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Article ; Online: Optimal resting heart rate and ascites-related death in patients with cirrhosis and ascites using nonselective beta-blockers (ORCA).

Mingpun, Warunee / Sobhonslidsuk, Abhasnee / Chumnumwat, Supatat

2023 Volume 17, Issue 1, Page(s) e13681

Abstract: Nonselective beta-blockers (NSBBs) may exacerbate ascites by impairing cardiac function. This study evaluated the impact of achieving a heart rate target of 55-60 beats per minute (bpm) on ascites-related death and complications from worsening ascites in ...

Abstract	Nonselective beta-blockers (NSBBs) may exacerbate ascites by impairing cardiac function. This study evaluated the impact of achieving a heart rate target of 55-60 beats per minute (bpm) on ascites-related death and complications from worsening ascites in patients with cirrhosis and diuretic-responsive ascites using NSBBs. A retrospective study was conducted at the Faculty of Medicine Ramathibodi Hospital, Mahidol University (2012-2022) and analyzed patients with cirrhosis and diuretic-responsive ascites using NSBBs (propranolol/carvedilol) for variceal bleeding prophylaxis. The outcomes were incidence of ascites-related death and complications from worsening ascites, comparing the achievable target group (heart rate 55-60 bpm) and the unachievable target group (heart rate >60 bpm). A total of 206 patients were included in the study, with a median follow-up time of 20 months. The patients were divided into an achievable target group (n = 75, median heart rate = 58.0 bpm) and an unachievable target group (n = 131, median heart rate = 73.6 bpm). Propranolol was the most used NSBB (95.1%). The adjusted hazard ratio (HR) for ascites-related death from spontaneous bacterial peritonitis (SBP) or refractory ascites (RA) or hepatorenal syndrome (HRS) or hepatic encephalopathy (HE) showed no difference between the groups (adjusted HR 0.59 [0.23-1.54]; p = 0.28). Additionally, no significant difference was found in the incidence of complications between groups, including SBP, RA, HRS, and HE. Achieving a heart rate target of 55-60 bpm with NSBBs for variceal bleeding prophylaxis is safe in patients with diuretic-responsive ascites and cirrhosis.
MeSH term(s)	Humans ; Propranolol ; Retrospective Studies ; Esophageal and Gastric Varices/chemically induced ; Esophageal and Gastric Varices/complications ; Esophageal and Gastric Varices/drug therapy ; Heart Rate ; Ascites/drug therapy ; Ascites/epidemiology ; Ascites/etiology ; Gastrointestinal Hemorrhage/etiology ; Liver Cirrhosis/drug therapy ; Adrenergic beta-Antagonists ; Diuretics/therapeutic use
Chemical Substances	Propranolol (9Y8NXQ24VQ) ; Adrenergic beta-Antagonists ; Diuretics
Language	English
Publishing date	2023-11-23
Publishing country	United States
Document type	Journal Article
ZDB-ID	2433157-0
ISSN	1752-8062 ; 1752-8054
ISSN (online)	1752-8062
ISSN	1752-8054
DOI	10.1111/cts.13681
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Article: Associations of

Choochuay, Kanuengnit / Kunhapan, Punna / Puangpetch, Apichaya / Tongsima, Sissades / Srisawasdi, Pornpen / Sobhonslidsuk, Abhasnee / Sungkanuparph, Somnuek / Biswas, Mohitosh / Sukasem, Chonlaphat

World journal of hepatology

2024 Volume 16, Issue 3, Page(s) 366–378

Abstract: Background: The prevalence of metabolic-associated fatty liver disease (MAFLD) is a growing public health issue in people living with human immunodeficiency virus (PLWH). However, the pathophysiology of MAFLD is still unknown, and the role of genetic ... ...

Abstract	Background: The prevalence of metabolic-associated fatty liver disease (MAFLD) is a growing public health issue in people living with human immunodeficiency virus (PLWH). However, the pathophysiology of MAFLD is still unknown, and the role of genetic variables is only now becoming evident. Aim: To evaluate the associations of gene-polymorphism-related MAFLD in PLWH. Methods: The study employed transient elastography with a controlled attenuation parameter ≥ 248 dB/m to identify MAFLD in patients from a Super Tertiary Hospital in central Thailand. Candidate single-nucleotide polymorphisms (SNPs) were genotyped using TaqMan Results: The G-allele carriers of Conclusion: The current study shows an association between
Language	English
Publishing date	2024-04-04
Publishing country	United States
Document type	Journal Article
ZDB-ID	2573703-X
ISSN	1948-5182
ISSN	1948-5182
DOI	10.4254/wjh.v16.i3.366
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Article: Current position of vasoconstrictor and albumin infusion for type 1 hepatorenal syndrome.

