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1. Urinary soluble CD163 is useful as 'liquid biopsy' marker in lupus nephritis at both diagnosis and follow-up to predict impending flares

Author

Yves Renaudineau, Dominique Chauveau, Stanislas Faguer, Antoine Huart, David Ribes, Gregory Pugnet, Laurent Sailler, Thibaut Jamme, Emmanuel Treiner, Françoise Fortenfant, Chloé Bost, Caroline Carlé, and Julie Belliere

Subjects
lupus nephritis, Biomarkers, Urinary soluble CD163, Flare, Remission, End stage kidney disease, Immunologic diseases. Allergy, RC581-607
Abstract

Lupus nephritis (LN) diagnosis and follow-up requires noninvasive biomarkers. Therefore, the added value of coupling the urinary soluble (s)CD163/creatinuria ratio with serological markers was evaluated in a real-world clinical practice. To this end, a monocentric and retrospective study was conducted in 139 SLE patients with biopsy-proven nephritis having an active LN (LN-A, n = 63 with a positive SLEDAI-renal score) or inactive (n = 76), as well as 98 non-renal SLE patients. The urinary sCD163/creatinuria ratio outperformed serological markers for predicting LN-A (AUC>0.972; p 0.750 versus non-LN patients, and AUC>0.640 versus LN-IR patients) best predicted LN-A, and higher levels were retrieved in class III/IV proliferative LN-A. In multivariate logistic regression analysis, the urinary sCD163/creatinuria ratio remained the only statistically significant biomarker to predict LN-A (p

Published
2024
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2. O8 Hydroxychloroquine blood levels at first trimester of pregnancy, and materno-fetal outcomes: a prospective study of 174 patients with systemic lupus erythematosus (GR2 study)

Author

Nathalie Costedoat-Chalumeau, Anna Molto, Maddalena Larosa, Christophe Richez, Luc Mouthon, Laurent Sailler, Estibaliz Lazaro, Viviane Queyrel, Nathalie Morel, Gaëlle Guettrot-Imbert, Veronique Le Guern, Gelsomina Alle, Anne Murarasu, Pauline Orquevaux, Emmanuelle Pannier, and Benoît Blanchet

Subjects
Immunologic diseases. Allergy, RC581-607
Published
2024
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3. Host-microbiota relationship in the pathophysiology of aseptic abscess syndrome: protocol for a multicentre case-control study (ABSCESSBIOT)

Author

Nathalie Costedoat-Chalumeau, Patrick Jégo, Nicolas Barnich, Emilie Vazeille, Maria Nachury, Marc André, Stanislas Faguer, Laurent Sailler, Bruno Pereira, Olivier Chosidow, Alexandre Thibault Jacques Maria, Jean-François Viallard, Arnaud Hot, Jean-David Bouaziz, Jérôme Connault, Jean Schmidt, Ludovic Trefond, Felix Ackermann, Fabrice Bonnet, François Lifermann, Nicolas Limal, Guillaume Cadiot, Elisabeth Billard, Richard Bonnet, Romain Altwegg, Alexandra Audemard-Verger, Damien Richard, Elisabeth Aslangul, Fairouzé Bani Sadr, Sophie Besnard, Jean-François Bourgaux, Sebastien De Almeida, Amandine Dernoncourt, Hélène Desmurs Clavel, Amelie Dutheil, Jean-Marc Galempoix, Camille Hua, Estelle Jean, Wendy Jourde, Clemence Lepelletier, Jean Benoit Monfort, Yves Poinsignon, Marie Laure Rabilloux, Jerome Razatomaery, Clea Rouillon, Mihaela Saplacan, and Laure Swiader

Subjects
Medicine
Abstract

Introduction Aseptic abscess (AA) syndrome is a rare disease whose pathophysiology is unknown. It is often associated with inflammatory bowel disease and characterised by sterile inflammation with collections of neutrophils affecting several organs, especially the spleen. Microbiota are known to influence local and systemic immune responses, and both gut and oral microbiota perturbations have been reported in diseases associated with AA syndrome. However, interactions between these factors have never been studied in AA syndrome. The purpose of this translational case-control study (ABSCESSBIOT) is to investigate gut and/or oral microbiota in patients with AA syndrome compared with healthy controls. Moreover, microbiota associated metabolites quantification and Treg/Th17 balance characterisation will give a mechanistic insight on how microbiota may be involved in the pathophysiology of AA syndrome.Methods and analysis This French multicentre case-control study including 30 French centres (University hospital or regional hospital) aims to prospectively enrol 30 patients with AA syndrome with 30 matched controls and to analyse microbiota profiling (in stools and saliva), microbial metabolites quantification in stools and circulating CD4+ T cell populations.Ethics and dissemination This study protocol was reviewed and approved by an independent French regional review board (n° 2017-A03499-44, Comité de Protection des Personnes Ile de France 1) on 10 October 2022, and declared to the competent French authority (Agence Nationale de Sécurité du Médicament et des produits de santé, France). Oral and written informed consent will be obtained from each included patient and the control participant. Study results will be reported to the scientific community at conferences and in peer-reviewed scientific journals.Trial registration number Clinical Trials web-based platform (NCT05537909).

Published
2023
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4. Glucocorticoids selectively affect the memory T cell response to SARS-Cov2 spike in vaccinated and post-infected patients with systemic lupus erythematosus

Author

Yves Renaudineau, Chloé Bost, Florence Abravanel, Jacques Izopet, Antoine Blancher, Nicolas Congy, Emmanuel Treiner, and Laurent Sailler

Subjects
Systemic lupus erythematosus, Spike, Nucleocapsid, COVID-19, Antibody, Interferon gamma release assay, Immunologic diseases. Allergy, RC581-607
Abstract

Immune response to vaccines and pathogens remains unclear in patients with systemic lupus erythematosus (SLE). To investigate this, a single-center retrospective study was conducted with 47 SLE patients vaccinated against COVID-19, including 13 who subsequently developed an asymptomatic/mild disease. As compared to controls, post-vaccine response against Spike was reduced in SLE patients when considering both memory T-cells in a whole blood interferon gamma release assay (IGRA-S) and IgG anti-Spike antibody (Ab) responses. The SLE-associated defective IGRA-S response was associated with a serum albumin level below 40 g/L and with the use of glucocorticoids, while a defective IgG anti-Spike Ab response was associated with lower levels of anti-dsDNA and anti-SSA/Ro 52 kDa Abs. IGRA-S and IgG anti-Spike responses were independent from SLE activity and clinical phenotype, low complement, hypergammaglobulinemia, and lymphopenia. As compared to controls, SLE patients showed a rapid decay of anti-Spike T-cell memory and stable IgG anti-Spike Ab responses. In conclusion, both T cell and humoral anti-Spike responses were independently affected in our SLE patients cohort, which supports the exploration of both responses in the follow-up of SLE patients and especially in those receiving glucocorticoids.

Published
2023
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5. Immunological and translational key challenges in systemic lupus erythematosus: A symposium update

Author

Yves Renaudineau, Sylviane Muller, Christian M. Hedrich, Dominique Chauveau, Julie Bellière, Sébastien De Almeida, Jan Damoiseaux, Marc Scherlinger, Jean Charles Guery, Laurent Sailler, and Chloé Bost

Subjects
Systemic lupus erythematosus, Genetics, TLR7, Platelets, Vaccine, COVID-19, Immunologic diseases. Allergy, RC581-607
Abstract

The first LBMR-Tim (Toulouse Referral Medical Laboratory of Immunology) symposium convened on December 16, 2022 in Toulouse, France to address challenging questions in systemic lupus erythematosus (SLE). Special focus was put on (i) the role played by genes, sex, TLR7, and platelets on SLE pathophysiology; (ii) autoantibodies, urinary proteins, and thrombocytopenia contribution at the time of diagnosis and during follow-up; (iii) neuropsychiatric involvement, vaccine response in the COVID-19 era, and lupus nephritis management at the clinical frontline; and (iv) therapeutic perspectives in patients with lupus nephritis and the unexpected adventure of the Lupuzor/P140 peptide. The multidisciplinary panel of experts further supports the concept that a global approach including basic sciences, translational research, clinical expertise, and therapeutic development have to be prioritized in order to better understand and then improve the management of this complex syndrome.

Published
2023
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6. Sine scleroderma, limited cutaneous, and diffused cutaneous systemic sclerosis survival and predictors of mortality

Author

Sébastien De Almeida Chaves, Tiphaine Porel, Mickael Mounié, Laurent Alric, Léonardo Astudillo, Antoine Huart, Olivier Lairez, Martin Michaud, Grégoire Prévot, David Ribes, Laurent Sailler, Francis Gaches, Daniel Adoue, and Gregory Pugnet

Subjects
Autoimmune diseases, Systemic sclerosis, Mortality, Prognostic factors, Diseases of the musculoskeletal system, RC925-935
Abstract

Highlights • Male sex, cardiac involvement, DLCO 5 mg/l are strong predictors of mortality in systemic sclerosis. • This study shows the survival of subtypes and in particular sine scleroderma. • Sine scleroderma subtype has better survival than diffuse or limited cutaneous subtypes. • Non-systemic sclerosis-related deaths are more frequent than systemic sclerosis-related deaths. • Cardiovascular events non-systemic sclerosis-related are the main deaths.

Published
2021
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7. Hydroxychloroquine levels in patients with systemic lupus erythematosus: whole blood is preferable but serum levels also detect non-adherence

Author

Benoit Blanchet, Moez Jallouli, Marie Allard, Pascale Ghillani-Dalbin, Lionel Galicier, Olivier Aumaître, François Chasset, Véronique Le Guern, Frédéric Lioté, Amar Smail, Nicolas Limal, Laurent Perard, Hélène Desmurs-Clavel, Du Le Thi Huong, Bouchra Asli, Jean-Emmanuel Kahn, Laurent Sailler, Félix Ackermann, Thomas Papo, Karim Sacré, Olivier Fain, Jérôme Stirnemann, Patrice Cacoub, Gaelle Leroux, Judith Cohen-Bittan, Jérémie Sellam, Xavier Mariette, Claire Goulvestre, Jean Sébastien Hulot, Zahir Amoura, Michel Vidal, Jean-Charles Piette, on behalf of the PLUS Group, Noémie Jourde-Chiche, and Nathalie Costedoat-Chalumeau

Subjects
Hydroxychloroquine, Systemic lupus erythematosus, Serum, Drug monitoring, Adherence, Diseases of the musculoskeletal system, RC925-935
Abstract

Abstract Background Hydroxychloroquine (HCQ) levels can be measured in both serum and whole blood. No cut-off point for non-adherence has been established in serum nor have these methods ever been compared. The aims of this study were to compare these two approaches and determine if serum HCQ cut-off points can be established to identify non-adherent patients. Methods HCQ levels were measured in serum and whole blood from 573 patients with systemic lupus erythematosus (SLE). The risk factors for active SLE (SLEDAI score > 4) were identified by multiple logistic regression. Serum HCQ levels were measured in 68 additional patients known to be non-adherent, i.e. with whole-blood HCQ

Published
2020
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8. Presentation and Real-World Management of Giant Cell Arteritis (Artemis Study)

Author

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

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

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

Published
2021
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9. Value of natriuretic peptides and tissue Doppler imaging in the estimation of left ventricular filling pressure in patients with cardiac amyloidosis

Author

Didier Carrié, Stéphanie Brun, Eve Cariou, Pauline Fournier, David Ribes, Stanislas Faguer, Antoine Huart, Michel Galinier, Daniel Adoue, Laurent Alric, Léonardo Astudillo, Pauline Bernadet Monrozies, Dominique Chauveau, Pascal Cintas, Magali Colombat, Audrey Delas, Delphine Dupin-Deguine, Joelle Guitard, Bénédicte Puissant, Grégory Pugnet, Grégoire Prévot, Murielle Roussel, and Laurent Sailler

Subjects
Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract

Background Estimation of left ventricular filling pressures (LVFP) is a determining factor in the follow-up of patients with cardiac amyloidosis (CA). Natriuretic peptides (NPs) and tissue Doppler imaging may be used to monitor LVFP in patients with CA. The aim of this study was to evaluate the value of NPs and Doppler parameters in estimating LVFP in patients with CA.Methods Fifty patients with biopsy-verified light chain (n=31), A protein amyloidosis (AA) (n=1), apoliporotein A2 (n=1) or bone scintigraphy-proven transthyretin (n=17) CA were retrospectively included. All patients underwent right heart catheterisation (RHC). Among them, 48 (96%) and 43 (86%) had assays of NPs (20 brain natriuretic peptide (BNP), 27 N-terminal pro-hormone brain natriuretic peptide (NT-proBNP) and 1 both) and transthoracic echocardiography performed within 24 hours of RHC, respectively.Results The median BNP and NT-proBNP levels were 1000 (243–1477) ng/L and 10 106 (2935–13 348) ng/L, respectively. Echocardiography demonstrated left atrial enlargement with a mean volume of 47±16 mL and low tissue Doppler lateral Ea of 5±2 cm/s. The mean early diastolic mitral inflow velocity on early lateral mitral annular diastolic velocity ratio (E/Ea) ratio was 18±7, and the mean pulmonary capillary wedge pressure (PCWP) by RHC was 18±8 mm Hg. There was no correlation between BNP (r=0.260, p=0.774) or NT-proBNP (r=−0.103, p=0.984) levels and PCWP. There was a slight correlation between E/Ea ratio and PCWP (r=0.337, p=0.029). E/Ea ratio >14 performed poorly in differentiating elevated and low LVFP.Conclusion In patients with CA, NPs do not accurately estimate PCWP. Tissue Doppler-derived mitral E/Ea ratio is correlated with PCWP, but the slight correlation requires to estimate LVFP in a broad clinical and imaging context to avoid diagnostic errors.

Published
2019
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10. Corticosteroid Risk Function of Severe Infection in Primary Immune Thrombocytopenia Adults. A Nationwide Nested Case-Control Study.

Author

Guillaume Moulis, Aurore Palmaro, Laurent Sailler, and Maryse Lapeyre-Mestre

Subjects
Medicine, Science
Abstract

Corticosteroid (CS)-related infection risk in immune thrombocytopenia (ITP) is unknown. The aim of this study was to assess the adjusted CS risk function of severe infection in persistent or chronic primary ITP adults. We designed a nested case-control study in the FAITH cohort. This cohort is built through the French national health insurance database named SNIIRAM and includes all treated incident persistent or chronic primary ITP adults in France (ENCePP n°4574). Patients who entered the FAITH cohort between 2009 and 2012 were eligible (n = 1805). Cases were patients with infection as primary diagnosis code during hospitalization. Index date was the date of first hospitalization for infection. A 2:1 matching was performed on age and entry date in the cohort. Various CS exposure time-windows were defined: current user, exposure during the 1/3/6 months preceding index date and from the entry date. CS doses were converted in prednisone equivalent (PEQ). The cumulative CS doses were averaged in each time-window to obtain daily PEQ dosages. Each CS exposure definition was assessed using multivariate conditional regression models. During the study period, 161 cases (9 opportunistic) occurred. The model with the best goodness of fit was CS exposure during the month before the index date (OR: 2.48, 95% CI: 1.61-3.83). The dose-effect relation showed that the risk existed from averaged daily doses ≥5 mg PEQ (vs.

Published
2015
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11. Cancer risk of anti-TNF-α at recommended doses in adult rheumatoid arthritis: a meta-analysis with intention to treat and per protocol analyses.

Author

Guillaume Moulis, Agnès Sommet, Johana Béné, François Montastruc, Laurent Sailler, Jean-Louis Montastruc, and Maryse Lapeyre-Mestre

Subjects
Medicine, Science
Abstract

BACKGROUND: The risk of malignancies on TNF-α antagonists is controversial. The aim of this survey was to assess cancer risk on TNF-α antagonists in adult rheumatoid arthritis patients, including the five marketed drugs (infliximab, etanercept, adalimumab, golimumab and certolizumab) used in line with the New Drug Application. Furthermore, the relative interest of modified intention to treat or per protocol analyses to assess such sparse events remains unknown. METHODOLOGY/PRINCIPAL FINDINGS: Data sources were MEDLINE, CENTRAL, ISI Web of Science, ACR and EULAR meeting abstracts, scientific evaluation of the drugs leading to their marketing approval, and clinicaltrials.gov, until 31 December 2012.We selected double-blind randomized controlled trials in adult rheumatoid arthritis patients, including at least one treatment arm in line with New Drug Application. We performed random effect meta-analysis, with modified intention to treat and per protocol analyses. Thirty-three trials were included. There was no excess risk of malignancies on anti-TNF-α administered in line with New Drug Application in the per protocol model (OR, 0.93 95%CI[0.59-1.44]), as well as in the modified intention to treat model (OR, 1.27 95%CI[0.82-1.98]). There was a non-significant tendency for an excess non-melanoma skin cancer risk in both models (respectively, 1.37 [0.71-2.66] and 1.90 [0.98-3.67]). With fixed effect Peto model restricting to trials during at least 52 weeks, the overall cancer risk was respectively 1.60 [0.97-2.64] and 1.22 [0.72-2.08]. Whatever the model, modified intention to treat analysis led to higher estimations than per protocol analysis. The later may underestimate the treatment effect when assessing very sparse events and when many patients dropped out in placebo arms. In metaregression, there was no differential risk among the five drugs. CONCLUSIONS/SIGNIFICANCE: This study did not find any evidence for an excess cancer risk on TNF-α antagonists in adult rheumatoid arthritis patients, but an excess cancer risk after several years of exposure cannot be ruled out. Both modified intention to treat and per protocol analyses should be presented in such safety analyses.

