25 results on '"Hervé Pegliasco"'
Search Results
2. Concerted and multidisciplinary management of COVID-19 drug therapies during the first two epidemic waves in a tertiary hospital in Marseille, France: Results of the PHARMA-COVID study.
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Matthieu Peretti, Stanislas Rebaudet, Laurent Chiche, Hervé Pegliasco, and Emilie Coquet
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Medicine ,Science - Abstract
ObjectivesTo evaluate the impact of local therapeutic recommendation updates made by the COVID multidisciplinary consultation meeting (RCP) at the Hôpital Européen Marseille (HEM) through the description of the drug prescriptions for COVID-19 during the first two waves of the epidemic.MethodsThis retrospective observational study analysed data from the hospital's pharmaceutical file. We included all patients hospitalized for COVID-19 between February 1, 2020 and January 21, 2021 and extracted specific anti-COVID-19 therapies (ST) from computerized patient record, as well as patients' demographic characteristics, comorbidities and outcome. The evolution of ST prescriptions during the study period was described and put into perspective with the updates of local recommendations made during the first (V1, from 2/24/2020 to 7/27/2020), and second (V2, from 7/28/2020 to 1/21/2021) epidemic waves.ResultsA total of 607 COVID-19 hospitalized patients, 197 during V1 and 410 during V2. Their mean age was 65 years-old, and they presented frequent comorbidities. In total, 93% of hospitalized patients received ST: anticoagulants (90%), glucocorticoids (39%) mainly during V2 (49% vs 17%, PConclusionsThe effective dissemination of evidence-based and concerted recommendations seems to have allowed an optimized management of COVID-19 drug therapies in the context of this emerging infection with rapidly evolving therapeutic questions.
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- 2023
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3. 460 Spatial distribution of infiltrating T lymphocytes with Immunoscore® CR T cells exhaustion test helps stratification of NSCLC patients treated with PD1/PDL1 inhibitors in the PIONeeR project
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Noémie Resseguier, Julien Mazières, Fabrice Barlesi, Maurice Pérol, Thomas Sbarrato, Fanny Arnoux, Stéphane Garcia, Jacques Fieschi-Meric, Vanina Leca, Alboukadel Kassambara, Lamia Ghezali, Pernelle Outters, Christelle Cotteaux-Lautard, Florence Monville, Maryannick Le Ray, Marie Roumieux, Richard Malkoun, Arnaud Boyer, Louisiane Lebas, Hervé Pegliasco, Patricia Barré, Clarisse Audigier-valette, Sarah Zahi, Luc Odier, Stéphane Hominal, and Laurent Greillier
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Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,RC254-282 - Published
- 2021
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4. An optimized stepwise algorithm combining rapid antigen and RT-qPCR for screening of COVID-19 patients.
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Philippe Halfon, Guillaume Penaranda, Hacène Khiri, Vincent Garcia, Hortense Drouet, Patrick Philibert, Christina Psomas, Marion Delord, Frédérique Retornaz, Caroline Charpin, Thomas Gonzales, Hervé Pegliasco, and Jérôme Allardet-Servent
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Medicine ,Science - Abstract
Background & aimWe investigated the combination of rapid antigen detection (RAD) and RT-qPCR assays in a stepwise procedure to optimize the detection of COVID-19.MethodsFrom August 2020 to November 2020, 43,399 patients were screened in our laboratory for COVID-19 diagnostic by RT-qPCR using nasopharyngeal swab. Overall, 4,691 of the 43,399 were found to be positive, and 200 were retrieved for RAD testing allowing comparison of diagnostic accuracy between RAD and RT-qPCR. Cycle threshold (Ct) and time from symptoms onset (TSO) were included as covariates.ResultsThe overall sensitivity, specificity, PPV, NPV, LR-, and LR+ of RAD compared with RT-qPCR were 72% (95%CI 62%-81%), 99% (95% CI95%-100%), 99% (95%CI 93%-100%), and 78% (95%CI 70%-85%), 0.28 (95%CI 0.21-0.39), and 72 (95%CI 10-208) respectively. Sensitivity was higher for patients with Ct ≤ 25 regardless of TSO: TSO ≤ 4 days 92% (95%CI 75%-99%), TSO > 4 days 100% (95%CI 54%-100%), and asymptomatic 100% (95%CI 78-100%). Overall, combining RAD and RT-qPCR would allow reducing from only 4% the number of RT-qPCR needed.ConclusionsThis study highlights the risk of misdiagnosing COVID-19 in 28% of patients if RAD is used alone. A stepwise analysis that combines RAD and RT-qPCR would be an efficient screening procedure for COVID-19 detection and may facilitate the control of the outbreak.
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- 2021
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5. Risk factors for early mortality from lung cancer: evolution over the last 20 years in the French nationwide KBP cohorts
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Debieuvre, D., Asselain, B., Cortot, A., Couraud, S., Duval, Y., Falchero, L., Locher, C., Meyer, N., Molinier, O., Morel, H., Templement-Grangerat, D., Tredaniel, J., Olivier, Leleu, Caroline, Clarot, Stéphanie, Martinez, Marie, Bernardi, Etienne, Auvray, Julian, Pinsolle, Chantal, Decroisette, Dorine, Templement, Laure, Belmont, Thierry, Saelens, Amélie, Turlotte, Jérôme, Virally, Reda, Chikouche, Marielle, Sabatini, Sophie, Schneider, Jacky, Crequit, Faraj, Al Freijat, Baihas, Jarjour, Rym, Haouachi, Fethi, El Khanjari, Luc, Stoven, Pascal, Beynel, Vincent, Tack, Fatima, Meniai, Yannick, Duval, Hannah, Ghalloussi-Tebai, Claudia, Rizzo, Waad, Al Sheikh, Marguerite, Lepoulain Doubliez, Florence, Lamotte, François, Christiann, Patrick, Dumont, Philippe, Masson, Fréderic, Bigot, Hervé, Le Floch, Issam, Belhaj, Lionel, Moreau, Stéphanie, Dehette, Antoine, Belle, Lidia, Petit, Thomas, Laurent, Sandrine, Loutski-Vettese, Isabelle, Monnet, Jean-Bernard, Auliac, Edith, Maetz, Jean-Yves, Tavernier, Christian, Delafosse, Pierre-Alexandre, Hauss, Colette, Vincent, Mohamad, Jaafar, Jean Philippe, Kraemer, Laetitia, Chablais, Anne-Sophie, Bravard, Philippe, Bonnefoy, Christine, Lefoll, Alexandra, Bedossa, Élise, Redureau, Acya, Bizieux-Thaminy, Virginie, Levrat, Kevin, Fouet, Claire, Alizon, Cécile, Dujon, Hong, Rabut, Mihai, Popa, Jean, Quieffin, Pierre, Demontrond, Olivier, Molinier, François, Goupil, Kheir Eddine, Benmammar, Vanessa, Pante, Laurent, Portel, Anne-Sophie, Blanchet-Legens, Sébastien, Larive, Jacques, Le Treut, Herve, Pegliasco, Chrystèle, Locher, Séverine, Thomassin, Benoît, Godbert, Cécile, Maincent, Christophe, Perrin, Julie, Obert, Cyril, Maurer, David, Renault, Karim, Amrane, Didier, Debieuvre, Geoffroy, Milliet De Faverges, Andreea, Tudor, Maud, Russier, Hugues, Morel, Hugues, Francois, Jean, Tredaniel, Patrick Aldo, Renault, Magalie, Paysse, Anne-Marie, Chiappa, Romain, Corre, Laurent, Mosser, Sylvie, Julien, David, Nunes, Soraya, Bordier, Eric, Briens, Gwenaëlle, Le Garff, Clothilde, Marty, Bénédicte, Martignac, Charles, Dayen, Emmanuelle, Lecuyer, Philippe, Slaouti, Serge, Jeandeau, Christina, Delmas, Eric, Goarant, Marie, Tiercin, Jean-Michel, Peloni, Joelle, Courdeau-Labourie, Nicolae, Banciu, Anne-Sophie, Bugnet, Olivier, Bylicki, Marjorie, Picaud, Laurence, Thirard, Bertrand, Delclaux, Philippe, Brun, Marion, Nancy, David, Marquette, Gonzague, De Chabot, Pierre, Kuntz, Catherine, Marichy, Lionel, Falchero, Christine, Dussopt, Alexa, Mairovitz, Jean-Marc, Dot, Fanny, Magne, Hoang, T.C.T., Bravard, A.-S., Martinez, S., Le Garff, G., Jeandeau, S., Petit, L., Marquette, D., Amrane, K., Demontrond, P., Tiercin, M., Jarjour, B., Turlotte, A., Masson, P., Jaafar, M., and Hauss, P.-A.