Sobhonslidsuk, Abhasnee

World journal of gastrointestinal pharmacology and therapeutics

2015 Volume 6, Issue 3, Page(s) 28–31

Abstract: Spontaneous bacterial peritonitis (SBP), refractory ascites, hepatorenal syndrome (HRS), hyponatremia and hepatic encephalopathy are complications which frequently happen during a clinical course of decompensated cirrhosis. Splanchnic and peripheral ... ...

Abstract	Spontaneous bacterial peritonitis (SBP), refractory ascites, hepatorenal syndrome (HRS), hyponatremia and hepatic encephalopathy are complications which frequently happen during a clinical course of decompensated cirrhosis. Splanchnic and peripheral vasodilatation, increased intrarenal vasoconstriction and impaired cardiac responsive function are pathological changes causing systemic and hemodynamic derangement. Extreme renal vasoconstriction leads to severe reduction of renal blood flow and glomerular filtration rate, which finally evolves into the clinical feature of HRS. Clinical manifestations of type 1 and type 2 HRS come to medical attention differently. Patients with type 1 HRS present as acute kidney injury whereas those with type 2 HRS will have refractory ascites as the leading problem. Prompt diagnosis of type 1 HRS can halt the progression of HRS to acute tubular necrosis if the combined treatment of albumin infusion and vasoconstrictors is started timely. HRS reversal was seen in 34%-60% of patients, followed with decreasing mortality. Baseline serum levels of creatinine less than 5 mg/dL, bilirubin less than 10 mg/dL, and increased mean arterial pressure of over 5 mmHg by day 3 of the combined treatment of vasoconstrictor and albumin are the predictors of good response. Type 1 HRS can be prevented in some conditions such as albumin infusion in SBP, prophylactic antibiotics for upper gastrointestinal hemorrhage, albumin replacement after large volume paracentesis in cirrhotic patients with massive ascites. The benefit of albumin infusion in infection with primary source other than SBP requires more studies.
Language	English
Publishing date	2015-08-11
Publishing country	United States
Document type	Journal Article
ZDB-ID	2583480-0
ISSN	2150-5349
ISSN	2150-5349
DOI	10.4292/wjgpt.v6.i3.28
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Article ; Online: Cost-utility analysis of atezolizumab combined with bevacizumab for unresectable hepatocellular carcinoma in Thailand.

Sriphoosanaphan, Supachaya / Pantumongkol, Witthawat / Kulpeng, Wantanee / Charonpongsuntorn, Chanchai / Tanwandee, Tawesak / Sukeepaisarnjaroen, Wattana / Sobhonslidsuk, Abhasnee / Tangkijvanich, Pisit

PloS one

2024 Volume 19, Issue 3, Page(s) e0300327

Abstract: Background: Clinical trials have proven the efficacy and safety of atezolizumab combined with bevacizumab (A+B) in treating unresectable hepatocellular carcinoma (uHCC). This study aimed to assess the cost-utility of A+B compared to best supportive care ...