Published
2012
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12. Pregnancy outcomes in women with primary Sjögren's syndrome: an analysis of data from the multicentre, prospective, GR2 study

Author

Grégoire Martin de Frémont, Nathalie Costedoat-Chalumeau, Estibaliz Lazaro, Rakiba Belkhir, Gaëlle Guettrot-Imbert, Nathalie Morel, Gaétane Nocturne, Anna Molto, Tiphaine Goulenok, Elisabeth Diot, Laurent Perard, Nicole Ferreira-Maldent, Maelle Le Besnerais, Nicolas Limal, Nihal Martis, Noémie Abisror, Odile Debouverie, Christophe Richez, Vincent Sobanski, François Maurier, Gaëtan Sauvetre, Hervé Levesque, Marie-Agnès Timsit, Nathalie Tieulié, Pauline Orquevaux, Boris Bienvenu, Matthieu Mahevas, Thomas Papo, Céline Lartigau-Roussin, Elodie Chauvet, Emilie Berthoux, Françoise Sarrot-Reynauld, Loïc Raffray, Marion Couderc, Nicolas Martin Silva, Noémie Jourde-Chiche, Nicolas Belhomme, Thierry Thomas, Vincent Poindron, Viviane Queyrel-Moranne, Juliette Delforge, Camille Le Ray, Emmanuelle Pannier, Xavier Mariette, Véronique Le Guern, Raphaèle Seror, Alexandra AUDEMARD-VERGER, Emmanuel AZZI, Béatrice BANNEVILLE, Antoine BAUDET, Constance BEAUDOUIN BAZIRE, Cristina BELIZNA, Alexandre Belot, Ygal BENHAMOU, Alice Berezné, Fanny BERNARD-GUERVILLY, Sabine BERTHIER, Holy BEZANAHARY, Lisa BIALE, Adrien BIGOT, Claire BLANCHARD-DELAUNAY, Anne CALAS, Julien CAMPAGNE, Pascal CATHEBRAS, Claire CAZALETS, Benjamin CHAIGNE, Olivia CHANDESRIS, Jérémy CHATELAIS, Emmanuel CHATELUS, Fleur COHEN, Bernard Combe, Céline COMPARON, Pascal COQUERELLE, Louise DAMIAN, Eric DAUGAS, Mathilde DE MENTHON, Claire DE MOREUIL, Estelle DELATTRE, Azeddine DELLAL, Catherine Deneux-Tharaux, Amélie DENIS, Camille DEPROUW, Emmanuelle DERNIS, Alban DEROUX, Sandra DESOUCHES, Philippe Dieudé, Guillaume DIREZ, Maxime Dougados, Marine DRIESSEN, Aurélie DU THANH, Laetitia DUNOGEANT, Cécile DURANT, Cécile-Audrey DUREL, Isabelle DURIEU, Florence EBOUE, Elisabeth Elefant, Olivier FAIN, Bruno FAUTREL, René-Marc FLIPO, Aline FRAZIER, Antoine FROISSART, Sophie GEORGIN-LAVIALLE, Elisabeth GERVAIS, Bertrand GODEAU, François Goffinet, Anne GOMPEL, Laure GOSSEC, Philippe GOUPILLE, Claire GRANGE, Constance GUILLAUD-DANIS, Eric HACHULLA, Sabine HOEFSLOOT, Aurélie HUMMEL, Patrick JEGO, Stéphanie JOBARD, Laurence JOSSELIN-MAHR, Marc LAMBERT, Vincent LANGLOIS, Delphine LARIVIERE, Claire LARROCHE, Augustin LATOURTE, Christian LAVIGNE, Thomas LE GALLOU, Gaëlle LEROUX, Jean Guillaume LETAROUILLY, Frédéric LIOTÉ, Laurence Loeuillet, Jonathan London, Valentine Loustau, Pierre LOZAC'H, Emmanuel MAHEU, Hélène MAILLARD, Hubert MAROTTE, Agathe MASSEAU, Arsène MEKINIAN, Sara Melboucy Belkhir, Corinne Miceli-Richard, Martin MICHAUD, Marc MICHEL, Olivier MORANNE, Chafika MORATI-HAFSAOUI, Guillaume MOULIS, Luc MOUTHON, Barbara NICOLAS, Jacky Nizard, Jérémy ORA, Rodérau OUTH, Elisabeth PASQUIER, Jean-Loup PENNAFORTE, Antoinette PERLAT, Hélène PETIT-BAUER, Evangeline PILLEBOUT, Jean-Maxime PIOT, Agnès PORTIER, Olivier Pourrat, Xavier PUECHAL, Gregory PUGNET, Manon REDONDIN, Alexis REGENT, Mélanie RORIZ, Laurent SAILLER, Léa SAVEY, Marc SCHERLINGER, Nicolas SCHLEINITZ, Jérémie Sellam, Loïc Sentilhes, Aude SERVAIS, Perrine SMETS, Christelle SORDET, Martin SOUBRIER, Katia STANKOVIC-STOJANOVIC, Geoffrey URBANSKI, Véronique VEIT, Emmanuelle WEBER, and Cécile YELNIK

Subjects
Rheumatology, Immunology, Immunology and Allergy
Published
2023

13. Characterisation of a high-risk profile for maternal thrombotic and severe haemorrhagic complications in pregnant women with antiphospholipid syndrome in France (GR2): a multicentre, prospective, observational study

Author

Anne Murarasu, Gaëlle Guettrot-Imbert, Véronique Le Guern, Cécile Yelnik, Viviane Queyrel, Nicolas Schleinitz, Nicole Ferreira-Maldent, Elisabeth Diot, Geoffrey Urbanski, Emmanuelle Pannier, Estibaliz Lazaro, Odile Souchaud-Debouverie, Pauline Orquevaux, Nicolas Belhomme, Nathalie Morel, Elodie Chauvet, François Maurier, Maëlle Le Besnerais, Noemie Abisror, Tiphaine Goulenok, Françoise Sarrot-Reynauld, Alban Deroux, Elisabeth Pasquier, Claire de Moreuil, Holy Bezanahary, Laurent Pérard, Nicolas Limal, Vincent Langlois, Anne Calas, Bertrand Godeau, Christian Lavigne, Eric Hachulla, Fleur Cohen, Ygal Benhamou, Loïc Raffray, Mathilde de Menthon, Nathalie Tieulié, Vincent Poindron, Luc Mouthon, Maddalena Larosa, Elisabeth Eléfant, Loic Sentilhes, Anna Molto, Catherine Deneux-Tharaux, Nathalie Costedoat-Chalumeau, Emmanuel Azzi, Béatrice Banneville, Antoine Baudet, Constance Beaudouin-Bazire, Cristina Belizna, Rakiba Belkhir, Alice Berezne, Emilie Berthoux, Sabine Berthier, Lisa Biale, Boris Bienvenu, Claire Blanchard-Delaunay, Pascal Cathebras, Claire Cazalets, Benjamin Chaigne, Olivia Chandesris, Jérémy Chatelais, Emmanuel Chatelus, Pascal Coquerelle, Marion Couderc, Juliette Delforge, Amélie Denis, Sandra Desouches, Philippe Dieudé, Guillaume Direz, Marine Driessen, Aurélie Du Thanh, Laetitia Dunogeant, Cécile Durant, Isabelle Durieu, Marc Fabre, Olivier Fain, René-Marc Flipo, Aline Frazier, Antoine Froissart, Sophie Georgin-Lavialle, Elisabeth Gervais, Anne Gompel, Laure Gossec, Phillipe Goupille, Claire Grange, Constance Guillaud-Danis, Aurélie Hummel, Moez Jallouli, Patrick Jego, Stéphane Jobard, Laurence Josselin-Mahr, Noémie Jourde-Chiche, Anne-Sophie Korganow, Marc Lambert, Delphine Lariviere, Claire Larroche, Céline Lartigau-Roussin, Augustin Latourte, Thomas Le Gallou, Gaëlle Leroux, Hervé Levesque, Frédéric Lioté, Jonathan London, Valentine Loustau, Emmanuel Maheu, Matthieu Mahevas, Hélène Maillard, Xavier Mariette, Hubert Marotte, Nicolas Martin-Silva, Nihal Martis, Agathe Masseau, Arsène Mekinian, Sara Melboucy-Belkhir, Martin Michaud, Marc Michel, Chafika Morati-Hafsaoui, Jacky Nizard, Jérémy Ora, Jean-Loup Pennaforte, Antoinette Perlat, Hélène Petit Bauer, Evangeline Pillebout, Jean-Maxime Piot, Agnès Portier, Gregory Pugnet, Manon Redondin, Alexis Regent, Christophe Richez, Mélanie Roriz, Laurent Sailler, Gaëtan Sauvêtre, Léa Savey, Vincent Sobanski, Christelle Sordet, Martin Soubrier, Katia Stankovic Stojanovic, Thierry Thomas, Marie-Agnès Timsit, and Vassilis Tsatsaris

Subjects
Rheumatology, Immunology, Immunology and Allergy
Published
2022

14. Sine scleroderma, limited cutaneous, and diffused cutaneous systemic sclerosis survival and predictors of mortality

Author

Antoine Huart, Leonardo Astudillo, Sébastien De Almeida Chaves, Grégoire Prévot, Daniel Adoue, David Ribes, Laurent Alric, T. Porel, Laurent Sailler, Mickael Mounié, Grégory Pugnet, Francis Gaches, Martin Michaud, and Olivier Lairez

Subjects
Male, medicine.medical_specialty, Scleroderma, Systemic, business.industry, Hypertension, Pulmonary, Autoimmune diseases, Diseases of the musculoskeletal system, Prognosis, medicine.disease, Prognostic factors, Dermatology, Scleroderma, RC925-935, Scleroderma, Limited, Scleroderma, Diffuse, medicine, Humans, Systemic sclerosis, Mortality, Lung Diseases, Interstitial, business, Research Article
Abstract

Background Systemic sclerosis (SSc) is associated with a variability of mortality rates in the literature. Objective To determine the mortality and its predictors in a long-term follow-up of a bi-centric cohort of SSc patients. Methods A retrospective observational study by systematically analyzing the medical records of patients diagnosed with SSc in Toulouse University Hospital and Ducuing Hospital. Standardized Mortality Ratio (SMR), mortality at 1, 3, 5, 10, and 15 years of disease and causes of death were described. Predictors of mortality using Cox regression were assessed. Results Three hundred seventy-five patients were included: 63 with diffuse cutaneous SSc, 279 with limited cutaneous SSc, and 33 with sine scleroderma. The SMR ratio was 1.88 (95% CI 1.46–1.97). The overall survival rates were 97.6% at 1 year, 93.4% at 3 years, 87.1% at 5 years, 77.9% at 10 years, and 61.3% at 15 years. Sixty-nine deaths were recorded. 46.4% were SSc related deaths secondary to interstitial lung disease (ILD) (34.4%), pulmonary hypertension (31.2%), and digestive tract involvement (18.8%). 53.6% were non-related to SSc: cardiovascular disorders (37.8%) and various infections (35.1%) largely distanced those from cancer (13.5%). Four significant independent predictive factors were identified: carbon monoxide diffusing capacity (DLCO) < 70% (HR=3.01; p=0.0053), C-reactive protein (CRP) >5 mg/l (HR=2.13; p=0.0174), cardiac involvement (HR=2.86; p=0.0012), and the fact of being male (HR=3.25; p=0.0004). Conclusion Long-term data confirmed high mortality of SSc. Male sex, DLCO 5mg/l were identified as independent predictors of mortality. Supplementary Information The online version contains supplementary material available at 10.1186/s13075-021-02672-y., • Male sex, cardiac involvement, DLCO 5 mg/l are strong predictors of mortality in systemic sclerosis. • This study shows the survival of subtypes and in particular sine scleroderma. • Sine scleroderma subtype has better survival than diffuse or limited cutaneous subtypes. • Non-systemic sclerosis-related deaths are more frequent than systemic sclerosis-related deaths. • Cardiovascular events non-systemic sclerosis-related are the main deaths. Supplementary Information The online version contains supplementary material available at 10.1186/s13075-021-02672-y.

Published
2021

15. Long-term prophylaxis in hereditary angioedema management: Current practices in France and unmet needs

Author

Laurence Bouillet, Olivier Fain, Guillaume Armengol, Magali Aubineau, Claire Blanchard-Delaunay, Marie-Caroline Dalmas, Claire De Moreuil, Aurélie Du Thanh, Delphine Gobert, Stéphane Guez, Cyrille Hoarau, Roland Jaussaud, Pierre-Yves Jeandel, Hervé Maillard, Nicolas Marmion, Agathe Masseau, Céline Menetrey, Yann Ollivier, Fabien Pelletier, Geneviève Plu-Bureau, Laurent Sailler, Denis Vincent, Benoit Bouquillon, Edouard Verdier, Pierre Clerson, Isabelle Boccon-Gibod, David Launay, Centre Hospitalier Universitaire [Grenoble] (CHU), Centre de référence national des angiœdèmes (CREAK), CHU Grenoble-Université Grenoble Alpes (UGA), Translational Innovation in Medicine and Complexity / Recherche Translationnelle et Innovation en Médecine et Complexité - UMR 5525 (TIMC ), VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes (UGA)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP ), Université Grenoble Alpes (UGA), CHU Saint-Antoine [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), CHU Rouen, Normandie Université (NU), Hospices Civils de Lyon (HCL), Centre Hospitalier Georges Renon [Niort] (CH Georges Renon Niort), CHU Strasbourg, Département de Médecine Interne et Pneumologie [Brest] (DMIP - Brest), Centre Hospitalier Régional Universitaire de Brest (CHRU Brest), Pathogenesis and Control of Chronic and Emerging Infections (PCCEI), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université des Antilles (UA)-Etablissement français du don du sang [Montpellier]-Université de Montpellier (UM), Université de Montpellier (UM), CHU de Bordeaux Pellegrin [Bordeaux], CHU Trousseau [Tours], Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Centre Hospitalier Universitaire de Nice (CHU Nice), Centre Hospitalier Le Mans (CH Le Mans), CHU Sud Saint Pierre [Ile de la Réunion], Centre hospitalier universitaire de Nantes (CHU Nantes), CH Esquirol [Limoges] (CH Esquirol), CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN), Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), Maternité Port-Royal [CHU Cochin], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Equipe 1 : EPOPé - Épidémiologie Obstétricale, Périnatale et Pédiatrique (CRESS - U1153), Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité (CRESS (U1153 / UMR_A_1125 / UMR_S_1153)), Conservatoire National des Arts et Métiers [CNAM] (CNAM), HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)-Conservatoire National des Arts et Métiers [CNAM] (CNAM), HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Centre Hospitalier Universitaire de Nîmes (CHU Nîmes), Soladis, Institute for Translational Research in Inflammation - U 1286 (INFINITE (Ex-Liric)), and Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lille-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille)

Subjects
Pulmonary and Respiratory Medicine, Quality of life, MESH: Complement C1 Inhibitor Protein, MESH: Quality of life, Administration route, MESH: Angioedemas, Hereditary, Unmet needs, Immunology and Allergy, Humans, [SDV.IMM.ALL]Life Sciences [q-bio]/Immunology/Allergology, Side effects, Survey, Hereditary angioedema, MESH: Humans, Angioedemas, Hereditary, General Medicine, MESH: Tranexamic Acid, Treatment, Long-term prophylaxis, Tranexamic Acid, Expert opinion, Androgens, MESH: Androgens, MESH: Progestins, Progestins, Complement C1 Inhibitor Protein, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology, Decision-making
Abstract

Background: Hereditary angioedema (HAE) is characterized by unpredictable and potentially life-threatening attacks of cutaneous and submucosal swelling. Over the past decade, new agents, based on a better understanding of the underlying biologic mechanisms of HAE, have changed the face of long-term prophylaxis (LTP). Objective: The objective was to describe current practices and unmet needs with regard to LTP for HAE in expert centers in France. Methods: The study was conducted in France in 2020. Based on their experience with patients with HAE who had visited their center at least once in the past 3 years, physicians from 25 centers who are expert in the management of HAE were requested to fill in a questionnaire that encapsulated their active patient list, criteria for prescribing LTP, and medications used. They were asked about potential unmet needs with currently available therapies. They were asked to express their expectations with regard to the future of HAE management. Results: Analysis was restricted to 20 centers that had an active patient file and agreed to participate. There were 714 patients with C1 inhibitor (C1-INH) deficiency, of whom 423 (59.2%) were treated with LTP. Altered quality of life triggered the decision to start LTP, as did the frequency and severity of attacks. Ongoing LTP included androgens (28.4%), progestins (25.8%), lanadelumab (25.3%), tranexamic acid (14.2%), intravenous C1-INHs (5.6%), and recombinant C1-INH (0.7%). Twenty-nine percent of the patents with LTP were considered to still have unmet needs. Physicians' concerns varied among therapies: poor tolerability for androgens and progestins, a lack of efficacy for tranexamic acid and progestins, dosage form, and high costs for C1-INHs and lanadelumab. Physicians' expectations encompassed more-efficacious and better-tolerated medications, easier treatment administration for the sake of improved quality of life of patients, and less-expensive therapies. Conclusion: Despite the recent enrichment of the therapeutic armamentarium for LTP, physicians still expressed unmet needs with currently available therapies.