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- 2024
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6. 701 Brightplex® TCE and brightplex® MDSC assays combination improves advanced NSCLC patients’ stratification under anti-PD1/L1 immunotherapy in the PIONeeR project
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Lamia Ghezali, Marcellin Landri, Florence Monville, Vanina Leca, Théo Vasse, Chafik Hamdad, Margaux Mercadal, Laurent Vanhille, Alboukadel Kassambara, Thomas Sbarrato, Maryannick Le Ray, Marie Roumieux, Richard Malkoun, Noémie Resseguier, Arnaud Boyer, Clarisse Audigier-Valette, Stephanie Martinez, Hervé Pegliasco, Patrice Ray, Lionel Falchero, Antoine Serre, Nicolas Cloarec, Louisiane Lebas, Stéphane Hominal, Patricia Barré, Sarah Zahi, Ahmed Frikha, Pierre Bory, Lilian Laborde, Julien Mazières, Virginie Martin, Maurice Pérol, Laurent Greillier, Fabrice Barlesi, and Jacques Fieschi
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- 2022
7. An optimized stepwise algorithm combining rapid antigen and RT-qPCR for screening of COVID-19 patients
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Hacène Khiri, Christina Psomas, Hortense Drouet, Philippe Halfon, Jérôme Allardet-Servent, Guillaume Penaranda, Caroline Charpin, Hervé Pegliasco, Vincent Garcia, Patrick Philibert, Frédérique Retornaz, Thomas Gonzales, and Marion Delord
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Male ,RNA viruses ,Viral Diseases ,Pulmonology ,Coronaviruses ,Epidemiology ,Diagnostic accuracy ,Medical Conditions ,Medicine and Health Sciences ,Medicine ,Mass Screening ,Antigens, Viral ,Pathology and laboratory medicine ,Virus Testing ,Multidisciplinary ,Middle Aged ,Medical microbiology ,Viral Load ,Clinical Laboratory Sciences ,Clinical Laboratories ,Infectious Diseases ,COVID-19 Nucleic Acid Testing ,Viruses ,Female ,medicine.symptom ,SARS CoV 2 ,Pathogens ,Viral load ,Algorithms ,Research Article ,2019-20 coronavirus outbreak ,Coronavirus disease 2019 (COVID-19) ,SARS coronavirus ,Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ,Science ,Real-Time Polymerase Chain Reaction ,Asymptomatic ,Sensitivity and Specificity ,Microbiology ,Respiratory Disorders ,Antigen ,Diagnostic Medicine ,Virology ,Humans ,Cycle threshold ,Biology and life sciences ,business.industry ,SARS-CoV-2 ,Organisms ,Viral pathogens ,COVID-19 ,Covid 19 ,Microbial pathogens ,Medical Risk Factors ,Respiratory Infections ,business ,Nuclear medicine ,Viral Transmission and Infection - Abstract
Background & aim We investigated the combination of rapid antigen detection (RAD) and RT-qPCR assays in a stepwise procedure to optimize the detection of COVID-19. Methods From August 2020 to November 2020, 43,399 patients were screened in our laboratory for COVID-19 diagnostic by RT-qPCR using nasopharyngeal swab. Overall, 4,691 of the 43,399 were found to be positive, and 200 were retrieved for RAD testing allowing comparison of diagnostic accuracy between RAD and RT-qPCR. Cycle threshold (Ct) and time from symptoms onset (TSO) were included as covariates. Results The overall sensitivity, specificity, PPV, NPV, LR-, and LR+ of RAD compared with RT-qPCR were 72% (95%CI 62%–81%), 99% (95% CI95%–100%), 99% (95%CI 93%–100%), and 78% (95%CI 70%–85%), 0.28 (95%CI 0.21–0.39), and 72 (95%CI 10–208) respectively. Sensitivity was higher for patients with Ct ≤ 25 regardless of TSO: TSO ≤ 4 days 92% (95%CI 75%–99%), TSO > 4 days 100% (95%CI 54%–100%), and asymptomatic 100% (95%CI 78–100%). Overall, combining RAD and RT-qPCR would allow reducing from only 4% the number of RT-qPCR needed. Conclusions This study highlights the risk of misdiagnosing COVID-19 in 28% of patients if RAD is used alone. A stepwise analysis that combines RAD and RT-qPCR would be an efficient screening procedure for COVID-19 detection and may facilitate the control of the outbreak.
