{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T17:59:39Z","timestamp":1788371979493,"version":"build-2803163510"},"reference-count":38,"publisher":"Springer Science and Business Media LLC","issue":"2","license":[{"start":{"date-parts":[[2023,12,23]],"date-time":"2023-12-23T00:00:00Z","timestamp":1703289600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2023,12,23]],"date-time":"2023-12-23T00:00:00Z","timestamp":1703289600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100007514","name":"Universit\u00e0 di Pisa","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100007514","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Clin Rheumatol"],"published-print":{"date-parts":[[2024,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Introduction<\/jats:title>\n                <jats:p>The use of Janus Kinase Inhibitors (JAK-Is) in rheumatoid arthritis (RA) has entered in daily practice. In consideration of ORAL-Surveillance trial and the new EULAR recommendations, real-world data are needed to assess Jak-Is safety and effectiveness. The multicenter study presented here aimed to evaluate effectiveness and safety of tofacitinib in a real-life cohort.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>A retrospective analysis was performed from September 2021 to December 2022. Data were collected when tofacitinib was started (T0) and after 3 (T3), 6 (T6) and 12 (T12) months of treatment. The primary objective was to analyze the efficacy and safety of tofacitinib. Safety was assessed by recording adverse events (AEs) with and without discontinuation.<\/jats:p>\n                <jats:p>The secondary objective was to assess the difference between Patient-Reported Outcomes (PROs) and Physician's Global Assessment of disease activity (PhGA).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>122 patients were included in the study from the following rheumatology Centers: Pisa, Ancona, Florence (two Centers), Siena, and Sardinia. A statistically significant improvement in DAS-28-CRP, CDAI and SDAI score was observed at T3, T6, compared to baseline (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). Improvement was confirmed in patients who reach T12. Patients na\u00efve to bDMARDs showed a shorter remission time and higher remission rates. There was also a statistically significant improvement in PROs compared to baseline (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). The improvement was rapid and was consistent with PhGA. The 12-month retention rate for tofacitinib was 89.35%. Reasons to stop tofacitinib were: insufficient response (7), gastrointestinal symptoms (2), infection (1), malignancy (1), Zoster (1), pruritus sine materia (1).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>Tofacitinib is safe and effective in our RA cohort. It induces higher remission rates in patients naive to bDMARDs, suggesting that there may be a benefit using it as first-line therapy. Additionally, improvement in PROs was consistent with PhGA scores, demonstrating how tofacitinib affects both the objective and subjective components of disease activity.<\/jats:p>\n                <jats:p><jats:table-wrap><jats:table><jats:tbody>\n                      <jats:tr>\n                        <jats:td align=\"left\" colspan=\"2\"><jats:bold>Key Points<\/jats:bold>1. <jats:italic>JAK inhibitors are considered at a similar level as biologic agents in terms of effectiveness.<\/jats:italic>2. <jats:italic>After ORAL-Surveillance results, real-world data are needed to assess the benefit\/risk profile of Jaki.<\/jats:italic>3. <jats:italic>Disagreement between patients and physicians has been previously reported with biologic therapy among patients with rheumatoid arthritis, with patients rating disease activity higher than physicians.<\/jats:italic>4. <jats:italic>Jak inhibitors could reduce this discrepancy, due to their mechanism of action.