Published
2022

16. Risk factors of hospitalisation for thrombosis in adults with primary immune thrombocytopenia, including disease‐specific treatments: a French nationwide cohort study

Author

Agnès Sommet, Margaux Lafaurie, Mette Nørgaard, Charlotta Ekstrand, Bérangère Baricault, Shahram Bahmanyar, Julien Maquet, Christian Fynbo Christiansen, Maryse Lapeyre-Mestre, Marie Linder, Laurent Sailler, and Guillaume Moulis

Subjects
Male, pharmacoepidemiology, medicine.medical_treatment, Comorbidity, corticosteroids, Adrenal Cortex Hormones, Risk Factors, intravenous immunoglobulin, hemic and lymphatic diseases, education.field_of_study, Hazard ratio, Age Factors, Immunoglobulins, Intravenous, Hematology, Middle Aged, Combined Modality Therapy, Hospitalization, Venous thrombosis, immune thrombocytopenia, Cardiovascular Diseases, Cohort, Splenectomy, Female, France, Receptors, Thrombopoietin, Cohort study, Adult, medicine.medical_specialty, Adolescent, Population, splenectomy, Young Adult, Sex Factors, Internal medicine, medicine, Humans, education, thrombosis, Aged, Proportional Hazards Models, Purpura, Thrombocytopenic, Idiopathic, Proportional hazards model, business.industry, Thrombosis, medicine.disease, Thrombocytopenia, Confidence interval, thrombopoietin-receptor agonists, Anemia, Hemolytic, Autoimmune, business
Abstract

We aimed to assess the risk factors of venous thrombosis (VT) and arterial thrombosis (AT) in adults with primary immune thrombocytopenia (ITP), particularly in relation to treatments. The population comprised all incident primary ITP adults in France between 2009 and 2017 (FAITH cohort; NCT03429660) built in the national health database. Outcomes were the first hospitalisation for VT and AT. Multivariable Cox regression models included baseline risk factors, time-varying exposure to ITP drugs, splenectomy and to cardiovascular drugs. The cohort included 10 039 patients. A higher risk of hospitalisation for VT was observed with older age, history of VT, history of cancer, splenectomy [hazard ratio (HR) 3·23, 95% confidence interval (CI) 2·26-4·61], exposure to corticosteroids (HR 3·55, 95% CI 2·74-4·58), thrombopoietin-receptor agonists (TPO-RAs; HR 2·28, 95% CI 1·59-3·26) and intravenous immunoglobulin (IVIg; HR 2·10, 95% CI 1·43-3·06). A higher risk of hospitalisation for AT was observed with older age, male sex, a history of cardiovascular disease, splenectomy (HR 1·50, 95% CI 1·12-2·03), exposure to IVIg (HR 1·85, 95% CI 1·36-2·52) and TPO-RAs (HR 1·64, 95% CI 1·26-2·13). Rituximab was not associated with an increased risk. These findings help to estimate the risk of thrombosis in adult patients with ITP and to select treatment.

Published
2021

17. Prognostic factors in giant cell arteritis associated aortitis with PET/CT and CT angiography at diagnosis

Author

Victor Genin, Jean-François Alexandra, Hubert de Boysson, Laurent Sailler, Maxime Samson, Brigitte Granel, Karim Sacre, Thomas Quéméneur, Clémentine Rousselin, Geoffrey Urbanski, Julie Magnant, Valérie Devauchelle-Pensec, Viviane Queyrel-Moranne, Mickaël Martin, Emmanuel Héron, Aurélie Daumas, Quentin Gomes de Pinho, Bastien Jamet, Jean-Michel Serfaty, Christian Agard, and Olivier Espitia

Subjects
Anesthesiology and Pain Medicine, Rheumatology
Published
2023

18. Syndrome TAFRO et vascularite nécrosante cutanée : une association inédite

Author

Stanislas Faguer, J. Maquet, M.B. Nogier, K. Paricaud, Grégory Pugnet, Guillaume Moulis, Leonardo Astudillo, A. Toledano, G. Aizel, E. Bories, Laurent Sailler, and C. Beck

Subjects
0301 basic medicine, Gynecology, medicine.medical_specialty, business.industry, Gastroenterology, Cutaneous necrotizing vasculitis, 03 medical and health sciences, chemistry.chemical_compound, 030104 developmental biology, 0302 clinical medicine, Tocilizumab, chemistry, 030220 oncology & carcinogenesis, Necrotizing Vasculitis, Internal Medicine, Medicine, Rituximab, business, medicine.drug
Abstract

Resume Introduction Le syndrome TAFRO est un syndrome inflammatoire systemique proche de la maladie de Castleman, associant, anasarque, fievre, insuffisance renale et/ou fibrose reticulinique et organomegalie. Nous rapportons la premiere observation de vascularite necrosante compliquant un syndrome TAFRO. Observation Une femme de 69 ans presentait amaigrissement, fievre, anasarque, splenomegalie, adenomegalies, oligoanurie et livedo necrotique extensif au decours d’une diarrhee aigue. Les examens biologiques montraient une anemie, une thrombopenie, une insuffisance renale, une hypergammaglobulinemie, un clone lymphocytaire B circulant minime, une hypoparathyroidie et une hypothyroidie auto-immune. La biopsie cutanee montrait une vascularite avec necrose fibrinoide des petits vaisseaux. Le tocilizumab, associe a des perfusions de methylprednisolone, etait inefficace. Les echanges plasmatiques associes au rituximab ont permis la remission initiale, consolidee par 6 cures de rituximab, cyclophosphamide et dexamethasone. Conclusion Le syndrome TAFRO peut s’associer a une vascularite necrosante cutanee. La resistance possible au tocilizumab merite d’etre connue.

Published
2021

19. Republication de : Complications ischémiques de l’artérite à cellules géantes

Author

K. Paricaud and Laurent Sailler

Subjects
030203 arthritis & rheumatology, 03 medical and health sciences, 0302 clinical medicine, Emergency Medicine, 030204 cardiovascular system & hematology, Critical Care and Intensive Care Medicine
Abstract

Points essentiels Les complications ischemiques de l’arterite a cellules geantes surviennent essentiellement chez des patients presentant une vascularite encore non diagnostiquee ou mal controlee par le traitement. Lorsque le traitement controle symptomes et signes biologiques, les complications sont generalement attribuees a l’atherosclerose. Les complications ophtalmiques sont les plus frequentes, dominees par la neuropathie optique ischemique anterieure aigue. Les accidents vasculaires cerebraux se localisent de facon privilegiee dans le territoire vertebral posterieur. Les complications coronariennes par vascularite sont exceptionnelles. Le diagnostic des complications ischemiques de membre beneficie largement des progres de l’imagerie (signe du halo a l’echographie, hypermetabolisme au TEP-scanner). Le traitement repose sur la corticotherapie (initialement au moins 1 mg/kg d’equivalent prednisone, precede de bolus intraveineux selon les cas), le controle des facteurs de risque cardiovasculaire traditionnels et la prescription d’antiagregant plaquettaire ; l’heparinotherapie est a envisager pour les complications ischemiques des membres.

Published
2020

20. Diagnostic Value of 18F-FDG PET/CT vs. Chest-Abdomen-Pelvis CT Scan in Management of Patients with Fever of Unknown Origin, Inflammation of Unknown Origin or Episodic Fever of Unknown Origin: A Comparative Multicentre Prospective Study

Author

Kim-Heang Ly, Nathalie Costedoat-Chalumeau, Eric Liozon, Stéphanie Dumonteil, Jean-Pierre Ducroix, Laurent Sailler, Olivier Lidove, Boris Bienvenu, Olivier Decaux, Pierre-Yves Hatron, Amar Smail, Léonardo Astudillo, Nathalie Morel, Jonathan Boutemy, Antoinette Perlat, Eric Denes, Marc Lambert, Thomas Papo, Anne Cypierre, Elisabeth Vidal, Pierre-Marie Preux, Jacques Monteil, Anne-Laure Fauchais, Service de Médecine interne A et polyclinique médicale [CHU Limoges], CHU Limoges, Centre de Référence des Maladies auto-immunes systémiques rares d'Ile-de-Frances [Hopital Cochin], Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Service de Médecine Interne [CHU Amiens-Picardie], CHU Amiens-Picardie, Service Médecine Interne et immunologie clinique [CHU Toulouse], Pôle Maladies de l'appareil digestif [CHU Toulouse], Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Médecine interne [Diaconesses Croix Saint-Simon], Groupe Hospitalier Diaconesses Croix Saint-Simon, Service de médecine interne [CHU Caen], Université de Caen Normandie (UNICAEN), Normandie Université (NU)-Normandie Université (NU)-CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Tumorothèque de Caen Basse-Normandie (TCBN), Service de Médecine interne et immunologie clinique [Rennes] = internal medicine and clinical immunology [Rennes], CHU Pontchaillou [Rennes], Service de médecine interne [Lille], Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Service des Maladies infectieuses et tropicales [CHU Limoges], Hospital Bichat Paris, Neuroépidémiologie Tropicale (NET), CHU Limoges-Institut d'Epidémiologie Neurologique et de Neurologie Tropicale-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut Génomique, Environnement, Immunité, Santé, Thérapeutique (GEIST), Université de Limoges (UNILIM)-Université de Limoges (UNILIM), Service de l'Information Médicale et de l'Évaluation [CHU Limoges] (SIME), Laboratoire de Biostatistique et d'Informatique Médicale, Université de Limoges (UNILIM), Service de médecine nucléaire [CHU Limoges], and Grelier, Elisabeth

Subjects
PET/CT, chest-abdomen-pelvis CT, FUO, IUO, EFUO, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Medicine, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, General Medicine, Article
Abstract

Fluorodesoxyglucose Positron Emission Tomography (PET/CT) has never been compared to Chest-Abdomen-Pelvis CT (CAPCT) in patients with a fever of unknown origin (FUO), inflammation of unknown origin (IUO) and episodic fever of unknown origin (EFUO) through a prospective and multicentre study. In this study, we investigated the diagnostic value of PET/CT compared to CAPCT in these patients. The trial was performed between 1 May 2008 through 28 February 2013 with 7 French University Hospital centres. Patients who fulfilled the FUO, IUO or EFUO criteria were included. Diagnostic orientation (DO), diagnostic contribution (DC) and time for diagnosis of both imaging resources were evaluated. One hundred and three patients were included with 35 FUO, 35 IUO and 33 EFUO patients. PET/CT showed both a higher DO (28.2% vs. 7.8%, p < 0.001) and DC (19.4% vs. 5.8%, p < 0.001) than CAPCT and reduced the time for diagnosis in patients (3.8 vs. 17.6 months, p = 0.02). Arthralgia (OR 4.90, p = 0.0012), DO of PET/CT (OR 4.09, p = 0.016), CRP > 30 mg/L (OR 3.70, p = 0.033), and chills (OR 3.06, p = 0.0248) were associated with the achievement of a diagnosis (Se: 89.1%, Sp: 56.8%). PET/CT both orients and contributes to diagnoses at a higher rate than CAPCT, especially in patients with FUO and IUO, and reduces the time for diagnosis.

Published
2022

21. Aseptic Abscess Syndrome: Clinical Characteristics, Associated Diseases, and up to 30 Years' Evolution Data on a 71-Patient Series

Author

Ludovic, Trefond, Camille, Frances, Nathalie, Costedoat-Chalumeau, Jean-Charles, Piette, Julien, Haroche, Laurent, Sailler, Souad, Assaad, Jean-François, Viallard, Patrick, Jego, Arnaud, Hot, Jerome, Connault, Jean-Marc, Galempoix, Elisabeth, Aslangul, Nicolas, Limal, Fabrice, Bonnet, Stanislas, Faguer, Olivier, Chosidow, Christophe, Deligny, François, Lifermann, Alexandre Thibault Jacques, Maria, Bruno, Pereira, Olivier, Aumaitre, Marc, André, On Behalf Of The French Study Group On Aseptic Abscesses, Service de Médecine Interne [CHU Clermont-Ferrand], CHU Gabriel Montpied [Clermont-Ferrand], CHU Clermont-Ferrand-CHU Clermont-Ferrand, Microbes, Intestin, Inflammation et Susceptibilité de l'Hôte (M2iSH), Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre de Recherche en Nutrition Humaine d'Auvergne (CRNH d'Auvergne)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)-Université Clermont Auvergne (UCA), Service de dermatologie et allergologie [CHU Tenon], CHU Tenon [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité (CRESS (U1153 / UMR_A_1125 / UMR_S_1153)), Conservatoire National des Arts et Métiers [CNAM] (CNAM), HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Service de médecine interne et centre de référence des maladies rares [CHU Cochin], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Institut E3M [CHU Pitié-Salpêtrière], Centre National de Référence du Lupus Systémique, Syndrome des Anticorps Anti-phospholipides et Maladies Auto-immunes Systémiques Rares [CHU Pitié Salpêtrière], Service de Médecine Interne 2, maladies auto-immunes et systémiques [CHU Pitié-Salpêtrière], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Institut E3M [CHU Pitié-Salpêtrière], Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Centre Léon Bérard [Lyon], Service de médecine interne et maladies infectieuses [Bordeaux], CHU Bordeaux [Bordeaux]-Groupe hospitalier Saint-André, Institut de recherche en santé, environnement et travail (Irset), Université d'Angers (UA)-Université de Rennes (UR)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Service de Médecine interne et immunologie clinique [Rennes] = internal medicine and clinical immunology [Rennes], CHU Pontchaillou [Rennes], Hôpital Edouard Herriot [CHU - HCL], Hospices Civils de Lyon (HCL), Centre hospitalier universitaire de Nantes (CHU Nantes), Centre Hospitalier de Charleville-Mezières, Université Paris Descartes - Paris 5 (UPD5), Hôpital Louis Mourier - AP-HP [Colombes], CHU Henri Mondor, CHU Bordeaux [Bordeaux], Bordeaux population health (BPH), Université de Bordeaux (UB)-Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre de Référence du Sud Ouest des Maladies Rénales Rares, Dynamic Microbiology - EA 7380 (DYNAMIC), École nationale vétérinaire - Alfort (ENVA)-Agence nationale de sécurité sanitaire de l'alimentation, de l'environnement et du travail (ANSES)-Université Paris-Est (UPE)-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), CHU de la Martinique [Fort de France], Centre Hospitalier de Dax, Hôpital Saint Eloi (CHRU Montpellier), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Unité de Biostatistiques [CHU Clermont-Ferrand], Direction de la recherche clinique et de l’innovation [CHU Clermont-Ferrand] (DRCI), Chard-Hutchinson, Xavier, CHU Henri Mondor [Créteil], Global Health in the Global South (GHiGS), Institut de Recherche pour le Développement (IRD)- Bordeaux population health (BPH), Université de Bordeaux (UB)-Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Bordeaux (UB)-Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED)-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Toulouse [Toulouse], Université d'Angers (UA)-Université de Rennes 1 (UR1), and Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique )

Subjects
Crohn's disease, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, aseptic abscess syndrome, Crohn’s disease, colchicine, biologics, [SDV.MHEP.HEG]Life Sciences [q-bio]/Human health and pathology/Hépatology and Gastroenterology, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, General Medicine, [SDV.MHEP.HEG] Life Sciences [q-bio]/Human health and pathology/Hépatology and Gastroenterology
Abstract

Aseptic abscess (AA) syndrome is a rare type of inflammatory disorder involving polymorphonuclear neutrophils (PMNs), often associated with inflammatory bowel disease (IBD). This study sought to describe the clinical characteristics and evolution of this syndrome in a large cohort. We included all patients included in the French AA syndrome register from 1999 to 2020. All patients fulfilled the criteria outlined by André et al. in 2007. Seventy-one patients were included, 37 of which were men (52.1%), of a mean age of 34.5 ± 17 years. The abscesses were located in the spleen (71.8%), lymph nodes (50.7%), skin (29.5%), liver (28.1%), lung (22.5), and rarer locations (brain, genitals, kidneys, ENT, muscles, or breasts). Of all the patients, 59% presented with an associated disease, primarily IBD (42%). They were treated with colchicine (28.1%), corticosteroids (85.9%), immunosuppressants (61.9%), and biologics (32.3%). A relapse was observed in 62% of cases, mostly in the same organ. Upon multivariate analysis, factors associated with the risk of relapse were: prescription of colchicine (HR 0.52; 95% CI [0.28–0.97]; p = 0.042), associated IBD (HR 0.57; 95% CI [0.32–0.99]; p = 0.047), and hepatic or skin abscesses at diagnosis (HR 2.14; 95% CI [1.35–3.40]; p = 0.001 and HR 1.78; 95% CI [1.07–2.93]; p = 0.024, respectively). No deaths occurred related to this disease. This large retrospective cohort study with long follow up showed that AA syndrome is a relapsing systemic disease that can evolve on its own or be the precursor of an underlying disease, such as IBD. Of all the available treatments, colchicine appeared to be protective against relapse.

