Search

Julie Bulsei, 1 Jeanne Pfister, 1 Sylvie Leroy, 2 Jeanne Marie Perotin, 3 Coralie Barbe, 4 Charles-Hugo Marquette, 2 Gaëtan Deslee, 3 Isabelle Durand-Zaleski 1 On behalf of the REVOLENS study group 1AP-HP URC Eco IdF, Unité de recherche clinique en économie de la santé d’Ile de France, Paris, France; 2Service de Pneumologie, CHU de Nice, FHU OncoAge, Université Côte d’Azur, Nice, France; 3Service de Pneumologie, INSERM U1250, Hôpital Universitaire, Reims, France; 4Unité d’Aide Méthodologique, Pôle Recherche et Santé Publique, Hôpital Universitaire de Reims, Reims, FranceCorrespondence: Julie BulseiUrc Eco Ile-de-France (AP-HP), Hôtel Dieu, 1, place du Parvis Notre-Dame, Paris 75004, FranceTel +33 1 40 27 57 52Email julie.bulsei@urc-eco.frIntroduction: The use of two quality-of-life questionnaires in a single clinical trial with an economic component can be challenging due to the associated workload in terms of data collection and an increased risk of missing data. The aim of our study was to determine whether the questionnaire chosen to measure health status, the St. George’s Respiratory Questionnaire (SGRQ), could be administered on its own without adding the EuroQol five dimensions questionnaire (EQ-5D) for economic evaluation in emphysema studies.Materials and Methods: Data were prospectively collected during the REVOLENS trial assessing endobronchial coil treatment in severe emphysema. To quantify the association between the two questionnaires, correlations between the EQ-5D and the SGRQ were first tested and the concordance was then studied in order to know whether the two questionnaires were interchangeable. Finally, the Starkie et al algorithm predicting EQ-5D utility values from the SGRQ was used on REVOLENS’s individual patient data. The Student’s t-test, correlation and concordance between EQ-5D individual value (from the REVOLENS study) and predicted value (from the Starkie et al algorithm) were studied to test this algorithm.Results: Results showed a strong correlation but no concordance between the EQ-5D and the SGRQ, demonstrating that the two questionnaires are not interchangeable. Moreover, the algorithm predicting EQ-5D utilities from the SGRQ did not provide utility values comparable to those observed in the REVOLENS study. Indeed, our study demonstrated a strong correlation between predicted and individual EQ-5D values but no concordance.Conclusion: The use of both the EQ-5D and the SGRQ in a clinical study with an economic component is justified. Based on our results, the SGRQ should not be used to obtain a utility score to calculate the incremental cost-effectiveness ratio and conclude on the efficiency of an intervention in emphysema patients.Keywords: quality-of-life, St. George’s Respiratory Questionnaire, EuroQol five dimensions questionnaire, correlation, concordance

Jeanne Marie Perotin,1 Sylvie Leroy,2 Charles Hugo Marquette,2 Hervé Mal,3 Hervé Dutau,4 Arnaud Bourdin,5 Jean Michel Vergnon,6 Christophe Pison,7 Coralie Barbe,8 Gaëtan Deslee1 On behalf of the REVOLENS Study Group 1Service de Pneumologie, INSERM U1250, Hôpital Universitaire, Reims, France; 2Service de Pneumologie, CHU de Nice, FHU OncoAge, Université Côte d’Azur, Nice, France; 3Service de Pneumologie, Hôpital Universitaire Bichat, Paris, France; 4Service d’Oncologie Thoracique, Maladies de la Plèvre, Pneumologie Interventionnelle, Hôpital Universitaire, Marseille, France; 5Département de Pneumologie et Addictologie, PhyMedExp, INSERM U1046, CNRS UMR, Hôpital Universitaire, Montpellier, France; 6Service de Pneumologie, Hôpital Universitaire, Saint Etienne, France; 7Clinique Universitaire de Pneumologie, Pôle Thorax et Vaisseaux, Inserm1055, Hôpital Universitaire Grenoble Alpes, Université Grenoble Alpes, Grenoble, France; 8Département de Méthodologie, Pôle Recherche-Innovations, Hôpital Universitaire, Reims, France Abstract: Endobronchial coil treatment (ECT) is a minimally invasive procedure developed for palliative care of patients with severe emphysema. ECT has demonstrated a decrease in hyperinflation, an improvement in quality of life, and an acceptable safety profile in randomized controlled trials (RCTs). Because alpha-1 antitrypsin deficiency (AATD) is a classical exclusion criterion in RCTs, there is no available data for ECT in AATD. In this post hoc analysis of the REVOLENS study (Réduction volumique endobronchique par spirales; ClinicalTrials.gov Identifier: NCT01822795), a multicenter 1:1 RCT which compared bilateral ECT with usual care in severe emphysema, we analyzed the efficacy and safety results at 1 year in six patients with AATD (five males, one female; mean age: 52±9 years) who underwent ECT. A significant decrease in hyperinflation (0.35 L decrease in residual volume [RV]) was observed in four out of six patients at 6 months and three out of six patients at 12 months, and an improvement in quality of life (improvement of 4 points in the St George’s Respiratory Questionnaire [SGRQ]) was observed in four out of six patients at both 6 and 12 months. Efficacy results at 6 and 12 months from the six AATD patients were compared with 84 non-AATD patients who underwent ECT, and no statistically significant differences were found for FEV1, RV, 6MWT score and SGRQ score. Respiratory-related serious adverse event was limited to pneumonia in one AATD patient at 1 year post-ECT. This post hoc study suggests that AATD patients may have similar efficacy and safety outcomes at 1 year as non-AATD patients. Because of the paucity of available data, appropriately powered studies are needed to determine the effects of ECT in AATD. Keywords: COPD, volume reduction, interventional, bronchoscopy

