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4 results on '"Philippe Sultanik"'

1. A history of variceal bleeding is associated with further bleeding under atezolizumab–bevacizumab in patients with <scp>HCC</scp>

Author

Edouard Larrey, Bertille Campion, Manon Evain, Philippe Sultanik, Lorraine Blaise, Héloïse Giudicelli, Mathilde Wagner, Philippe Cluzel, Marika Rudler, Nathalie Ganne‐Carrié, Dominique Thabut, and Manon Allaire

Subjects
Male, Bevacizumab, Liver Cirrhosis, Carcinoma, Hepatocellular, Hepatology, Liver Neoplasms, Humans, Prospective Studies, Sorafenib, Esophageal and Gastric Varices, Gastrointestinal Hemorrhage, Retrospective Studies
Abstract

Atezolizumab-bevacizumab is the new standard for advanced hepatocellular carcinoma (HCC) but its impact on portal hypertension (PHT) is unknown. We aimed to identify predictive factors of acute variceal bleeding (AVB) and to monitor PHT parameters under treatment.We conducted a prospective study including all cirrhotic patients treated with atezolizumab-bevacizumab since 2020. We performed monitoring of PHT using upper endoscopy at inclusion and at 6 months and hepatic venous pressure gradient (HVPG) at inclusion, 3 and 6 months after the beginning of treatment. We also included a retrospective series of patients treated with sorafenib. Time-to-events data were estimated by Kaplan-Meier with the log-rank test, along with Cox models.Forty-three patients treated with atezolizumab-bevacizumab were included (male 79.1%, Child-Pugh A 86%). At baseline, 48.8% were treated with curative anticoagulation, 16.3% already experienced AVB and 25.6% had large oesophageal varices (EV). Sorafenib group characteristics were similar. Vascular invasion was present in 60.5% and median was HVPG 8.5 mm Hg. No significant modification in HVPG and EV size was observed at 6 months in the whole cohort but also when considering vascular invasion and radiological response. 14% presented AVB within a median time of occurrence of 3 months, without bleeding-related death. In multivariate analysis, history of AVB (HR = 10.58, p = .03) was associated with AVB. AVB incidence was higher in atezolizumab-bevacizumab compared to sorafenib group (21% vs. 5% at 1 year, p = .02).Atezolizumab-bevacizumab treatment was associated with a higher risk of AVB compared to sorafenib. A history of AVB was associated with AVB during follow-up, which questions the use of bevacizumab in this setting.

Published
2022
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2. Optimal management of ascites

Author

Maxime Mallet, Dominique Thabut, Philippe Sultanik, Charlotte Bouzbib, Marika Rudler, CHU Pitié-Salpêtrière [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Sorbonne Université - Faculté de Médecine (SU FM), and Sorbonne Université (SU)

Subjects
Liver Cirrhosis, medicine.medical_specialty, Cirrhosis, [SDV]Life Sciences [q-bio], medicine.medical_treatment, Liver transplantation, ascites, 03 medical and health sciences, Liver disease, 0302 clinical medicine, Quality of life, Ascites, medicine, Paracentesis, Humans, Diuretics, Intensive care medicine, Hepatology, medicine.diagnostic_test, business.industry, cirrhosis, portal hypertension, medicine.disease, Liver Transplantation, 3. Good health, 030220 oncology & carcinogenesis, Quality of Life, Portal hypertension, 030211 gastroenterology & hepatology, medicine.symptom, Complication, business
Abstract

International audience; Ascites is the most common complication of cirrhosis, which develops in 5%-10% of patients per year. Its management is based on symptomatic measures including restriction of sodium intake, diuretics and paracentesis. Underlying liver disease must always be treated and may improve ascites. In some patients, ascites is not controlled by medical therapies and has a major impact on quality of life and survival. TIPS placement and liver transplantation must therefore be discussed. More recently, repeated albumin infusions and Alfapump® have emerged as new therapies in ascites. In this review, the current data on these different options are analysed and an algorithm to help the physician make clinical decisions is suggested.