Abstract	Background: Clinical trials have proven the efficacy and safety of atezolizumab combined with bevacizumab (A+B) in treating unresectable hepatocellular carcinoma (uHCC). This study aimed to assess the cost-utility of A+B compared to best supportive care (BSC) among uHCC patients in Thailand. Methods: We conducted a cost-utility analysis from a societal perspective. We used a three-state Markov model to estimate relevant costs and health outcomes over the lifetime horizon. Local cost and utility data from Thai patients were applied. All costs were adjusted to 2023 values using the consumer price index. We reported results as incremental cost-effectiveness ratios (ICERs) in United States dollars ($) per quality-adjusted life year (QALY) gained. We discounted future costs and outcomes at 3% per annum. We then performed one-way sensitivity analysis and probabilistic sensitivity analysis to assess parameter uncertainty. The budget impact was conducted to estimate the financial burden from the governmental perspective over a five-year period. Results: Compared to BSC, A+B provided a better health benefit with 0.8309 QALY gained at an incremental lifetime cost of $45,357. The ICER was $54,589 per QALY gained. The result was sensitive to the hazard ratios for the overall survival and progression-free survival of A+B. At the current Thai willingness-to-pay (WTP) threshold of $4,678 per QALY gained, the ICER of A+B remained above the threshold. The projected budgetary requirements for implementing A+B in the respective first and fifth years would range from 8.2 to 27.9 million USD. Conclusion: Although A+B yielded the highest clinical benefit compared with BSC for the treatment of uHCC patients, A+B is not cost-effective in Thailand at the current price and poses budgetary challenges.
MeSH term(s)	Humans ; Carcinoma, Hepatocellular/drug therapy ; Bevacizumab/therapeutic use ; Cost-Benefit Analysis ; Thailand ; Liver Neoplasms/drug therapy ; Quality-Adjusted Life Years ; Antibodies, Monoclonal, Humanized
Chemical Substances	Bevacizumab (2S9ZZM9Q9V) ; atezolizumab (52CMI0WC3Y) ; Antibodies, Monoclonal, Humanized
Language	English
Publishing date	2024-03-21
Publishing country	United States
Document type	Journal Article
ZDB-ID	2267670-3
ISSN	1932-6203 ; 1932-6203
ISSN (online)	1932-6203
ISSN	1932-6203
DOI	10.1371/journal.pone.0300327
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Article: Outcomes of direct-acting antivirals in patients with HCV decompensated cirrhosis: a systematic review and meta-analysis.

Jongraksak, Tanawat / Chuncharunee, Alan / Intaraprasong, Pongphob / Tansawet, Amarit / Thakkinstian, Ammarin / Sobhonslidsuk, Abhasnee

Frontiers in medicine

2023 Volume 10, Page(s) 1295857

Abstract: Background: Direct-acting antivirals (DAA) are effective for chronic hepatitis C virus (HCV) treatment. However, their impact on overall survival (OS), hepatocellular carcinoma (HCC) occurrence, HCC-free survival, and liver function in patients with HCV ...

Abstract	Background: Direct-acting antivirals (DAA) are effective for chronic hepatitis C virus (HCV) treatment. However, their impact on overall survival (OS), hepatocellular carcinoma (HCC) occurrence, HCC-free survival, and liver function in patients with HCV decompensated cirrhosis remains uncertain. This study aimed to evaluate the effects of DAA treatment on this population. Methods: Studies were identified by searching the MEDLINE, SCOPUS, and CENTRAL databases. OS and HCC-free survival probabilities and time data were extracted from Kaplan-Meier curves. A one-stage meta-analysis using parametric Weibull regression was conducted to estimate the relative treatment effects of DAA vs. no DAA. The primary outcome was the OS rate. The secondary outcomes were HCC-free survival, HCC occurrence rate, and improvement in the Model for End-stage Liver Disease (MELD) score. Results: Eight cohorts comprising 3,430 participants (2,603 in the DAA group and 1,999 in the no-DAA group) were included. The OS probabilities at 12 and 24 months were 95 and 90% for the DAA group, respectively, compared with 89 and 80% in the no-DAA group, respectively. Hazard ratio (HR) was 0.48 (95% confidence interval (CI): 0.39, 0.60; Conclusion: Improvement in OS and MELD score is a long-term benefit of DAA treatment in patients with HCV decompensated cirrhosis, with a marginal effect of the treatment on HCC development.
Language	English
Publishing date	2023-11-29
Publishing country	Switzerland
Document type	Systematic Review
ZDB-ID	2775999-4
ISSN	2296-858X
ISSN	2296-858X
DOI	10.3389/fmed.2023.1295857
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Article ; Online: Diffuse gallbladder wall thickening in autoimmune hepatitis: an unusual presentation.

Rattananukrom, Chitchai / Angkathunyakul, Napat / Sobhonslidsuk, Abhasnee

BMJ case reports

2021 Volume 14, Issue 5

Abstract: A 63-year-old woman presented with jaundice and epigastric pain for 2 weeks. Physical examination revealed marked jaundice, and palpable gallbladder with right upper quadrant tenderness. Liver function test was remarkable for hepatocellular injury ... ...

