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Savale L, Dorfmüller P, Boucly A, Jaïs X, Lacoste-Palasset T, Jevnikar M, Seferian A, Humbert M, Sitbon O, Montani D. Sarcoidosis-Associated Pulmonary Hypertension. Clin Chest Med 2024; 45:185-197. [PMID: 38245366 DOI: 10.1016/j.ccm.2023.08.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2024]
Abstract
Pulmonary hypertension is a life-threatening complication of advanced sarcoidosis. Many mechanisms can cause an elevation of pulmonary pressure in sarcoidosis, leading to precapillary or postcapillary pulmonary hypertension. Sarcoidosis-associated pulmonary hypertension contributes to severe exertional dyspnea, reduced exercise capacity, and notably compromised the survival. Despite the critical functional and prognostic implications of pulmonary hypertension in sarcoidosis, there is a scarcity of specific guidelines on the management of these patients due to a lack of evidence. Hence, further research is required to identify subgroups of patients who may benefit from pulmonary arterial hypertension-targeted therapies and/or immunosuppressive therapies.
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Affiliation(s)
- Laurent Savale
- Université Paris-Saclay, School of Medicine, Le Kremlin-Bicêtre, France; INSERM UMR_S 999, Hôpital Marie Lannelongue, Le Plessis-Robinson, France; AP-HP, Department of Respiratory and Intensive CareMedicine, Hôpital Bicêtre, Le Kremlin-Bicêtre, France.
| | - Peter Dorfmüller
- Pathology Department, University Hospital of Giessen and Marburg, Rudolf-Buchheim-Straße 8, Gießen 35392, Deutschland; German Center for Lung Research (DZL), Giessen, Germany
| | - Athénaïs Boucly
- Université Paris-Saclay, School of Medicine, Le Kremlin-Bicêtre, France; INSERM UMR_S 999, Hôpital Marie Lannelongue, Le Plessis-Robinson, France; AP-HP, Department of Respiratory and Intensive CareMedicine, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
| | - Xavier Jaïs
- Université Paris-Saclay, School of Medicine, Le Kremlin-Bicêtre, France; INSERM UMR_S 999, Hôpital Marie Lannelongue, Le Plessis-Robinson, France; AP-HP, Department of Respiratory and Intensive CareMedicine, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
| | - Thomas Lacoste-Palasset
- Université Paris-Saclay, School of Medicine, Le Kremlin-Bicêtre, France; INSERM UMR_S 999, Hôpital Marie Lannelongue, Le Plessis-Robinson, France; AP-HP, Department of Respiratory and Intensive CareMedicine, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
| | - Mitja Jevnikar
- Université Paris-Saclay, School of Medicine, Le Kremlin-Bicêtre, France; INSERM UMR_S 999, Hôpital Marie Lannelongue, Le Plessis-Robinson, France; AP-HP, Department of Respiratory and Intensive CareMedicine, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
| | - Andrei Seferian
- Université Paris-Saclay, School of Medicine, Le Kremlin-Bicêtre, France; INSERM UMR_S 999, Hôpital Marie Lannelongue, Le Plessis-Robinson, France; AP-HP, Department of Respiratory and Intensive CareMedicine, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
| | - Marc Humbert
- Université Paris-Saclay, School of Medicine, Le Kremlin-Bicêtre, France; INSERM UMR_S 999, Hôpital Marie Lannelongue, Le Plessis-Robinson, France; AP-HP, Department of Respiratory and Intensive CareMedicine, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
| | - Olivier Sitbon
- Université Paris-Saclay, School of Medicine, Le Kremlin-Bicêtre, France; INSERM UMR_S 999, Hôpital Marie Lannelongue, Le Plessis-Robinson, France; AP-HP, Department of Respiratory and Intensive CareMedicine, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
| | - David Montani
- Université Paris-Saclay, School of Medicine, Le Kremlin-Bicêtre, France; INSERM UMR_S 999, Hôpital Marie Lannelongue, Le Plessis-Robinson, France; AP-HP, Department of Respiratory and Intensive CareMedicine, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
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Takam Kamga P, Mayenga M, Sebane L, Costantini A, Julie C, Capron C, Parent F, Seferian A, Guettier C, Emile JF, Giroux Leprieur E. Colony stimulating factor-1 (CSF-1) signalling is predictive of response to immune checkpoint inhibitors in advanced non-small cell lung cancer. Lung Cancer 2024; 188:107447. [PMID: 38176297 DOI: 10.1016/j.lungcan.2023.107447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Revised: 11/13/2023] [Accepted: 12/20/2023] [Indexed: 01/06/2024]
Abstract
The identification of biomarkers related to treatment in patients with non-small cell lung cancer (NSCLC) treated with immune checkpoint inhibitors (ICIs) represents a significant challenge. The aim of this study was to determine the predictive value of macrophage-related markers assessed in plasma and tissue samples of patients with NSCLC undergoing ICI treatment. This bicentric study included a prospective cohort of 88 patients with advanced NSCLC who received first-line therapy with ICI (either as monotherapy or in combination with chemotherapy) or chemotherapy alone (CT). Samples were collected from the patients at baseline and during follow-up. Plasma levels of CSF-1 and IL-34 were measured using ELISA, while expression levels of the macrophage receptors CD163 and CSF-1-R were evaluated using immunohistochemistry on lung biopsies. At baseline, the median plasma CSF-1 expression was higher in patients who did not respond to immunotherapy compared to those who responded (8898 pg/mL vs. 14031 pg/mL, p = 0.0005). Importantly, high CSF-1 levels at the initial assessment were associated with disease progression regardless of the treatment received. Furthermore, high CSF-1 levels were associated with shorter progression-free survival (PFS) and overall survival (OS) in patients receiving ICI therapy, but not in those treated with chemotherapy. There was no correlation between IL-34, CSF-1R, CD163 and therapeutic response. We observed in vitro that the activation of lymphocytes mediated by pembrolizumab was hindered by the treatment of PBMC with recombinant CSF-1, suggesting that CSF-1 creates a systemic immunosuppressive state that interferes with ICI treatment. In conclusion, baseline CSF-1 levels represent a potential predictive marker to ICI treatment in NSCLC.
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Affiliation(s)
- Paul Takam Kamga
- Université Paris-Saclay, UVSQ, EA4340 BECCOH, Boulogne-Billancourt, France
| | - Marie Mayenga
- Université Paris-Saclay, UVSQ, EA4340 BECCOH, Boulogne-Billancourt, France
| | - Louise Sebane
- Université Paris-Saclay, UVSQ, EA4340 BECCOH, Boulogne-Billancourt, France
| | - Adrien Costantini
- Université Paris-Saclay, UVSQ, EA4340 BECCOH, Boulogne-Billancourt, France; APHP - Hôpital Ambroise Paré, Department of Respiratory Diseases and Thoracic Oncology, Boulogne-Billancourt, France
| | - Catherine Julie
- Université Paris-Saclay, UVSQ, EA4340 BECCOH, Boulogne-Billancourt, France; APHP - Hôpital Ambroise Paré, Department of Pathology, Boulogne-Billancourt, France
| | - Claude Capron
- Université Paris-Saclay, UVSQ, EA4340 BECCOH, Boulogne-Billancourt, France; APHP - Hôpital Ambroise Paré, Department of Hematology Immunology, Boulogne-Billancourt, France
| | - Florence Parent
- APHP - Hôpital Bicêtre, Department of Pulmonology, Kremlin-Bicêtre, France
| | - Andrei Seferian
- APHP - Hôpital Bicêtre, Department of Pulmonology, Kremlin-Bicêtre, France
| | - Catherine Guettier
- APHP - Hôpital Bicêtre, Department of Pathology, Kremlin-Bicêtre, France
| | - Jean-François Emile
- Université Paris-Saclay, UVSQ, EA4340 BECCOH, Boulogne-Billancourt, France; APHP - Hôpital Ambroise Paré, Department of Pathology, Boulogne-Billancourt, France
| | - Etienne Giroux Leprieur
- Université Paris-Saclay, UVSQ, EA4340 BECCOH, Boulogne-Billancourt, France; APHP - Hôpital Ambroise Paré, Department of Respiratory Diseases and Thoracic Oncology, Boulogne-Billancourt, France.
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3
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Boucly A, Solinas S, Beurnier A, Jaïs X, Keddache S, Eyries M, Seferian A, Jevnikar M, Roche A, Bulifon S, Bourdin A, Chaouat A, Cottin V, Bertoletti L, Savale L, Humbert M, Sitbon O, Montani D. Outcomes and risk assessment in pulmonary veno-occlusive disease. ERJ Open Res 2024; 10:00612-2023. [PMID: 38226059 PMCID: PMC10789263 DOI: 10.1183/23120541.00612-2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 11/13/2023] [Indexed: 01/17/2024] Open
Abstract
Introduction Pulmonary veno-occlusive disease (PVOD) is a rare and severe subtype of pulmonary arterial hypertension (PAH). Although European Society of Cardiology/European Respiratory Society (ESC/ERS) guidelines advise assessing PAH severity at baseline and during follow-up, no existing risk assessment methods have been validated for PVOD. This study aimed to identify prognostic factors, examine the impact of treatment strategies and evaluate risk assessment methods for PVOD patients. Methods The study analysed all incident PVOD patients included in the French Pulmonary Hypertension Registry between 2006 and 2021. Survival was assessed based on initial treatment strategy and risk status and compared to a matched (age, sex, pulmonary vascular resistance) PAH group. Six risk assessment methods (number of four low-risk and three noninvasive low-risk variables, ESC/ERS guidelines three-strata and four-strata models, REVEAL 2.0 and Lite 2) were applied at baseline and early follow-up, and their accuracy was compared using Harrell's c-statistic. Results Among the 327 included PVOD patients, survival rates at 1, 3 and 5 years were 86%, 50% and 27%, respectively. Multivariate analysis showed that only 6-min walk distance was associated with survival, with no significant difference based on initial treatment strategy. All six risk assessment methods could discriminate mortality risk, and the ESC/ERS four-strata model was the most accurate at both baseline and follow-up (C-index 0.64 and 0.74). PVOD survival rates were consistently lower than PAH when comparing baseline risk status using the ESC/ERS four-strata model. Conclusion PVOD is associated with poor outcomes, and initial treatment strategies do not significantly affect survival. Risk assessment methods can be useful in predicting survival for PVOD patients.
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Affiliation(s)
- Athénaïs Boucly
- Université Paris-Saclay, Faculté de Médecine, Le Kremlin-Bicêtre, France
- Institut National de la Santé et de la Recherche Scientifique, Unité Mixte de Recherche S_999 “Pulmonary Hypertension: Pathophysiology and Novel Therapies”, Faculté de Médecine de Bicêtre et Hôpital Marie Lannelongue, Le Plessis Robinson, France
- Assistance Publique – Hôpitaux de Paris, Groupe Hospitalo-Universitaire Paris-Saclay, Hôpital Bicêtre, Département Médico-Universitaire “THORINNO”, Service de Pneumologie et Soins Intensifs, Centre de Référence de l'Hypertension Pulmonaire PULMOTENSION, Le Kremlin-Bicêtre, France
| | - Sabina Solinas
- Université Paris-Saclay, Faculté de Médecine, Le Kremlin-Bicêtre, France
- Institut National de la Santé et de la Recherche Scientifique, Unité Mixte de Recherche S_999 “Pulmonary Hypertension: Pathophysiology and Novel Therapies”, Faculté de Médecine de Bicêtre et Hôpital Marie Lannelongue, Le Plessis Robinson, France
- Assistance Publique – Hôpitaux de Paris, Groupe Hospitalo-Universitaire Paris-Saclay, Hôpital Bicêtre, Département Médico-Universitaire “THORINNO”, Service de Pneumologie et Soins Intensifs, Centre de Référence de l'Hypertension Pulmonaire PULMOTENSION, Le Kremlin-Bicêtre, France
| | - Antoine Beurnier
- Université Paris-Saclay, Faculté de Médecine, Le Kremlin-Bicêtre, France
- Institut National de la Santé et de la Recherche Scientifique, Unité Mixte de Recherche S_999 “Pulmonary Hypertension: Pathophysiology and Novel Therapies”, Faculté de Médecine de Bicêtre et Hôpital Marie Lannelongue, Le Plessis Robinson, France
- Assistance Publique – Hôpitaux de Paris, Groupe Hospitalo-Universitaire Paris-Saclay, Hôpital Bicêtre, Département Médico-Universitaire “THORINNO”, Service de Physiologie et Explorations Fonctionnelles Respiratoires, Le Kremlin-Bicêtre, France
| | - Xavier Jaïs
- Université Paris-Saclay, Faculté de Médecine, Le Kremlin-Bicêtre, France
- Institut National de la Santé et de la Recherche Scientifique, Unité Mixte de Recherche S_999 “Pulmonary Hypertension: Pathophysiology and Novel Therapies”, Faculté de Médecine de Bicêtre et Hôpital Marie Lannelongue, Le Plessis Robinson, France
- Assistance Publique – Hôpitaux de Paris, Groupe Hospitalo-Universitaire Paris-Saclay, Hôpital Bicêtre, Département Médico-Universitaire “THORINNO”, Service de Pneumologie et Soins Intensifs, Centre de Référence de l'Hypertension Pulmonaire PULMOTENSION, Le Kremlin-Bicêtre, France
| | - Sophia Keddache
- Université Paris-Saclay, Faculté de Médecine, Le Kremlin-Bicêtre, France
- Institut National de la Santé et de la Recherche Scientifique, Unité Mixte de Recherche S_999 “Pulmonary Hypertension: Pathophysiology and Novel Therapies”, Faculté de Médecine de Bicêtre et Hôpital Marie Lannelongue, Le Plessis Robinson, France
- Assistance Publique – Hôpitaux de Paris, Groupe Hospitalo-Universitaire Paris-Saclay, Hôpital Bicêtre, Département Médico-Universitaire “THORINNO”, Service de Pneumologie et Soins Intensifs, Centre de Référence de l'Hypertension Pulmonaire PULMOTENSION, Le Kremlin-Bicêtre, France
| | - Mélanie Eyries
- Sorbonne Université, AP-HP, Département de Génétique, Hôpital Pitié-Salpêtrière, Paris, France
- INSERM UMRS1166, ICAN – Institute of CardioMetabolism and Nutrition, Sorbonne Université, Paris, France
| | - Andrei Seferian
- Université Paris-Saclay, Faculté de Médecine, Le Kremlin-Bicêtre, France
- Institut National de la Santé et de la Recherche Scientifique, Unité Mixte de Recherche S_999 “Pulmonary Hypertension: Pathophysiology and Novel Therapies”, Faculté de Médecine de Bicêtre et Hôpital Marie Lannelongue, Le Plessis Robinson, France
- Assistance Publique – Hôpitaux de Paris, Groupe Hospitalo-Universitaire Paris-Saclay, Hôpital Bicêtre, Département Médico-Universitaire “THORINNO”, Service de Pneumologie et Soins Intensifs, Centre de Référence de l'Hypertension Pulmonaire PULMOTENSION, Le Kremlin-Bicêtre, France
| | - Mitja Jevnikar
- Université Paris-Saclay, Faculté de Médecine, Le Kremlin-Bicêtre, France
- Institut National de la Santé et de la Recherche Scientifique, Unité Mixte de Recherche S_999 “Pulmonary Hypertension: Pathophysiology and Novel Therapies”, Faculté de Médecine de Bicêtre et Hôpital Marie Lannelongue, Le Plessis Robinson, France
- Assistance Publique – Hôpitaux de Paris, Groupe Hospitalo-Universitaire Paris-Saclay, Hôpital Bicêtre, Département Médico-Universitaire “THORINNO”, Service de Pneumologie et Soins Intensifs, Centre de Référence de l'Hypertension Pulmonaire PULMOTENSION, Le Kremlin-Bicêtre, France
| | - Anne Roche
- Université Paris-Saclay, Faculté de Médecine, Le Kremlin-Bicêtre, France
- Institut National de la Santé et de la Recherche Scientifique, Unité Mixte de Recherche S_999 “Pulmonary Hypertension: Pathophysiology and Novel Therapies”, Faculté de Médecine de Bicêtre et Hôpital Marie Lannelongue, Le Plessis Robinson, France
- Assistance Publique – Hôpitaux de Paris, Groupe Hospitalo-Universitaire Paris-Saclay, Hôpital Bicêtre, Département Médico-Universitaire “THORINNO”, Service de Pneumologie et Soins Intensifs, Centre de Référence de l'Hypertension Pulmonaire PULMOTENSION, Le Kremlin-Bicêtre, France
| | - Sophie Bulifon
- Université Paris-Saclay, Faculté de Médecine, Le Kremlin-Bicêtre, France
- Institut National de la Santé et de la Recherche Scientifique, Unité Mixte de Recherche S_999 “Pulmonary Hypertension: Pathophysiology and Novel Therapies”, Faculté de Médecine de Bicêtre et Hôpital Marie Lannelongue, Le Plessis Robinson, France
- Assistance Publique – Hôpitaux de Paris, Groupe Hospitalo-Universitaire Paris-Saclay, Hôpital Bicêtre, Département Médico-Universitaire “THORINNO”, Service de Pneumologie et Soins Intensifs, Centre de Référence de l'Hypertension Pulmonaire PULMOTENSION, Le Kremlin-Bicêtre, France
| | - Arnaud Bourdin
- Department of Respiratory Diseases, Univ Montpellier, CHU Montpellier, Montpellier, France
- PhyMedExp, Univ Montpellier, CNRS, INSERM, CHU Montpellier, Montpellier, France
| | - Ari Chaouat
- Institut National de la Santé et de la Recherche Scientifique, Unité Mixte de Recherche S1116, Faculté de Médecine de Nancy, Université de Lorraine, Département de Pneumologie, CHRU de Nancy, Vandœuvre-lès-Nancy, France
| | - Vincent Cottin
- Centre Hospitalier Universitaire de Lyon HCL, Service de Pneumologie, Centre de Référence des Maladies Pulmonaires Rares, Groupement Hospitalier Est, Hôpital Louis Pradel, Université Claude Bernard Lyon 1, Lyon, France
| | - Laurent Bertoletti
- Université Jean Monnet Saint-Etienne, CHU Saint Etienne, Mines Saint-Etienne, Département de Médecine Vasculaire et Thérapeutique, Saint-Etienne, France
| | - Laurent Savale
- Université Paris-Saclay, Faculté de Médecine, Le Kremlin-Bicêtre, France
- Institut National de la Santé et de la Recherche Scientifique, Unité Mixte de Recherche S_999 “Pulmonary Hypertension: Pathophysiology and Novel Therapies”, Faculté de Médecine de Bicêtre et Hôpital Marie Lannelongue, Le Plessis Robinson, France
- Assistance Publique – Hôpitaux de Paris, Groupe Hospitalo-Universitaire Paris-Saclay, Hôpital Bicêtre, Département Médico-Universitaire “THORINNO”, Service de Pneumologie et Soins Intensifs, Centre de Référence de l'Hypertension Pulmonaire PULMOTENSION, Le Kremlin-Bicêtre, France
| | - Marc Humbert
- Université Paris-Saclay, Faculté de Médecine, Le Kremlin-Bicêtre, France
- Institut National de la Santé et de la Recherche Scientifique, Unité Mixte de Recherche S_999 “Pulmonary Hypertension: Pathophysiology and Novel Therapies”, Faculté de Médecine de Bicêtre et Hôpital Marie Lannelongue, Le Plessis Robinson, France
- Assistance Publique – Hôpitaux de Paris, Groupe Hospitalo-Universitaire Paris-Saclay, Hôpital Bicêtre, Département Médico-Universitaire “THORINNO”, Service de Pneumologie et Soins Intensifs, Centre de Référence de l'Hypertension Pulmonaire PULMOTENSION, Le Kremlin-Bicêtre, France
| | - Olivier Sitbon
- Université Paris-Saclay, Faculté de Médecine, Le Kremlin-Bicêtre, France
- Institut National de la Santé et de la Recherche Scientifique, Unité Mixte de Recherche S_999 “Pulmonary Hypertension: Pathophysiology and Novel Therapies”, Faculté de Médecine de Bicêtre et Hôpital Marie Lannelongue, Le Plessis Robinson, France
- Assistance Publique – Hôpitaux de Paris, Groupe Hospitalo-Universitaire Paris-Saclay, Hôpital Bicêtre, Département Médico-Universitaire “THORINNO”, Service de Pneumologie et Soins Intensifs, Centre de Référence de l'Hypertension Pulmonaire PULMOTENSION, Le Kremlin-Bicêtre, France
- These authors contributed equally
| | - David Montani
- Université Paris-Saclay, Faculté de Médecine, Le Kremlin-Bicêtre, France
- Institut National de la Santé et de la Recherche Scientifique, Unité Mixte de Recherche S_999 “Pulmonary Hypertension: Pathophysiology and Novel Therapies”, Faculté de Médecine de Bicêtre et Hôpital Marie Lannelongue, Le Plessis Robinson, France
- Assistance Publique – Hôpitaux de Paris, Groupe Hospitalo-Universitaire Paris-Saclay, Hôpital Bicêtre, Département Médico-Universitaire “THORINNO”, Service de Pneumologie et Soins Intensifs, Centre de Référence de l'Hypertension Pulmonaire PULMOTENSION, Le Kremlin-Bicêtre, France
- These authors contributed equally
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4
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Jevnikar M, Solinas S, Brenot P, Lechartier B, Kularatne M, Montani D, Savale L, Garcia-Alonso C, Sitbon O, Beurnier A, Boucly A, Bulifon S, Seferian A, Roche A, Mercier O, Simonneau G, Fadel E, Humbert M, Jaïs X. Sequential multimodal therapy in chronic thromboembolic pulmonary hypertension with mixed anatomical lesions: a proof of concept. Eur Respir J 2023; 62:2300517. [PMID: 37802632 DOI: 10.1183/13993003.00517-2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 09/18/2023] [Indexed: 10/09/2023]
Affiliation(s)
- Mitja Jevnikar
- Université Paris-Saclay, Faculty of Medicine, Le Kremlin-Bicêtre, France
- Assistance Publique - Hôpitaux de Paris (AP-HP), Department of Respiratory and Intensive Care Medicine, Pulmonary Hypertension National Referral Center, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
- INSERM UMR_S 999, "Pulmonary Hypertension: Pathophysiology and Novel Therapies", Groupe Hospitalier Saint Joseph - Hôpital Marie Lannelongue, Le Plessis-Robinson, France
- These authors contributed equally
| | - Sabina Solinas
- Université Paris-Saclay, Faculty of Medicine, Le Kremlin-Bicêtre, France
- Assistance Publique - Hôpitaux de Paris (AP-HP), Department of Respiratory and Intensive Care Medicine, Pulmonary Hypertension National Referral Center, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
- INSERM UMR_S 999, "Pulmonary Hypertension: Pathophysiology and Novel Therapies", Groupe Hospitalier Saint Joseph - Hôpital Marie Lannelongue, Le Plessis-Robinson, France
- These authors contributed equally
| | - Philippe Brenot
- Université Paris-Saclay, Faculty of Medicine, Le Kremlin-Bicêtre, France
- Assistance Publique - Hôpitaux de Paris (AP-HP), Department of Respiratory and Intensive Care Medicine, Pulmonary Hypertension National Referral Center, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
- Department of Radiology, Hôpital Marie Lannelongue, Le Plessis-Robinson, France
| | - Benoit Lechartier
- Université Paris-Saclay, Faculty of Medicine, Le Kremlin-Bicêtre, France
- Assistance Publique - Hôpitaux de Paris (AP-HP), Department of Respiratory and Intensive Care Medicine, Pulmonary Hypertension National Referral Center, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
- INSERM UMR_S 999, "Pulmonary Hypertension: Pathophysiology and Novel Therapies", Groupe Hospitalier Saint Joseph - Hôpital Marie Lannelongue, Le Plessis-Robinson, France
- Respiratory division, Lausanne University Hospitals, Lausanne, Switzerland
| | - Mithum Kularatne
- Department of Medicine, University of Calgary, Calgary, AB, Canada
| | - David Montani
- Université Paris-Saclay, Faculty of Medicine, Le Kremlin-Bicêtre, France
- Assistance Publique - Hôpitaux de Paris (AP-HP), Department of Respiratory and Intensive Care Medicine, Pulmonary Hypertension National Referral Center, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
- INSERM UMR_S 999, "Pulmonary Hypertension: Pathophysiology and Novel Therapies", Groupe Hospitalier Saint Joseph - Hôpital Marie Lannelongue, Le Plessis-Robinson, France
| | - Laurent Savale
- Université Paris-Saclay, Faculty of Medicine, Le Kremlin-Bicêtre, France
- Assistance Publique - Hôpitaux de Paris (AP-HP), Department of Respiratory and Intensive Care Medicine, Pulmonary Hypertension National Referral Center, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
- INSERM UMR_S 999, "Pulmonary Hypertension: Pathophysiology and Novel Therapies", Groupe Hospitalier Saint Joseph - Hôpital Marie Lannelongue, Le Plessis-Robinson, France
| | - Carlos Garcia-Alonso
- Université Paris-Saclay, Faculty of Medicine, Le Kremlin-Bicêtre, France
- Assistance Publique - Hôpitaux de Paris (AP-HP), Department of Respiratory and Intensive Care Medicine, Pulmonary Hypertension National Referral Center, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
- Department of Radiology, Hôpital Marie Lannelongue, Le Plessis-Robinson, France
| | - Olivier Sitbon
- Université Paris-Saclay, Faculty of Medicine, Le Kremlin-Bicêtre, France
- Assistance Publique - Hôpitaux de Paris (AP-HP), Department of Respiratory and Intensive Care Medicine, Pulmonary Hypertension National Referral Center, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
- INSERM UMR_S 999, "Pulmonary Hypertension: Pathophysiology and Novel Therapies", Groupe Hospitalier Saint Joseph - Hôpital Marie Lannelongue, Le Plessis-Robinson, France
| | - Antoine Beurnier
- Université Paris-Saclay, Faculty of Medicine, Le Kremlin-Bicêtre, France
- Assistance Publique - Hôpitaux de Paris (AP-HP), Department of Respiratory and Intensive Care Medicine, Pulmonary Hypertension National Referral Center, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
- Department of Thoracic and Vascular Surgery and Heart-Lung Transplantation, Hôpital Marie Lannelongue, Le Plessis-Robinson, France
| | - Athénaïs Boucly
- Université Paris-Saclay, Faculty of Medicine, Le Kremlin-Bicêtre, France
- Assistance Publique - Hôpitaux de Paris (AP-HP), Department of Respiratory and Intensive Care Medicine, Pulmonary Hypertension National Referral Center, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
- INSERM UMR_S 999, "Pulmonary Hypertension: Pathophysiology and Novel Therapies", Groupe Hospitalier Saint Joseph - Hôpital Marie Lannelongue, Le Plessis-Robinson, France
| | - Sophie Bulifon
- Université Paris-Saclay, Faculty of Medicine, Le Kremlin-Bicêtre, France
- Assistance Publique - Hôpitaux de Paris (AP-HP), Department of Respiratory and Intensive Care Medicine, Pulmonary Hypertension National Referral Center, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
- INSERM UMR_S 999, "Pulmonary Hypertension: Pathophysiology and Novel Therapies", Groupe Hospitalier Saint Joseph - Hôpital Marie Lannelongue, Le Plessis-Robinson, France
| | - Andrei Seferian
- Université Paris-Saclay, Faculty of Medicine, Le Kremlin-Bicêtre, France
- Assistance Publique - Hôpitaux de Paris (AP-HP), Department of Respiratory and Intensive Care Medicine, Pulmonary Hypertension National Referral Center, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
- INSERM UMR_S 999, "Pulmonary Hypertension: Pathophysiology and Novel Therapies", Groupe Hospitalier Saint Joseph - Hôpital Marie Lannelongue, Le Plessis-Robinson, France
| | - Anne Roche
- Université Paris-Saclay, Faculty of Medicine, Le Kremlin-Bicêtre, France
- Assistance Publique - Hôpitaux de Paris (AP-HP), Department of Respiratory and Intensive Care Medicine, Pulmonary Hypertension National Referral Center, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
- INSERM UMR_S 999, "Pulmonary Hypertension: Pathophysiology and Novel Therapies", Groupe Hospitalier Saint Joseph - Hôpital Marie Lannelongue, Le Plessis-Robinson, France
| | - Olaf Mercier
- Université Paris-Saclay, Faculty of Medicine, Le Kremlin-Bicêtre, France
- Assistance Publique - Hôpitaux de Paris (AP-HP), Department of Respiratory and Intensive Care Medicine, Pulmonary Hypertension National Referral Center, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
- Department of Thoracic and Vascular Surgery and Heart-Lung Transplantation, Hôpital Marie Lannelongue, Le Plessis-Robinson, France
| | - Gérald Simonneau
- Université Paris-Saclay, Faculty of Medicine, Le Kremlin-Bicêtre, France
- Assistance Publique - Hôpitaux de Paris (AP-HP), Department of Respiratory and Intensive Care Medicine, Pulmonary Hypertension National Referral Center, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
- INSERM UMR_S 999, "Pulmonary Hypertension: Pathophysiology and Novel Therapies", Groupe Hospitalier Saint Joseph - Hôpital Marie Lannelongue, Le Plessis-Robinson, France
| | - Elie Fadel
- Université Paris-Saclay, Faculty of Medicine, Le Kremlin-Bicêtre, France
- Assistance Publique - Hôpitaux de Paris (AP-HP), Department of Respiratory and Intensive Care Medicine, Pulmonary Hypertension National Referral Center, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
- Department of Thoracic and Vascular Surgery and Heart-Lung Transplantation, Hôpital Marie Lannelongue, Le Plessis-Robinson, France
| | - Marc Humbert
- Université Paris-Saclay, Faculty of Medicine, Le Kremlin-Bicêtre, France
- Assistance Publique - Hôpitaux de Paris (AP-HP), Department of Respiratory and Intensive Care Medicine, Pulmonary Hypertension National Referral Center, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
- INSERM UMR_S 999, "Pulmonary Hypertension: Pathophysiology and Novel Therapies", Groupe Hospitalier Saint Joseph - Hôpital Marie Lannelongue, Le Plessis-Robinson, France
| | - Xavier Jaïs
- Université Paris-Saclay, Faculty of Medicine, Le Kremlin-Bicêtre, France
- Assistance Publique - Hôpitaux de Paris (AP-HP), Department of Respiratory and Intensive Care Medicine, Pulmonary Hypertension National Referral Center, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
- INSERM UMR_S 999, "Pulmonary Hypertension: Pathophysiology and Novel Therapies", Groupe Hospitalier Saint Joseph - Hôpital Marie Lannelongue, Le Plessis-Robinson, France
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Ezzedine R, Canellas A, Naltet C, Wislez M, Azarian R, Seferian A, Giroux Leprieur E. Evaluation of Real-Life Chemoimmunotherapy Combination in Patients with Metastatic Small Cell Lung Carcinoma (SCLC): A Multicentric Case-Control Study. Cancers (Basel) 2023; 15:4593. [PMID: 37760561 PMCID: PMC10526821 DOI: 10.3390/cancers15184593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2023] [Revised: 08/29/2023] [Accepted: 09/07/2023] [Indexed: 09/29/2023] Open
Abstract
The current first-line standard treatment for advanced small cell lung cancer (SCLC) is a combination of chemotherapy and immunotherapy. However, few efficacy data are available in a real-life settings, including frail patients. The aim of this study is to describe the real-life efficacy of chemoimmunotherapy in an unselected SCLC population. We conducted a retrospective multicenter study, which compared two cohorts of patients with treatment-naive metastatic SCLC treated in six academic centers in the Greater Paris area. Cohort 1 included patients treated with chemotherapy between January 2017 and December 2018, and cohort 2 included patients treated with chemoimmunotherapy between January 2019 and December 2020. A total of 153 consecutive patients were included (cohort 1: n = 96; cohort 2: n = 57). Clinical characteristics were similar between the two cohorts. Overall survival (OS) was statistically higher in cohort 2 (median survival 15.47 months) than in cohort 1 (median survival 9.5 months) (p = 0.0001). OS for patients with a performance status ≥2 and for patients ≥70 years old was not statistically different between the two cohorts. Chemoimmunotherapy efficacy was better compared to chemotherapy alone in case of brain or liver metastases. In conclusion, the combination of chemoimmunotherapy in metastatic SCLC appears to provide a real-life OS benefit. Dedicated clinical trials are needed to test this strategy in patients with impaired performance status or advanced age.
