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Felix A, Louis-Sidney F, Deligny C, Suzon B. Ethnicity also influences the clinical heterogeneity of mixed connective tissue disease of childhood onset: The French West Indies experience. Autoimmun Rev 2024; 23:103519. [PMID: 38447762 DOI: 10.1016/j.autrev.2024.103519] [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: 02/26/2024] [Revised: 02/27/2024] [Accepted: 03/03/2024] [Indexed: 03/08/2024]
Affiliation(s)
- Arthur Felix
- Department of General Pediatrics, Competence Centre for Rheumatic, Autoimmune and Systemic Diseases in Children (RAISE) Antilles-Guyane, France; EpiCliV Research Unit, University of the French West Indies, Martinique University Hospital, Fort-de France, France.
| | - Fabienne Louis-Sidney
- EpiCliV Research Unit, University of the French West Indies, Martinique University Hospital, Fort-de France, France; Department of Rheumatology, Martinique University Hospital, Fort-de-France, France
| | - Christophe Deligny
- EpiCliV Research Unit, University of the French West Indies, Martinique University Hospital, Fort-de France, France; Department of Internal Medicine, Martinique University Hospital, Fort-de-France, France
| | - Benoit Suzon
- EpiCliV Research Unit, University of the French West Indies, Martinique University Hospital, Fort-de France, France; Department of Internal Medicine, Martinique University Hospital, Fort-de-France, France
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Suzon B, Louis-Sidney F, Abel A, Moinet F, Bagoée C, Henry K, Coco-Viloin I, Cougnaud R, Wolff S, Guilpain P, Rivière S, Flori N, Deligny C, Maria A. [Severe small bowel involvement and chronic intestinal pseudo-obstruction in systemic sclerosis (scleroderma): Pathophysiological, diagnostic and therapeutic basis, including parenteral nutrition]. Rev Med Interne 2024; 45:147-155. [PMID: 38388303 DOI: 10.1016/j.revmed.2024.02.001] [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: 03/04/2023] [Revised: 01/15/2024] [Accepted: 02/03/2024] [Indexed: 02/24/2024]
Abstract
Gastrointestinal involvement in systemic sclerosis can be severe, reaching the critical point of chronic intestinal pseudo-obstruction, secondary to major disorders of small bowel motility. It is associated with some clinical and biological characteristics, in particular the positivity of anti-fibrillarin/U3RNP antibodies. Chronic intestinal pseudo-obstruction (CIPO) is complicated by a small intestinal bacterial overgrowth that requires cyclic antibiotic therapy. CIPO leads to a reduction of the food intake, due to painful symptoms, nausea and vomiting caused by meals, and ultimately to severe malnutrition. Meal splitting is often transiently effective and patients require exogenous nutritional support, mostly parenteral. Systemic sclerosis is not an obstacle to initiation and long-term continuation of parenteral nutrition and central venous catheter implantation is not associated with an increased risk of cutaneous or infectious complications. However, continuation of long-term parenteral nutrition requires monitoring in an expert nutrition center in order to adapt nutritional volumes and intakes and to limit potentially fatal cardiac and hepatobiliary complications. In addition to nutrition, prokinetic treatments, whose side effects must be known, can be associated. Invasive procedures, whose risk-benefit ratio must be carefully assessed, can also be used to treat symptoms exclusively.
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Affiliation(s)
- B Suzon
- Médecine Interne, CHU de Martinique, Fort-de-France, Martinique; Unité EpiCliV, Université des Antilles, Fort-de-France, Martinique.