<\/jats:italic><\/jats:td>\n                      <\/jats:tr>\n                    <\/jats:tbody><\/jats:table><\/jats:table-wrap><\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s10067-023-06836-w","type":"journal-article","created":{"date-parts":[[2023,12,23]],"date-time":"2023-12-23T04:34:16Z","timestamp":1703306056000},"page":"657-665","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["ToRaRI (Tofacitinib in Rheumatoid Arthritis a Real-Life experience in Italy): Effectiveness, safety profile of tofacitinib and concordance between patient-reported outcomes and physician's global assessment of disease activity in a retrospective study in Central-Italy"],"prefix":"10.1007","volume":"43","author":[{"given":"Francesco","family":"D\u2019Alessandro","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9437-8359","authenticated-orcid":false,"given":"Massimiliano","family":"Cazzato","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elenia","family":"Laurino","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Riccardo","family":"Morganti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Bardelli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruno","family":"Frediani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudia","family":"Buongarzone","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gianluca","family":"Moroncini","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Serena","family":"Guiducci","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Cometi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maurizio","family":"Benucci","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesca","family":"Ligobbi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniela","family":"Marotto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marta","family":"Mosca","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2023,12,23]]},"reference":[{"key":"6836_CR1","doi-asserted-by":"publisher","first-page":"2205","DOI":"10.1056\/NEJMra1004965","volume":"365","author":"IB McInnes","year":"2011","unstructured":"McInnes IB, Schett G (2011) The pathogenesis of rheumatoid arthritis. N Engl J Med 365:2205\u20132219","journal-title":"N Engl J Med"},{"key":"6836_CR2","doi-asserted-by":"publisher","first-page":"1360","DOI":"10.1001\/jama.2018.13103","volume":"320","author":"D Aletaha","year":"2018","unstructured":"Aletaha D, Smolen JS (2018) Diagnosis and management of rheumatoid arthritis: A review. JAMA 320:1360\u20131372","journal-title":"JAMA"},{"key":"6836_CR3","doi-asserted-by":"publisher","first-page":"865","DOI":"10.1136\/annrheumdis-2020-219012","volume":"80","author":"PG Traves","year":"2021","unstructured":"Traves PG et al (2021) JAK selectivity and the implications for clinical inhibition of pharmacodynamic cytokine signalling by filgotinib, upadacitinib, tofacitinib and baricitinib. Ann Rheum Dis 80:865\u2013875","journal-title":"Ann Rheum Dis"},{"key":"6836_CR4","doi-asserted-by":"publisher","first-page":"273","DOI":"10.1111\/j.1600-065X.2008.00754.x","volume":"228","author":"K Ghoreschi","year":"2009","unstructured":"Ghoreschi K, Laurence A, O\u2019Shea JJ (2009) Janus kinases in immune cell signaling. Immunol Rev 228:273\u2013287","journal-title":"Immunol Rev"},{"key":"6836_CR5","doi-asserted-by":"publisher","first-page":"1790","DOI":"10.1002\/art.34329","volume":"64","author":"K Maeshima","year":"2012","unstructured":"Maeshima K et al (2012) The JAK inhibitor tofacitinib regulates synovitis through inhibition of interferon-\u03b3 and interleukin-17 production by human CD4+ T cells. Arthritis Rheum 64:1790\u20131798","journal-title":"Arthritis Rheum"},{"key":"6836_CR6","doi-asserted-by":"publisher","first-page":"301","DOI":"10.1038\/s41584-022-00767-7","volume":"18","author":"KL Winthrop","year":"2022","unstructured":"Winthrop KL, Cohen SB (2022) Oral surveillance and JAK inhibitor safety: the theory of relativity. Nat Rev Rheumatol 18:301\u2013304","journal-title":"Nat Rev Rheumatol"},{"key":"6836_CR7","doi-asserted-by":"publisher","first-page":"316","DOI":"10.1056\/NEJMoa2109927","volume":"386","author":"SR Ytterberg","year":"2022","unstructured":"Ytterberg SR et al (2022) Cardiovascular and cancer risk with tofacitinib in rheumatoid arthritis. N Engl J Med 386:316\u2013326","journal-title":"N Engl J Med"},{"key":"6836_CR8","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1136\/ard-2022-223356","volume":"82","author":"JS Smolen","year":"2023","unstructured":"Smolen JS et al (2023) EULAR recommendations for the management of rheumatoid arthritis with synthetic and biological disease-modifying antirheumatic drugs: 2022 update. Ann Rheum Dis 82:3\u201318","journal-title":"Ann Rheum Dis"},{"key":"6836_CR9","doi-asserted-by":"publisher","first-page":"173","DOI":"10.1002\/acr2.11232","volume":"3","author":"JM Kremer","year":"2021","unstructured":"Kremer JM