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1. History of pre-eclampsia does not appear to be a risk factor for vascular phenotype in women with systemic sclerosis

Author

Arsène Mekinian, Eric Hachulla, Alain Lescoat, Elisabeth Pasquier, Christian Agard, Sabine Berthier, Perrine Smets, Grégory Pugnet, Emmanuel Chatelus, Marie-Elise Truchetet, Viviane Queyrel, Nathalie Tieulie, Bénédicte Rouvière, Claire de Moreuil, Emilie Brenaut, Valérie Devauchelle-Pensec, Olivier Lidove, Jérémy Keraen, Benjamin Subran, Nicolas Belhomme, Elizabeth Diot, Mathieu Delplanque, Sandy Lucier, and Emmanuelle Courtois-Communier

Subjects
Medicine
Abstract

Background Vascular phenotype is associated with a poor prognosis in systemic sclerosis (SSc). The identification of its risk factors could facilitate its early detection.Objectives To explore risk factors for a vascular phenotype of SSc, among them a history of pre-eclampsia.Methods This observational multicentre case–control study enrolled adult women fulfilling European Alliance of Associations for Rheumatology 2013 diagnosis criteria for SSc and having a pregnancy history≥6 months before SSc diagnosis in 14 French hospital-based recruiting centres from July 2020 to July 2022. Cases had specific vascular complications of SSc defined as history of digital ischaemic ulcers, pulmonary arterial hypertension, specific cardiac involvement or renal crisis. Women with SSc were included during their annual follow-up visit and filled in a self-administered questionnaire about pregnancy. A case report form was completed by their physician, reporting data on medical history, physical examination, clinical investigations and current medication. The main outcome was the presence/absence of a personal history of pre-eclampsia before SSc diagnosis, according to the validated pre-eclampsia questionnaire.Results 378 women were included: 129 cases with a vascular phenotype and 249 matched controls. A history of pre-eclampsia was reported in 5 (3.9%) cases and 12 (4.8%) controls and was not associated with a vascular phenotype (OR=0.96, 95% CI 0.28 to 3.34, p=0.9). Besides, Rodnan skin score and disease duration≥5 years were risk factors for vascular phenotype.Conclusions In women with SSc and a pregnancy history≥6 months before SSc, a history of pre-eclampsia is not associated with a vascular phenotype.

Published
2024
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2. Assessment of the efficacy and safety of tocilizumab in patients over 80 years old with giant cell arteritis

Author

Hubert de Boysson, Maelle Le Besnerais, Félix Blaison, Aurélie Daumas, Pierre-André Jarrot, François Perrin, Nathalie Tieulié, Alexandre Maria, Pierre Duffau, Bruno Gombert, Maxime Samson, Olivier Espitia, Marc Lambert, Arsène Mékinian, Achille Aouba, and for the French Study Group for Large Vessel Vasculitis (GEFA)

Subjects
Giant cell arteritis, Tocilizumab, Elderly, Old patients, Efficacy, Safety, Diseases of the musculoskeletal system, RC925-935
Abstract

Abstract Objective To assess the efficacy and tolerance of tocilizumab (TCZ) in giant cell arteritis (GCA) patients over 80. Method GCA patients over 80 years old from the French Study Group for Large Vessel Vasculitis register who received TCZ were analyzed. Results Twenty-one GCA patients (median age 84 [81–90] years old, including nine over 85) received TCZ for the following nonexclusive reasons: glucocorticoid (GC)-sparing effect in 14, relapsing disease in 8, disease severity in 4, and/or failure of another immunosuppressant in 4. TCZ was introduced with GCs at diagnosis in 6 patients and at 8 [3–37] months after GC initiation in 15 others. After a median delay of 8 [2–21] months post-TCZ introduction, 14 (67%) patients were able to definitively stop GCs, including 6 who were GC-dependent before TCZ. At the last follow-up (median 20 [3–48] months), 11 (52%) patients had definitively stopped TCZ, and 2 additional patients had stopped but relapsed and resumed TCZ. Seven (33%) patients experienced 11 adverse events: hypercholesterolemia in 4 patients; infections, i.e., pyelonephritis, bronchitis, and fatal septic shock associated with mesenteric infarction following planned surgery (GCs were stopped for 1 year and TCZ infusions for 2 months), respectively, in 3 patients; moderate thrombocytopenia and moderate neutropenia in 2 patients; and a 5-fold increase in transaminase levels in another that improved after TCZ dose reduction. Conclusion TCZ remains a valuable GC-sparing option in the oldest GCA patients with an interesting risk-benefit ratio. Mild-to-moderate adverse events were observed in one-third of patients.

