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Article History

Received: 24 June 2025

Accepted: 5 November 2025

First Online: 9 January 2026

Declarations

:

: The study has been approved by the ethical committee at the University of Kiel under the following ethical votes: A103/14, D474/12, and A161/08. The IBSEN and IBSEN-III study was approved by the South-Eastern Regional Committee for Medical and Health Research Ethics (Ref: 2010/1540 and 2015/946-3, respectively) and performed in accordance with the Declaration of Helsinki. As per the Declaration of Helsinki, written informed consent was obtained from participants in accordance with local research ethics committee approvals.

: Not applicable.

: MP, DM, BH, and HR acknowledge employment by, and equity ownership in, Adaptive Biotechnologies Corp. H.E. did an internship at Adaptive Biotechnologies from July 2023 to September 2023. JH has received consulting and/or advisory board fees from: AbbVie, Alfasigma, Aqilion, Bristol Myers Squibb, Celgene, Celltrion, Eli Lilly, Ferring, Galapagos, Gilead, Hospira, Index Pharma, Janssen, Johnson & Johnson, MEDA, Medivir, Medtronic, Merck, Merck Sharp & Dohme, Novartis, Pfizer, Prometheus Laboratories Inc., Sandoz, Shire, STADA, Takeda, Thermo Fisher Scientific, Tillotts Pharma, Vifor Pharma, UCB; and speaker’s fees from: AbbVie, Alfasigma, Bristol Myers Squibb, Celgene, Eli Lilly, Ferring, Galapagos, Gilead, Hospira, Janssen, Johnson & Johnson, Merck Sharp & Dohme, Novartis, Pfizer, Shire, Takeda, Thermo Fisher Scientific, Tillotts Pharma; and research grant support from Janssen, Merck Sharp & Dohme and Takeda. G.P. has served as a speaker and/or advisory board member for AbbVie. She has also received grant support from Ferring, Tillotts Pharma, and Takeda. V.A.K. received speaker honoraria from Thermo Fischer Scientific, is a consultant for Janssen-Cilag AS, and is on the advisory Board of Tillotts Pharma AG and Takeda AS. J.R.H. received a research grant from Biogen and speaker honoraria from Roche, Novartis, Amgen, and has been a consultant for Novartis and Orkla Health, all unrelated to the present work. M.L.H. received investigator-initiated research grants from Takeda, Pfizer, Tilllotts, Ferring, and Janssen. Speaker honoraria from Takeda, Tillotts, Ferring, AbbVie, Galapagos, and Meda. She is also on the advisory board of Takeda, Galapagos, MSD, Lilly, and AbbVie. All other co-authors declare no competing interests.