Abstract	A 63-year-old woman presented with jaundice and epigastric pain for 2 weeks. Physical examination revealed marked jaundice, and palpable gallbladder with right upper quadrant tenderness. Liver function test was remarkable for hepatocellular injury pattern. Antinuclear antibody and anti-smooth muscle antibody were positive with high titre and serum IgG was elevated more than upper normal range. Ultrasound and CT scan demonstrated mildly diffuse periportal oedema of liver parenchyma and markedly diffuse gallbladder wall thickening up to 2 cm. Liver histology showed focal interface hepatitis with prominent plasma cell infiltration and cluster formation, moderate lobular spotty necrosis and emperipolesis consistent with autoimmune hepatitis. The patient was treated with steroid and azathioprine. She had complete resolution of symptoms and normal biochemical laboratory results. Diffuse gallbladder thickening was seen in acute hepatitis from definite autoimmune hepatitis.
MeSH term(s)	Acute Disease ; Female ; Gallbladder/diagnostic imaging ; Hepatitis, Autoimmune/complications ; Hepatitis, Autoimmune/diagnosis ; Hepatitis, Autoimmune/drug therapy ; Humans ; Liver Function Tests ; Middle Aged
Language	English
Publishing date	2021-05-31
Publishing country	England
Document type	Case Reports ; Journal Article
ISSN	1757-790X
ISSN (online)	1757-790X
DOI	10.1136/bcr-2020-241325
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Article: Cost-Utility Analysis of Vasoconstrictors Plus Albumin in the Treatment of Thai Patients with Type 1 Hepatorenal Syndrome.

Sangroongruangsri, Sermsiri / Kittrongsiri, Kankamon / Charatcharoenwitthaya, Phunchai / Sobhonslidsuk, Abhasnee / Chaikledkaew, Usa

ClinicoEconomics and outcomes research : CEOR

2021 Volume 13, Page(s) 703–715

Abstract: Purpose: Type 1 hepatorenal syndrome (type 1 HRS) or hepatorenal syndrome-acute renal injury (HRS-AKI) leads to high short-term mortality rates in patients with cirrhosis. Vasoconstrictor therapy effectively improves survival of these patients and has ... ...

Abstract	Purpose: Type 1 hepatorenal syndrome (type 1 HRS) or hepatorenal syndrome-acute renal injury (HRS-AKI) leads to high short-term mortality rates in patients with cirrhosis. Vasoconstrictor therapy effectively improves survival of these patients and has been a bridge to liver transplantation. The aim of this study was to assess the cost-utility of terlipressin plus albumin (T+A) and noradrenaline plus albumin (N+A) compared to best supportive care (BSC) for treating type 1 HRS patients in Thailand. Methods: A cost-utility analysis using a six-state Markov model was performed from societal and payer perspectives over a lifetime horizon. The clinical outcomes, costs, and utility parameters were obtained from literature, network meta-analyses, and expert opinion. One-way and probabilistic sensitivity analyses were conducted to account for uncertainty. Results: The T+A yielded the highest cost (848,325 Thai Baht (THB)) and health outcomes (2.82 life-years (LY) and 2.27 quality-adjusted life-years (QALY)). Compared to BSC, incremental cost-effectiveness ratios (ICERs) of the T+A and N+A were 377,566 and 412,979 THB per QALY gained, respectively. If N+A is administered outside the intensive care unit, the ICER was 308,964 THB per QALY. The treatment cost after liver transplantation from year 3 onwards was the most influential factor for ICERs, followed by the cost of terlipressin, duration of noradrenaline treatment, and cost of albumin. At the Thai societal willingness-to-pay threshold of 160,000 THB per QALY gained, the probabilities of being cost-effective for T+A, N+A, and BSC were 11%, 20%, and 69%, respectively. Conclusion: The T+A and N+A treatments would not be cost-effective compared to BSC in the Thai setting.
Language	English
Publishing date	2021-07-29
Publishing country	New Zealand
Document type	Journal Article
ZDB-ID	2520698-9
ISSN	1178-6981
ISSN	1178-6981
DOI	10.2147/CEOR.S317390
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Article ; Online: Cellular senescence in liver fibrosis: Implications for age-related chronic liver diseases.