Published
2022

22. USAID Associated with Myeloid Neoplasm and VEXAS Syndrome: Two Differential Diagnoses of Suspected Adult Onset Still’s Disease in Elderly Patients

Author

Achille Aouba, Julien Rossignol, Matthieu Mahévas, Damien Roos-Weil, Pierre Hirsch, Anna Sevoyan, Yervand Hakobyan, Sébastien Miranda, Louis Terriou, Julie Graveleau, Gwenola Maigne, Matthieu Groh, Thomas Quemeneur, Florent Malard, Marie Sebert, Sophie Georgin-Lavialle, Artem Oganesyan, Arsène Mekinian, Nabil Belfeki, Pierre Fenaux, Matthieu Decamp, Laurent Sailler, Louis Drevon, M. Delplanque, Jerome Razanamahery, Centre de Référence des Maladies Auto-Inflammatoires et des Amyloses [CHU Tenon] (CeréMAIA), CHU Tenon [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Service de Médecine Interne = Hôpital de jour de médecine [CHU Tenon], Service de médecine interne [CHU Caen], Université de Caen Normandie (UNICAEN), Normandie Université (NU)-Normandie Université (NU)-CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Tumorothèque de Caen Basse-Normandie (TCBN), Service d'immunologie et hématologies biologiques [CHU Saint-Antoine], CHU Saint-Antoine [AP-HP], Centre de Recherche Saint-Antoine (CRSA), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), Hopital Saint-Louis [AP-HP] (AP-HP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Centre hospitalier de Saint-Nazaire, Service d'Hématologie Biologique [CHU Pitié-Salpêtrière], CHU Pitié-Salpêtrière [AP-HP], Centre hospitalier Marc Jacquet (Melun), National Academy of Sciences of the Republic of Armenia [Yerevan] (NAS RA), Hôpital Foch [Suresnes], Hôpital Henri Mondor, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), Service de Génétique [CHU Caen], Service de Médecine Interne [CHU Rouen], CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU), Centre hospitalier [Valenciennes, Nord], CHU Necker - Enfants Malades [AP-HP], Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Service de médecine interne [CHU Saint-Antoine], HAL-SU, Gestionnaire, Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Service de Médecine Interne [CHU Tenon], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Tenon [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Université de Caen Normandie (UNICAEN), Centre de Recherche Saint-Antoine (CR Saint-Antoine), Sorbonne Université (SU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Saint-Antoine [AP-HP], CHU Toulouse [Toulouse], and Service de Médecine Interne [CHU Saint-Antoine]

Subjects
medicine.medical_specialty, Chronic myelomonocytic leukemia, Disease, adult-onset Still's disease, SAID, Article, 03 medical and health sciences, chemistry.chemical_compound, 0302 clinical medicine, Tocilizumab, Internal medicine, hemic and lymphatic diseases, Atypia, USAID, adult-onset Still’s disease, Medicine, VEXAS, azacytidine, myelodysplastic syndrome, 030203 arthritis & rheumatology, Anakinra, [SDV.MHEP] Life Sciences [q-bio]/Human health and pathology, business.industry, Myeloid leukemia, Retrospective cohort study, General Medicine, medicine.disease, Infliximab, 3. Good health, chemistry, 030220 oncology & carcinogenesis, business, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology, medicine.drug
Abstract

International audience; Background: Patients with solid cancers and hematopoietic malignancy can experience systemic symptoms compatible with adult-onset Still’s disease (AOSD). The newly described VEXAS, associated with somatic UBA1 mutations, exhibits an overlap of clinical and/or biological pictures with auto inflammatory signs and myelodysplastic syndrome (MDS). Objectives: To describe a cohort of patients with signs of undifferentiated systemic autoinflammatory disorder (USAID) concordant with AOSD and MDS/chronic myelomonocytic leukemia (CMML) and the prevalence of VEXAS proposed management and outcome. Methods: A French multicenter retrospective study from the MINHEMON study group also used for other published works with the support of multidisciplinary and complementary networks of physicians and a control group of 104 MDS/CMML. Results: Twenty-six patients were included with a median age at first signs of USAID of 70.5 years with male predominance (4:1). Five patients met the criteria for confirmed AOSD. The most frequent subtypes were MDS with a blast excess (31%) and MDS with multilineage dysplasia (18%). Seven patients presented with acute myeloid leukemia and twelve died during a median follow-up of 2.5 years. Six out of 18 tested patients displayed a somatic UBA1 mutation concordant with VEXAS, including one woman. High-dose corticosteroids led to a response in 13/16 cases and targeted biological therapy alone or in association in 10/12 patients (anakinra, tocilizumab, and infliximab). Azacytidine resulted in complete or partial response in systemic symptoms for 10/12 (83%) patients including 3 VEXAS. Conclusions: Systemic form of VEXAS syndrome can mimic AOSD. The suspicion of USAID or AOSD in older males with atypia should prompt an evaluation of underlying MDS and assessment of somatic UBA1 mutation.

Published
2021

23. Glucocorticoid use as a cause of non-cellular immune response to SARS-Cov2 Spike in patients with immune system diseases

Author

Yves Renaudineau, Laurent Sailler, Florence Abravanel, Jacques Izopet, Adrien Delourme, Damien Biotti, Jonathan Ciron, Emmanuel Treiner, Nicolas Congy-Jolivet, Chloé Bost, Antoine Blancher, Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées, Institut Toulousain des Maladies Infectieuses et Inflammatoires (Infinity), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Institut Fédératif de Biologie (IFB), Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Laboratoire Virologie [CHU Toulouse], Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Pôle Biologie [CHU Toulouse], Pôle Neurosciences [CHU Toulouse], Université de Strasbourg (UNISTRA), Centre de Recherches en Cancérologie de Toulouse (CRCT), Département Immunologie [CHU Toulouse], and Touzanné, Gisèle

Subjects
IGRA, Sarcoidosis, [SDV]Life Sciences [q-bio], Immunology, COVID-19, Spike, Vasculitis, Immune system diseases, Multiple sclerosis, [SDV] Life Sciences [q-bio], Systemic lupus erythematosus, Immunology and Allergy, Glucocorticoids, Antibody
Abstract

International audience; Disease modifying therapies compromise immune response to SARS-Cov2 or its vaccine in patients with immune system diseases (ISD). Therefore, analysis of the humoral and cellular responses against Spike is of utmost importance to manage ISD patients. A single-center retrospective study was conducted to evaluate the impact of COVID-19 immunization in 87 ISD patients and 81 healthy controls. We performed a whole blood interferon gamma release assay using SARS-Cov2 Spike and Nucleocapsid recombinant proteins in order to evaluate T-cell memory response, and an IgG anti-Spike ELISA to evaluate humoral response. Cellular (26.4%) and humoral (44.8%) responses were negative against Spike in ISD patients following COVID-19 immunization. In univariate analysis, an anti-Spike T cell defective response was associated with the use of glucocorticoids (Odds ratio [OR] = 10.0; p < 10-4), serum albumin level ≤40 g/L (OR = 18.9; p < 10-4), age over 55 years old (OR = 3.9, p = 0.009) and ≤2 vaccine injections (OR = 4.9; p = 0.001). The impact of glucocorticoids persisted after adjustment for age and number of vaccine injections (OR = 8.38, p < 0.001). In contrast, the humoral response was impacted by the use of anti-CD20 mAb (OR = 24.8, p < 10-4), and an extended time since immunization (≥75 days; OR = 4.3, p = 0.002). Double defective cellular/humoral responses (6.9%) were typically encountered in glucocorticoids and/or anti-CD20 mAb treated ISD with a serum albumin level ≤40 g/L (OR = 17.5; p = 0.002). Glucocorticoid usage, B cell depleting therapies, and a low serum albumin level were the main factors associated with a non-response to COVID-19 immunization in ISD patients. These results need further confirmation in larger studies.

Published
2022

24. Eltrombopag in adult patients with immune thrombocytopenia in the real-world in France, including off-label use before 6 months of disease duration: The multicenter, prospective ELEXTRA study

Author

Julia Moeglin, Morgane Mourguet, Laurent Alric, Laure Swiader, Suzanne Tavitian, Jean-Marc Durand, Sylvie Ollier, Aline Moignet‐Autrel, Karen Delavigne, Miguel Carreiro, Pierre Cougoul, Jean Estelle, Sylvain Audia, Benjamin De Sainte Marie, Veronique Remy, Xavier Delbrel, Samuel Deshayes, Francis Gaches, Helene Hennique, Lorraine Leplay, Gaetan Sauvetre, Antoine Briantais, Cécile Borel, Kamel Laribi, Martin Michaud, Stéphane Cheze, Sondess Hadj‐Khelifa, Guillaume Martin‐Blondel, Geoffrey Urbanski, Brice Castel, Guillaume Moulis, Fanny Nuccio, Soraya Leclerc-Teffahi, Odile Beyne‐Rauzy, Benjamin Hebraud, Aurelie Godel‐Labouret, Pierre Duffau, Sarah Khatibi, Baptiste Andre, Gregory Pugnet, Daniel Adoue, Julie Seguier, Clement Gaudin, Marc Michel, Myriam Aroichane, Laurent Prudhomme, Margaux Lafaurie, Manuela Rueter, Philippe Montane De La Roque, Natacha Brun, Aurelie Saunier, Julie Graveleau, Johanne Germain, Willy Vaillant, Agnès Sommet, Maryse Lapeyre-Mestre, Delphine Bonnet, Stephane Sire, Yann Leveneur, Caroline Soubrier, Alina Danu, Veronique Veit, Patrick Giraud, François Lifermann, Gwenola Maigne, Jean-François Viallard, Clothilde Martel, Nicolas Limal, Delphine Brechemier, Frederique Roy‐Peaud, Serge Madaule, Laurent Sailler, Thibault Comont, Benoit Faucher, Laurent Balardy, Carine Courtault, Claire Dingremont, Jean-Robert Harlé, Sophie Arista, Mikael Ebbo, Bertrand Godeau, Jeremie Dion, Bernard Bonnotte, Irène Machelart, Matthieu Mahévas, Nicolas Schleinitz, Arnaud Saint‐Lezer, Corentin Orvain, Christian Recher, Patrick Rispal, and Bertrand Lioger

Subjects
Adult, Male, Pediatrics, medicine.medical_specialty, Disease duration, Eltrombopag, Off-label use, Benzoates, chemistry.chemical_compound, medicine, Humans, Prospective Studies, Aged, Purpura, Thrombocytopenic, Idiopathic, Adult patients, business.industry, Hematology, Off-Label Use, Middle Aged, Immune thrombocytopenia, Hydrazines, Treatment Outcome, chemistry, Pyrazoles, Female, France, business
Published
2021

25. Presentation and Real-World Management of Giant Cell Arteritis (Artemis Study)

Author

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

Subjects
medicine.medical_specialty, Medicine (General), glucocorticoids (GCs), Constitutional symptoms, management - healthcare, methotrexate, Polymyalgia rheumatica, chemistry.chemical_compound, tocilizumab, Tocilizumab, R5-920, Interquartile range, Internal medicine, Diabetes mellitus, medicine, observational, skin and connective tissue diseases, Original Research, business.industry, giant cell arteritis, General Medicine, phenotype [mesh], medicine.disease, Comorbidity, Giant cell arteritis, chemistry, Medicine, business, Dyslipidemia
Abstract

Background: Few studies of daily practice for patients with giant cell arteritis (GCA) are available. This French study aimed to describe the characteristics and management of GCA in a real-life setting.Methods: Cross-sectional, non-interventional, multicenter study of patients ≥50 years old who consulted hospital-based specialists for GCA and were under treatment. Patient characteristics and journey, diagnostic methods and treatments were collected. Descriptive analyses were performed.Results: In total, 306 patients (67% females, mean age 74 ± 8 years old) were recruited by 69 physicians (internists: 85%, rheumatologists: 15%); 13% of patients had newly diagnosed GCA (diagnosis-to-visit interval 18FDG-PET, and aortic angio-CT, respectively. All patients received glucocorticoids, which were ongoing for 89%; 29% also received adjunct medication(s) (methotrexate: 19%, tocilizumab: 15%). A total of 40% had relapse(s); the median time to the first relapse was 10 months. Also, 37% had comorbidity(ies) related to or aggravated by glucocorticoids therapy.Conclusion: This large observational study provides insight into current medical practices for GCA. More than one third of patients had comorbidities related to glucocorticoid therapy for a median disease duration of 13 months. Methotrexate and tocilizumab were the most common adjunct medications.

Published
2021

26. IgA vasculitis in adult patient following vaccination by ChadOx1 nCoV-19

Author

Margaux Lafaurie, Guillaume Moulis, T. Porel, Laure Badier, Haleh Bagheri, Julien Jouglen, Sylvain Dumond, Albanie Toledano, and Laurent Sailler

Subjects
Immunoglobulin A, Vasculitis, Adult, 2019-20 coronavirus outbreak, COVID-19 Vaccines, Coronavirus disease 2019 (COVID-19), IgA Vasculitis, Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), Immunology, Autoimmunity, Review, ChAdOx1 nCoV-19, medicine, Immunology and Allergy, Humans, Letter to the Editor, biology, business.industry, SARS-CoV-2, Vaccination, COVID-19, medicine.disease, IgA vasculitis, Adverse events, biology.protein, business, COVID-19 vaccine
Published
2021

27. Evaluation of lupus anticoagulant, damage, and remission as predictors of pregnancy complications in systemic lupus erythematosus: the French GR2 study

Author

Maddalena, Larosa, Véronique, Le Guern, Gaëlle, Guettrot-Imbert, Nathalie, Morel, Noémie, Abisror, Chafika, Morati-Hafsaoui, Pauline, Orquevaux, Elisabeth, Diot, Andrea, Doria, Françoise, Sarrot-Reynauld, Nicolas, Limal, Viviane, Queyrel, Odile, Souchaud-Debouverie, Laurent, Sailler, Maëlle, Le Besnerais, Tiphaine, Goulenok, Anna, Molto, Emmanuelle, Pannier-Metzger, Loic, Sentilhes, Luc, Mouthon, Estibaliz, Lazaro, Nathalie, Costedoat-Chalumeau, and Cécile, Yelnik

Subjects
Male, Placenta, Infant, Newborn, Pregnancy Outcome, Antiphospholipid Syndrome, Pregnancy Complications, Rheumatology, Pregnancy, Lupus Coagulation Inhibitor, Humans, Lupus Erythematosus, Systemic, Pharmacology (medical), Female, Prospective Studies, Retrospective Studies
Abstract

Objectives The specific roles of remission status, lupus low disease activity state (LLDAS), and damage accrual on the prognosis of pregnancies in women with SLE are unknown. We analysed their impact on maternal flares and adverse pregnancy outcomes (APOs). Methods We evaluated all women (≥18 years) with SLE enrolled in the prospective GR2 study with an ongoing singleton pregnancy at 12 weeks (one pregnancy/woman). Several sets of criteria were used to define remission, disease activity and damage. APOs included: foetal/neonatal death, placental insufficiency with preterm delivery and small-for-gestational-age birth weight. First trimester maternal and disease features were tested as predictors of maternal flares and APOs. Results The study included 238 women (98.3% on hydroxychloroquine (HCQ)) with 230 live births. Thirty-five (14.7%) patients had at least one flare during the second/third trimester. At least one APOs occurred in 34 (14.3%) women. Hypocomplementemia in the first trimester was the only factor associated with maternal flares later in pregnancy (P=0.02), while several factors were associated with APOs. In the logistic regression models, damage by SLICC-Damage Index [odds ratio (OR) 1.8, 95% CI: 1.1, 2.9 for model 1 and OR 1.7, 95% CI: 1.1, 2.8 for model 2] and lupus anticoagulant (LA, OR 4.2, 95% CI: 1.8, 9.7 for model 1; OR 3.7, 95% CI: 1.6, 8.7 for model 2) were significantly associated with APOs. Conclusion LA and damage at conception were predictors of APOs, and hypocomplementemia in the first trimester was associated with maternal flares later in pregnancy in this cohort of pregnant patients mostly with well-controlled SLE treated with HCQ. Trial registration ClinicalTrials.gov, https://clinicaltrials.gov, NCT02450396.

Published
2021

28. Développement d'un sarcome sur foyer ectopique hématopoïétique secondaire à une sphérocytose héréditaire : à propos d'un cas et revue de la littérature

Author

Laurent Sailler, S. Le Guellec, Leonardo Astudillo, Grégory Pugnet, S. De Almeida Chaves, G. Moulis, Service d'anatomopathologie, CHU Toulouse [Toulouse]-Université Toulouse III - Paul Sabatier (UT3), and Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées

Subjects
0301 basic medicine, Gynecology, medicine.medical_specialty, [SDV]Life Sciences [q-bio], media_common.quotation_subject, Gastroenterology, Art, 03 medical and health sciences, 030104 developmental biology, 0302 clinical medicine, 030220 oncology & carcinogenesis, Internal Medicine, medicine, media_common
Abstract

Resume Introduction L'hematopoiese extra-medullaire complique de nombreuses maladies, notamment les syndromes myeloproliferatifs et les hemolyses chroniques. Ses localisations sont essentiellement spleniques, ganglionnaires ou paravertebrales. Rarement, l'hematopoiese extra-medullaire s'associe a un foyer cancereux. Observation Nous rapportons une observation originale de sarcome developpe au sein d'un foyer d'hematopoiese extra-medullaire connue chez une femme de 72 ans suivie pour une spherocytose hereditaire. Une masse paravertebrale droite asymptomatique etait mise en evidence de facon fortuite en 2004 ; la biopsie confirmait un foyer d'hematopoiese extra-medullaire. En 2016, la patiente etait hospitalisee pour des douleurs paravertebrales rebelles aux antalgiques de palier 3. Le scanner retrouvait une progression de la masse paravertebrale droite, avec une extension a la plevre et au mediastin et des lyses osseuses vertebrales. La tomographie a emission de positrons couplee au scanner retrouvait un hypermetabolisme intense de cette masse. La biopsie retrouvait un sarcome indifferencie. L'evolution etait rapidement defavorable. Conclusion Cette observation illustre le risque de transformation neoplasique d'un foyer d'hematopoiese extra-medullaire, et la necessite de biopsie en cas d'aspect atypique.