| | - F Louis-Sidney
- Unité EpiCliV, Université des Antilles, Fort-de-France, Martinique; Rhumatologie, CHU de Martinique, Fort-de-France, Martinique
| | - A Abel
- Médecine Interne, CHU de Martinique, Fort-de-France, Martinique
| | - F Moinet
- Médecine Interne, CHU de Martinique, Fort-de-France, Martinique
| | - C Bagoée
- Médecine interne et polyvalente, Centre hospitalier territorial Gaston-Bourret, Nouméa, Nouvelle-Calédonie
| | - K Henry
- Maladies infectieuses et tropicales, Centre hospitalier de Cayenne, Cayenne, Guyane
| | - I Coco-Viloin
- Médecine Interne, CHU de Martinique, Fort-de-France, Martinique
| | - R Cougnaud
- Médecine Interne, CHU de Martinique, Fort-de-France, Martinique
| | - S Wolff
- Médecine Interne, CHU de Martinique, Fort-de-France, Martinique
| | - P Guilpain
- Médecine interne et maladies multi-organiques, Hôpital Saint Eloi, CHU de Montpellier, Montpellier, France; Institut de médecine régénérative et biothérapies, Inserm U1183, Montpellier, France; Faculté de médecine, Université de Montpellier, Montpellier, France
| | - S Rivière
- Médecine interne et maladies multi-organiques, Hôpital Saint Eloi, CHU de Montpellier, Montpellier, France
| | - N Flori
- Centre expert régional de nutrition, ICM, Montpellier, France
| | - C Deligny
- Médecine Interne, CHU de Martinique, Fort-de-France, Martinique; Unité EpiCliV, Université des Antilles, Fort-de-France, Martinique
| | - A Maria
- Institut de médecine régénérative et biothérapies, Inserm U1183, Montpellier, France; Faculté de médecine, Université de Montpellier, Montpellier, France; Médecine interne et immuno-oncologie (MedI2O), Hôpital Saint-Eloi, CHU de Montpellier, Montpellier, France
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Felix A, Osei L, Delion F, Suzon B, Abel A, Drame M, Hatchuel Y, Deligny C, Louis-Sidney F. Longitudinal follow-up of mixed connective tissue disease and overlapping autoimmune diseases of childhood onset in the Afro-descendant population of the French West Indies. Pediatr Rheumatol Online J 2024; 22:13. [PMID: 38212775 PMCID: PMC10785358 DOI: 10.1186/s12969-023-00951-3] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Accepted: 12/26/2023] [Indexed: 01/13/2024] Open
Abstract
INTRODUCTION Overlap autoimmune syndromes (OAS) and mixed connective tissue disease (MCTD) are rare in children. We performed a retrospective, longitudinal and descriptive study of Afro-Caribbean patients from the French West Indies followed for MCTD and OAS to describe their characteristics and outcomes during childhood. METHODS Retrospective study from January 2000 to 2023. Listings of patients were obtained from multiple sources: computerized hospital archives and national hospital-based surveillance system, registry of pediatricians and adult specialists in internal medicine and the national registry for rare diseases. MCTD was defined according to Kasukawa's criteria. OAS was defined as overlapping features of systemic lupus erythematosus (SLE), systemic sclerosis (SSc), and dermatomyositis/autoimmune myositis (DM/AM). RESULTS Sixteen patients were included over a 23-year period (10 MCTD and 6 OAS). The incidence was 0.23 per 100,000 children-years. The mean age at diagnosis was 11.9 years old (2.4-17) with median follow up of 7.9 years (2.1-19.6). SLE phenotype was present in the highest, followed by SSc and DM/AM. Patients had an average of three flares during childhood (1-7). A quarter (25%) had symptomatic pulmonary arterial hypertension (PAH). Ninety-four percent received steroids during follow-up and 88% required a corticosteroid-sparing therapy. Three patients (19%) developed SLE after more than 10y of follow-up. There were no death and no chronic organ failure. CONCLUSION This is the largest pediatric cohort of MCTD and OAS in Afro-descendant patients treated in a country with a high standard of care. The clinical evolution did not differ between MCTD and OAS. The main complication was PAH, more frequent in our cohort.
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Affiliation(s)
- Arthur Felix
- Department of General Pediatrics, Competence Centre for Rheumatic, Autoimmune and Systemic Diseases in Children (RAISE) Antilles-GuyaneEpiCliV Research Unit, University of the French West Indies, Martinique University Hospital, Fort-de France, France.