Udomsinprasert, Wanvisa / Sobhonslidsuk, Abhasnee / Jittikoon, Jiraphun / Honsawek, Sittisak / Chaikledkaew, Usa

Expert opinion on therapeutic targets

2021 Volume 25, Issue 9, Page(s) 799–813

Abstract: Introduction: New insights indicate a causative link between cellular senescence and liver fibrosis. Senescent hepatic stellate cells (HSCs) facilitate fibrosis resolution, while senescence in hepatocytes and cholangiocytes acts as a potent mechanism ... ...

Abstract	Introduction: New insights indicate a causative link between cellular senescence and liver fibrosis. Senescent hepatic stellate cells (HSCs) facilitate fibrosis resolution, while senescence in hepatocytes and cholangiocytes acts as a potent mechanism driving liver fibrogenesis. In many clinical studies, telomeres and mitochondrial DNA contents, which are both aging biomarkers, were reportedly associated with a degree of liver fibrosis in patients with chronic liver diseases (CLDs); this highlights their potential as biomarkers for liver fibrogenesis. A deeper understanding of mechanisms underlying multi-step progression of senescence may yield new therapeutic strategies for age-related chronic liver pathologies. Areas covered: This review examines the recent findings from preclinical and clinical studies on mechanisms of senescence in liver fibrogenesis and its involvement in liver fibrosis. A comprehensive literature search in electronic databases consisting of PubMed and Scopus from inception to 31 August 2021 was performed. Expert opinion: Cellular senescence has diagnostic, prognostic, and therapeutic potential in progressive liver complications, especially liver fibrosis. Stimulating or reinforcing the immune response against senescent cells may be a promising and forthright biotherapeutic strategy. This approach will need a deeper understanding of the immune system's ability to eliminate senescent cells and the molecular and cellular mechanisms underlying this process.
MeSH term(s)	Cellular Senescence ; Hepatic Stellate Cells/pathology ; Humans ; Liver/pathology ; Liver Cirrhosis/pathology ; Liver Cirrhosis/therapy ; Liver Diseases
Language	English
Publishing date	2021-10-22
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't ; Review
ZDB-ID	2055208-7
ISSN	1744-7631 ; 1472-8222
ISSN (online)	1744-7631
ISSN	1472-8222
DOI	10.1080/14728222.2021.1992385
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Article ; Online: An updated meta-analysis of effects of curcumin on metabolic dysfunction-associated fatty liver disease based on available evidence from Iran and Thailand.

Lukkunaprasit, Thitiya / Tansawet, Amarit / Boonmanunt, Suparee / Sobhonslidsuk, Abhasnee / McKay, Gareth J / Attia, John / Thakkinstian, Ammarin

Scientific reports

2023 Volume 13, Issue 1, Page(s) 5824

Abstract: Metabolic dysfunction-associated fatty liver disease (MAFLD) is a common cause of chronic liver disease and can progress to nonalcoholic steatohepatitis and cirrhosis. This study aims to summarize the evidence for the effects of curcumin on MAFLD ... ...

Abstract	Metabolic dysfunction-associated fatty liver disease (MAFLD) is a common cause of chronic liver disease and can progress to nonalcoholic steatohepatitis and cirrhosis. This study aims to summarize the evidence for the effects of curcumin on MAFLD progression. Studies were identified from Medline and Scopus databases until April 2022. Systematic reviews and meta-analyses (SRMA) and randomized controlled trials (RCT) were selected based on pre-specified criteria. Three reviewers independently extracted data and assessed quality of included studies. Of the 427 identified records, 6 SRMAs and 16 RCTs were included in the analysis. Very high overlap was observed among SRMAs with corrected covered area of 21.9%. From an updated meta-analysis, curcumin demonstrated significant improvement in aspartate and alanine aminotransferase with pooled mean difference [95% confidence interval (CI)] of -3.90 (-5.97, -1.82) and -5.61 (-9.37, -1.85) units/L, respectively. Resolution and improvement of hepatic steatosis was higher in curcumin than control group with pooled relative risk (95% CI) of 3.53 (2.01, 6.22) and 3.41 (1.36, 8.56), respectively. Curcumin supplementation also led to lower fasting blood sugar, body mass index, and total cholesterol. Further trials should be conducted to assess the effect of curcumin on liver histology, especially regarding non-invasive hepatic fibrosis and steatosis.
MeSH term(s)	Humans ; Non-alcoholic Fatty Liver Disease/drug therapy ; Curcumin/therapeutic use ; Curcumin/pharmacology ; Iran ; Thailand ; Liver Cirrhosis
Chemical Substances	Curcumin (IT942ZTH98)
Language	English
Publishing date	2023-04-10
Publishing country	England
Document type	Meta-Analysis ; Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2615211-3
ISSN	2045-2322 ; 2045-2322
ISSN (online)	2045-2322
ISSN	2045-2322
DOI	10.1038/s41598-023-33023-3
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Article ; Online: Use of transient elastography to assess hepatic steatosis and fibrosis in patients with juvenile idiopathic arthritis during methotrexate treatment.