Published
2021
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3. Factors associated with COVID-19-related death in people with rheumatic diseases: results from the COVID-19 Global Rheumatology Alliance physician-reported registry

Author

Anja, Strangfeld, Martin, Schäfer, Milena, A Gianfrancesco, Saskia, Lawson-Tovey, Jean, W Liew, Lotta, Ljung, Elsa, F Mateus, Christophe, Richez, Maria, J Santos, Gabriela, Schmajuk, Carlo, A Scirè, Emily, Sirotich, Jeffrey, A Sparks, Paul, Sufka, Thierry, Thomas, Laura, Trupin, Zachary, S Wallace, Sarah, Al-Adely, Javier, Bachiller-Corral, Suleman, Bhana, Patrice, Cacoub, Loreto, Carmona, Ruth, Costello, Wendy, Costello, Laure, Gossec, Rebecca, Grainger, Eric, Hachulla, Rebecca, Hasseli, Jonathan, S Hausmann, Kimme, L Hyrich, Zara, Izadi, Lindsay, Jacobsohn, Patricia, Katz, Lianne, Kearsley-Fleet, Philip, C Robinson, Jinoos, Yazdany, Pedro, M Machado, COVID-19 Global Rheumatology Alliance, COVID-19 Global Rheumatology Alliance Consortium Collaborators: COVID-19 Global Rheumatology Alliance Consortium, Brahim, Dahou, Marcelo, Pinheiro, Francinne, M Ribeiro, Anne-Marie, Chassin-Trubert, Sebastián, Ibáñez, Lingli, Dong, Lui, Cajas, Hesham, Hamoud, Jérôme, Avouac, Véronique, Belin, Raphaël, Borie, Pascal, Chazerain, Xavier, Chevalier, Pascal, Claudepierre, Gaëlle, Clavel, Marie-Eve, Colette-Cedoz, Bernard, Combe, Elodie, Constant, Nathalie, Costedoat-Chalumeau, Marie, Desmurs, Valérie, Devauchelle-Pensec, Mathilde, Devaux, Robin, Dhote, Yannick, Dieudonné, Fanny, Domont, Pierre-Marie, Duret, Mikaël, Ebbo, Esther, Ebstein, Soumaya El Mahou, Bruno, Fautrel, Renaud, Felten, René-Marc, Flipo, Violaine, Foltz, Antoine, Froissart, Joris, Galland, Véronique, Gaud-Listrat, Sophie, Georgin-Lavialle, Aude, Giraud-Morelet, Jeanine, S Giraudet-Le Quitrec, Philippe, Goupille, Sophie, Govindaraju-Audouard, Franck, Grados, Séverine, Guillaume-Czitrom, Marion, Hermet, Ambre, Hittinger-Roux, Christophe, Hudry, Isabelle, Kone-Paut, Sylvain La Batide Alanore, Pierre, Lafforgue, Sophie, Lahalle, Isabelle, Lambrecht, Vincent, Langlois, Jean-Paul, Larbre, Emmanuel, Ledoult, Christophe, Leroux, Frédéric, Liote, Alexandre TJ Maria, Hubert, Marotte, Arsène, Mekinian, Isabelle, Melki, Laurent, Messer, Catherine, Michel, Gauthier, Morel, Jacques, Morel, Marie-Noelle, Paris-Havard, Edouard, Pertuiset, Thao, Pham, Myriam, Renard, Sabine, Revuz, Sébastien, Rivière, Clémentine, Rousselin, Christian, Roux, Diane, Rouzaud, Jérémie, Sellam, Raphaele, Seror, Amelie, Servettaz, Vincent, Sobanski, Christelle, Sordet, Lionnel, Spielmann, Nathalie, Tieulié, Alice, Tison, Sophie, Trijau, Alexandre, Virone, Ursula, Warzocha, Daniel, Wendling, Frederik, N Albach, Peer, Aries, Elvira, Decker, Urs, Hartmann, Joerg, Henes, Bimba, F Hoyer, Andreas, Krause, Klaus, Krüger, Hanns-Martin, Lorenz, Ulf, Müller-Ladner, Alexander, Pfeil, Anne, Regierer, Jutta, G Richter, Markus, Rihl, Tim, Schmeiser, Hendrik, Schulze-Koops, Christof, Specker, Reinhard, E Voll, Stephanie, Werner, Gabriela MG Melgar, Mahdi, Vojdanian, Andreoli, Laura, Elena, Bartoloni-Bocci, Maurizio, Benucci, Francesco, Campanaro, Marta, Caprioli, Davide, Carboni, Greta, Carrara, Edoardo, Cipolletta, Chiara, Crotti, Gloria, Dallagiacoma, Paola, Faggioli, Rosario, Foti, Franceschini, Franco, Fredi, Micaela, Giacomo, Guidelli, Florenzo, Iannone, Gianpiero, Landolfi, Caludia, Lomater, Ceciclia, Nalli, Simone, Parisi, Luca, Quartuccio, Bernd, Raffeiner, Rossella, Reggia, Marta, Riva, Nicoletta, Romeo, Cinzia, Rotondo, Ettore, Silvagni, Luigi, Sinigaglia, Ilaria, Tinazzi, Anna, Zanetti, Giovanni, Zanframundo, Fatemah, Abutiban, Deshiré, Alpízar-Rodríguez, Marina, R Gabayet, Fedra, Irazoque, Xochitl, Jimenez, Eduardo, Martín, Angel AC Ortiz, Tatiana, S Rodriguez-Reyna, Diana, C Rosete, Erick AZ Tehozol, David, Vega, Beatriz, Zaueta, Nasra, Al-Adhoubi, Babur, Salim, Enrique, Giraldo, Ariel, Salinas, Manuel, Ugarte-Gil, Diogo, Almeida, Miguel, Bernardes, Rita, C