore been investigating the course of pregnancies from the time of the actual desire to have children in the Rhekiss Pregnancy Register. We collect prospective data on the course and outcome of the pregnancy and the development of the child until its second birthday. The results will help to improve the counselling and management of women suffering from rheumatic diseases during the desire for children and during pregnancy.

Together with the European network of pregnancy registers EuNeP, which is also led by our group and supported by the FOREUM Foundation, collaborative evaluations on the course and outcome of pregnancy will be carried out.

In view of the COVID-19 pandemic, the group has actively participated in the establishment of the German and European COVID-19 registry. Anja Strangfeld and Anne Regierer are members of the steering committee of the German and Anja Strangfeld is a member of the steering committee of the European registry. Due to the international cooperation, important insights into the special situation of patients with autoimmune diseases under immunosuppression could be gained very quickly.

The group is continuously developing both the technical prerequisites of data acquisition (online registry, patient apps, automated monitoring) and the methodological basis of data analysis.

Keywords
disease register
observational cohort
long-term safety
effectiveness

Pharmacoepidemiology Prof. Dr. med. Anja Strangfeld Phone +49 (0)30 28460-635 strangfeld@drfz.de more
Continue to Members

Group Leader:
Prof. Dr. med. Anja Strangfeld

Deputy Group Leader:
PD Dr. med. Anne Regierer

Scientists:
Dr. Doreen Huschek, PhD,  Lisa Lindner, MSc, Dr. rer. medic. Yvette Meißner, Dr. rer. nat. Martin Schäfer, Gisela Schulze, Dr. rer. medic. Anja Weiß, MSc, Dr. rer. nat. Vera Zietemann, MPH

Medical documentalists/Data manager:
Josephin Baumert, Felix Butzke, Tanja Ellmann, Mandy Grope, Juliana Hoffmann, Ulrike Kamenz, Hannah Kropp, Jacqueline Lohr, Steffen Meixner, Andreas Reich, Jasmin Sandor, Samuel Ofori Sasu, Franca Stein, Corina Walter, Carina Wittkopp, Birgit Wuthe, Susanna Zernicke

Project coordination:
Christina Bungartz, Dr. Eva Gutschke

Database development/Interfaces:
Claudia Fritz, Siegfried Kindler, Dina Schreckeis

Doctoral students:
Alina Purschke, Ronja Ramien, Tatjana Rudi

Student assistants:
Isabel Böttcher, Sebastian Butzke, Sara Lenge, Julia Leskow, Friedrich Zernicke

Continue to Cooperation partners

Currently, about 300 rheumatological clinics and practices throughout Germany actively participate in the registries.

Scientific advisory boards
PD Dr. Frank Behrens, Frankfurt am Main
Prof. Dr. Jürgen Braun, Herne
PD Dr. Rebecca Fischer-Betz, Düsseldorf
Prof. Dr. Peter Herzer, München
Prof. Dr. Jörn Kekow, Vogelsang-Gommern
Dr. Joachim Listing, Berlin
Prof. Dr. Bernhard Manger, Erlangen
Prof. Dr. Jutta Richter, Düsseldorf
Prof. Dr. Georg Schett, Erlangen
Prof. Dr. Matthias Schneider, Düsseldorf
Prof. Dr. Joachim Sieper, Berlin
Dr. Susanna Späthling-Mestekemper, München
Prof. Dr. Christof Specker, Essen
Prof. Dr. Angela Zink, Berlin

Cooperations with European registries
BSRBR (Manchester, GB)
ARTIS (Stockholm, S)
DANBIO (Kopenhagen, DK)
BIOBADASER (Madrid, E)
EGR2 (Paris, France)
RePreg (Bern, Switzerland)
RevNatus (Trondheim, Norway)
RATIO (Paris, F)
AIR (Montpellier, F)
ORA (Straßburg, F)
REGATE (Straßburg, F)
ATTRA (Prag, CZ)
GISEA (Bari, I)
SCQM (Genf, S)
Rheuma.pt (Lissabon, P)