et al (2021) Postapproval comparative safety study of tofacitinib and biological disease-modifying antirheumatic drugs: 5-year results from a united states-based rheumatoid arthritis registry. ACR Open Rheumatol 3:173\u2013184","journal-title":"ACR Open Rheumatol"},{"key":"6836_CR10","doi-asserted-by":"publisher","first-page":"89","DOI":"10.1186\/s13075-019-1866-2","volume":"21","author":"J Wollenhaupt","year":"2019","unstructured":"Wollenhaupt J et al (2019) Safety and efficacy of tofacitinib for up to 9.5 years in the treatment of rheumatoid arthritis: final results of a global, open-label, long-term extension study. Arthritis Res Ther 21:89","journal-title":"Arthritis Res Ther"},{"key":"6836_CR11","doi-asserted-by":"publisher","first-page":"674","DOI":"10.1111\/jcpt.13142","volume":"45","author":"Y Ho Lee","year":"2020","unstructured":"Ho Lee Y, Gyu Song G (2020) Comparative efficacy and safety of tofacitinib, baricitinib, upadacitinib, filgotinib and peficitinib as monotherapy for active rheumatoid arthritis. J Clin Pharm Ther 45:674\u2013681","journal-title":"J Clin Pharm Ther"},{"key":"6836_CR12","doi-asserted-by":"publisher","first-page":"508","DOI":"10.1056\/NEJMoa1112072","volume":"367","author":"RF van Vollenhoven","year":"2012","unstructured":"van Vollenhoven RF et al (2012) Tofacitinib or adalimumab versus placebo in rheumatoid arthritis. N Engl J Med 367:508\u2013519","journal-title":"N Engl J Med"},{"key":"6836_CR13","doi-asserted-by":"publisher","first-page":"652","DOI":"10.1056\/NEJMoa1608345","volume":"376","author":"PC Taylor","year":"2017","unstructured":"Taylor PC et al (2017) Baricitinib versus Placebo or Adalimumab in Rheumatoid Arthritis. N Engl J Med 376:652\u2013662","journal-title":"N Engl J Med"},{"key":"6836_CR14","doi-asserted-by":"publisher","first-page":"263","DOI":"10.1093\/mr\/roab030","volume":"32","author":"Y Tanaka","year":"2022","unstructured":"Tanaka Y et al (2022) Efficacy and safety of filgotinib in combination with methotrexate in Japanese patients with active rheumatoid arthritis who have an inadequate response to methotrexate: Subpopulation analyses of 24-week data of a global phase 3 study (FINCH 1). Mod Rheumatol 32:263\u2013272","journal-title":"Mod Rheumatol"},{"issue":"Suppl 6","key":"6836_CR15","doi-asserted-by":"publisher","first-page":"vi5","DOI":"10.1093\/rheumatology\/kes279","volume":"51","author":"J Kay","year":"2012","unstructured":"Kay J, Upchurch KS (2012) ACR\/EULAR 2010 rheumatoid arthritis classification criteria. Rheumatol Oxf Engl 51(Suppl 6):vi5-9","journal-title":"Rheumatol Oxf Engl"},{"key":"6836_CR16","doi-asserted-by":"publisher","first-page":"134","DOI":"10.1186\/s12933-017-0617-4","volume":"16","author":"M de Jong","year":"2017","unstructured":"de Jong M, van der Worp HB, van der Graaf Y, Visseren FLJ, Westerink J (2017) Pioglitazone and the secondary prevention of cardiovascular disease. A meta-analysis of randomized-controlled trials. Cardiovasc Diabetol 16:134","journal-title":"Cardiovasc Diabetol"},{"key":"6836_CR17","doi-asserted-by":"publisher","first-page":"2814","DOI":"10.1002\/art.34543","volume":"64","author":"P Studenic","year":"2012","unstructured":"Studenic P, Radner H, Smolen JS, Aletaha D (2012) Discrepancies between patients and physicians in their perceptions of rheumatoid arthritis disease activity. Arthritis Rheum 64:2814\u20132823","journal-title":"Arthritis Rheum"},{"key":"6836_CR18","first-page":"103","volume":"46","author":"L Brites","year":"2021","unstructured":"Brites L et al (2021) Patient-Physician discordance in assessment of disease activity in Rheumatoid Arthritis patients. Acta Reumatol Port 46:103\u2013109","journal-title":"Acta Reumatol Port"},{"key":"6836_CR19","doi-asserted-by":"publisher","first-page":"82","DOI":"10.1186\/s41927-022-00314-7","volume":"6","author":"K Janke","year":"2022","unstructured":"Janke K et al (2022) A systematic comparison of different composite measures (DAS 28, CDAI, SDAI, and Boolean approach) for determining treatment effects on low disease activity and remission in rheumatoid arthritis. BMC Rheumatol 6:82","journal-title":"BMC Rheumatol"},{"key":"6836_CR20","doi-asserted-by":"publisher","first-page":"e001601","DOI":"10.1136\/rmdopen-2021-001601","volume":"7","author":"S Mori","year":"2021","unstructured":"Mori S, Urata Y, Yoshitama T, Ueki Y (2021) Tofacitinib versus tocilizumab in the