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- 2021
8. Optimisation du traitement médicamenteux des patients atteints de BPCO en état stable. Position de la Société de pneumologie de langue française. Actualisation 2021
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François Chabot, B. Ribeiro Baptista, Laurent Boyer, Thibaud Soumagne, Nicolas Roche, Bruno Degano, Clémence Martin, V Marques da Silva, A. Lorenzo, Chantal Raherison, P. Devillier, Arnaud Bourdin, Hervé Pegliasco, M Zysman, C. Thibault De Menonville, C Delafosse, Thierry Perez, Pierre-Régis Burgel, D. Piperno, C. Morelot Panzini, Bruno Housset, Gaëtan Deslée, C Zanetti, H. Morel, B. Delclaux, Pathologies Pulmonaires et Plasticité Cellulaire - UMR-S 1250 (P3CELL), and Université de Reims Champagne-Ardenne (URCA)-Institut National de la Santé et de la Recherche Médicale (INSERM)
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Pulmonary and Respiratory Medicine ,COPD ,medicine.medical_specialty ,business.industry ,[SDV]Life Sciences [q-bio] ,MEDLINE ,French ,medicine.disease ,language.human_language ,3. Good health ,Pharmacological treatment ,03 medical and health sciences ,Position (obstetrics) ,0302 clinical medicine ,030228 respiratory system ,language ,Medicine ,In patient ,030212 general & internal medicine ,business ,Intensive care medicine ,ComputingMilieux_MISCELLANEOUS - Abstract
International audience
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- 2021
9. Dual versus triple therapy in patients hospitalized for COPD in France: a claims data study
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Hervé Pegliasco, Bruno Housset, Philippe Devillier, F. Dalon, Eric Van Ganse, Maeva Nolin, Gaëtan Deslée, Nicolas Roche, and Manon Belhassen
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COPD ,medicine.medical_specialty ,business.industry ,General Medicine ,medicine.disease ,3. Good health ,03 medical and health sciences ,0302 clinical medicine ,030228 respiratory system ,Disease severity ,Internal medicine ,Claims data ,Propensity score matching ,Health care ,medicine ,Resource use ,In patient ,030212 general & internal medicine ,business ,Cost of care - Abstract
Purposes Following a hospitalization for COPD, dual and triple therapies were compared in terms of persistence and relations with outcomes (exacerbations, health care resource use and costs). Methods This was a historical observational database study. All patients aged ≥45 hospitalized for COPD between 2007 and 2015 were identified in a 1/97th random sample of French claims data. Patients receiving dual therapy within 60 days after hospitalization were compared to patients receiving triple therapy, after propensity score matching on disease severity. Results Of the 3,089 patients hospitalized for COPD, 1,538 (49.8%) received either dual or triple therapy in the 2 months following inclusion, and 1,500 (48.6%) had at least 30 days of follow-up available; 846 (27.4%) received dual therapy, and 654 (21.2%) received triple therapy. After matching, the number of exacerbations was 2.4 per year in the dual vs 2.3 in the triple group (p=0.45). Among newly treated patients (n=206), persistence at 12 months was similar in the dual and triple groups (48% vs 41%, respectively, p=0.37). As compared to patients on dual therapy, more patients on triple therapy received oral corticosteroids (49.1 vs 40.4%, p=0.003) or were hospitalized for any reason (67% vs 55.8%, p=0.0001) or for COPD (35.3 vs 25.1%, p=0.0002) during follow-up. Cost of care was higher for patients on triple than for those on dual therapy (€11,877.1 vs €9,825.1, p=0.01). Conclusion Following hospitalizations for COPD, patients on dual and triple therapy experienced recurrent exacerbations, limited adherence to therapies and high cost of care. Patients on triple therapy appeared more severe than those on dual therapy, as reflected by exacerbations and health care resource use.
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- 2019
10. Abstract LB120: Comprehensive biomarkers analysis to explain resistances to PD1-L1 ICIs: The precision immuno-oncology for advanced non-small cell lung cancer (PIONeeR) trial
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Laurent Greillier, Florence Monville, Vanina Leca, Frédéric Vely, Stephane Garcia, Joseph Ciccolini, Florence Sabatier, Gilbert Ferrani, Nawel Boudai, Lamia Ghezali, Marcellin Landri, Clémence Marin, Mourad Hamimed, Laurent Arnaud, Melanie Karlsen, Kevin Atsou, Sivan Bokobza, Pauline Fleury, Arnaud Boyer, Clarisse Audigier-Valette, Stéphanie Martinez, Hervé Pegliasco, Patrice Ray, Lionel Falchero, Antoine Serre, Nicolas Cloarec, Louisiane Lebas, Stephane Hominal, Patricia Barre, Sarah Zahi, Ahmed Frikha, Pierre Bory, Maryannick Le Ray, Lilian Laborde, Virginie Martin, Richard Malkoun, Marie Roumieux, Julien Mazieres, Maurice Perol, Eric Vivier, Sebastien Benzekry, Jacques Fieschi, and Fabrice Barlesi
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Cancer Research ,Oncology - Abstract
Background: Resistance to PD1/L1 immune checkpoint inhibitors (ICIs) in advanced NSCLC patients is observed in about 80% of individuals with no robust predictive biomarker yet. The PIONeeR trial (NCT03493581) aims to predict such resistances through a comprehensive multiparametric biomarkers analysis. Methodology: Among the >300 advanced NSCLC patients (pts) recruited in PIONeeR, we focused on the first 137 ≥2nd line ECOG PS0-1 pts treated with single-agent nivolumab, pembrolizumab or atezolizumab. Tumor tissue was collected at baseline and pts were re-biopsied at 6 weeks, and blood-sampled every cycle throughout the 24 weeks post C1D1. Response to PD1/L1 ICIs was assessed by RECIST 1.1 every 6 weeks. Immune contexture was characterized in tumor & blood of each pt through FACS for circulating immune cell subtypes quantification and endothelial activation, blood soluble factors dosage, dual- & multiplex IHC/digital pathology to quantify immune cells infiltrating the tumor, WES for TMB & ICI plasma dosage, leading to 331 measured biomarkers in addition to routine clinical parameters. Multivariable (MV) logistic regression was used to examine the association of each biomarker (controlled by sex, age, smoking status, histological type & PDL1+ Tumor Cells) with the risk of Early Progression (EP), i.e. within 3.5 months of treatment. Multivariable Cox regression analysis was conducted for association with PFS and OS. Results: Overall, the 137 pts were mainly male (64%), smokers (92%) and 1% PDL1+ TC in 36% of the cases, and 21% of pts were still on treatment at data cut-off. Archived samples were available for 80% of pts at inclusion and re-biopsy was available in 52.9% of these cases. The median follow up was 19.8 months, 22.5% of pts did not progress at data cut-off while 62% presented EP. Tumor Cytotoxic T-cells density, especially PD1+ were lower in EP (MV OR=0.45, p=0.022); conversely, higher proportions of circulating cytotoxic T-cells and activated T-cells (HLA-DR+) were observed in EP (MV OR=3.8, p65% inter-pt variability was observed in plasma exposures for all ICIs, with 8-10% of pts displaying trough levels below the target engagement threshold. Data will be presented through unsupervised clustering algorithms & multi-modal supervised learning methods. Changes after 6 weeks of treatment will be analyzed to further investigate drugs mechanisms of action. Conclusion: The PIONeeR trial provides with the 1st comprehensive biomarkers’ analysis to establish predictive models of resistance in advanced NSCLC pts treated with PD1/L1 ICIs and highlights how tumor and circulating biomarkers are complementary. Citation Format: Laurent Greillier, Florence Monville, Vanina Leca, Frédéric Vely, Stephane Garcia, Joseph Ciccolini, Florence Sabatier, Gilbert Ferrani, Nawel Boudai, Lamia Ghezali, Marcellin Landri, Clémence Marin, Mourad Hamimed, Laurent Arnaud, Melanie Karlsen, Kevin Atsou, Sivan Bokobza, Pauline Fleury, Arnaud Boyer, Clarisse Audigier-Valette, Stéphanie Martinez, Hervé Pegliasco, Patrice Ray, Lionel Falchero, Antoine Serre, Nicolas Cloarec, Louisiane Lebas, Stephane Hominal, Patricia Barre, Sarah Zahi, Ahmed Frikha, Pierre Bory, Maryannick Le Ray, Lilian Laborde, Virginie Martin, Richard Malkoun, Marie Roumieux, Julien Mazieres, Maurice Perol, Eric Vivier, Sebastien Benzekry, Jacques Fieschi, Fabrice Barlesi. Comprehensive biomarkers analysis to explain resistances to PD1-L1 ICIs: The precision immuno-oncology for advanced non-small cell lung cancer (PIONeeR) trial [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr LB120.