Published
2020
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3. Plasma apolipoprotein H limits HCV replication and associates with response to NS3 protease inhibitors-based therapy

Author

Matthew L. Albert, Yoann Barthe, Armanda Casrouge, Arnaud Fontanet, Stanislas Pol, Sylvie Lagaye, Hélène Fontaine, Vincent Mallet, Philippe Sultanik, Christophe Hézode, Estelle Mottez, Laurent Abel, Etienne Gayat, Céline Dorival, Fabrice Carrat, Jean-Pierre Bronowicki, Ioannis Theodorou, Institut Cochin (IC UM3 (UMR 8104 / U1016)), Centre National de la Recherche Scientifique (CNRS)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM), Département d'hépatologie, Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Immunobiologie des Cellules Dendritiques, Institut Pasteur [Paris]-Institut National de la Santé et de la Recherche Médicale (INSERM), Epidémiologie, systèmes d'information, modélisation, Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM), Departement d'Hépatho-Gastro-Enterologie [Mondor], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Centre Hospitalier Universitaire Henri Mondor, Centre d'Immunologie Humaine (CIH), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Nutrition-Génétique et Exposition aux Risques Environnementaux (NGERE), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL), Service de santé publique [CHU Saint-Antoine], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Saint-Antoine [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Sorbonne Université (SU), Immunité et Infection, Université Pierre et Marie Curie - Paris 6 (UPMC)-IFR113-Institut National de la Santé et de la Recherche Médicale (INSERM), Imagine - Institut des maladies génétiques (IMAGINE - U1163), Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM), Laboratory of Human Genetics of Infectious Diseases, Rockefeller University [New York]-Rockefeller Branch, Biomarqueurs CArdioNeuroVASCulaires (BioCANVAS), Université Paris 13 (UP13)-Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM), Department of anesthesiology and critical care medicine, Hôpitaux Universitaire Saint-Louis, Lariboisière, Fernand-Widal, Département Infection et Epidémiologie - Department of Infection and Epidemiology, Institut Pasteur [Paris], The CUPIC Cohort study was sponsored and funded by The National Agency for research on Aids and Viral Hepatitis (ANRS), with support by the French Association for the Study of the Liver(AFEF). The authors also wish to acknowledge the Center for Human Immunology for its support of the research project., Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Institut Pasteur [Paris] (IP)-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Saint-Antoine [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Institut Pasteur [Paris] (IP), CHU Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Centre Hospitalier Universitaire Henri Mondor, Université de Lorraine (UL)-Institut National de la Santé et de la Recherche Médicale (INSERM), Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-CHU Saint-Antoine [APHP], Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR113-Université Pierre et Marie Curie - Paris 6 (UPMC), Rockefeller Branch-rockefeller university, Institut Cochin ( UM3 (UMR 8104 / U1016) ), Université Paris Descartes - Paris 5 ( UPD5 ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Centre National de la Recherche Scientifique ( CNRS ), Institut Pasteur [Paris]-Institut National de la Santé et de la Recherche Médicale ( INSERM ), Université Pierre et Marie Curie - Paris 6 ( UPMC ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Assistance publique - Hôpitaux de Paris (AP-HP)-Centre Hospitalier Universitaire Henri Mondor, Centre d'Immunologie Humaine ( CIH ), Centre Hospitalier Régional Universitaire de Nancy ( CHRU Nancy ), Assistance publique - Hôpitaux de Paris (AP-HP)-CHU Saint-Antoine [APHP], Institut National de la Santé et de la Recherche Médicale ( INSERM ) -IFR113-Université Pierre et Marie Curie - Paris 6 ( UPMC ), Imagine - Institut des maladies génétiques ( IMAGINE - U1163 ), Centre National de la Recherche Scientifique ( CNRS ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Université Paris Descartes - Paris 5 ( UPD5 ), Biomarqueurs CArdioNeuroVASCulaires ( BioCANVAS ), Université Paris Diderot - Paris 7 ( UPD7 ) -Université Paris 13 ( UP13 ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), and Département Infection et Epidémiologie

