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Le Ralle MF, Daste C, Rannou F, Kwakkenbos L, Carrier ME, Lefèvre-Colau MM, Roren A, Thombs BD, Mouthon L, Nguyen C. Patient acceptable symptom state for burden from appearance changes in people with systemic sclerosis: a cross-sectional survey. J Rheumatol Suppl 2022; 49:903-907. [PMID: 35649549 DOI: 10.3899/jrheum.210889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/17/2022] [Indexed: 11/22/2022]
Abstract
OBJECTIVE People with systemic sclerosis (SSc) often report substantial burden from appearance changes. We aimed to estimate the patient acceptable symptom state (PASS) for burden from appearance changes in people with SSc. METHODS We conducted a secondary analysis of the SCISCIF II study, a cross-sectional survey of 113 patients with SSc from France enrolled in the Scleroderma Patient-centered Intervention Network Cohort. Burden from appearance changes was assessed with a self-administered numeric rating scale (0, no burden to 10, maximal burden). Acceptability of the symptom state was assessed with a specific anchoring question. Participants who answered "yes" were in the group of patients who considered their symptom state as acceptable. The PASS for the burden from appearance changes was estimated with the 75th percentile method. RESULTS Assessments of burden from appearance changes and answers to the anchoring question were available in 82/113 (73%) participants from the SCISCIF II study. Mean age was 55.9 (14.3) years, disease duration 9.6 (6.5) years and 32/82 (40%) participants had diffuse cutaneous SSc. The PASS estimate for the burden from appearance changes was 4.8 (95% CI from 1.0 to 7.0) of 10 points. CONCLUSION Our study provides a PASS estimate for burden from appearance changes. Our estimate could serve as a binary response criterion to assess the efficacy of treatments targeting burden from appearance changes.
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Affiliation(s)
- Myrianne-Fleur Le Ralle
- Centre-Université Paris Cité, Department of Rehabilitation and Rehabilitation of the Musculoskeletal System and Pathologies of the Spine, Hôpital Cochin, 75014 Paris, France; University Paris City, Faculty de Santé, UFR de Médecine, 75006 Paris, France; INSERM UMR-S 1153, Epidemiology and Statistics Research Center Paris Sorbonne 75004 Cité, Paris, France; 4INSERM UMR-S 1124, Toxicity Environmental, Therapeutic Targets, Cellular Signaling and Biomarkers (T3S), Campus Saint-Germain-des-Prés, 75006 Paris, France; Clinical Psychology, Radboud University Nijmegen, The Netherlands; Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Canada; Federated Institute for Disability Research, 75013 Paris, France; Departments of Psychiatry; Epidemiology, Biostatistics, and Occupational Health; Medical; psychology; and Educational and Counseling Psychology; and Biomedical Ethics Unit, McGill University, Montreal, Quebec, Canada; AP-HP. Centre-Université Paris Cité, Department of Internal Medicine, Reference Center for Rare Autoimmune Systemic Diseases of le-de-France, Hôpital Cochin, 75014 Paris, France. Corresponding author: Prof. Christelle NGUYEN, MD, PhD. Assistance Publique-Hôpitaux de Paris.Centre-Université Paris City. Rehabilitation and Rehabilitation Rehabilitation Musculoskeletal System and Pathologies of the Spine. 27, Rue du Faubourg Saint-Jacques, 75014 Paris, FRANCE.
| | - Camille Daste
- Centre-Université Paris Cité, Department of Rehabilitation and Rehabilitation of the Musculoskeletal System and Pathologies of the Spine, Hôpital Cochin, 75014 Paris, France; University Paris City, Faculty de Santé, UFR de Médecine, 75006 Paris, France; INSERM UMR-S 1153, Epidemiology and Statistics Research Center Paris Sorbonne 75004 Cité, Paris, France; 4INSERM UMR-S 1124, Toxicity Environmental, Therapeutic Targets, Cellular Signaling and Biomarkers (T3S), Campus Saint-Germain-des-Prés, 75006 Paris, France; Clinical Psychology, Radboud University Nijmegen, The Netherlands; Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Canada; Federated Institute for Disability Research, 75013 Paris, France; Departments of Psychiatry; Epidemiology, Biostatistics, and Occupational Health; Medical; psychology; and Educational and Counseling Psychology; and Biomedical Ethics Unit, McGill University, Montreal, Quebec, Canada; AP-HP. Centre-Université Paris Cité, Department of Internal Medicine, Reference Center for Rare Autoimmune Systemic Diseases of le-de-France, Hôpital Cochin, 75014 Paris, France. Corresponding author: Prof. Christelle NGUYEN, MD, PhD. Assistance Publique-Hôpitaux de Paris.Centre-Université Paris City. Rehabilitation and Rehabilitation Rehabilitation Musculoskeletal System and Pathologies of the Spine. 27, Rue du Faubourg Saint-Jacques, 75014 Paris, FRANCE.