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- 2022
11. An optimized stepwise algorithm combining rapid antigen and RT-qPCR for screening of COVID-19 patients
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Caroline Charpin, Jérôme Allardet-Servent, Thomas Gonzales, Christina Psomas, Philippe Halfon, Vincent Garcia, Hortense Drouet, Hacène Khiri, Marion Delord, Hervé Pegliasco, Guillaume Penaranda, Julie Allemand-Sourrieu, Patrick Philibert, and Frédérique Retornaz
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2019-20 coronavirus outbreak ,Cycle threshold ,Antigen ,Coronavirus disease 2019 (COVID-19) ,business.industry ,Medicine ,Diagnostic accuracy ,Treatment decision making ,medicine.symptom ,Case management ,business ,Nuclear medicine ,Asymptomatic - Abstract
BackgroundDiagnosing SARS CoV-2 infection with certainty is essential for appropriate case management. We investigated the combination of rapid antigen detection (RAD) and RT-qPCR assays in a stepwise procedure to optimize the detection of COVID-19.MethodsFrom August 2020 to November 2020, 43,399 patients were screened in our laboratory for COVID-19 diagnostic by RT-qPCR using nasopharyngeal swab. Overall, 4,691 of the 43,399 were found to be positive, and 200 were retrieved for RAD testing allowing comparison of diagnostic accuracy between RAD and RT-qPCR. Cycle threshold (Ct) and time from symptoms onset (TSO) were included as covariates.ResultsThe overall sensitivity, specificity, PPV, NPV, LR-, and LR+ of RAD compared with RT- qPCR were 72% (95%CI 62%–81%), 99% (95% CI95%–100%), 99% (95%CI 93%–100%), and 78% (95%CI 70%–85%), 0.28 (95%CI 0.21-0.39), and 72 (95%CI 10-208) respectively. Sensitivity was higher for patients with Ct ≤ 25 regardless of TSO: TSO ≤ 4 days 92% (95%CI 75%–99%), TSO > 4 days 100% (95%CI 54%–100%), and asymptomatic 100% (95%CI 78-100%). Overall, combining RAD and RT-qPCR would allow reducing from only 4% the number of RT-qPCR needed.ConclusionThis study highlights the risk of misdiagnosing COVID-19 in 28% of patients if RAD is used alone. Thus, negative results from RAD needs to be confirmed by RT-qPCR prior to making treatment decisions. A stepwise analysis that combines RAD and RT-qPCR would be an efficient screening procedure for COVID-19 detection and may facilitate the control of the outbreak.
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- 2021
12. Intestinal Akkermansia muciniphila predicts clinical response to PD-1 blockade in patients with advanced non-small-cell lung cancer
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Lisa Derosa, Bertrand Routy, Andrew Maltez Thomas, Valerio Iebba, Gerard Zalcman, Sylvie Friard, Julien Mazieres, Clarisse Audigier-Valette, Denis Moro-Sibilot, François Goldwasser, Carolina Alves Costa Silva, Safae Terrisse, Melodie Bonvalet, Arnaud Scherpereel, Hervé Pegliasco, Corentin Richard, François Ghiringhelli, Arielle Elkrief, Antoine Desilets, Felix Blanc-Durand, Fabio Cumbo, Aitor Blanco, Romain Boidot, Sandy Chevrier, Romain Daillère, Guido Kroemer, Laurie Alla, Nicolas Pons, Emmanuelle Le Chatelier, Nathalie Galleron, Hugo Roume, Agathe Dubuisson, Nicole Bouchard, Meriem Messaoudene, Damien Drubay, Eric Deutsch, Fabrice Barlesi, David Planchard, Nicola Segata, Stéphanie Martinez, Laurence Zitvogel, Jean-Charles Soria, Benjamin Besse, Derosa, Lisa, Routy, Bertrand, Thomas, Andrew Maltez, Iebba, Valerio, Zalcman, Gerard, Friard, Sylvie, Mazieres, Julien, Audigier-Valette, Clarisse, Moro-Sibilot, Deni, Goldwasser, Françoi, Silva, Carolina Alves Costa, Terrisse, Safae, Bonvalet, Melodie, Scherpereel, Arnaud, Pegliasco, Hervé, Richard, Corentin, Ghiringhelli, Françoi, Elkrief, Arielle, Desilets, Antoine, Blanc-Durand, Felix, Cumbo, Fabio, Blanco, Aitor, Boidot, Romain, Chevrier, Sandy, Daillère, Romain, Kroemer, Guido, Alla, Laurie, Pons, Nicola, Le Chatelier, Emmanuelle, Galleron, Nathalie, Roume, Hugo, Dubuisson, Agathe, Bouchard, Nicole, Messaoudene, Meriem, Drubay, Damien, Deutsch, Eric, Barlesi, Fabrice, Planchard, David, Segata, Nicola, Martinez, Stéphanie, Zitvogel, Laurence, Soria, Jean-Charle, and Besse, Benjamin
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metagenomics ,Lung Neoplasms ,Microbiota ,Programmed Cell Death 1 Receptor ,biomarkers ,kidney cancer ,General Medicine ,Akkermansia ,patients stratification ,NSCLC ,General Biochemistry, Genetics and Molecular Biology ,B7-H1 Antigen ,Microbiome ,immunotherapy ,Akkermansia muciniphila ,cancer ,immune checkpoint inhibitors (ICIs) ,tumor microenvironment ,Carcinoma, Non-Small-Cell Lung ,Tumor Microenvironment ,biomarker ,Humans ,metagenomic ,Retrospective Studies - Abstract
Aside from PD-L1 expression, biomarkers of response to immune checkpoint inhibitors (ICIs) in non-small-cell lung cancer (NSCLC) are needed. In a previous retrospective analysis, we documented that fecal Akkermansia muciniphila (Akk) was associated with clinical benefit of ICI in patients with NSCLC or kidney cancer. In the current study, we performed shotgun-metagenomics-based microbiome profiling in a large cohort of patients with advanced NSCLC (n = 338) treated with first- or second-line ICIs to prospectively validate the predictive value of fecal Akk. Baseline stool Akk was associated with increased objective response rates and overall survival in multivariate analyses, independent of PD-L1 expression, antibiotics, and performance status. Intestinal Akk was accompanied by a richer commensalism, including Eubacterium hallii and Bifidobacterium adolescentis, and a more inflamed tumor microenvironment in a subset of patients. However, antibiotic use (20% of cases) coincided with a relative dominance of Akk above 4.8% accompanied with the genus Clostridium, both associated with resistance to ICI. Our study shows significant differences in relative abundance of Akk that may represent potential biomarkers to refine patient stratification in future studies.
