4D Clinic

Immune diseases have a variety of different clinical manifestations and as systemic diseases often affect several organ systems at the same time. A good two-thirds of all immune-mediated diseases can be assigned to the fields of rheumatology, dermatology or gastroenterology, with many immune diseases having symptoms from all three disciplines occurring simultaneously. A multidisciplinary, interdisciplinary and transdisciplinary approach is therefore essential for the optimal care of patients with immune diseases, as well as for optimal scientific research into specific disease-determining characteristics.

This is difficult to implement in clinical routine, as patient care is assigned to different specialist departments. In the concept of the 4D clinic, the required interdisciplinary and transdisciplinary approach is now to be implemented in a unique manner.

By building a transdisciplinary team that combines scientific and medical experts from various disciplines (rheumatology, dermatology and gastroenterology), interdisciplinary patient care is ensured and combined with scientific excellence. This enables integrated scientific approaches to better describe the indications, leading to an optimization of patient care, with permanent focus on the patient.


Core competencies:

  • Access to patient groups from the indication fields of immune diseases in rheumatology, dermatology, gastroenterology
  • Standardized clinical characterization of the patient population
  • Detection of the disease phenotype (clinical parameters, serological biomarkers, imaging)
  • Direct interface to the 4D (drugs, devices, data, diagnostics)
  • Research close to the patient population
  • Trans-sectional team for the supply and research of the examined fields of indication

The 4D Clinic offers the direct interface for the care of patients from the indication areas of immune diseases from the areas of rheumatology / immunology, dermatology and gastroenterology. Research projects with an analytical and clinical focus can be initiated and carried out through the combination of clinical care and translational research based on the 4D expertise of Fraunhofer, taking into account drugs, devices, data and diagnostics.


Clinical study project in cooperation with the Institute for General Practice to improve the early rheumatological work-up of patients with positive detection of antiCCP antibodies in the rapid test and newly emerged unspecific musculoskeletal complaints via the general practitioner.

Partner: Institute for General Practice, Goethe University Frankfurt

Early arthritis detection

Clinical research project as part of the Fraunhofer CIMD for the detection of biomarkers for the early diagnosis of psoriatic arthritis in the risk group. In addition to the clinical evaluation, imaging parameters and serological markers for early diagnosis are assessed.

Partners: Fraunhofer IAIS, IGD, IZI, ITEM, FIT

Additional information


Controlled, open, parallel group study (according to AMG) in the indication of active rheumatoid arthritis to demonstrate the superiority of therapy using a JAK inhibitor (compared to a TNF alpha-inhibiting therapy) in the proportion of patients who experience early pain reduction (as measured by the proportion of patients who can stop controlled celecoxib treatment at week 12 and who experience clinically relevant pain relief).

Löhr S, Ekici AB, Uebe S, Büttner C, Köhm M, Behrens F, Böhm B, Sticherling M, Schett G, Simon D, Mössner R, Nimeh A, Oji V, Assmann G, Rech J, Holmdahl R, Burkhardt H, Reis A, Hüffmeier U.
Analyses of association of psoriatic arthritis and psoriasis vulgaris with functional NCF1 variants.
Rheumatology (Oxford). 2019 Feb 7
doi: 10.1093/rheumatology/key448


Mojtahed Poor S, Ulshöfer T, Gabriel LA, Henke M, Köhm M, Behrens F, Geisslinger G, Parnham MJ, Burkhardt H, Schiffmann S.
Immunogenicity assay development and validation for biological therapy as exemplified by ustekinumab.
Clin Exp Immunol. 2019 Jan 17
doi: 10.1111/cei.13261


Dauth S, Köhm M, Rossmanith T, Herrmann E, Lehn A, Burkhardt H, Behrens F.
Value of combining biologics with methotrexate for treatment of psoriatic arthritis-questions remain.
Z Rheumatol. 2018 Nov;77(9):808-814

doi: 10.1007/s00393-018-0533-3


Behrens F, Koehm M, Schwaneck EC, Schmalzing M, Gnann H, Greger G, Tony HP, Burkhardt H.
Minimal disease activity is a stable measure of therapeutic response in psoriatic arthritis patients receiving treatment with adalimumab.
Rheumatology (Oxford). 2018 Nov 1;57(11):1938-1946
doi: 10.1093/rheumatology/key203


Behrens F, Koehm M, Arndt U, Wittig BM, Greger G, Thaçi D, Scharbatke E, Tony HP, Burkhardt H.
Does Concomitant Methotrexate with Adalimumab Influence Treatment Outcomes in Patients with Psoriatic Arthritis? Data from a Large Observational Study.
J Rheumatol. 2016 Mar;43(3):632-9
doi 10.3899/jrheum.141596