| | - François Rannou
- Centre-Université Paris Cité, Department of Rehabilitation and Rehabilitation of the Musculoskeletal System and Pathologies of the Spine, Hôpital Cochin, 75014 Paris, France; University Paris City, Faculty de Santé, UFR de Médecine, 75006 Paris, France; INSERM UMR-S 1153, Epidemiology and Statistics Research Center Paris Sorbonne 75004 Cité, Paris, France; 4INSERM UMR-S 1124, Toxicity Environmental, Therapeutic Targets, Cellular Signaling and Biomarkers (T3S), Campus Saint-Germain-des-Prés, 75006 Paris, France; Clinical Psychology, Radboud University Nijmegen, The Netherlands; Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Canada; Federated Institute for Disability Research, 75013 Paris, France; Departments of Psychiatry; Epidemiology, Biostatistics, and Occupational Health; Medical; psychology; and Educational and Counseling Psychology; and Biomedical Ethics Unit, McGill University, Montreal, Quebec, Canada; AP-HP. Centre-Université Paris Cité, Department of Internal Medicine, Reference Center for Rare Autoimmune Systemic Diseases of le-de-France, Hôpital Cochin, 75014 Paris, France. Corresponding author: Prof. Christelle NGUYEN, MD, PhD. Assistance Publique-Hôpitaux de Paris.Centre-Université Paris City. Rehabilitation and Rehabilitation Rehabilitation Musculoskeletal System and Pathologies of the Spine. 27, Rue du Faubourg Saint-Jacques, 75014 Paris, FRANCE.
| | - Linda Kwakkenbos
- Centre-Université Paris Cité, Department of Rehabilitation and Rehabilitation of the Musculoskeletal System and Pathologies of the Spine, Hôpital Cochin, 75014 Paris, France; University Paris City, Faculty de Santé, UFR de Médecine, 75006 Paris, France; INSERM UMR-S 1153, Epidemiology and Statistics Research Center Paris Sorbonne 75004 Cité, Paris, France; 4INSERM UMR-S 1124, Toxicity Environmental, Therapeutic Targets, Cellular Signaling and Biomarkers (T3S), Campus Saint-Germain-des-Prés, 75006 Paris, France; Clinical Psychology, Radboud University Nijmegen, The Netherlands; Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Canada; Federated Institute for Disability Research, 75013 Paris, France; Departments of Psychiatry; Epidemiology, Biostatistics, and Occupational Health; Medical; psychology; and Educational and Counseling Psychology; and Biomedical Ethics Unit, McGill University, Montreal, Quebec, Canada; AP-HP. Centre-Université Paris Cité, Department of Internal Medicine, Reference Center for Rare Autoimmune Systemic Diseases of le-de-France, Hôpital Cochin, 75014 Paris, France. Corresponding author: Prof. Christelle NGUYEN, MD, PhD. Assistance Publique-Hôpitaux de Paris.Centre-Université Paris City. Rehabilitation and Rehabilitation Rehabilitation Musculoskeletal System and Pathologies of the Spine. 27, Rue du Faubourg Saint-Jacques, 75014 Paris, FRANCE.
| | - Marie-Eve Carrier
- Centre-Université Paris Cité, Department of Rehabilitation and Rehabilitation of the Musculoskeletal System and Pathologies of the Spine, Hôpital Cochin, 75014 Paris, France; University Paris City, Faculty de Santé, UFR de Médecine, 75006 Paris, France; INSERM UMR-S 1153, Epidemiology and Statistics Research Center Paris Sorbonne 75004 Cité, Paris, France; 4INSERM UMR-S 1124, Toxicity Environmental, Therapeutic Targets, Cellular Signaling and Biomarkers (T3S), Campus Saint-Germain-des-Prés, 75006 Paris, France; Clinical Psychology, Radboud University Nijmegen, The Netherlands; Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Canada; Federated Institute for Disability Research, 75013 Paris, France; Departments of Psychiatry; Epidemiology, Biostatistics, and Occupational Health; Medical; psychology; and Educational and Counseling Psychology; and Biomedical Ethics Unit, McGill University, Montreal, Quebec, Canada; AP-HP. Centre-Université Paris Cité, Department of Internal Medicine, Reference Center for Rare Autoimmune Systemic Diseases of le-de-France, Hôpital Cochin, 75014 Paris, France. Corresponding author: Prof. Christelle NGUYEN, MD, PhD. Assistance Publique-Hôpitaux de Paris.Centre-Université Paris City. Rehabilitation and Rehabilitation Rehabilitation Musculoskeletal System and Pathologies of the Spine. 27, Rue du Faubourg Saint-Jacques, 75014 Paris, FRANCE.