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Affiliation(s)
- Rémy Ezzedine
- Department of Respiratory Diseases and Thoracic Oncology, APHP—Hôpital Ambroise Paré, 92104 Boulogne-Billancourt, France;
| | - Anthony Canellas
- Department of Respiratory Diseases and Thoracic Oncology, APHP—Hôpital Tenon, 75020 Paris, France;
| | - Charles Naltet
- Department of Respiratory Diseases, Hôpital Paris Saint Joseph, 75014 Paris, France;
| | - Marie Wislez
- Thoracic Oncology Unit, Pulmonology Department, APHP—Hôpital Cochin, Université Paris Cité, 75006 Paris, France;
| | - Reza Azarian
- Department of Respiratory Diseases, Hôpital Mignot, 78150 Le Chesnay, France;
| | - Andrei Seferian
- Department of Respiratory Diseases, APHP—Hôpital Bicêtre, 94270 Le Kremlin-Bicêtre, France;
| | - Etienne Giroux Leprieur
- Department of Respiratory Diseases and Thoracic Oncology, APHP—Hôpital Ambroise Paré, 92104 Boulogne-Billancourt, France;
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6
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Montani D, Thoré P, Mignard X, Jaïs X, Boucly A, Jevnikar M, Seferian A, Jutant EM, Cottin V, Fadel E, Simonneau G, Savale L, Sitbon O, Humbert M. Clinical Phenotype and Outcomes of Pulmonary Hypertension Associated with Myeloproliferative Neoplasms: A Population-based Study. Am J Respir Crit Care Med 2023; 208:600-612. [PMID: 37311222 DOI: 10.1164/rccm.202210-1941oc] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Accepted: 06/13/2023] [Indexed: 06/15/2023] Open
Abstract
Rationale: Precapillary pulmonary hypertension (PH) is a rare and largely unrecognized complication of myeloproliferative neoplasms (MPNs), including polycythemia vera (PV), essential thrombocythemia (ET), and primary myelofibrosis (MF). Objectives: To describe characteristics and outcomes of MPN-associated PH. Methods: We report clinical, functional, and hemodynamic characteristics, classification, and outcomes of patients with PV, ET, or primary MF in the French PH registry. Measurements and Main Results: Ninety patients with MPN (42 PV, 35 ET, 13 primary MF) presented with precapillary PH with severe hemodynamic impairment, with a median mean pulmonary arterial pressure and pulmonary vascular resistance of 42 mm Hg and 6.7 Wood units, respectively, and impaired clinical conditions, with 71% in New York Heart Association functional classes III/IV and having a median 6-minute-walk distance of 310 m. Half of the patients were diagnosed with chronic thromboembolic PH (CTEPH); the other half were considered to have group 5 PH. MF was preferentially associated with group 5 PH, whereas PV and ET were generally related to CTEPH. Proximal lesions were diagnosed in half of the patients with CTEPH. Thromboendarterectomy was performed in 18 selected patients with high risk of complications (5 early deaths). Overall survival at 1, 3, and 5 years was 67%, 50%, and 34% in group 5 PH and 81%, 66%, and 42% in CTEPH, respectively. Conclusions: PH is a life-threatening condition potentially occurring in MPN. There are multiple mechanisms, with equal diagnoses of CTEPH and group 5 PH. Physicians should be aware that PH strongly affects the burden of patients with MPN, especially in group 5 PH, with unknown pathophysiological mechanisms.
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Affiliation(s)
- David Montani
- School of Medicine, Université Paris-Saclay, Le Kremlin-Bicêtre, France
- Assistance Publique - Hôpitaux de Paris, Department of Respiratory and Intensive Care Medicine, Pulmonary Hypertension National Referral Center, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
- Institut National de la Santé et de la Recherche Médicale Unité Mixte de Recherche 999 Pulmonary Hypertension: Pathophysiology and Novel Therapies and
| | - Pierre Thoré
- Assistance Publique - Hôpitaux de Paris, Department of Respiratory Medicine, Histiocytosis National Referral Center, Hôpital Saint-Louis, Paris, France
- School of Medicine, Université Paris Cité, Paris, France
| | - Xavier Mignard
- School of Medicine, Université Paris-Saclay, Le Kremlin-Bicêtre, France
- Assistance Publique - Hôpitaux de Paris, Department of Respiratory and Intensive Care Medicine, Pulmonary Hypertension National Referral Center, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
- Institut National de la Santé et de la Recherche Médicale Unité Mixte de Recherche 999 Pulmonary Hypertension: Pathophysiology and Novel Therapies and
| | - Xavier Jaïs
- School of Medicine, Université Paris-Saclay, Le Kremlin-Bicêtre, France
- Assistance Publique - Hôpitaux de Paris, Department of Respiratory and Intensive Care Medicine, Pulmonary Hypertension National Referral Center, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
- Institut National de la Santé et de la Recherche Médicale Unité Mixte de Recherche 999 Pulmonary Hypertension: Pathophysiology and Novel Therapies and
| | - Athénaïs Boucly
- School of Medicine, Université Paris-Saclay, Le Kremlin-Bicêtre, France
- Assistance Publique - Hôpitaux de Paris, Department of Respiratory and Intensive Care Medicine, Pulmonary Hypertension National Referral Center, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
- Institut National de la Santé et de la Recherche Médicale Unité Mixte de Recherche 999 Pulmonary Hypertension: Pathophysiology and Novel Therapies and
| | - Mitja Jevnikar
- School of Medicine, Université Paris-Saclay, Le Kremlin-Bicêtre, France
- Assistance Publique - Hôpitaux de Paris, Department of Respiratory and Intensive Care Medicine, Pulmonary Hypertension National Referral Center, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
- Institut National de la Santé et de la Recherche Médicale Unité Mixte de Recherche 999 Pulmonary Hypertension: Pathophysiology and Novel Therapies and
| | - Andrei Seferian
- School of Medicine, Université Paris-Saclay, Le Kremlin-Bicêtre, France
- Assistance Publique - Hôpitaux de Paris, Department of Respiratory and Intensive Care Medicine, Pulmonary Hypertension National Referral Center, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
- Institut National de la Santé et de la Recherche Médicale Unité Mixte de Recherche 999 Pulmonary Hypertension: Pathophysiology and Novel Therapies and
| | - Etienne-Marie Jutant
- Department of Pneumology, University Hospital of Poitiers, Institut National de la Santé et de la Recherche Médicale Centre D'investigation Clinique 1402, University of Poitiers, Poitiers, France; and
| | - Vincent Cottin
- Centre Hospitalier Universitaire de Lyon Hospices Civils de Lyon, Service de Pneumologie, Centre de Référence des Maladies Pulmonaires Rares, Groupement Hospitalier Est, Hôpital Louis Pradel, Bron, France
| | - Elie Fadel
- Institut National de la Santé et de la Recherche Médicale Unité Mixte de Recherche 999 Pulmonary Hypertension: Pathophysiology and Novel Therapies and
- Department of Thoracic Surgery, Hôpital Marie Lannelongue, Le Plessis-Robinson, France
| | - Gérald Simonneau
- School of Medicine, Université Paris-Saclay, Le Kremlin-Bicêtre, France
- Assistance Publique - Hôpitaux de Paris, Department of Respiratory and Intensive Care Medicine, Pulmonary Hypertension National Referral Center, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
- Institut National de la Santé et de la Recherche Médicale Unité Mixte de Recherche 999 Pulmonary Hypertension: Pathophysiology and Novel Therapies and
| | - Laurent Savale
- School of Medicine, Université Paris-Saclay, Le Kremlin-Bicêtre, France
- Assistance Publique - Hôpitaux de Paris, Department of Respiratory and Intensive Care Medicine, Pulmonary Hypertension National Referral Center, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
- Institut National de la Santé et de la Recherche Médicale Unité Mixte de Recherche 999 Pulmonary Hypertension: Pathophysiology and Novel Therapies and
| | - Olivier Sitbon
- School of Medicine, Université Paris-Saclay, Le Kremlin-Bicêtre, France
- Assistance Publique - Hôpitaux de Paris, Department of Respiratory and Intensive Care Medicine, Pulmonary Hypertension National Referral Center, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
- Institut National de la Santé et de la Recherche Médicale Unité Mixte de Recherche 999 Pulmonary Hypertension: Pathophysiology and Novel Therapies and
| | - Marc Humbert
- School of Medicine, Université Paris-Saclay, Le Kremlin-Bicêtre, France
- Assistance Publique - Hôpitaux de Paris, Department of Respiratory and Intensive Care Medicine, Pulmonary Hypertension National Referral Center, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
- Institut National de la Santé et de la Recherche Médicale Unité Mixte de Recherche 999 Pulmonary Hypertension: Pathophysiology and Novel Therapies and
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7
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Beurnier A, Savale L, Jaïs X, Colle R, Pham T, Morin L, Bulifon S, Noël N, Boucly A, Delbarre B, Ebstein N, Figueiredo S, Gasnier M, Harrois A, Jutant EM, Jevnikar M, Keddache S, Lecoq AL, Meyrignac O, Parent F, Pichon J, Preda M, Roche A, Seferian A, Bellin MF, Gille T, Corruble E, Sitbon O, Becquemont L, Monnet X, Humbert M, Montani D. Functional respiratory complaints among COVID-19 survivors: a prospective cohort study. ERJ Open Res 2023; 9:00063-2023. [PMID: 37131523 PMCID: PMC9969230 DOI: 10.1183/23120541.00063-2023] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 02/06/2023] [Indexed: 02/25/2023] Open
Abstract
BackgroundDyspnoea is a common persistent symptom after COVID-19. Whether it is associated with functional respiratory disorders remains unclear.MethodsWe assessed the proportion and characteristics of patients with “functional respiratory complaints” (FRCs) (as defined by Nijmegen Questionnaire>22) among 177 post-COVID-19 individuals who benefited from outclinic evaluation in the COMEBAC study (i.e., symptomatic and/or ICU survivors at 4 months). In a distinct explanatory cohort of 21 consecutive individuals with unexplained post-COVID-19 dyspnoea after routine tests, we also analysed the physiological responses to incremental cardio-pulmonary exercise testing (CPET).FindingsIn the COMEBAC cohort, 37 had significant FRCs (20.9%, IC95: 14.9–26.9). The prevalence of FRCs ranged from 7.2% (ICU patients) to 37.5% (non-ICU patients). The presence of FRCs was significantly associated with more severe dyspnoea, lower 6-minute walk distance, more frequent psychological and neurological symptoms (cognitive complaint, anxiety, depression, insomnia and post-traumatic stress disorders) and poorer quality of life (all p<0.01). In the explanatory cohort, 7/21 patients had significant FRCs. Based on CPET, dysfunctional breathing was identified in 12/21 patients, 5/21 had normal CPET, 3/21 had deconditioning and 1/21 had evidence of uncontrolled cardiovascular disease.InterpretationFRCs are common during post-COVID-19 follow-up, especially among patients with unexplained dyspnoea. Diagnosis of dysfunctional breathing should be considered in those cases.FundingAssistance Publique-Hôpitaux de Paris.
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Montani D, Lechartier B, Girerd B, Eyries M, Ghigna MR, Savale L, Jaïs X, Seferian A, Jevnikar M, Boucly A, Riou M, Traclet J, Chaouat A, Levy M, Le Pavec J, Fadel E, Perros F, Soubrier F, Remy-Jardin M, Sitbon O, Bonnet D, Humbert M. An emerging phenotype of pulmonary arterial hypertension patients carrying SOX17 variants. Eur Respir J 2022; 60:2200656. [PMID: 35618278 PMCID: PMC10436756 DOI: 10.1183/13993003.00656-2022] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Accepted: 05/17/2022] [Indexed: 11/05/2022]
Abstract
BACKGROUND The phenotype of pulmonary arterial hypertension (PAH) patients carrying SOX17 pathogenic variants remains mostly unknown. METHODS We report the genetic analysis findings, characteristics and outcomes of patients with heritable PAH carrying SOX17 variants from the French Pulmonary Hypertension Network. RESULTS 20 patients and eight unaffected relatives were identified. The median (range) age at diagnosis was 17 (2-53) years, with a female:male ratio of 1.5. At diagnosis, most of the patients (74%) were in New York Heart Association Functional Class III or IV with severe haemodynamic compromise, including a median pulmonary vascular resistance of 14.0 (4.2-31.5) WU. An associated congenital heart disease (CHD) was found in seven PAH patients (35%). Patients with CHD-associated PAH were significantly younger at diagnosis than PAH patients without CHD. Four patients (20%) suffered from recurrent haemoptysis requiring repeated arterial embolisations. 13 out of 16 patients (81%) for whom imaging was available displayed chest computed tomography abnormalities, including dilated, tortuous pulmonary vessels, ground-glass opacities as well as anomalies of the bronchial and nonbronchial arteries. After a median (range) follow-up of 47 (1-591) months, 10 patients underwent lung transplantation and one patient benefited from a heart-lung transplantation due to associated CHD. Histopathological analysis of lung explants showed a congested lung architecture with severe pulmonary arterial remodelling, subpleural vessel dilation and numerous haemorrhagic foci. CONCLUSIONS PAH due to SOX17 pathogenic variants is a severe phenotype, frequently associated with CHD, haemoptysis and radiological abnormalities. Pathological assessment reveals severe pulmonary arterial remodelling and malformations affecting pulmonary vessels and thoracic systemic arteries.
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Affiliation(s)
- David Montani
- AP-HP, Dept of Respiratory and Intensive Care Medicine, Pulmonary Hypertension National Referral Centre, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
- School of Medicine, Université Paris-Saclay, Le Kremlin-Bicêtre, France
- INSERM UMR_S 999 "Pulmonary Hypertension: Pathophysiology and Novel Therapies", Hôpital Marie Lannelongue, Le Plessis-Robinson, France
- D. Montani and B. Lechartier contributed equally to this work
| | - Benoit Lechartier
- AP-HP, Dept of Respiratory and Intensive Care Medicine, Pulmonary Hypertension National Referral Centre, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
- School of Medicine, Université Paris-Saclay, Le Kremlin-Bicêtre, France
- INSERM UMR_S 999 "Pulmonary Hypertension: Pathophysiology and Novel Therapies", Hôpital Marie Lannelongue, Le Plessis-Robinson, France
- D. Montani and B. Lechartier contributed equally to this work
| | - Barbara Girerd
- AP-HP, Dept of Respiratory and Intensive Care Medicine, Pulmonary Hypertension National Referral Centre, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
- School of Medicine, Université Paris-Saclay, Le Kremlin-Bicêtre, France
- INSERM UMR_S 999 "Pulmonary Hypertension: Pathophysiology and Novel Therapies", Hôpital Marie Lannelongue, Le Plessis-Robinson, France
| | - Mélanie Eyries
- Dépt de Génétique, Hôpital Pitié-Salpêtrière, AP-HP and UMR_S 1166 Sorbonne Université, Paris, France
| | - Maria-Rosa Ghigna
- INSERM UMR_S 999 "Pulmonary Hypertension: Pathophysiology and Novel Therapies", Hôpital Marie Lannelongue, Le Plessis-Robinson, France
- Service d'Anatomopathologie, Hôpital Marie Lannelongue, Le Plessis-Robinson, France
| | - Laurent Savale
- AP-HP, Dept of Respiratory and Intensive Care Medicine, Pulmonary Hypertension National Referral Centre, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
- School of Medicine, Université Paris-Saclay, Le Kremlin-Bicêtre, France
- INSERM UMR_S 999 "Pulmonary Hypertension: Pathophysiology and Novel Therapies", Hôpital Marie Lannelongue, Le Plessis-Robinson, France
| | - Xavier Jaïs
- AP-HP, Dept of Respiratory and Intensive Care Medicine, Pulmonary Hypertension National Referral Centre, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
- School of Medicine, Université Paris-Saclay, Le Kremlin-Bicêtre, France
- INSERM UMR_S 999 "Pulmonary Hypertension: Pathophysiology and Novel Therapies", Hôpital Marie Lannelongue, Le Plessis-Robinson, France
| | - Andrei Seferian
- AP-HP, Dept of Respiratory and Intensive Care Medicine, Pulmonary Hypertension National Referral Centre, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
- School of Medicine, Université Paris-Saclay, Le Kremlin-Bicêtre, France
- INSERM UMR_S 999 "Pulmonary Hypertension: Pathophysiology and Novel Therapies", Hôpital Marie Lannelongue, Le Plessis-Robinson, France
| | - Mitja Jevnikar
- AP-HP, Dept of Respiratory and Intensive Care Medicine, Pulmonary Hypertension National Referral Centre, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
- School of Medicine, Université Paris-Saclay, Le Kremlin-Bicêtre, France
- INSERM UMR_S 999 "Pulmonary Hypertension: Pathophysiology and Novel Therapies", Hôpital Marie Lannelongue, Le Plessis-Robinson, France
| | - Athénais Boucly
- AP-HP, Dept of Respiratory and Intensive Care Medicine, Pulmonary Hypertension National Referral Centre, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
- School of Medicine, Université Paris-Saclay, Le Kremlin-Bicêtre, France
- INSERM UMR_S 999 "Pulmonary Hypertension: Pathophysiology and Novel Therapies", Hôpital Marie Lannelongue, Le Plessis-Robinson, France
| | - Marianne Riou
- Dépt de Pneumologie, Nouvel Hôpital Civil, Strasbourg, France
| | - Julie Traclet
- Université Lyon 1, Hospices Civils de Lyon, Centre de Référence des Maladies Pulmonaires Rares, Centre de Compétences de l'Hypertension Pulmonaire, Hôpital Louis Pradel, Lyon, France
| | - Ari Chaouat
- Université de Lorraine, CHU de Nancy, Pôle des Spécialités Médicales, Dépt de Pneumologie, Vandoeuvre-lès-Nancy, France
| | - Maryline Levy
- Service de Cardiologie Congénitale et Pédiatrique, Hôpital Necker Enfants Malades, AP-HP, Université de Paris, Paris, France
| | - Jerome Le Pavec
- School of Medicine, Université Paris-Saclay, Le Kremlin-Bicêtre, France
- INSERM UMR_S 999 "Pulmonary Hypertension: Pathophysiology and Novel Therapies", Hôpital Marie Lannelongue, Le Plessis-Robinson, France
- Service de Pneumologie et Transplantation Pulmonaire, Hôpital Marie Lannelongue, Le Plessis-Robinson, France
| | - Elie Fadel
- School of Medicine, Université Paris-Saclay, Le Kremlin-Bicêtre, France
- INSERM UMR_S 999 "Pulmonary Hypertension: Pathophysiology and Novel Therapies", Hôpital Marie Lannelongue, Le Plessis-Robinson, France
- Service de Chirurgie Thoracique, Hôpital Marie Lannelongue, Le Plessis-Robinson, France
| | - Frédéric Perros
- INSERM UMR_S 999 "Pulmonary Hypertension: Pathophysiology and Novel Therapies", Hôpital Marie Lannelongue, Le Plessis-Robinson, France
| | - Florent Soubrier
- Dépt de Génétique, Hôpital Pitié-Salpêtrière, AP-HP and UMR_S 1166 Sorbonne Université, Paris, France
| | - Martine Remy-Jardin
- CHU de Lille, Service d'Imagerie Thoracique, Hôpital Albert Calmette, Lille, France
| | - Olivier Sitbon
- AP-HP, Dept of Respiratory and Intensive Care Medicine, Pulmonary Hypertension National Referral Centre, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
- School of Medicine, Université Paris-Saclay, Le Kremlin-Bicêtre, France
- INSERM UMR_S 999 "Pulmonary Hypertension: Pathophysiology and Novel Therapies", Hôpital Marie Lannelongue, Le Plessis-Robinson, France
| | - Damien Bonnet
- Service de Cardiologie Congénitale et Pédiatrique, Hôpital Necker Enfants Malades, AP-HP, Université de Paris, Paris, France
| | - Marc Humbert
- AP-HP, Dept of Respiratory and Intensive Care Medicine, Pulmonary Hypertension National Referral Centre, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
- School of Medicine, Université Paris-Saclay, Le Kremlin-Bicêtre, France
- INSERM UMR_S 999 "Pulmonary Hypertension: Pathophysiology and Novel Therapies", Hôpital Marie Lannelongue, Le Plessis-Robinson, France
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9
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Montani D, Certain MC, Weatherald J, Jaïs X, Bulifon S, Noel-Savina E, Nieves A, Renard S, Traclet J, Bouvaist H, Riou M, de Groote P, Moceri P, Bertoletti L, Favrolt N, Guillaumot A, Jutant EM, Beurnier A, Boucly A, Ebstein N, Jevnikar M, Pichon J, Keddache S, Preda M, Roche A, Solinas S, Seferian A, Reynaud-Gaubert M, Cottin V, Savale L, Humbert M, Sitbon O. COVID-19 in Patients with Pulmonary Hypertension: A National Prospective Cohort Study. Am J Respir Crit Care Med 2022; 206:573-583. [PMID: 35549842 PMCID: PMC9716894 DOI: 10.1164/rccm.202112-2761oc] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Rationale: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is associated with pulmonary endothelial dysfunction. There are limited data available on the outcomes of coronavirus disease (COVID-19) in patients with pulmonary hypertension (PH), a disease characterized by pulmonary endothelial dysfunction. Objectives: To describe characteristics and outcomes of patients with precapillary PH and COVID-19. Methods: We prospectively collected characteristics, management, and outcomes of adult patients with precapillary PH in the French PH network who had COVID-19 between February 1, 2020, and April 30, 2021. Clinical, functional, and hemodynamic characteristics of PH before COVID-19 were collected from the French PH registry. Measurements and Main Results: A total of 211 patients with PH (including 123 with pulmonary arterial hypertension, 47 with chronic thromboembolic PH, and 41 with other types of PH) experienced COVID-19, and 40.3% of them were outpatients, 32.2% were hospitalized in a conventional ward, and 27.5% were in an ICU. Among hospitalized patients (n = 126), 54.0% received corticosteroids, 37.3% high-flow oxygen, and 11.1% invasive ventilation. Right ventricular and acute renal failure occurred in 30.2% and 19.8% of patients, respectively. Fifty-two patients (all hospitalized) died from COVID-19. Overall mortality was 24.6% (95% CI [confidence interval], 18.8-30.5) and in-hospital mortality 41.3% (95% CI, 32.7-49.9). Nonsurvivors were significantly older, more frequently male and suffering comorbidities (diabetes, chronic respiratory diseases, systemic hypertension, chronic cardiac diseases, and/or chronic renal failure), and had more severe PH at their most recent evaluation preceding COVID-19 diagnosis (in terms of functional class and 6-minute-walk distance; all P < 0.05). Use of pulmonary arterial hypertension therapy was similar between survivors and nonsurvivors. Conclusions: COVID-19 in patients with precapillary PH was associated with a high in-hospital mortality. The typical risk factors for severe COVID-19 and severity of PH were associated with mortality in this population.