Published
2020

29. High rate of indeterminate results of the QuantiFERON-TB Gold in-tube test, third generation, in patients with systemic vasculitis

Author

Laurent Sailler, G. Moulis, K. Paricaud, Grégory Pugnet, Antoine Blancher, Leonardo Astudillo, Emmanuel Treiner, Stella Rousset, Philippe Arlet, Bénédicte Puissant-Lubrano, CHU Toulouse [Toulouse], Centre de Physiopathologie Toulouse Purpan (CPTP), Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Epidémiologie et analyses en santé publique : risques, maladies chroniques et handicaps (LEASP), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées, and Laboratoire d'Immunogénétique Moléculaire (LIMT)

Subjects
Male, diagnosis, latent tuberculosis infection, phytohemagglutinins, Interferon gamma release assay, Gastroenterology, vasculitis, 0302 clinical medicine, neutrophils, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Adrenal Cortex Hormones, Reference Values, gender, Pharmacology (medical), quantiferon-tb gold test, interferon gamma release assay, glucocorticoids, Latent tuberculosis, Incidence, Systemic Vasculitis, Age Factors, interferon, Middle Aged, Prognosis, 3. Good health, Exact test, Female, Vasculitis, Systemic vasculitis, Adult, medicine.medical_specialty, gamma release assay, immunosuppressive agents, Risk Assessment, QuantiFERON, Diagnosis, Differential, 03 medical and health sciences, Sex Factors, Rheumatology, Latent Tuberculosis, Predictive Value of Tests, Internal medicine, medicine, Humans, Retrospective Studies, Immunosuppression Therapy, 030203 arthritis & rheumatology, active tuberculosis, giant cell arteritis, Tuberculin Test, business.industry, Mycobacterium tuberculosis, Odds ratio, indeterminate results, medicine.disease, Giant cell arteritis, 030228 respiratory system, Case-Control Studies, Multivariate Analysis, business, Interferon-gamma Release Tests
Abstract

Objectives To describe the frequency of QuantiFERON-TB Gold in-tube test® (QFT-GIT) indeterminate results due to no response to phytohaemagglutinin A stimulation in the control tube in vasculitis patients prior to immunosuppressant therapy; and to compare it with other groups of patients. Methods This was a single-centre, retrospective study. Patients and controls were included between 1 January 2008 and 31 December 2015. We assessed the rate of indeterminate results of the QFT-GIT in 38 patients with systemic vasculitis prior to any corticosteroid or immunosuppressant therapy, compared with 40 non-vasculitis patients with biological inflammatory syndrome, and 310 non-immunosuppressed patients matched for gender and age. Results Indeterminate results due to no response to phytohaemagglutinin A were more frequent in vasculitis patients (21.1%) compared with non-vasculitis patients with biological inflammatory syndrome (7.5%) (Fisher's exact test: P = 0.11) and to anonymized controls (7%) (P = 0.009). Responses to phytohaemagglutinin A were significantly lower in vasculitis patients compared with other groups (Kruskal–Wallis test: P < 0.0001) and compared with non-vasculitis patients with biological inflammatory syndrome (P = 0.0015). The multivariable analysis identified as independent predictors of an indeterminate result of the QFT-GIT: the presence of systemic vasculitis (odds ratio 9.64 [1.14–81.3], P = 0.037) and a high neutrophil-to-lymphocyte ratio (odds ratio 1.70 [1.21–2.37], P = 0.002). One patient with an indeterminate result of QFT-GIT developed active tuberculosis after one year of corticosteroid therapy for giant cell arteritis. Conclusion Our results question the reliability of QFT-GIT to rule out latent tuberculosis in vasculitis patients at diagnosis, prior to immunosuppressant therapy.

Published
2019

30. De l’art dramatique à l’art de l’entrevue médicale : retour d’une expérience auprès d’étudiants en médecine

Author

Charles-Henri Houze-Cerfon, Fabrice Muscari, Sarah Fourage, Grégory Pugnet, Laurent Sailler, Brice Carayol, Ivan Tack, Philippe Arlet, and Thomas Geeraerts

Subjects
03 medical and health sciences, 0302 clinical medicine, 030221 ophthalmology & optometry, 030208 emergency & critical care medicine
Abstract

Contexte : Tant l’enseignement du savoir-faire que celui du savoir-être, en particulier la communication médecin-patient peuvent être améliorés. Objectifs : Décrire et documenter l’intérêt des étudiants pour des dispositifs de formation à la communication et à la relation médecin-patient associant l’art dramatique et la simulation. Méthodes : Trente-trois étudiants en médecine (diplôme de formation approfondie en sciences médicales 1 et 2) ont participé à des ateliers de communication associant successivement une approche théâtrale comportant plusieurs exercices et une mise en situation professionnelle de communication en situation de consultation avec un patient simulé. Résultats : La grande majorité (92 %) des étudiants ayant participé à ces ateliers ont estimé que l’expérience leur a été bénéfique tant sur le plan du savoir-faire que du savoir-être et 94 % ont validé l’intérêt de ces ateliers pour leur pratique ultérieure. Les exercices théâtraux les plus plébiscités étaient l’histoire en cercle, l’histoire à plusieurs et l’histoire avec contrainte. Conclusion : L’association d’outils pédagogiques contextualisants, comme l’expérience théâtrale, le recours aux patients simulés en situation de problématiques cliniques fréquentes ou complexes, à des étudiants observateurs, le recours à la vidéo, et le débriefing entre les différents acteurs, recueille une très forte adhésion et détermine un grand bénéfice ressenti auprès des apprenants. Les résultats très positifs de cette expérience nous encouragent à étendre cette approche pédagogique intégrative à l’ensemble des étudiants du deuxième cycle des études médicales.

Published
2019

31. Diagnostic biologique des angioedèmes bradykiniques : les recommandations du CREAK

Author

David Launay, Gaëlle Hardy, Guillaume Armengol, Julien Faure, Claire de Moreuil, Bernard Floccard, Frederica Defendi, C. Mansard, Nicolas Marmion, Alban Deroux, Laurence Bouillet, Anne Gompel, Roland Jaussaud, Yann Olliver, Isabelle Boccon-Gibod, Nicolas Javaud, Chantal Dumestre-Pérard, Lucile Sorin, Etienne Beaudouin, Aureli Du Than, Olivier Fain, Fabien Pelletier, Stéphane Gayet, Laurent Sailler, Jean Yves Cesbron, Anne Sarrat, Stephane Guez, Centre National de Reference des Angioedemes à Kinines, CHU Grenoble, Service d'immunologie [CHU Grenoble], CHU de Grenoble, Barrière Naturelle et Infectiosité (TIMC-IMAG-BNI), Techniques de l'Ingénierie Médicale et de la Complexité - Informatique, Mathématiques et Applications, Grenoble - UMR 5525 (TIMC-IMAG), Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes [2016-2019] (UGA [2016-2019])-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes [2016-2019] (UGA [2016-2019]), Centre Hospitalier Universitaire [Grenoble] (CHU), Service de gynécologie et d'endocrinologie [CHU Cochin], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Hôpital Edouard Herriot [CHU - HCL], Hospices Civils de Lyon (HCL), Université de Reims Champagne-Ardenne (URCA), Service d’Allergologie, Centre Hospitalier Emile Durkheim [Epinal] (CH Epinal / CHED), UNIROUEN - UFR Santé (UNIROUEN UFR Santé), Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU), Hôpital de la Timone [CHU - APHM] (TIMONE), CHU Toulouse [Toulouse], CHU Bordeaux [Bordeaux], Département de Médecine Interne et Pneumologie [Brest] (DMIP - Brest), Centre Hospitalier Régional Universitaire de Brest (CHRU Brest), Département de dermatologie, Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC)-Hôpital Saint-Jacques-Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), Hôpital Louis Mourier - AP-HP [Colombes], Centre Hospitalier Universitaire de La Réunion (CHU La Réunion), Service de Médecine Interne [CHU Saint-Antoine], CHU Saint-Antoine [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Orange Labs [Lannion], and France Télécom

Subjects
0301 basic medicine, medicine.medical_specialty, MESH: Complement C1 Inhibitor Protein, Bradykinin, MESH: Algorithms, MESH: Angioedemas, Hereditary, MESH: Comorbidity, Context (language use), MESH: Fibrinolysin, MESH: Kallikreins, Gastroenterology, 03 medical and health sciences, chemistry.chemical_compound, MESH: Pregnancy, 0302 clinical medicine, MESH: Early Diagnosis, MESH: Child, Internal medicine, medicine, MESH: Angioedema, MESH: Hereditary Angioedema Types I and II, MESH: Lupus Erythematosus, Systemic, 030203 arthritis & rheumatology, MESH: Bradykinin, Pregnancy, MESH: Humans, Lupus erythematosus, biology, Angioedema, business.industry, MESH: Symptom Assessment, MESH: Angiotensin-Converting Enzyme Inhibitors, Angiotensin-converting enzyme, General Medicine, MESH: Hematologic Diseases, medicine.disease, 3. Good health, [SDV.MP]Life Sciences [q-bio]/Microbiology and Parasitology, 030104 developmental biology, chemistry, MESH: Pregnancy Complications, Hereditary angioedema, biology.protein, Antibody, medicine.symptom, business, MESH: Female, MESH: Factor XII
Abstract

International audience; Bradykinin mediated angioedema (BK-AE) can be associated either with C1Inhibitor deficiency (hereditary and acquired forms), either with normal C1Inh (hereditary form and drug induced AE as angiotensin converting enzyme inhibitors…). In case of high clinical suspicion of BK-AE, C1Inh exploration must be done at first: C1Inh function and antigenemy as well as C4 concentration. C1Inh deficiency is significant if the tests are below 50 % of the normal values and controlled a second time. In case of C1Inh deficiency, you have to identify hereditary from acquired forms. C1q and anti-C1Inh antibody tests are useful for acquired BK-AE. SERPING1 gene screening must be done if a hereditary angioedema is suspected, even if there is no family context (de novo mutation 15 %). If a hereditary BK-AE with normal C1Inh is suspected, F12 and PLG gene screening is suitable.

Published
2019

33. Péricardite lupique: caractéristiques, prise en charge, évolution et facteurs prédictifs de rechute. Une étude de cohorte rétrospective

Author

Laurent Alric, A. Constantin, M.L. Piel-Julian, David Ribes, M. Lemeu, Stanislas Faguer, G. Moulis, Antoine Huart, Olivier Lairez, Grégory Pugnet, Laurent Sailler, and Dominique Chauveau

Subjects
Gastroenterology, Internal Medicine
Abstract

Introduction La pericardite est frequente au cours du lupus, et habituellement benigne. L’evolution et la prise en charge therapeutique de la pericardite lupique non grave sont toutefois peu etudiees. L’objectif de notre etude etait de decrire la pericardite lupique, sa prise en charge, son evolution et les facteurs de risque de rechute dans notre Centre Hospitalier Universitaire. Materiels et methodes Il s’agissait d’une etude retrospective de janvier 1997 a decembre 2019. Les cas de pericardite lupique motivant une consultation ou une hospitalisation etaient selectionnes a partir de la base de donnees du PMSI. L’inclusion definitive dans l’etude necessitait: un diagnostic de lupus (criteres ACR/EULAR 2019), associe a un diagnostic de pericardite (criteres de la ESC 2015), et un suivi d’au moins 1 an. Les patients etaient exclus en cas de facteur confondant potentiellement a l’origine de pericardite (notamment infection, insuffisance renale terminale, dialyse,…) ainsi qu’en cas de myo-pericardite. Les courbes de survies etaient decrites par un modele de survie actuarielle. Le faible effectif n’a pas permis une analyse multivariee. Resultats Parmi 103 patients identifies dans la base de donnees du PMSI, 29 (dont 25 femmes), ont ete inclus et suivis durant 1 a 21 ans (mediane: 7 ans). A la premiere poussee de pericardite: l’âge moyen etait de 36 ans ± 16. Neuf episodes (31 %) inauguraient le lupus. Les autres survenaient apres un suivi median de 65 mois [extremes: 1,7- 400,0]. Dans 55 % des cas (n = 16), il s’agissait d’une poussee multi-systemique. Le score SLEDAI-2 K median etait de 9 [4-30]. Au plan clinique, 27 patients (93 %) presentaient une douleur thoracique typique, 16 (55 %) une dyspnee, 9 (31 %) un frottement pericardique, 11 (38 %) de la fievre. Cinquante-neuf pour cent des ECG etaient pathologiques (9 avec aplatissement de l’onde T, 4 avec un sus-decalage du ST, 2 avec un micro-voltage, 7 avec un sous-decalage du PQ). L’epanchement etait present chez 22 patients (76 %), minime a modere ( Conclusion Cette etude confirme la frequence des recurrences dans la pericardite lupique. Le traitement par AINS/AAS (± colchicine) parait suffisant chez certains patients. L’usage prolonge (> 3 mois) de colchicine pourrait etre utile pour prevenir les recurrences. Ce benefice est a etablir par des etudes prospectives.

Published
2021

34. Clinical impact and prognosis of cryoglobulinemia and cryofibrinogenemia in systemic sclerosis

Author

Sébastien, De Almeida Chaves, Bénédicte, Puissant, Tiphaine, Porel, Eva, Bories, Daniel, Adoue, Laurent, Alric, Léonardo, Astudillo, Antoine, Huart, Olivier, Lairez, Martin, Michaud, David, Ribes, Grégoire, Prévot, Laurent, Sailler, Francis, Gaches, and Gregory, Pugnet

Subjects
Scleroderma, Systemic, Cryoglobulinemia, Immunology, Humans, Immunology and Allergy, Prognosis, Cryoglobulins
Abstract

An association of systemic sclerosis (SSc) with cryoglobulin and/or cryofibrinogenemia has been described. However, clinical, biological, morphological and prognostic implications are unknown. The objective of this study was to describe the phenotype and evaluate the prognosis of cryoglobulinemia and/or cryofibrinogenemia in the progression of SSc.Patients were included from the Systemic Scleroderma Toulouse Cohort (SSTC), between June 1, 2005 and May 31, 2018, and underwent a measurement of a cryoglobulin and/or cryofibrinogen in immunology laboratory at the Toulouse University Hospital Center. Patients with and without cryoglobulinemia50 mg/l and patients with and without cryofibrinogenemia were compared to identified the impact of cryoprcipitate on the phenotype. Mortality based on cryoprecipitate was explored.166 patients were included in the study. 43.3% and 46.6% had a cryoglobulinemia50 mg/l and cryofibrinogenemia, respectively. Cryoglobulin50 mg was not associated with microvascular damage. Cryoglobulin does not influence the phenotype. 5-and 10-years survival were 97.6% and 88.8% respectively in patients with cryoglobulinemia50 mg/l versus 91.9% and 78.4% in patients without cryoglobulin50 mg/l. 10-years survival was better for patients with cryoglobulinemia50 mg/l (log-rank 0.0363). Cryofibrinogenemia was not associated with neoplasia, any clinical (in particular ischemic damage), biological or morphological features. Cryofibrinogenemia had no influence on the mortality of these patients.Cryoglobulinemia and cryofibrinogenemia are frequent in SSc. The presence of cryoprecipitate (cryoglobulin or cryofibrinogen) not influence the phenotype and has not associated with a poor survival.