treatment of biological-na\u00efve or previous biological-failure patients with methotrexate-refractory active rheumatoid arthritis. RMD Open 7:e001601","journal-title":"RMD Open"},{"key":"6836_CR21","doi-asserted-by":"publisher","first-page":"1895","DOI":"10.1002\/art.24567","volume":"60","author":"JM Kremer","year":"2009","unstructured":"Kremer JM et al (2009) The safety and efficacy of a JAK inhibitor in patients with active rheumatoid arthritis: Results of a double-blind, placebo-controlled phase IIa trial of three dosage levels of CP-690,550 versus placebo. Arthritis Rheum 60:1895\u20131905","journal-title":"Arthritis Rheum"},{"key":"6836_CR22","doi-asserted-by":"publisher","first-page":"451","DOI":"10.1016\/S0140-6736(12)61424-X","volume":"381","author":"GR Burmester","year":"2013","unstructured":"Burmester GR et al (2013) Tofacitinib (CP-690,550) in combination with methotrexate in patients with active rheumatoid arthritis with an inadequate response to tumour necrosis factor inhibitors: a randomised phase 3 trial. Lancet Lond Engl 381:451\u2013460","journal-title":"Lancet Lond Engl"},{"key":"6836_CR23","doi-asserted-by":"publisher","first-page":"837","DOI":"10.3899\/jrheum.130683","volume":"41","author":"J Wollenhaupt","year":"2014","unstructured":"Wollenhaupt J et al (2014) Safety and efficacy of tofacitinib, an oral janus kinase inhibitor, for the treatment of rheumatoid arthritis in open-label, longterm extension studies. J Rheumatol 41:837\u2013852","journal-title":"J Rheumatol"},{"key":"6836_CR24","doi-asserted-by":"publisher","first-page":"1548","DOI":"10.3390\/jcm8101548","volume":"8","author":"RB Mueller","year":"2019","unstructured":"Mueller RB et al (2019) Effectiveness, tolerability, and safety of tofacitinib in rheumatoid arthritis: A retrospective analysis of real-world data from the St. Gallen and Aarau Cohorts. J Clin Med 8:1548","journal-title":"J Clin Med"},{"key":"6836_CR25","doi-asserted-by":"publisher","unstructured":"Tasso M, Bertolini N, Mostacciuolo E, Passavanti S, Luppino JME, Del Puente A, Peluso R, Santelli F, Scarpa R, Costa L, Caso F (2022) Effectiveness and safety profile of tofacitinib and baricitinib in rheumatoid arthritis patients: results from a 24-month real-life prospective study in Southern-Italy. Reumatismo 74(3). https:\/\/doi.org\/10.4081\/reumatismo.2022.1511","DOI":"10.4081\/reumatismo.2022.1511"},{"key":"6836_CR26","doi-asserted-by":"publisher","first-page":"3952","DOI":"10.1093\/rheumatology\/keac068","volume":"61","author":"A Barbulescu","year":"2022","unstructured":"Barbulescu A et al (2022) Effectiveness of baricitinib and tofacitinib compared with bDMARDs in RA: results from a cohort study using nationwide Swedish register data. Rheumatol Oxf Engl 61:3952\u20133962","journal-title":"Rheumatol Oxf Engl"},{"key":"6836_CR27","first-page":"318","volume":"34","author":"JA Hodge","year":"2016","unstructured":"Hodge JA et al (2016) The mechanism of action of tofacitinib - an oral Janus kinase inhibitor for the treatment of rheumatoid arthritis. Clin Exp Rheumatol 34:318\u2013328","journal-title":"Clin Exp Rheumatol"},{"key":"6836_CR28","doi-asserted-by":"publisher","first-page":"1378","DOI":"10.55563\/clinexprheumatol\/do2uxu","volume":"39","author":"A Shouval","year":"2021","unstructured":"Shouval A et al (2021) Real-world effectiveness of tofacitinib in patients with rheumatoid arthritis: a prospective observational study. Clin Exp Rheumatol 39:1378\u20131384","journal-title":"Clin Exp Rheumatol"},{"key":"6836_CR29","doi-asserted-by":"publisher","first-page":"663","DOI":"10.2169\/internalmedicine.9341-17","volume":"57","author":"S Mori","year":"2018","unstructured":"Mori S, Yoshitama T, Ueki Y (2018) Tofacitinib therapy for rheumatoid arthritis: A direct comparison study between biologic-na\u00efve and experienced patients. Intern Med Tokyo Jpn 57:663\u2013670","journal-title":"Intern Med Tokyo Jpn"},{"key":"6836_CR30","doi-asserted-by":"publisher","first-page":"71","DOI":"10.1016\/j.semarthrit.2016.03.004","volume":"46","author":"C Charles-Schoeman","year":"2016","unstructured":"Charles-Schoeman C et al (2016) Effects of tofacitinib and other DMARDs on lipid profiles in rheumatoid arthritis: implications for the rheumatologist. Semin Arthritis Rheum 46:71\u201380","journal-title":"Semin Arthritis Rheum"},{"key":"6836_CR31","doi-asserted-by":"publisher","first-page":"857","DOI":"10.1002\/acr.20132","volume":"62","author":"JL