Publications by authors named "Sergio Schwartzman"

Article Synopsis
  • This safety analysis examines the occurrence of mucosal/cutaneous Candida infections in patients using ixekizumab (IXE) for treating psoriasis, psoriatic arthritis, and axial spondyloarthritis.
  • Data from 25 clinical studies indicated a low incidence rate of 1.2-2.0 per 100 patient-years, with most infections being mild, typically single occurrences, and largely resolved during the studies without requiring treatment discontinuation.
  • Overall, the findings suggest that the risk of Candida infections with IXE is low and usually mild-to-moderate in severity, with effective management strategies in place.
View Article and Find Full Text PDF
Article Synopsis
  • Systemic immunomodulatory agents are used to treat moderate-to-severe plaque psoriasis and psoriatic arthritis, but their use before surgery may raise the risk of infections and complications.
  • The study aimed to assess the risk of surgical site infections (SSI) in patients with autoimmune diseases who are on various immunomodulatory drugs and undergoing surgery.
  • Findings suggest that for low-risk surgeries, many immunomodulatory treatments, such as TNF-α inhibitors and methotrexate, can be safely continued, while for more complex surgeries, a careful evaluation is recommended before continuing their use.
View Article and Find Full Text PDF

Background: We report long-term, end-of-study program safety outcomes from 25 randomized clinical trials (RCTs) in adult patients with psoriasis (PsO), psoriatic arthritis (PsA), or axial spondyloarthritis (axSpA) [including ankylosing spondylitis (AS) and non-radiographic axial spondyloarthritis (nr-axSpA)] who received ≥ 1 dose of Ixekizumab (IXE) over 5 years (PsO) or up to 3 years (PsA, axSpA).

Methods: This integrated safety analysis consists of data from patients who received any dose of IXE, across 25 RCTs (17 PsO, 4 PsA, 4 axSpA). Rates of treatment-emergent adverse events (TEAEs), serious adverse events (SAEs) and selected adverse events (AEs) of interest were analyzed for all pooled studies by years of therapy and overall, through March 2022.

View Article and Find Full Text PDF
Article Synopsis
  • Psoriatic patients receiving vaccines need clear guidelines on whether to pause or maintain their systemic medications, especially for live and nonlive vaccines.
  • The National Psoriasis Foundation Medical Board and experts developed 22 consensus statements recommending that most patients can continue oral and biologic therapies for nonlive vaccines, but should consider stopping methotrexate.
  • For live vaccines, most therapies should be interrupted before and after vaccination, except for abatacept, and timing adjustments for vaccine administration are crucial.
View Article and Find Full Text PDF
Article Synopsis
  • * Using validated screening tools for related conditions, like psoriatic arthritis, can help improve access to specialists and reduce delays in diagnosis and treatment.
  • * While telehealth offers convenience and may enhance care, it should complement, not completely replace, traditional in-person dermatology or rheumatology visits.
View Article and Find Full Text PDF
Article Synopsis
  • The study reviews randomized controlled trials (RCTs) on advanced therapies for psoriatic arthritis (PsA), Crohn disease (CD), ulcerative colitis (UC), and noninfectious uveitis, updating previous findings from 2013.
  • A total of 32 RCTs were identified, with tumor necrosis factor inhibitors (TNFi) showing efficacy and safety across CD, UC, and uveitis, but caution is advised for IL-17 inhibitors in high-risk PsA patients.
  • The research emphasizes a multispecialty approach for managing these related conditions, highlighting the variability in efficacy and safety of advanced therapies.
View Article and Find Full Text PDF

Nonradiographic axial spondyloarthritis (nr-axSpA) represents a distinct phenotype within the spectrum of axial spondyloarthritis (axSpA), which is characterized by a range of clinical manifestations. Despite a high disease burden that is comparable to ankylosing spondylitis (also known as radiographic axSpA), there is an unmet need to recognize and effectively manage patients with active nr-axSpA.A targeted literature search was conducted in OVID (MEDLINE and Embase databases) to identify articles on nr-axSpA, including its definition, demographics, epidemiology, burden, diagnosis, clinical presentation, and treatment guidelines.

View Article and Find Full Text PDF

Introduction: Differences in psoriatic arthritis (PsA) treatment response between sexes for ixekizumab, an interleukin-17A antagonist, are largely unexplored. This analysis used data from randomized clinical trials (RCTs) evaluating ixekizumab to study differences in treatment response between male and female patients with PsA.

Methods: We used pooled data from patients enrolled in SPIRIT-P1 and SPIRIT-P2 (NCT01695239 and NCT02349295, respectively), phase 3 RCTs evaluating ixekizumab every 4 and 2 weeks in patients with active PsA.

View Article and Find Full Text PDF

Background: Intravenous (IV) golimumab, a TNFi, is approved for treating rheumatoid arthritis (RA), psoriatic arthritis (PsA), and ankylosing spondylitis (AS). We analyzed pooled safety results from three phase 3 IV golimumab trials in these rheumatologic diseases and hypothesized that the safety profile of IV golimumab would be similar to that established for other TNFi, including subcutaneous golimumab.

Methods: Data from three double-blind, randomized trials of IV golimumab in patients with RA, PsA, and AS, each with a placebo-controlled period and an extension of active treatment, were included.