| | - Marie-Martine Lefèvre-Colau
- Centre-Université Paris Cité, Department of Rehabilitation and Rehabilitation of the Musculoskeletal System and Pathologies of the Spine, Hôpital Cochin, 75014 Paris, France; University Paris City, Faculty de Santé, UFR de Médecine, 75006 Paris, France; INSERM UMR-S 1153, Epidemiology and Statistics Research Center Paris Sorbonne 75004 Cité, Paris, France; 4INSERM UMR-S 1124, Toxicity Environmental, Therapeutic Targets, Cellular Signaling and Biomarkers (T3S), Campus Saint-Germain-des-Prés, 75006 Paris, France; Clinical Psychology, Radboud University Nijmegen, The Netherlands; Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Canada; Federated Institute for Disability Research, 75013 Paris, France; Departments of Psychiatry; Epidemiology, Biostatistics, and Occupational Health; Medical; psychology; and Educational and Counseling Psychology; and Biomedical Ethics Unit, McGill University, Montreal, Quebec, Canada; AP-HP. Centre-Université Paris Cité, Department of Internal Medicine, Reference Center for Rare Autoimmune Systemic Diseases of le-de-France, Hôpital Cochin, 75014 Paris, France. Corresponding author: Prof. Christelle NGUYEN, MD, PhD. Assistance Publique-Hôpitaux de Paris.Centre-Université Paris City. Rehabilitation and Rehabilitation Rehabilitation Musculoskeletal System and Pathologies of the Spine. 27, Rue du Faubourg Saint-Jacques, 75014 Paris, FRANCE.
| | - Alexandra Roren
- Centre-Université Paris Cité, Department of Rehabilitation and Rehabilitation of the Musculoskeletal System and Pathologies of the Spine, Hôpital Cochin, 75014 Paris, France; University Paris City, Faculty de Santé, UFR de Médecine, 75006 Paris, France; INSERM UMR-S 1153, Epidemiology and Statistics Research Center Paris Sorbonne 75004 Cité, Paris, France; 4INSERM UMR-S 1124, Toxicity Environmental, Therapeutic Targets, Cellular Signaling and Biomarkers (T3S), Campus Saint-Germain-des-Prés, 75006 Paris, France; Clinical Psychology, Radboud University Nijmegen, The Netherlands; Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Canada; Federated Institute for Disability Research, 75013 Paris, France; Departments of Psychiatry; Epidemiology, Biostatistics, and Occupational Health; Medical; psychology; and Educational and Counseling Psychology; and Biomedical Ethics Unit, McGill University, Montreal, Quebec, Canada; AP-HP. Centre-Université Paris Cité, Department of Internal Medicine, Reference Center for Rare Autoimmune Systemic Diseases of le-de-France, Hôpital Cochin, 75014 Paris, France. Corresponding author: Prof. Christelle NGUYEN, MD, PhD. Assistance Publique-Hôpitaux de Paris.Centre-Université Paris City. Rehabilitation and Rehabilitation Rehabilitation Musculoskeletal System and Pathologies of the Spine. 27, Rue du Faubourg Saint-Jacques, 75014 Paris, FRANCE.