Machado, Maria, Rato, Samar, Al-Emadi, Richard, Conway, Rachael, Flood, Juan, J Alegre-Sancho, Montserrat, C Coro, Natalia de la Torre-Rubio, Jose, C Esteban, Maria del Martin, Jose, G Puerta, Johan, Back, Maryam, Dastmalchi, Brigitte, Dupré, Emma, Grenholm, Aase, Hensvold, Ann, Knight, Servet, Akar, Ozan, C Icacan, Laura, Chadwick, Kirsty, Devine, Sasha, Dunt, Lucia, Fusi, Caroline, M Jones, Elizabeth, Macphie, Elena, Nikiphorou, Diana, O'Kane, Sheila, O'Reilly, Samir, Patel, Rosaria, Salerno, Lucy, Thornton, Jenny, Tyler, Claire, Vandevelde, Elizabeth, Warner, Su-Ann, Yeoh, Sara, Baig, Hammad, Bajwa, Byung, Ban, Vernon, Berglund, Cassandra, Calabrese, Kristin, D'Silva, Angela, Dahle, Kathryn, Dao, Nicole, Daver, William, Davis, Walter, Dorman, Ezzati, Fatemeh, Theodore, Fields, Jody, Hargrove, Melissa, Harvey, Maren, Hilton, Tiffany, Hsu, Arundathi, Jayatilleke, David, Karp, Gilbert, Kepecs, Neil, Kramer, Concetta, Lamore, Nicholas, Lebedoff, Susan, Leonard, Sushama, Mody, Jennifer, Morgan, Emily, Pfeifer, Guillermo, Quiceno, Robert, Quinet, Elliot, Rosenstein, Eric, Ruderman, Evangeline, Scopelitis, Naomi, Serling-Boyd, Faizah, Siddique, Archibald, Skemp, Jeffrey, Sparks, Derrick, Todd, Karen, T Toribio, Rachel, Wallwork, Tameka, Webb-Detiege, Douglas, White, Jeffrey, Wilson, Melanie, Winter, Leanna, Wise, Anne, Wolff, Kristen, Young, Jerald, Zakem, Joann, Zell, and Kurt Zimmerman, Leibniz Forschungsinstitut für Molekulare Pharmakolgie = Leibniz Institute for Molecular Pharmacology [Berlin, Allemagne] (FMP), Leibniz Association, University of California, University of Manchester [Manchester], Boston University School of Medicine (BUSM), Boston University [Boston] (BU), Umeå University, EULAR standing committee of People with Arthritis/Rheumatism in Europe (PARE), CHU Bordeaux [Bordeaux], Club Rhumatismes et Inflammation, Faculdade de Medicina [Lisboa], Universidade de Lisboa (ULISBOA), Università degli Studi di Ferrara (UniFE), McMaster University [Hamilton, Ontario], Brigham & Women’s Hospital [Boston] (BWH), Harvard Medical School [Boston] (HMS), INSERM U1059, SAINBIOSE - Santé, Ingénierie, Biologie, Saint-Etienne (SAINBIOSE-ENSMSE), Université Jean Monnet [Saint-Étienne] (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre Ingénierie et Santé (CIS-ENSMSE), École des Mines de Saint-Étienne (Mines Saint-Étienne MSE), Institut Mines-Télécom [Paris] (IMT)-Institut Mines-Télécom [Paris] (IMT)-École des Mines de Saint-Étienne (Mines Saint-Étienne MSE), Institut Mines-Télécom [Paris] (IMT)-Institut Mines-Télécom [Paris] (IMT), Universidad de Alcalá - University of Alcalá (UAH), Service de rhumatologie [CHU Saint-Antoine], CHU Saint-Antoine [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP), Sorbonne Université (SU)-Institut National de la Santé et de la Recherche Médicale (INSERM), University of Otago [Dunedin, Nouvelle-Zélande], Université de Lille, Technische Hochschule Mittelhessen - University of Applied Sciences [Giessen] (THM), University of Queensland [Brisbane], University College of London [London] (UCL), Repositório da Universidade de Lisboa, University of California (UC), Universidade de Lisboa = University of Lisbon (ULISBOA), Università degli Studi di Ferrara = University of Ferrara (UniFE), Santé Ingénierie Biologie Saint-Etienne (SAINBIOSE), Centre Ingénierie et Santé (CIS-ENSMSE), Institut Mines-Télécom [Paris] (IMT)-Institut Mines-Télécom [Paris] (IMT)-Université Jean Monnet - Saint-Étienne (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), Strangfeld, A, Schafer, M, Gianfrancesco, M, Lawson-Tovey, S, Liew, J, Ljung, L, Mateus, E, Richez, C, Santos, M, Schmajuk, G, Scire, C, Sirotich, E, Sparks, J, Sufka, P, Thomas, T, Trupin, L, Wallace, Z, Al-Adely, S, Bachiller-Corral, J, Bhana, S, Cacoub, P, Carmona, L, Costello, R, Costello, W, Gossec, L, Grainger, R, Hachulla, E, Hasseli, R, Hausmann, J, Hyrich, K, Izadi, Z, Jacobsohn, L, Katz, P, Kearsley-Fleet, L, Robinson, P, Yazdany, J, Machado, P, and HAL-SU, Gestionnaire