Published
2022

35. Epidemiology of autoimmune hemolytic anemia: A nationwide population-based study in France

Author

Marc Michel, Margaux Lafaurie, Maryse Lapeyre-Mestre, Agnès Sommet, Guillaume Moulis, Julien Maquet, Ondine Walter, and Laurent Sailler

Subjects
Adult, medicine.medical_specialty, Pediatrics, Adolescent, business.industry, MEDLINE, Hematology, Middle Aged, medicine.disease, Population based study, Young Adult, Epidemiology, medicine, Humans, Anemia, Hemolytic, Autoimmune, France, Autoimmune hemolytic anemia, business, Aged
Published
2021

36. COVID-19 outcomes in patients with inflammatory rheumatic and musculoskeletal diseases treated with rituximab: a cohort study

Author

Jérôme Avouac, Elodie Drumez, Eric Hachulla, Raphaèle Seror, Sophie Georgin-Lavialle, Soumaya El Mahou, Edouard Pertuiset, Thao Pham, Hubert Marotte, Amélie Servettaz, Fanny Domont, Pascal Chazerain, Mathilde Devaux, Pascal Claudepierre, Vincent Langlois, Arsène Mekinian, Alexandre Thibault Jacques Maria, Béatrice Banneville, Bruno Fautrel, Jacques Pouchot, Thierry Thomas, René-Marc Flipo, Christophe Richez, Florence Aeschlimann, Christian Agard, Nassim Ait-Abdallah, Jean-David Albert, Didier Alcais, Jean-Sébastien Allain, Yannick Allanore, Blanca Amador-Borreiro, Zahir Amoura, Emma Andre, Anaïs Arbault, Jean-Benoît Arlet, Laurent Arnaud, Denis Arniaud, Herliette Arty-Hue, Lucie Atlan, Alexandra Audemard-Verger, Christine Audoin-Pajot, Victor Audren, Maxime Bach-Bunner, Hélène Bacquet-Deschryver, Brigitte Bader-Meunier, Nathalie Balandraud, Jean-Charles Balblanc, Stéphane Bally, Frédéric Banal, Pierre Barbery, Thomas Barnetche, Audre Barrelet, André Basch, Vincent Baumier, Guillaume Bayer, Sophie Bayle, Catherine Beauvais, Rudie Beinat, Véronique Belin, Rakiba Belkhir, Ruben Benainous, Alexandre Belot, Mohammed Benammar, Mathilde Benhamou, Ygal Benhamou, Ahmed Benmansour, Pascal Bennet, Brigitte Bernoux-Manat, Elise Berthet, Emilie Berthoux, Ewa Bertolini, Adrien Bigot, Aurélia Bisson-Vaivre, Gilles Blaison, Gilles Bolla, Olivier Bonidan, Christine Bonnet, Raphaël Borie, Marie Bossert, Laurence Boudou, Françoise Bouhour, Kévin Bouiller, Bastien Bouldoires, Karima Boussoualim, Eric Bouvard, Regine Brondino, Pierre Buchlin, Laurence Cabantous, Patrice Cacoub, Simon Cadiou, Maurizio Carteni, Aurélia Carbasse, Brice Castel, Pascal Cathebras, Hervé Caumont, Annalisa Celant, Benjamin Chaigne, Benoît Chaillous, Romuald Champy, Agnès Charcot, Pierre Charles, Isabelle Charlot-Lambrecht, Caroline Charpin, Emmanuel Chatelus, Bernard Chaudier, Pascale Chertok, Xavier Chevalier, Maxime Chevreau, Emilie Chotard, Delphine Chu Miow Lin, Gaëlle Clavel, Cyril Clavel-Osorio, Fleur Cohen, Gregory Cohen, Marie-Eve Colette-Cedoz, Nived Collercandy, Antoine Colombey, Chloé Comarmond, Bernard Combe, Céline Comparon, Elodie Constant, Pascal Coquerelle, Justine Corli, Clémence Corre, Nathalie Costedoat-Chalumeau, Marie Couret, Natacha Courvoisier, Fabienne Coury-Lucas, Cécile Coutarel, Fabrice Coutier, Richard Damade, Laurence Daver-Malaterre, Sarahe Dehimat, Michel Delahousse, Emilie Barrois-Delattre, Delphine Denarie, Camille Deprouw, Emanuelle Dernis, Alban Deroux, Renaud Desbarbieux, Elise Descamps, Chantal Deslandre, Marie Desmurs, Jacques Despaux, Marie Desplats, Frédérick Detree, Valérie Devauchelle-Pensec, Robin Dhote, Philippe Dieude, Yannick Dieudonne, Elisabeth Diot, Guillaume Direz, Djamal-Dine Djeddi, Sarah Douvier, Béatrice Drouet, Catherine Duc, Angélique Ducornet, Carine Dufauret-Lombard, Alain Duhamel, Cécile Dumaine, Anne-Elisabeth Dumel, Chantal Dumoulin-Richez, Agnès Duquesne, Géraldine Durand, Mariane Durandin-Truffinet, Pierre-Marie Duret, Maïka Duval, Mikaël Ebbo, Esther Ebstein, Andra Economu-Dubosc, Stéphanie Emilie, Romain Euvrard, Philippe Evon, Sylvie Fabre, Dorothée Fagedet, Meryem Farhat, Marion Fauconier, Jacques Fechtenbaum, Renaud Felten, Fanny Fernandes, Nicole Ferreira-Maldent, Elodie Feurer, Amandine Fichet, Françoise Flaisler, Nans Florens, Violaine Foltz, Elisabeth Fontanges, Jennifer Foret, Anne-Claire Fougerousse, Anne Fouque-Aubert, Catherine Foutrier-Morello, Hélène Francois-Pradier, Léa Frantzen, Pierre Fritz, Antoine Froissart, Jean Fulpin, Piera Fuzibet, Francis Gaches, Laurence Gagneux-Lemoussu, Mélanie Penhoat-Gahier, Joris Galland, Frédérique Gandjbakhch, Nicole Garnier, Thomas Garraud, Jean-François Garrot, Romain Gastaldi, Véronique Gaud-Listrat, Maud Gauthier-Prieur, Dana Georgescu, Nathalie Gerard, Elisabeth Gervais, Christelle Gibert, Eric Gibert, Ghislaine Gill, Jérôme Gillard, Mélanie Gilson, Pauline Gimonnet, Jeanine-Sophie Giraudet-Le Quintrec, Aude Giraud-Morelet, Baptiste Glace, Camille Glanowski, Bertrand Godeau, Bruno Gombert, Camille Gonnet-Gracia, Tiphaine Goulenok, Philippe Goupille, Olivier Gourmelen, Sophie Govindaraju-Audouard, Franck Grados, Martine Grall-Lerosey, Bruno Grardel, Anne Grasland, Gilles Grateau, Monica Groza, Constance Guillaud, Séverine Guillaume, Caroline Guillibert, Xavier Guillot, Philippe Guilpain, Aline Gury, Marie-Hélène Guyot, Cécile Hacquard-Bouder, Marie-Noelle Havard, Jean-Pierre Hellier, Pascal Hennequin, Basile Henriot, Julien Henry, Véronique Hentgen, Marion Hermet, Muriel Herasse, Julie Hernandez, Miguel Hie, Pascal Hilliquin, Olivier Hinschberger, Ambre Hittinger-Roux, Jan Holubar, Christophe Hudry, Serge Huguenel, Clara Jaccard, Jean-Michel, Jacquemier, Bénédicte Jamard, Catherine Jan, Sylvie Jean, Mathieu Jouvray, Pierre-Antoine Juge, Laurent Juillard, Denis Jullien, Anna Kabala, Abdelkrim Kabchou, Ludovic Karkowski, Françoise Karman, Farid Kemiche, Jérémy Keraen, Pierre Kieffer, Isabelle Kone-Paut, Abdeldajallil Koreichi, Marie Kostine, Sylvain La Batide Alanore, Pierre Lafforgue, Sophie Lahalle, Marc Lambert, Isabelle Lambrecht, Sylvain Lanot, Aurélia Lanteri, Jean-Paul Larbre, Augustin Latourte, Christian Lavigne, Sophie Le Guen Guegan, Guillaume, Le Guenno, Diane Leguy, Agnès Lebrun, Emmanuel Ledoult, Nathalie Legoupil, Erick Legrand, Charlotte Lejeune, Olivier Leloire, Christophe Leroux, Rémi Leroy, Marie Leroy-Gouix, Tifenn Leturcq, Amélie Leurs, Céline Leveque-Michaud, François-Xavier Limbach, Frédéric Liote, Anne Lohse, Pierre Lozac'h, Virginie Lucas, Aurélie Madelon, Nadine Magy-Bertrand, Matthieu Mahevas, Hélène Maillard, Thibault Maillet, Sandrine Malochet-Guinamand, Quentin Mangon, Sylvie Marchou-Lopez, Nathalie Margarit, Thierry Marhadour, Xavier Mariette, Claire Martin, Alexis Mathian, François Maurier, Frédéric Maury, Betty Mazet-Guillaume, Arnaud Mazouyez, Hassan Mazyad, Nadia Mehsen-Cetre, Ulrich Meinzer, Isabelle Melki, Laurent Messer, Corinne Miceli, Martin Michaud, Catherine Michel, Matthias Michel, Mathilde Michon, Anne-Marie Milesi-Lecat, Anna Molto, Marie Moly, Olivier Moranne, Gautier Morel, Hugo Morel, Jacques Morel, Franck Morin, Laurence Moulinier, Guillaume Moulis, Bertrand Moura, Minh Nguyen, Sabine Nicolas-Vullierme, Hubert Nielly, Gaétane Nocturne, Aurore Nottez, Henri-Olivier Ollagnon, Isabelle Pacaud-Vitoux, Anne Pagnier, Caroline Paris, Antoine Parrot, Tristan Pascart, Yasmina Pascaud-Mansour, Lætitia Paulin, Stephan Pavy, Laurent Perard, Yves-Marie Pers, Micheline Pha, Maud Pichon, Audrey Pierreisnard, Gabrielle Pizana, Sylvaine Poignant, Elsa Poix, Agnès Portier, Antoine Poulet, Samira Plassard, Grégory Pugnet, Déborah Puyraimond-Zemmour, Pierre Quartier-Dit-Maire, Marion Quenet, Viviane Queyrel, Loïc Raffray, Philippe Remy, Myriam Renard, Jessica Rene, Sabine Revuz, Bénédicte Rey, Gaëlle Richard-Colmant, Etienne Riviere, Sébastien Riviere, Sophie Robin, Julien Rohmer, Isabelle Roitg, Mélanie Romier, Michel Rolland, Mélanie Roriz, Carole Rosenberg, Linda Rossi, Olivier Roth, Sid-Ahmed Rouidi, Mathilde Roumier, Mickaël Rousiere, Clémentine Rousselin, Bénédicte Rouviere, Christian Roux, Fabienne Roux, Marielle Roux, Nicolas Roux, Diane Rouzaud, Sylvie Rozenberg, Isabelle Sacco, Fatiha Sadji, Laurent Sailler, Carine Salliot, Jean-Hugues Salmon, Alain Saraux, Jean Schmidt, Julie Seguier, Jérémie Sellam, Eric Senbel, Thomas Sene, Patricia Senet, Pascal Seve, Aurélie Sicaud, Perrine Smets, Vincent Sobanski, Christelle Sordet, Elisabeth Sornay-Rendu, Odile Souchaud-Debouverie, Lætitia Sparsa, Lionel Spielmann, Sarah Steib, Chloé Stavris, Catherine Straus, Victor Strotz, Paulina Szafors, Séverine Taffignon-Clave, Justine Simoens, Claire Theillac, Nora Tenenbaum, Benoît Thomachot, Nathalie Tieulie, Soizic Tiriau, Alice Tison, Eric Toussirot, Ludovic Trefond, Sophie Trijau, Sébastien Trouillier, Anne-Priscille Trouvin, Marie-Elise Truchetet, Marc Ulrich, Jacques Vaquier, Eric Veillard, Laurent Veillon, Guillaume Vial, Jean-François Viallard, Judith Victor, Claire Vidon, Mathias Vidon, Camille Vigne, Alexandre Virone, Ursula Warzocha, Daniel Wendling, Claude Werle, Cécile Wibaux, Alexandra Willems, Michel Wisniewski, Juliette Woessner, Bernadette Xerri-Campano, Service de rhumatologie [CHU Cochin], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Evaluation des technologies de santé et des pratiques médicales - ULR 2694 (METRICS), Université de Lille-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Service de médecine interne [Lille], Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Institute for Translational Research in Inflammation - U 1286 (INFINITE (Ex-Liric)), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lille-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Immunologie des Maladies Virales et Autoimmunes (IMVA - U1184), Université Paris-Sud - Paris 11 (UP11)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Tenon [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Centre Hospitalier Tourcoing, Centre Hospitalier René Dubos [Pontoise], Assistance Publique - Hôpitaux de Marseille (APHM), Santé Ingénierie Biologie Saint-Etienne (SAINBIOSE), Centre Ingénierie et Santé (CIS-ENSMSE), École des Mines de Saint-Étienne (Mines Saint-Étienne MSE), Institut Mines-Télécom [Paris] (IMT)-Institut Mines-Télécom [Paris] (IMT)-École des Mines de Saint-Étienne (Mines Saint-Étienne MSE), Institut Mines-Télécom [Paris] (IMT)-Institut Mines-Télécom [Paris] (IMT)-Université Jean Monnet - Saint-Étienne (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM), Biologie Intégrative du Tissu Osseux (LBTO), Université Jean Monnet - Saint-Étienne (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre d'Investigation Clinique - Epidémiologie Clinique Saint-Etienne (CIC-EC), Centre Hospitalier Universitaire de Saint-Etienne [CHU Saint-Etienne] (CHU ST-E)-Université Jean Monnet - Saint-Étienne (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier Universitaire de Reims (CHU Reims), CHU Pitié-Salpêtrière [AP-HP], Groupe Hospitalier Diaconesses Croix Saint-Simon, Centre hospitalier intercommunal de Poissy/Saint-Germain-en-Laye - CHIPS [Poissy], Epidemiology in Dermatology and Evaluation in Therapeutics (EpiDermE), Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), CHU Saint-Antoine [AP-HP], Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Cellules Souches, Plasticité Cellulaire, Médecine Régénératrice et Immunothérapies (IRMB), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Centre Hospitalier Universitaire de Saint-Etienne [CHU Saint-Etienne] (CHU ST-E), CHU Bordeaux [Bordeaux], Composantes innées de la réponse immunitaire et différenciation (CIRID), Université Bordeaux Segalen - Bordeaux 2-Centre National de la Recherche Scientifique (CNRS), Laboratoire Chrono-environnement (UMR 6249) (LCE), Centre National de la Recherche Scientifique (CNRS)-Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), Maladies génétiques d'expression pédiatrique (U933), Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Trousseau [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Service de Médecine Interne = Hôpital de jour de médecine [CHU Tenon], INSERM U1059, SAINBIOSE - Santé, Ingénierie, Biologie, Saint-Etienne (SAINBIOSE-ENSMSE), Institut Mines-Télécom [Paris] (IMT)-Institut Mines-Télécom [Paris] (IMT)-Université Jean Monnet [Saint-Étienne] (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM), Biologie intégrative du tissu osseux, Université Jean Monnet [Saint-Étienne] (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM), CIC Saint Etienne, Centre Hospitalier Universitaire de Saint-Etienne (CHU de Saint-Etienne)-Université Jean Monnet [Saint-Étienne] (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Hôpital Nord (Saint Etienne), centre hospitalier intercommunal de Poissy/Saint-Germain-en-Laye - CHIPS [Poissy], Centre Hospitalier Universitaire de Saint-Etienne (CHU de Saint-Etienne), Laboratoire Chrono-environnement - CNRS - UBFC (UMR 6249) (LCE), Service de rhumatologie, Université Paris-Sud - Paris 11 (UP11)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Bicêtre, Service de Médecine Interne [CHU Tenon], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Tenon [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Service de rhumatologie [CH Gustave Dron, Tourcoing], Centre Hospitalier Gustave Dron [Tourcoing], Hopital Réné Dubos, Université Paris 1 Panthéon-Sorbonne - UFR Science Politique (UP1 UFR11), and Université Paris 1 Panthéon-Sorbonne (UP1)

Subjects
medicine.medical_specialty, Immunology, law.invention, 03 medical and health sciences, 0302 clinical medicine, Rheumatology, immune system diseases, law, hemic and lymphatic diseases, Internal medicine, Clinical endpoint, Immunology and Allergy, Medicine, 030212 general & internal medicine, 030203 arthritis & rheumatology, business.industry, Hazard ratio, Odds ratio, Articles, medicine.disease, Intensive care unit, 3. Good health, [SDV.MP]Life Sciences [q-bio]/Microbiology and Parasitology, Rheumatoid arthritis, Cohort, Rituximab, business, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology, Cohort study, medicine.drug
Abstract

Summary Background Various observations have suggested that the course of COVID-19 might be less favourable in patients with inflammatory rheumatic and musculoskeletal diseases receiving rituximab compared with those not receiving rituximab. We aimed to investigate whether treatment with rituximab is associated with severe COVID-19 outcomes in patients with inflammatory rheumatic and musculoskeletal diseases. Methods In this cohort study, we analysed data from the French RMD COVID-19 cohort, which included patients aged 18 years or older with inflammatory rheumatic and musculoskeletal diseases and highly suspected or confirmed COVID-19. The primary endpoint was the severity of COVID-19 in patients treated with rituximab (rituximab group) compared with patients who did not receive rituximab (no rituximab group). Severe disease was defined as that requiring admission to an intensive care unit or leading to death. Secondary objectives were to analyse deaths and duration of hospital stay. The inverse probability of treatment weighting propensity score method was used to adjust for potential confounding factors (age, sex, arterial hypertension, diabetes, smoking status, body-mass index, interstitial lung disease, cardiovascular diseases, cancer, corticosteroid use, chronic renal failure, and the underlying disease [rheumatoid arthritis vs others]). Odds ratios and hazard ratios and their 95% CIs were calculated as effect size, by dividing the two population mean differences by their SD. This study is registered with ClinicalTrials.gov, NCT04353609. Findings Between April 15, 2020, and Nov 20, 2020, data were collected for 1090 patients (mean age 55·2 years [SD 16·4]); 734 (67%) were female and 356 (33%) were male. Of the 1090 patients, 137 (13%) developed severe COVID-19 and 89 (8%) died. After adjusting for potential confounding factors, severe disease was observed more frequently (effect size 3·26, 95% CI 1·66–6·40, p=0·0006) and the duration of hospital stay was markedly longer (0·62, 0·46–0·85, p=0·0024) in the 63 patients in the rituximab group than in the 1027 patients in the no rituximab group. 13 (21%) of 63 patients in the rituximab group died compared with 76 (7%) of 1027 patients in the no rituximab group, but the adjusted risk of death was not significantly increased in the rituximab group (effect size 1·32, 95% CI 0·55–3·19, p=0·53). Interpretation Rituximab therapy is associated with more severe COVID-19. Rituximab will have to be prescribed with particular caution in patients with inflammatory rheumatic and musculoskeletal diseases. Funding None.