An electrochemical technique for monitoring ionic transport was developed to study the correlation between diffusion coefficient and porosity in dye coated porous TiO2 films. The presence of adsorbed sensitizer cis-(SCN-)2 bis(2,2'-bipyridyl-4,4'-dicarboxylate)ruthenium(II)in TiO2 colloidal films is found to reduce the original naked film porosity by up to 30%. Results also showed that the effective diffusion coefficient of triiodide does not greatly deviate with respect to the free-stream values.

Background: The prognosis of unresectable cutaneous squamous cell carcinomas is very poor. Objective: To evaluate the efficacy and safety of panitumumab alone or in association with radiotherapy in the treatment of unresectable cutaneous squamous cell carcinoma. Methods: This was a monocentre retrospective study of all consecutive patients having received at least two courses of panitumumab, alone or in association with radiotherapy, between 2016 and 2019. The primary endpoint was the rate of best overall response, evaluated according to the RECIST 1.1 criteria. The secondary endpoints were the response and disease control rates at 6 weeks and 6 months, progression‐free survival, overall survival and safety. Results: A total of 25 patients were included; their median age was 86 years, and 17 (86%) had a WHO performance status over 2. The best overall response rate was 52%, including four complete responses (16%) and nine partial responses (36%). All patients with complete response and five out of nine patients with partial response had received concurrent radiotherapy, in most cases in moderate to low doses (<40 Gray, 67%). The response rates at 6 weeks and 6 months were 12% and 28%, respectively. The control rates at 6 weeks and 6 months were 84% and 32%, respectively. Median progression‐free survival was 6.9 months, and median overall survival was 10.5 months. Grade 3 side‐effects, mostly dermatological, occurred in 16 patients (64%). Conclusion: These results suggest that panitumumab remains pertinent in the treatment of unresectable cutaneous squamous cell carcinoma, in particular in association with radiotherapy, despite recent advances with anti‐PD‐1 antibodies. It presents several advantages: it can be used in very elderly or feeble patients, it does not provoke anaphylactic or other irreversible or life‐threatening side‐effects, and our study observed some long‐term responses. Further prospective investigation of anti‐EGFR antibodies, in association with anti‐PD‐1 antibodies and/or chemotherapy, should be conducted. [ABSTRACT FROM AUTHOR]

Background: Palmoplantar pustulosis (PPP) and acrodermatitis continua of Hallopeau (ACH) are rare variants of psoriasis. Knowledge of the efficacy of biologics is scarce. Objectives: To evaluate the real‐life efficacy of tumour necrosis factor blockers and ustekinumab in PPP and in ACH. Methods: A multicentre retrospective descriptive study was conducted in 19 dermatology departments, including all patients with PPP or ACH seen from 2014 to 2016 who received one of the studied biologics. The data were collected by a standardized document. Factors associated with complete clearance (CC) were analysed by multivariate analysis, estimating odds ratios (ORs) and 95% confidence intervals (CIs). Results: Among 92 patients included, 50 received adalimumab, 44 ustekinumab, 36 etanercept and 31 infliximab. Improvement and CC were observed in 83.9% and 20.0% patients receiving infliximab, 75.0% and 38.6% ustekinumab, 57.1% and 20.0% etanercept and 60.4% and 29.2% adalimumab. We found no significant difference in CC rates or duration of treatment among the biological treatments (P = 0.18 and P = 0.10, respectively). On multivariate analysis, CC with etanercept was associated with the ACH form and not smoking [OR = 9.5 (95% CI 1.1–82.7), P = 0.04 and 0.1 (0.01–0.9), P = 0.04]; with ustekinumab, male sex and absence of obesity [6.0 (1.3–28.6), P = 0.02 and 4.7 (1.0–22.7), P = 0.05]; with adalimumab, the ACH form [11.9 (2.7–52.3), P = 0.001]; and with infliximab, obesity [5.6 (1.1–29.4), P = 0.04]. Conclusions: We found no difference in efficacy between TNF blockers and ustekinumab and among the three different TNF blockers in real life for PPP or ACH, which reveals the heterogeneity of clinical response to biologics in pustular psoriasis as compared with plaque psoriasis. [ABSTRACT FROM AUTHOR]