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Article ; Online: IL-23 induces CLEC5A

Furuya, Hiroki / Nguyen, Cuong Thach / Chan, Trevor / Marusina, Alina I / Merleev, Alexander A / Garcia-Hernandez, Maria de la Luz / Hsieh, Shie-Liang / Tsokos, George C / Ritchlin, Christopher T / Tagkopoulos, Ilias / Maverakis, Emanual / Adamopoulos, Iannis E

Journal of autoimmunity

2024 Volume 143, Page(s) 103167

Abstract: IL-23-activation of IL-17 producing T cells is involved in many rheumatic diseases. Herein ...

Abstract	IL-23-activation of IL-17 producing T cells is involved in many rheumatic diseases. Herein, we investigate the role of IL-23 in the activation of myeloid cell subsets that contribute to skin inflammation in mice and man. IL-23 gene transfer in WT, IL-23R
MeSH term(s)	Humans ; Arthritis, Psoriatic/pathology ; Interleukin-17/genetics ; Interleukin-17/metabolism ; Neutrophils/metabolism ; Psoriasis ; Skin/pathology ; Dermatitis/pathology ; Inflammation ; Interleukin-23/genetics ; Interleukin-23/metabolism ; Receptors, Cell Surface/metabolism ; Lectins, C-Type/genetics
Chemical Substances	Interleukin-17 ; Interleukin-23 ; CLEC5A protein, human ; Receptors, Cell Surface ; Lectins, C-Type
Language	English
Publishing date	2024-02-01
Publishing country	England
Document type	Journal Article
ZDB-ID	639452-8
ISSN	1095-9157 ; 0896-8411
ISSN (online)	1095-9157
ISSN	0896-8411
DOI	10.1016/j.jaut.2024.103167
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Zs.A 2368: Show issues

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Article ; Online: Therapeutic considerations in spondyloarthritis patients who fail tumour necrosis factor antagonists.

Ritchlin, C T

Best practice & research. Clinical rheumatology

2010 Volume 24, Issue 5, Page(s) 683–692

Abstract: The tumour necrosis factor (TNF) antagonists have significantly improved quality of life and functional status in patients with spondyloarthritis (SpA). The excitement regarding the remarkable success of these agents is justified but challenges remain. ... ...

Abstract	The tumour necrosis factor (TNF) antagonists have significantly improved quality of life and functional status in patients with spondyloarthritis (SpA). The excitement regarding the remarkable success of these agents is justified but challenges remain. In particular, alternative systemic therapies with proven efficacy for patients who fail TNF antagonists have been developed in rheumatoid arthritis but are not yet available in SpA. In this article, the approach to patients with psoriatic arthritis (PsA) or ankylosing spondylitis (AS) who fail TNF antagonists will be discussed with the goal of providing a path to the clinician, who must manage these patients amidst uncertainty. Three central questions will be addressed. Why does a particular SpA patient not respond to a TNF antagonist? How can the clinician improve the probability of treatment response in patients who fail a TNF antagonist? What specific approaches can be taken to control disease activity in PsA or AS following treatment failure with a TNF antagonist? Data from controlled trials, registries and pilot studies will be combined with expert opinion to address these important questions.
MeSH term(s)	Arthritis, Psoriatic/drug therapy ; Humans ; Spondylarthritis/drug therapy ; Spondylitis, Ankylosing/drug therapy ; Treatment Failure ; Tumor Necrosis Factor-alpha/antagonists & inhibitors
Chemical Substances	Tumor Necrosis Factor-alpha
Language	English
Publishing date	2010-10
Publishing country	Netherlands
Document type	Journal Article ; Review
ZDB-ID	2052323-3
ISSN	1532-1770 ; 1521-6942
ISSN (online)	1532-1770
ISSN	1521-6942
DOI	10.1016/j.berh.2010.06.002
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Article ; Online: Bimekizumab treatment in patients with active psoriatic arthritis and prior inadequate response to tumour necrosis factor inhibitors: 52-week safety and efficacy from the phase III BE COMPLETE study and its open-label extension BE VITAL.