Subjects
Male, 0301 basic medicine, Aging, antirheumatic agents, Epidemiology, Azathioprine, Comorbidity, Disease, Global Health, Cardiovascular, 0302 clinical medicine, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Odds Ratio, Immunology and Allergy, Registries, AcademicSubjects/MED00360, [SDV.MHEP.ME] Life Sciences [q-bio]/Human health and pathology/Emerging diseases, [SDV.MHEP.RSOA] Life Sciences [q-bio]/Human health and pathology/Rhumatology and musculoskeletal system, [SDV.MHEP.ME]Life Sciences [q-bio]/Human health and pathology/Emerging diseases, glucocorticoids, Middle Aged, health care, 3. Good health, [SDV.MHEP.RSOA]Life Sciences [q-bio]/Human health and pathology/Rhumatology and musculoskeletal system, Letter to the Editor (Other), 6.1 Pharmaceuticals, [SDV.MHEP.MI] Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Public Health and Health Services, Female, epidemiology, Rituximab, medicine.drug, medicine.medical_specialty, Clinical Sciences, Immunology, autoimmune disease, Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis, Autoimmune Disease, General Biochemistry, Genetics and Molecular Biology, Antibodies, Antineutrophil Cytoplasmic, 03 medical and health sciences, Rheumatology, Sulfasalazine, Rheumatic Diseases, Internal medicine, medicine, Humans, autoimmune diseases, outcome assessment, Aged, Rheumatology and Autoimmunity, 030203 arthritis & rheumatology, Reumatologi och inflammation, SARS-CoV-2, business.industry, Arthritis, Evaluation of treatments and therapeutic interventions, COVID-19, Odds ratio, medicine.disease, Arthritis & Rheumatology, Good Health and Well Being, 030104 developmental biology, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, COVID-19 Global Rheumatology Alliance, antirheumatic agent, glucocorticoid, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, business
Abstract

© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ., Objectives: To determine factors associated with COVID-19-related death in people with rheumatic diseases. Methods: Physician-reported registry of adults with rheumatic disease and confirmed or presumptive COVID-19 (from 24 March to 1 July 2020). The primary outcome was COVID-19-related death. Age, sex, smoking status, comorbidities, rheumatic disease diagnosis, disease activity and medications were included as covariates in multivariable logistic regression models. Analyses were further stratified according to rheumatic disease category. Results: Of 3729 patients (mean age 57 years, 68% female), 390 (10.5%) died. Independent factors associated with COVID-19-related death were age (66-75 years: OR 3.00, 95% CI 2.13 to 4.22; >75 years: 6.18, 4.47 to 8.53; both vs ≤65 years), male sex (1.46, 1.11 to 1.91), hypertension combined with cardiovascular disease (1.89, 1.31 to 2.73), chronic lung disease (1.68, 1.26 to 2.25) and prednisolone-equivalent dosage >10 mg/day (1.69, 1.18 to 2.41; vs no glucocorticoid intake). Moderate/high disease activity (vs remission/low disease activity) was associated with higher odds of death (1.87, 1.27 to 2.77). Rituximab (4.04, 2.32 to 7.03), sulfasalazine (3.60, 1.66 to 7.78), immunosuppressants (azathioprine, cyclophosphamide, ciclosporin, mycophenolate or tacrolimus: 2.22, 1.43 to 3.46) and not receiving any disease-modifying anti-rheumatic drug (DMARD) (2.11, 1.48 to 3.01) were associated with higher odds of death, compared with methotrexate monotherapy. Other synthetic/biological DMARDs were not associated with COVID-19-related death. Conclusion: Among people with rheumatic disease, COVID-19-related death was associated with known general factors (older age, male sex and specific comorbidities) and disease-specific factors (disease activity and specific medications). The association with moderate/high disease activity highlights the importance of adequate disease control with DMARDs, preferably without increasing glucocorticoid dosages. Caution may be required with rituximab, sulfasalazine and some immunosuppressants.

Published
2021

4. Corticosteroids in patients hospitalized for COVID-19 pneumonia who require oxygen: observational comparative study using routine care data