Published
2021

37. Real-world Risk of Relapse of Giant Cell Arteritis Treated With Tocilizumab: A Retrospective Analysis of 43 Patients

Author

Pierre Duffau, Fabrice Bonnet, Thierry Schaeverbeke, Jérémy Clément, Laurent Sailler, Jean-Philippe Vernhes, Joël Constans, Damien Barcat, Jean-François Viallard, Bordeaux population health (BPH), and Université de Bordeaux (UB)-Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED)-Institut National de la Santé et de la Recherche Médicale (INSERM)

Subjects
medicine.medical_specialty, Immunology, Population, Giant Cell Arteritis, Antibodies, Monoclonal, Humanized, 03 medical and health sciences, chemistry.chemical_compound, 0302 clinical medicine, Tocilizumab, Rheumatology, Recurrence, Internal medicine, medicine, Adjuvant therapy, Immunology and Allergy, Humans, 030212 general & internal medicine, 10. No inequality, education, Adverse effect, Aged, Retrospective Studies, 030203 arthritis & rheumatology, education.field_of_study, Cumulative dose, business.industry, Retrospective cohort study, medicine.disease, 3. Good health, Discontinuation, Giant cell arteritis, Treatment Outcome, chemistry, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, business
Abstract

ObjectiveTocilizumab (TCZ), an interleukin 6 (IL-6) receptor antagonist, is approved for giant cell arteritis (GCA) as a cortisone-sparing strategy and in refractory patients. This study assessed the real-world efficacy, safety, and long-term outcomes of patients with GCA treated with TCZ.MethodsWe conducted a multicenter retrospective observational study at 3 French centers. All patients aged ≥ 50 years who met the American College of Rheumatology (ACR) criteria, and had received at least 1 dose of TCZ were included. Relapse was defined by therapeutic escalation, such as increased doses of corticosteroids (CS), resumption of CS after weaning, or introduction or intensification of adjuvant therapy.ResultsBetween 2013 and 2019, 43 patients were included. Patients were followed up for a median 511 days between GCA diagnosis and inclusion, with 34/43 (79%) patients experiencing relapses. At inclusion, median age was 77 years, and median dose of CS was 15 mg/day. After inclusion, the mean cumulative dose of CS was 2.1 g/year vs 9.4 g/year before inclusion (P < 2 × 10–7), with 12/43 (28%) patients experiencing relapses on TCZ. Among 29 patients undergoing TCZ discontinuation, 18 (62%) experienced relapses. Factors associated with relapse after inclusion were introduction of TCZ > 6 months after diagnosis (P = 0.005), absence of ischemic signs at diagnosis (P = 0.006), relapse rate > 0.8/year (P = 0.03), and absence of CS tapering ≤ 5 mg/day (P = 0.03) before inclusion. Serious adverse events occurred in 18/43 patients (42%), including 4 deaths.ConclusionOur results confirm the effectiveness of TCZ for CS sparing, but after discontinuation of treatment, TCZ allows for a prolonged remission in < 50% of patients. Attention must be paid to the tolerance of this long-term treatment in this elderly, heavily treated refractory population.

Published
2021

38. Safety of Pyrazinamide for the Treatment of Tuberculosis in Older Patients Over 75 Years of Age: A Retrospective Monocentric Cohort Study

Author

Hélène Guet-Revillet, Agnès Sommet, Stella Rousset, Guillaume Martin-Blondel, Peggy Gandia, Pierre Delobel, Caroline Protin, Jean Le Grusse, Laurent Sailler, Fatemeh Nourhashemi, Margaux Lafaurie, Hélène Derumeaux, Service des maladies infectieuses et tropicales [Toulouse], Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-CHU Toulouse [Toulouse]-Hôpital Purpan [Toulouse], CHU Toulouse [Toulouse], Laboratoire de pharmacologie médicale et clinique, Epidémiologie et analyses en santé publique : risques, maladies chroniques et handicaps (LEASP), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées, Service de Bactériologie-Hygiène [Toulouse], Hôpital Purpan [Toulouse], CHU Toulouse [Toulouse]-CHU Toulouse [Toulouse], Hôpital Joseph Ducuing, Laboratoire de Pharmacocinétique et de Toxicologie clinique [Toulouse], Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-CHU Toulouse [Toulouse]-Institut Fédératif de Biologie (IFB) - Hôpital Purpan, CHU Toulouse [Toulouse]-CHU Toulouse [Toulouse]-Hôpital Purpan [Toulouse], Hôpital La Grave-Casselardit [Toulouse], Centre de Physiopathologie Toulouse Purpan (CPTP), and Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)

Subjects
medicine.medical_specialty, Tuberculosis, Antitubercular Agents, Logistic regression, Cohort Studies, 03 medical and health sciences, 0302 clinical medicine, Pharmacotherapy, Older patients, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Internal medicine, medicine, Humans, Pharmacology (medical), 030212 general & internal medicine, Risk factor, Aged, Retrospective Studies, business.industry, Odds ratio, Pyrazinamide, medicine.disease, 3. Good health, Geriatrics and Gerontology, business, 030217 neurology & neurosurgery, medicine.drug, Cohort study
Abstract

International audience; Objectives: Pyrazinamide (PZA) has a controversial safety profile in older patients. We aimed to assess the frequency and risk factors for adverse drug reactions (ADRs) in patients over 75 years of age treated for tuberculosis with or without PZA.Methods: We conducted a retrospective monocentric study including patients aged over 75 years treated for active tuberculosis between 2008 and 2018. The frequency, type, seriousness, and causality assessment of ADRs to anti-tuberculosis treatment were compared between patients receiving PZA or not. Risk factors for ADRs were investigated using univariable and multivariable analyses by logistic regression.Results: Among the 110 patients included, 54 (49.1%) received PZA (group 1) and 56 (50.9%) did not (group 2). ADRs to anti-tuberculosis drugs occurred in 31 patients (57.4%) in groups 1 and 15 (26.8%) in group 2 (p = 0.003). PZA-related ADRs occurred in 40.7% of exposed patients. Frequency of renal ADRs was higher in group 1 (9.3% vs 0%; p = 0.026). Rates of hepatic (18.5% vs 12.5%; p = 0.38), digestive (22.2% vs 8.9%; p = 0.054), and allergic (14.8% vs 5.4%; p = 0.12) ADRs were numerically higher in group 1 although the differences were not statistically significant. Serious ADRs occurred more frequently in group 1 (24.1% vs 8.9%; p = 0.03). The use of PZA was the only independent risk factor for ADRs to anti-tuberculosis drugs (odds ratio 3.75, 95% CI 1.5-9.6; p = 0.0056). No risk factors for PZA-related ADRs were identified.Conclusion: In older French patients, the use of PZA was associated with more frequent ADRs to anti-tuberculosis drugs.

Published
2021

39. Risk of Immune Thrombocytopenia After Influenza Vaccine

Author

Margaux Lafaurie, Maryse Lapeyre-Mestre, Laurent Sailler, Agnès Sommet, and Guillaume Moulis

Subjects
Purpura, Thrombocytopenic, Idiopathic, Influenza Vaccines, Influenza, Human, Research Letter, Internal Medicine, Humans, Thrombocytopenia
Abstract

This cohort study uses data from the French National Health Database to examine the risk of immune thrombocytopenia after receiving influenza vaccine among patients who were 65 years or older.

Published
2022

41. Maladie de Still et PseudoStill associés aux SMD et LMMC : Étude nationale Française

Author

Julie Graveleau, M. Delplanque, Florent Malard, S. guillet, M. Sebert, N. Belfeki, Pierre Hirsch, Sébastien Miranda, Louis Terriou, Damien Roos-Weil, Thomas Quemeneur, S. Georgin-Lavialle, Matthieu Mahevas, G. Maigné, Albertine Aouba, Pierre Fenaux, J. Razanamahery, Laurent Sailler, A. Mekinian, and M. Groh

Subjects
Gastroenterology, Internal Medicine
Abstract

Introduction Dix a 20 % des syndromes myelodysplasiques (SMD)/Leucemies myelomonocytaires chroniques (LMMC) pourraient etre associes a diverses pathologies extra-hematologiques telles que des dermatoses neutrophiles, des vascularites systemiques, des arthrites inflammatoires, des pseudo-maladies de Behcet ou des polychondrites [1] . La fievre, l’atteinte articulaire, le syndrome inflammatoire biologique marque, le rash evanescent sont des symptomes frequemment associes aux SMD et LMMC, mais ils peuvent egalement etre les signes cardinaux caracteristiques de la maladie de Still de l’adulte (MSA). Les MSA associees aux SMD/LMMC existent, principalement decrites dans les neoplasies solides mais aussi hematologiques [2] . L’identification recente du VEXAS syndrome (vacuoles, enzyme E1, lie a l’X, auto-inflammatoire, somatique) lie a une mutation somatique de UBA1 [3] nous amene a nous interroger sur l’existence de telles mutations chez les patients presentant des tableaux d’autoinflammation de type MSA ou pseudo Still associes a des SMD/LMMC. Dans cette etude nationale francaise, nous avons donc cherche a decrire les patients atteints de SMD/LMMC presentant une fievre recurrente inexpliquee avec des signes extra-hematologiques suggerant une MSA ainsi que leur pronostic/reponse therapeutique et recherche la presence d’une mutation UBA1 chez ces patients. Patients et methodes Les caracteristiques demographiques, cliniques et biologiques des 26 patients identifies avec cette association etaient collectees et analysees dans une etude retrospective multicentrique francaise. Le groupe temoin de SMD/LMMC etait compose de 104 patients du registre du Groupe francophone des myelodysplasies avec SMD/LMMC. La presence d’une mutation UBA1 etait realisee chez 15 patients. Resultats Les SMD avec exces de blastes (30,8 %) etaient les plus representes, le R-IPSS median etait de 3,7 [2–5]. Des traitements hematologiques specifiques etaient mis en place dans 17 cas (65 %), 0,5 an [0,1–1,2] apres le diagnostic de SMD, principalement par azacitidine (n = 15 ; 58 %). Les SMD/CMML de nos patients etaient plus precoces (71,4 [36–85] contre 78 ans (42-92) ; p = 0,0005) que ceux sans caracteristiques dysimmunitaires sans difference significative pour la survie globale et le delai d’evolution vers la leucemie myeloide aigue. Les patients identifies suspects de MSA presentaient tous une fievre recurrente inexpliquee et un syndrome inflammatoire biologique marque. Ils ont ete classes soit en MSA confirmee (n = 5) d’apres les criteres de Yamaguchi ou de Fautrel, soit en pseudoStill (n = 21) avec (n = 8) ou sans (n = 13) caracteristiques inhabituelles de MSA. Chez les pseudoStill, l’hyperleucocytose a polynucleaire neutrophile manquait pour 85 % des patients. Les diagnostics etaient concomitants chez 8 patients (32 %), celui de MSA precedait le SMD/CMML chez 12 patients (48 %) et survenait apres le diagnostic du SMD/CMML chez 5 patients (24 %) dans un delai median de 1,0 an [0,2–2]. L’âge median au diagnostic etait de 70,5 ans [64,3–78,9] et 76 % etaient des hommes. Des complications graves de MSA etaient constatees au moment du diagnostic ou au cours du suivi chez 9 patients (3 %) : des syndromes d’activation macrophagique (n = 5) ; des myopericardites (n = 3), des maladies pulmonaires interstitielles (n = 3) et un syndrome de detresse respiratoire aigue (n = 1). Parmi les 21 (91 %) patients ayant recu un traitement specifique pour la MSA, 16 (76 %) recevaient en 1ere ligne des corticostertiquedoides seuls ou en association avec de l’anakinra ou de l’infliximab. Les corticosteroides a forte dose conduisait a une reponse dans 12/15 des cas et les biotherapies dans 8/13 cas. Douze patients (57 %) necessitait un traitement de deuxieme ligne. L’azacitidine conduisait a une reponse de la MSA dans 11 (69 %) cas. Enfin, la mutation d’UBA1 etait recherchee chez 15 patients et revelait 5 (33 %) cas positifs. Conclusion Un tableau evocateur de MSA apres 65 ans chez un homme doit faire rechercher un SMD/LMMC en particulier devant l’absence d’hyperleucocytose ou d’atypies mais aussi l’existence de mutations somatiques dont celle d’UBA1. En cas de MSA refractaire associee a un SMD/LMMC, l’indication a un traitement hematologique specifique peut etre discute.

Published
2021

42. Correspondence on 'Risk of systemic lupus erythematosus after immune thrombocytopenia and autoimmune haemolytic anaemia: a nationwide French study'

Author

Guillaume Moulis, Maryse Lapeyre-Mestre, Julien Maquet, Margaux Lafaurie, and Laurent Sailler

Subjects
030203 arthritis & rheumatology, 0301 basic medicine, National health, education.field_of_study, medicine.medical_specialty, Pediatrics, Lupus erythematosus, Adult patients, business.industry, Immunology, Population, medicine.disease, General Biochemistry, Genetics and Molecular Biology, Immune thrombocytopenia, 03 medical and health sciences, 030104 developmental biology, 0302 clinical medicine, Chronic disease, Rheumatology, immune system diseases, Epidemiology, medicine, Immunology and Allergy, education, business
Abstract

We read with great interest the articles by Zhu et al 1 and Mo et al 2 studying the risk of new systemic lupus erythematosus (SLE) diagnosis after immune thrombocytopenia (ITP) and autoimmune haemolytic anaemia (AIHA) diagnoses in the Taiwanese National Health Database. Zhu et al observed 34 SLE cases among 723 patients with incident ITP between 2000 and 2013. The 1-year and 5-year cumulative incidences were 1.9% and 4.8%, respectively.1 Mo et al reported the diagnosis of 117 SLE during the follow-up of 731 patients with incident AIHA between 2005 and 2012. The 1-year and 5-year cumulative incidences were 11.3% and 17.3%, respectively.2 In the present study, we estimated the risk of new SLE after incident ITP or AIHA in the entire French general population. FAITH and AHEAD cohorts3 are the French nationwide cohorts of adult patients with incident primary ITP and AIHA, respectively. These cohorts are built using validated algorithms in the French health database ( Systeme National des Donnees de Sante ), which links sociodemographic, out-hospital and in-hospital data for the entire French population (>66 million inhabitants).4 SLE was defined by the date of first in-hospital or chronic disease (the …

Published
2020

43. Hydroxychloroquine levels in patients with systemic lupus erythematosus: whole blood is preferable but serum levels also detect non-adherence

Author

Jean-Sébastien Hulot, Felix Ackermann, N. Costedoat-Chalumeau, Jérémie Sellam, Amar Smail, Claire Goulvestre, Jean-Emmanuel Kahn, François Chasset, Gaëlle Leroux, Laurent Perard, Patrice Cacoub, Karim Sacre, Du Le Thi Huong, Moez Jallouli, Olivier Fain, Lionel Galicier, Bouchra Asli, Noémie Jourde-Chiche, Michel Vidal, Véronique Le Guern, Frédéric Lioté, Jean-Charles Piette, Judith Cohen-Bittan, Xavier Mariette, O. Aumaître, Thomas Papo, Benoit Blanchet, Marie Allard, Pascale Ghillani-Dalbin, Jérôme Stirnemann, Nicolas Limal, Hélène Desmurs-Clavel, Zahir Amoura, Laurent Sailler, Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Cibles Thérapeutiques et conception de médicaments (CiTCoM - UMR 8038), Institut de Chimie du CNRS (INC)-Centre National de la Recherche Scientifique (CNRS)-Université Paris Cité (UPCité), Chimie médicinale et recherche translationnelle (ERL Inserm U1268), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité), Hedi Chaker Hospital [Sfax], CIC - CHU Bichat, Institut National de la Santé et de la Recherche Médicale (INSERM), Université Sorbonne Paris Cité (USPC), CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Hopital Saint-Louis [AP-HP] (AP-HP), CHU Gabriel Montpied [Clermont-Ferrand], CHU Clermont-Ferrand, CHU Tenon [AP-HP], Sorbonne Université - Faculté de Médecine (SU FM), Sorbonne Université (SU), Service de Rhumatologie [CHU Lariboisière], Hôpital Lariboisière-Fernand-Widal [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), CHU Amiens-Picardie, Service de médecine interne [Mondor], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Centre hospitalier Saint Joseph - Saint Luc [Lyon], Hospices Civils de Lyon (HCL), Hôpital Ambroise Paré [AP-HP], Université Paris-Saclay, Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Université Toulouse III - Paul Sabatier (UT3), Université de Toulouse (UT), Hôpital Foch [Suresnes], CHU Saint-Antoine [AP-HP], Hôpitaux Universitaires de Genève (HUG), Immunologie des maladies virales, auto-immunes, hématologiques et bactériennes (IMVA-HB), Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Saclay, Paris-Centre de Recherche Cardiovasculaire (PARCC (UMR_S 970/ U970)), Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité), Centre recherche en CardioVasculaire et Nutrition = Center for CardioVascular and Nutrition research (C2VN), Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Centre de néphrologie et transplantation rénale [Hôpital de la Conception - APHM], Assistance Publique - Hôpitaux de Marseille (APHM)-Hôpital de la Conception [CHU - APHM] (LA CONCEPTION), Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité (CRESS (U1153 / UMR_A_1125 / UMR_S_1153)), Conservatoire National des Arts et Métiers [CNAM] (CNAM), HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Service d'Immunologie [CHU Pitié-Salpétrière], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Service de dermatologie et allergologie [CHU Tenon], Centre National de Référence du Lupus Systémique, Syndrome des Anticorps Anti-phospholipides et Maladies Auto-immunes Systémiques Rares [CHU Pitié Salpêtrière], Service de Médecine Interne 2, maladies auto-immunes et systémiques [CHU Pitié-Salpêtrière], Institut E3M [CHU Pitié-Salpêtrière], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Institut E3M [CHU Pitié-Salpêtrière], Service de médecine interne [CHU Pitié-Salpétrière], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Sorbonne Université (SU), CHU Toulouse [Toulouse], Université Fédérale Toulouse Midi-Pyrénées, Service de médecine interne [CHU Saint-Antoine], Centre National de Référence Maladies auto-immunes Systémiques Rares [CHU Pitié-Salpêtrière], Service de Département de médecine interne et immunologie clinique [CHU Pitié-Salpêtrière] (DMIIC), Service de Médecine Gériatrique [CHU Pitié-Salpêtrière], Service de rhumatologie [CHU Saint-Antoine], Institut de Chimie du CNRS (INC)-Centre National de la Recherche Scientifique (CNRS)-Université de Paris (UP), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Paris (UP), Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Pitié-Salpêtrière [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut E3M [CHU Pitié-Salpêtrière], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Hôpital Purpan [Toulouse], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Paris (UP), Conservatoire National des Arts et Métiers [CNAM] (CNAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Paris (UP)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Service de médecine interne et d'immunologie clinique [CHU Pitié-Salpêtrière], Service de gériatrie [CHU Pitié-Salpêtrière], and Gestionnaire, Hal Sorbonne Université