Coates, Laura C / Landewé, Robert / McInnes, Iain B / Mease, Philip J / Ritchlin, Christopher T / Tanaka, Yoshiya / Asahina, Akihiko / Behrens, Frank / Gladman, Dafna D / Gossec, Laure / Orbai, Ana-Maria / Gottlieb, Alice B / Warren, Richard B / Ink, Barbara / Bajracharya, Rajan / Shende, Vishvesh / Coarse, Jason / Merola, Joseph F

RMD open

2024 Volume 10, Issue 1

Abstract: Objectives: To assess 52-week safety and efficacy of bimekizumab in patients with active psoriatic arthritis (PsA) and prior inadequate response/intolerance to tumour necrosis factor inhibitors.: Methods: Patients completing the 16-week phase III ... ...

Abstract	Objectives: To assess 52-week safety and efficacy of bimekizumab in patients with active psoriatic arthritis (PsA) and prior inadequate response/intolerance to tumour necrosis factor inhibitors. Methods: Patients completing the 16-week phase III double-blind, placebo-controlled BE COMPLETE (NCT03896581) study entered the open-label extension, BE VITAL (NCT04009499). All patients in BE VITAL received 160 mg bimekizumab every 4 weeks. Safety and efficacy are reported to week 52. Results: A total of 347/400 (86.8%) patients completed week 52. To week 52, the exposure-adjusted incidence rate/100 patient-years for ≥1 treatment-emergent adverse event (TEAE) was 126.0, and was 7.0 for serious TEAEs. The most frequent TEAEs were SARS-CoV-2 (COVID-19), oral candidiasis, nasopharyngitis and urinary tract infection. All fungal infections were mild or moderate in severity and localised; two patients discontinued the study due to oral candidiasis. No cases of active tuberculosis, uveitis or inflammatory bowel disease were reported. One sudden death occurred. Sustained efficacy was observed with bimekizumab from week 16 to ‍52 across clinical and patient-reported outcomes. At week 52, 51.7% bimekizumab-randomised and 40.6% placebo/bimekizumab patients (receiving bimekizumab from week 16 to 52) had ≥50% improvement in the American College of Rheumatology criteria. Complete skin clearance (Psoriasis Area and Severity Index 100) was achieved by 65.9% bimekizumab and 60.2% placebo/bimekizumab patients at week 52. Minimal disease activity was achieved by 47.2% bimekizumab and 33.1% placebo/bimekizumab patients at week 52. Conclusions: Bimekizumab demonstrated a safety profile consistent with previous reports; no new safety signals were identified. Sustained efficacy was observed from week 16 to 52.
MeSH term(s)	Humans ; Antibodies, Monoclonal, Humanized ; Arthritis, Psoriatic/drug therapy ; Candidiasis, Oral ; Treatment Outcome ; Tumor Necrosis Factor Inhibitors/therapeutic use ; United States ; Double-Blind Method
Chemical Substances	Antibodies, Monoclonal, Humanized ; bimekizumab (09495UIM6V) ; Tumor Necrosis Factor Inhibitors
Language	English
Publishing date	2024-02-22
Publishing country	England
Document type	Clinical Trial, Phase III ; Journal Article
ZDB-ID	2812592-7
ISSN	2056-5933 ; 2056-5933
ISSN (online)	2056-5933
ISSN	2056-5933
DOI	10.1136/rmdopen-2023-003855
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Article ; Online: Guselkumab Modulates Differentially Expressed Genes in Blood of Patients With Psoriatic Arthritis: Results from Two Phase 3, Randomized, Placebo-Controlled Trials.

Siebert, Stefan / Sweet, Kristen M / Ritchlin, Christopher T / Hsia, Elizabeth C / Kollmeier, Alexa P / Xu, Xie L / Seridi, Loqmane / Song, Qingxuan / Gao, Sheng / Chen, Warner / Miron, Michelle

ACR open rheumatology

2023 Volume 5, Issue 9, Page(s) 490–498

Abstract: ... eosinophil, and macrophage gene sets; genes upregulated by guselkumab were enriched with B cell, T cell, and ...