Subjects
Male, MESH : Aged, MESH : Prospective Studies, MESH : Viral Load, MESH : Hepatitis C, Chronic/blood, Hepacivirus, MESH : Virus Replication/drug effects, Polyethylene Glycols, MESH: Molecular Targeted Therapy, [ SDV.IMM ] Life Sciences [q-bio]/Immunology, Molecular Targeted Therapy, Prospective Studies, MESH: Ribavirin/therapeutic use, MESH : Proline/analogs & derivatives, MESH: Treatment Outcome, MESH : Hepacivirus/drug effects, MESH: Viral Nonstructural Proteins/metabolism, MESH: Middle Aged, MESH: RNA, Viral/blood, virus diseases, MESH : beta 2-Glycoprotein I/blood, Blood proteins, 3. Good health, beta 2-Glycoprotein I, Area Under Curve, MESH: Hepacivirus/genetics, Drug Therapy, Combination, Oligopeptides, Apolipoprotein H, MESH : Biomarkers/blood, MESH: Hepatitis C, Chronic/drug therapy, Proline, MESH: Hepatitis C, Chronic/blood, virological response, MESH: Proline/analogs & derivatives, MESH : Antiviral Agents/therapeutic use, Antiviral Agents, MESH : Proline/therapeutic use, Boceprevir, MESH : Recombinant Proteins/therapeutic use, Humans, chronic hepatitis C, MESH : Middle Aged, Protease Inhibitors, MESH: Interferon-alpha/therapeutic use, MESH : Predictive Value of Tests, Aged, MESH: Polyethylene Glycols/therapeutic use, MESH : Hepacivirus/genetics, MESH: Humans, Surrogate endpoint, MESH : Humans, MESH: beta 2-Glycoprotein I/blood, MESH: ROC Curve, digestive system diseases, chemistry, MESH: Protease Inhibitors/therapeutic use, Immunology, MESH: Female, Biomarkers, Time Factors, MESH : Viral Nonstructural Proteins/antagonists & inhibitors, MESH : Hepatitis C, Chronic/diagnosis, MESH : Protease Inhibitors/therapeutic use, Viral Nonstructural Proteins, Virus Replication, MESH : Polyethylene Glycols/therapeutic use, HCV protease inhibitor, Telaprevir, MESH: Virus Replication/drug effects, MESH: Proline/therapeutic use, chemistry.chemical_compound, apolipoprotein H, MESH: Hepacivirus/drug effects, MESH : RNA, Viral/blood, MESH : Female, MESH: Hepatitis C, Chronic/diagnosis, MESH : Viral Nonstructural Proteins/metabolism, MESH: Aged, Middle Aged, Viral Load, MESH: Hepacivirus/growth & development, Recombinant Proteins, MESH: Predictive Value of Tests, MESH : Hepacivirus/enzymology, Treatment Outcome, RNA, Viral, biomarker, [SDV.IMM]Life Sciences [q-bio]/Immunology, Biomarker (medicine), Female, France, MESH: Viral Load, MESH : Oligopeptides/therapeutic use, MESH : Time Factors, medicine.drug, MESH : Hepatitis C, Chronic/drug therapy, MESH : Molecular Targeted Therapy, MESH: Biomarkers/blood, MESH: Hepacivirus/enzymology, MESH : Male, MESH : Ribavirin/therapeutic use, MESH : Interferon-alpha/therapeutic use, MESH : Treatment Outcome, Biology, Predictive Value of Tests, MESH: Recombinant Proteins/therapeutic use, Ribavirin, medicine, MESH : France, NS3, MESH: Viral Nonstructural Proteins/antagonists & inhibitors, Hepatology, MESH : Drug Therapy, Combination, MESH: Time Factors, Interferon-alpha, Hepatitis C, Chronic, MESH : Hepacivirus/growth & development, MESH: Male, MESH: Prospective Studies, MESH: France, MESH: Drug Therapy, Combination, ROC Curve, MESH: Antiviral Agents/therapeutic use, MESH: Oligopeptides/therapeutic use, MESH: Area Under Curve, MESH : Area Under Curve, MESH : ROC Curve
Abstract

International audience; BACKGROUND & AIMS:Chronic infection with HCV remains a public health problem with approximately 150 million people infected worldwide. HCV intersects with lipid metabolism for replication and entry; and plasma concentrations of apolipoproteins have been identified as predictors for response to therapy. Herein, we conducted a screen of plasma proteins, including all apolipoproteins, to identify correlates of response to pegylated-interferon/ribavirin (PR) and HCV non-structural protein 3 (NS3) inhibitors (i.e., telaprevir/boceprevir) therapy in treatment-experienced cirrhotic patients from the ANRS CUPIC cohort.METHODS:We analysed 220 baseline plasma protein concentrations in 189 patients using Luminex technology and analyzed results.RESULTS:We identified baseline levels of apolipoprotein H (apoH) as a surrogate marker for sustained virological response (SVR). Notably, increased plasma concentration of apoH, used in combination with known clinical parameters, established a robust model with improved classification of patients as likely to achieve SVR (AUC = 0.77, Se = 66%, Sp = 72%, NRI = 39%). Moreover, we provide mechanistic information that indicates a previously unidentified role for apoH during viral entry. Using a human liver slices HCV infection model, we demonstrate that apoH limits replication.CONCLUSION:These data support testing of new biomarker strategies for the management of cirrhotic HCV patients and expand our understanding of how apoH may intersect with HCV infection

Published
2015
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4. HIV-associated obliterative portopathy (HIV-OP) underlies cryptogenic liver disease in HIV-seropositive patients

Author

Vincent Mallet, Anaïs Vallet-Pichard, Philippe Sultanik, and Stanislas Pol

Subjects
Hiv seropositive, business.industry, Liver Diseases, Health Policy, Human immunodeficiency virus (HIV), HIV Infections, medicine.disease_cause, medicine.disease, Radiography, Liver disease, Infectious Diseases, Immunology, medicine, Humans, Pharmacology (medical), business
Published
2010
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