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Affiliation(s)
- David Montani
- Faculty of Medicine, Université Paris-Saclay, Le Kremlin-Bicêtre, France;,Institut National de la Santé et de la Recherche Médicale Unité Mixte de Recherche _S 999, Hôpital Marie Lannelongue, Le Plessis Robinson, France;,Department of Respiratory and Intensive Care Medicine, Pulmonary Hypertension National Referral Centre, and
| | - Marie-Caroline Certain
- Faculty of Medicine, Université Paris-Saclay, Le Kremlin-Bicêtre, France;,Institut National de la Santé et de la Recherche Médicale Unité Mixte de Recherche _S 999, Hôpital Marie Lannelongue, Le Plessis Robinson, France;,Department of Respiratory and Intensive Care Medicine, Pulmonary Hypertension National Referral Centre, and
| | - Jason Weatherald
- Division of Respirology, Department of Medicine, University of Calgary, Calgary, Alberta, Canada;,Division of Pulmonary Medicine, Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Xavier Jaïs
- Faculty of Medicine, Université Paris-Saclay, Le Kremlin-Bicêtre, France;,Institut National de la Santé et de la Recherche Médicale Unité Mixte de Recherche _S 999, Hôpital Marie Lannelongue, Le Plessis Robinson, France;,Department of Respiratory and Intensive Care Medicine, Pulmonary Hypertension National Referral Centre, and
| | - Sophie Bulifon
- Faculty of Medicine, Université Paris-Saclay, Le Kremlin-Bicêtre, France;,Institut National de la Santé et de la Recherche Médicale Unité Mixte de Recherche _S 999, Hôpital Marie Lannelongue, Le Plessis Robinson, France;,Department of Respiratory and Intensive Care Medicine, Pulmonary Hypertension National Referral Centre, and
| | | | - Ana Nieves
- Service de Pneumologie Centre Hospitalier Universitaire Nord, Assistance Publique Hôpitaux de Marseille, Marseille, France
| | - Sébastien Renard
- Service de Cardiologie, Centre Régional de Compétences de l'Hypertension Pulmonaire, Hôpital La Timone, Marseille, France
| | - Julie Traclet
- Université Lyon-1, Hospices Civils de Lyon, Centre de Référence des Maladies Pulmonaires Rares, Centre de Compétences de l'Hypertension Pulmonaire, Hôpital Louis Pradel, Lyon, France
| | - Hélène Bouvaist
- Service de Cardiologie, Hôpital Universitaire Grenoble-Alpes, Grenoble, France
| | - Marianne Riou
- Département de Pneumologie, Nouvel Hôpital Civil, Strasbourg, France
| | - Pascal de Groote
- Hôpital Cardiologique de Lille, Centre de Compétences de l'Hypertension Pulmonaire, Lille, France
| | - Pamela Moceri
- Unité de Recherche Clinique Côte d'Azur, Service de Cardiologie, Centre Hospitalier Universitaire de Nice, Université Côte d'Azur, Nice, France
| | - Laurent Bertoletti
- Service de Médecine Vasculaire et Thérapeutique, Institut National de la Santé et de la Recherche Médicale Unité 1059 et Centre d'Investigation Clinique 1408, Centre Hospitalier Universitaire de Saint-Etienne, Université Jean-Monnet, Saint-Etienne, France
| | - Nicolas Favrolt
- Service de Pneumologie et Soins Intensifs Respiratoires, Centre Hospitalier Universitaire de Dijon, Dijon, France
| | - Anne Guillaumot
- Université de Lorraine, Centre Hospitalo-Universitaire Nancy, Pôle des Spécialités Médicales, Département de Pneumologie, Vandoeuvre-lès-Nancy, France; and
| | - Etienne-Marie Jutant
- Université de Poitiers, Centre Hospitalo-Universitaire de Poitiers, Service de pneumologie, Institut National de la Santé et de la Recherche Médicale Centre d'Investigation Clinique 1402, Poitiers, France
| | - Antoine Beurnier
- Faculty of Medicine, Université Paris-Saclay, Le Kremlin-Bicêtre, France;,Institut National de la Santé et de la Recherche Médicale Unité Mixte de Recherche _S 999, Hôpital Marie Lannelongue, Le Plessis Robinson, France;,Department of Physiology – Pulmonary Function Testing, Assistance Publique – Hôpitaux de Paris, Hôpital Bicêtre, Département Médico-Universitaire 5 Thorinno, Le Kremlin-Bicêtre, France
| | - Athénaïs Boucly
- Faculty of Medicine, Université Paris-Saclay, Le Kremlin-Bicêtre, France;,Institut National de la Santé et de la Recherche Médicale Unité Mixte de Recherche _S 999, Hôpital Marie Lannelongue, Le Plessis Robinson, France;,Department of Respiratory and Intensive Care Medicine, Pulmonary Hypertension National Referral Centre, and
| | - Nathan Ebstein
- Faculty of Medicine, Université Paris-Saclay, Le Kremlin-Bicêtre, France;,Institut National de la Santé et de la Recherche Médicale Unité Mixte de Recherche _S 999, Hôpital Marie Lannelongue, Le Plessis Robinson, France;,Department of Respiratory and Intensive Care Medicine, Pulmonary Hypertension National Referral Centre, and
| | - Mitja Jevnikar
- Faculty of Medicine, Université Paris-Saclay, Le Kremlin-Bicêtre, France;,Institut National de la Santé et de la Recherche Médicale Unité Mixte de Recherche _S 999, Hôpital Marie Lannelongue, Le Plessis Robinson, France;,Department of Respiratory and Intensive Care Medicine, Pulmonary Hypertension National Referral Centre, and
| | - Jérémie Pichon
- Faculty of Medicine, Université Paris-Saclay, Le Kremlin-Bicêtre, France;,Institut National de la Santé et de la Recherche Médicale Unité Mixte de Recherche _S 999, Hôpital Marie Lannelongue, Le Plessis Robinson, France;,Department of Respiratory and Intensive Care Medicine, Pulmonary Hypertension National Referral Centre, and
| | - Sophia Keddache
- Faculty of Medicine, Université Paris-Saclay, Le Kremlin-Bicêtre, France;,Institut National de la Santé et de la Recherche Médicale Unité Mixte de Recherche _S 999, Hôpital Marie Lannelongue, Le Plessis Robinson, France;,Department of Respiratory and Intensive Care Medicine, Pulmonary Hypertension National Referral Centre, and
| | - Mariana Preda
- Faculty of Medicine, Université Paris-Saclay, Le Kremlin-Bicêtre, France;,Institut National de la Santé et de la Recherche Médicale Unité Mixte de Recherche _S 999, Hôpital Marie Lannelongue, Le Plessis Robinson, France;,Department of Respiratory and Intensive Care Medicine, Pulmonary Hypertension National Referral Centre, and
| | - Anne Roche
- Faculty of Medicine, Université Paris-Saclay, Le Kremlin-Bicêtre, France;,Institut National de la Santé et de la Recherche Médicale Unité Mixte de Recherche _S 999, Hôpital Marie Lannelongue, Le Plessis Robinson, France;,Department of Respiratory and Intensive Care Medicine, Pulmonary Hypertension National Referral Centre, and
| | - Sabina Solinas
- Faculty of Medicine, Université Paris-Saclay, Le Kremlin-Bicêtre, France;,Institut National de la Santé et de la Recherche Médicale Unité Mixte de Recherche _S 999, Hôpital Marie Lannelongue, Le Plessis Robinson, France;,Department of Respiratory and Intensive Care Medicine, Pulmonary Hypertension National Referral Centre, and
| | - Andrei Seferian
- Faculty of Medicine, Université Paris-Saclay, Le Kremlin-Bicêtre, France;,Institut National de la Santé et de la Recherche Médicale Unité Mixte de Recherche _S 999, Hôpital Marie Lannelongue, Le Plessis Robinson, France;,Department of Respiratory and Intensive Care Medicine, Pulmonary Hypertension National Referral Centre, and
| | - Martine Reynaud-Gaubert
- Service de Pneumologie Centre Hospitalier Universitaire Nord, Assistance Publique Hôpitaux de Marseille, Marseille, France
| | - Vincent Cottin
- Université Lyon-1, Hospices Civils de Lyon, Centre de Référence des Maladies Pulmonaires Rares, Centre de Compétences de l'Hypertension Pulmonaire, Hôpital Louis Pradel, Lyon, France
| | - Laurent Savale
- Faculty of Medicine, Université Paris-Saclay, Le Kremlin-Bicêtre, France;,Institut National de la Santé et de la Recherche Médicale Unité Mixte de Recherche _S 999, Hôpital Marie Lannelongue, Le Plessis Robinson, France;,Department of Respiratory and Intensive Care Medicine, Pulmonary Hypertension National Referral Centre, and
| | - Marc Humbert
- Faculty of Medicine, Université Paris-Saclay, Le Kremlin-Bicêtre, France;,Institut National de la Santé et de la Recherche Médicale Unité Mixte de Recherche _S 999, Hôpital Marie Lannelongue, Le Plessis Robinson, France;,Department of Respiratory and Intensive Care Medicine, Pulmonary Hypertension National Referral Centre, and
| | - Olivier Sitbon
- Faculty of Medicine, Université Paris-Saclay, Le Kremlin-Bicêtre, France;,Institut National de la Santé et de la Recherche Médicale Unité Mixte de Recherche _S 999, Hôpital Marie Lannelongue, Le Plessis Robinson, France;,Department of Respiratory and Intensive Care Medicine, Pulmonary Hypertension National Referral Centre, and
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10
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Certain MC, Baron A, Turpin M, Ebstein N, Boucly A, Beurnier A, Jevnikar M, Roche A, Keddache S, Bulifon S, Seferian A, Jaïs X, Montani D, Humbert M, Sitbon O, Savale L. Outcomes of cirrhotic patients with pre-capillary pulmonary hypertension and pulmonary vascular resistance between 2 and 3 Wood Units. Eur Respir J 2022; 60:13993003.00107-2022. [PMID: 35680147 DOI: 10.1183/13993003.00107-2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2022] [Accepted: 05/22/2022] [Indexed: 11/05/2022]
Affiliation(s)
- Marie Caroline Certain
- Université Paris-Saclay, School of Medicine, Le Kremlin-Bicêtre, France.,INSERM UMR_S 999 «Pulmonary Hypertension: Pathophysiology and Novel Therapies», Hôpital Marie Lannelongue, Le Plessis-Robinson, France.,Assistance Publique - Hôpitaux de Paris (AP-HP), Department of Respiratory and Intensive Care Medicine, Pulmonary Hypertension National Referral Center, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
| | - Audrey Baron
- Université Paris-Saclay, School of Medicine, Le Kremlin-Bicêtre, France.,INSERM UMR_S 999 «Pulmonary Hypertension: Pathophysiology and Novel Therapies», Hôpital Marie Lannelongue, Le Plessis-Robinson, France.,Assistance Publique - Hôpitaux de Paris (AP-HP), Department of Respiratory and Intensive Care Medicine, Pulmonary Hypertension National Referral Center, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
| | - Matthieu Turpin
- Université Paris-Saclay, School of Medicine, Le Kremlin-Bicêtre, France.,INSERM UMR_S 999 «Pulmonary Hypertension: Pathophysiology and Novel Therapies», Hôpital Marie Lannelongue, Le Plessis-Robinson, France.,Assistance Publique - Hôpitaux de Paris (AP-HP), Department of Respiratory and Intensive Care Medicine, Pulmonary Hypertension National Referral Center, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
| | - Nathan Ebstein
- Université Paris-Saclay, School of Medicine, Le Kremlin-Bicêtre, France.,INSERM UMR_S 999 «Pulmonary Hypertension: Pathophysiology and Novel Therapies», Hôpital Marie Lannelongue, Le Plessis-Robinson, France.,Assistance Publique - Hôpitaux de Paris (AP-HP), Department of Respiratory and Intensive Care Medicine, Pulmonary Hypertension National Referral Center, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
| | - Athénaïs Boucly
- Université Paris-Saclay, School of Medicine, Le Kremlin-Bicêtre, France.,INSERM UMR_S 999 «Pulmonary Hypertension: Pathophysiology and Novel Therapies», Hôpital Marie Lannelongue, Le Plessis-Robinson, France.,Assistance Publique - Hôpitaux de Paris (AP-HP), Department of Respiratory and Intensive Care Medicine, Pulmonary Hypertension National Referral Center, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
| | - Antoine Beurnier
- Université Paris-Saclay, School of Medicine, Le Kremlin-Bicêtre, France.,INSERM UMR_S 999 «Pulmonary Hypertension: Pathophysiology and Novel Therapies», Hôpital Marie Lannelongue, Le Plessis-Robinson, France.,Assistance Publique - Hôpitaux de Paris (AP-HP), Department of Respiratory and Intensive Care Medicine, Pulmonary Hypertension National Referral Center, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
| | - Mitja Jevnikar
- Université Paris-Saclay, School of Medicine, Le Kremlin-Bicêtre, France.,INSERM UMR_S 999 «Pulmonary Hypertension: Pathophysiology and Novel Therapies», Hôpital Marie Lannelongue, Le Plessis-Robinson, France.,Assistance Publique - Hôpitaux de Paris (AP-HP), Department of Respiratory and Intensive Care Medicine, Pulmonary Hypertension National Referral Center, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
| | - Anne Roche
- Université Paris-Saclay, School of Medicine, Le Kremlin-Bicêtre, France.,INSERM UMR_S 999 «Pulmonary Hypertension: Pathophysiology and Novel Therapies», Hôpital Marie Lannelongue, Le Plessis-Robinson, France.,Assistance Publique - Hôpitaux de Paris (AP-HP), Department of Respiratory and Intensive Care Medicine, Pulmonary Hypertension National Referral Center, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
| | - Sophia Keddache
- Université Paris-Saclay, School of Medicine, Le Kremlin-Bicêtre, France.,INSERM UMR_S 999 «Pulmonary Hypertension: Pathophysiology and Novel Therapies», Hôpital Marie Lannelongue, Le Plessis-Robinson, France.,Assistance Publique - Hôpitaux de Paris (AP-HP), Department of Respiratory and Intensive Care Medicine, Pulmonary Hypertension National Referral Center, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
| | - Sophie Bulifon
- Université Paris-Saclay, School of Medicine, Le Kremlin-Bicêtre, France.,INSERM UMR_S 999 «Pulmonary Hypertension: Pathophysiology and Novel Therapies», Hôpital Marie Lannelongue, Le Plessis-Robinson, France.,Assistance Publique - Hôpitaux de Paris (AP-HP), Department of Respiratory and Intensive Care Medicine, Pulmonary Hypertension National Referral Center, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
| | - Andrei Seferian
- Université Paris-Saclay, School of Medicine, Le Kremlin-Bicêtre, France.,INSERM UMR_S 999 «Pulmonary Hypertension: Pathophysiology and Novel Therapies», Hôpital Marie Lannelongue, Le Plessis-Robinson, France.,Assistance Publique - Hôpitaux de Paris (AP-HP), Department of Respiratory and Intensive Care Medicine, Pulmonary Hypertension National Referral Center, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
| | - Xavier Jaïs
- Université Paris-Saclay, School of Medicine, Le Kremlin-Bicêtre, France.,INSERM UMR_S 999 «Pulmonary Hypertension: Pathophysiology and Novel Therapies», Hôpital Marie Lannelongue, Le Plessis-Robinson, France.,Assistance Publique - Hôpitaux de Paris (AP-HP), Department of Respiratory and Intensive Care Medicine, Pulmonary Hypertension National Referral Center, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
| | - David Montani
- Université Paris-Saclay, School of Medicine, Le Kremlin-Bicêtre, France.,INSERM UMR_S 999 «Pulmonary Hypertension: Pathophysiology and Novel Therapies», Hôpital Marie Lannelongue, Le Plessis-Robinson, France.,Assistance Publique - Hôpitaux de Paris (AP-HP), Department of Respiratory and Intensive Care Medicine, Pulmonary Hypertension National Referral Center, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
| | - Marc Humbert
- Université Paris-Saclay, School of Medicine, Le Kremlin-Bicêtre, France.,INSERM UMR_S 999 «Pulmonary Hypertension: Pathophysiology and Novel Therapies», Hôpital Marie Lannelongue, Le Plessis-Robinson, France.,Assistance Publique - Hôpitaux de Paris (AP-HP), Department of Respiratory and Intensive Care Medicine, Pulmonary Hypertension National Referral Center, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
| | - Olivier Sitbon
- Université Paris-Saclay, School of Medicine, Le Kremlin-Bicêtre, France.,INSERM UMR_S 999 «Pulmonary Hypertension: Pathophysiology and Novel Therapies», Hôpital Marie Lannelongue, Le Plessis-Robinson, France.,Assistance Publique - Hôpitaux de Paris (AP-HP), Department of Respiratory and Intensive Care Medicine, Pulmonary Hypertension National Referral Center, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
| | - Laurent Savale
- Université Paris-Saclay, School of Medicine, Le Kremlin-Bicêtre, France .,INSERM UMR_S 999 «Pulmonary Hypertension: Pathophysiology and Novel Therapies», Hôpital Marie Lannelongue, Le Plessis-Robinson, France.,Assistance Publique - Hôpitaux de Paris (AP-HP), Department of Respiratory and Intensive Care Medicine, Pulmonary Hypertension National Referral Center, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
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11
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Parent F, Preda M, Seferian A. [Prevention of venous thromboembolism in patients with cancer]. Rev Prat 2022; 72:281-285. [PMID: 35638952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
"Prevention of venous thromboembolism in patients with cancer Risk of venous thromboembolism (vte) is elevated in cancer and leads to high mor¬bidity and mortality in this population. Drug prophylaxis is questionable, due hemor¬rhagic risk in these patients, and explains the importance of selecting high risk popu¬lation, depending on the type of cancer and on individual risk factors for thrombosis. While the indications for prevention are well established during hospitalization for an acute condition and during cancer surgery, mostly with low molecular weight heparin, questions persist as to the indication of prophylaxis for outpatients receiving chemo¬therapy, and to the place of direct oral anticoagulant in this indication."
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Affiliation(s)
- Florence Parent
- Service de pneumologie et soins intensifs respiratoires, hôpital Bicêtre, AP-HP, Inserm UMR_S 999, Le Kremlin-Bicêtre, France
| | - Mariana Preda
- Service de pneumologie et soins intensifs respiratoires, hôpital Bicêtre, AP-HP, Inserm UMR_S 999, Le Kremlin-Bicêtre, France
| | - Andrei Seferian
- Service de pneumologie et soins intensifs respiratoires, hôpital Bicêtre, AP-HP, Inserm UMR_S 999, Le Kremlin-Bicêtre, France
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12
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Jutant E, Meyrignac O, Beurnier A, Jais X, Pham T, Morin L, Boucly A, Bulifon S, Samy F, Harrois A, Jevnikar M, Noël N, Pichon J, Roche A, Seferian A, Soliman S, Duranteau J, Becquemont L, Monnet X, Sitbon O, Bellin M, Humbert M, Savale L, Montani D. Symptômes respiratoires et anomalies radiologiques dans le COVID long. Revue des Maladies Respiratoires Actualités 2022. [PMCID: PMC8709679 DOI: 10.1016/j.rmra.2021.11.203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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13
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Jutant EM, Meyrignac O, Beurnier A, Jaïs X, Pham T, Morin L, Boucly A, Bulifon S, Figueiredo S, Harrois A, Jevnikar M, Noël N, Pichon J, Roche A, Seferian A, Soliman S, Duranteau J, Becquemont L, Monnet X, Sitbon O, Bellin MF, Humbert M, Savale L, Montani D. Respiratory symptoms and radiologic findings in post-acute COVID-19 syndrome. ERJ Open Res 2021; 8:00479-2021. [PMID: 35445129 PMCID: PMC8685862 DOI: 10.1183/23120541.00479-2021] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Accepted: 10/27/2021] [Indexed: 01/08/2023] Open
Abstract
Rationale The characteristics of patients with respiratory complaints and/or lung
radiologic abnormalities after hospitalisation for coronavirus disease 2019
(COVID-19) are unknown. The objectives were to determine their
characteristics and the relationships between dyspnoea, radiologic
abnormalities and functional impairment. Methods In the COMEBAC (Consultation Multi-Expertise de Bicêtre Après
COVID-19) cohort study, 478 hospital survivors were evaluated by telephone
4 months after hospital discharge, and 177 who had been hospitalised
in an intensive care unit (ICU) or presented relevant symptoms underwent an
ambulatory evaluation. New-onset dyspnoea and cough were evaluated, and the
results of pulmonary function tests and high-resolution computed tomography
of the chest were collected. Results Among the 478 patients, 78 (16.3%) reported new-onset dyspnoea, and 23
(4.8%) new-onset cough. The patients with new-onset dyspnoea were
younger (56.1±12.3 versus
61.9±16.6 years), had more severe COVID-19 (ICU admission
56.4% versus 24.5%) and more frequent
pulmonary embolism (18.0% versus 6.8%) (all
p≤0.001) than patients without dyspnoea. Among the patients
reassessed at the ambulatory care visit, the prevalence of fibrotic lung
lesions was 19.3%, with extent <25% in 97% of
the patients. The patients with fibrotic lesions were older (61±11
versus 56±14 years, p=0.03), more
frequently managed in an ICU (87.9 versus 47.4%,
p<0.001), had lower total lung capacity (74.1±13.7
versus 84.9±14.8% pred, p<0.001)
and diffusing capacity of the lung for carbon monoxide
(DLCO) (73.3±17.9
versus 89.7±22.8% pred, p<0.001).
The combination of new-onset dyspnoea, fibrotic lesions and
DLCO <70% pred was observed in
eight out of 478 patients. Conclusions New-onset dyspnoea and mild fibrotic lesions were frequent at
4 months, but the association of new-onset dyspnoea, fibrotic lesions
and low DLCO was rare. New-onset dyspnoea is a frequent complaint 4 months after #COVID19
and is generally multifactorial, and the combination of new-onset dyspnoea,
fibrotic lesions and DLCO <70%
pred is rarely observedhttps://bit.ly/3q4hyyM
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Lilien C, Reyngoudt H, Seferian A, Gidaro T, Annoussamy M, Chê V, Decostre V, Ledoux I, Louër JL, Guemas E, Muntoni F, Hogrel J, Carlier P, Servais L. CLINICAL RESEARCH. Neuromuscul Disord 2021. [DOI: 10.1016/j.nmd.2021.07.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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15
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Shieh P, Kuntz N, Dowling J, Müller-Felber W, Blaschek A, Bönnemann C, Foley R, Saade D, Seferian A, Servais L, Lawlor M, Noursalehi M, Prasad S, Rico S, Miller W. CLINICAL TRIAL HIGHLIGHTS. Neuromuscul Disord 2021. [DOI: 10.1016/j.nmd.2021.07.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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16
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Besson FL, Fernandez B, Faure S, Mercier O, Seferian A, Mussot S, Levy A, Parent F, Bulifon S, Jais X, Montani D, Mitilian D, Fadel E, Planchard D, Ghigna-Bellinzoni MR, Comtat C, Lebon V, Durand E. Fully Integrated Quantitative Multiparametric Analysis of Non-Small Cell Lung Cancer at 3-T PET/MRI: Toward One-Stop-Shop Tumor Biological Characterization at the Supervoxel Level. Clin Nucl Med 2021; 46:e440-e447. [PMID: 34374682 DOI: 10.1097/rlu.0000000000003680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
INTRODUCTION The aim of this study was to study the feasibility of a fully integrated multiparametric imaging framework to characterize non-small cell lung cancer (NSCLC) at 3-T PET/MRI. PATIENTS AND METHODS An 18F-FDG PET/MRI multiparametric imaging framework was developed and prospectively applied to 11 biopsy-proven NSCLC patients. For each tumor, 12 parametric maps were generated, including PET full kinetic modeling, apparent diffusion coefficient, T1/T2 relaxation times, and DCE full kinetic modeling. Gaussian mixture model-based clustering was applied at the whole data set level to define supervoxels of similar multidimensional PET/MRI behaviors. Taking the multidimensional voxel behaviors as input and the supervoxel class as output, machine learning procedure was finally trained and validated voxelwise to reveal the dominant PET/MRI characteristics of these supervoxels at the whole data set and individual tumor levels. RESULTS The Gaussian mixture model-based clustering clustering applied at the whole data set level (17,316 voxels) found 3 main multidimensional behaviors underpinned by the 12 PET/MRI quantitative parameters. Four dominant PET/MRI parameters of clinical relevance (PET: k2, k3 and DCE: ve, vp) predicted the overall supervoxel behavior with 97% of accuracy (SD, 0.7; 10-fold cross-validation). At the individual tumor level, these dimensionality-reduced supervoxel maps showed mean discrepancy of 16.7% compared with the original ones. CONCLUSIONS One-stop-shop PET/MRI multiparametric quantitative analysis of NSCLC is clinically feasible. Both PET and MRI parameters are useful to characterize the behavior of tumors at the supervoxel level. In the era of precision medicine, the full capabilities of PET/MRI would give further insight of the characterization of NSCLC behavior, opening new avenues toward image-based personalized medicine in this field.
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Affiliation(s)
| | | | - Sylvain Faure
- Laboratoire de Mathématiques d'Orsay, CNRS, Université Paris-Saclay, Orsay
| | - Olaf Mercier
- Department of Thoracic and Vascular Surgery and Heart-Lung Transplantation, Marie Lannelongue Hospital
| | | | - Sacha Mussot
- Department of Thoracic and Vascular Surgery and Heart-Lung Transplantation, Marie Lannelongue Hospital
| | | | | | | | | | | | - Delphine Mitilian
- Department of Thoracic and Vascular Surgery and Heart-Lung Transplantation, Marie Lannelongue Hospital
| | - Elie Fadel
- Department of Thoracic and Vascular Surgery and Heart-Lung Transplantation, Marie Lannelongue Hospital
| | - David Planchard
- Oncology, Institut d'Oncologie Thoracique, Gustave Roussy, Université Paris Saclay, Villejuif
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Jevnikar M, Sanchez O, Chocron R, Andronikof M, Raphael M, Meyrignac O, Fournier L, Montani D, Planquette B, Soudani M, Boucly A, Pichon J, Preda M, Beurnier A, Bulifon S, Seferian A, Jaïs X, Sitbon O, Savale L, Humbert M, Parent F. Prevalence of pulmonary embolism in patients with COVID-19 at the time of hospital admission. Eur Respir J 2021; 58:13993003.00116-2021. [PMID: 33692122 PMCID: PMC7947356 DOI: 10.1183/13993003.00116-2021] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2020] [Accepted: 02/28/2021] [Indexed: 01/30/2023]
Abstract
A high prevalence of venous thromboembolism (VTE) has been reported during intensive care unit (ICU) hospitalisation in patients with severe coronavirus disease 2019 (COVID-19) [1, 2]. In most cases, the diagnosis of pulmonary embolism (PE) was incidental as patients underwent computed tomography pulmonary angiography (CTPA) for aggravation of their respiratory condition. Higher mortality is also described in patients with high D-dimer levels suggesting that VTE complication may contribute to unfavourable prognosis [3, 4]. Even though, prevalence of thromboembolic complications during ICU hospitalisation seems to be high, the prevalence of pulmonary embolism at hospital admission for COVID-19 is unknown and may be underestimated. There is a high prevalence of pulmonary embolism in patients with COVID-19 at the time of hospital admissionhttps://bit.ly/3reaLjv
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Affiliation(s)
- Mitja Jevnikar
- Université Paris-Saclay, Faculty of Medicine, Le Kremlin-Bicêtre, France.,INSERM UMR_S 999, Le Kremlin-Bicêtre, France.,AP-HP, Service de Pneumologie et soins intensifs respiratoires, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
| | - Olivier Sanchez
- AP-HP, Service de Pneumologie et Soins Intensifs, Hôpital Européen Georges Pompidou, Paris, France.,INSERM UMR-S 1140; Paris, France and INNOVTE, St-Etienne, France.,Université Paris Descartes, Faculty of Medicine, Paris, France
| | - Richard Chocron
- Université Paris Descartes, Faculty of Medicine, Paris, France.,AP-HP, Service d'Urgence, Hôpital Européen Georges Pompidou, Paris, France
| | - Marc Andronikof
- Université Paris-Saclay, Faculty of Medicine, Le Kremlin-Bicêtre, France.,AP-HP, Service d'Urgenc, Hôpital Antoine Béclère, Clamart, France
| | - Maurice Raphael
- Université Paris-Saclay, Faculty of Medicine, Le Kremlin-Bicêtre, France.,AP-HP, Service d'Urgence, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
| | - Olivier Meyrignac
- Université Paris-Saclay, Faculty of Medicine, Le Kremlin-Bicêtre, France.,AP-HP, Service de Radiologie, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
| | - Laure Fournier
- Université Paris Descartes, Faculty of Medicine, Paris, France.,AP-HP, Service de Radiologie, Hôpital Européen Georges Pompidou, Paris, France
| | - David Montani
- Université Paris-Saclay, Faculty of Medicine, Le Kremlin-Bicêtre, France.,INSERM UMR_S 999, Le Kremlin-Bicêtre, France.,AP-HP, Service de Pneumologie et soins intensifs respiratoires, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
| | - Benjamin Planquette
- AP-HP, Service de Pneumologie et Soins Intensifs, Hôpital Européen Georges Pompidou, Paris, France.,INSERM UMR-S 1140; Paris, France and INNOVTE, St-Etienne, France.,Université Paris Descartes, Faculty of Medicine, Paris, France
| | - Mary Soudani
- Université Paris-Saclay, Faculty of Medicine, Le Kremlin-Bicêtre, France.,AP-HP, Service de gériatrie, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
| | - Athénaïs Boucly
- Université Paris-Saclay, Faculty of Medicine, Le Kremlin-Bicêtre, France.,INSERM UMR_S 999, Le Kremlin-Bicêtre, France.,AP-HP, Service de Pneumologie et soins intensifs respiratoires, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
| | - Jeremie Pichon
- Université Paris-Saclay, Faculty of Medicine, Le Kremlin-Bicêtre, France.,INSERM UMR_S 999, Le Kremlin-Bicêtre, France.,AP-HP, Service de Pneumologie et soins intensifs respiratoires, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
| | - Mariana Preda
- Université Paris-Saclay, Faculty of Medicine, Le Kremlin-Bicêtre, France.,INSERM UMR_S 999, Le Kremlin-Bicêtre, France.,AP-HP, Service de Pneumologie et soins intensifs respiratoires, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
| | - Antoine Beurnier
- Université Paris-Saclay, Faculty of Medicine, Le Kremlin-Bicêtre, France.,INSERM UMR_S 999, Le Kremlin-Bicêtre, France.,AP-HP, Service de physiologie et d'explorations fonctionnelles respiratoires (CRISALIS/F-CRIN network), Hôpital Bicêtre, Le Kremlin-Bicêtre, France
| | - Sophie Bulifon
- Université Paris-Saclay, Faculty of Medicine, Le Kremlin-Bicêtre, France.,INSERM UMR_S 999, Le Kremlin-Bicêtre, France.,AP-HP, Service de Pneumologie et soins intensifs respiratoires, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
| | - Andrei Seferian
- Université Paris-Saclay, Faculty of Medicine, Le Kremlin-Bicêtre, France.,INSERM UMR_S 999, Le Kremlin-Bicêtre, France.,AP-HP, Service de Pneumologie et soins intensifs respiratoires, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
| | - Xavier Jaïs
- Université Paris-Saclay, Faculty of Medicine, Le Kremlin-Bicêtre, France.,INSERM UMR_S 999, Le Kremlin-Bicêtre, France.,AP-HP, Service de Pneumologie et soins intensifs respiratoires, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
| | - Olivier Sitbon
- Université Paris-Saclay, Faculty of Medicine, Le Kremlin-Bicêtre, France.,INSERM UMR_S 999, Le Kremlin-Bicêtre, France.,AP-HP, Service de Pneumologie et soins intensifs respiratoires, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
| | - Laurent Savale
- Université Paris-Saclay, Faculty of Medicine, Le Kremlin-Bicêtre, France.,INSERM UMR_S 999, Le Kremlin-Bicêtre, France.,AP-HP, Service de Pneumologie et soins intensifs respiratoires, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
| | - Marc Humbert
- Université Paris-Saclay, Faculty of Medicine, Le Kremlin-Bicêtre, France.,INSERM UMR_S 999, Le Kremlin-Bicêtre, France.,AP-HP, Service de Pneumologie et soins intensifs respiratoires, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
| | - Florence Parent
- Université Paris-Saclay, Faculty of Medicine, Le Kremlin-Bicêtre, France.,INSERM UMR_S 999, Le Kremlin-Bicêtre, France.,AP-HP, Service de Pneumologie et soins intensifs respiratoires, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
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Boucly A, Savale L, Jaïs X, Bauer F, Bergot E, Bertoletti L, Beurnier A, Bourdin A, Bouvaist H, Bulifon S, Chabanne C, Chaouat A, Cottin V, Dauphin C, Degano B, De Groote P, Favrolt N, Feng Y, Horeau-Langlard D, Jevnikar M, Jutant EM, Liang Z, Magro P, Mauran P, Moceri P, Mornex JF, Palat S, Parent F, Picard F, Pichon J, Poubeau P, Prévot G, Renard S, Reynaud-Gaubert M, Riou M, Roblot P, Sanchez O, Seferian A, Tromeur C, Weatherald J, Simonneau G, Montani D, Humbert M, Sitbon O. Association Between Initial Treatment Strategy and Long-term Survival in Pulmonary Arterial Hypertension. Am J Respir Crit Care Med 2021; 204:842-854. [PMID: 34185620 DOI: 10.1164/rccm.202009-3698oc] [Citation(s) in RCA: 80] [Impact Index Per Article: 26.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Rationale: The relationship between initial treatment strategy and survival in pulmonary arterial hypertension (PAH) remains uncertain. Objectives: To evaluate long-term survival in PAH according to initial treatment strategy. Methods: Retrospective analysis of incident patients with idiopathic, heritable or anorexigen-induced PAH enrolled in the French Registry (01/2006 to 12/2018). Survival was assessed according to initial strategy: monotherapy, dual or triple combination (two oral medications and a parenteral prostacyclin). Results: Among 1611 enrolled patients, 984 were initiated with monotherapy, 551 with dual and 76 with triple therapy. The triple combination group was younger with fewer comorbidities but higher mortality risk. Survival was better with triple therapy (91% at 5 years) as compared to dual or monotherapy (both 61% at 5 years), p<0.001. A propensity score matching on age, sex and pulmonary vascular resistance also showed significant differences between triple and dual therapy (10-year survival 85% vs 65%). In high-risk patients (n=243), survival was better with triple therapy vs monotherapy or dual therapy, while there was no difference between monotherapy and double therapy. In intermediate-risk patients (n=1134), survival improved with increasing number of therapies. In multivariable Cox regression, triple therapy was independently associated with a lower risk of death (hazard ratio 0.29, 95% confidence interval 0.11-0.80, p=0.017). Among the 148 patients initiated with a parenteral prostacyclin, those on triple therapy had better survival than those on monotherapy or dual therapy. Conclusions: Initial triple combination therapy including parenteral prostacyclin seems to be associated with better survival in PAH, particularly in the youngest high-risk patients.
