14 results on '"L. Widawski"'
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2. Psoriatic arthritis with hyperuricemia: more peripheral, destructive, and challenging to treat
- Author
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L. Widawski, T. Fabacher, L. Spielmann, JE. Gottenberg, J. Sibilia, PM. Duret, L. Messer, and R. Felten
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Rheumatology ,General Medicine - Abstract
Objective To study the impact of hyperuricemia on clinical presentation, severity, and associated comorbidities of psoriatic arthritis (PsA). Methods Retrospective bicentric case–control study performed in Strasbourg and Colmar, France, from 2009 to 2019. Patients with PsA (according to ICD-10 coding) and at least one available serum urate (SU) measurement were included. Demographic, comorbidities, clinical, and radiographic data were collected. Hyperuricemia was defined as SU level ≥ 360 µmol/L. Results We included 242 patients: 73 (30.2%) had hyperuricemia and 15 (6.2%) met 2015 ACR/EULAR criteria for gout. On univariate analysis, as compared with normo-uricemic patients, hyperuricemic patients were more frequently male (72.6% vs 39.1%, p = 1.6 × 10−6) with higher body mass index (30.9 vs 28.7 kg/m2, p = 0.015) and more comorbidities (Charlson comorbidity index: 2.6 vs 1.8, p = 0.005). PsA started at an older age (47.5 vs 43 years, p = 0.016) was more polyarticular (56.2% vs 41.9%, p = 0.049) than axial (9.6% vs 22.8%, p = 0.019) and more destructive (52.8% vs 37.4%, p = 0.032). PsA patients with joint destruction more frequently had hyperuricemia than did others (37.6% vs 25.8%, p = 0.047). Multivariable analysis confirmed the association of hyperuricemic PsA with peripheral joint involvement (odds ratio 2.98; 95% confidence interval 1.15–7.75; p = 0.025) and less good response to treatment (0.35; 0.15–0.87; p = 0.024). Conclusion Patients with hyperuricemic PsA show poorer response to PsA treatment and have more peripheral and destructive joint damage than normo-uricemic patients. Key Points• Gout and psoriatic arthritis (PsA) can co-exist in the same patient.• Monosodium urate crystals might have a deleterious impact on PsA.• Hyperuricemic PsA is more polyarticular, less frequently axial, and more destructive than normo-uricemic PsA.• PsA with hyperuricemia should lead to more personalized medicine. more...
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- 2022
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Catalog
3. Impact de l’hyperuricémie sur les caractéristiques cliniques et radiographiques et la réponse au sécukinumab dans le rhumatisme psoriasique : analyse post hoc des données poolées de 5 études de phase 3
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R. Felten, L. Widawski, L. Spielmann, C. Gaillez, W. Bao, H. O’neill, J.E. Gottenberg, P.M. Duret, and L. Messer
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Rheumatology - Published
- 2022
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4. Quelle place pour une consultation pharmaceutique dans un programme de retour à l’activité physique destiné à des patients souffrant de rhumatismes inflammatoires chroniques ?
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K. Demesmay, S. Genéton, L. Widawski, M.-S. Mann, D. Roncalez, and L. Messer
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Pharmacology (medical) - Published
- 2022
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5. Psoriatic arthritis with hyperuricemia: more peripheral, destructive, and challenging to treat
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L, Widawski, T, Fabacher, L, Spielmann, J E, Gottenberg, J, Sibilia, P M, Duret, L, Messer, and R, Felten
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Gout ,Case-Control Studies ,Arthritis, Psoriatic ,Humans ,Hyperuricemia ,Retrospective Studies - Abstract
To study the impact of hyperuricemia on clinical presentation, severity, and associated comorbidities of psoriatic arthritis (PsA).Retrospective bicentric case-control study performed in Strasbourg and Colmar, France, from 2009 to 2019. Patients with PsA (according to ICD-10 coding) and at least one available serum urate (SU) measurement were included. Demographic, comorbidities, clinical, and radiographic data were collected. Hyperuricemia was defined as SU level ≥ 360 µmol/L.We included 242 patients: 73 (30.2%) had hyperuricemia and 15 (6.2%) met 2015 ACR/EULAR criteria for gout. On univariate analysis, as compared with normo-uricemic patients, hyperuricemic patients were more frequently male (72.6% vs 39.1%, p = 1.6 × 10Patients with hyperuricemic PsA show poorer response to PsA treatment and have more peripheral and destructive joint damage than normo-uricemic patients. Key Points • Gout and psoriatic arthritis (PsA) can co-exist in the same patient. • Monosodium urate crystals might have a deleterious impact on PsA. • Hyperuricemic PsA is more polyarticular, less frequently axial, and more destructive than normo-uricemic PsA. • PsA with hyperuricemia should lead to more personalized medicine. more...
