Publications by authors named "Schmalzing Marc"

Background: Clonal T cell populations are frequently detected in patients with rheumatic diseases. The relevance of this finding is often uncertain, as the clinical spectrum can range from being asymptomatic to T cell leukemia. Former studies suggested that certain anti-rheumatic drugs might influence the course of the clonal T cell populations.

View Article and Find Full Text PDF

Objective: In severe cases of systemic sclerosis (SSc), autologous hematopoietic stem cell transplantation (aHSCT) is superior compared to cyclophosphamide. But treatment related morbidity and mortality have to be considered. To date, data on major physical and psychological impacts of aHSCT are scarce.

View Article and Find Full Text PDF
Article Synopsis
  • The University Hospital of Würzburg established a specialized Centre for Giant-cell Arteritis (ZeRi) to enhance collaboration in diagnosing and treating GCA.
  • A study evaluated diagnostic methods in 101 patients suspected of having GCA from 2017 to 2022, focusing on their effectiveness, including temporal artery biopsy.
  • Results showed that clinical symptoms, ESR, and CRP tests were crucial for detecting GCA, with sonography and MRI providing high predictive values, suggesting that biopsies may not be needed as frequently.
View Article and Find Full Text PDF

Background: Safety recommendations for Janus kinase inhibitors (JAKi) issued by the European Medical Agency (EMA) in 2023 could potentially influence treatment patterns for rheumatoid arthritis (RA) drugs, but little is known about the impact of these recommendations in routine clinical care.

Methods: We retrospectively analyzed the German RHADAR rheumatology database for adult patients with RA and documentation of a new therapy with a JAKi, tumor necrosis factor inhibitor (TNFi), or interleukin-6 receptor inhibitor (IL-6Ri). Data were grouped into half-yearly intervals from quarter (Q)2/2020 to Q3/2023.

View Article and Find Full Text PDF

Background: Vaccinations represent an easily accessible, safe, and important method for preventing infections. Patients with primary immunodeficiencies (PID) are more susceptible to infections and should receive an extended spectrum of immunizations in many countries.

Methods: Between January 2019 and May 2020, vaccination certificates of 70 patients with PID from the regions of Würzburg and Hanover in Germany were evaluated.

View Article and Find Full Text PDF
Article Synopsis
  • Janus kinase inhibitors (JAKi) have recently been approved alongside tumor necrosis factor inhibitors (TNFi) and interleukin-17 inhibitors (IL-17i) as treatment options for axial spondyloarthritis (axSpA), yet their real-world drug survival is under-studied.
  • A retrospective analysis of 1,222 axSpA patients, focusing on treatment initiation timing from January 2015 to October 2023, reveals median drug survival rates of 31 months for TNFi, 25 months for IL-17i, and 18 months for JAKi.
  • Higher discontinuation rates were seen for JAKi and IL-17i compared to TNFi, with
View Article and Find Full Text PDF

Background: The complex nature of rheumatic diseases poses considerable challenges for clinicians when developing individualized treatment plans. Large language models (LLMs) such as ChatGPT could enable treatment decision support.

Objective: To compare treatment plans generated by ChatGPT-3.

View Article and Find Full Text PDF
Article Synopsis
  • Treatment options for psoriatic arthritis have expanded to include various biologic DMARDs and Janus kinase inhibitors, but real-world data on their persistence in patients is limited.
  • A study analyzed 1352 prescriptions and found that the 5-year survival rates were highest for IL-17 inhibitors (67.8%) and lowest for IL-12/23 inhibitors (46.0%), with JAKi showing a higher likelihood of discontinuation.
  • The findings suggest that patients in Germany may stick with TNFi and IL-17i longer than IL-12/23i or JAKi, potentially influenced by disease severity and other health conditions like osteoarthritis.
View Article and Find Full Text PDF

Background: Patients with axial spondyloarthritis (axSpA) benefit from regular home-based exercise (HbE). In spite of recommendations, a relevant proportion of German axSpA patients does not adhere to recommended HbE practices. To enhance HbE care, we developed the novel digital therapeutic (DTx) "Axia" compliant with the European medical device regulation (MDR).

View Article and Find Full Text PDF
Article Synopsis
  • The study aimed to create a standardized scoring system called the Magnetic Resonance Vasculitis Activity Score (MRVAS) to evaluate the extent of Giant Cell Arteritis (GCA) using MRI images of cranial vessels and the aorta.
  • A total of 80 patients were assessed with different levels of readers (experienced and inexperienced), who rated inflammation in the vessels, leading to a score ranging from 0 to 20.
  • Results showed excellent agreement among readers in scoring inflammation levels, indicating that the MRVAS effectively allows for a reliable assessment of GCA inflammation.
View Article and Find Full Text PDF

Inactivated vaccines, such as tick-borne-encephalitis-virus-(TBEV) vaccine, have been discussed as less immunogenic in elderly and in immunocompromised patients. In this controlled cross-sectional cohort study, the antibody and cellular responses after TBEV-vaccination were investigated in 36 rheumatoid arthritis (RA) patients and 112 healthy controls (HC) by evaluating IgG-anti-TBEV concentration, neutralization and relative avidity index (RAI). Cellular reactivity was assessed by IFNgamma-producing spot-forming-units (SFU) by ELISPOT assay and flow cytometry.

View Article and Find Full Text PDF

Objective: Giant Cell arteritis (GCA) is a large vessel vasculitis, typically involving the aorta and its branches with predilection for the scalp arteries. Intracranial involvement is still part of ongoing research. We assess inflammation of the intracranial arteries on 3D-black-blood magnetic resonance imaging (3D-CS-BB-MRI) in patients with GCA and age-matched controls.