Continue to Research Networks

EULAR COVID-19 database

COVID-19 Global Rheumatology Alliance

EULAR Working Group RODS (Register and Observational Drugs Studies)

ENCePP (European Network of Centers of Pharmacovigilance and Pharmacoepidemiology)

EuNeP (European Network of Pregnancy Registers in Rheumatology)

Characterising comorbidity in RA in Europe: a multi‐national analysis of big healthcare data (FOREUM grant)

German Covid-19 Register for patients with inflammatory rheumatic disease

Continue to Selected Publications
  1. [Celebrating 33 years of the DRFZ: Epidemiology and Health Services Research]. Strangfeld A, Albrecht K, Regierer A, Callhoff J, Zink A, Minden K. Z Rheumatol. 2022 Apr 5. doi: 10.1007/s00393-022-01187-4. Online ahead of print. PMID: 35380251 Review. German.
  2. [Latest findings from the RABBIT register]. Meißner Y, Strangfeld A. Z Rheumatol. 2022 Mar;81(2):100-109. doi: 10.1007/s00393-021-01139-4. Epub 2021 Dec 23. PMID: 34940891 Free PMC article. Review. German.
  3. Risk of herpes zoster (shingles) in patients with rheumatoid arthritis under biologic, targeted synthetic and conventional synthetic DMARD treatment: data from the German RABBIT register Redeker I, Albrecht K, Kekow J, Burmester GR, Braun J, Schäfer M, Zink A, Strangfeld A. Ann Rheum Dis. 2022 Jan;81(1):41-47. doi: 10.1136/annrheumdis-2021-220651. Epub 2021 Jul 28. PMID: 34321218
  4. [Risk profile of disease-modifying antirheumatic drugs: an update from the RABBIT register]  Albrecht K, Strangfeld A. Dtsch Med Wochenschr. 2021 Aug;146(15):998-1002. doi: 10.1055/a-1334-7609. Epub 2021 Aug 3. PMID: 34344036 German
  5. [Relevant information on reproduction and rheumatism]. Fischer-Betz R, Strangfeld A, Förger F. Z Rheumatol. 2021 Oct;80(8):697-698. doi: 10.1007/s00393-021-01108-x. Epub 2021 Oct 7. PMID: 34618198 German.
  6. Implementing an automated monitoring process in a digital, longitudinal observational cohort study. Lindner L, Weiß A, Reich A, Kindler S, Behrens F, Braun J, Listing J, Schett G, Sieper J, Strangfeld A, Regierer AC. Arthritis Res Ther. 2021 Jul 7;23(1):181. doi: 10.1186/s13075-021-02563-2. PMID: 34233730 Free PMC article.
  7. Pregnancy in women with psoriatic arthritis: A systematic literature review of disease activity and adverse pregnancy outcomes.  Meissner Y, Rudi T, Fischer-Betz R, Strangfeld A. Semin Arthritis Rheum. 2021 Jun;51(3):530-538. doi: 10.1016/j.semarthrit.2021.04.003. Epub 2021 Apr 15. PMID: 33887551 Review.
  8. EULAR recommendations for a core data set for pregnancy registries in rheumatology.  Meissner Y, Fischer-Betz R, Andreoli L, Costedoat-Chalumeau N, De Cock D, Dolhain RJEM, Forger F, Goll D, Molto A, Nelson-Piercy C, Özdemir R, Raio L, Rodríguez-García SC, Sciascia S, Wallenius M, Zbinden A, Zink A, Strangfeld A. Ann Rheum Dis. 2021 Jan;80(1):49-56. doi: 10.1136/annrheumdis-2020-218356. Epub 2020 Oct 14. PMID: 33055080 Free PMC article.
  9. Different risk profiles of biologic agents for new-onset psoriasis in patients with rheumatoid arthritis. Baganz L, Listing J, Kekow J, Eisterhues C, Wassenberg S, Zink A, Strangfeld A. Semin Arthritis Rheum. 2020 Feb;50(1):36-41. doi: 10.1016/j.semarthrit.2019.07.004. Epub 2019 Jul 11. PMID: 3135005
