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Nikolaos Kougkas reports a relationship with UCB that includes: speaking and lecture fees. Nikolaos Kougkas reports a relationship with Abbvie that includes: speaking and lecture fees. Nikolaos Kougkas reports a relationship with MSD that includes: speaking and lecture fees. Nikolaos Kougkas reports a relationship with Novartis that includes: speaking and lecture fees. Nikolaos Kougkas reports a relationship with Amgen that includes: speaking and lecture fees. Nikolaos Kougkas reports a relationship with Lilly that includes: speaking and lecture fees. Paraskevi V. Voulgari reports a relationship with Abbvie that includes: consulting or advisory. Paraskevi V. Voulgari reports a relationship with Amgen Hellas SA that includes: consulting or advisory. Paraskevi V. Voulgari reports a relationship with Janssen-Cilag that includes: consulting or advisory. Paraskevi V. Voulgari reports a relationship with Vianex that includes: consulting or advisory. Paraskevi V. Voulgari reports a relationship with DEMO that includes: consulting or advisory. Paraskevi V. Voulgari reports a relationship with UCB that includes: consulting or advisory. Anastasios Karamanakos reports a relationship with Aenorasis that includes: consulting or advisory. Anastasios Karamanakos reports a relationship with Abbvie that includes: speaking and lecture fees. Anastasios Karamanakos reports a relationship with Vianex that includes: speaking and lecture fees. Anastasios Karamanakos reports a relationship with Janssen that includes: speaking and lecture fees. Anastasios Karamanakos reports a relationship with Amgen that includes: speaking and lecture fees. Maria G. Tektonidou reports a relationship with Eli Lilly that includes: consulting or advisory. Maria G. Tektonidou reports a relationship with GSK that includes: consulting or advisory and funding grants. Maria G. Tektonidou reports a relationship with UCB that includes: consulting or advisory and funding grants. Maria G. Tektonidou reports a relationship with Abbvie that includes: funding grants. Maria G. Tektonidou reports a relationship with Boehringer Ingelheim that includes: funding grants. Maria G. Tektonidou reports a relationship with DEMO that includes: funding grants. Maria G. Tektonidou reports a relationship with FARAN that includes: funding grants. Maria G. Tektonidou reports a relationship with Vianex that includes: funding grants. Petros P. Sfikakis reports a relationship with Novartis that includes: funding grants. Petros P. Sfikakis reports a relationship with Pfizer that includes: funding grants. Petros P. Sfikakis reports a relationship with UCB that includes: funding grants. Petros P. Sfikakis reports a relationship with Genesis Pharma SA that includes: funding grants. Petros P. Sfikakis reports a relationship with Eli Lilly that includes: funding grants. Petros P. Sfikakis reports a relationship with Aenorasis that includes: funding grants. Petros P. Sfikakis reports a relationship with Abbvie that includes: funding grants. Petros P. Sfikakis reports a relationship with Janssen that includes: funding grants. Petros P. Sfikakis reports a relationship with Vianex that includes: funding grants. Petros P. Sfikakis reports a relationship with Boehringer Ingelheim that includes: funding grants. Eleni Kalavri reports a relationship with UCB that includes: speaking and lecture fees. Gkikas Katsifis reports a relationship with Abbvie that includes: consulting or advisory and speaking and lecture fees. Gkikas Katsifis reports a relationship with Genesis Pharma that includes: consulting or advisory and speaking and lecture fees. Gkikas Katsifis reports a relationship with Janssen that includes: consulting or advisory and speaking and lecture fees. Gkikas Katsifis reports a relationship with MSD that includes: consulting or advisory and speaking and lecture fees. Gkikas Katsifis reports a relationship with Novartis that includes: consulting or advisory and speaking and lecture fees. Gkikas Katsifis reports a relationship with Pfizer that includes: consulting or advisory and speaking and lecture fees. Gkikas Katsifis reports a relationship with UCB that includes: consulting or advisory and speaking and lecture fees. Gkikas Katsifis reports a relationship with Aenorasis that includes: speaking and lecture fees. Gkikas Katsifis reports a relationship