Abstract	Objective: To evaluate gene expression in blood of patients with psoriatic arthritis (PsA) versus healthy controls and identify changes associated with guselkumab treatment. Methods: Whole blood transcriptome profiling via paired-end RNA sequencing was conducted using samples from DISCOVER-1 and DISCOVER-2 at baseline (n = 673) and at weeks 4 and 24 from a representative subgroup that received placebo or guselkumab (n = 227 [longitudinal PsA cohort]). Baseline samples were compared with demographically matched healthy controls (n = 21). Guselkumab-mediated changes in gene expression were assessed in participants from the longitudinal PsA cohort who did versus did not achieve at least 20% improvement in American College of Rheumatology response criteria (ACR20) or at least 75% improvement in Psoriasis Area and Severity Index (PASI75). Differential gene expression was analyzed using edgeR. Results: At baseline, 355 upregulated and 314 downregulated genes (PsA-associated genes) were identified in patients with PsA versus healthy controls. Upregulated genes were related to neutrophil, mononuclear cell, and CD11b+ gene sets. No cell type-specific gene sets were identified among downregulated genes. Most PsA-associated genes were modulated by guselkumab treatment. At week 24, genes downregulated by guselkumab were enriched with neutrophil, monocyte, eosinophil, and macrophage gene sets; genes upregulated by guselkumab were enriched with B cell, T cell, and natural killer cell gene sets. Reductions in expression of upregulated PsA-associated gene sets were more pronounced in ACR20 and PASI75 responders than in nonresponders. Conclusion: These findings suggest a dysregulation of immune cell profiles in blood from patients in the baseline PsA cohort that approached levels in healthy controls after guselkumab treatment.
Language	English
Publishing date	2023-08-08
Publishing country	United States
Document type	Journal Article
ISSN	2578-5745
ISSN (online)	2578-5745
DOI	10.1002/acr2.11589
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Article ; Online: Hospitalization of patients with systemic lupus erythematosus is a major cause of direct and indirect healthcare costs.

Anandarajah, A P / Luc, M / Ritchlin, C T

Lupus

2017 Volume 26, Issue 7, Page(s) 756–761

Abstract: Objectives The objective of this study was to calculate the direct and indirect costs of admission for systemic lupus erythematosus (SLE) patients, identify the population at risk and investigate potential reasons for admission. Methods We conducted a ... ...

Abstract	Objectives The objective of this study was to calculate the direct and indirect costs of admission for systemic lupus erythematosus (SLE) patients, identify the population at risk and investigate potential reasons for admission. Methods We conducted a financial analysis of all admissions for SLE to Strong Memorial Hospital between 1 July 2013 and 30 June 2015. Patient and financial records for admissions with a SLE diagnosis for the above period were retrieved. The total cost of admissions was used as a measure of direct costs and the length of stay used to assess indirect costs. Additionally, we analyzed the demographics of the hospitalized population. Results The average, annual cost of confirmed admissions to Strong Memorial Hospital for SLE was US$3.9-6.4 m. The mean annual cost per patient for hospitalization was US$51,808.41. The length of stay for all SLE patients was 1564-2507 days with an average of 8.5 days per admission. The majority of patients admitted were young women from the city of Rochester. Infections were the most common reason for admissions. Conclusion We demonstrated that admissions are a source of high direct and indirect costs to the hospital and a significant financial burden to the patient. Implementing measures to improve the quality of care for SLE patients will help decrease the morbidity and lower the economic costs to hospitals.
Language	English
Publishing date	2017-06
Publishing country	England
Document type	Journal Article
ZDB-ID	1154407-7
ISSN	1477-0962 ; 0961-2033
ISSN (online)	1477-0962
ISSN	0961-2033
DOI	10.1177/0961203316676641
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Article ; Online: Correction to: New onset of axial spondyloarthropathy in patients treated with isotretinoin for acne vulgaris: incidence, follow-up, and MRI findings.

Elnady, Basant / Elkhouly, Tohamy / Dawoud, Noha M / Desouky, Dalia E / Kewan, Hanady H / Dawoud, Dalia M / Ritchlin, Christopher

Clinical rheumatology

2022 Volume 41, Issue 8, Page(s) 2615

Language	English
Publishing date	2022-04-13
Publishing country	Germany
Document type	Published Erratum
ZDB-ID	604755-5
ISSN	1434-9949 ; 0770-3198
ISSN (online)	1434-9949
ISSN	0770-3198
DOI	10.1007/s10067-022-06178-z
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Article ; Online: The Relationship Between Focal and Generalized Bone Loss in Rheumatoid Arthritis.