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- 2020
13. Impact of a Multimodal Telemonitoring Intervention on CPAP Adherence in Symptomatic OSA and Low Cardiovascular Risk
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Marc Sapene, Meriem Benmerad, Optisas trial Investigators, Renaud Tamisier, Hervé Pegliasco, Yves Grillet, Jean-Louis Pépin, Bruno Stach, Patrick Levy, Jean-François Muir, Sébastien Bailly, Erika Treptow, Marie Joyeux-Faure, Hypoxie : Physiopathologie Respiratoire et Cardiovasculaire (HP2), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Grenoble Alpes (UGA), Nouvelle Clinique Bel-Air [Bordeaux] (NCBA), Private practice sleep and respiratory disease center Valence, Private Practice Sleep and Respiratory Disease Centre [Valenciennes], CHU Rouen, Normandie Université (NU), and ANR-19-P3IA-0003,MIAI,MIAI @ Grenoble Alpes(2019)
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Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,medicine.medical_treatment ,Critical Care and Intensive Care Medicine ,law.invention ,03 medical and health sciences ,0302 clinical medicine ,Quality of life ,Randomized controlled trial ,law ,Interquartile range ,Internal medicine ,medicine ,030212 general & internal medicine ,Continuous positive airway pressure ,ComputingMilieux_MISCELLANEOUS ,Intention-to-treat analysis ,business.industry ,Epworth Sleepiness Scale ,medicine.disease ,3. Good health ,Obstructive sleep apnea ,030228 respiratory system ,Apnea–hypopnea index ,Cardiology and Cardiovascular Medicine ,business ,[SDV.MHEP]Life Sciences [q-bio]/Human health and pathology - Abstract
Background One of the major challenges in treating OSA is to achieve adequate CPAP adherence. Telemonitoring has the potential to provide individualized management and early recognition of problems during treatment. Research Question What is the effect of a multimodal telemonitoring intervention on treatment adherence, quality of life, and functional status in symptomatic patients with OSA and low cardiovascular risk? Study Design and Methods In a multicenter, randomized controlled trial, patients newly diagnosed with OSA were randomly assigned to multimodal telemonitoring for 6 months vs usual care (UC). Telemonitoring consisted of built-in electronic alert algorithms for early adjustment of CPAP treatment in case of side effects, leaks, or persistent residual events. The primary outcome was CPAP adherence (in hours per night). Secondary outcomes included daily symptoms such as fatigue and sleepiness, and quality of life measured by using self-reported questionnaires. Results A total of 206 patients with OSA and a median age of 50.6 years (interquartile range [IQR], 42.1; 58.1 years) were included in the study; they were predominantly male (63%) with a median BMI of 30.6 kg/m2 (IQR, 26.8; 35.1 kg/m2) and a median apnea-hypopnea index of 45.2 events/h (IQR, 34.0; 60.0 events/h). Of these, 102 received UC and 104 received telemonitoring. After 6 months of treatment, CPAP adherence was similar in the two groups when assessed either by mean duration of usage (4.73 ± 2.48 h per night in the telemonitoring group and 5.08 ± 2.44 h per night in the UC group; P = .30) or in percentage of patients adherent to treatment (> 4 h usage per night, > 70% nights; 64% in the telemonitoring group vs 72% in the UC group; P = .24). There was no significant difference between the groups in effect size of improvement in fatigue and sleepiness. Interpretation In patients with severe OSA and low cardiovascular risk, multimodal telemonitoring did not increase CPAP adherence. For both the telemonitoring and UC groups, similar improvements in daytime symptoms were achieved. Trial Registry ClinicalTrials.gov; No.: 01796769; URL: www.clinicaltrials.gov
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- 2020
14. Impact of a multimodal telemonitoring intervention on CPAP adherence in symptomatic low-cardiovascular risk sleep apnea: a randomized controlled trial
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Renaud Tamisier, Marie Joyeux-Faure, Bruno Stach, Jean-Louis Pépin, Hervé Pegliasco, Marc Sapene, Yves Grillet, Patrick Levy, Jean-François Muir, Sébastien Bailly, Erika Treptow, and Meriem Benmerad
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medicine.medical_specialty ,business.industry ,medicine.medical_treatment ,Sleep apnea ,medicine.disease ,Cpap adherence ,respiratory tract diseases ,law.invention ,Obstructive sleep apnea ,Quality of life ,Randomized controlled trial ,law ,Intervention (counseling) ,Internal medicine ,Medicine ,Continuous positive airway pressure ,business ,Body mass index - Abstract
Background: One of the major challenges in treating obstructive sleep apnea (OSA) is to achieve adequate continuous positive airway pressure (CPAP) adherence. We determined the effect of a multimodal telemonitoring intervention on CPAP adherence, quality of life and functional status in symptomatic OSA patients with low cardiovascular risk. Study Design and Methods: In a multicenter, randomized controlled trial, newly diagnosed OSA patients were randomly assigned to multimodal telemonitoring(TM) for 6 months vs usual care (UC). TMconsisted ofbuilt-in electronic alert algorithms for early adjustment of CPAP treatment in case of side effects, leaks or persistent residual events.The outcomesincluded CPAP adherence, daily symptoms such as fatigue and sleepiness, and quality of life. Results: Of 206 OSA patients aged 50.6 [42.1;58.1] (median [IQR]) years;predominantly male (63%) with body mass index of 30.6 [26.8;35.1] kg/m2and an AHI of 45.2 [34.0;60.0] events/hour) 102 received UC and 104 TM. After 6 months of treatment, CPAPadherence was similar in the two groups when assessed either by mean duration of usage (4.73±2.48 hours/night in the TM group and 5.08±2.44 hours/night in the UC group, p=0.30) or in % of patients adherent to treatment (over 4 hours usage/night, > 70% nights; 64% in TM vs 72% in UC, p=0.24). There was no significant difference between the groups in effect size of improvement in fatigue and sleepiness. Interpretation: In severe OSA patients with low cardiovascular risk, multimodal telemonitoring did not increase CPAP adherence. For both TM and UC groups similar improvements in daytime symptoms were achieved.
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- 2020
15. Impact of a Multimodal Telemonitoring Intervention on CPAP Adherence in Symptomatic OSA and Low Cardiovascular Risk: A Randomized Controlled Trial
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Renaud, Tamisier, Erika, Treptow, Marie, Joyeux-Faure, Patrick, Levy, Marc, Sapene, Meriem, Benmerad, Sebastien, Bailly, Yves, Grillet, Bruno, Stach, Jean-François, Muir, Hervé, Pegliasco, and Jean-Louis, Pépin
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Adult ,Male ,Sleep Apnea, Obstructive ,Continuous Positive Airway Pressure ,Incidence ,Middle Aged ,Telemedicine ,Cardiovascular Diseases ,Risk Factors ,Quality of Life ,Humans ,Patient Compliance ,Female ,France ,Prospective Studies ,Self Report ,Follow-Up Studies ,Monitoring, Physiologic - Abstract
One of the major challenges in treating OSA is to achieve adequate CPAP adherence. Telemonitoring has the potential to provide individualized management and early recognition of problems during treatment.What is the effect of a multimodal telemonitoring intervention on treatment adherence, quality of life, and functional status in symptomatic patients with OSA and low cardiovascular risk?In a multicenter, randomized controlled trial, patients newly diagnosed with OSA were randomly assigned to multimodal telemonitoring for 6 months vs usual care (UC). Telemonitoring consisted of built-in electronic alert algorithms for early adjustment of CPAP treatment in case of side effects, leaks, or persistent residual events. The primary outcome was CPAP adherence (in hours per night). Secondary outcomes included daily symptoms such as fatigue and sleepiness, and quality of life measured by using self-reported questionnaires.A total of 206 patients with OSA and a median age of 50.6 years (interquartile range [IQR], 42.1; 58.1 years) were included in the study; they were predominantly male (63%) with a median BMI of 30.6 kg/mIn patients with severe OSA and low cardiovascular risk, multimodal telemonitoring did not increase CPAP adherence. For both the telemonitoring and UC groups, similar improvements in daytime symptoms were achieved.ClinicalTrials.gov; No.: 01796769; URL: www.clinicaltrials.gov.