Niyasom, Chayakamon / Soponkanaporn, Sirisucha / Vilaiyuk, Soamarat / Lertudomphonwanit, Chatmanee / Getsuwan, Songpon / Tanpawpong, Pornthep / Kaewduang, Piyaporn / Sobhonslidsuk, Abhasnee

Clinical rheumatology

2023 Volume 43, Issue 1, Page(s) 423–433

Abstract: Objectives: This study aimed to assess the prevalence and identify predictors of hepatic steatosis and fibrosis in patients with juvenile idiopathic arthritis (JIA) during methotrexate treatment.: Method: This cross-sectional study included JIA ... ...

Abstract	Objectives: This study aimed to assess the prevalence and identify predictors of hepatic steatosis and fibrosis in patients with juvenile idiopathic arthritis (JIA) during methotrexate treatment. Method: This cross-sectional study included JIA patients who had received methotrexate for > 1 year. Laboratory data including liver chemistry and lipid profiles were collected. Liver stiffness measurements (LSM) and controlled attenuation parameters (CAP) were determined by transient elastography. Significant hepatic fibrosis was defined as LSM > 7 kilopascal (kPa), and hepatic steatosis was defined as CAP > 225 decibel/meter (dB/m). Logistic regression analysis was performed to identify predictors associated with hepatic steatosis and fibrosis. Results: Of 60 patients, 66.7% were female, and the median age (IQR) was 12.8 (10.6-15.0) years. The median duration of methotrexate usage (IQR) was 45 (22-85) months, and the median cumulative dose of methotrexate (IQR) was 3768 (1806-6466) mg. The median LSM (IQR) and CAP (IQR) were 4.1 (3.4-4.6) kPa and 191.0 (170.3-223.8) dB/m, respectively. No patients had transient elastography-defined hepatic fibrosis, whereas 21.7% had hepatic steatosis. A body mass index Z-score > 1 (OR 5.71 [95%CI 1.31-24.98], p = 0.021) and higher cumulative dose of methotrexate (OR 1.02 [95%CI 1.00-1.04], p = 0.041) were associated with hepatic steatosis, whereas the cumulative dose of steroids was not (OR 1.00 [95%CI 1.00-1.01], p = 0.097). Conclusions: Hepatic steatosis is common among JIA patients receiving methotrexate, but none had transient elastography-defined hepatic fibrosis. Overweight/obese JIA adolescents and patients with a high cumulative dose of methotrexate are at risk for hepatic steatosis. Key Points •Long-term low-dose methotrexate usage and the concomitant use of other DMARDs did not increase the risk of hepatic fibrosis in JIA patients. •The prevalence of hepatic steatosis in JIA patients receiving methotrexate was higher than in a healthy pediatric population. •Overweight/obesity and a higher cumulative dose of methotrexate were predictors of hepatic steatosis.
MeSH term(s)	Child ; Adolescent ; Humans ; Female ; Male ; Methotrexate/adverse effects ; Arthritis, Juvenile/complications ; Arthritis, Juvenile/diagnostic imaging ; Arthritis, Juvenile/drug therapy ; Elasticity Imaging Techniques ; Overweight ; Cross-Sectional Studies ; Fatty Liver/chemically induced ; Fatty Liver/diagnostic imaging ; Liver/diagnostic imaging ; Liver/pathology ; Liver Cirrhosis/complications ; Fibrosis ; Obesity/complications
Chemical Substances	Methotrexate (YL5FZ2Y5U1)
Language	English
Publishing date	2023-12-08
Publishing country	Germany
Document type	Journal Article
ZDB-ID	604755-5
ISSN	1434-9949 ; 0770-3198
ISSN (online)	1434-9949
ISSN	0770-3198
DOI	10.1007/s10067-023-06835-x
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