| | - Brett D Thombs
- Centre-Université Paris Cité, Department of Rehabilitation and Rehabilitation of the Musculoskeletal System and Pathologies of the Spine, Hôpital Cochin, 75014 Paris, France; University Paris City, Faculty de Santé, UFR de Médecine, 75006 Paris, France; INSERM UMR-S 1153, Epidemiology and Statistics Research Center Paris Sorbonne 75004 Cité, Paris, France; 4INSERM UMR-S 1124, Toxicity Environmental, Therapeutic Targets, Cellular Signaling and Biomarkers (T3S), Campus Saint-Germain-des-Prés, 75006 Paris, France; Clinical Psychology, Radboud University Nijmegen, The Netherlands; Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Canada; Federated Institute for Disability Research, 75013 Paris, France; Departments of Psychiatry; Epidemiology, Biostatistics, and Occupational Health; Medical; psychology; and Educational and Counseling Psychology; and Biomedical Ethics Unit, McGill University, Montreal, Quebec, Canada; AP-HP. Centre-Université Paris Cité, Department of Internal Medicine, Reference Center for Rare Autoimmune Systemic Diseases of le-de-France, Hôpital Cochin, 75014 Paris, France. Corresponding author: Prof. Christelle NGUYEN, MD, PhD. Assistance Publique-Hôpitaux de Paris.Centre-Université Paris City. Rehabilitation and Rehabilitation Rehabilitation Musculoskeletal System and Pathologies of the Spine. 27, Rue du Faubourg Saint-Jacques, 75014 Paris, FRANCE.
| | - Luc Mouthon
- Centre-Université Paris Cité, Department of Rehabilitation and Rehabilitation of the Musculoskeletal System and Pathologies of the Spine, Hôpital Cochin, 75014 Paris, France; University Paris City, Faculty de Santé, UFR de Médecine, 75006 Paris, France; INSERM UMR-S 1153, Epidemiology and Statistics Research Center Paris Sorbonne 75004 Cité, Paris, France; 4INSERM UMR-S 1124, Toxicity Environmental, Therapeutic Targets, Cellular Signaling and Biomarkers (T3S), Campus Saint-Germain-des-Prés, 75006 Paris, France; Clinical Psychology, Radboud University Nijmegen, The Netherlands; Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Canada; Federated Institute for Disability Research, 75013 Paris, France; Departments of Psychiatry; Epidemiology, Biostatistics, and Occupational Health; Medical; psychology; and Educational and Counseling Psychology; and Biomedical Ethics Unit, McGill University, Montreal, Quebec, Canada; AP-HP. Centre-Université Paris Cité, Department of Internal Medicine, Reference Center for Rare Autoimmune Systemic Diseases of le-de-France, Hôpital Cochin, 75014 Paris, France. Corresponding author: Prof. Christelle NGUYEN, MD, PhD. Assistance Publique-Hôpitaux de Paris.Centre-Université Paris City. Rehabilitation and Rehabilitation Rehabilitation Musculoskeletal System and Pathologies of the Spine. 27, Rue du Faubourg Saint-Jacques, 75014 Paris, FRANCE.
| | - Christelle Nguyen
- Centre-Université Paris Cité, Department of Rehabilitation and Rehabilitation of the Musculoskeletal System and Pathologies of the Spine, Hôpital Cochin, 75014 Paris, France; University Paris City, Faculty de Santé, UFR de Médecine, 75006 Paris, France; INSERM UMR-S 1153, Epidemiology and Statistics Research Center Paris Sorbonne 75004 Cité, Paris, France; 4INSERM UMR-S 1124, Toxicity Environmental, Therapeutic Targets, Cellular Signaling and Biomarkers (T3S), Campus Saint-Germain-des-Prés, 75006 Paris, France; Clinical Psychology, Radboud University Nijmegen, The Netherlands; Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Canada; Federated Institute for Disability Research, 75013 Paris, France; Departments of Psychiatry; Epidemiology, Biostatistics, and Occupational Health; Medical; psychology; and Educational and Counseling Psychology; and Biomedical Ethics Unit, McGill University, Montreal, Quebec, Canada; AP-HP. Centre-Université Paris Cité, Department of Internal Medicine, Reference Center for Rare Autoimmune Systemic Diseases of le-de-France, Hôpital Cochin, 75014 Paris, France. Corresponding author: Prof. Christelle NGUYEN, MD, PhD. Assistance Publique-Hôpitaux de Paris.Centre-Université Paris City. Rehabilitation and Rehabilitation Rehabilitation Musculoskeletal System and Pathologies of the Spine. 27, Rue du Faubourg Saint-Jacques, 75014 Paris, FRANCE.
