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Guitton Z, Viget N, Surgers L, Cheret A, Fontier C, Deconinck L, Bataille P, Meybeck A, Bazus H, Robineau O. Impact and Tolerance of Immunosuppressive Treatments in Patients Living with HIV with Inflammatory or Autoimmune Diseases. Microorganisms 2022; 10:1891. [PMID: 36296168 PMCID: PMC9610421 DOI: 10.3390/microorganisms10101891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Revised: 09/09/2022] [Accepted: 09/16/2022] [Indexed: 11/16/2022] Open
Abstract
Background: Patients living with HIV (PLWHIV) can develop autoimmune diseases (AD) needing immunosuppressive treatments (IST). This study aims to describe the impact of IST in PLWHIV. Methods: This was a multicentric retrospective observational study in six HIV referral centers on PLWHIV under IST for AD. Demographic factors, viral co-infections, immunovirological status before and under IST, infectious events, and their descriptions were collected and described focusing on infectious events, immunovirological variations, and IST effectiveness. Results: 9480 PLWHIV were screened for inclusion. Among them, 138 (1.5%) had a history of auto-immune disease, among which 32 (23%) received IST. There was mainly spondyloarthropathy (28%) and the most commonly used IST was methotrexate. The median follow-up under IST was 3.8 years (2.7; 5.9). There were 15 infectious events (0.5 events/individuals) concerning nine patients. At the last medical follow-up, 81% of these were in remission of their AD. Under IST, there was an increase in CD4 during follow-up (629 vs. 827 CD4/mm3, p = 0.04). No HIV virological failure was noted. Conclusions: This study supports a growing evidence base that IST can be used safely and effectively in PLWHIV with careful monitoring.
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Fakih O, Prati C, Wendling D, Verhoeven F. Differences in distribution by department of prevalence and incidence of spondyloarthritis and inflammatory bowel diseases declared to the French National Health Insurance and their evolution between 2008 and 2018. Joint Bone Spine 2021; 89:105289. [PMID: 34648939 DOI: 10.1016/j.jbspin.2021.105289] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Accepted: 09/29/2021] [Indexed: 11/17/2022]
Affiliation(s)
- Olivier Fakih
- Department of Rheumatology, CHRU de Besançon, 3, boulevard Fleming, 25000 Besançon, France
| | - Clément Prati
- Department of Rheumatology, CHRU de Besançon, 3, boulevard Fleming, 25000 Besançon, France; EA 4267 "PEPITE", UFR Santé, Franche-Comté University, 19, rue Ambroise Paré, bâtiment S, 25030 Besançon cedex, France
| | - Daniel Wendling
- Department of Rheumatology, CHRU de Besançon, 3, boulevard Fleming, 25000 Besançon, France; EA 4266 « EPILAB », UFR Santé, Franche-Comté University, 19, rue Ambroise Paré, bâtiment S, 25030 Besançon cedex, France
| | - Frank Verhoeven
- Department of Rheumatology, CHRU de Besançon, 3, boulevard Fleming, 25000 Besançon, France; EA 4267 "PEPITE", UFR Santé, Franche-Comté University, 19, rue Ambroise Paré, bâtiment S, 25030 Besançon cedex, France.
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Hamilton B, Green H, Heerasing N, Hendy P, Moore L, Chanchlani N, Walker G, Bewshea C, Kennedy NA, Ahmad T, Goodhand J. Incidence and prevalence of inflammatory bowel disease in Devon, UK. Frontline Gastroenterol 2020; 12:461-470. [PMID: 34712463 PMCID: PMC8515282 DOI: 10.1136/flgastro-2019-101369] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2019] [Revised: 04/28/2020] [Accepted: 05/14/2020] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND AND AIMS We sought to define temporal changes in prevalence of inflammatory bowel disease (IBD) in East Devon, UK, in order to facilitate service planning over the next 5 years. METHODS Multiple primary and secondary care databases were used to identify and verify cases. Point prevalence and incidence of IBD were reported in April 2017 and from 2008 to 2016, respectively. Future prevalence and healthcare activity requirements were estimated by linear regression. RESULTS Prevalence of ulcerative colitis (UC), Crohn's disease (CD) and inflammatory bowel disease unclassified (IBDU) were 479.72, 265.94 and 35.34 per 100 000 persons, respectively. In 2016, the incidence rates of UC, CD and IBDU were 15.4, 10.7 and 1.4 per 100 000 persons per year, respectively. There were no significant changes in the incidence of CD (p=0.49, R=0.26) or UC (p=0.80, R=0.10). IBD prevalence has increased by 39.9% (95% CI 28.2 to 53.7) in the last 10 years without differences in the rate of change between UC and CD. Overall, 27% of patients were managed in primary care, a quarter of whom were eligible but not receiving endoscopic surveillance. Outpatient clinics, MRI and biologic use, but not helpline calls, admissions, or surgeries increased over and above the change in IBD prevalence. CONCLUSIONS We report one of the highest prevalence and incidence rates of IBD from Northern Europe. Overall, IBD incidence is static, but prevalence is increasing. We estimate that 1% of our population will live with IBD between 2025 and 2030.