  10. Incidence of facial nerve palsies stratified by DMARD treatment in patients with rheumatoid arthritis: data from the RABBIT register. Meissner Y, Schäfer M, Schneider M, Wilden E, Zinke S, Zink A, Strangfeld A. RMD Open. 2020 Oct;6(3):e001403. doi: 10.1136/rmdopen-2020-001403. PMID: 33070117 Free PMC article.
  11. [RABBIT-SpA: a new disease register for axial spondyloarthritis and psoriatic arthritis]. Regierer AC, Weiß A, Baraliakos X, Zink A, Listing J, Strangfeld A. Z Rheumatol. 2020 Mar;79(2):135-142. doi: 10.1007/s00393-019-0613-z. PMID: 30874933 German.
  12. Obesity reduces the real-world effectiveness of cytokine-targeted but not cell-targeted disease-modifying agents in rheumatoid arthritis. Schäfer M, Meißner Y, Kekow J, Berger S, Remstedt S, Manger B, Listing J, Strangfeld A, Zink A. Rheumatology (Oxford). 2020 Aug 1;59(8):1916-1926. doi: 10.1093/rheumatology/kez535.
  13. Factors associated with treatment satisfaction in patients with rheumatoid arthritis: data from the biological register RABBIT.  Schäfer M, Albrecht K, Kekow J, Rockwitz K, Liebhaber A, Zink A, Strangfeld A. RMD Open. 2020 Oct;6(3):e001290. doi: 10.1136/rmdopen-2020-001290. PMID: 33051270 Free PMC article.
  14. EULAR recommendations for the management of rheumatoid arthritis with synthetic and biological disease-modifying antirheumatic drugs: 2019 update. Smolen JS, Landewé RBM, Bijlsma JWJ, Burmester GR, Dougados M, Kerschbaumer A, McInnes IB, Sepriano A, van Vollenhoven RF, de Wit M, Aletaha D, Aringer M, Askling J, Balsa A, Boers M, den Broeder AA, Buch MH, Buttgereit F, Caporali R, Cardiel MH, De Cock D, Codreanu C, Cutolo M, Edwards CJ, van Eijk-Hustings Y, Emery P, Finckh A, Gossec L, Gottenberg JE, Hetland ML, Huizinga TWJ, Koloumas M, Li Z, Mariette X, Müller-Ladner U, Mysler EF, da Silva JAP, Poór G, Pope JE, Rubbert-Roth A, Ruyssen-Witrand A, Saag KG, Strangfeld A, Takeuchi T, Voshaar M, Westhovens R, van der Heijde D.Ann Rheum Dis. 2020 Jun;79(6):685-699. doi: 10.1136/annrheumdis-2019-216655.
  15. Methotrexate: what are the true risks of treatment? Strangfeld A, Burmester GR. Ann Rheum Dis. 2020 Jul 1:annrheumdis-2020-217207. doi: 10.1136/annrheumdis-2020-217207. Online ahead of print.
  16. European Network of  Pregnancy Registers in Rheumatology (EuNeP)-an overview of procedures and data collection. Meissner Y, Strangfeld A, Costedoat-Chalumeau N, Förger F, Goll D, Molto A, Özdemir R, Wallenius M, Fischer-Betz R. Arthritis Res Ther. 2019 Nov 14;21(1):241. doi: 10.1186/s13075-019-2019-3.
  17. 2018 EULAR recommendations for a core data set to support observational research and clinical care in giant cell arteritis. Ehlers L, Askling J, Bijlsma HW, Cid MC, Cutolo M, Dasgupta B, Dejaco C, Dixon WG, Feltelius N, Finckh A, Gilbert K, Mackie SL, Mahr A, Matteson EL, Neill L, Salvarani C, Schmidt WA, Strangfeld A, van Vollenhoven RF, Buttgereit F. Ann Rheum Dis. 2019 Sep;78(9):1160-1166. doi: 10.1136/annrheumdis-2018-214755.
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