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Article History

Received: 18 December 2025

Accepted: 18 February 2026

First Online: 9 March 2026

Declarations

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: The authors declare no conflict of interest regarding this publication. Outside the submitted work, the authors received honoraria for lectures, consulting, travel grants or research grants. Thiemo M. Möllenkamp received travel honoraria from Merck Healthcare and Novartis. Konstantin F. Jendretzky received travel compensation and congress fee from Merck, Neuraxpharm, Argenx and Novartis. Julian R. Kretschmer received institutional research support from NEMOS e.V. Franz F. Konen received honoraria for lectures and travel compensation from Alexion, Argenx, Merck, Novartis, Siemens and Takeda, research support as fellow of the German Research Foundation and Hannover Medical School-funded Clinician Scientist Program and from Merck, Siemens and Erwin-Röver-Foundation. Martin W. Hümmert received research support from Myelitis e. V., German Federal Joint Committee/Innovation Fund, NEMOS e.V. and Argenx, speaker honoraria from selpers og, AMGEN/Horizon and Alexion, travel grants from Alexion and compensation for serving on advisory boards from Alexion, Roche, AMGEN and UCB. Hayrettin Tumani received institutional support for research projects from Ministry of Science and Arts State BW, BG, DMSG and Chemische Fabrik Karl Bucher GmbH, and he received honoraria for acting as a consultant/speaker and/or for attending events sponsored by Alexion, Bayer, Biogen, Bristol-Myers Squibb, Celgene, Diamed, Fresenius, Fujirebio, GlaxoSmithKline, Hexal, Horizon, Janssen-Cilag, Merck, Novartis, Ottobock, Roche, Sanofi-Genzyme, Siemens, Teva and Viatris. Hayrettin Tumani is a member of the following societies: AMSEL, DGG, DGLN, DGN, DMSG, EAN, GENERATE, GBS and NEMOS. Thomas Skripuletz reports research support from Alnylam, CSL Behring, Merck, Novartis and Siemens; honoraria for lectures, travel support and/or consultancy fees from Alexion, Alnylam, Amgen, argenx, Bayer, Biogen, Bristol Myers Squibb, Centogene, CSL Behring, Grifols, Hexal AG, Horizon, Janssen, Merck, Novartis, Pfizer, Purpose pharma, Roche, Sanofi, Siemens, SOBI, Teva and Viatris. Stefan Gingele reports research support from Alnylam Pharmaceuticals, CSL Behring, Else Kröner Fresenius Foundation, Deutsche Forschungsgemeinschaft and Hannover Biomedical Research School and consulting and/or speaker honoraria or compensation for travel or congress fees from Alexion, Alnylam Pharmaceuticals, AstraZeneca, CSL Behring, GSK, Pfizer, Merck and Takeda Pharmaceuticals all outside the submitted work. Gudrun M. Körner, Anna Christina Saparilla Pietschmann, Janna M. Siemer, Jarle von Hörsten, Philipp Schwenkenbecher, Franziska Bachhuber and Roland Jacobs report no conflict of interest.

: All research procedures were in concordance with the Helsinki Declaration of 1964 and its later amendments to ensure full compliance with ethical guidelines. The study was approved by the local Ethics Committee of Hannover Medical School (no. 8787_BO_K_2019), and the included patients gave written informed consent.