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Affiliation(s)
- Athénaïs Boucly
- Centre Hospitalier Universitaire de Bicêtre, 41664, Service de Pneumologie et Soins Intensifs Respiratoires, Le Kremlin-Bicetre, France.,Paris-Saclay University Faculty of Medicine, 89691, Le Kremlin-Bicetre, France.,INSERM U999, 130034, Le Plessis Robinson, France
| | - Laurent Savale
- Centre Hospitalier Universitaire de Bicêtre, 41664, Service de Pneumologie et Soins Intensifs Respiratoires, Le Kremlin-Bicetre, France.,Paris-Saclay University Faculty of Medicine, 89691, Le Kremlin-Bicetre, France.,INSERM U999, 130034, Le Plessis Robinson, France
| | - Xavier Jaïs
- Centre Hospitalier Universitaire de Bicêtre, 41664, Service de Pneumologie et Soins Intensifs Respiratoires, Le Kremlin-Bicetre, France.,Paris-Saclay University Faculty of Medicine, 89691, Le Kremlin-Bicetre, France.,INSERM U999, 130034, Le Plessis Robinson, France
| | - Fabrice Bauer
- INSERM U1096, Heart Failure Clinic and Pulmonary Hypertension Center, Service de chirurgie cardiaque, Hôpital Charles Nicole, Rouen, France
| | | | - Laurent Bertoletti
- Université de Saint-Etienne, Jean Monnet; INSERM, Thrombosis Research Group, EA3065; CIC-CIE3, Saint-Etienne, France.,Centre Hospitalier Universitaire, Service de Médecine Interne et Thérapeutique, Saint-Etienne, France
| | - Antoine Beurnier
- Centre Hospitalier Universitaire de Bicêtre, 41664, Service de Physiologie, Le Kremlin-Bicetre, France.,Paris-Saclay University Faculty of Medicine, 89691, Le Kremlin-Bicetre, France.,INSERM U999, 130034, Le Plessis Robinson, France
| | - Arnaud Bourdin
- Centre Hospitalier Regional Universitaire de Montpellier, 26905, Pneumonology, Montpellier, France
| | - Hélène Bouvaist
- CHU Grenoble Alpes Service de Cardiologie, 568151, Grenoble, France
| | - Sophie Bulifon
- Centre Hospitalier Universitaire de Bicêtre, 41664, Service de Pneumologie et Soins Intensifs Respiratoires, Le Kremlin-Bicetre, France.,Paris-Saclay University Faculty of Medicine, 89691, Le Kremlin-Bicetre, France.,INSERM U999, 130034, Le Plessis Robinson, France
| | - Céline Chabanne
- CHU de Rennes, Hôpital Pontchaillou, Cardiology, Rennes, France
| | - Ari Chaouat
- Centre hospitalier régional universitaire de Nancy, 26920, Département de Pneumologie Hôpital de Brabois, Nancy, France.,Université de Lorraine, 137665, Inserm UMR_S 1116, Défaillance Cardiovasculaire Aigüe et Chronique, Faculté de Médecine de Nancy, Nancy, France
| | - Vincent Cottin
- Louis Pradel University Hospital, Respiratory Medicine, Lyon, France
| | - Claire Dauphin
- Hôpital Gabriel Montpied, 55448, Service de Cardiologie et Maladies Vasculaires, Clermont-Ferrand, France
| | - Bruno Degano
- Centre Hospitalier Universitaire Grenoble Alpes, 36724, Pneumologie-Physiologie, Grenoble, France
| | - Pascal De Groote
- CHR Lille - Hôpital cardiologique, Clinique de cardiologie, Lille, France
| | - Nicolas Favrolt
- CHU François Mitterrand, Service de Pneumologie et Soins Intensifs Respiratoires, Dijon, France
| | - Yuanchao Feng
- Libin Cardiovascular Institute of Alberta, 157745, Calgary, Alberta, Canada
| | | | - Mitja Jevnikar
- Centre Hospitalier Universitaire de Bicêtre, 41664, Service de Pneumologie et Soins Intensifs Respiratoires, Le Kremlin-Bicetre, France.,Paris-Saclay University Faculty of Medicine, 89691, Le Kremlin-Bicetre, France.,INSERM U999, 130034, Le Plessis Robinson, France
| | - Etienne-Marie Jutant
- Centre Hospitalier Universitaire de Bicêtre, 41664, Service de Pneumologie et Soins Intensifs Respiratoires, Le Kremlin-Bicetre, France.,Paris-Saclay University Faculty of Medicine, 89691, Le Kremlin-Bicetre, France.,INSERM U999, 130034, Le Plessis Robinson, France
| | - Zhiying Liang
- Libin Cardiovascular Institute of Alberta, 157745, Calgary, Alberta, Canada
| | - Pascal Magro
- CHU de Tours, service de pneumologie, Tours, France
| | - Pierre Mauran
- Paediatric and Congenital Cardiology Unit, American Memorial Hospital, CHU Reims, Reims, France
| | | | | | | | - Florence Parent
- Centre Hospitalier Universitaire de Bicêtre, 41664, Service de Pneumologie et Soins Intensifs Respiratoires, Le Kremlin-Bicetre, France.,Paris-Saclay University Faculty of Medicine, 89691, Le Kremlin-Bicetre, France.,INSERM U999, 130034, Le Plessis Robinson, France
| | | | - Jérémie Pichon
- Centre Hospitalier Universitaire de Bicêtre, 41664, Service de Pneumologie et Soins Intensifs Respiratoires, Le Kremlin-Bicetre, France.,Paris-Saclay University Faculty of Medicine, 89691, Le Kremlin-Bicetre, France.,INSERM U999, 130034, Le Plessis Robinson, France
| | - Patrice Poubeau
- CHU de La Réunion Sites Sud Saint-Pierre, 56577, Saint-Pierre, Réunion
| | | | - Sébastien Renard
- Hopital de la Timone - Deparment de Cardiologie, 375330, Marseille, France
| | | | | | - Pascal Roblot
- Department of Internal Medicine, Infectious and Tropical Diseases, Poitiers University Hospital, Poitiers, France
| | - Olivier Sanchez
- Hopital Europeen Georges Pompidou, 55647, Respiratory Unit, Paris, France
| | - Andrei Seferian
- Centre Hospitalier Universitaire de Bicêtre, 41664, Service de Pneumologie et Soins Intensifs Respiratoires, Le Kremlin-Bicetre, France.,Paris-Saclay University Faculty of Medicine, 89691, Le Kremlin-Bicetre, France.,INSERM U999, 130034, Le Plessis Robinson, France
| | - Cécile Tromeur
- CHRU de Brest, 26990, Internal Medicine and Chest Disease, Brest, France
| | | | - Gérald Simonneau
- Centre Hospitalier Universitaire de Bicêtre, 41664, Service de Pneumologie et Soins Intensifs Respiratoires, Le Kremlin-Bicetre, France.,Paris-Saclay University Faculty of Medicine, 89691, Le Kremlin-Bicetre, France.,INSERM U999, 130034, Le Plessis Robinson, France
| | - David Montani
- Centre Hospitalier Universitaire de Bicêtre, 41664, Service de Pneumologie et Soins Intensifs Respiratoires, Le Kremlin-Bicetre, France.,Paris-Saclay University Faculty of Medicine, 89691, Le Kremlin-Bicetre, France.,INSERM U999, 130034, Le Plessis Robinson, France
| | - Marc Humbert
- Centre Hospitalier Universitaire de Bicêtre, 41664, Service de Pneumologie et Soins Intensifs Respiratoires, Le Kremlin-Bicetre, France.,Paris-Saclay University Faculty of Medicine, 89691, Le Kremlin-Bicetre, France.,INSERM U999, 130034, Le Plessis Robinson, France
| | - Olivier Sitbon
- Centre Hospitalier Universitaire de Bicêtre, 41664, Service de Pneumologie et Soins Intensifs Respiratoires, Le Kremlin-Bicetre, France.,Paris-Saclay University Faculty of Medicine, 89691, Le Kremlin-Bicetre, France.,INSERM U999, 130034, Le Plessis Robinson, France;
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19
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Beurnier A, Jutant EM, Jevnikar M, Boucly A, Pichon J, Preda M, Frank M, Laurent J, Richard C, Monnet X, Duranteau J, Harrois A, Chaumais MC, Bellin MF, Noël N, Bulifon S, Jaïs X, Parent F, Seferian A, Savale L, Sitbon O, Montani D, Humbert M. Characteristics and outcomes of asthmatic patients with COVID-19 pneumonia who require hospitalisation. Eur Respir J 2020; 56:13993003.01875-2020. [PMID: 32732333 PMCID: PMC7397950 DOI: 10.1183/13993003.01875-2020] [Citation(s) in RCA: 73] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Accepted: 07/18/2020] [Indexed: 01/22/2023]
Abstract
Background Viral respiratory infections are the main causes of asthma exacerbation. The susceptibility of patients with asthma to develop an exacerbation when they present with severe pneumonia due to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is unknown. The objective of this study was to investigate the characteristics and outcomes of asthmatic patients with coronavirus disease 2019 (COVID-19) pneumonia who required hospitalisation during the spring 2020 outbreak in Paris, France. Methods A prospective cohort follow-up was carried out from 15 March to 15 April 2020 in Bicêtre Hospital, University Paris-Saclay, France. All hospitalised patients with a SARS-CoV-2 infection who reported a history of asthma were included. Results Among 768 hospitalised patients, 37 (4.8%) reported a history of asthma, which had been previously confirmed by a pulmonologist in 85% of cases. These asthmatic patients were mainly female (70%) and nonsmokers (85%), with a median age of 54 years (interquartile range (IQR) 42–67 years). None of them presented with an asthma exacerbation. 22 (59%) had major comorbidities and 31 (84%) had a body mass index ≥25 kg·m−2. The most common comorbidities were obesity (36%), hypertension (27%) and diabetes (19%). All patients had a confirmed diagnosis of COVID-19 pneumonia on computed tomography of the chest. Eosinopenia was a typical biological feature with a median count of 0 cells·mm−3 (IQR 0–0 cells·mm−3). 11 patients (30%) were admitted into the intensive care unit, with three deaths (8.1%) occurring in the context of comorbidities. Conclusion Asthma patients were not overrepresented among those with severe pneumonia due to SARS-CoV-2 infection who required hospitalisation. The worst outcomes were observed mainly in patients with major comorbidities. Asthmatic patients were not overrepresented among those with severe pneumonia due to SARS-CoV-2 infection who required hospitalisation. None presented with an asthma exacerbation. Worst outcomes were observed mainly in patients with major comorbidities.https://bit.ly/303djG6
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Affiliation(s)
- Antoine Beurnier
- Université Paris-Saclay, Faculty of Medicine, Le Kremlin-Bicêtre, France.,INSERM UMR_S 999, Le Kremlin-Bicêtre, France.,AP-HP, Service de physiologie et d'explorations fonctionnelles respiratoires (CRISALIS/F-CRIN network), Hôpital Bicêtre, Le Kremlin-Bicêtre, France
| | - Etienne-Marie Jutant
- Université Paris-Saclay, Faculty of Medicine, Le Kremlin-Bicêtre, France.,INSERM UMR_S 999, Le Kremlin-Bicêtre, France.,AP-HP, Service de pneumologie et soins intensifs respiratoires, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
| | - Mitja Jevnikar
- Université Paris-Saclay, Faculty of Medicine, Le Kremlin-Bicêtre, France.,INSERM UMR_S 999, Le Kremlin-Bicêtre, France.,AP-HP, Service de pneumologie et soins intensifs respiratoires, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
| | - Athénaïs Boucly
- Université Paris-Saclay, Faculty of Medicine, Le Kremlin-Bicêtre, France.,INSERM UMR_S 999, Le Kremlin-Bicêtre, France.,AP-HP, Service de pneumologie et soins intensifs respiratoires, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
| | - Jérémie Pichon
- Université Paris-Saclay, Faculty of Medicine, Le Kremlin-Bicêtre, France.,INSERM UMR_S 999, Le Kremlin-Bicêtre, France.,AP-HP, Service de pneumologie et soins intensifs respiratoires, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
| | - Mariana Preda
- Université Paris-Saclay, Faculty of Medicine, Le Kremlin-Bicêtre, France.,INSERM UMR_S 999, Le Kremlin-Bicêtre, France.,AP-HP, Service de pneumologie et soins intensifs respiratoires, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
| | - Marie Frank
- AP-HP, Département d'information médicale, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
| | - Jérémy Laurent
- AP-HP, Département d'information médicale, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
| | - Christian Richard
- Université Paris-Saclay, Faculty of Medicine, Le Kremlin-Bicêtre, France.,AP-HP, Service de médecine intensive-réanimation, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
| | - Xavier Monnet
- Université Paris-Saclay, Faculty of Medicine, Le Kremlin-Bicêtre, France.,AP-HP, Service de médecine intensive-réanimation, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
| | - Jacques Duranteau
- Université Paris-Saclay, Faculty of Medicine, Le Kremlin-Bicêtre, France.,AP-HP, Département d'anesthésie et réanimation, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
| | - Anatole Harrois
- Université Paris-Saclay, Faculty of Medicine, Le Kremlin-Bicêtre, France.,AP-HP, Département d'anesthésie et réanimation, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
| | - Marie-Camille Chaumais
- Université Paris-Saclay, Faculty of Medicine, Le Kremlin-Bicêtre, France.,INSERM UMR_S 999, Le Kremlin-Bicêtre, France.,AP-HP, Service de pharmacie, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
| | - Marie-France Bellin
- Université Paris-Saclay, Faculty of Medicine, Le Kremlin-Bicêtre, France.,AP-HP, Service d'imagerie médicale, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
| | - Nicolas Noël
- Université Paris-Saclay, Faculty of Medicine, Le Kremlin-Bicêtre, France.,AP-HP, Service de médecine interne, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
| | - Sophie Bulifon
- Université Paris-Saclay, Faculty of Medicine, Le Kremlin-Bicêtre, France.,INSERM UMR_S 999, Le Kremlin-Bicêtre, France.,AP-HP, Service de pneumologie et soins intensifs respiratoires, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
| | - Xavier Jaïs
- Université Paris-Saclay, Faculty of Medicine, Le Kremlin-Bicêtre, France.,INSERM UMR_S 999, Le Kremlin-Bicêtre, France.,AP-HP, Service de pneumologie et soins intensifs respiratoires, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
| | - Florence Parent
- Université Paris-Saclay, Faculty of Medicine, Le Kremlin-Bicêtre, France.,INSERM UMR_S 999, Le Kremlin-Bicêtre, France.,AP-HP, Service de pneumologie et soins intensifs respiratoires, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
| | - Andrei Seferian
- Université Paris-Saclay, Faculty of Medicine, Le Kremlin-Bicêtre, France.,INSERM UMR_S 999, Le Kremlin-Bicêtre, France.,AP-HP, Service de pneumologie et soins intensifs respiratoires, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
| | - Laurent Savale
- Université Paris-Saclay, Faculty of Medicine, Le Kremlin-Bicêtre, France.,INSERM UMR_S 999, Le Kremlin-Bicêtre, France.,AP-HP, Service de pneumologie et soins intensifs respiratoires, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
| | - Olivier Sitbon
- Université Paris-Saclay, Faculty of Medicine, Le Kremlin-Bicêtre, France.,INSERM UMR_S 999, Le Kremlin-Bicêtre, France.,AP-HP, Service de pneumologie et soins intensifs respiratoires, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
| | - David Montani
- Université Paris-Saclay, Faculty of Medicine, Le Kremlin-Bicêtre, France.,INSERM UMR_S 999, Le Kremlin-Bicêtre, France.,AP-HP, Service de pneumologie et soins intensifs respiratoires, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
| | - Marc Humbert
- Université Paris-Saclay, Faculty of Medicine, Le Kremlin-Bicêtre, France.,INSERM UMR_S 999, Le Kremlin-Bicêtre, France.,AP-HP, Service de pneumologie et soins intensifs respiratoires, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
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Hogrel J, Decostre V, Ledoux I, de Antonio M, Niks E, de Groot I, Straub V, Muntoni F, Ricotti V, Voit T, Seferian A, Gidaro T, Servais L. DMD – BIOMARKERS & OUTCOME MEASURES. Neuromuscul Disord 2020. [DOI: 10.1016/j.nmd.2020.08.132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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21
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Goff LL, Seferian A, Phelep A, Rippert P, Mathieu M, Cances C, de Lattre C, Durigneux J, Gousse G, Quijano-Roy S, Sarret C, Servais L, Vuillerot C. SMA – THERAPY. Neuromuscul Disord 2020. [DOI: 10.1016/j.nmd.2020.08.275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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22
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Lilien C, Annoussamy M, Polleur M, Seferian A, Boespflug-Tanguy O, Gorni K, Eggenspieler D, Servais L. SMA: REGISTRIES, BIOMARKERS & OUTCOME MEASURES. Neuromuscul Disord 2020. [DOI: 10.1016/j.nmd.2020.08.184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Certain MC, Chaumais MC, Jaïs X, Savale L, Seferian A, Parent F, Georges M, Favrolt N, Bourdin A, Boissin C, Cottin V, Traclet J, Renard S, Noel V, Picard F, Girerd B, Ghigna MR, Perros F, Sitbon O, Bonniaud P, Humbert M, Montani D. Characteristics and Long-term Outcomes of Pulmonary Venoocclusive Disease Induced by Mitomycin C. Chest 2020; 159:1197-1207. [PMID: 32979348 DOI: 10.1016/j.chest.2020.09.238] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Revised: 08/05/2020] [Accepted: 09/16/2020] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND Pulmonary venoocclusive disease (PVOD) is an uncommon form of pulmonary hypertension (PH) predominantly characterized by pulmonary vein and capillary involvement. An association between chemotherapy, in particular mitomycin C (MMC), and PVOD has been reported. RESEARCH QUESTION What are the characteristics of MMC-induced PVOD, and what is the prognosis for patients with MMC-induced PVOD? STUDY DESIGN AND METHODS We report the clinical, functional, radiologic, and hemodynamic characteristics at diagnosis and outcomes of patients with PVOD from the French PH Registry after exposure to MMC. The results are expressed as the median (minimum-maximum). RESULTS From June 2011 to December 2018, 17 incident cases of MMC-induced PVOD were identified. At diagnosis, these patients had severe clinical and functional impairment, with 12 patients having a New York Heart Association (NYHA) functional class of III or IV and a 6-min walk distance of 220 (0-465) m. Right heart catheterization confirmed severe precapillary PH with a mean pulmonary artery pressure of 38 (30-52) mm Hg, a cardiac index of 2.2 (1.5-4) L/(min × m2), and pulmonary vascular resistance of 8.3 (5.1-14.5) Wood units. The diffusing capacity of the lungs for carbon monoxide was markedly decreased at 31% (20%-51%) of the theoretical values associated with severe hypoxemia. MMC was withdrawn for all patients, and 14 patients received specific pulmonary arterial hypertension (PAH) therapies. Among these patients, mild but statistically insignificant improvements were observed in NYHA functional class (P = .10), 6-min walk distance (P = .09), and pulmonary vascular resistance (-4.7 Wood units; P = .052) at reassessment (median delay of 4.8 months). Three patients experienced pulmonary edema requiring the cessation or reduction of PAH treatment. The median overall survival was 20 months, and the 6-, 12-, and 24-month survival rates were 76%, 58%, and 18%, respectively. INTERPRETATION PVOD after MMC treatment is a rare but life-threatening complication associated with a poor prognosis despite MMC withdrawal and PAH-specific therapy.
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Affiliation(s)
- Marie-Caroline Certain
- Department of Respiratory and Intensive Care Medicine, National French Reference Constitutive Center for Rare Pulmonary Diseases, Hôpital François Mitterrand, Burgundy University Hospital, Dijon, France
| | - Marie-Camille Chaumais
- INSERM UMR_S 999 "Pulmonary Hypertension: Pathophysiology and Novel Therapies", Hôpital Marie Lannelongue, Le Plessis-Robinson, France; Assistance Publique-Hôpitaux de Paris (AP-HP), Department of Pharmacy, Hôpital Bicêtre, Le Kremlin-Bicêtre, France; University of Paris-Saclay, Faculty of Pharmacy, Châtenay Malabry, France
| | - Xavier Jaïs
- INSERM UMR_S 999 "Pulmonary Hypertension: Pathophysiology and Novel Therapies", Hôpital Marie Lannelongue, Le Plessis-Robinson, France; AP-HP, Department of Respiratory and Intensive Care Medicine, Pulmonary Hypertension National Referral Center, Hôpital Bicêtre, Le Kremlin-Bicêtre, France; University of Paris-Saclay, School of Medicine, Le Kremlin-Bicêtre, France
| | - Laurent Savale
- INSERM UMR_S 999 "Pulmonary Hypertension: Pathophysiology and Novel Therapies", Hôpital Marie Lannelongue, Le Plessis-Robinson, France; AP-HP, Department of Respiratory and Intensive Care Medicine, Pulmonary Hypertension National Referral Center, Hôpital Bicêtre, Le Kremlin-Bicêtre, France; University of Paris-Saclay, School of Medicine, Le Kremlin-Bicêtre, France
| | - Andrei Seferian
- AP-HP, Department of Respiratory and Intensive Care Medicine, Pulmonary Hypertension National Referral Center, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
| | - Florence Parent
- AP-HP, Department of Respiratory and Intensive Care Medicine, Pulmonary Hypertension National Referral Center, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
| | - Marjolaine Georges
- Department of Respiratory and Intensive Care Medicine, National French Reference Constitutive Center for Rare Pulmonary Diseases, Hôpital François Mitterrand, Burgundy University Hospital, Dijon, France; University of Bourgogne Franche-Comté, School of Medicine, Dijon, France; INSERM UMR 123-1, LNC Faculty of Medicine and Pharmacy, Dijon, France
| | - Nicolas Favrolt
- Department of Respiratory and Intensive Care Medicine, National French Reference Constitutive Center for Rare Pulmonary Diseases, Hôpital François Mitterrand, Burgundy University Hospital, Dijon, France
| | - Arnaud Bourdin
- Department of Respiratory Diseases, Hôpital Arnaud de Villeneuve, Montpellier University Hospitals, Montpellier, France; University of Montpellier, School of Medicine, Montpellier, France; INSERM U1046, Montpellier, France
| | - Clément Boissin
- Department of Respiratory Diseases, Hôpital Arnaud de Villeneuve, Montpellier University Hospitals, Montpellier, France
| | - Vincent Cottin
- Department of Respiratory Medicine, National Coordinating Reference Center for Rare Pulmonary Diseases, Hôpital Louis Pradel, Lyon, France; Claude-Bernard Lyon 1 University, University of Lyon, INRA, UMR754, Lyon, France; UMR 754, Lyon, France
| | - Julie Traclet
- Department of Respiratory Medicine, National Coordinating Reference Center for Rare Pulmonary Diseases, Hôpital Louis Pradel, Lyon, France
| | - Sébastien Renard
- Department of Cardiology, Assistance Publique-Hôpitaux de Marseille (AP-HM), Hôpital de la Timone, Aix-Marseille University, Marseille, France
| | - Violaine Noel
- Internal Medicine Department, Hôpital Robert-Debré, Reims, France
| | - François Picard
- Department of Cardiology, University Hospital of Bordeaux, Bordeaux, France
| | - Barbara Girerd
- INSERM UMR_S 999 "Pulmonary Hypertension: Pathophysiology and Novel Therapies", Hôpital Marie Lannelongue, Le Plessis-Robinson, France; AP-HP, Department of Respiratory and Intensive Care Medicine, Pulmonary Hypertension National Referral Center, Hôpital Bicêtre, Le Kremlin-Bicêtre, France; University of Paris-Saclay, School of Medicine, Le Kremlin-Bicêtre, France
| | - Maria-Rosa Ghigna
- Department of Pathology, Hôpital Marie Lannelongue, Le Plessis-Robinson, France
| | - Frédéric Perros
- INSERM UMR_S 999 "Pulmonary Hypertension: Pathophysiology and Novel Therapies", Hôpital Marie Lannelongue, Le Plessis-Robinson, France
| | - Olivier Sitbon
- INSERM UMR_S 999 "Pulmonary Hypertension: Pathophysiology and Novel Therapies", Hôpital Marie Lannelongue, Le Plessis-Robinson, France; AP-HP, Department of Respiratory and Intensive Care Medicine, Pulmonary Hypertension National Referral Center, Hôpital Bicêtre, Le Kremlin-Bicêtre, France; University of Paris-Saclay, School of Medicine, Le Kremlin-Bicêtre, France
| | - Philippe Bonniaud
- Department of Respiratory and Intensive Care Medicine, National French Reference Constitutive Center for Rare Pulmonary Diseases, Hôpital François Mitterrand, Burgundy University Hospital, Dijon, France; University of Bourgogne Franche-Comté, School of Medicine, Dijon, France; INSERM UMR 123-1, LNC Faculty of Medicine and Pharmacy, Dijon, France
| | - Marc Humbert
- INSERM UMR_S 999 "Pulmonary Hypertension: Pathophysiology and Novel Therapies", Hôpital Marie Lannelongue, Le Plessis-Robinson, France; AP-HP, Department of Respiratory and Intensive Care Medicine, Pulmonary Hypertension National Referral Center, Hôpital Bicêtre, Le Kremlin-Bicêtre, France; University of Paris-Saclay, School of Medicine, Le Kremlin-Bicêtre, France
| | - David Montani
- INSERM UMR_S 999 "Pulmonary Hypertension: Pathophysiology and Novel Therapies", Hôpital Marie Lannelongue, Le Plessis-Robinson, France; AP-HP, Department of Respiratory and Intensive Care Medicine, Pulmonary Hypertension National Referral Center, Hôpital Bicêtre, Le Kremlin-Bicêtre, France; University of Paris-Saclay, School of Medicine, Le Kremlin-Bicêtre, France.