Barton","year":"2010","unstructured":"Barton JL et al (2010) Patient-physician discordance in assessments of global disease severity in rheumatoid arthritis. Arthritis Care Res 62:857\u2013864","journal-title":"Arthritis Care Res"},{"key":"6836_CR32","doi-asserted-by":"publisher","first-page":"668","DOI":"10.55563\/clinexprheumatol\/e7ayu8","volume":"39","author":"N Crispino","year":"2021","unstructured":"Crispino N, Ciccia F (2021) JAK\/STAT pathway and nociceptive cytokine signalling in rheumatoid arthritis and psoriatic arthritis. Clin Exp Rheumatol 39:668\u2013675","journal-title":"Clin Exp Rheumatol"},{"key":"6836_CR33","doi-asserted-by":"publisher","first-page":"1311","DOI":"10.1080\/14712598.2022.2130243","volume":"22","author":"A Alciati","year":"2022","unstructured":"Alciati A et al (2022) Effect of biological DMARDs and JAK inhibitors in pain of chronic inflammatory arthritis. Expert Opin Biol Ther 22:1311\u20131322","journal-title":"Expert Opin Biol Ther"},{"key":"6836_CR34","doi-asserted-by":"publisher","first-page":"34","DOI":"10.1186\/s13075-016-0932-2","volume":"18","author":"H Yamanaka","year":"2016","unstructured":"Yamanaka H et al (2016) Tofacitinib, an oral Janus kinase inhibitor, as monotherapy or with background methotrexate, in Japanese patients with rheumatoid arthritis: an open-label, long-term extension study. Arthritis Res Ther 18:34","journal-title":"Arthritis Res Ther"},{"key":"6836_CR35","doi-asserted-by":"publisher","first-page":"491","DOI":"10.3109\/14397595.2015.1123211","volume":"26","author":"M Harigai","year":"2016","unstructured":"Harigai M et al (2016) Postmarketing surveillance of the safety and effectiveness of abatacept in Japanese patients with rheumatoid arthritis. Mod Rheumatol 26:491\u2013498","journal-title":"Mod Rheumatol"},{"key":"6836_CR36","doi-asserted-by":"publisher","first-page":"1253","DOI":"10.1136\/annrheumdis-2016-210457","volume":"76","author":"SB Cohen","year":"2017","unstructured":"Cohen SB et al (2017) Long-term safety of tofacitinib for the treatment of rheumatoid arthritis up to 8.5 years: integrated analysis of data from the global clinical trials. Ann Rheum Dis 76:1253\u20131262","journal-title":"Ann Rheum Dis"},{"key":"6836_CR37","doi-asserted-by":"publisher","first-page":"362","DOI":"10.1186\/s13075-015-0880-2","volume":"17","author":"V Strand","year":"2015","unstructured":"Strand V et al (2015) Systematic review and meta-analysis of serious infections with tofacitinib and biologic disease-modifying antirheumatic drug treatment in rheumatoid arthritis clinical trials. Arthritis Res Ther 17:362","journal-title":"Arthritis Res Ther"},{"key":"6836_CR38","doi-asserted-by":"publisher","first-page":"769","DOI":"10.1007\/s10067-019-04865-y","volume":"39","author":"J-L Wang","year":"2020","unstructured":"Wang J-L et al (2020) Risk of non-melanoma skin cancer for rheumatoid arthritis patients receiving TNF antagonist: a systematic review and meta-analysis. Clin Rheumatol 39:769\u2013778","journal-title":"Clin Rheumatol"}],"container-title":["Clinical Rheumatology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10067-023-06836-w.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s10067-023-06836-w\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10067-023-06836-w.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,2,1]],"date-time":"2024-02-01T11:13:03Z","timestamp":1706785983000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s10067-023-06836-w"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,12,23]]},"references-count":38,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2024,2]]}},"alternative-id":["6836"],"URL":"https:\/\/doi.org\/10.1007\/s10067-023-06836-w","relation":{},"ISSN":["0770-3198","1434-9949"],"issn-type":[{"value":"0770-3198","type":"print"},{"value":"1434-9949","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,12,23]]},"assertion":[{"value":"21 October 2023","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"21 November 2023","order":2,"name":"revised","label":"Revised","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"26 November 2023","order":3,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"23 December 2023","order":4,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"None.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Disclosures"}}]}}