View Article and Find Full Text PDF

Autologous hematopoietic stem cell transplantation (aHSCT) represents an effective treatment option in patients with severe forms of systemic sclerosis (SSc) by resetting the immune system. Nevertheless, secondary autoimmune disorders and progressive disease after aHSCT might necessitate renewed immunosuppressive treatments. This is particularly challenging when organ dysfunction, i.

View Article and Find Full Text PDF
Article Synopsis
  • This article investigates cancer occurrences in patients with rheumatoid arthritis (RA), psoriatic arthritis (PsA), ankylosing spondylitis (AS), and non-radiographic axial spondyloarthritis (nr-axSpA) who were treated with upadacitinib (UPA) compared to other treatments.
  • The study analyzed data from 11 phase 3 clinical trials, assessing adverse events related to treatment, specifically focusing on malignancies and distinguishing between nonmelanoma skin cancer and other cancers.
  • The findings indicate comparable rates of cancer (excluding nonmelanoma skin cancer) across different treatments, with a notable increase in nonmelanoma skin cancer rates
View Article and Find Full Text PDF

Introduction: COMPACT, a non-interventional study, evaluated the persistence, effectiveness, safety and patient-reported outcomes (PROs) in patients with rheumatoid arthritis (RA), axial-spondyloarthritis (axSpA) or psoriatic arthritis (PsA) treated with SDZ ETN (etanercept [ETN] biosimilar) in Europe and Canada.

Methods: Patients (aged ≥ 18 years) who have been treated with SDZ ETN were categorised on the basis of prior treatment status (groups A-D): patients in clinical remission or with low disease activity under treatment with reference ETN or biosimilar ETN and switched to SDZ ETN; patients who received non-ETN targeted therapies and switched to SDZ ETN; biologic-naïve patients who started SDZ ETN after conventional therapy failure; or disease-modifying anti-rheumatic drug (DMARD)-naïve patients with RA considered suitable for treatment initiation with a biologic and started on treatment with SDZ ETN. The primary endpoint was drug persistence, defined as time from study enrolment until discontinuation of SDZ ETN treatment.

View Article and Find Full Text PDF
Article Synopsis
  • A study was conducted on patients with autoinflammatory diseases who received anti-IL-1 therapy, analyzing clinical symptoms and genetic variants over a nine-year period from 2013 to 2022 in Germany, involving 152 patients with various conditions.
  • Results showed that inflammatory attacks commonly began before age 18 (over 61% of patients), with an average delay of 17.8 years before starting anti-IL-1 treatment; genetic analysis confirmed diagnoses in the majority of patients.
  • The presence of variants of unknown significance (VUS) was notably high in patients, associated with older age at disease onset, suggesting a milder phenotype, and Turkish-Armenian ancestry was linked to more severe disease activity in familial
View Article and Find Full Text PDF

Background:  Despite anti-inflammatory treatment, patients with giant cell arteritis (GCA) experience relapse. We aimed to determine respective relapse predictors focusing on [F]fluorodeoxyglucose ([F]FDG)-PET-based parameters.

Material And Methods:  21 therapy-naïve GCA patients received [F]FDG-PET/CT.

View Article and Find Full Text PDF

Background: Pulmonary involvement is the leading cause of death in systemic sclerosis (SSc) and may manifest as interstitial lung disease (ILD), pulmonary arterial hypertension (PAH), or in combination of both (ILD with pulmonary hypertension [ILD-PH]). The aim of this analysis was to determine prevalence, clinical characteristics, and survival of these different forms within the registry of the German Network for Systemic Sclerosis.

Research Question: Does SSc-associated ILD-PH or ILD without PH affect survival differently, and are there any risk factors that have an additional impact?

Study Design And Methods: Clinical data of 5,831 patients with SSc were collected in the German Network for Systemic Sclerosis registry.

View Article and Find Full Text PDF

Background: The importance of proinflammatory T-cells and their cytokine production in patients with autoimmune arthritis has been widely described. Due to their immunomodulatory properties, mesenchymal stem cells (MSCs) have come into focus as a potential therapeutic concept. The aim of this study was to investigate the influence of MSCs on the phenotype, cytokine profile, and functionality of naive and non-naive CD4 T-cells from healthy donors (HD) and patients with autoimmune arthritis under Th17-cytokine polarizing conditions in an explorative way using a transwell system prohibiting any cell-cell-contact.

View Article and Find Full Text PDF

We aimed to investigate (1) student-led clinics and (2) electronic patient-reported outcomes (ePROs) to accelerate diagnosis and treatment of patients with axial spondyloarthritis (axSpA). Patients with suspected axSpA completed an initial student-led clinic visit (T-1) prior to their planned actual rheumatologist visit (T0). Acceleration of patient appointment and NSAID therapy start, availability of diagnostic findings, and treatment response at T0 were evaluated.

View Article and Find Full Text PDF

Objectives: The spectrum of giant cell arteritis (GCA) and polymyalgia rheumatica (PMR) represents highly inflammatory rheumatic diseases. Patients mostly report severe physical impairment. Possible consequences for mental health have been scarcely studied.

View Article and Find Full Text PDF

Patients with axial spondyloarthritis (axSpA) suffer from one of the longest diagnostic delays among all rheumatic diseases. Telemedicine (TM) may reduce this diagnostic delay by providing easy access to care. Diagnostic rheumatology telehealth studies are scarce and largely limited to traditional synchronous approaches such as resource-intensive video and telephone consultations.

View Article and Find Full Text PDF