Author

Viet-Thi Tran, Matthieu Mahévas, Firouze Bani-Sadr, Olivier Robineau, Thomas Perpoint, Elodie Perrodeau, Laure Gallay, Philippe Ravaud, François Goehringer, François-Xavier Lescure, Sophie Ismaël, Cédric Laouénan, Jennifer Soulier, Oriane Puéchal, Eric D’Ortenzio, Yazdan Yazdanpanah, Laurence Maulin, Stéphanie Martinez, Diane Sanderink, Pascale Fialaire, Séverine Ansart, Lucas Perez, Anne - Laure Destrem, Chloé Moulin, Pascal Gicquel, Frédéric Rivière, Martin Martinot, Mahsa Mohseni Zadeh, Tomasz Chroboczek, Thibaut Challan Belval, Lionel Piroth, Thibault Sixt, Florian Moretto, André Cabié, Jérémie Pasquier, Ornella Cabras, Marine Morrier, Jean Reuter, Thomas Henin, Pierre Braquet, Helene Desmurs-Clavel, Arnaud Hot, Boris Bienvenu, Belkacem Asselate, Nicolas Vignier, Steve Nguala, Sylvain Diamantis, Guillemette Frémont, Pierre Louis Nivose, Mathilde Thiébaut, Benjamin Lefevre, Hélène Auge, Paul le Turnier, Naila Benkalfate, Olivier Grossi, Samuel Pineau, Elisa Demonchy, Julie Merindol, Claire Durand, Nathalie Tieulié, Viviane Queyrel, Didier Laureillard, Paul Loubet, Ségolène Greffe, Nathalie Dournon, Youssouf Mohamed Kassim, Cyrille Gourjault, Alexandre Lahens, Paul Legendre, Caroline Morbieu, Matthieu Mahevas, Giovanna Melica, Jean-Daniel Levièvre, Frédéric Schlemmer, Simone Tunesi, Claire Leblanc, Anne Bourgarit-Durand, Alexandre Bleibtreu, Gianpiero Tebano, Jérôme Pacanowski, Jean-Benoit Zabbe, Mathilde Devaux, Laurent Bellec, Marine Gosset-Woimant, Céleste Lambert, Maxime Hentzien, Amélie Servettaz, Kevin Alexandre, Manuel Etienne, Romain Leguillon, Marion Dollat, Rémi Lefrancois, Anne Pouvaret, Yvon Ruch, Yannick Dieudonné, Guillaume Martin-Blondel, Xavier Boumaza, Margaux Lafaurie, Macha Tetart, Adrien Lemaignen, Nicole Ferreira-Maldent, Amélie Duréault, Marie Gousseff, Claire Chantepie, Francesca Bisio, Fanny Pommeret, Emeline Colomba Blamble, and Claire Ara Somohano

Subjects
0301 basic medicine, Adult, Male, Microbiology (medical), medicine.medical_specialty, Adolescent, medicine.medical_treatment, Therapeutic evaluation, 030106 microbiology, Population, Severity of Illness Index, 03 medical and health sciences, Young Adult, 0302 clinical medicine, Prednisone, Adrenal Cortex Hormones, Internal medicine, Observational study, Severity of illness, Medicine, Intubation, Corticosteroids, Humans, 030212 general & internal medicine, education, Aged, Mechanical ventilation, Aged, 80 and over, education.field_of_study, business.industry, Mortality rate, Hazard ratio, Oxygen Inhalation Therapy, COVID-19, General Medicine, Middle Aged, medicine.disease, Respiration, Artificial, COVID-19 Drug Treatment, Pneumonia, C-Reactive Protein, Infectious Diseases, Original Article, Female, business, medicine.drug
Abstract

OBJECTIVE: To assess the effectiveness of corticosteroids on outcomes of patients with COVID-19 pneumonia requiring oxygen without mechanical ventilation. METHODS: We used routine care data from 51 hospitals in France and Luxembourg to assess the effectiveness of corticosteroids at 0.8 mg/kg/day eq. prednisone (CTC group) versus standard of care (no-CTC group) among adults 18 to 80 years old with confirmed COVID-19 pneumonia requiring oxygen without mechanical ventilation. The primary outcome was intubation or death by day 28. In our main analysis, characteristics of patients at baseline (i.e., time when patients met all inclusion criteria) were balanced by using propensity-score inverse probability of treatment weighting. RESULTS: Among the 891 patients included in the analysis, 203 were assigned to the CTC group. Use of corticosteroids was not significantly associated with risk of intubation or death by day 28 (weighted hazard ratio [wHR] 0.92, 95% CI 0.61 to 1.39) or cumulative death rate (wHR 1.03, 95% CI 0.54 to 1.98). However, use of corticosteroids was associated with reduced risk of intubation or death by day 28 in the prespecified subgroups of patients requiring oxygen ≥ 3 L/min (wHR 0.50, 95% CI 0.30 to 0.85) or C-reactive protein level ≥ 100 mg/L (wHR 0.44, 95%CI 0.23 to 0.85). Number of hyperglycaemia events was higher for patients with than without corticosteroids, but number of infections was similar. CONCLUSIONS: We found no association between the use of corticosteroids and intubation or death in the broad population of patients 18 to 80 years old with COVID-19 hospitalized in non-intensive care unit settings. However, the treatment was associated with reduced risk of intubation or death for patients with ≥ 3 L/min oxygen or C-reactive protein level ≥ 100 mg/L at baseline. Further research need to confirm the right timing of corticosteroids for patients with COVID-19 requiring oxygen only.