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24
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Besson FL, Fernandez B, Faure S, Mercier O, Seferian A, Mignard X, Mussot S, le Pechoux C, Caramella C, Botticella A, Levy A, Parent F, Bulifon S, Montani D, Mitilian D, Fadel E, Planchard D, Besse B, Ghigna-Bellinzoni MR, Comtat C, Lebon V, Durand E. 18F-FDG PET and DCE kinetic modeling and their correlations in primary NSCLC: first voxel-wise correlative analysis of human simultaneous [18F]FDG PET-MRI data. EJNMMI Res 2020; 10:88. [PMID: 32734484 PMCID: PMC7392998 DOI: 10.1186/s13550-020-00671-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Accepted: 07/14/2020] [Indexed: 02/07/2023] Open
Abstract
OBJECTIVES To decipher the correlations between PET and DCE kinetic parameters in non-small-cell lung cancer (NSCLC), by using voxel-wise analysis of dynamic simultaneous [18F]FDG PET-MRI. MATERIAL AND METHODS Fourteen treatment-naïve patients with biopsy-proven NSCLC prospectively underwent a 1-h dynamic [18F]FDG thoracic PET-MRI scan including DCE. The PET and DCE data were normalized to their corresponding T1-weighted MR morphological space, and tumors were masked semi-automatically. Voxel-wise parametric maps of PET and DCE kinetic parameters were computed by fitting the dynamic PET and DCE tumor data to the Sokoloff and Extended Tofts models respectively, by using in-house developed procedures. Curve-fitting errors were assessed by computing the relative root mean square error (rRMSE) of the estimated PET and DCE signals at the voxel level. For each tumor, Spearman correlation coefficients (rs) between all the pairs of PET and DCE kinetic parameters were estimated on a voxel-wise basis, along with their respective bootstrapped 95% confidence intervals (n = 1000 iterations). RESULTS Curve-fitting metrics provided fit errors under 20% for almost 90% of the PET voxels (median rRMSE = 10.3, interquartile ranges IQR = 8.1; 14.3), whereas 73.3% of the DCE voxels showed fit errors under 45% (median rRMSE = 31.8%, IQR = 22.4; 46.6). The PET-PET, DCE-DCE, and PET-DCE voxel-wise correlations varied according to individual tumor behaviors. Beyond this wide variability, the PET-PET and DCE-DCE correlations were mainly high (absolute rs values > 0.7), whereas the PET-DCE correlations were mainly low to moderate (absolute rs values < 0.7). Half the tumors showed a hypometabolism with low perfused/vascularized profile, a hallmark of hypoxia, and tumor aggressiveness. CONCLUSION A dynamic "one-stop shop" procedure applied to NSCLC is technically feasible in clinical practice. PET and DCE kinetic parameters assessed simultaneously are not highly correlated in NSCLC, and these correlations showed a wide variability among tumors and patients. These results tend to suggest that PET and DCE kinetic parameters might provide complementary information. In the future, this might make PET-MRI a unique tool to characterize the individual tumor biological behavior in NSCLC.
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Affiliation(s)
- Florent L Besson
- Université Paris-Saclay, CEA, CNRS, Inserm, BioMAPs, 91401, Orsay, France.
- Department of Biophysics and Nuclear Medicine-Molecular Imaging, Hôpitaux Universitaires Paris-Saclay, Assistance Publique-Hôpitaux de Paris, CHU Bicêtre, 94270, Le Kremlin-Bicêtre, France.
- School of Medicine, Université Paris-Saclay, Le Kremlin-Bicêtre, France.
| | | | - Sylvain Faure
- Laboratoire de Mathématiques d'Orsay, CNRS, Université Paris-Saclay, 91405, Orsay, France
| | - Olaf Mercier
- Department of Thoracic and Vascular Surgery and Heart-Lung Transplantation, Marie Lannelongue Hospital, 92350, Le Plessis Robinson, France
| | - Andrei Seferian
- Service de Pneumologie, Centre de Référence de l'Hypertension Pulmonaire, Hôpitaux Universitaires Paris-Saclay, Assistance Publique-Hôpitaux de Paris, 94270, Le Kremlin-Bicêtre, France
- Inserm UMR_S999, Marie Lannelongue Hospital, 92350, Le Plessis Robinson, France
| | - Xavier Mignard
- Service de Pneumologie, Centre de Référence de l'Hypertension Pulmonaire, Hôpitaux Universitaires Paris-Saclay, Assistance Publique-Hôpitaux de Paris, 94270, Le Kremlin-Bicêtre, France
| | - Sacha Mussot
- Department of Thoracic and Vascular Surgery and Heart-Lung Transplantation, Marie Lannelongue Hospital, 92350, Le Plessis Robinson, France
| | - Cecile le Pechoux
- Department of Radiation Oncology, Institut d'Oncologie Thoracique (IOT), Gustave Roussy, Université Paris Saclay, Villejuif, France
| | - Caroline Caramella
- Department of Radiology, Institut d'Oncologie Thoracique (IOT), Gustave Roussy, Université Paris Saclay, Villejuif, France
| | - Angela Botticella
- Department of Radiation Oncology, Institut d'Oncologie Thoracique (IOT), Gustave Roussy, Université Paris Saclay, Villejuif, France
| | - Antonin Levy
- Department of Radiation Oncology, Institut d'Oncologie Thoracique (IOT), Gustave Roussy, Université Paris Saclay, Villejuif, France
| | - Florence Parent
- Service de Pneumologie, Centre de Référence de l'Hypertension Pulmonaire, Hôpitaux Universitaires Paris-Saclay, Assistance Publique-Hôpitaux de Paris, 94270, Le Kremlin-Bicêtre, France
- Inserm UMR_S999, Marie Lannelongue Hospital, 92350, Le Plessis Robinson, France
| | - Sophie Bulifon
- Service de Pneumologie, Centre de Référence de l'Hypertension Pulmonaire, Hôpitaux Universitaires Paris-Saclay, Assistance Publique-Hôpitaux de Paris, 94270, Le Kremlin-Bicêtre, France
- Inserm UMR_S999, Marie Lannelongue Hospital, 92350, Le Plessis Robinson, France
| | - David Montani
- Service de Pneumologie, Centre de Référence de l'Hypertension Pulmonaire, Hôpitaux Universitaires Paris-Saclay, Assistance Publique-Hôpitaux de Paris, 94270, Le Kremlin-Bicêtre, France
- Inserm UMR_S999, Marie Lannelongue Hospital, 92350, Le Plessis Robinson, France
| | - Delphine Mitilian
- Department of Thoracic and Vascular Surgery and Heart-Lung Transplantation, Marie Lannelongue Hospital, 92350, Le Plessis Robinson, France
| | - Elie Fadel
- Department of Thoracic and Vascular Surgery and Heart-Lung Transplantation, Marie Lannelongue Hospital, 92350, Le Plessis Robinson, France
| | - David Planchard
- Department of Oncology, Institut d'Oncologie Thoracique (IOT), Gustave Roussy, Université Paris Saclay, Villejuif, France
| | - Benjamin Besse
- Department of Oncology, Institut d'Oncologie Thoracique (IOT), Gustave Roussy, Université Paris Saclay, Villejuif, France
| | | | - Claude Comtat
- Université Paris-Saclay, CEA, CNRS, Inserm, BioMAPs, 91401, Orsay, France
- School of Medicine, Université Paris-Saclay, Le Kremlin-Bicêtre, France
| | - Vincent Lebon
- Université Paris-Saclay, CEA, CNRS, Inserm, BioMAPs, 91401, Orsay, France
- School of Medicine, Université Paris-Saclay, Le Kremlin-Bicêtre, France
| | - Emmanuel Durand
- Université Paris-Saclay, CEA, CNRS, Inserm, BioMAPs, 91401, Orsay, France
- Department of Biophysics and Nuclear Medicine-Molecular Imaging, Hôpitaux Universitaires Paris-Saclay, Assistance Publique-Hôpitaux de Paris, CHU Bicêtre, 94270, Le Kremlin-Bicêtre, France
- School of Medicine, Université Paris-Saclay, Le Kremlin-Bicêtre, France
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25
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Jevnikar M, Montani D, Savale L, Seferian A, Jutant EM, Boucly A, Preda M, Weatherald J, Bulifon S, Parent F, Brenot P, Fadel E, Sitbon O, Simonneau G, Humbert M, Jaïs X. Chronic thromboembolic pulmonary hypertension and totally implantable central venous access systems. Eur Respir J 2020; 57:13993003.02208-2020. [PMID: 32675214 DOI: 10.1183/13993003.02208-2020] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2020] [Accepted: 07/09/2020] [Indexed: 11/05/2022]
Affiliation(s)
- Mitja Jevnikar
- Université Paris-Saclay, Faculty of Medicine, Le Kremlin-Bicêtre, France.,INSERM UMR_S 999, "Pulmonary Hypertension: Pathophysiology and Novel Therapies", Hôpital Marie Lannelongue, Le Plessis-Robinson, France.,Assistance Publique - Hôpitaux de Paris (AP-HP), Dept of Respiratory and Intensive Care Medicine, Pulmonary Hypertension National Referral Center, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
| | - David Montani
- Université Paris-Saclay, Faculty of Medicine, Le Kremlin-Bicêtre, France.,INSERM UMR_S 999, "Pulmonary Hypertension: Pathophysiology and Novel Therapies", Hôpital Marie Lannelongue, Le Plessis-Robinson, France.,Assistance Publique - Hôpitaux de Paris (AP-HP), Dept of Respiratory and Intensive Care Medicine, Pulmonary Hypertension National Referral Center, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
| | - Laurent Savale
- Université Paris-Saclay, Faculty of Medicine, Le Kremlin-Bicêtre, France.,INSERM UMR_S 999, "Pulmonary Hypertension: Pathophysiology and Novel Therapies", Hôpital Marie Lannelongue, Le Plessis-Robinson, France.,Assistance Publique - Hôpitaux de Paris (AP-HP), Dept of Respiratory and Intensive Care Medicine, Pulmonary Hypertension National Referral Center, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
| | - Andrei Seferian
- Université Paris-Saclay, Faculty of Medicine, Le Kremlin-Bicêtre, France.,INSERM UMR_S 999, "Pulmonary Hypertension: Pathophysiology and Novel Therapies", Hôpital Marie Lannelongue, Le Plessis-Robinson, France.,Assistance Publique - Hôpitaux de Paris (AP-HP), Dept of Respiratory and Intensive Care Medicine, Pulmonary Hypertension National Referral Center, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
| | - Etienne-Marie Jutant
- Université Paris-Saclay, Faculty of Medicine, Le Kremlin-Bicêtre, France.,INSERM UMR_S 999, "Pulmonary Hypertension: Pathophysiology and Novel Therapies", Hôpital Marie Lannelongue, Le Plessis-Robinson, France.,Assistance Publique - Hôpitaux de Paris (AP-HP), Dept of Respiratory and Intensive Care Medicine, Pulmonary Hypertension National Referral Center, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
| | - Athénaïs Boucly
- Université Paris-Saclay, Faculty of Medicine, Le Kremlin-Bicêtre, France.,INSERM UMR_S 999, "Pulmonary Hypertension: Pathophysiology and Novel Therapies", Hôpital Marie Lannelongue, Le Plessis-Robinson, France.,Assistance Publique - Hôpitaux de Paris (AP-HP), Dept of Respiratory and Intensive Care Medicine, Pulmonary Hypertension National Referral Center, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
| | - Mariana Preda
- Université Paris-Saclay, Faculty of Medicine, Le Kremlin-Bicêtre, France.,INSERM UMR_S 999, "Pulmonary Hypertension: Pathophysiology and Novel Therapies", Hôpital Marie Lannelongue, Le Plessis-Robinson, France.,Assistance Publique - Hôpitaux de Paris (AP-HP), Dept of Respiratory and Intensive Care Medicine, Pulmonary Hypertension National Referral Center, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
| | - Jason Weatherald
- Dept of Medicine, Division of Respirology, University of Calgary, Calgary, AB, Canada.,Libin Cardiovascular Institute, Calgary, AB, Canada
| | - Sophie Bulifon
- Université Paris-Saclay, Faculty of Medicine, Le Kremlin-Bicêtre, France.,INSERM UMR_S 999, "Pulmonary Hypertension: Pathophysiology and Novel Therapies", Hôpital Marie Lannelongue, Le Plessis-Robinson, France.,Assistance Publique - Hôpitaux de Paris (AP-HP), Dept of Respiratory and Intensive Care Medicine, Pulmonary Hypertension National Referral Center, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
| | - Florence Parent
- Université Paris-Saclay, Faculty of Medicine, Le Kremlin-Bicêtre, France.,INSERM UMR_S 999, "Pulmonary Hypertension: Pathophysiology and Novel Therapies", Hôpital Marie Lannelongue, Le Plessis-Robinson, France.,Assistance Publique - Hôpitaux de Paris (AP-HP), Dept of Respiratory and Intensive Care Medicine, Pulmonary Hypertension National Referral Center, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
| | - Philippe Brenot
- Université Paris-Saclay, Faculty of Medicine, Le Kremlin-Bicêtre, France.,INSERM UMR_S 999, "Pulmonary Hypertension: Pathophysiology and Novel Therapies", Hôpital Marie Lannelongue, Le Plessis-Robinson, France.,Dept of Radiology, Hôpital Marie Lannelongue, Le Plessis-Robinson, France
| | - Elie Fadel
- Université Paris-Saclay, Faculty of Medicine, Le Kremlin-Bicêtre, France.,INSERM UMR_S 999, "Pulmonary Hypertension: Pathophysiology and Novel Therapies", Hôpital Marie Lannelongue, Le Plessis-Robinson, France.,Dept of Thoracic and Vascular Surgery and Heart-Lung Transplantation, Hôpital Marie Lannelongue, Le Plessis-Robinson, France
| | - Olivier Sitbon
- Université Paris-Saclay, Faculty of Medicine, Le Kremlin-Bicêtre, France.,INSERM UMR_S 999, "Pulmonary Hypertension: Pathophysiology and Novel Therapies", Hôpital Marie Lannelongue, Le Plessis-Robinson, France.,Assistance Publique - Hôpitaux de Paris (AP-HP), Dept of Respiratory and Intensive Care Medicine, Pulmonary Hypertension National Referral Center, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
| | - Gérald Simonneau
- Université Paris-Saclay, Faculty of Medicine, Le Kremlin-Bicêtre, France.,INSERM UMR_S 999, "Pulmonary Hypertension: Pathophysiology and Novel Therapies", Hôpital Marie Lannelongue, Le Plessis-Robinson, France.,Assistance Publique - Hôpitaux de Paris (AP-HP), Dept of Respiratory and Intensive Care Medicine, Pulmonary Hypertension National Referral Center, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
| | - Marc Humbert
- Université Paris-Saclay, Faculty of Medicine, Le Kremlin-Bicêtre, France.,INSERM UMR_S 999, "Pulmonary Hypertension: Pathophysiology and Novel Therapies", Hôpital Marie Lannelongue, Le Plessis-Robinson, France.,Assistance Publique - Hôpitaux de Paris (AP-HP), Dept of Respiratory and Intensive Care Medicine, Pulmonary Hypertension National Referral Center, Hôpital Bicêtre, Le Kremlin-Bicêtre, France.,These authors contributed equally
| | - Xavier Jaïs
- Université Paris-Saclay, Faculty of Medicine, Le Kremlin-Bicêtre, France .,INSERM UMR_S 999, "Pulmonary Hypertension: Pathophysiology and Novel Therapies", Hôpital Marie Lannelongue, Le Plessis-Robinson, France.,Assistance Publique - Hôpitaux de Paris (AP-HP), Dept of Respiratory and Intensive Care Medicine, Pulmonary Hypertension National Referral Center, Hôpital Bicêtre, Le Kremlin-Bicêtre, France.,These authors contributed equally
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26
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Besson FL, Fernandez B, Faure S, Mercier O, Seferian A, Blanchet É, Mignard X, Chetouani A, Bulifon S, Mussot S, Parent F, Bouderraoui F, Montani D, Mitilian D, Fadel E, Ghigna-Bellinzoni MR, Cherkaoui H, Comtat C, Lebon V, Durand E. Diffusion-weighted Imaging Voxelwise-matched Analyses of Lung Cancer at 3.0-T PET/MRI: Reverse Phase Encoding Approach for Echo-planar Imaging Distortion Correction. Radiology 2020; 295:692-700. [PMID: 32208099 DOI: 10.1148/radiol.2020192013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Background PET/MRI has drawn increasing interest in thoracic oncology due to the simultaneous acquisition of PET and MRI data. Geometric distortions related to diffusion-weighted imaging (DWI) limit the evaluation of voxelwise multimodal analyses. Purpose To assess the effectiveness of reverse phase encoding in correcting DWI geometric distortion for multimodal PET/MRI voxelwise lung tumor analyses. Materials and Methods In this prospective study, reverse phase encoding method was implemented with 3.0-T PET/MRI to correct geometric distortions related to DWI. The method was validated in dedicated phantom and then applied to 12 consecutive patients (mean age, 66 years ± 13 [standard deviation]; 10 men) suspected of having lung cancer who underwent fluorodeoxyglucose PET/MRI between October 2018 and April 2019. The effects on DWI-related image matching and apparent diffusion coefficient (ADC) regional map computation were assessed. Consequences on multimodal PET/MRI voxelwise lung tumor analyses were evaluated. Spearman correlation coefficients (rs) between the standardized uptake value (SUV) and ADC data corrected for distortion were computed from optimal realigned DWI PET data, along with bootstrap confidence intervals. Results Phantom results showed that in highly distorted areas, correcting the distortion significantly reduced the mean error against the ground truth (-25% ± 10.6 to -18.4% ± 12.6; P < .001) and the number of voxels with more than 20% error (from 85.3% to 31.4%). In the 12 patients, the coregistration of multimodal PET/MRI tumor data was improved by using the reverse phase encoding method (0.4%-44%). In all tumors, voxelwise correlations (rs) between ADC and SUV revealed null or weak monotonic relationships (mean rs of 0.016 ± 0.24 with none above 0.5). Conclusion Reverse phase encoding is a simple-to-implement method for improved diffusion-weighted multimodal PET/MRI voxelwise-matched analyses in lung cancer. © RSNA, 2020 Online supplemental material is available for this article. See also the editorial by Colletti in this issue.
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Affiliation(s)
- Florent L Besson
- From the Dept of Biophysics and Nuclear Medicine-Molecular Imaging, Hôpitaux Universitaires Paris-Saclay, Assistance Publique-Hôpitaux de Paris, CHU Bicêtre, 94270, Le Kremlin-Bicêtre, France (F.L.B., E.D.); Université Paris-Saclay, School of Medicine, Le Kremlin-Bicêtre, France (F.L.B., O.M., A.S., S.B., S.M., F.P., D. Montani, D. Mitiliian, E.F., V.L., E.D.), Université Paris-Saclay, CEA, CNRS, Inserm, BioMaps, Orsay, 91401, France (F.L.B., C.C., V.L., E.D.); Applications and Workflow, GE Healthcare, Buc, France (B.F.); Laboratoire de Mathématiques d'Orsay, Université Paris-Saclay CNRS, 91405 Orsay, France (S.F.); Dept of Thoracic and Vascular Surgery and Heart-Lung Transplantation, Hôpital Marie Lannelongue, 92350 Le Plessis Robinson, France (O.M., S.M., D. Mitilian, E.F.); Dept of Respiratory and Intensive Care Medicine, Pulmonary Hypertension National Referral Center, Hôpitaux Universitaires Paris-Saclay, Assistance Publique-Hôpitaux de Paris, CHU Bicêtre, 94270, Le Kremlin-Bicêtre, France (A.S., X.M., S.B., F.P., D. Montani); Inserm UMR_S999 Pulmonary Hypertension: Pathophysiology and Novel Therapies, Hôpital Marie Lannelongue, 92350 Le Plessis Robinson, France (A.S., D. Montani); Service Hospitalier Frédéric Joliot (SHFJ), CEA/Université Paris-Saclay, Orsay, France (É.B., A.C., F.B., V.L.); Dept of Pathology, Hôpital Marie Lannelongue, 92350 Le Plessis Robinson, France (M.R.G.B.); NeuroSpin, CEA Saclay, Université Paris-Saclay, Gif-sur-Yvette, France and Parietal, INRIA, Palaiseau, 91120, France (H.C.)
| | - Brice Fernandez
- From the Dept of Biophysics and Nuclear Medicine-Molecular Imaging, Hôpitaux Universitaires Paris-Saclay, Assistance Publique-Hôpitaux de Paris, CHU Bicêtre, 94270, Le Kremlin-Bicêtre, France (F.L.B., E.D.); Université Paris-Saclay, School of Medicine, Le Kremlin-Bicêtre, France (F.L.B., O.M., A.S., S.B., S.M., F.P., D. Montani, D. Mitiliian, E.F., V.L., E.D.), Université Paris-Saclay, CEA, CNRS, Inserm, BioMaps, Orsay, 91401, France (F.L.B., C.C., V.L., E.D.); Applications and Workflow, GE Healthcare, Buc, France (B.F.); Laboratoire de Mathématiques d'Orsay, Université Paris-Saclay CNRS, 91405 Orsay, France (S.F.); Dept of Thoracic and Vascular Surgery and Heart-Lung Transplantation, Hôpital Marie Lannelongue, 92350 Le Plessis Robinson, France (O.M., S.M., D. Mitilian, E.F.); Dept of Respiratory and Intensive Care Medicine, Pulmonary Hypertension National Referral Center, Hôpitaux Universitaires Paris-Saclay, Assistance Publique-Hôpitaux de Paris, CHU Bicêtre, 94270, Le Kremlin-Bicêtre, France (A.S., X.M., S.B., F.P., D. Montani); Inserm UMR_S999 Pulmonary Hypertension: Pathophysiology and Novel Therapies, Hôpital Marie Lannelongue, 92350 Le Plessis Robinson, France (A.S., D. Montani); Service Hospitalier Frédéric Joliot (SHFJ), CEA/Université Paris-Saclay, Orsay, France (É.B., A.C., F.B., V.L.); Dept of Pathology, Hôpital Marie Lannelongue, 92350 Le Plessis Robinson, France (M.R.G.B.); NeuroSpin, CEA Saclay, Université Paris-Saclay, Gif-sur-Yvette, France and Parietal, INRIA, Palaiseau, 91120, France (H.C.)
| | - Sylvain Faure
- From the Dept of Biophysics and Nuclear Medicine-Molecular Imaging, Hôpitaux Universitaires Paris-Saclay, Assistance Publique-Hôpitaux de Paris, CHU Bicêtre, 94270, Le Kremlin-Bicêtre, France (F.L.B., E.D.); Université Paris-Saclay, School of Medicine, Le Kremlin-Bicêtre, France (F.L.B., O.M., A.S., S.B., S.M., F.P., D. Montani, D. Mitiliian, E.F., V.L., E.D.), Université Paris-Saclay, CEA, CNRS, Inserm, BioMaps, Orsay, 91401, France (F.L.B., C.C., V.L., E.D.); Applications and Workflow, GE Healthcare, Buc, France (B.F.); Laboratoire de Mathématiques d'Orsay, Université Paris-Saclay CNRS, 91405 Orsay, France (S.F.); Dept of Thoracic and Vascular Surgery and Heart-Lung Transplantation, Hôpital Marie Lannelongue, 92350 Le Plessis Robinson, France (O.M., S.M., D. Mitilian, E.F.); Dept of Respiratory and Intensive Care Medicine, Pulmonary Hypertension National Referral Center, Hôpitaux Universitaires Paris-Saclay, Assistance Publique-Hôpitaux de Paris, CHU Bicêtre, 94270, Le Kremlin-Bicêtre, France (A.S., X.M., S.B., F.P., D. Montani); Inserm UMR_S999 Pulmonary Hypertension: Pathophysiology and Novel Therapies, Hôpital Marie Lannelongue, 92350 Le Plessis Robinson, France (A.S., D. Montani); Service Hospitalier Frédéric Joliot (SHFJ), CEA/Université Paris-Saclay, Orsay, France (É.B., A.C., F.B., V.L.); Dept of Pathology, Hôpital Marie Lannelongue, 92350 Le Plessis Robinson, France (M.R.G.B.); NeuroSpin, CEA Saclay, Université Paris-Saclay, Gif-sur-Yvette, France and Parietal, INRIA, Palaiseau, 91120, France (H.C.)
| | - Olaf Mercier
- From the Dept of Biophysics and Nuclear Medicine-Molecular Imaging, Hôpitaux Universitaires Paris-Saclay, Assistance Publique-Hôpitaux de Paris, CHU Bicêtre, 94270, Le Kremlin-Bicêtre, France (F.L.B., E.D.); Université Paris-Saclay, School of Medicine, Le Kremlin-Bicêtre, France (F.L.B., O.M., A.S., S.B., S.M., F.P., D. Montani, D. Mitiliian, E.F., V.L., E.D.), Université Paris-Saclay, CEA, CNRS, Inserm, BioMaps, Orsay, 91401, France (F.L.B., C.C., V.L., E.D.); Applications and Workflow, GE Healthcare, Buc, France (B.F.); Laboratoire de Mathématiques d'Orsay, Université Paris-Saclay CNRS, 91405 Orsay, France (S.F.); Dept of Thoracic and Vascular Surgery and Heart-Lung Transplantation, Hôpital Marie Lannelongue, 92350 Le Plessis Robinson, France (O.M., S.M., D. Mitilian, E.F.); Dept of Respiratory and Intensive Care Medicine, Pulmonary Hypertension National Referral Center, Hôpitaux Universitaires Paris-Saclay, Assistance Publique-Hôpitaux de Paris, CHU Bicêtre, 94270, Le Kremlin-Bicêtre, France (A.S., X.M., S.B., F.P., D. Montani); Inserm UMR_S999 Pulmonary Hypertension: Pathophysiology and Novel Therapies, Hôpital Marie Lannelongue, 92350 Le Plessis Robinson, France (A.S., D. Montani); Service Hospitalier Frédéric Joliot (SHFJ), CEA/Université Paris-Saclay, Orsay, France (É.B., A.C., F.B., V.L.); Dept of Pathology, Hôpital Marie Lannelongue, 92350 Le Plessis Robinson, France (M.R.G.B.); NeuroSpin, CEA Saclay, Université Paris-Saclay, Gif-sur-Yvette, France and Parietal, INRIA, Palaiseau, 91120, France (H.C.)
| | - Andrei Seferian
- From the Dept of Biophysics and Nuclear Medicine-Molecular Imaging, Hôpitaux Universitaires Paris-Saclay, Assistance Publique-Hôpitaux de Paris, CHU Bicêtre, 94270, Le Kremlin-Bicêtre, France (F.L.B., E.D.); Université Paris-Saclay, School of Medicine, Le Kremlin-Bicêtre, France (F.L.B., O.M., A.S., S.B., S.M., F.P., D. Montani, D. Mitiliian, E.F., V.L., E.D.), Université Paris-Saclay, CEA, CNRS, Inserm, BioMaps, Orsay, 91401, France (F.L.B., C.C., V.L., E.D.); Applications and Workflow, GE Healthcare, Buc, France (B.F.); Laboratoire de Mathématiques d'Orsay, Université Paris-Saclay CNRS, 91405 Orsay, France (S.F.); Dept of Thoracic and Vascular Surgery and Heart-Lung Transplantation, Hôpital Marie Lannelongue, 92350 Le Plessis Robinson, France (O.M., S.M., D. Mitilian, E.F.); Dept of Respiratory and Intensive Care Medicine, Pulmonary Hypertension National Referral Center, Hôpitaux Universitaires Paris-Saclay, Assistance Publique-Hôpitaux de Paris, CHU Bicêtre, 94270, Le Kremlin-Bicêtre, France (A.S., X.M., S.B., F.P., D. Montani); Inserm UMR_S999 Pulmonary Hypertension: Pathophysiology and Novel Therapies, Hôpital Marie Lannelongue, 92350 Le Plessis Robinson, France (A.S., D. Montani); Service Hospitalier Frédéric Joliot (SHFJ), CEA/Université Paris-Saclay, Orsay, France (É.B., A.C., F.B., V.L.); Dept of Pathology, Hôpital Marie Lannelongue, 92350 Le Plessis Robinson, France (M.R.G.B.); NeuroSpin, CEA Saclay, Université Paris-Saclay, Gif-sur-Yvette, France and Parietal, INRIA, Palaiseau, 91120, France (H.C.)