View Article and Find Full Text PDF

Sacroiliac (SI) joint subchondral resorption on high-resolution magnetic resonance imaging (MRI) may be an early sign of the development of sacroiliitis. At our institution, high-resolution intermediate-weighted (proton density) MRI sequences are used in the workup of suspected spondyloarthritis (SpA). : We sought to test the hypothesis that SI joint subchondral resorption might be a useful MRI feature in the diagnosis of sacroiliitis.

View Article and Find Full Text PDF

To critically appraise study designs evaluating spondyloarthritis (SpA) phenotypes in patients with inflammatory bowel disease (IBD). A systematic literature review of PubMed, Ovid, Scopus, Cinahl, Medline, Web of Science, and Cochrane databases was performed. Articles published from January 2000 - March 2020 were included if they evaluated the prevalence/incidence of musculoskeletal disease in cohorts of IBD patients.

View Article and Find Full Text PDF

Objective: Frailty is associated with disability and mortality independent of age. Although studies have evaluated frailty in rheumatoid arthritis (RA), information on the prevalence of frailty in ankylosing spondylitis (AS) and psoriatic arthritis (PsA) is limited. We aimed to determine the prevalence of frailty in AS and PsA and to evaluate whether characteristics known to be associated with frailty, including anxiety, differ among these three types of inflammatory arthritis.

View Article and Find Full Text PDF

Axial spondyloarthritis (axSpA) is a chronic, immune-mediated inflammatory disease characterized by inflammatory low back pain, inflammation in peripheral joints and entheses, and other extra-articular or systemic manifestations. Although our understanding of the natural history of axSpA has been limited by incomplete knowledge of disease pathogenesis, axSpA is increasingly understood as a spectrum of axial, peripheral, and extra-articular inflammatory conditions that includes nonradiographic axSpA and radiographic axSpA, also known as ankylosing spondylitis. In this narrative review, we present a road map of this axSpA continuum, highlighting genetic risk factors for the development of axSpA, triggers of disease, and reasons for and implications of diagnostic delay.

View Article and Find Full Text PDF

Objective: Evaluate tolerability and effectiveness of golimumab-IV versus infliximab in patients with rheumatoid arthritis (RA) in a real-world setting.

Methods: AWARE, a prospective, real-world, pragmatic, observational, multicenter, phase 4 study, enrolled RA patients when initiating golimumab-IV or infliximab. Treatment decisions were made by the treating rheumatologist.

View Article and Find Full Text PDF

Objective: Prevalence of sacroiliitis in Crohn's disease (CD) is variable depending on defining criteria. This study utilized standardized sacroiliac joint (SIJ) magnetic resonance imaging (MRI) to identify sacroiliitis in CD patients and its association with clinical and serological markers.

Methods: Consecutive adult subjects with CD prospectively enrolled from an inflammatory bowel disease clinic underwent SIJ MRI.

View Article and Find Full Text PDF

Objective: To update guidance regarding the management of psoriatic disease during the COVID-19 pandemic.

Study Design: The task force (TF) includes 18 physician voting members with expertise in dermatology, rheumatology, epidemiology, infectious diseases, and critical care. The TF was supplemented by nonvoting members, which included fellows and National Psoriasis Foundation staff.

View Article and Find Full Text PDF

Objective: To provide guidance about management of psoriatic disease during the coronavirus disease 2019 (COVID-19) pandemic.

Study Design: A task force (TF) of 18 physician voting members with expertise in dermatology, rheumatology, epidemiology, infectious diseases, and critical care was convened. The TF was supplemented by nonvoting members, which included fellows and National Psoriasis Foundation (NPF) staff.

View Article and Find Full Text PDF

Objectives: The aim of this integrated analysis is to evaluate the long-term safety and tolerability of ixekizumab in adults with psoriasis, PsA and axial SpA.

Methods: Integrated safety data from 21 clinical trials are presented by indication in patients who received at least one dose of ixekizumab. Adverse events (AEs) and treatment-emergent adverse events (TEAEs) adjusted incidence rates (IRs) per 100 patient-years (PY) up to 5 years' exposure are reported.

View Article and Find Full Text PDF

Objective: The development of biomarkers to guide treatment decisions is a major research focus in rheumatoid arthritis (RA). Patients with RA have elevated interleukin-6 (IL-6) levels; however, the utility of IL-6 as a predictor of treatment response is unclear. This study was undertaken to investigate, by post hoc analysis, whether baseline IL-6 levels are predictive of sarilumab treatment responses in 2 phase III studies.

View Article and Find Full Text PDF

Hydroxychloroquine and quinacrine are frequently used to treat rheumatic diseases. Ocular toxicity, although infrequent, is one of the potential side effects of antimalarial therapies. Current recommendations are unifocal in being developed by only ophthalmologists who do not treat patients for their rheumatic diseases.

View Article and Find Full Text PDF

Psoriasis is a chronic skin condition that is associated with several comorbidities and co-manifestations that reduce patient quality of life. Psoriatic arthritis (PsA) is a form of spondyloarthritis that is associated with psoriasis and typically involves peripheral disease, axial disease, enthesitis, dactylitis, and skin and nail lesions. Psoriatic arthritis is associated with a substantial psychosocial and functional burden and can lead to irreversible joint damage if left untreated.

View Article and Find Full Text PDF