{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T03:10:26Z","timestamp":1740107426600,"version":"3.37.3"},"reference-count":25,"publisher":"Springer Science and Business Media LLC","issue":"5","license":[{"start":{"date-parts":[[2021,3,11]],"date-time":"2021-03-11T00:00:00Z","timestamp":1615420800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,3,11]],"date-time":"2021-03-11T00:00:00Z","timestamp":1615420800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Universit\u00e4tsmedizin Greifswald"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Z Rheumatol"],"published-print":{"date-parts":[[2021,6]]},"abstract":"<jats:title>Zusammenfassung<\/jats:title><jats:sec>\n                <jats:title>Hintergrund<\/jats:title>\n                <jats:p>Methotrexat (MTX) ist das das am h\u00e4ufigsten verordnete krankheitsmodifizierende Antirheumatikum. Ein regelm\u00e4\u00dfiges Labormonitoring wird empfohlen, um Nebenwirkungen wie Hepatotoxizit\u00e4t und Myelotoxizit\u00e4t sowie MTX-Toxizit\u00e4t-beg\u00fcnstigende Zust\u00e4nde wie eingeschr\u00e4nkte Nierenfunktion fr\u00fch zu erkennen. Zudem wird eine prophylaktische Fols\u00e4uregabe empfohlen. Diese Arbeit untersucht, ob die empfohlene Kontrolluntersuchungen und Fols\u00e4ureverordnungen w\u00e4hrend der MTX-Therapie durchgef\u00fchrt werden.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Material und Methoden<\/jats:title>\n                <jats:p>Abrechnungsdaten der gesetzlichen Krankenkassen vom 01.01.2009 bis 31.12.2013 wurden analysiert. Aus der Forschungsdatenbank des InGef (Institut f\u00fcr angewandte Gesundheitsforschung Berlin, fr\u00fcher Health Risk Institute) wurden 40.087 Erwachsene mit einer kodierten rheumatischen Erkrankung (ICD-10-Codes M05\u2013M18), ohne Karzinomdiagnose und ohne MTX-Verordnung \u2265\u202f12\u00a0Monate vor Erstverordnung extrahiert. Es wurde analysiert, ob Laborkontrollen entsprechend den Handlungsempfehlungen, eine j\u00e4hrliche rheumatologische Betreuung sowie die Verordnung von Fols\u00e4ure erfolgten.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Ergebnisse<\/jats:title>\n                <jats:p>Es begannen 12.451 Patienten eine neue MTX-Therapie im Beobachtungszeitraum. Das Blutbild, die Leberwerte und die Nierenfunktion wurden bei 42\u201346\u202f% und der Urinstatus bei 14\u202f% der Patienten wie empfohlen untersucht; 84\u202f% befanden sich in regelm\u00e4\u00dfiger rheumatologischer Betreuung, und 74\u202f% bekamen eine Fols\u00e4ureprophylaxe. M\u00f6glicherweise MTX-assoziierte schwerwiegende Komplikationen wurden in 0,7 bis 3,5\u00a0F\u00e4llen\/1000 Personenjahre beobachtet.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Diskussion<\/jats:title>\n                <jats:p>Kontrolluntersuchungen bei MTX-Therapie werden seltener als empfohlen durchgef\u00fchrt. M\u00f6glicherweise MTX-assoziierte Komplikationen sind aus der Praxisperspektive sehr selten. Einerseits sind Ma\u00dfnahmen f\u00fcr die bessere Koordination der Kontrolluntersuchungen erforderlich. Andererseits m\u00fcssen der Nutzen des Monitorings und die Abst\u00e4nde der Monitoringintervalle durch empirische Untersuchungen besser belegt werden.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s00393-021-00976-7","type":"journal-article","created":{"date-parts":[[2021,3,11]],"date-time":"2021-03-11T22:02:47Z","timestamp":1615500167000},"page":"418-424","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Patientensicherheit in der Rheumatherapie","Patient safety in the treatment of rheumatic diseases"],"prefix":"10.1007","volume":"80","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3679-671X","authenticated-orcid":false,"given":"Elizabeth","family":"Sierocinski","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1027-231X","authenticated-orcid":false,"given":"Aniela","family":"Angelow","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Armin","family":"Mainz","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7838-7829","authenticated-orcid":false,"given":"Jochen","family":"Walker","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8877-2950","authenticated-orcid":false,"given":"Jean-Fran\u00e7ois","family":"Chenot","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2021,3,11]]},"reference":[{"issue":"6","key":"976_CR1","doi-asserted-by":"publisher","first-page":"960","DOI":"10.1136\/annrheumdis-2016-210715","volume":"76","author":"JS Smolen","year":"2017","unstructured":"Smolen\u00a0JS et al (2017) EULAR recommendations for the management of rheumatoid arthritis with synthetic and biological disease-modifying antirheumatic drugs: 2016 update. 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