Published
2021
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5. Presentation and Real-World Management of Giant Cell Arteritis (Artemis Study)

Author

Alfred Mahr, Eric Hachulla, Hubert de Boysson, Nassim Guerroui, Emmanuel Héron, Stéphane Vinzio, Jonathan Broner, François-Xavier Lapébie, Martin Michaud, Laurent Sailler, Thierry Zenone, Mohamed Djerad, Mathieu Jouvray, Emilie Shipley, Nathalie Tieulie, Guillaume Armengol, Bastien Bouldoires, Jean-Francois Viallard, Isabelle Idier, Marc Paccalin, and Valérie Devauchelle-Pensec

Subjects
giant cell arteritis, phenotype [mesh], management - healthcare, observational, glucocorticoids (GCs), methotrexate, Medicine (General), R5-920
Abstract

Background: Few studies of daily practice for patients with giant cell arteritis (GCA) are available. This French study aimed to describe the characteristics and management of GCA in a real-life setting.Methods: Cross-sectional, non-interventional, multicenter study of patients ≥50 years old who consulted hospital-based specialists for GCA and were under treatment. Patient characteristics and journey, diagnostic methods and treatments were collected. Descriptive analyses were performed.Results: In total, 306 patients (67% females, mean age 74 ± 8 years old) were recruited by 69 physicians (internists: 85%, rheumatologists: 15%); 13% of patients had newly diagnosed GCA (diagnosis-to-visit interval

Published
2021
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6. Evaluating the cost-consequence of a standardized strategy for the etiological diagnosis of uveitis (ULISSE study).

Author

Audrey de Parisot, Yvan Jamilloux, Laurent Kodjikian, Marie-Hélène Errera, Neila Sedira, Emmanuel Heron, Laurent Pérard, Pierre-Loïc Cornut, Christelle Schneider, Sophie Rivière, Priscille Ollé, Grégory Pugnet, Pascal Cathébras, Pierre Manoli, Bahram Bodaghi, David Saadoun, Stéphanie Baillif, Nathalie Tieulie, Marc André, Frédéric Chiambaretta, Nicolas Bonin, Philip Bielefeld, Alain Bron, Frédéric Mouriaux, Boris Bienvenu, Nassira Amamra, Pascale Guerre, Evelyne Decullier, Pascal Sève, and ULISSE group

Subjects
Medicine, Science
Abstract

MAIN OBJECTIVE:To prospectively assess the cost-consequence of a standardized diagnostic strategy as to compared to an open one for the etiological diagnosis of uveitis. DESIGN:This was a prospective, non-inferiority, multicentre, randomized controlled trial. METHODS:We included all consecutive patients with uveitis who had visited at least one of the Departments of Ophthalmology. In the standardized group, patients had a minimal work-up regardless of the type of uveitis (including evaluation of the CBC, ESR, C-reactive protein, tuberculin skin test, syphilis serology and chest X-ray). Depending on ophthalmological findings, further investigations could be performed. In the open strategy, ophthalmologists were free to order any kind of investigation. The main outcome was the mean cost per patient of each strategy. RESULTS:903 uveitis patients were included from January, 2010 to May, 2013. The mean cost per patient of the standardized strategy was 182.97 euros [CI 95% (173.14; 192.80)], and the mean cost per patient of the open strategy was 251.75 euros [CI 95% (229.24; 274.25)]. Therefore, the mean cost per patient of the standardized strategy was significantly lower than the mean cost per patient of the open strategy (p

Published
2020
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