| | - Élise Blanchet
- From the Dept of Biophysics and Nuclear Medicine-Molecular Imaging, Hôpitaux Universitaires Paris-Saclay, Assistance Publique-Hôpitaux de Paris, CHU Bicêtre, 94270, Le Kremlin-Bicêtre, France (F.L.B., E.D.); Université Paris-Saclay, School of Medicine, Le Kremlin-Bicêtre, France (F.L.B., O.M., A.S., S.B., S.M., F.P., D. Montani, D. Mitiliian, E.F., V.L., E.D.), Université Paris-Saclay, CEA, CNRS, Inserm, BioMaps, Orsay, 91401, France (F.L.B., C.C., V.L., E.D.); Applications and Workflow, GE Healthcare, Buc, France (B.F.); Laboratoire de Mathématiques d'Orsay, Université Paris-Saclay CNRS, 91405 Orsay, France (S.F.); Dept of Thoracic and Vascular Surgery and Heart-Lung Transplantation, Hôpital Marie Lannelongue, 92350 Le Plessis Robinson, France (O.M., S.M., D. Mitilian, E.F.); Dept of Respiratory and Intensive Care Medicine, Pulmonary Hypertension National Referral Center, Hôpitaux Universitaires Paris-Saclay, Assistance Publique-Hôpitaux de Paris, CHU Bicêtre, 94270, Le Kremlin-Bicêtre, France (A.S., X.M., S.B., F.P., D. Montani); Inserm UMR_S999 Pulmonary Hypertension: Pathophysiology and Novel Therapies, Hôpital Marie Lannelongue, 92350 Le Plessis Robinson, France (A.S., D. Montani); Service Hospitalier Frédéric Joliot (SHFJ), CEA/Université Paris-Saclay, Orsay, France (É.B., A.C., F.B., V.L.); Dept of Pathology, Hôpital Marie Lannelongue, 92350 Le Plessis Robinson, France (M.R.G.B.); NeuroSpin, CEA Saclay, Université Paris-Saclay, Gif-sur-Yvette, France and Parietal, INRIA, Palaiseau, 91120, France (H.C.)
| | - Xavier Mignard
- From the Dept of Biophysics and Nuclear Medicine-Molecular Imaging, Hôpitaux Universitaires Paris-Saclay, Assistance Publique-Hôpitaux de Paris, CHU Bicêtre, 94270, Le Kremlin-Bicêtre, France (F.L.B., E.D.); Université Paris-Saclay, School of Medicine, Le Kremlin-Bicêtre, France (F.L.B., O.M., A.S., S.B., S.M., F.P., D. Montani, D. Mitiliian, E.F., V.L., E.D.), Université Paris-Saclay, CEA, CNRS, Inserm, BioMaps, Orsay, 91401, France (F.L.B., C.C., V.L., E.D.); Applications and Workflow, GE Healthcare, Buc, France (B.F.); Laboratoire de Mathématiques d'Orsay, Université Paris-Saclay CNRS, 91405 Orsay, France (S.F.); Dept of Thoracic and Vascular Surgery and Heart-Lung Transplantation, Hôpital Marie Lannelongue, 92350 Le Plessis Robinson, France (O.M., S.M., D. Mitilian, E.F.); Dept of Respiratory and Intensive Care Medicine, Pulmonary Hypertension National Referral Center, Hôpitaux Universitaires Paris-Saclay, Assistance Publique-Hôpitaux de Paris, CHU Bicêtre, 94270, Le Kremlin-Bicêtre, France (A.S., X.M., S.B., F.P., D. Montani); Inserm UMR_S999 Pulmonary Hypertension: Pathophysiology and Novel Therapies, Hôpital Marie Lannelongue, 92350 Le Plessis Robinson, France (A.S., D. Montani); Service Hospitalier Frédéric Joliot (SHFJ), CEA/Université Paris-Saclay, Orsay, France (É.B., A.C., F.B., V.L.); Dept of Pathology, Hôpital Marie Lannelongue, 92350 Le Plessis Robinson, France (M.R.G.B.); NeuroSpin, CEA Saclay, Université Paris-Saclay, Gif-sur-Yvette, France and Parietal, INRIA, Palaiseau, 91120, France (H.C.)
| | - Ahmed Chetouani
- From the Dept of Biophysics and Nuclear Medicine-Molecular Imaging, Hôpitaux Universitaires Paris-Saclay, Assistance Publique-Hôpitaux de Paris, CHU Bicêtre, 94270, Le Kremlin-Bicêtre, France (F.L.B., E.D.); Université Paris-Saclay, School of Medicine, Le Kremlin-Bicêtre, France (F.L.B., O.M., A.S., S.B., S.M., F.P., D. Montani, D. Mitiliian, E.F., V.L., E.D.), Université Paris-Saclay, CEA, CNRS, Inserm, BioMaps, Orsay, 91401, France (F.L.B., C.C., V.L., E.D.); Applications and Workflow, GE Healthcare, Buc, France (B.F.); Laboratoire de Mathématiques d'Orsay, Université Paris-Saclay CNRS, 91405 Orsay, France (S.F.); Dept of Thoracic and Vascular Surgery and Heart-Lung Transplantation, Hôpital Marie Lannelongue, 92350 Le Plessis Robinson, France (O.M., S.M., D. Mitilian, E.F.); Dept of Respiratory and Intensive Care Medicine, Pulmonary Hypertension National Referral Center, Hôpitaux Universitaires Paris-Saclay, Assistance Publique-Hôpitaux de Paris, CHU Bicêtre, 94270, Le Kremlin-Bicêtre, France (A.S., X.M., S.B., F.P., D. Montani); Inserm UMR_S999 Pulmonary Hypertension: Pathophysiology and Novel Therapies, Hôpital Marie Lannelongue, 92350 Le Plessis Robinson, France (A.S., D. Montani); Service Hospitalier Frédéric Joliot (SHFJ), CEA/Université Paris-Saclay, Orsay, France (É.B., A.C., F.B., V.L.); Dept of Pathology, Hôpital Marie Lannelongue, 92350 Le Plessis Robinson, France (M.R.G.B.); NeuroSpin, CEA Saclay, Université Paris-Saclay, Gif-sur-Yvette, France and Parietal, INRIA, Palaiseau, 91120, France (H.C.)
| | - Sophie Bulifon
- From the Dept of Biophysics and Nuclear Medicine-Molecular Imaging, Hôpitaux Universitaires Paris-Saclay, Assistance Publique-Hôpitaux de Paris, CHU Bicêtre, 94270, Le Kremlin-Bicêtre, France (F.L.B., E.D.); Université Paris-Saclay, School of Medicine, Le Kremlin-Bicêtre, France (F.L.B., O.M., A.S., S.B., S.M., F.P., D. Montani, D. Mitiliian, E.F., V.L., E.D.), Université Paris-Saclay, CEA, CNRS, Inserm, BioMaps, Orsay, 91401, France (F.L.B., C.C., V.L., E.D.); Applications and Workflow, GE Healthcare, Buc, France (B.F.); Laboratoire de Mathématiques d'Orsay, Université Paris-Saclay CNRS, 91405 Orsay, France (S.F.); Dept of Thoracic and Vascular Surgery and Heart-Lung Transplantation, Hôpital Marie Lannelongue, 92350 Le Plessis Robinson, France (O.M., S.M., D. Mitilian, E.F.); Dept of Respiratory and Intensive Care Medicine, Pulmonary Hypertension National Referral Center, Hôpitaux Universitaires Paris-Saclay, Assistance Publique-Hôpitaux de Paris, CHU Bicêtre, 94270, Le Kremlin-Bicêtre, France (A.S., X.M., S.B., F.P., D. Montani); Inserm UMR_S999 Pulmonary Hypertension: Pathophysiology and Novel Therapies, Hôpital Marie Lannelongue, 92350 Le Plessis Robinson, France (A.S., D. Montani); Service Hospitalier Frédéric Joliot (SHFJ), CEA/Université Paris-Saclay, Orsay, France (É.B., A.C., F.B., V.L.); Dept of Pathology, Hôpital Marie Lannelongue, 92350 Le Plessis Robinson, France (M.R.G.B.); NeuroSpin, CEA Saclay, Université Paris-Saclay, Gif-sur-Yvette, France and Parietal, INRIA, Palaiseau, 91120, France (H.C.)
| | - Sacha Mussot
- From the Dept of Biophysics and Nuclear Medicine-Molecular Imaging, Hôpitaux Universitaires Paris-Saclay, Assistance Publique-Hôpitaux de Paris, CHU Bicêtre, 94270, Le Kremlin-Bicêtre, France (F.L.B., E.D.); Université Paris-Saclay, School of Medicine, Le Kremlin-Bicêtre, France (F.L.B., O.M., A.S., S.B., S.M., F.P., D. Montani, D. Mitiliian, E.F., V.L., E.D.), Université Paris-Saclay, CEA, CNRS, Inserm, BioMaps, Orsay, 91401, France (F.L.B., C.C., V.L., E.D.); Applications and Workflow, GE Healthcare, Buc, France (B.F.); Laboratoire de Mathématiques d'Orsay, Université Paris-Saclay CNRS, 91405 Orsay, France (S.F.); Dept of Thoracic and Vascular Surgery and Heart-Lung Transplantation, Hôpital Marie Lannelongue, 92350 Le Plessis Robinson, France (O.M., S.M., D. Mitilian, E.F.); Dept of Respiratory and Intensive Care Medicine, Pulmonary Hypertension National Referral Center, Hôpitaux Universitaires Paris-Saclay, Assistance Publique-Hôpitaux de Paris, CHU Bicêtre, 94270, Le Kremlin-Bicêtre, France (A.S., X.M., S.B., F.P., D. Montani); Inserm UMR_S999 Pulmonary Hypertension: Pathophysiology and Novel Therapies, Hôpital Marie Lannelongue, 92350 Le Plessis Robinson, France (A.S., D. Montani); Service Hospitalier Frédéric Joliot (SHFJ), CEA/Université Paris-Saclay, Orsay, France (É.B., A.C., F.B., V.L.); Dept of Pathology, Hôpital Marie Lannelongue, 92350 Le Plessis Robinson, France (M.R.G.B.); NeuroSpin, CEA Saclay, Université Paris-Saclay, Gif-sur-Yvette, France and Parietal, INRIA, Palaiseau, 91120, France (H.C.)
| | - Florence Parent
- From the Dept of Biophysics and Nuclear Medicine-Molecular Imaging, Hôpitaux Universitaires Paris-Saclay, Assistance Publique-Hôpitaux de Paris, CHU Bicêtre, 94270, Le Kremlin-Bicêtre, France (F.L.B., E.D.); Université Paris-Saclay, School of Medicine, Le Kremlin-Bicêtre, France (F.L.B., O.M., A.S., S.B., S.M., F.P., D. Montani, D. Mitiliian, E.F., V.L., E.D.), Université Paris-Saclay, CEA, CNRS, Inserm, BioMaps, Orsay, 91401, France (F.L.B., C.C., V.L., E.D.); Applications and Workflow, GE Healthcare, Buc, France (B.F.); Laboratoire de Mathématiques d'Orsay, Université Paris-Saclay CNRS, 91405 Orsay, France (S.F.); Dept of Thoracic and Vascular Surgery and Heart-Lung Transplantation, Hôpital Marie Lannelongue, 92350 Le Plessis Robinson, France (O.M., S.M., D. Mitilian, E.F.); Dept of Respiratory and Intensive Care Medicine, Pulmonary Hypertension National Referral Center, Hôpitaux Universitaires Paris-Saclay, Assistance Publique-Hôpitaux de Paris, CHU Bicêtre, 94270, Le Kremlin-Bicêtre, France (A.S., X.M., S.B., F.P., D. Montani); Inserm UMR_S999 Pulmonary Hypertension: Pathophysiology and Novel Therapies, Hôpital Marie Lannelongue, 92350 Le Plessis Robinson, France (A.S., D. Montani); Service Hospitalier Frédéric Joliot (SHFJ), CEA/Université Paris-Saclay, Orsay, France (É.B., A.C., F.B., V.L.); Dept of Pathology, Hôpital Marie Lannelongue, 92350 Le Plessis Robinson, France (M.R.G.B.); NeuroSpin, CEA Saclay, Université Paris-Saclay, Gif-sur-Yvette, France and Parietal, INRIA, Palaiseau, 91120, France (H.C.)
| | - Fahd Bouderraoui
- From the Dept of Biophysics and Nuclear Medicine-Molecular Imaging, Hôpitaux Universitaires Paris-Saclay, Assistance Publique-Hôpitaux de Paris, CHU Bicêtre, 94270, Le Kremlin-Bicêtre, France (F.L.B., E.D.); Université Paris-Saclay, School of Medicine, Le Kremlin-Bicêtre, France (F.L.B., O.M., A.S., S.B., S.M., F.P., D. Montani, D. Mitiliian, E.F., V.L., E.D.), Université Paris-Saclay, CEA, CNRS, Inserm, BioMaps, Orsay, 91401, France (F.L.B., C.C., V.L., E.D.); Applications and Workflow, GE Healthcare, Buc, France (B.F.); Laboratoire de Mathématiques d'Orsay, Université Paris-Saclay CNRS, 91405 Orsay, France (S.F.); Dept of Thoracic and Vascular Surgery and Heart-Lung Transplantation, Hôpital Marie Lannelongue, 92350 Le Plessis Robinson, France (O.M., S.M., D. Mitilian, E.F.); Dept of Respiratory and Intensive Care Medicine, Pulmonary Hypertension National Referral Center, Hôpitaux Universitaires Paris-Saclay, Assistance Publique-Hôpitaux de Paris, CHU Bicêtre, 94270, Le Kremlin-Bicêtre, France (A.S., X.M., S.B., F.P., D. Montani); Inserm UMR_S999 Pulmonary Hypertension: Pathophysiology and Novel Therapies, Hôpital Marie Lannelongue, 92350 Le Plessis Robinson, France (A.S., D. Montani); Service Hospitalier Frédéric Joliot (SHFJ), CEA/Université Paris-Saclay, Orsay, France (É.B., A.C., F.B., V.L.); Dept of Pathology, Hôpital Marie Lannelongue, 92350 Le Plessis Robinson, France (M.R.G.B.); NeuroSpin, CEA Saclay, Université Paris-Saclay, Gif-sur-Yvette, France and Parietal, INRIA, Palaiseau, 91120, France (H.C.)
| | - David Montani
- From the Dept of Biophysics and Nuclear Medicine-Molecular Imaging, Hôpitaux Universitaires Paris-Saclay, Assistance Publique-Hôpitaux de Paris, CHU Bicêtre, 94270, Le Kremlin-Bicêtre, France (F.L.B., E.D.); Université Paris-Saclay, School of Medicine, Le Kremlin-Bicêtre, France (F.L.B., O.M., A.S., S.B., S.M., F.P., D. Montani, D. Mitiliian, E.F., V.L., E.D.), Université Paris-Saclay, CEA, CNRS, Inserm, BioMaps, Orsay, 91401, France (F.L.B., C.C., V.L., E.D.); Applications and Workflow, GE Healthcare, Buc, France (B.F.); Laboratoire de Mathématiques d'Orsay, Université Paris-Saclay CNRS, 91405 Orsay, France (S.F.); Dept of Thoracic and Vascular Surgery and Heart-Lung Transplantation, Hôpital Marie Lannelongue, 92350 Le Plessis Robinson, France (O.M., S.M., D. Mitilian, E.F.); Dept of Respiratory and Intensive Care Medicine, Pulmonary Hypertension National Referral Center, Hôpitaux Universitaires Paris-Saclay, Assistance Publique-Hôpitaux de Paris, CHU Bicêtre, 94270, Le Kremlin-Bicêtre, France (A.S., X.M., S.B., F.P., D. Montani); Inserm UMR_S999 Pulmonary Hypertension: Pathophysiology and Novel Therapies, Hôpital Marie Lannelongue, 92350 Le Plessis Robinson, France (A.S., D. Montani); Service Hospitalier Frédéric Joliot (SHFJ), CEA/Université Paris-Saclay, Orsay, France (É.B., A.C., F.B., V.L.); Dept of Pathology, Hôpital Marie Lannelongue, 92350 Le Plessis Robinson, France (M.R.G.B.); NeuroSpin, CEA Saclay, Université Paris-Saclay, Gif-sur-Yvette, France and Parietal, INRIA, Palaiseau, 91120, France (H.C.)
| | - Delphine Mitilian
- From the Dept of Biophysics and Nuclear Medicine-Molecular Imaging, Hôpitaux Universitaires Paris-Saclay, Assistance Publique-Hôpitaux de Paris, CHU Bicêtre, 94270, Le Kremlin-Bicêtre, France (F.L.B., E.D.); Université Paris-Saclay, School of Medicine, Le Kremlin-Bicêtre, France (F.L.B., O.M., A.S., S.B., S.M., F.P., D. Montani, D. Mitiliian, E.F., V.L., E.D.), Université Paris-Saclay, CEA, CNRS, Inserm, BioMaps, Orsay, 91401, France (F.L.B., C.C., V.L., E.D.); Applications and Workflow, GE Healthcare, Buc, France (B.F.); Laboratoire de Mathématiques d'Orsay, Université Paris-Saclay CNRS, 91405 Orsay, France (S.F.); Dept of Thoracic and Vascular Surgery and Heart-Lung Transplantation, Hôpital Marie Lannelongue, 92350 Le Plessis Robinson, France (O.M., S.M., D. Mitilian, E.F.); Dept of Respiratory and Intensive Care Medicine, Pulmonary Hypertension National Referral Center, Hôpitaux Universitaires Paris-Saclay, Assistance Publique-Hôpitaux de Paris, CHU Bicêtre, 94270, Le Kremlin-Bicêtre, France (A.S., X.M., S.B., F.P., D. Montani); Inserm UMR_S999 Pulmonary Hypertension: Pathophysiology and Novel Therapies, Hôpital Marie Lannelongue, 92350 Le Plessis Robinson, France (A.S., D. Montani); Service Hospitalier Frédéric Joliot (SHFJ), CEA/Université Paris-Saclay, Orsay, France (É.B., A.C., F.B., V.L.); Dept of Pathology, Hôpital Marie Lannelongue, 92350 Le Plessis Robinson, France (M.R.G.B.); NeuroSpin, CEA Saclay, Université Paris-Saclay, Gif-sur-Yvette, France and Parietal, INRIA, Palaiseau, 91120, France (H.C.)
| | - Elie Fadel
- From the Dept of Biophysics and Nuclear Medicine-Molecular Imaging, Hôpitaux Universitaires Paris-Saclay, Assistance Publique-Hôpitaux de Paris, CHU Bicêtre, 94270, Le Kremlin-Bicêtre, France (F.L.B., E.D.); Université Paris-Saclay, School of Medicine, Le Kremlin-Bicêtre, France (F.L.B., O.M., A.S., S.B., S.M., F.P., D. Montani, D. Mitiliian, E.F., V.L., E.D.), Université Paris-Saclay, CEA, CNRS, Inserm, BioMaps, Orsay, 91401, France (F.L.B., C.C., V.L., E.D.); Applications and Workflow, GE Healthcare, Buc, France (B.F.); Laboratoire de Mathématiques d'Orsay, Université Paris-Saclay CNRS, 91405 Orsay, France (S.F.); Dept of Thoracic and Vascular Surgery and Heart-Lung Transplantation, Hôpital Marie Lannelongue, 92350 Le Plessis Robinson, France (O.M., S.M., D. Mitilian, E.F.); Dept of Respiratory and Intensive Care Medicine, Pulmonary Hypertension National Referral Center, Hôpitaux Universitaires Paris-Saclay, Assistance Publique-Hôpitaux de Paris, CHU Bicêtre, 94270, Le Kremlin-Bicêtre, France (A.S., X.M., S.B., F.P., D. Montani); Inserm UMR_S999 Pulmonary Hypertension: Pathophysiology and Novel Therapies, Hôpital Marie Lannelongue, 92350 Le Plessis Robinson, France (A.S., D. Montani); Service Hospitalier Frédéric Joliot (SHFJ), CEA/Université Paris-Saclay, Orsay, France (É.B., A.C., F.B., V.L.); Dept of Pathology, Hôpital Marie Lannelongue, 92350 Le Plessis Robinson, France (M.R.G.B.); NeuroSpin, CEA Saclay, Université Paris-Saclay, Gif-sur-Yvette, France and Parietal, INRIA, Palaiseau, 91120, France (H.C.)
| | - Maria-Rosa Ghigna-Bellinzoni
- From the Dept of Biophysics and Nuclear Medicine-Molecular Imaging, Hôpitaux Universitaires Paris-Saclay, Assistance Publique-Hôpitaux de Paris, CHU Bicêtre, 94270, Le Kremlin-Bicêtre, France (F.L.B., E.D.); Université Paris-Saclay, School of Medicine, Le Kremlin-Bicêtre, France (F.L.B., O.M., A.S., S.B., S.M., F.P., D. Montani, D. Mitiliian, E.F., V.L., E.D.), Université Paris-Saclay, CEA, CNRS, Inserm, BioMaps, Orsay, 91401, France (F.L.B., C.C., V.L., E.D.); Applications and Workflow, GE Healthcare, Buc, France (B.F.); Laboratoire de Mathématiques d'Orsay, Université Paris-Saclay CNRS, 91405 Orsay, France (S.F.); Dept of Thoracic and Vascular Surgery and Heart-Lung Transplantation, Hôpital Marie Lannelongue, 92350 Le Plessis Robinson, France (O.M., S.M., D. Mitilian, E.F.); Dept of Respiratory and Intensive Care Medicine, Pulmonary Hypertension National Referral Center, Hôpitaux Universitaires Paris-Saclay, Assistance Publique-Hôpitaux de Paris, CHU Bicêtre, 94270, Le Kremlin-Bicêtre, France (A.S., X.M., S.B., F.P., D. Montani); Inserm UMR_S999 Pulmonary Hypertension: Pathophysiology and Novel Therapies, Hôpital Marie Lannelongue, 92350 Le Plessis Robinson, France (A.S., D. Montani); Service Hospitalier Frédéric Joliot (SHFJ), CEA/Université Paris-Saclay, Orsay, France (É.B., A.C., F.B., V.L.); Dept of Pathology, Hôpital Marie Lannelongue, 92350 Le Plessis Robinson, France (M.R.G.B.); NeuroSpin, CEA Saclay, Université Paris-Saclay, Gif-sur-Yvette, France and Parietal, INRIA, Palaiseau, 91120, France (H.C.)
| | - Hamza Cherkaoui
- From the Dept of Biophysics and Nuclear Medicine-Molecular Imaging, Hôpitaux Universitaires Paris-Saclay, Assistance Publique-Hôpitaux de Paris, CHU Bicêtre, 94270, Le Kremlin-Bicêtre, France (F.L.B., E.D.); Université Paris-Saclay, School of Medicine, Le Kremlin-Bicêtre, France (F.L.B., O.M., A.S., S.B., S.M., F.P., D. Montani, D. Mitiliian, E.F., V.L., E.D.), Université Paris-Saclay, CEA, CNRS, Inserm, BioMaps, Orsay, 91401, France (F.L.B., C.C., V.L., E.D.); Applications and Workflow, GE Healthcare, Buc, France (B.F.); Laboratoire de Mathématiques d'Orsay, Université Paris-Saclay CNRS, 91405 Orsay, France (S.F.); Dept of Thoracic and Vascular Surgery and Heart-Lung Transplantation, Hôpital Marie Lannelongue, 92350 Le Plessis Robinson, France (O.M., S.M., D. Mitilian, E.F.); Dept of Respiratory and Intensive Care Medicine, Pulmonary Hypertension National Referral Center, Hôpitaux Universitaires Paris-Saclay, Assistance Publique-Hôpitaux de Paris, CHU Bicêtre, 94270, Le Kremlin-Bicêtre, France (A.S., X.M., S.B., F.P., D. Montani); Inserm UMR_S999 Pulmonary Hypertension: Pathophysiology and Novel Therapies, Hôpital Marie Lannelongue, 92350 Le Plessis Robinson, France (A.S., D. Montani); Service Hospitalier Frédéric Joliot (SHFJ), CEA/Université Paris-Saclay, Orsay, France (É.B., A.C., F.B., V.L.); Dept of Pathology, Hôpital Marie Lannelongue, 92350 Le Plessis Robinson, France (M.R.G.B.); NeuroSpin, CEA Saclay, Université Paris-Saclay, Gif-sur-Yvette, France and Parietal, INRIA, Palaiseau, 91120, France (H.C.)
| | - Claude Comtat
- From the Dept of Biophysics and Nuclear Medicine-Molecular Imaging, Hôpitaux Universitaires Paris-Saclay, Assistance Publique-Hôpitaux de Paris, CHU Bicêtre, 94270, Le Kremlin-Bicêtre, France (F.L.B., E.D.); Université Paris-Saclay, School of Medicine, Le Kremlin-Bicêtre, France (F.L.B., O.M., A.S., S.B., S.M., F.P., D. Montani, D. Mitiliian, E.F., V.L., E.D.), Université Paris-Saclay, CEA, CNRS, Inserm, BioMaps, Orsay, 91401, France (F.L.B., C.C., V.L., E.D.); Applications and Workflow, GE Healthcare, Buc, France (B.F.); Laboratoire de Mathématiques d'Orsay, Université Paris-Saclay CNRS, 91405 Orsay, France (S.F.); Dept of Thoracic and Vascular Surgery and Heart-Lung Transplantation, Hôpital Marie Lannelongue, 92350 Le Plessis Robinson, France (O.M., S.M., D. Mitilian, E.F.); Dept of Respiratory and Intensive Care Medicine, Pulmonary Hypertension National Referral Center, Hôpitaux Universitaires Paris-Saclay, Assistance Publique-Hôpitaux de Paris, CHU Bicêtre, 94270, Le Kremlin-Bicêtre, France (A.S., X.M., S.B., F.P., D. Montani); Inserm UMR_S999 Pulmonary Hypertension: Pathophysiology and Novel Therapies, Hôpital Marie Lannelongue, 92350 Le Plessis Robinson, France (A.S., D. Montani); Service Hospitalier Frédéric Joliot (SHFJ), CEA/Université Paris-Saclay, Orsay, France (É.B., A.C., F.B., V.L.); Dept of Pathology, Hôpital Marie Lannelongue, 92350 Le Plessis Robinson, France (M.R.G.B.); NeuroSpin, CEA Saclay, Université Paris-Saclay, Gif-sur-Yvette, France and Parietal, INRIA, Palaiseau, 91120, France (H.C.)
| | - Vincent Lebon
- From the Dept of Biophysics and Nuclear Medicine-Molecular Imaging, Hôpitaux Universitaires Paris-Saclay, Assistance Publique-Hôpitaux de Paris, CHU Bicêtre, 94270, Le Kremlin-Bicêtre, France (F.L.B., E.D.); Université Paris-Saclay, School of Medicine, Le Kremlin-Bicêtre, France (F.L.B., O.M., A.S., S.B., S.M., F.P., D. Montani, D. Mitiliian, E.F., V.L., E.D.), Université Paris-Saclay, CEA, CNRS, Inserm, BioMaps, Orsay, 91401, France (F.L.B., C.C., V.L., E.D.); Applications and Workflow, GE Healthcare, Buc, France (B.F.); Laboratoire de Mathématiques d'Orsay, Université Paris-Saclay CNRS, 91405 Orsay, France (S.F.); Dept of Thoracic and Vascular Surgery and Heart-Lung Transplantation, Hôpital Marie Lannelongue, 92350 Le Plessis Robinson, France (O.M., S.M., D. Mitilian, E.F.); Dept of Respiratory and Intensive Care Medicine, Pulmonary Hypertension National Referral Center, Hôpitaux Universitaires Paris-Saclay, Assistance Publique-Hôpitaux de Paris, CHU Bicêtre, 94270, Le Kremlin-Bicêtre, France (A.S., X.M., S.B., F.P., D. Montani); Inserm UMR_S999 Pulmonary Hypertension: Pathophysiology and Novel Therapies, Hôpital Marie Lannelongue, 92350 Le Plessis Robinson, France (A.S., D. Montani); Service Hospitalier Frédéric Joliot (SHFJ), CEA/Université Paris-Saclay, Orsay, France (É.B., A.C., F.B., V.L.); Dept of Pathology, Hôpital Marie Lannelongue, 92350 Le Plessis Robinson, France (M.R.G.B.); NeuroSpin, CEA Saclay, Université Paris-Saclay, Gif-sur-Yvette, France and Parietal, INRIA, Palaiseau, 91120, France (H.C.)
| | - Emmanuel Durand
- From the Dept of Biophysics and Nuclear Medicine-Molecular Imaging, Hôpitaux Universitaires Paris-Saclay, Assistance Publique-Hôpitaux de Paris, CHU Bicêtre, 94270, Le Kremlin-Bicêtre, France (F.L.B., E.D.); Université Paris-Saclay, School of Medicine, Le Kremlin-Bicêtre, France (F.L.B., O.M., A.S., S.B., S.M., F.P., D. Montani, D. Mitiliian, E.F., V.L., E.D.), Université Paris-Saclay, CEA, CNRS, Inserm, BioMaps, Orsay, 91401, France (F.L.B., C.C., V.L., E.D.); Applications and Workflow, GE Healthcare, Buc, France (B.F.); Laboratoire de Mathématiques d'Orsay, Université Paris-Saclay CNRS, 91405 Orsay, France (S.F.); Dept of Thoracic and Vascular Surgery and Heart-Lung Transplantation, Hôpital Marie Lannelongue, 92350 Le Plessis Robinson, France (O.M., S.M., D. Mitilian, E.F.); Dept of Respiratory and Intensive Care Medicine, Pulmonary Hypertension National Referral Center, Hôpitaux Universitaires Paris-Saclay, Assistance Publique-Hôpitaux de Paris, CHU Bicêtre, 94270, Le Kremlin-Bicêtre, France (A.S., X.M., S.B., F.P., D. Montani); Inserm UMR_S999 Pulmonary Hypertension: Pathophysiology and Novel Therapies, Hôpital Marie Lannelongue, 92350 Le Plessis Robinson, France (A.S., D. Montani); Service Hospitalier Frédéric Joliot (SHFJ), CEA/Université Paris-Saclay, Orsay, France (É.B., A.C., F.B., V.L.); Dept of Pathology, Hôpital Marie Lannelongue, 92350 Le Plessis Robinson, France (M.R.G.B.); NeuroSpin, CEA Saclay, Université Paris-Saclay, Gif-sur-Yvette, France and Parietal, INRIA, Palaiseau, 91120, France (H.C.)