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Affiliation(s)
- Ben Hamilton
- Exeter IBD Pharmacogenetics Research Group, University of Exeter, Exeter, UK,Department of Gastroenterology, Royal Devon and Exeter Hospital NHS Foundation Trust, Exeter, Devon, UK
| | - Harry Green
- Exeter IBD Pharmacogenetics Research Group, University of Exeter, Exeter, UK,Genetics of Complex Traits, University of Exeter, Exeter, UK
| | - Neel Heerasing
- Exeter IBD Pharmacogenetics Research Group, University of Exeter, Exeter, UK
| | - Peter Hendy
- Exeter IBD Pharmacogenetics Research Group, University of Exeter, Exeter, UK
| | - Lucy Moore
- Exeter IBD Pharmacogenetics Research Group, University of Exeter, Exeter, UK
| | - Neil Chanchlani
- Exeter IBD Pharmacogenetics Research Group, University of Exeter, Exeter, UK,Department of Gastroenterology, Royal Devon and Exeter Hospital NHS Foundation Trust, Exeter, Devon, UK
| | - Gareth Walker
- Exeter IBD Pharmacogenetics Research Group, University of Exeter, Exeter, UK,Department of Gastroenterology, Royal Devon and Exeter Hospital NHS Foundation Trust, Exeter, Devon, UK
| | - Claire Bewshea
- Exeter IBD Pharmacogenetics Research Group, University of Exeter, Exeter, UK
| | - Nicholas A Kennedy
- Exeter IBD Pharmacogenetics Research Group, University of Exeter, Exeter, UK,Department of Gastroenterology, Royal Devon and Exeter Hospital NHS Foundation Trust, Exeter, Devon, UK
| | - Tariq Ahmad
- Exeter IBD Pharmacogenetics Research Group, University of Exeter, Exeter, UK,Department of Gastroenterology, Royal Devon and Exeter Hospital NHS Foundation Trust, Exeter, Devon, UK
| | - James Goodhand
- Exeter IBD Pharmacogenetics Research Group, University of Exeter, Exeter, UK,Department of Gastroenterology, Royal Devon and Exeter Hospital NHS Foundation Trust, Exeter, Devon, UK
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Bertrand V, Massy N, Pigneur B, Coopman S, Durrieu G, Gaboriau L, Langlois V, Gower-Rousseau C, Hugot JP, Ruemmele FM; GETAID (Groupe d’Etude thérapeutique des Affections Inflammatoires du Tube Digestif) Pdiatrique. Neurological Adverse Effects Associated With Anti-tumor Necrosis Factor Alpha Antibodies in Pediatric Inflammatory Bowel Diseases. J Pediatr Gastroenterol Nutr 2020; 70:841-8. [PMID: 32443044 DOI: 10.1097/MPG.0000000000002654] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
OBJECTIVES Neurological adverse effects (NAEs) induced by biotherapies have been reported in the literature mainly in adult patients with inflammatory bowel disease (IBD), rheumatic diseases, or psoriasis. There are scant data in children. Aims of this study are to report and describe noninfective NAE associated with anti-TNFα antibodies in pediatric IBD, and to evaluate their incidence. METHODS We retrospectively collected all reports of NAE in pediatric IBD treated with anti-TNFα antibodies recorded in the French Pharmacovigilance Database. To estimate the national incidence of NAEs, we extrapolated data from the French regional inception population-based cohort EPIMAD. RESULTS Between 2000 and 2018, 231 adverse events in pediatric IBD exposed to anti-TNFα antibodies were reported to this Database. Seventeen NAEs (7.36%) were collected: 8 severe NAE (1 demyelinating neuropathy, 1 optic neuritis, 1 acute transverse myelitis, 1 polyradiculoneuritis, 1 sensorineural hearing loss, 1 seizure, 1 stroke, and 1 glioma), 7 moderate NAE (headaches), and 2 neuropsychic events. The median delay between anti-TNFα start and NAE occurrence was 6 months (range: 13 days to 26 months). In 10 of 17 patients, anti-TNFα antibodies were stopped. Nine of 17 patients had a complete resolution (including 2 severe NAE) and 8 of 17 a partial resolution (including 6 severe NAE). We estimate the incidence of severe NAE in pediatric IBD treated with anti-TNFα antibodies at 1 case for 10,000 patients-year in France. CONCLUSIONS NAE associated with anti-TNFα antibodies in pediatric IBD are rare. In severe NAE, we recommend to discontinue anti-TNFα therapy and to consider alternative treatment.
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