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- 2021
6. Mise en place d’un dispositif régional de Reprise d’activité physique « RAP » pour les patients atteints de rhumatisme inflammatoire chronique
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C. Sordet, L. Messer, L. Widawski, K. Demesmay, M. Ardizzone, J. Walther, and S. Geneton
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Rheumatology - Published
- 2021
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7. POS1065 IMPACT OF HYPERURICEMIA ON CLINICAL PHENOTYPE, COMORBIDITIES, AND RESPONSE TO SECUKINUMAB IN PSORIATIC ARTHRITIS: POST HOC ANALYSIS OF FUTURE AND MAXIMISE STUDIES
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R. Felten, L. Widawski, L. Spielmann, C. Gaillez, W. Bao, J. E. Gottenberg, P. M. Duret, and L. Messer
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Rheumatology ,Immunology ,Immunology and Allergy ,General Biochemistry, Genetics and Molecular Biology - Abstract
BackgroundHyperuricemia (HU) is a metabolic abnormality associated with psoriasis (PsO) and psoriatic arthritis (PsA)1. The prevalence of HU is 2–13% in general population, 19–20% in PsO patients (pts), and 27–32% in PsA pts1,2. Pts with PsO/PsA are at significantly increased risk of HU and development of gout1. The pathogenic role of chronic HU in the development and maintenance of PsA is based on epidemiological, clinical, and fundamental arguments and hence does not appear fortuitous. These processes can influence each other3. Moreover, PsA with HU has been shown to be more peripheral, destructive, and challenging to treat4.ObjectivesTo evaluate the impact of HU on PsA in terms of clinical presentation, severity, comorbidities, and response to secukinumab (SEC) over 1-year.MethodsThis post hoc analysis included pooled data from PsA pts enrolled in the FUTURE 2–5 and MAXIMISE phase 3 trials. Pts were stratified into 2 groups based on baseline (BL) serum uric acid (SUA) level (HU: ≥360 µmol/L; without HU: ResultsOverall, 2504 PsA pts were included in the analysis, of which 822 (32.8%) had HU (62 [2.5%] with gout; 49 [2.0%] treated with ULT). At BL, pts with HU were mostly male (76.0% vs 34.2%) and had a higher body mass index (30.9 vs 28.3 kg/m2) with more comorbidities, such as hypertension (43.8% vs 31.3%), compared to pts without HU. A higher proportion of pts with HU had dactylitis (34.5% vs 25.9%), and PsO (48.3% vs 36.3%) with a greater mean PASI score (13.6 vs 10.2), compared to pts without HU (Table 1). The proportion of pts achieving ACR50, resolution of enthesitis/dactylitis, and mean change in HAQ-DI score were comparable up to Week 52 irrespective of BL HU status. The PASI90 response rate was higher in pts without HU with SEC 150 mg (with and without load) and similar in SEC 300 mg group irrespective of BL HU status (Figure 1).Table 1.Demographics and baseline characteristicsParameters, mean ± SD unless specifiedWith hyperuricemia (N=822)Without hyperuricemia (N=1682)Age (Years)48.5 ± 12.4148.3 ± 12.19Gender (Male), n (%)625 (76.0)576 (34.2)Weight (kg)92.71 ± 18.6279.59 ± 17.55BMI (kg/m2)30.90 ± 5.8628.33 ± 5.91History of hypertension, n (%)360 (43.8)526 (31.3)History of diabetes mellitus, n (%)85 (10.3)144 (8.6)TJC20.6 ± 15.5221.3 ± 16.25SJC10.9 ± 9.3110.8 ± 9.13Enthesitis, n (%)412 (50.1)852 (50.7)Dactylitis, n (%)284 (34.5)436 (25.9)Evidence of current psoriasis; n (%)397 (48.3)611 (36.3)Mean PASI score*13.61 ± 11.0310.16 ± 9.13TNFi naїve, n (%)477 (58.0)938 (55.8)MTX use at randomization, n (%)321 (39.1)685 (40.7)Serum uric acid (µmol/L)420.7 ± 57.11274.9 ± 51.98CRP (mg/L)11.6 ± 18.6610.7 ± 23.36*not collected in MAXMISEBMI, body mass index; CRP, C-reactive protein; MTX, methotrexate; SJC, swollen joint count; TJC, tender joint count; TNFi, tumor necrosis factor inhibitorConclusionIn this pooled analysis of SEC PsA studies, pts with HU reported a higher prevalence of hypertension, with more clinical dactylitis, and more PsO, with higher PASI score compared to pts without HU. Efficacy across all musculoskeletal manifestations was similar with SEC 150 and 300 mg; while PASI90 response rate was slightly better in patients without HU with SEC 150 mg, and similar with SEC 300 mg irrespective of HU status, at 1-year.References[1]Tripolino C, et al. Front Med. 2021;8:737573[2]AlJohani R, et al. J Rheumatol. 