- Published
- 2019
16. 460 Spatial distribution of infiltrating T lymphocytes with Immunoscore® CR T cells exhaustion test helps stratification of NSCLC patients treated with PD1/PDL1 inhibitors in the PIONeeR project
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Vanina Leca, Alboukadel Kassambara, Lamia Ghezali, Pernelle Outters, Christelle Cotteaux-Lautard, Fanny Arnoux, Thomas Sbarrato, Florence Monville, Maryannick Le Ray, Marie Roumieux, Stephane Garcia, Richard Malkoun, Noémie Resseguier, Arnaud Boyer, Louisiane Lebas, Hervé Pegliasco, Patricia Barré, Clarisse Audigier-valette, Sarah Zahi, Luc Odier, Stéphane Hominal, Maurice Perol, Julien Mazieres, Laurent Greillier, Fabrice Barlesi, and Jacques Fieschi-Meric
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Pharmacology ,Oncology ,Cancer Research ,medicine.medical_specialty ,business.industry ,Immunology ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,Cancer ,Pembrolizumab ,medicine.disease ,Informed consent ,Atezolizumab ,Internal medicine ,Statistical significance ,Good clinical practice ,medicine ,Molecular Medicine ,Immunology and Allergy ,Nivolumab ,Lung cancer ,business ,RC254-282 - Abstract
BackgroundPD1/L1 Immune Checkpoint Inhibitors (ICI) have significantly improved long-term outcome in about 20% of advanced Non Small Cells Lung Cancer (NSCLC) patients (pts), but 80% present primary or secondary resistance. The PIONeeR project (NCT03493581) aims to predict the response/resistance to PD1/L1 ICIs in advanced NSCLC pts through a comprehensive agnostic multiparametric and longitudinal biomarkers assessment. Data presented here are a focus on the quantification of tumor infiltration by lymphocytes, their activation as potential markers of the resistance to treatment by ICI.MethodsAdvanced NSCLC pts with available archived tumor tissue at screening visit (VS), treated with standard PD1/L1 ICIs (nivolumab, pembrolizumab or atezolizumab), alone (2nd line or more) or combined with chemotherapy (1st line), were re-biopsied at 6 weeks (V2) of treatment. PD1/L1 ICIs overall response rate (ORR) was assessed by RECIST 1.1 every 6 weeks. The multiplex IHC test ”Immunoscore® CR T Cells Exhaustion” (IS TCE) quantifies cytotoxic lymphocytes expressing three checkpoints: PD1, LAG3, TIM3, extrapolating their exhaustion status, both in the stroma and parenchyma. The unsupervised neural-network-based machine learning algorithm SOM (Self-Organizing Maps) was used to classify samples based on the 27 IS TCE variables. Statistical significance of survival differences between groups was evaluated using the log-rank test.ResultsAmong the first 100 pts, (male (64%), smokers (91,8%), ConclusionsIS TCE test may help stratifying and predicting responders to anti PD1/L1 therapy through checkpoint expressing lymphocytes quantification and spatial distribution. Additional tests performed on the PIONeeR cohort to explore other aspects of the immune response to cancer should complete these results.AcknowledgementsThis work is supported by French National Research Agency (ANR-17-RHUS-0007), a partnership of AMU, APHM, AstraZeneca, Centre Léon Bérard, CNRS, HalioDx, ImCheck Therapeutics, Innate Pharma, Inserm, Institut Paoli Calmettes and sponsored by AP HM. Drug supply is funded by AstraZeneca. Special thanks to patients and families.Trial RegistrationNCT03493581Ethics ApprovalThe study is conducted in accordance with Good Clinical Practice and the French applicable regulatory requirements (Public Health Code, article L.1121-1/La loi n° 2012–300 du 5 mars 2012 relative aux recherches impliquant la personne humaine (dite loi Jardé), the applicable subject privacy requirements, and the ethical principles that are outlined in the Declaration of Helsinski. The study was approved by the French Ethic Committee, CPP Ouest II - Angers, ref. CPP: 2028/08, Ref ANSM (French competent authority) 2018020500208, 2018072600120, 2019083000148. Freely given written informed consent was signed and obtained from each individual participating in the study, before any study specific procedure was undertaken and after the provision of information about the study by the investigator during a physician-patient consultation and sufficient time for reflection.
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- 2021
17. Comparison of dual vs triple therapies in patients hospitalized for COPD in France: a claims data study
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Bruno Housset, F. Dalon, Daniel Vesque, Manon Belhassen, Philippe Devillier, Gaëtan Deslée, Hervé Pegliasco, Maeva Nolin, Nicolas Roche, and Eric Van Ganse
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medicine.medical_specialty ,COPD ,biology ,business.industry ,Lama ,biology.organism_classification ,medicine.disease ,Clinical trial ,Claims data ,Internal medicine ,Propensity score matching ,medicine ,In patient ,Claims database ,Dual therapy ,business - Abstract
Introduction: COPD dual (inhaled corticosteroids (ICS) + long-acting beta2-agonists (LABA) or LABA + long-acting muscarinic antagonist (LAMA)) and triple (ICS + LABA+ LAMA) therapies have been compared in clinical trials but not yet in real-life conditions. Aims: To compare dual and triple therapies in patients hospitalized for COPD, on exacerbations, healthcare resource use, costs and persistence. Methods: All patients aged 45 and over, hospitalized for COPD between 2007 and 2015, were included, using the EGB (Echantillon Generaliste de Beneficiaires, 1/97e random sample of the French claims database SNIIRAM). Patients on dual therapy within 60 days after hospitalization were compared with patients on triple therapy, after propensity score matching on disease severity. Results: Out of 3,089 patients included, 926 received dual and 1,017 triple therapy. After matching, the number of exacerbations was 2.4 per year in the dual group vs 2.3 in the triple group (p=0.45). The persistence of newly treated patients (n=206) was low in both matched groups: 48% in the dual group vs 41% in the triple group. As compared to patients on any dual therapy, more patients under triple therapy received oral corticosteroids (49.1 vs 40.4%, p=0.003) and were hospitalized for any causes (67 vs 55.8%, p=0.0001) and for COPD (35.3 vs 25.1%, p=0.0002). Triple therapy patients had a higher total annual cost than dual therapy patients (€11,877.1 vs €9,825.1, p=0.009). Conclusion: Patients hospitalized for COPD experienced recurrent hospitalizations and oral CS therapy, especially when under triple therapy, besides high cost of treatments and poor adherence to both dual and triple therapies.