Anandarajah, A P / El-Taha, M / Peng, C / Ritchlin, C T

Current rheumatology reviews

2017 Volume 13, Issue 2, Page(s) 152–157

Abstract: ... constructed to assess the association between the presence or absence of erosions and T-scores at the lumbar ... activity indices.: Results: Data on erosions and T-scores were available in 3,898 and 5,099 subjects ... respectively. Patients with erosions had a significantly lower LS T-scores (-0.9) compared to RA patients ...

Abstract	Objective: To determine if there is an association between focal and systemic bone loss in patients with RA. Methods: Bone loss is a hallmark finding in rheumatoid arthritis (RA) and manifests as localized, periarticular and systemic bone loss. RA patients were selected from the Consortium of Rheumatology Researchers of North America (CORRONA) database. Multiple logistic regression models were constructed to assess the association between the presence or absence of erosions and T-scores at the lumbar spine (LS) and total hips and adjusted for age, gender, body mass index (BMI), medications and disease activity indices. Results: Data on erosions and T-scores were available in 3,898 and 5,099 subjects, respectively. Patients with erosions had a significantly lower LS T-scores (-0.9) compared to RA patients without erosions (p=0.0002). Similarly, the mean total hip T-scores were significantly lower in patients with (-1.4) compared to subjects without erosions (-1.0) (p<0.01). The odds of having no erosion increased by 21% for each 1-unit increase in LS T-score and 46% for each 1 unit increase in hip Tscore. Patients with erosions were significantly younger (p<0.01) had a lower BMI (p<0.01) and higher DAS28 scores than those without erosions. More patients with erosions were on anti-TNF therapy, disease modifying drugs and osteoporosis medications than patients without erosions (p<0.01, 0.003 and 0.0003). Conclusion: RA patients with bone erosions have significantly lower T-scores at the LS and hips compared with RA patients without erosions. These data suggest a relationship between localized and generalized bone loss in RA.
Language	English
Publishing date	2017
Publishing country	United Arab Emirates
Document type	Journal Article
ISSN	1875-6360
ISSN (online)	1875-6360
DOI	10.2174/1573397112666160909094403
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Article ; Online: Meaningful Improvement in General Health Outcomes with Guselkumab Treatment for Psoriatic Arthritis: Patient-Reported Outcomes Measurement Information System-29 Results from a Phase 3 Study.

Orbai, Ana-Maria / Coates, Laura C / Deodhar, Atul / Helliwell, Philip S / Ritchlin, Christopher T / Leibowitz, Evan / Kollmeier, Alexa P / Hsia, Elizabeth C / Xu, Xie L / Sheng, Shihong / Jiang, Yusang / Liu, Yan / Han, Chenglong

The patient

2022 Volume 15, Issue 6, Page(s) 657–668

Abstract: ... domain scores are converted to standardized T-scores, with norms based on a US general population mean ... of 50 (1 standard deviation (SD) = 10). T-score changes of ≥ 5 are considered clinically meaningful ... Least-squares mean PROMIS-29 T-score changes from baseline to Week 24 and Week 52 were summarized ...