2018;45(2):213–7[3]Felten R, et al. Clin Rheumatol. 2020;39:1405–13[4]Widawski L, et al. Clin Rheumatol. 2022. https://doi.org/10.1007/s10067-022-06061-xDisclosure of InterestsRenaud FELTEN Consultant of: Novartis (Advisory board), Laura Widawski: None declared, Lionel Spielmann: None declared, Corine Gaillez Shareholder of: Novartis, Employee of: Novartis, Weibin Bao Shareholder of: Novartis, Employee of: Novartis, Jacques-Eric Gottenberg Consultant of: Novartis (Advisory board), Pierre-Marie Duret: None declared, Laurent Messer: None declared more...
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- 2022
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8. Dispositif régional de Reprise d’activité physique « RAP » pour les patients atteints de rhumatisme inflammatoire chronique : 1ers résultats à 3 mois
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L. Widawski, Christelle Sordet, Laurent Messer, K. Demesmay, S. Geneton, J. Walther, and M. Ardizzone
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Rheumatology - Abstract
Introduction Mise en place d’un dispositif d’accompagnement de reprise d’activite physique « RAP » pour les patients ayant un rhumatisme inflammatoire chronique (RIC) au sein des hopitaux de Colmar, Mulhouse, Strasbourg depuis octobre 2020. Il se deroule en 3 phases de 3 mois, lui permettant apres une 1ere periode de pratique d’activites physiques supervisees (2 fois/semaines d’une duree de 1 h a 1h30), d’etre accompagne vers une pratique autonome. L’objectif final etant diminuer la sedentarite et augmenter le temps hebdomadaire d’activite physique chez les patients RIC. Patients et methodes Inclusion des patients majeurs avec un RIC sans contre-indication medicale a la pratique d’APA. A M0 et M3, les donnees sociodemographiques, le niveau d’activite du RIC, EVA douleur, Fatigue, la prise de traitement de fond, d’antalgique, le test de marche de6 mins, les poussees du RIC sont recueillies. Des entretiens semi directifs menes par l’enseignant en activite physique adaptee permettent de recueillir le vecu des patients. Seances d’activites physiques presentielles ou distancielles (contrainte COVID) realisees par un enseignant en activite physique adapte (EAPA) Resultats 62 patients (24 hommes et 38 femmes) beneficiaires de « RAP » en 8 mois. L’âge moyen est de 46,9 ans. 49 ont une spondyloarthrite (SA), 13 ont une polyarthrite rhumatoide (PR). A M0, BASDAI moyen a 3,92, mediane a 3,8, DAS 28 moyen a 2,22, mediane a 2,25. Moyenne de l’EVA douleur est 3,78 (0–8,5), Mediane est 4, moyenne de l’EVA fatigue est a 5,39 (0–9,5), mediane est 6. 91 % des patients ont un traitement de fond classique ou biologique. 60 % (n = 37) prennent des antalgiques ou AINS. Le test de marche de 6 min est en moyenne a 65,59 % de la valeur theorique. Le resultat moyen du questionnaire de Ricci Gagnon est de 21,86, 16 patients consideres comme inactif (score Discussion Le dispositif RAP permet d’integrer l’APA dans le parcours de soin du patient RIC. Les patients beneficiaires etaient en activite faible du rhumatisme mais avec un niveau de fatigue important. Le programme d’APA n’a pas engendre d’aggravation du rhumatisme (DAS 28, BASDAI, EVA douleur fatigue stables). Donnes superposables a la litterature scientifique. Le dispositif en distanciel a permis de « recruter » des patients habitants loin du centre hospitalier referent. Si en distanciel, le cote organisationnel semble plus simple pour les patients, ses limites sont entre autres le niveau de litteratie numerique, et le manque de lien social qui est plebiscite par les patients lors des seances presentielles. Les retours patients sont tres positifs tant sur le fond et la forme du dispositif. Ils apprecient les competences specifiques des enseignants en activite physique adapte. Conclusion Les 1ers resultats sont encourageants, le dispositif RAP distanciel ou presentiel permet aux patients RIC de reprendre une APA. Les donnees de suivi a 6 et 9 mois lors de l’autonomisation seront tres interessantes et representent le 2eme challenge de RAP. more...