- Published
- 2018
18. Étude comparative des bithérapies versus trithérapies chez les patients hospitalisés pour BPCO en France : une étude EGB
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Bruno Housset, Nicolas Roche, Hervé Pegliasco, P. Devillier, F. Dalon, Gaëtan Deslée, Daniel Vesque, Maeva Nolin, Manon Belhassen, and E. Van Ganse
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Pulmonary and Respiratory Medicine - Abstract
Resume Introduction A ce jour, les bitherapies (corticosteroides inhales [CSI] + beta2-agonistes a longue duree d’action [LABA] ou LABA + anticholinergiques de longue duree d’action [LAMA]) et les tritherapies libres (CSI + LABA + LAMA) dans la prise en charge de la BPCO ont ete comparees dans des essais cliniques, mais rarement en conditions reelles d’utilisation. Objectif Comparer les bi- et tritherapies chez les patients hospitalises pour BPCO, en termes d’exacerbations, de consommations de soins, de couts, et de persistance au traitement etudie a 12 mois. Methodes Ont ete inclus tous les patients de ≥ 45 ans, hospitalises pour BPCO entre 2007 et 2015, a partir de l’EGB (Echantillon Generaliste de Beneficiaires–echantillon aleatoire representant 1/97e de la base de donnees de remboursements SNIIRAM). Les patients sous bitherapie dans les 60 jours apres l’hospitalisation ont ete compares aux patients sous tritherapie, apres appariement sur les variables liees au plan experimental de l’etude et sur un score de propension pour les facteurs de confusion (severite et comorbidites). La persistance au traitement etudie a ete definie par la non-interruption des delivrances de ce traitement sur une periode de plus de 90 jours. Resultats Sur 3089 patients inclus, 926 etaient sous bitherapie et 1017 sous tritherapie. Apres appariement (530 paires), le nombre d’exacerbations etait de 2,4 par an dans le groupe bitherapie, vs 2,3 dans le groupe tritherapie (p = 0,45). La proportion de patients persistants chez les patients nouvellement traites (n = 206) etait faible dans les deux groupes, avec toutefois une difference importante (mais ici NS) : 47,8 % dans le groupe bitherapie vs 40,8 % dans le groupe tritherapie. En moyenne, les patients sous bitherapie etaient hospitalises (toutes causes) 2,5 fois par an, compare a 3 fois chez ceux sous tritherapie (p = 0,08). Le nombre median d’EFR par an etait de 0,8 dans le groupe bitherapie, vs 1,5 dans le groupe tritherapie (p = 0,04). Les patients sous bitherapie avaient recours a 4,8 VNI par an en moyenne, vs 4,4 VNI chez ceux sous tritherapie (p = 0,63). Ces derniers representaient un cout total annuel plus eleve que les patients sous bitherapie (11 877,1 € vs 9825,1€, p = 0,01). Conclusion Cette etude met en exergue l’importante consommation de soins des patients BPCO et leur faible persistance aux traitements. Les patients BPCO etudies etaient sujets a des hospitalisations recurrentes et souvent traites par corticosteroides oraux. Les couts de sante totaux chez ces patients etaient eleves.
- Published
- 2019
19. Prise en charge de la BPCO en pneumologie selon le stade de sévérité
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Nicolas Roche, Christos Chouaid, J.M. Marcos, Yann Martinat, Hervé Pegliasco, B. Scherrer, and B. Delclaux
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Pulmonary and Respiratory Medicine ,Gynecology ,medicine.medical_specialty ,Smoking epidemiology ,Guideline adherence ,business.industry ,Lung disease ,Medicine ,Pulmonary disease ,business ,Utilization review - Abstract
Resume Introduction Le diagnostic et le traitement de la BPCO sont sous-optimaux chez de nombreux malades, ce qui peut etre deletere pour leur devenir. Objectifs Decrire les modalites de prise en charge pneumologique des patients atteints de BPCO selon leur stade de severite. Methodes Etude observationnelle transversale realisee en France metropolitaine en 2006-2007, aupres de 515 medecins pneumologues repartis sur le territoire national, devant recruter chacun 5 BPCO stables. Resultats L’observatoire a inclus 2 494 patients (âge moyen 67 ans, 78% d’hommes) dont pres de 50% de BPCO severes ou tres severes (Stades III ou IV de la classification GOLD). A l’inclusion, 93,2% des patients avaient un traitement medicamenteux, le plus souvent un bronchodilatateur (91,2%, hors nebulisations) et/ou un corticosteroide inhale (73,7%). Une rehabilitation respiratoire etait rapportee au cours des deux annees precedentes ou prevue chez 26,9% des patients. Si la frequence des explorations et traitements augmentait avec la severite de la maladie, il existait un fort recouvrement entre les stades. Conclusions Les decisions d’explorations et de traitements des pneumologues ne peuvent etre expliquees par la seule severite des malades atteints de BPCO. Des efforts doivent porter sur l’identification des autres caracteristiques des malades associees a ces decisions, afin d’aider a l’elaboration des recommandations a venir.
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- 2009
20. Morphine prescription to terminally ill patients with lung cancer and dyspnea: French physicians’ attitudes
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Hervé Pegliasco, Yolande Obadia, Roger Favre, Marc K. Bendiane, J.M. Lapiana, Anne Galinier, and Patrick Peretti-Watel
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medicine.medical_specialty ,Lung Neoplasms ,Attitude of Health Personnel ,media_common.quotation_subject ,education ,Analgesic ,MEDLINE ,Empathy ,medicine ,Humans ,Terminally Ill ,Pharmacology (medical) ,Practice Patterns, Physicians' ,Medical prescription ,Lung cancer ,media_common ,Terminal Care ,Morphine ,business.industry ,General Medicine ,medicine.disease ,Analgesics, Opioid ,Dyspnea ,Anesthesiology and Pain Medicine ,Anesthesia ,Family medicine ,Anxiety ,medicine.symptom ,business ,End-of-life care ,medicine.drug - Abstract
This study aimed to investigate factors associated with analgesic use of morphine in end-of-life care. French general practitioners (GPs) and oncologists (N = 719) were asked whether they would prescribe morphine asfirst-line therapy to patients with terminal lung cancer suffering from dyspnea associated with cough and great anxiety. Overall, 54 percent of oncologists and 40percent of GPs stated that they would prescribe morphine in the presented case. This prescriptive attitude correlated with physicians’ age, professional back-ground, communication skills, and attitude toward terminally ill patients. The findings of this study indicate that improving analgesic use of opioids in end-of-life care is not only a matter of enhancing technical skills acquired through training or experience but also a matter of improving communication and empathy between physicians and patients.
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- 2005
21. French Physicians’ Attitudes toward Legalisation of Euthanasia and the Ambiguous Relationship between Euthanasia and Palliative Care
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R. Favre, Marc K. Bendiane, Hervé Pegliasco, Jean-Paul Moatti, Anne Galinier, Patrick Peretti-Watel, and J.M. Lapiana
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medicine.medical_specialty ,Palliative care ,business.industry ,Parliament ,media_common.quotation_subject ,Public debate ,social sciences ,General Medicine ,Palliative sedation ,humanities ,03 medical and health sciences ,0302 clinical medicine ,Nursing ,030502 gerontology ,030220 oncology & carcinogenesis ,Family medicine ,Medical profession ,Medical training ,Medicine ,0305 other medical science ,business ,media_common - Abstract
In 1999, the French Parliament established a “right to palliative care”, which reactivated public debate about euthanasia. In order to investigate jointly physicians’ attitude toward palliative care and euthanasia, we conducted a cross-sectional survey of a national sample of French GPs, oncologists, and neurologists. Overall, 917 physicians participated in the survey. Significant proportions of respondents, especially among GPs and neurologists, considered that palliative sedation and withdrawing life-sustaining treatments (WLST) were euthanasia. Multivariate analysis showed that the physicians who had special medical training in palliative care, and those who distinguish palliative sedation and WLST from euthanasia were more likely to oppose legalisation of euthanasia. Thus, French physicians’ attitude to the legalisation of euthanasia is strongly influenced by whether or not they distinguish palliative care from euthanasia. Improved palliative care requires better training of the entire medical profession, and clearer guidelines about which end-of-life care practices are legally and ethically acceptable.