Abstract	Objective: The Phase 3 DISCOVER-1 study of guselkumab is the first randomized controlled trial to use Patient-Reported Outcomes Measurement Information System (PROMIS) measures to assess the effects of treatment on general health outcomes in patients with psoriatic arthritis (PsA). Methods: Patients (N = 381) with active PsA were randomized 1:1:1 to guselkumab 100 mg every 4 weeks (Q4W); guselkumab 100 mg at Week 0, Week 4, then every 8 weeks (Q8W); or placebo with Week 24 crossover to guselkumab Q4W. The PROMIS-29 Profile contains four items for each of seven domains (anxiety, depression, fatigue, pain interference, physical function, sleep disturbance, and social participation) and one pain-intensity item. Raw domain scores are converted to standardized T-scores, with norms based on a US general population mean of 50 (1 standard deviation (SD) = 10). T-score changes of ≥ 5 are considered clinically meaningful. Least-squares mean PROMIS-29 T-score changes from baseline to Week 24 and Week 52 were summarized for the guselkumab and placebo groups; nominal p-values comparing results between guselkumab and placebo were calculated at Week 24 using a mixed model for repeated measures. The proportions of patients who achieved clinically meaningful improvement in PROMIS-29 T-scores were also summarized at Week 24 and Week 52; nominal p-values comparing results between guselkumab and placebo were calculated at Week 24 using the Cochran-Mantel-Haenszel test. Results: In the DISCOVER-1 patient population, mean PROMIS-29 T-scores at baseline were ~ 1 SD worse for physical function and pain interference and were numerically worse for social participation, fatigue, and sleep disturbance compared with the US general population. At Week 24, mean PROMIS-29 T-scores improved in guselkumab-treated patients, approaching US population norms; T-scores continued to improve through Week 52. Significantly higher proportions of patients in both guselkumab treatment arms (31-52% across domains) had clinically meaningful improvements in pain interference, fatigue, physical function, sleep, and social participation at Week 24 versus placebo (all nominal p ≤ 0.05). Conclusion: In patients with active PsA, guselkumab treatment provided clinically meaningful reductions in fatigue and pain and improvement in physical function and social participation, as measured by the PROMIS-29 Profile. These improvements were maintained through 1 year. Clinicaltrials: GOV: Registration number, NCT03162796; Submission date 19 May 2017.
MeSH term(s)	Humans ; Arthritis, Psoriatic/drug therapy ; Fatigue/chemically induced ; Sleep Wake Disorders ; Pain ; Patient Reported Outcome Measures ; Outcome Assessment, Health Care ; Information Systems ; Treatment Outcome
Chemical Substances	guselkumab (089658A12D)
Language	English
Publishing date	2022-06-30
Publishing country	New Zealand
Document type	Randomized Controlled Trial ; Clinical Trial, Phase III ; Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2466680-4
ISSN	1178-1661 ; 1178-1653
ISSN (online)	1178-1661
ISSN	1178-1653
DOI	10.1007/s40271-022-00588-6
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Article ; Online: Bimekizumab treatment in biologic DMARD-naïve patients with active psoriatic arthritis: 52-week efficacy and safety results from the phase III, randomised, placebo-controlled, active reference BE OPTIMAL study.

Ritchlin, Christopher T / Coates, Laura C / McInnes, Iain B / Mease, Philip J / Merola, Joseph F / Tanaka, Yoshiya / Asahina, Akihiko / Gossec, Laure / Gottlieb, Alice B / Warren, Richard B / Ink, Barbara / Bajracharya, Rajan / Shende, Vishvesh / Coarse, Jason / Landewé, Robert Bm

Annals of the rheumatic diseases

2023 Volume 82, Issue 11, Page(s) 1404–1414

Abstract: Objectives: Bimekizumab (BKZ) is a monoclonal IgG1 antibody that selectively inhibits interleukin (IL)-17F in addition to IL-17A. BKZ treatment has demonstrated superior efficacy versus placebo (PBO) at Week 16 in biologic disease-modifying ... ...

Abstract	Objectives: Bimekizumab (BKZ) is a monoclonal IgG1 antibody that selectively inhibits interleukin (IL)-17F in addition to IL-17A. BKZ treatment has demonstrated superior efficacy versus placebo (PBO) at Week 16 in biologic disease-modifying antirheumatic drug (DMARD)-naïve patients with active psoriatic arthritis (PsA). Here, we report long-term efficacy and safety to Week 52. Methods: BE OPTIMAL comprised a 16-week, double-blind, PBO-controlled period, then 36 weeks treatment-blind. Patients were randomised 3:2:1 to subcutaneous BKZ 160 mg every 4 weeks, PBO with switch to BKZ at Week 16, or reference arm (adalimumab (ADA) 40 mg every 2 weeks). Efficacy outcomes included the American College of Rheumatology (ACR) response criteria 20/50/70, Psoriasis Area and Severity Index (PASI) 75/90/100 in patients with baseline psoriasis affecting ≥3% body surface area and minimal disease activity (MDA); non-responder imputation. Results: ACR20/50/70, PASI75/90/100 and MDA responses were sustained with BKZ to Week 52, consistent with results observed at Week 16. Patients who switched to BKZ at Week 16 demonstrated improvements in efficacy with similar results to BKZ-randomised patients by Week 52.To Week 52, 555/702 (79.1%) patients had ≥1 treatment-emergent adverse event (TEAE) during BKZ treatment; 113/140 (80.7%) on ADA. On BKZ, 46 (6.6%) patients had serious TEAEs. 54 (7.7%) Conclusions: The efficacy of BKZ in bDMARD-naïve patients with PsA was sustained from Week 16 to Week 52. BKZ was well tolerated with no new safety signals observed. Trial registration number: NCT03895203.
MeSH term(s)	Humans ; Adalimumab/therapeutic use ; Antibodies, Monoclonal/therapeutic use ; Antirheumatic Agents ; Arthritis, Psoriatic/drug therapy ; Biological Products/therapeutic use ; Double-Blind Method ; Psoriasis/drug therapy ; Severity of Illness Index ; Treatment Outcome
Chemical Substances	Adalimumab (FYS6T7F842) ; Antibodies, Monoclonal ; Antirheumatic Agents ; bimekizumab (09495UIM6V) ; Biological Products
Language	English
Publishing date	2023-09-11
Publishing country	England
Document type	Journal Article ; Randomized Controlled Trial ; Research Support, Non-U.S. Gov't
ZDB-ID	7090-7
ISSN	1468-2060 ; 0003-4967
ISSN (online)	1468-2060
ISSN	0003-4967
DOI	10.1136/ard-2023-224431
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Article ; Online: Safety and Efficacy of Bimekizumab in Patients With Active Psoriatic Arthritis: Three-Year Results From a Phase IIb Randomized Controlled Trial and Its Open-Label Extension Study.