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- 2021
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9. Use of sertraline, paroxetine and fluvoxamine by nursing women
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Alan Fukuchi, Martina V. Brunhuber, M. E. L. Widawski, Victoria Hendrick, Lori L. Altshuler, and A. M. Y. Wertheimer
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Fluvoxamine ,Breast milk ,030226 pharmacology & pharmacy ,Risk Assessment ,Depression, Postpartum ,03 medical and health sciences ,0302 clinical medicine ,Nursing ,030225 pediatrics ,Sertraline ,medicine ,Humans ,Risk factor ,Chromatography, High Pressure Liquid ,Infant, Newborn ,Paroxetine ,Psychiatry and Mental health ,Breast Feeding ,Toxicity ,Regression Analysis ,Female ,Psychology ,Reuptake inhibitor ,Breast feeding ,Selective Serotonin Reuptake Inhibitors ,medicine.drug - Abstract
BackgroundThe pharmacological treatment of depression in nursing women requires information on the magnitude of medication exposure to the infant that may occur through breast milk.AimsTo examine serum concentrations of antidepressants in infants exposed to these medications through breast-feeding.MethodMaternal and infant serum concentrations of sertraline, paroxetine and fluvoxamine were determined with high-performance liquid chromatography (limit of detections=1 ng/ml).ResultsNo detectable medication was present in any infant exposed to paroxetine (n=16) or fluvoxamine (n=4). Among infants exposed to sertraline (n=30), detectable medication was present in 24% of serum samples. A significant negative correlation was found between infant age and infant serum concentration. Sertraline was significantly more likely to be detected in an infant if the mother's daily dose was 100 mg or higher. No adverse sequelae occurred in any infant.ConclusionsThis study shows that paroxetine, fluvoxamine and sertraline produce minimal exposure to infants when taken by nursing mothers. more...
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- 2001
10. Impact of hyperuricaemia on patients with psoriatic arthritis treated with secukinumab in the FUTURE 2-5 and MAXIMISE studies.
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Felten R, Widawski L, Spielmann L, Gaillez C, Bao W, Gottenberg JE, Duret PM, and Messer L
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- Humans, Male, Female, Quality of Life, Uric Acid, Arthritis, Psoriatic complications, Arthritis, Psoriatic drug therapy, Hyperuricemia complications, Hyperuricemia drug therapy
- Abstract
Objectives: Patients with psoriatic arthritis (PsA) are at a significantly increased risk of hyperuricaemia and development of gout, and those with hyperuricaemia have been found to respond poorly to PsA treatment and have more peripheral and destructive joint damage. We present a comprehensive post hoc analysis using pooled data from the FUTURE 2-5 studies and the MAXIMISE study to further evaluate the impact of hyperuricaemia on clinical presentation/disease severity and response to secukinumab in patients with PsA., Methods: Patients were stratified into two groups based on baseline serum uric acid (SUA) level (threshold of 360 µmol/L). A sensitivity analysis was also performed based on SUA thresholds of 300 µmol/L and 420 µmol/L. Demographics, clinical, radiological characteristics and comorbidities data were collected., Results: At baseline, patients with hyperuricaemia were mostly male, reported a higher prevalence of hypertension, with more clinical dactylitis, more psoriasis and more severe skin disease compared with patients with normouricaemia. A similar proportion of patients in the normouricaemic and hyperuricaemic cohorts achieved American College of Rheumatology responses, resolution of enthesitis and dactylitis, inhibition of structural damage progression and improvement in health-related quality of life across all secukinumab doses at week 52., Conclusion: Patients with PsA and hyperuricaemia have different clinical characteristics from patients with PsA and normouricaemia. Identification of these patients at an early stage may facilitate a personalised treatment approach and improved management of comorbidities. Furthermore, secukinumab provided a rapid and sustained response across all manifestations of PsA up to week 52, irrespective of baseline uricaemia status., Competing Interests: Competing interests: RF: Consulting fees and advisory boards (Novartis); J-EG: Consulting fees and advisory boards (Novartis); CG and WB are employees and shareholders of Novartis., (© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.) more...