with Lilly that includes: speaking and lecture fees. Gkikas Katsifis reports a relationship with Roche that includes: speaking and lecture fees. Gkikas Katsifis reports a relationship with Sobi that includes: speaking and lecture fees. Christos Koutsianas reports a relationship with Janssen that includes: consulting or advisory. Christos Koutsianas reports a relationship with Pfizer that includes: consulting or advisory and speaking and lecture fees. Christos Koutsianas reports a relationship with Viatris that includes: consulting or advisory. Christos Koutsianas reports a relationship with Aenorasis that includes: consulting or advisory and speaking and lecture fees. Christos Koutsianas reports a relationship with Abbvie that includes: consulting or advisory and speaking and lecture fees. Christos Koutsianas reports a relationship with Genesis Pharma that includes: speaking and lecture fees. Christos Koutsianas reports a relationship with Novartis that includes: speaking and lecture fees. Christos Koutsianas reports a relationship with Eli Lilly that includes: speaking and lecture fees. Christos Koutsianas reports a relationship with UCB that includes: speaking and lecture fees. Christos Koutsianas reports a relationship with Amgen that includes: speaking and lecture fees. Pelagia Katsimpri reports a relationship with Amgen that includes: consulting or advisory. Pelagia Katsimpri reports a relationship with Aenorasis that includes: consulting or advisory. Pelagia Katsimpri reports a relationship with Novartis that includes: consulting or advisory. Pelagia Katsimpri reports a relationship with Lilly that includes: consulting or advisory. Pelagia Katsimpri reports a relationship with Pfizer that includes: consulting or advisory. Pelagia Katsimpri reports a relationship with Janssen-Cilag that includes: consulting or advisory. Pelagia Katsimpri reports a relationship with Abbvie that includes: consulting or advisory. Alexios Iliopoulos reports a relationship with Abbvie that includes: speaking and lecture fees. Dimitrios Daoussis reports a relationship with Pfizer that includes: speaking and lecture fees. Dimitrios Daoussis reports a relationship with Abbvie that includes: speaking and lecture fees. Dimitrios Daoussis reports a relationship with Lilly that includes: speaking and lecture fees. Dimitrios Daoussis reports a relationship with UCB that includes: speaking and lecture fees. Dimitrios Daoussis reports a relationship with GSK that includes: speaking and lecture fees. Dimitrios Daoussis reports a relationship with Boehringer Ingelheim that includes: speaking and lecture fees. Dimitrios Daoussis reports a relationship with Janssen that includes: speaking and lecture fees. Ilias Bournazos reports a relationship with UCB that includes: consulting or advisory and travel reimbursement. Ilias Bournazos reports a relationship with Novartis that includes: consulting or advisory. Ilias Bournazos reports a relationship with Excelya Greece CRO Single Member S.A. that includes: consulting or advisory. Ilias Bournazos reports a relationship with Primeview that includes: consulting or advisory. Ilias Bournazos reports a relationship with Aenorasis that includes: speaking and lecture fees and travel reimbursement. Ilias Bournazos reports a relationship with MSD that includes: travel reimbursement. Dimos Patrikos reports a relationship with Janssen-Cilag that includes: consulting or advisory and speaking and lecture fees. Dimos Patrikos reports a relationship with Amgen Hellas that includes: consulting or advisory. Dimos Patrikos reports a relationship with Novartis that includes: consulting or advisory and speaking and lecture fees. Dimos Patrikos reports a relationship with Pfizer Hellas that includes: consulting or advisory. Dimos Patrikos reports a relationship with Menarini Hellas that includes: speaking and lecture fees. Dimos Patrikos reports a relationship with Genesis Pharma that includes: speaking and lecture fees. Dimos Patrikos reports a relationship with Abbvie that includes: speaking and lecture fees. Dimos Patrikos reports a relationship with UCB that includes: speaking and lecture fees. Dimos Patrikos reports a relationship with Lilly that includes: speaking and lecture fees. Theodoros Dimitroulas reports a relationship with Abbvie that includes: speaking and lecture fees and travel reimbursement. Theodoros