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Michot JM, Lappara A, Le Pavec J, Simonaggio A, Collins M, De Martin E, Danlos FX, Ammari S, Cauquil C, Ederhy S, Barreau E, Belkhir R, Berdelou A, Lazarovici J, Chanson P, Izzedine H, Seferian A, Le Pajolec C, Baldini C, Martin-Romano P, Mariette X, Robert C, Besse B, Hollebecque A, Varga A, Laghouati S, Mateus C, Voisin AL, Soria JC, Massard C, Marabelle A, Champiat S, Lambotte O. The 2016-2019 ImmunoTOX assessment board report of collaborative management of immune-related adverse events, an observational clinical study. Eur J Cancer 2020; 130:39-50. [PMID: 32172197 DOI: 10.1016/j.ejca.2020.02.010] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Accepted: 02/11/2020] [Indexed: 12/13/2022]
Abstract
PURPOSE We investigated the activities of an ImmunoTOX board, an academic, multidisciplinary group of oncologists and organ specialists that adopts a real-life, case-by-case approach in the management of patients with immune-related adverse events (irAEs). EXPERIMENTAL DESIGN The ImmunoTOX assessment board was set up in 2016 at Gustave Roussy in France. It meets every 2 weeks to discuss the case-by-case management of patients presenting with irAEs. Here, we describe the ImmunoTOX board's activities between 2016 and 2019. RESULTS Over study period, 398 requests (concerning 356 patients) were submitted to the ImmunoTOX board. Most of the requests concerned the putative causal link between immunotherapy and the irAE (n = 148, 37%), followed by possible retreatment after temporary withdrawal because of an adverse event (n = 109, 27%), the clinical management of complex situations (n = 100, 25%) and the initiation of immunotherapy in patients with pre-existing comorbidities (n = 41, 10%). The ImmunoTOX board discerned 273 irAEs. The five organ systems most frequently involved by irAEs were lung (n = 58, 21%), gastrointestinal tract (n = 36, 13%), liver or biliary tract (n = 33, 12%), musculoskeletal system (n = 27, 10%), and nervous system (n = 23, 8%). The time to occurrence was shorter for severe irAEs (grade III and VI) than for mild irAEs (grades I and II), with medians of 47 and 91 days, respectively (p = 0.0216). CONCLUSION The main medical needs in the management of irAEs involved the lung organ. Severe irAEs were expected to occur earlier than mild irAEs. This real-life study can help to better estimate medical needs and therefore help to assess the management of irAEs.
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Affiliation(s)
- Jean-Marie Michot
- Gustave Roussy, Université Paris-Saclay, Département des Innovations Thérapeutiques et Essais Précoces, Villejuif, France.
| | - Ariane Lappara
- Assistance Publique - Hôpitaux de Paris, Hôpital Bicêtre, Service de Médecine Interne and Immunologie clinique, Le Kremlin-Bicêtre, France
| | - Jérôme Le Pavec
- Hôpital Marie-Lannelongue, Department of Thoracic and Cardiovascular, and Transplantation Cardio-Pulmonary, Le Plessis-Robinson, France
| | - Audrey Simonaggio
- Gustave Roussy, Université Paris-Saclay, Département des Innovations Thérapeutiques et Essais Précoces, Villejuif, France
| | - Michael Collins
- Assistance Publique-Hôpitaux de Paris, Université Paris-Sud, Hôpitaux Universitaires Paris Sud, Gastroenterology Unit, Le Kremlin Bicêtre, France
| | - Eléonora De Martin
- Assistance Publique-Hôpitaux de Paris, Hôpital Universitaire Paul Brousse, Centre Hépato-Biliaire, Villejuif, France
| | - François-Xavier Danlos
- Gustave Roussy, Université Paris-Saclay, Département des Innovations Thérapeutiques et Essais Précoces, Villejuif, France
| | - Samy Ammari
- Gustave Roussy, Université Paris-Saclay, Department of Diagnostic Radiology, Villejuif, France
| | - Cécile Cauquil
- Assistance Publique - Hôpitaux de Paris, Hôpital Bicêtre, Division of Adult Neurology, Le Kremlin Bicêtre, France
| | - Stéphane Ederhy
- Assistance Publique-Hôpitaux de Paris, Saint-Antoine Hospital, Service de cardiologie, Unite de cardio-oncologie, Pierre et Marie Curie University, Paris, France
| | - Emmanuel Barreau
- Assistance Publique - Hôpitaux de Paris, Hôpital Bicêtre, Department of Ophthalmology, Le Kremlin Bicêtre, France
| | - Rakiba Belkhir
- Assistance Publique - Hôpitaux de Paris, Hôpital Bicêtre, Department of Rheumatology, Le Kremlin Bicêtre, France
| | - Amandine Berdelou
- Gustave Roussy, Université Paris-Saclay, Department of Cancer Medicine, Villejuif, France
| | - Julien Lazarovici
- Gustave Roussy, Université Paris-Saclay, Department of Hematology, Villejuif, France
| | - Philippe Chanson
- Assistance Publique - Hôpitaux de Paris, Hôpital Bicêtre, Unit of Endocrinology and Reproductive Health, Le Kremlin Bicêtre, France
| | - Hassan Izzedine
- Peupliers Private Hospital, Nephrology Department, Paris, France
| | - Andrei Seferian
- Assistance Publique - Hôpitaux de Paris, Hôpital Bicêtre, Service de Pneumologie, Centre de Référence de l'Hypertension Pulmonaire, Le Kremlin Bicêtre, France
| | - Christine Le Pajolec
- Assistance Publique - Hôpitaux de Paris, Hôpital Bicêtre, Ear Nose and Throat Department, Le Kremlin Bicêtre, France
| | - Capucine Baldini
- Gustave Roussy, Université Paris-Saclay, Département des Innovations Thérapeutiques et Essais Précoces, Villejuif, France
| | - Patricia Martin-Romano
- Gustave Roussy, Université Paris-Saclay, Département des Innovations Thérapeutiques et Essais Précoces, Villejuif, France
| | - Xavier Mariette
- Assistance Publique - Hôpitaux de Paris, Hôpital Bicêtre, Department of Rheumatology, Le Kremlin Bicêtre, France
| | - Caroline Robert
- Gustave Roussy, Université Paris-Saclay, Department of Cancer Medicine, Villejuif, France
| | - Benjamin Besse
- Gustave Roussy, Université Paris-Saclay, Department of Cancer Medicine, Villejuif, France
| | - Antoine Hollebecque
- Gustave Roussy, Université Paris-Saclay, Département des Innovations Thérapeutiques et Essais Précoces, Villejuif, France
| | - Andrea Varga
- Gustave Roussy, Université Paris-Saclay, Département des Innovations Thérapeutiques et Essais Précoces, Villejuif, France
| | - Salim Laghouati
- Gustave Roussy, Université Paris-Saclay, Unité de Pharmacovigilance, Villejuif, France
| | - Christine Mateus
- Gustave Roussy, Université Paris-Saclay, Department of Cancer Medicine, Villejuif, France
| | - Anne-Laure Voisin
- Gustave Roussy, Université Paris-Saclay, Unité de Pharmacovigilance, Villejuif, France
| | - Jean-Charles Soria
- Gustave Roussy, Université Paris-Saclay, Département des Innovations Thérapeutiques et Essais Précoces, Villejuif, France
| | - Christophe Massard
- Gustave Roussy, Université Paris-Saclay, Département des Innovations Thérapeutiques et Essais Précoces, Villejuif, France
| | - Aurélien Marabelle
- Gustave Roussy, Université Paris-Saclay, Département des Innovations Thérapeutiques et Essais Précoces, Villejuif, France
| | - Stéphane Champiat
- Gustave Roussy, Université Paris-Saclay, Département des Innovations Thérapeutiques et Essais Précoces, Villejuif, France
| | - Olivier Lambotte
- Assistance Publique - Hôpitaux de Paris, Hôpital Bicêtre, Service de Médecine Interne and Immunologie clinique, Le Kremlin-Bicêtre, France; INSERM U1184, Immunology of Viral Infections and Autoimmune Diseases, Le Kremlin Bicêtre, France; Université Paris Sud, UMR 1184, Le Kremlin Bicêtre, France; CEA, DSV/iMETI, IDMIT, Fontenay-aux-Roses, France
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Hoffmann-Vold AM, Maher TM, Philpot EE, Ashrafzadeh A, Barake R, Barsotti S, Bruni C, Carducci P, Carreira PE, Castellví I, Del Galdo F, Distler JHW, Foeldvari I, Fraticelli P, George PM, Griffiths B, Guillén-Del-Castillo A, Hamid AM, Horváth R, Hughes M, Kreuter M, Moazedi-Fuerst F, Olas J, Paul S, Rotondo C, Rubio-Rivas M, Seferian A, Tomčík M, Uzunhan Y, Walker UA, Więsik-Szewczyk E, Distler O. The identification and management of interstitial lung disease in systemic sclerosis: evidence-based European consensus statements. Lancet Rheumatol 2020; 2:e71-e83. [PMID: 38263663 DOI: 10.1016/s2665-9913(19)30144-4] [Citation(s) in RCA: 144] [Impact Index Per Article: 36.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Revised: 12/05/2019] [Accepted: 12/06/2019] [Indexed: 11/18/2022]
Abstract
BACKGROUND Systemic sclerosis-associated interstitial lung disease (ILD) carries a high mortality risk; expert guidance is required to aid early recognition and treatment. We aimed to develop the first expert consensus and define an algorithm for the identification and management of the condition through application of well established methods. METHODS Evidence-based consensus statements for systemic sclerosis-associated ILD management were established for six domains (ie, risk factors, screening, diagnosis and severity assessment, treatment initiation and options, disease progression, and treatment escalation) using a modified Delphi process based on a systematic literature analysis. A panel of 27 Europe-based pulmonologists, rheumatologists, and internists with expertise in systemic sclerosis-associated ILD participated in three rounds of online surveys, a face-to-face discussion, and a WebEx meeting, followed by two supplemental Delphi rounds, to establish consensus and define a management algorithm. Consensus was considered achieved if at least 80% of panellists indicated agreement or disagreement. FINDINGS Between July 1, 2018, and Aug 27, 2019, consensus agreement was reached for 52 primary statements and six supplemental statements across six domains of management, and an algorithm was defined for clinical practice use. The agreed statements most important for clinical use included: all patients with systemic sclerosis should be screened for systemic sclerosis-associated ILD using high-resolution CT; high-resolution CT is the primary tool for diagnosing ILD in systemic sclerosis; pulmonary function tests support screening and diagnosis; systemic sclerosis-associated ILD severity should be measured with more than one indicator; it is appropriate to treat all severe cases; no pharmacological treatment is an option for some patients; follow-up assessments enable identification of disease progression; progression pace, alongside disease severity, drives decisions to escalate treatment. INTERPRETATION Through a robust modified Delphi process developed by a diverse panel of experts, the first evidence-based consensus statements were established on guidance for the identification and medical management of systemic sclerosis-associated ILD. FUNDING An unrestricted grant from Boehringer Ingelheim International.
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Affiliation(s)
| | - Toby M Maher
- National Heart and Lung Institute, Imperial College London, London, UK; Interstitial Lung Disease Unit, Royal Brompton Hospital, London, UK
| | | | - Ali Ashrafzadeh
- Rheumatology Center of Excellence, IQVIA, San Diego, CA, USA
| | - Rafic Barake
- Department of Pulmonary Diseases, Centre Hospitalier de Rambouillet, Rambouillet, France
| | | | - Cosimo Bruni
- Department of Rheumatology/Scleroderma Unit, University of Florence, Florence, Italy
| | - Paolo Carducci
- Pulmonology Unit, San Salvatore Hospital, L'Aquila, Italy
| | | | - Ivan Castellví
- Department of Rheumatology, Hospital Universitari de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Francesco Del Galdo
- NIHR Biomedical Research Centre and Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK
| | - Jörg H W Distler
- Department of Internal Medicine 3 and Institute for Clinical Immunology, University of Erlangen-Nürnberg, Erlangen, Germany
| | - Ivan Foeldvari
- Hamburg Centre for Pediatric and Adolescent Rheumatology, Hamburg, Germany
| | - Paolo Fraticelli
- Department of Internal Medicine, Ospedali Riuniti-Università Politecnica delle Marche, Ancona, Italy
| | - Peter M George
- National Heart and Lung Institute, Imperial College London, London, UK; Interstitial Lung Disease Unit, Royal Brompton Hospital, London, UK
| | - Bridget Griffiths
- Department of Rheumatology, Freeman Hospital, Newcastle-upon-Tyne, UK
| | | | - Abdul Monem Hamid
- Department of Pneumology and Lung Transplantation, Foch Hospital, Paris, France; Collège de Médecine des Hôpitaux de Paris, Paris, France
| | - Rudolf Horváth
- Department of Paediatric and Adult Rheumatology, Faculty Hospital Motol, Prague, Czech Republic
| | - Michael Hughes
- Department of Rheumatology, Royal Hallamshire Hospital, Sheffield, UK
| | - Michael Kreuter
- Center for Interstitial and Rare Lung Diseases, Pneumology Thoraxklinik Heidelberg University Hospital, Heidelberg and German Center for Lung Research, Germany
| | - Florentine Moazedi-Fuerst
- Department of Internal Medicine, Division of Rheumatology and Immunology, Medical University of Graz, Graz, Austria
| | - Jacek Olas
- Scleroderma Outpatient Clinic, Małopolska Center of Rheumatology, Immunology and Rehabilitation, Krakow, Poland
| | - Suman Paul
- Respiratory Medicine Department, Royal Preston Hospital, Preston, UK
| | - Cinzia Rotondo
- Scleroderma Outpatient Clinic, Rheumatology Unit, University Hospital Ospedali Riuniti di Foggia, Foggia, Italy
| | - Manuel Rubio-Rivas
- Department of Internal Medicine, Bellvitge University Hospital, Barcelona, Spain
| | - Andrei Seferian
- University Paris-Sud, Faculté de Médecine, Université Paris-Saclay, Le Kremlin-Bicêtre, France; INSERM UMR_S 999, Hôpital Marie Lannelongue, Le Plessis-Robinson, France; Assistance Publique-Hôpitaux de Paris, Service de Pneumologie, Centre de Référence de l'Hypertension Pulmonaire, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
| | | | - Yurdagül Uzunhan
- Assistance Publique-Hôpitaux de Paris, Avicenne Hospital, Pneumology Department, INSERM UMR 1272, Paris 13 University, Bobigny, France
| | - Ulrich A Walker
- Department of Rheumatology, University Hospital Basel, Basel, Switzerland
| | - Ewa Więsik-Szewczyk
- Department of Internal Medicine, Pneumonology, Allergology and Clinical Immunology, Central Clinical Hospital of the Ministry of National Defense, Military Institute of Medicine, Warsaw, Poland
| | - Oliver Distler
- Department of Rheumatology, University Hospital Zurich, Zurich, Switzerland
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Servais L, Gidaro T, Seferian A, Gasnier E, Daron A, Ulinici A, Annoussamy M, Grelet M, Vissiere D. OUTCOME MEASURES. Neuromuscul Disord 2019. [DOI: 10.1016/j.nmd.2019.06.244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Catapano F, Scaglioni D, Maresh K, Selby V, Ala P, Domingos J, Ricotti V, Phillips L, van der Holst M, Servais L, Seferian A, de Groot I, Krom Y, Voit T, Verschuuren J, Niks E, Straub V, Morgan J, Muntoni F. P.144A cross sectional and longitudinal miRNA profiling study identified a set of novel free-circulating and exosomal miRNAs dysregulated in plasma from Duchenne muscular dystrophy patients. Neuromuscul Disord 2019. [DOI: 10.1016/j.nmd.2019.06.200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Chabanon A, Annoussamy M, Daron A, Péréon Y, Cances C, Vuillerot C, Goemans N, Cuisset J, Laugel V, Schara U, Gidaro T, Seferian A, Lowes L, Carlier P, Hogrel JR, Czech C, Hermosilla R, Kwaja O, Servais L. SMA CLINICAL DATA, OUTCOME MEASURES AND REGISTRIES. Neuromuscul Disord 2018. [DOI: 10.1016/j.nmd.2018.06.105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Lilien C, Grelet M, Gasnier E, Gidaro T, Seferian A, Rigaud A, Vissière D, Servais L. DUCHENNE MUSCULAR DYSTROPHY - PHYSIOTHERAPY. Neuromuscul Disord 2018. [DOI: 10.1016/j.nmd.2018.06.360] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Hogrel J, Annoussamy M, Chabanon A, Daron A, Péréon Y, Cances C, Vuillerot C, Goemans N, Cuisset J, Laugel V, Schara U, Gargaun E, Gidaro T, Seferian A, Turk S, Hermosilla R, Fournier E, Baudin P, Carlier P, Servais L, Study Group. SMA CLINICAL DATA, OUTCOME MEASURES AND REGISTRIES. Neuromuscul Disord 2018. [DOI: 10.1016/j.nmd.2018.06.116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Besson FL, Henry T, Meyer C, Chevance V, Roblot V, Blanchet E, Arnould V, Grimon G, Chekroun M, Mabille L, Parent F, Seferian A, Bulifon S, Montani D, Humbert M, Chaumet-Riffaud P, Lebon V, Durand E. Rapid Contour-based Segmentation for 18F-FDG PET Imaging of Lung Tumors by Using ITK-SNAP: Comparison to Expert-based Segmentation. Radiology 2018; 288:277-284. [DOI: 10.1148/radiol.2018171756] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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Phan C, Jutant EM, Tu L, Thuillet R, Seferian A, Montani D, Huertas A, Bezu JV, Breijer F, Vonk Noordegraaf A, Humbert M, Aman J, Guignabert C. Dasatinib increases endothelial permeability leading to pleural effusion. Eur Respir J 2018; 51:51/1/1701096. [PMID: 29348177 DOI: 10.1183/13993003.01096-2017] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2017] [Accepted: 10/14/2017] [Indexed: 12/13/2022]
Abstract
Pleural effusion is a frequent side-effect of dasatinib, a second-generation tyrosine kinase inhibitor used in the treatment of chronic myelogenous leukaemia. However, the underlying mechanisms remain unknown. We hypothesised that dasatinib alters endothelial integrity, resulting in increased pulmonary vascular endothelial permeability and pleural effusion.To test this, we established the first animal model of dasatinib-related pleural effusion, by treating rats with a daily regimen of high doses of dasatinib (10 mg·kg-1·day-1 for 8 weeks).Pleural ultrasonography revealed that rats chronically treated with dasatinib developed pleural effusion after 5 weeks. Consistent with these in vivo observations, dasatinib led to a rapid and reversible increase in paracellular permeability of human pulmonary endothelial cell monolayers as reflected by increased macromolecule passage, loss of vascular endothelial cadherin and zonula occludens-1 from cell-cell junctions, and the development of actin stress fibres. These results were replicated using human umbilical vein endothelial cells and confirmed by decreased endothelial resistance. Interestingly, we demonstrated that this increased endothelial permeability is a reactive oxygen species (ROS)-dependent mechanism in vitro and in vivo using a cotreatment with an antioxidant agent, N-acetylcysteine.This study shows that dasatinib alters pulmonary endothelial permeability in a ROS-dependent manner in vitro and in vivo leading to pleural effusion.
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Affiliation(s)
- Carole Phan
- INSERM UMR_S 999, Le Plessis-Robinson, France.,Université Paris-Sud and Université Paris-Saclay, Le Kremlin-Bicêtre, France.,Service de Pneumologie, AP-HP, Centre de Référence de l'Hypertension Pulmonaire Sévère, DHU TORINO, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
| | - Etienne-Marie Jutant
- INSERM UMR_S 999, Le Plessis-Robinson, France.,Université Paris-Sud and Université Paris-Saclay, Le Kremlin-Bicêtre, France.,Service de Pneumologie, AP-HP, Centre de Référence de l'Hypertension Pulmonaire Sévère, DHU TORINO, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
| | - Ly Tu
- INSERM UMR_S 999, Le Plessis-Robinson, France.,Université Paris-Sud and Université Paris-Saclay, Le Kremlin-Bicêtre, France.,Service de Pneumologie, AP-HP, Centre de Référence de l'Hypertension Pulmonaire Sévère, DHU TORINO, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
| | - Raphaël Thuillet
- INSERM UMR_S 999, Le Plessis-Robinson, France.,Université Paris-Sud and Université Paris-Saclay, Le Kremlin-Bicêtre, France.,Service de Pneumologie, AP-HP, Centre de Référence de l'Hypertension Pulmonaire Sévère, DHU TORINO, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
| | - Andrei Seferian
- INSERM UMR_S 999, Le Plessis-Robinson, France.,Université Paris-Sud and Université Paris-Saclay, Le Kremlin-Bicêtre, France.,Service de Pneumologie, AP-HP, Centre de Référence de l'Hypertension Pulmonaire Sévère, DHU TORINO, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
| | - David Montani
- INSERM UMR_S 999, Le Plessis-Robinson, France.,Université Paris-Sud and Université Paris-Saclay, Le Kremlin-Bicêtre, France.,Service de Pneumologie, AP-HP, Centre de Référence de l'Hypertension Pulmonaire Sévère, DHU TORINO, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
| | - Alice Huertas
- INSERM UMR_S 999, Le Plessis-Robinson, France.,Université Paris-Sud and Université Paris-Saclay, Le Kremlin-Bicêtre, France.,Service de Pneumologie, AP-HP, Centre de Référence de l'Hypertension Pulmonaire Sévère, DHU TORINO, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
| | - Jan van Bezu
- Dept of Physiology, VU University Medical Center, Amsterdam, The Netherlands
| | - Fabian Breijer
- Dept of Physiology, VU University Medical Center, Amsterdam, The Netherlands
| | - Anton Vonk Noordegraaf
- Dept of Pulmonary Disease, Institute of Cardiovascular Research, Amsterdam, The Netherlands
| | - Marc Humbert
- INSERM UMR_S 999, Le Plessis-Robinson, France.,Université Paris-Sud and Université Paris-Saclay, Le Kremlin-Bicêtre, France.,Service de Pneumologie, AP-HP, Centre de Référence de l'Hypertension Pulmonaire Sévère, DHU TORINO, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
| | - Jurjan Aman
- Dept of Pulmonary Disease, Institute of Cardiovascular Research, Amsterdam, The Netherlands.,Dept of Physiology, VU University Medical Center, Amsterdam, The Netherlands
| | - Christophe Guignabert
- INSERM UMR_S 999, Le Plessis-Robinson, France.,Université Paris-Sud and Université Paris-Saclay, Le Kremlin-Bicêtre, France.,Service de Pneumologie, AP-HP, Centre de Référence de l'Hypertension Pulmonaire Sévère, DHU TORINO, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
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Gargaun E, Seferian A, Quicke G, Moraux A, Gidaro T, Gasnier E, Daron A, Péréon Y, Cances C, Vuillerot C, Cuisset J, Toledano E, Hermosilla R, Khwaja O, Czech C, Chabanon A, Annoussamy M, Vissiere D, Servais L. Innovative home activity monitoring in non-ambulant patients with spinal muscular atrophy: a multicenter observational trial. Neuromuscul Disord 2017. [DOI: 10.1016/j.nmd.2017.06.469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Chabanon A, Annoussamy M, Daron A, Pereon Y, Cances C, Vuillerot C, Goemans N, Cuisset J, Laugel V, Schara U, Gargaun E, Gidaro T, Seferian A, Lowes L, Carlier P, Hogrel J, Czech C, Hermosilla R, Khwaja O, Servais L. Longitudinal data of the European prospective natural history study of patients with type 2 and 3 spinal muscular atrophy. Neuromuscul Disord 2017. [DOI: 10.1016/j.nmd.2017.06.154] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Aragon-Gawinska K, Gargaun E, Seferian A, Gidaro T, Gilabert S, Lilien C, Vuillerot C, Cances C, Daron A, Marucco E, De A, Berliac LF, Armier H, Fiedler L, Servais L. Safety, tolerability and clinical efficacy of nusinersen in SMA type 1 older than 7 months: a prospective study. Neuromuscul Disord 2017. [DOI: 10.1016/j.nmd.2017.06.422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Montani D, Seferian A, Parent F, Humbert M. Immune checkpoint inhibitor-associated interstitial lung diseases: some progress but still many issues. Eur Respir J 2017; 50:50/2/1701319. [DOI: 10.1183/13993003.01319-2017] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2017] [Accepted: 07/03/2017] [Indexed: 11/05/2022]
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Weatherald J, Chaumais MC, Savale L, Jaïs X, Seferian A, Canuet M, Bouvaist H, Magro P, Bergeron A, Guignabert C, Sitbon O, Simonneau G, Humbert M, Montani D. Long-term outcomes of dasatinib-induced pulmonary arterial hypertension: a population-based study. Eur Respir J 2017; 50:50/1/1700217. [DOI: 10.1183/13993003.00217-2017] [Citation(s) in RCA: 73] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2017] [Accepted: 05/23/2017] [Indexed: 12/21/2022]
Abstract
This study aimed to describe the long-term outcomes of pulmonary arterial hypertension (PAH) induced by dasatinib.21 incident, right heart catheterisation-confirmed cases of dasatinib-induced PAH were identified from the French Pulmonary Hypertension Registry. Clinical and haemodynamic variables were compared from baseline to last follow-up (median (range) 24 (1–81) months).Median age was 52 years and 15 patients were female (71%). 19 patients received dasatinib for chronic myelogenous leukaemia for a median (range) duration of 42 (8–74) months before PAH diagnosis. No bone morphogenic protein receptor-2 (BMPR2) mutations were found in the 10 patients tested. Dasatinib was uniformly discontinued and 11 patients received PAH medications. Four patients died during follow-up. New York Heart Association functional class improved from 76% in class III/IV to 90% in class I/II (p<0.01). Median (range) 6-min walk distance improved from 306 (0–660) to 430 (165–635) m (p<0.01). Median (range) mean pulmonary arterial pressure improved from 45 (30–70) to 26 (17–50) mmHg (p<0.01) and pulmonary vascular resistance from 6.1 (3.2–27.3) to 2.6 (1.2–5.9) Wood units (p<0.01). Patients treated with PAH medications had worse baseline haemodynamics but similar long-term outcomes to untreated patients. PAH persisted in 37% of patients.Dasatinib-induced PAH frequently improves after discontinuation but persisted in over one-third of patients, therefore systematic follow-up is essential.
