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Article History

Received: 29 October 2025

Accepted: 24 February 2026

First Online: 27 March 2026

Acknowledgements

: We thank the individuals whose data were included in this analysis. We are especially grateful to the clinical and laboratory staff at University Hospital Ulm for their dedicated and thoughtful work that made this study possible.

: The data generated during the current study are not publicly available because of privacy and ethical restrictions.

: Open Access funding enabled and organized by Projekt DEAL. This work was in part supported by an ERC Consolidator grant (CrossPeriBrain, Project 101125605, to MH). The views and opinions expressed are however those of the author(s) only and do not necessarily reflect those of the European Union or the European Research Council Executive Agency. Neither the European Union nor the granting authority can be held responsible for them.

: Outside the current work, RW reports honoraria during the past 36 months for lectures/presentations/speaker’s bureaus from Daiichi Sankyo, Eli Lilly, Boehringer Ingelheim, Novo Nordisk, Sanofi-Aventis and Synlab; travel support from Eli Lilly, Novo Nordisk, Daiichi Sankyo and Sanofi-Aventis; and honoraria for advisory boards from Eli Lilly, Boehringer Ingelheim and Sanofi-Aventis. GU reports lecture fees from Boehringer Ingelheim and travel support from Ipsen, Lilly and Boehringer Ingelheim. Outside the current work, RSa reports presentations/speaker’s fees from Amgen. She has also served on advisory boards for Sobi, Recordati Rare Diseases and Novartis. MH reports lecture fees from Amryt/Chiesi, AstraZeneca, Bayer, Boehringer Ingelheim, Daiichi Sankyo, Lilly, Novartis, Novo Nordisk and Sanofi-Aventis. He has also served on advisory boards for Amryt/Chiesi and Boehringer Ingelheim. The authors declare that there are no other relationships or activities that might bias, or be perceived to bias, their work.

: RSp collected and analysed data and drafted the manuscript. GU and RSa collected data and contributed to discussion and revised the manuscript. JH contributed to the statistical analysis and the selection of patients who fulfilled the inclusion criteria from the initial dataset and revised the manuscript. AP and RW contributed to data interpretation/discussion and revised the manuscript. MH collected data and drafted the manuscript. He supervised this work and is the guarantor for this work. All authors approved the final version of the manuscript.