Dimitroulas reports a relationship with Amgen that includes: speaking and lecture fees. Theodoros Dimitroulas reports a relationship with Janssen that includes: speaking and lecture fees and travel reimbursement. Theodoros Dimitroulas reports a relationship with Lilly that includes: speaking and lecture fees and travel reimbursement. Theodoros Dimitroulas reports a relationship with UCB that includes: speaking and lecture fees and travel reimbursement. Theodoros Dimitroulas reports a relationship with Genesis Pharma that includes: travel reimbursement. Theodoros Dimitroulas reports a relationship with Pfizer that includes: speaking and lecture fees. George E. Fragoulis reports a relationship with Novartis that includes: consulting or advisory and speaking and lecture fees. George E. Fragoulis reports a relationship with FARAN that includes: consulting or advisory. George E. Fragoulis reports a relationship with UCB that includes: consulting or advisory and speaking and lecture fees. George E. Fragoulis reports a relationship with Lilly that includes: consulting or advisory and speaking and lecture fees. George E. Fragoulis reports a relationship with Boehringer Ingelheim that includes: consulting or advisory. George E. Fragoulis reports a relationship with GSK that includes: consulting or advisory. George E. Fragoulis reports a relationship with Aenorasis that includes: consulting or advisory. George E. Fragoulis reports a relationship with Abbvie that includes: speaking and lecture fees. George E. Fragoulis reports a relationship with Pfizer that includes: speaking and lecture fees. George E. Fragoulis reports a relationship with Janssen that includes: speaking and lecture fees. Charalampos Papagoras reports financial support was provided by Greek Rheumatology Society and Professional Association of Rheumatologists. Charalampos Papagoras reports a relationship with Pfizer that includes: consulting or advisory and speaking and lecture fees. Charalampos Papagoras reports a relationship with Pharmaserve - Lilly that includes: consulting or advisory, funding grants, and speaking and lecture fees. Charalampos Papagoras reports a relationship with UCB that includes: consulting or advisory and speaking and lecture fees. Charalampos Papagoras reports a relationship with Janssen that includes: consulting or advisory and speaking and lecture fees. Charalampos Papagoras reports a relationship with FARAN that includes: funding grants. Charalampos Papagoras reports a relationship with DEMO that includes: funding grants. Charalampos Papagoras reports a relationship with AbbVie that includes: speaking and lecture fees. Charalampos Papagoras reports a relationship with MSD that includes: speaking and lecture fees. Charalampos Papagoras reports a relationship with Amgen that includes: speaking and lecture fees.All other authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.","order":1,"name":"Ethics","label":"Conflict of interest","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The study protocol was approved by the institutional review boards and ethics committees of participating centers, including University General Hospital of Alexandroupolis (protocol no. 51004\/01-12-2021, 10 December 2021), Thriasio General Hospital (protocol no. 27701, 10 December 2021), University Hospital of Ioannina (approval date: 30 November 2021), Hippokration General Hospital of Athens (Scientific Council decision no. 65\/8-11-2021), General Hospital of Attica KAT (Board decision no. 36\/17-12-2021), Naval Hospital of Athens (protocol no. 8\/21, 9 November 2021), Henry Dunant Hospital Center (Scientific Committee approval, 17 December 2021), and \u201cG. Hatzikosta\u201d General Hospital (Scientific Council approval, 10 April 2025). Written informed consent was obtained from all participants prior to inclusion in the registry. The study was conducted in accordance with the Declaration of Helsinki (October 2024 revision).","order":2,"name":"Ethics","label":"Ethical approval","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This manuscript is original, has not been published in full previously, and is not under consideration elsewhere. Parts of this work have been presented in abstract form as disclosed above.","order":3,"name":"Ethics","label":"Disclaimer","group":{"name":"EthicsHeading","label":"Declarations"}}],"article-number":"193"}}