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Montani D, Girerd B, Jaïs X, Levy M, Amar D, Savale L, Dorfmüller P, Seferian A, Lau EM, Eyries M, Le Pavec J, Parent F, Bonnet D, Soubrier F, Fadel E, Sitbon O, Simonneau G, Humbert M. Clinical phenotypes and outcomes of heritable and sporadic pulmonary veno-occlusive disease: a population-based study. Lancet Respir Med 2017; 5:125-134. [PMID: 28087362 DOI: 10.1016/s2213-2600(16)30438-6] [Citation(s) in RCA: 104] [Impact Index Per Article: 14.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/30/2016] [Revised: 11/14/2016] [Accepted: 11/17/2016] [Indexed: 11/18/2022]
Abstract
BACKGROUND Bi-allelic mutations of the EIF2AK4 gene cause heritable pulmonary veno-occlusive disease and/or pulmonary capillary haemangiomatosis (PVOD/PCH). We aimed to assess the effect of EIF2AK4 mutations on the clinical phenotypes and outcomes of PVOD/PCH. METHODS We did a population-based study using clinical, functional, and haemodynamic data from the registry of the French Pulmonary Hypertension Network. We reviewed the clinical data and outcomes from all patients referred to the French Referral Centre (Pulmonary Department, Hospital Kremlin-Bicêtre, University Paris-Sud) with either confirmed or highly probable PVOD/PCH with DNA available for mutation screening (excluding patients with other risk factors of pulmonary hypertension, such as chronic respiratory diseases). We sequenced the coding sequence and intronic junctions of the EIF2AK4 gene, and compared clinical characteristics and outcomes between EIF2AK4 mutation carriers and non-carriers. Medical therapies approved for pulmonary arterial hypertension (prostacyclin derivatives, endothelin receptor antagonists and phosphodiesterase type-5 inhibitors) were given to patients according to the clinical judgment and discretion of treating physicians. The primary outcome was the event-free survival (death or transplantation). Secondary outcomes included response to therapies for pulmonary arterial hypertension and survival after lung transplantation. A satisfactory clinical response to specific therapy for pulmonary arterial hypertension was defined by achieving New York Heart Association functional class I or II, a 6-min walk distance of more than 440 m, and a cardiac index greater than 2·5 L/min per m2 at the first reassessment after initiation of specific therapy for pulmonary arterial hypertension. FINDINGS We obtained data from Jan 1, 2003, to June 1, 2016, and identified 94 patients with sporadic or heritable PVOD/PCH (confirmed or highly probable). 27 (29%) of these patients had bi-allelic EIF2AK4 mutations. PVOD/PCH due to EIF2AK4 mutations occurred from birth to age 50 years, and these patients were younger at presentation than non-carriers (median 26·0 years [range 0-50.3] vs 60·0 years [6·7-81·4] years; p<0·0001). At diagnosis, both mutations carriers and non-carriers had similarly severe precapillary pulmonary hypertension and functional impairment. 22 (81%) of mutations carriers and 63 (94%) of non-carriers received therapy approved for pulmonary arterial hypertension. Drug-induced pulmonary oedema occurred in five (23%) of treated EIF2AK4 mutations carriers and 13 (21%) of treated non-carriers. Follow-up assessment after initiation of treatment showed that only three (4%) patients with PVOD/PCH reached the predefined criteria for satisfactory clinical response. The probabilities of event-free survival (death or transplantation) at 1 and 3 years were 63% and 32% in EIF2AK4 mutations carriers, and 75% and 34% in non-carriers. No significant differences occurred in event-free survival between the 2 groups (p=0·38). Among the 33 patients who had lung transplantation, estimated post-transplantation survival rates at 1, 2, and 5 years were 84%, 81%, and 73%, respectively. INTERPRETATION Heritable PVOD/PCH due to bi-allelic EIF2AK4 mutations is characterised by a younger age at diagnosis but these patients display similar disease severity compared with mutation non-carriers. Response to therapy approved for pulmonary arterial hypertension in PVOD/PCH is rare. PVOD/PCH is a devastating condition and lung transplantation should be considered for eligible patients. FUNDING None.
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Affiliation(s)
- David Montani
- University Paris-Sud, Faculté de Médecine, Paris, F-94270, France; AP-HP, Centre de Référence de l'Hypertension Pulmonaire Sévère, Département Hospitalo-Universitaire (DHU) Thorax Innovation (TORINO), Service de Pneumologie, Hôpital de Bicêtre, Le Kremlin Bicêtre, Paris, France; UMR_S 999, Univ. Paris-Sud, INSERM, Laboratoire d'Excellence (LabEx) en Recherche sur le Médicament et l'Innovation Thérapeutique (LERMIT), Centre Chirurgical Marie Lannelongue, Le Plessis Robinson, Paris, France
| | - Barbara Girerd
- University Paris-Sud, Faculté de Médecine, Paris, F-94270, France; AP-HP, Centre de Référence de l'Hypertension Pulmonaire Sévère, Département Hospitalo-Universitaire (DHU) Thorax Innovation (TORINO), Service de Pneumologie, Hôpital de Bicêtre, Le Kremlin Bicêtre, Paris, France; UMR_S 999, Univ. Paris-Sud, INSERM, Laboratoire d'Excellence (LabEx) en Recherche sur le Médicament et l'Innovation Thérapeutique (LERMIT), Centre Chirurgical Marie Lannelongue, Le Plessis Robinson, Paris, France
| | - Xavier Jaïs
- University Paris-Sud, Faculté de Médecine, Paris, F-94270, France; AP-HP, Centre de Référence de l'Hypertension Pulmonaire Sévère, Département Hospitalo-Universitaire (DHU) Thorax Innovation (TORINO), Service de Pneumologie, Hôpital de Bicêtre, Le Kremlin Bicêtre, Paris, France; UMR_S 999, Univ. Paris-Sud, INSERM, Laboratoire d'Excellence (LabEx) en Recherche sur le Médicament et l'Innovation Thérapeutique (LERMIT), Centre Chirurgical Marie Lannelongue, Le Plessis Robinson, Paris, France
| | - Marilyne Levy
- M3C-Necker, Reference Centre for Complex Congenital Heart Diseases, Hôpital Universitaire Necker-Enfants malades, AP-HP, Université Paris Descartes, Paris, France
| | - David Amar
- University Paris-Sud, Faculté de Médecine, Paris, F-94270, France; AP-HP, Centre de Référence de l'Hypertension Pulmonaire Sévère, Département Hospitalo-Universitaire (DHU) Thorax Innovation (TORINO), Service de Pneumologie, Hôpital de Bicêtre, Le Kremlin Bicêtre, Paris, France; UMR_S 999, Univ. Paris-Sud, INSERM, Laboratoire d'Excellence (LabEx) en Recherche sur le Médicament et l'Innovation Thérapeutique (LERMIT), Centre Chirurgical Marie Lannelongue, Le Plessis Robinson, Paris, France
| | - Laurent Savale
- University Paris-Sud, Faculté de Médecine, Paris, F-94270, France; AP-HP, Centre de Référence de l'Hypertension Pulmonaire Sévère, Département Hospitalo-Universitaire (DHU) Thorax Innovation (TORINO), Service de Pneumologie, Hôpital de Bicêtre, Le Kremlin Bicêtre, Paris, France; UMR_S 999, Univ. Paris-Sud, INSERM, Laboratoire d'Excellence (LabEx) en Recherche sur le Médicament et l'Innovation Thérapeutique (LERMIT), Centre Chirurgical Marie Lannelongue, Le Plessis Robinson, Paris, France
| | - Peter Dorfmüller
- University Paris-Sud, Faculté de Médecine, Paris, F-94270, France; AP-HP, Centre de Référence de l'Hypertension Pulmonaire Sévère, Département Hospitalo-Universitaire (DHU) Thorax Innovation (TORINO), Service de Pneumologie, Hôpital de Bicêtre, Le Kremlin Bicêtre, Paris, France; UMR_S 999, Univ. Paris-Sud, INSERM, Laboratoire d'Excellence (LabEx) en Recherche sur le Médicament et l'Innovation Thérapeutique (LERMIT), Centre Chirurgical Marie Lannelongue, Le Plessis Robinson, Paris, France; Centre Chirurgical Marie Lannelongue, Service de Chirurgie Thoracique, Vasculaire et Transplantation Cardiopulmonaire, Le Plessis Robinson, Paris, France
| | - Andrei Seferian
- University Paris-Sud, Faculté de Médecine, Paris, F-94270, France; AP-HP, Centre de Référence de l'Hypertension Pulmonaire Sévère, Département Hospitalo-Universitaire (DHU) Thorax Innovation (TORINO), Service de Pneumologie, Hôpital de Bicêtre, Le Kremlin Bicêtre, Paris, France; UMR_S 999, Univ. Paris-Sud, INSERM, Laboratoire d'Excellence (LabEx) en Recherche sur le Médicament et l'Innovation Thérapeutique (LERMIT), Centre Chirurgical Marie Lannelongue, Le Plessis Robinson, Paris, France
| | - Edmund M Lau
- University Paris-Sud, Faculté de Médecine, Paris, F-94270, France; AP-HP, Centre de Référence de l'Hypertension Pulmonaire Sévère, Département Hospitalo-Universitaire (DHU) Thorax Innovation (TORINO), Service de Pneumologie, Hôpital de Bicêtre, Le Kremlin Bicêtre, Paris, France; Sydney Medical School, University of Sydney, Camperdown, VIC, Australia; Royal Prince Alfred Hospital, Camperdown, VIC, Australia
| | - Mélanie Eyries
- Département de Génétique, Hôpital Pitié Salpétrière, AP-HP, UMR_S1166-ICAN, Paris, France; INSERM and UPMC Sorbonne Universités, Paris, France
| | - Jérôme Le Pavec
- Centre Chirurgical Marie Lannelongue, Service de Chirurgie Thoracique, Vasculaire et Transplantation Cardiopulmonaire, Le Plessis Robinson, Paris, France
| | - Florence Parent
- University Paris-Sud, Faculté de Médecine, Paris, F-94270, France; AP-HP, Centre de Référence de l'Hypertension Pulmonaire Sévère, Département Hospitalo-Universitaire (DHU) Thorax Innovation (TORINO), Service de Pneumologie, Hôpital de Bicêtre, Le Kremlin Bicêtre, Paris, France; UMR_S 999, Univ. Paris-Sud, INSERM, Laboratoire d'Excellence (LabEx) en Recherche sur le Médicament et l'Innovation Thérapeutique (LERMIT), Centre Chirurgical Marie Lannelongue, Le Plessis Robinson, Paris, France
| | - Damien Bonnet
- M3C-Necker, Reference Centre for Complex Congenital Heart Diseases, Hôpital Universitaire Necker-Enfants malades, AP-HP, Université Paris Descartes, Paris, France
| | - Florent Soubrier
- Département de Génétique, Hôpital Pitié Salpétrière, AP-HP, UMR_S1166-ICAN, Paris, France; INSERM and UPMC Sorbonne Universités, Paris, France
| | - Elie Fadel
- Centre Chirurgical Marie Lannelongue, Service de Chirurgie Thoracique, Vasculaire et Transplantation Cardiopulmonaire, Le Plessis Robinson, Paris, France
| | - Olivier Sitbon
- University Paris-Sud, Faculté de Médecine, Paris, F-94270, France; AP-HP, Centre de Référence de l'Hypertension Pulmonaire Sévère, Département Hospitalo-Universitaire (DHU) Thorax Innovation (TORINO), Service de Pneumologie, Hôpital de Bicêtre, Le Kremlin Bicêtre, Paris, France
| | - Gérald Simonneau
- University Paris-Sud, Faculté de Médecine, Paris, F-94270, France; AP-HP, Centre de Référence de l'Hypertension Pulmonaire Sévère, Département Hospitalo-Universitaire (DHU) Thorax Innovation (TORINO), Service de Pneumologie, Hôpital de Bicêtre, Le Kremlin Bicêtre, Paris, France; UMR_S 999, Univ. Paris-Sud, INSERM, Laboratoire d'Excellence (LabEx) en Recherche sur le Médicament et l'Innovation Thérapeutique (LERMIT), Centre Chirurgical Marie Lannelongue, Le Plessis Robinson, Paris, France
| | - Marc Humbert
- University Paris-Sud, Faculté de Médecine, Paris, F-94270, France; AP-HP, Centre de Référence de l'Hypertension Pulmonaire Sévère, Département Hospitalo-Universitaire (DHU) Thorax Innovation (TORINO), Service de Pneumologie, Hôpital de Bicêtre, Le Kremlin Bicêtre, Paris, France; UMR_S 999, Univ. Paris-Sud, INSERM, Laboratoire d'Excellence (LabEx) en Recherche sur le Médicament et l'Innovation Thérapeutique (LERMIT), Centre Chirurgical Marie Lannelongue, Le Plessis Robinson, Paris, France.
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Riou M, Seferian A, Savale L, Chaumais MC, Guignabert C, Canuet M, Magro P, Rea D, Sitbon O, Jaïs X, Humbert M, Montani D. Deterioration of pulmonary hypertension and pleural effusion with bosutinib following dasatinib lung toxicity. Eur Respir J 2016; 48:1517-1519. [DOI: 10.1183/13993003.01410-2016] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2016] [Accepted: 08/25/2016] [Indexed: 11/05/2022]
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Seferian A, Gargaun E, Grelet M, Gasnier E, Lilien C, Gillabert S, Duchene D, Voit T, Domingos JP, Guglieri M, Straub V, Leone D, Mercuri E, Laforet G, Muntoni F, Dorveaux E, Vissiere D, Servais L. Longitudinal results of magneto-inertial motion analysis in Duchenne muscular dystrophy ambulant patients. Neuromuscul Disord 2016. [DOI: 10.1016/j.nmd.2016.06.357] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Seferian A, Quicke G, Gidaro T, Gargaun E, Gasnier E, Pereon Y, Daron A, Cances C, Vuillerot C, Goemans N, Laugel V, Cuisset J, Schara U, Marquet A, Chabanon A, Annoussamy M, Vissiere D, Servais L. Feasibility of magneto-inertial motion analysis in non-ambulant patients with spinal muscular atrophy. Neuromuscul Disord 2016. [DOI: 10.1016/j.nmd.2016.06.065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Guignabert C, Phan C, Seferian A, Huertas A, Tu L, Thuillet R, Sattler C, Le Hiress M, Tamura Y, Jutant EM, Chaumais MC, Bouchet S, Manéglier B, Molimard M, Rousselot P, Sitbon O, Simonneau G, Montani D, Humbert M. Dasatinib induces lung vascular toxicity and predisposes to pulmonary hypertension. J Clin Invest 2016; 126:3207-18. [PMID: 27482885 DOI: 10.1172/jci86249] [Citation(s) in RCA: 179] [Impact Index Per Article: 22.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2015] [Accepted: 05/26/2016] [Indexed: 12/15/2022] Open
Abstract
Pulmonary arterial hypertension (PAH) is a life-threatening disease that can be induced by dasatinib, a dual Src and BCR-ABL tyrosine kinase inhibitor that is used to treat chronic myelogenous leukemia (CML). Today, key questions remain regarding the mechanisms involved in the long-term development of dasatinib-induced PAH. Here, we demonstrated that chronic dasatinib therapy causes pulmonary endothelial damage in humans and rodents. We found that dasatinib treatment attenuated hypoxic pulmonary vasoconstriction responses and increased susceptibility to experimental pulmonary hypertension (PH) in rats, but these effects were absent in rats treated with imatinib, another BCR-ABL tyrosine kinase inhibitor. Furthermore, dasatinib treatment induced pulmonary endothelial cell apoptosis in a dose-dependent manner, while imatinib did not. Dasatinib treatment mediated endothelial cell dysfunction via increased production of ROS that was independent of Src family kinases. Consistent with these findings, we observed elevations in markers of endothelial dysfunction and vascular damage in the serum of CML patients who were treated with dasatinib, compared with CML patients treated with imatinib. Taken together, our findings indicate that dasatinib causes pulmonary vascular damage, induction of ER stress, and mitochondrial ROS production, which leads to increased susceptibility to PH development.
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Bourlier D, O'Connell C, Montani D, Savale L, Seferian A, Parent F, Humbert M, Simonneau G, Sitbon O, Jaïs X. A rare case of sarcoidosis-associated pulmonary hypertension in a patient exposed to silica. Eur Respir Rev 2016; 25:93-6. [PMID: 26929426 DOI: 10.1183/16000617.0073-2015] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Affiliation(s)
- Delphine Bourlier
- Univ Paris-Sud, Faculté de Médecine, Université Paris-Saclay, Le Kremlin-Bicêtre, France AP-HP, Service de Pneumologie, Hôpital Bicêtre, Le Kremlin-Bicêtre, France INSERM UMR_S 999, Centre Chirurgical Marie Lannelongue, Le Plessis Robinson, France
| | - Caroline O'Connell
- Univ Paris-Sud, Faculté de Médecine, Université Paris-Saclay, Le Kremlin-Bicêtre, France AP-HP, Service de Pneumologie, Hôpital Bicêtre, Le Kremlin-Bicêtre, France INSERM UMR_S 999, Centre Chirurgical Marie Lannelongue, Le Plessis Robinson, France
| | - David Montani
- Univ Paris-Sud, Faculté de Médecine, Université Paris-Saclay, Le Kremlin-Bicêtre, France AP-HP, Service de Pneumologie, Hôpital Bicêtre, Le Kremlin-Bicêtre, France INSERM UMR_S 999, Centre Chirurgical Marie Lannelongue, Le Plessis Robinson, France
| | - Laurent Savale
- Univ Paris-Sud, Faculté de Médecine, Université Paris-Saclay, Le Kremlin-Bicêtre, France AP-HP, Service de Pneumologie, Hôpital Bicêtre, Le Kremlin-Bicêtre, France INSERM UMR_S 999, Centre Chirurgical Marie Lannelongue, Le Plessis Robinson, France
| | - Andrei Seferian
- Univ Paris-Sud, Faculté de Médecine, Université Paris-Saclay, Le Kremlin-Bicêtre, France AP-HP, Service de Pneumologie, Hôpital Bicêtre, Le Kremlin-Bicêtre, France INSERM UMR_S 999, Centre Chirurgical Marie Lannelongue, Le Plessis Robinson, France
| | - Florence Parent
- Univ Paris-Sud, Faculté de Médecine, Université Paris-Saclay, Le Kremlin-Bicêtre, France AP-HP, Service de Pneumologie, Hôpital Bicêtre, Le Kremlin-Bicêtre, France INSERM UMR_S 999, Centre Chirurgical Marie Lannelongue, Le Plessis Robinson, France
| | - Marc Humbert
- Univ Paris-Sud, Faculté de Médecine, Université Paris-Saclay, Le Kremlin-Bicêtre, France AP-HP, Service de Pneumologie, Hôpital Bicêtre, Le Kremlin-Bicêtre, France INSERM UMR_S 999, Centre Chirurgical Marie Lannelongue, Le Plessis Robinson, France
| | - Gérald Simonneau
- Univ Paris-Sud, Faculté de Médecine, Université Paris-Saclay, Le Kremlin-Bicêtre, France AP-HP, Service de Pneumologie, Hôpital Bicêtre, Le Kremlin-Bicêtre, France INSERM UMR_S 999, Centre Chirurgical Marie Lannelongue, Le Plessis Robinson, France
| | - Olivier Sitbon
- Univ Paris-Sud, Faculté de Médecine, Université Paris-Saclay, Le Kremlin-Bicêtre, France AP-HP, Service de Pneumologie, Hôpital Bicêtre, Le Kremlin-Bicêtre, France INSERM UMR_S 999, Centre Chirurgical Marie Lannelongue, Le Plessis Robinson, France
| | - Xavier Jaïs
- Univ Paris-Sud, Faculté de Médecine, Université Paris-Saclay, Le Kremlin-Bicêtre, France AP-HP, Service de Pneumologie, Hôpital Bicêtre, Le Kremlin-Bicêtre, France INSERM UMR_S 999, Centre Chirurgical Marie Lannelongue, Le Plessis Robinson, France
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Boucly A, Jaïs X, Seferian A, Sattler C, Amar D, Montani D, Simonneau G, Humbert M, Sitbon O, Savale L. Devenir à long terme des hypertensions pulmonaires associées à une sarcoïdose à l’ère des thérapeutiques ciblées de l’hypertension artérielle pulmonaire. Rev Mal Respir 2016. [DOI: 10.1016/j.rmr.2015.10.707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Montani D, Girerd B, Amar D, Jais X, Savale L, Seferian A, Parent F, Soubrier F, Fadel E, Sitbon O, Simonneau G, Humbert M. Caractéristiques des patients atteints de maladie veino-occlusive porteurs de mutations du gène EIF2AK4. Rev Mal Respir 2016. [DOI: 10.1016/j.rmr.2015.10.703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Seferian A, Steriade A, Jaïs X, Planche O, Savale L, Parent F, Amar D, Jovan R, Fadel E, Sitbon O, Simonneau G, Humbert M, Montani D. L’hypertension pulmonaire associée aux fibroses médiastinales. Rev Mal Respir 2016. [DOI: 10.1016/j.rmr.2015.10.702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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O'Connell C, Montani D, Savale L, Sitbon O, Parent F, Seferian A, Bulifon S, Fadel E, Mercier O, Mussot S, Fabre D, Dartevelle P, Humbert M, Simonneau G, Jaïs X. Chronic thromboembolic pulmonary hypertension. Presse Med 2015; 44:e409-16. [PMID: 26585271 DOI: 10.1016/j.lpm.2015.10.010] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Chronic thromboembolic pulmonary hypertension (CTEPH) is a form of pulmonary hypertension (PH) characterized by the persistence of thromboembolic obstructing the pulmonary arteries as an organized tissue and the presence of a variable small vessel arteriopathy. The consequence is an increase in pulmonary vascular resistance resulting in progressive right heart failure. CTEPH is classified as group IV pulmonary hypertension according to the WHO classification of pulmonary hypertension. CTEPH is defined as precapillary pulmonary hypertension (mean pulmonary artery pressure ≥ 25 mmHg with a pulmonary capillary wedge pressure ≤ 15 mmHg) associated with mismatched perfusion defects on ventilation-perfusion lung scan and signs of chronic thromboembolic disease on computed tomography pulmonary angiogram and/or conventional pulmonary angiography, in a patient who received at least 3 months of therapeutic anticoagulation. CTEPH as a direct consequence of symptomatic pulmonary embolism (PE) is rare, and a significant number of CTEPH cases develop in the absence of history of PE. Thus, CTEPH should be considered in any patient with unexplained PH. Splenectomy, chronic inflammatory conditions such as inflammatory bowel disease, indwelling catheters and cardiac pacemakers have been identified as associated conditions increasing the risk of CTEPH. Ventilation-perfusion scan (V/Q) is the best test available for establishing the thromboembolic nature of PH. When CTEPH is suspected, patients should be referred to expert centres where pulmonary angiography, right heart catheterization and high-resolution CT scan will be performed to confirm the diagnosis and to assess the operability. Pulmonary endarterectomy (PEA) remains the gold standard treatment for CTEPH when organized thrombi involve the main, lobar or segmental arteries. This operation should only be performed by experienced surgeons in specialized centres. For inoperable patients, current ESC/ERS guidelines for the diagnosis and treatment of pulmonary hypertension recommend the use of riociguat and say that off-label use of drugs approved for PAH and pulmonary angioplasty may be considered in expert centres.
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Affiliation(s)
- Caroline O'Connell
- Université Paris-Saclay, faculté de médecine, 94270 Le Kremlin-Bicêtre, France; AP-HP, hôpital Bicêtre, service de pneumologie, 94270 Le Kremlin-Bicêtre, France; Centre chirurgical Marie-Lannelongue, Inserm UMR_S 999, 92060 Le Plessis-Robinson, France
| | - David Montani
- Université Paris-Saclay, faculté de médecine, 94270 Le Kremlin-Bicêtre, France; AP-HP, hôpital Bicêtre, service de pneumologie, 94270 Le Kremlin-Bicêtre, France; Centre chirurgical Marie-Lannelongue, Inserm UMR_S 999, 92060 Le Plessis-Robinson, France
| | - Laurent Savale
- Université Paris-Saclay, faculté de médecine, 94270 Le Kremlin-Bicêtre, France; AP-HP, hôpital Bicêtre, service de pneumologie, 94270 Le Kremlin-Bicêtre, France; Centre chirurgical Marie-Lannelongue, Inserm UMR_S 999, 92060 Le Plessis-Robinson, France
| | - Olivier Sitbon
- Université Paris-Saclay, faculté de médecine, 94270 Le Kremlin-Bicêtre, France; AP-HP, hôpital Bicêtre, service de pneumologie, 94270 Le Kremlin-Bicêtre, France; Centre chirurgical Marie-Lannelongue, Inserm UMR_S 999, 92060 Le Plessis-Robinson, France
| | - Florence Parent
- Université Paris-Saclay, faculté de médecine, 94270 Le Kremlin-Bicêtre, France; AP-HP, hôpital Bicêtre, service de pneumologie, 94270 Le Kremlin-Bicêtre, France; Centre chirurgical Marie-Lannelongue, Inserm UMR_S 999, 92060 Le Plessis-Robinson, France
| | - Andrei Seferian
- Université Paris-Saclay, faculté de médecine, 94270 Le Kremlin-Bicêtre, France; AP-HP, hôpital Bicêtre, service de pneumologie, 94270 Le Kremlin-Bicêtre, France; Centre chirurgical Marie-Lannelongue, Inserm UMR_S 999, 92060 Le Plessis-Robinson, France
| | - Sophie Bulifon
- Université Paris-Saclay, faculté de médecine, 94270 Le Kremlin-Bicêtre, France; AP-HP, hôpital Bicêtre, service de pneumologie, 94270 Le Kremlin-Bicêtre, France; Centre chirurgical Marie-Lannelongue, Inserm UMR_S 999, 92060 Le Plessis-Robinson, France
| | - Elie Fadel
- Université Paris-Saclay, faculté de médecine, 94270 Le Kremlin-Bicêtre, France; Centre chirurgical Marie-Lannelongue, Inserm UMR_S 999, 92060 Le Plessis-Robinson, France; Centre chirurgical Marie-Lannelongue, service de chirurgie thoracique, 92060 Le Plessis-Robinson, France
| | - Olaf Mercier
- Université Paris-Saclay, faculté de médecine, 94270 Le Kremlin-Bicêtre, France; Centre chirurgical Marie-Lannelongue, Inserm UMR_S 999, 92060 Le Plessis-Robinson, France; Centre chirurgical Marie-Lannelongue, service de chirurgie thoracique, 92060 Le Plessis-Robinson, France
| | - Sacha Mussot
- Université Paris-Saclay, faculté de médecine, 94270 Le Kremlin-Bicêtre, France; Centre chirurgical Marie-Lannelongue, Inserm UMR_S 999, 92060 Le Plessis-Robinson, France; Centre chirurgical Marie-Lannelongue, service de chirurgie thoracique, 92060 Le Plessis-Robinson, France
| | - Dominique Fabre
- Université Paris-Saclay, faculté de médecine, 94270 Le Kremlin-Bicêtre, France; Centre chirurgical Marie-Lannelongue, Inserm UMR_S 999, 92060 Le Plessis-Robinson, France; Centre chirurgical Marie-Lannelongue, service de chirurgie thoracique, 92060 Le Plessis-Robinson, France
| | - Philippe Dartevelle
- Université Paris-Saclay, faculté de médecine, 94270 Le Kremlin-Bicêtre, France; Centre chirurgical Marie-Lannelongue, Inserm UMR_S 999, 92060 Le Plessis-Robinson, France; Centre chirurgical Marie-Lannelongue, service de chirurgie thoracique, 92060 Le Plessis-Robinson, France
| | - Marc Humbert
- Université Paris-Saclay, faculté de médecine, 94270 Le Kremlin-Bicêtre, France; AP-HP, hôpital Bicêtre, service de pneumologie, 94270 Le Kremlin-Bicêtre, France; Centre chirurgical Marie-Lannelongue, Inserm UMR_S 999, 92060 Le Plessis-Robinson, France
| | - Gérald Simonneau
- Université Paris-Saclay, faculté de médecine, 94270 Le Kremlin-Bicêtre, France; AP-HP, hôpital Bicêtre, service de pneumologie, 94270 Le Kremlin-Bicêtre, France; Centre chirurgical Marie-Lannelongue, Inserm UMR_S 999, 92060 Le Plessis-Robinson, France
| | - Xavier Jaïs
- Université Paris-Saclay, faculté de médecine, 94270 Le Kremlin-Bicêtre, France; AP-HP, hôpital Bicêtre, service de pneumologie, 94270 Le Kremlin-Bicêtre, France; Centre chirurgical Marie-Lannelongue, Inserm UMR_S 999, 92060 Le Plessis-Robinson, France.
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