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Charrière S, Maigne JY, Couzi E, Lefèvre-Colau MM, Rannou F, Nguyen C. Conservative treatment for chronic coccydynia: a 36-month prospective observational study of 115 patients. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2021; 30:3009-3018. [PMID: 34216237 DOI: 10.1007/s00586-021-06911-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Revised: 05/01/2021] [Accepted: 06/24/2021] [Indexed: 10/20/2022]
Abstract
PURPOSE To describe long-term outcomes of conservative treatment for chronic coccydynia. METHODS We conducted a 36-month prospective observational study. Adults with chronic coccydynia (> 2 months) were included. The first-line treatment was coccygeal corticosteroid injection. The second-line treatment was either manual therapy or coccygectomy. The primary endpoint was the mean variation from baseline of coccydynia intensity at 6 and 36 months, using a numeric rating scale (0, no pain; 10, maximal pain). Evolution was considered unfavorable when coccydynia intensity was > 3 of 10 points at 36 months or coccygectomy had been performed. We carried out bivariate and multivariate analyses to identify variables associated with an unfavorable evolution. RESULTS We included 115 participants. Mean (SD) age was 43.5 (12.3) years, duration of coccydynia 18.4 (21.6) months and coccydynia intensity 6.5 (2.0) of 10 points. Mean variations for coccydynia intensity were - 1.5 (3.0) at 6 months and - 2.8 (3.2) at 36 months. At 36 months, 59/115 (51%) participants had an unfavorable evolution. In bivariate analysis, posterior coccyx dislocations were numerically more frequent in participants with an unfavorable evolution compared to others (29/59 (48%) versus 17/56 (30%), p = 0.057). In multivariate analysis, longer duration of coccydynia was associated with an unfavorable evolution (OR = 1.04, 95% CI from 1.01 to 1.07, p = 0.023). CONCLUSION In adults with chronic coccydynia receiving conservative treatment, symptoms decrease overtime, but significantly persist at 36 months in more than half of them. For patients with posterior coccyx dislocation, coccygectomy may be considered rapidly.
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Affiliation(s)
- Solène Charrière
- Hôpital Cochin, Service de Rééducation Et de Réadaptation de L'Appareil Locomoteur et des Pathologies du Rachis, AP-HP. Centre-Université de Paris, 27, Rue du Faubourg Saint-Jacques, 75014, Paris, France
| | - Jean-Yves Maigne
- Hôpital Cochin, Service de Rééducation Et de Réadaptation de L'Appareil Locomoteur et des Pathologies du Rachis, AP-HP. Centre-Université de Paris, 27, Rue du Faubourg Saint-Jacques, 75014, Paris, France
| | - Emmanuel Couzi
- Hôpital Cochin, Service de Rééducation Et de Réadaptation de L'Appareil Locomoteur et des Pathologies du Rachis, AP-HP. Centre-Université de Paris, 27, Rue du Faubourg Saint-Jacques, 75014, Paris, France
| | - Marie-Martine Lefèvre-Colau
- Hôpital Cochin, Service de Rééducation Et de Réadaptation de L'Appareil Locomoteur et des Pathologies du Rachis, AP-HP. Centre-Université de Paris, 27, Rue du Faubourg Saint-Jacques, 75014, Paris, France.,Faculté de Santé, UFR de Médecine, Université de Paris, 75006, Paris, France.,Toxicité Environnementale, Cibles Thérapeutiques, Signalisation Cellulaire Et Biomarqueurs (T3S), INSERM UMR-S 1124, Campus Saint-Germain-des-Prés, 75006, Paris, France.,Institut Fédératif de Recherche Sur Le Handicap, 75013, Paris, France
| | - François Rannou
- Hôpital Cochin, Service de Rééducation Et de Réadaptation de L'Appareil Locomoteur et des Pathologies du Rachis, AP-HP. Centre-Université de Paris, 27, Rue du Faubourg Saint-Jacques, 75014, Paris, France.,Faculté de Santé, UFR de Médecine, Université de Paris, 75006, Paris, France.,Centre de Recherche Épidémiologie Et Statistique Paris (CRESS), ECaMO Team, INSERM UMR-S 1153, 75004, Paris, France
| | - Christelle Nguyen
- Hôpital Cochin, Service de Rééducation Et de Réadaptation de L'Appareil Locomoteur et des Pathologies du Rachis, AP-HP. Centre-Université de Paris, 27, Rue du Faubourg Saint-Jacques, 75014, Paris, France. .,Faculté de Santé, UFR de Médecine, Université de Paris, 75006, Paris, France. .,Centre de Recherche Épidémiologie Et Statistique Paris (CRESS), ECaMO Team, INSERM UMR-S 1153, 75004, Paris, France.
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