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- 2023
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11. Diffuse idiopathic skeletal hyperostosis associated ossification of the posterior longitudinal ligament.
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Spielmann L, Duret PM, Widawski L, Rinagel M, Messer L, and Manoila I
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- Humans, Longitudinal Ligaments, Osteogenesis, Cervical Vertebrae, Hyperostosis, Diffuse Idiopathic Skeletal complications, Hyperostosis, Diffuse Idiopathic Skeletal diagnostic imaging, Ossification, Heterotopic diagnostic imaging
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- 2022
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12. Psoriatic arthritis with hyperuricemia: more peripheral, destructive, and challenging to treat.
- Author
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Widawski L, Fabacher T, Spielmann L, Gottenberg JE, Sibilia J, Duret PM, Messer L, and Felten R
- Subjects
- Case-Control Studies, Humans, Retrospective Studies, Arthritis, Psoriatic complications, Arthritis, Psoriatic drug therapy, Gout complications, Hyperuricemia complications
- Abstract
Objective: To study the impact of hyperuricemia on clinical presentation, severity, and associated comorbidities of psoriatic arthritis (PsA)., Methods: Retrospective bicentric case-control study performed in Strasbourg and Colmar, France, from 2009 to 2019. Patients with PsA (according to ICD-10 coding) and at least one available serum urate (SU) measurement were included. Demographic, comorbidities, clinical, and radiographic data were collected. Hyperuricemia was defined as SU level ≥ 360 µmol/L., Results: We included 242 patients: 73 (30.2%) had hyperuricemia and 15 (6.2%) met 2015 ACR/EULAR criteria for gout. On univariate analysis, as compared with normo-uricemic patients, hyperuricemic patients were more frequently male (72.6% vs 39.1%, p = 1.6 × 10
-6 ) with higher body mass index (30.9 vs 28.7 kg/m2 , p = 0.015) and more comorbidities (Charlson comorbidity index: 2.6 vs 1.8, p = 0.005). PsA started at an older age (47.5 vs 43 years, p = 0.016) was more polyarticular (56.2% vs 41.9%, p = 0.049) than axial (9.6% vs 22.8%, p = 0.019) and more destructive (52.8% vs 37.4%, p = 0.032). PsA patients with joint destruction more frequently had hyperuricemia than did others (37.6% vs 25.8%, p = 0.047). Multivariable analysis confirmed the association of hyperuricemic PsA with peripheral joint involvement (odds ratio 2.98; 95% confidence interval 1.15-7.75; p = 0.025) and less good response to treatment (0.35; 0.15-0.87; p = 0.024)., Conclusion: Patients with hyperuricemic PsA show poorer response to PsA treatment and have more peripheral and destructive joint damage than normo-uricemic patients. Key Points • Gout and psoriatic arthritis (PsA) can co-exist in the same patient. • Monosodium urate crystals might have a deleterious impact on PsA. • Hyperuricemic PsA is more polyarticular, less frequently axial, and more destructive than normo-uricemic PsA. • PsA with hyperuricemia should lead to more personalized medicine., (© 2022. The Author(s).) more...- Published
- 2022
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13. [Which taxonomy for inflammatory diseases in rheumatology? The concept of Psout].
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Messer L, Felten R, Duret PM, Gottenberg JE, Widawski L, Meyer A, Lomo Myazhiom AC, Spielmann L, and Sibilia J
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- Humans, Terminology as Topic, Rheumatology
- Abstract
Clinical practice needs the identification of the patient disease. The physician has to rationalize symptoms allowing the recognition of a realistic entity and its classification in a reference nosology. Unlike other practices, the biomedical model uses scientific census methodology, from a tabular perspective to the definition of diseases. Due to its simplification process, it therefore neglects transitional or complex cases. In Rheumatology, this reasoning is challenged by the lack of objectivity and specificity of the items supporting the clinician when he builds the diagnosis, but also by the physiopathological complexity. Sometimes, diseases may be confused or superposed, possibly leading to the description of novel entities. The authors describe herein the difficulties encountered in practical clinical medicine. They show, from a concrete and real personal situation, how it can possibly lead to the justification of a new entity., (© 2021 médecine/sciences – Inserm.) more...
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- 2021
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14. Enthesitis of the ligamentum teres femoris in axial spondyloarthritis.
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Blaess J, Widawski L, Spielmann L, Moreau P, Duret PM, and Messer L
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- Humans, Enthesopathy, Round Ligament of Femur, Spondylarthritis diagnostic imaging
- Published
- 2021
- Full Text
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