Subjects
Serum, medicine.medical_specialty, lcsh:Diseases of the musculoskeletal system, Gastroenterology, 03 medical and health sciences, 0302 clinical medicine, Systemic lupus erythematosus, Pharmacokinetics, Risk Factors, Internal medicine, medicine, Humans, Lupus Erythematosus, Systemic, In patient, 030212 general & internal medicine, Whole blood, 030203 arthritis & rheumatology, [SDV.MHEP.RSOA] Life Sciences [q-bio]/Human health and pathology/Rhumatology and musculoskeletal system, business.industry, Hydroxychloroquine, Drug monitoring, Rheumatology, Non adherence, [SDV.MHEP.RSOA]Life Sciences [q-bio]/Human health and pathology/Rhumatology and musculoskeletal system, Adherence, Pharmacodynamics, [SDV.SP.PHARMA] Life Sciences [q-bio]/Pharmaceutical sciences/Pharmacology, Antirheumatic Agents, [SDV.SP.PHARMA]Life Sciences [q-bio]/Pharmaceutical sciences/Pharmacology, Patient Compliance, lcsh:RC925-935, business, medicine.drug, Research Article
Abstract

Background Hydroxychloroquine (HCQ) levels can be measured in both serum and whole blood. No cut-off point for non-adherence has been established in serum nor have these methods ever been compared. The aims of this study were to compare these two approaches and determine if serum HCQ cut-off points can be established to identify non-adherent patients. Methods HCQ levels were measured in serum and whole blood from 573 patients with systemic lupus erythematosus (SLE). The risk factors for active SLE (SLEDAI score > 4) were identified by multiple logistic regression. Serum HCQ levels were measured in 68 additional patients known to be non-adherent, i.e. with whole-blood HCQ Results The mean (± SD) HCQ levels were 469 ± 223 ng/mL in serum and 916 ± 449 ng/mL in whole blood. The mean ratio of serum/whole-blood HCQ levels was 0.53 ± 0.15. In the multivariate analysis, low whole-blood HCQ levels (P = 0.023), but not serum HCQ levels, were independently associated with active SLE. From the mean serum/whole-blood level ratio, a serum HCQ level of 106 ng/mL was extrapolated as the corresponding cut-off to identify non-adherent patients with a sensitivity of 0.87 (95% CI 0.76–0.94) and specificity of 0.89 (95% CI 0.72–0.98). All serum HCQ levels of patients with whole-blood HCQ below the detectable level ( Conclusions These data suggest that whole blood is better than serum for assessing the pharmacokinetic/pharmacodynamic relation of HCQ. Our results support the use of serum HCQ levels to assess non-adherence when whole blood is unavailable.

Published
2020

44. Pulmonary mucormycosis following autologous hematopoietic stem cell transplantation for rapidly progressive diffuse cutaneous systemic sclerosis: A case report

Author

K. Paricaud, Xavier Boumaza, Guillaume Beziat, Laurent Sailler, Grégory Pugnet, Damien Guinault, Sarah Guenounou, Marie Garric, Marie Piel-Julian, Anne Huynh, Dominique Farge, Guillaume Moulis, Cécile Borel, Karen Delavigne, Lucie Lelièvre, and Leonardo Astudillo

Subjects
medicine.medical_specialty, Antifungal Agents, systemic sclerosis, medicine.medical_treatment, Aftercare, Disease, Hematopoietic stem cell transplantation, Transplantation, Autologous, Scleroderma, 03 medical and health sciences, Young Adult, 0302 clinical medicine, Amphotericin B, medicine, Humans, Mucormycosis, 030212 general & internal medicine, Clinical Case Report, Young adult, Respiratory Distress Syndrome, Scleroderma, Systemic, Lung Diseases, Fungal, business.industry, Hematopoietic Stem Cell Transplantation, General Medicine, Stem-cell therapy, medicine.disease, Surgery, Transplantation, Treatment Outcome, 030220 oncology & carcinogenesis, Acute Disease, Scleroderma, Diffuse, Mucorales, Administration, Intravenous, Female, autologous stem cells, business, medicine.drug, Research Article
Abstract

Rationale: The use of autologous hematopoietic stem cell transplantation (AHSCT) for autoimmune diseases has become the first indication for transplant in nonmalignant disease. Mucormycosis is a rare invasive infection with increasing incidence in patients treated with AHSCT. We report the first case of pulmonary mucormycosis following AHSCT for systemic sclerosis (SSc). Patient concerns: A 24-year-old woman with rapidly progressive diffuse cutaneous SSc presented with an acute respiratory distress syndrome 6 days after AHSCT. Diagnoses: The results of clinical and computed tomography scan were consistent with pulmonary mucormycosis and the diagnosis was confirmed by a positive Mucorales Polymerase Chain Reaction on a peripheral blood sample. Interventions and Outcomes: Early antifungal therapy by intravenous amphotericin B provided rapid improvement within 4 days and sustained recovery after 2 years of follow-up. Lessons: With the progressively increasing use of AHSCT and other stem cell therapy for treatment of severe SSc and other autoimmune diseases, the potential onset of rare post-transplant fungal infections, such as mucormycosis, requires careful patient monitoring and better awareness of early initiation of adequate therapy.

Published
2020

45. Couverture vaccinale anti grippale insuffisante dans l’artérite à cellules géantes

Author

Grégory Pugnet, Maryse Lapeyre-Mestre, Laurent Sailler, Michael Mounié, Guillaume Moulis, Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées, Epidémiologie et analyses en santé publique : risques, maladies chroniques et handicaps (LEASP), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Centre d'investigation clinique de Toulouse (CIC 1436), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Santé et de la Recherche Médicale (INSERM)-Pôle Santé publique et médecine publique [CHU Toulouse], Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), CCSD, Accord Elsevier, CHU Toulouse [Toulouse], and Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-CHU Toulouse [Toulouse]-Institut National de la Santé et de la Recherche Médicale (INSERM)

Subjects
030203 arthritis & rheumatology, [SDV] Life Sciences [q-bio], 03 medical and health sciences, 0302 clinical medicine, [SDV]Life Sciences [q-bio], Gastroenterology, Internal Medicine, 030212 general & internal medicine, 3. Good health
Abstract

Resume Objectif Evaluer le taux de couverture vaccinale anti grippale saisonniere (CVG) chez les patients presentant une arterite a cellules geantes (ACG) incidente, par rapport aux temoins. Materiel et methode Nous avons mene une etude retrospective descriptive de janvier 2005 a avril 2011 incluant des patients de plus de 65 ans presentant une ACG incidente, en Midi-Pyrenees, a partir des donnees du Systeme national d’information inter-regimes de l’assurance maladie francais (SNIIRAM). Nous avons selectionne de facon aleatoire 6 temoins apparies sur le sexe et l’âge. Le taux de vaccination a ete estime a partir de la date de delivrance du vaccin enregistree dans le SNIIRAM. La CVG a ete comparee entre les personnes atteintes d’ACG et les temoins, a l’aide d’une regression de Poisson longitudinale multivariee. Resultats Quatre-vingt-sept patients atteints d’ACG incidente, de plus de 65 ans et 509 dans le groupe temoin ont ete inclus. La duree moyenne de suivi etait de 4,4 ± 1,2 et de 4,2 ± 1,2 ans, respectivement. Lors des campagnes annuelles de vaccination anti grippale de 2005–2006 a 2010–2011, les taux de CVG dans le groupe ACG et le groupe temoin allaient de 60,8 a 74,7 % vs 56,6 a 70,4 %, respectivement. Le taux de vaccination anti grippale chez les personnes atteintes d’ACG incidente etait de 20 % superieur a celui des temoins (RR = 1,20 ; IC 1,09 a 1,32, p Conclusion Les taux de vaccinations anti grippales sont insuffisants chez les patients de plus de 65 ans atteints d’ACG. La vaccination adequate au cours d’une ACG devrait faire l’objet d’une attention plus importante.

Published
2020

46. Validation of hemolytic anemia discharge diagnosis codes in the French hospital database

Author

Maryse Lapeyre-Mestre, Julien Maquet, Hélène Derumeaux, Laurent Sailler, and Guillaume Moulis

Subjects
Hemolytic anemia, Pediatrics, medicine.medical_specialty, Discharge diagnosis, Anemia, Hemolytic, Databases, Factual, business.industry, medicine.disease, Hospitals, Patient Discharge, Predictive value of tests, Epidemiology, Internal Medicine, medicine, Humans, business
Published
2020

47. No increased risk of cataract in adult patients with primary immune thrombocytopenia treated with eltrombopag. A French nationwide nested case-control study

Author

Vincent Soler, Bérangère Baricault, Myriam Cassagne, Margaux Lafaurie, Guillaume Moulis, Laurent Sailler, Maryse Lapeyre-Mestre, and Agnès Sommet

Subjects
Male, Pediatrics, medicine.medical_specialty, Eltrombopag, Benzoates, Cataract, chemistry.chemical_compound, Medicine, Humans, Aged, Aged, 80 and over, Purpura, Thrombocytopenic, Idiopathic, Adult patients, business.industry, Hematology, Pharmacoepidemiology, Immune thrombocytopenia, Increased risk, Hydrazines, chemistry, Case-Control Studies, Nested case-control study, Pyrazoles, Female, France, business
Published
2019

48. Antithrombotic therapy management in patients with inherited bleeding disorders and coronary artery disease: A single‐centre experience

Author

Ségolène Claeyssens, M.L. Piel-Julian, Laurent Sailler, Marie-Françoise Thiercelin-Legrand, Sophie Voisin, and Guillaume Moulis

Subjects
Male, medicine.medical_specialty, Treatment outcome, Myocardial Ischemia, MEDLINE, Hemorrhage, Coronary Artery Disease, Hemophilia A, Hemophilia B, Coronary artery disease, Blood Coagulation Disorders, Inherited, Fibrinolytic Agents, Internal medicine, Antithrombotic, Humans, Medicine, In patient, Genetics (clinical), Aged, Retrospective Studies, Aged, 80 and over, business.industry, Retrospective cohort study, Hematology, General Medicine, Middle Aged, medicine.disease, von Willebrand Diseases, Single centre, Therapy management, Treatment Outcome, Female, France, Safety, business, Platelet Aggregation Inhibitors
Published
2019

49. Le syndrome de tachycardie posturale (PoTS) : une maladie pour l’interniste

Author

P. Maury, G. Pugnet, A. Laure, Vincent Fabry, Leonardo Astudillo, Laurent Sailler, A. Pavy-Le Traon, and Marc Labrunee

Subjects
medicine.medical_specialty, Supine position, business.industry, Fludrocortisone, Incidence (epidemiology), Midodrine, Gastroenterology, food and beverages, Propranolol, 030204 cardiovascular system & hematology, Pathophysiology, 03 medical and health sciences, Orthostatic vital signs, 0302 clinical medicine, Internal medicine, Heart rate, Internal Medicine, Cardiology, medicine, business, 030217 neurology & neurosurgery, medicine.drug
Abstract

Postural tachycardia syndrome (PoTS) is a multifactorial syndrome defined by an increase in heart rate ≥30bpm, within 10minutes of standing (or during a head up tilt test to at least 60°), in absence of orthostatic hypotension. It is associated with symptoms of cerebral hypoperfusion that are worse when upright and improve in supine position. Patients have an intense fatigue with a high incidence on quality of life. This syndrome can be explained by many pathophysiological mechanisms. It can be associated with Ehlers-Danlos disease and some autoimmune disorders. The treatment is based on nonpharmacological measures and treatment with propranolol, fludrocortisone or midodrine.

Published
2018

50. Zoster after Cyclophosphamide for Systemic Lupus Erythematosus or Vasculitis: Incidence, Risk Factors, and Effect of Antiviral Prophylaxis

Author

David Ribes, Laurent Sailler, Guillaume Moulis, Laurent Alric, Antoine Huart, Grégoire Prévot, Hélène Derumeaux, Pierre Delobel, Catherine Mengelle, Camille Garnier, Daniel Adoue, Dominique Chauveau, Grégory Pugnet, Service de Maladies Infectieuses et Tropicales, Hôpital Purpan [Toulouse], CHU Toulouse [Toulouse]-CHU Toulouse [Toulouse], Centre de Référence du Sud Ouest des Maladies Rénales Rares, CHU Toulouse [Toulouse]-Hôpital des Enfants, CHU Toulouse [Toulouse], Epidémiologie et analyses en santé publique : risques, maladies chroniques et handicaps (LEASP), Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre d'investigation clinique de Toulouse (CIC 1436), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-CHU Toulouse [Toulouse]-Institut National de la Santé et de la Recherche Médicale (INSERM), Département de pneumologie [CHU Toulouse], Pharmacochimie et Biologie pour le Développement (PHARMA-DEV), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut de Chimie de Toulouse (ICT-FR 2599), Institut National Polytechnique (Toulouse) (Toulouse INP), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Centre National de la Recherche Scientifique (CNRS)-Institut de Recherche pour le Développement (IRD)-Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Institut de Chimie du CNRS (INC)-Institut National Polytechnique (Toulouse) (Toulouse INP), Université Fédérale Toulouse Midi-Pyrénées-Centre National de la Recherche Scientifique (CNRS)-Institut de Recherche pour le Développement (IRD)-Institut de Chimie du CNRS (INC)-Institut de Recherche pour le Développement (IRD), Laboratoire de Virologie, Service Maladies infectieuses et tropicales [CHU Toulouse], Pôle Inflammation, infection, immunologie et loco-moteur [CHU Toulouse] (Pôle I3LM Toulouse), Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Université de Toulouse (UT)-Université de Toulouse (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM), Université de Toulouse (UT)-Université de Toulouse (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Pôle Santé publique et médecine publique [CHU Toulouse], Service Pneumologie-Allergologie [CHU Toulouse], Pôle Clinique des Voies respiratoires [CHU Toulouse], Institut de Recherche pour le Développement (IRD)-Institut de Chimie de Toulouse (ICT), Institut de Recherche pour le Développement (IRD)-Université Toulouse III - Paul Sabatier (UT3), Université de Toulouse (UT)-Université de Toulouse (UT)-Institut de Chimie du CNRS (INC)-Centre National de la Recherche Scientifique (CNRS)-Institut National Polytechnique (Toulouse) (Toulouse INP), Université de Toulouse (UT)-Institut de Recherche pour le Développement (IRD)-Université Toulouse III - Paul Sabatier (UT3), Université de Toulouse (UT), Laboratoire Virologie [CHU Toulouse], Institut Fédératif de Biologie (IFB), and Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Pôle Biologie [CHU Toulouse]

Subjects
Adult, Male, Vasculitis, ANCA-ASSOCIATED VASCULITIS, medicine.medical_specialty, Cyclophosphamide, [SDV]Life Sciences [q-bio], Immunology, SYSTEMIC VASCULITIS, Antiviral Agents, Herpes Zoster, Young Adult, 03 medical and health sciences, 0302 clinical medicine, Rheumatology, Risk Factors, Internal medicine, Epidemiology, EPIDEMIOLOGY, Humans, Lupus Erythematosus, Systemic, Immunology and Allergy, Medicine, 030212 general & internal medicine, Aged, Retrospective Studies, 030203 arthritis & rheumatology, business.industry, Postherpetic neuralgia, Incidence, Incidence (epidemiology), Retrospective cohort study, Middle Aged, medicine.disease, 3. Good health, SYSTEMIC LUPUS ERYTHEMATOSUS, Cohort, VALACYCLOVIR, Female, business, Immunosuppressive Agents, Systemic vasculitis, medicine.drug
Abstract

Objective.To assess the incidence and the risk factors for zoster in patients exposed to intravenous cyclophosphamide (CYC) for systemic vasculitis or systemic lupus erythematosus (SLE), as well as the protective effect of prophylaxis by valacyclovir (VCV).Methods.This retrospective study included all adults treated by intravenous CYC for SLE or systemic vasculitis between 2011 and 2015 at Toulouse University Hospital, France. Zoster occurrence was recorded using medical chart review, laboratory data, and patient interviews. Univariate Cox models were computed to assess the risk factors for zoster and the protective effect of prophylaxis by VCV.Results.The cohort consisted of 110 patients (81 systemic vasculitis and 29 SLE). During a mean followup of 3.4 years after CYC initiation, 10 cases of zoster occurred, leading to an overall incidence of 27.9/1000 patient-years (95% CI 15.2–50.6); it was 59.4/1000 patients (95% CI 27.5–123.6) during the year after CYC initiation. Four patients experienced persistent postherpetic neuralgia. Probable risk factors were lymphopenia < 500/µl at CYC initiation (HR 5.11, 95% CI 0.94–27.93) and female sex (HR 4.36, 95% CI 0.51–37.31). The incidence was higher in patients with SLE (HR as compared with systemic vasculitis patients = 2.68, 95% CI 0.54–13.26). None of the 19 patients exposed to VCV during the followup developed zoster.Conclusion.The incidence of zoster is high in systemic vasculitis and in patients with SLE exposed to intravenous CYC. CYC may favor postherpetic neuralgia. Prophylaxis by VCV should be considered, particularly in cases of lymphopenia < 500/µl at CYC initiation and during the year after.

Published
2018

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