Coates, Laura C / McInnes, Iain B / Merola, Joseph F / Warren, Richard B / Kavanaugh, Arthur / Gottlieb, Alice B / Gossec, Laure / Assudani, Deepak / Bajracharya, Rajan / Coarse, Jason / Ink, Barbara / Ritchlin, Christopher T

Arthritis & rheumatology (Hoboken, N.J.)

2022 Volume 74, Issue 12, Page(s) 1959–1970

Abstract: Objective: To assess the long-term safety, tolerability, and efficacy of bimekizumab in active psoriatic arthritis (PsA).: Methods: Adult patients with active PsA who completed the double- and dose-blind periods of the BE ACTIVE randomized controlled ...

Abstract	Objective: To assess the long-term safety, tolerability, and efficacy of bimekizumab in active psoriatic arthritis (PsA). Methods: Adult patients with active PsA who completed the double- and dose-blind periods of the BE ACTIVE randomized controlled trial were eligible to enroll in the open-label extension (OLE) study at week 48, after which patients received 160 mg of bimekizumab every 4 weeks. Safety and efficacy results are presented through 152 weeks. Results: At week 152, 161 of 206 patients (78.2%) remained in the study. From weeks 0-152, 184 of 206 patients experienced ≥1 treatment-emergent adverse event (126.4 per 100 patient-years). The most frequent events were nasopharyngitis (7.6 per 100 patient-years), upper respiratory tract infection (6.8 per 100 patient-years), bronchitis (3.5 per 100 patient-years), and oral candidiasis (3.5 per 100 patient-years). Additionally, 47 of 206 patients had mild to moderate localized fungal infections (9.7 per 100 patient-years), including 24 of 206 patients who had Candida infections (4.6 per 100 patient years) and 19 of 206 patients who had oral candidiasis (3.5 per 100 patient years). Four patients had serious infections (0.7 per 100 patient-years); there were no reported cases of active tuberculosis, adjudicated major adverse cardiac events, or deaths. Efficacy demonstrated at week 48 was sustained in the OLE study. At week 152, nonresponder imputation analysis showed that 52.9% of patients (69.4% of observed cases) achieved the American College of Rheumatology criteria for 50% improvement, 57.7% (73.8% of observed cases) achieved 100% skin clearance per the Psoriasis Area and Severity Index, and 51.5% (67.5% of observed cases) achieved minimal disease activity. Patients also maintained improvements in pain, physical function, and health-related quality of life. Conclusion: The safety profile of bimekizumab was consistent with previous reports, with no new safety signals identified. Sustained joint and efficacy responses were observed over 3 years.
MeSH term(s)	Adult ; Humans ; Arthritis, Psoriatic/drug therapy ; Quality of Life ; Candidiasis, Oral ; Treatment Outcome ; Double-Blind Method ; Severity of Illness Index
Chemical Substances	bimekizumab (09495UIM6V)
Language	English
Publishing date	2022-11-18
Publishing country	United States
Document type	Randomized Controlled Trial ; Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2756371-6
ISSN	2326-5205 ; 2326-5191
ISSN (online)	2326-5205
ISSN	2326-5191
DOI	10.1002/art.42280
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