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- 2003
22. Lung cancer trends and tumor characteristic changes over 20 years (2000–2020): Results of three French consecutive nationwide prospective cohorts’ studies
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Didier Debieuvre, Olivier Molinier, Lionel Falchero, Chrystèle Locher, Dorine Templement-Grangerat, Nicolas Meyer, Hugues Morel, Yannick Duval, Bernard Asselain, Alexia Letierce, Jean Trédaniel, Jean-Bernard Auliac, Olivier Bylicki, Lionel Moreau, Mathieu Fore, Romain Corre, Sébastien Couraud, Alexis Cortot, Faraj Al Freijat, Waad Al Sheikh, Claire Alizon, Karim Amrane, Etienne Auvray, Nicolae Banciu, Alexandra Bedossa, Issam Belhaj, Antoine Belle, Laure Belmont, Kheir Eddine Benmammar, Marie Bernardi, Pascal Beynel, Fréderic Bigot, Acya Bizieux-Thaminy, Anne-Sophie Blanchet-Legens, Philippe Bonnefoy, Soraya Bordier, Anne-Sophie Bravard, Éric Briens, Philippe Brun, Anne-Sophie Bugnet, Laetitia Chablais, Anne-Marie Chiappa, Reda Chikouche, François Christiann, Caroline Clarot, Joelle Courdeau-Labourie, Jacky Crequit, Charles Dayen, Gonzague De chabot, Chantal Decroisette, Stéphanie Dehette, Christian Delafosse, Bertrand Delclaux, Christina Delmas, Pierre Demontrond, Jean-Marc Dot, Cécile Dujon, Patrick Dumont, Christine Dussopt, Fatima Duval, Fethi El Khanjari, Kevin Fouet, Hugues Francois, Yannick Ghalloussi-Tebai, Éric Goarant, Benoît Godbert, François Goupil, Rym Haouachi, Pierre-Alexandre Hauss, Mohamad Jaafar, Baihas Jarjour, Serge Jeandeau, Sylvie Julien, Jean Philippe Kraemer, Pierre Kuntz, Florence Lamotte, Sébastien Larive, Thomas Laurent, Hervé Le Floch, Gwenaëlle Le Garff, Jacques Le Treut, Emmanuelle Lecuyer, Christine Lefoll, Olivier Leleu, Marguerite Lepoulain Doubliez, Virginie Levrat, Sandrine Loutski-Vettese, Edith Maetz, Fanny Magne, Cécile Maincent, Alexa Mairovitz, Catherine Marichy, Nancy Marion, David Marquette, Bénédicte Martignac, Stéphanie Martinez, Clothilde Marty, Philippe Masson, Cyril Maurer, Vincent Meniai, Geoffroy Milliet De Faverges, Isabelle Monnet, Laurent Mosser, Anne-Catherine Neidhardt, David Nunes, Julie Obert, Vanessa Pante, Magalie Paysse, Herve Pegliasco, Jean-Michel Peloni, Christophe Perrin, Lidia Petit, Marjorie Picaud, Julian Pinsolle, Mihai Popa, Laurent Portel, Jean Quieffin, Hong Rabut, Élise Redureau, David Renault, Patrick Aldo Renault, Claudia Rizzo, Maud Russier, Marielle Sabatini, Thierry Saelens, Sophie Schneider, Philippe Slaouti, Luc Stoven, Vincent Tack, Jean-Yves Tavernier, Laurence Thirard, Séverine Thomassin, Marie Tiercin, Jean Tredaniel, Andreea Tudor, Amélie Turlotte, Colette Vincent, and Jérôme Virally
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Lung cancer ,Smoking habits ,Real-life ,Tumor characteristics ,Adenocarcinoma ,Non-small-cell lung cancer ,Public aspects of medicine ,RA1-1270 - Abstract
Summary: Background: Long-term changes in lung cancer (LC) patients are difficult to evaluate. We report results from the French KBP-2020 real-life cohort. Methods: KBP-2020 was a prospective cohort that included all patients diagnosed with LC in 2020, in nonacademic public hospital in France. Patient and tumour characteristics were described and compared with similarly designed cohorts in 2000 and 2010. Findings: In 2020, 82 centers included 8,999 patients diagnosed with LC. The proportion of women increased: 34·6% (3114/8999) compared to, 24·3% (1711/7051) and 16·0% (904/5667) in 2010 and 2000 (p
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- 2022
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23. Virus-associated hemophagocytic syndrome related to acute CMV and HBV sexual co-infection: A case report
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Philippe Halfon, Thierry Helbert, Hervé Pegliasco, Didier Mathieu, Patrick Philibert, and Frédérique Retornaz
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myalgia ,Hepatitis B virus ,medicine.medical_specialty ,Sexual transmission ,Anti-Inflammatory Agents ,Cytomegalovirus ,medicine.disease_cause ,Lymphohistiocytosis, Hemophagocytic ,Betaherpesvirinae ,Virology ,Internal medicine ,medicine ,Humans ,biology ,business.industry ,virus diseases ,Sexually Transmitted Diseases, Viral ,Middle Aged ,Viral Load ,Hepatitis B ,biology.organism_classification ,medicine.disease ,Infectious Diseases ,Cytomegalovirus Infections ,Immunology ,Prednisone ,Female ,Viral disease ,Reactive Hemophagocytic Syndrome ,medicine.symptom ,business ,Viral load - Abstract
Background Secondary or reactive hemophagocytic syndrome is frequently related to viral infections and is named Virus-Associated Hemophagocytic Syndrome (VAHS). Cytomegalovirus (CMV) has been associated with hemophagocytic syndrome in healthy subjects, patients with inflammatory bowel diseases rheumatologic diseases, and transplant recipients. CMV and hepatitis B virus (HBV) can be sexually transmitted. However, co-infection with these viruses has never been reported and the clinical follow-up after acute HBV–CMV infection is not known. Objectives To report on the first case of a VAHS related to acute CMV and HBV co-infection probably acquired after sexual contact. Study design A 47-year-old woman, with no past medical history, complaining of severe asthenia, pneumonia, myalgia, and high fever, was hospitalized for the first time on July 5, 2008. During 20 days, her CMV viral load and HBV DNA were monitored. Results Ten days after her hospitalization, all signs and symptoms worsened. Twenty days after hospitalization, the patient had a natural recovery from acute HBV infection and a rapid clearance of CMV infection. Three weeks later, the patient was discharged without any complaints. Conclusion This report points out the etiological role of CMV and HBV co-infection in VAHS due to probable sexual transmission.
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- 2009
24. [Why is allergic rhinitis currently at the centre of a debate?]
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Elie, Serrano, Pascal, Demoly, Hervé, Pegliasco, and Josiane, Percodani
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Adult ,Inflammation ,Rhinitis, Allergic, Perennial ,Adolescent ,Incidence ,Rhinitis, Allergic, Seasonal ,Prognosis ,Asthma ,Adrenal Cortex Hormones ,Terminology as Topic ,Histamine H1 Antagonists ,Prevalence ,Humans ,Child - Published
- 2004
25. [Opinion of general and specialized physicians toward euthanasia. Results from the French survey on attitudes and practices against palliative care, 2002]
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Marc K, Ben Diane, Patrick, Peretti-Watel, Jean-Marc, Lapiana, Roger, Favre, Anne, Galinier, Hervé, Pegliasco, and Yolande, Obadia
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Attitude ,Euthanasia ,Data Collection ,Humans ,Medicine ,Family Practice ,Specialization - Abstract
To evaluate opinion of physicians about the legalization of euthanasia according to their professional characteristics, their attitudes toward morphine, their attitudes toward communication with end-of-life patients, and their perception of specific types of terminal care.Univariate and multivariate analyses were carried out from data collected among 1.000 general practitioners, oncologists, neurologists and HIV specialists (French cross-sectional survey on palliative care, 2002).42.5% of physicians agreed with the statement that euthanasia should be legalized as it is already the case in the Netherlands. Inadequate prescription of morphine and calling terminal sedation as active euthanasia were associated with a favorable opinion toward legalization of euthanasia.Specific training on pain management and terminal sedation would help physicians to have a better view of the problem of euthanasia.
- Published
- 2004
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