- MFME, CHU de la Martinique La Meynard, Fort-de-France, 97261, France.
| | - Lindsay Osei
- Department of Pediatrics, Andrée Rosemon Hospital, Cayenne, France
| | - Frederique Delion
- Department of Pediatrics, Guadeloupe University Hospital, Pointe-à-Pitre, France
| | - Benoit Suzon
- Department of Internal Medicine, Martinique University Hospital, Fort-de-France, France
| | - Aurore Abel
- Department of Internal Medicine, Martinique University Hospital, Fort-de-France, France
| | - Moustapha Drame
- Department of Clinical Research and Innovation, Martinique University Hospital, Fort-de-France, France
| | - Yves Hatchuel
- Department of General Pediatrics, Competence Centre for Rheumatic, Autoimmune and Systemic Diseases in Children (RAISE) Antilles-GuyaneEpiCliV Research Unit, University of the French West Indies, Martinique University Hospital, Fort-de France, France
| | - Christophe Deligny
- Department of Internal Medicine, Martinique University Hospital, Fort-de-France, France
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Felix A, Delion F, Louis-Sidney F, Osei L, Armougon A, Bellance R, Dramé M, Deligny C, Suzon B, Hatchuel Y. Juvenile Dermatomyositis in Afro-Caribbean children: a cohort study in the French West Indies. Pediatr Rheumatol Online J 2023; 21:113. [PMID: 37805487 PMCID: PMC10559605 DOI: 10.1186/s12969-023-00904-w] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 09/30/2023] [Indexed: 10/09/2023] Open
Abstract
INTRODUCTION The epidemiology of Juvenile Dermatomyositis (JDM) in non-Caucasian population is poorly described. We performed a study of patients followed up in the French West Indies for JDM. We aimed to describe clinical and biological specificities during childhood. METHODS Retrospective study covering the period from Januarys 2000-2023. Listings of patients were obtained from multiple sources, namely computerized hospital archives, registry of referent pediatricians and adult specialists in internal medicine and the French National Registry for rare diseases. JDM and organ involvement were defined according to the international ILAR criteria. RESULTS Twenty-one patients were included over a 23 year-period. Median age at onset was 8.1 years (Range: 2.5-13.9) with a median follow up of 8 years (Range: 2-19). Two-thirds (14/21) had dysphagia at onset and 33% had respiratory involvement. Thirteen had specific autoantibodies (58%), most frequently anti-Mi-2. The median number of flares during childhood was three (1-9). During childhood, 76% had calcinosis lesions. Clinical evolution seemed to be more aggressive for boys than girls (respectively 4.2 versus 2.2 flares (p = 0.04) and 50% vs 18% needing more than one background therapy, p = 0.03). CONCLUSION This retrospective study is the largest cohort of pediatric patients of Afro-Caribbean and Black African descent treated for JDM in a high-income health system, and the first to describe the incidence and immunological profile in a population of African descent. They had higher rate of calcinosis and similar respiratory involvement. Overall outcomes during childhood were similar to North America and European countries.
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Affiliation(s)
- Arthur Felix
- Department of General Pediatrics, Competence Centre for Rheumatic, Autoimmune and Systemic diseases in children (RAISE) Antilles-Guyane, EpiCliV Research Unit, University of the French West Indies, Martinique University Hospital, MFME. CHU de la Martinique La Meynard, 97261, Fort-de France, France.
| | - Frederique Delion
- Department of Pediatrics, Guadeloupe University Hospital, Pointe-À-Pitre, France
| | | | - Lindsay Osei
- Department of Pediatrics, Andrée Rosemon Hospital, Cayenne, France
| | - Aurélie Armougon
- Department of General Pediatrics, Competence Centre for Rheumatic, Autoimmune and Systemic diseases in children (RAISE) Antilles-Guyane, EpiCliV Research Unit, University of the French West Indies, Martinique University Hospital, MFME. CHU de la Martinique La Meynard, 97261, Fort-de France, France
| | - Remi Bellance
- Neurological and Neuromuscular Rare Disorders Department, CERCA, University Hospital Center of Martinique, Martinique, France
| | - Moustapha Dramé
- Department of Clinical Research and Innovation, Martinique University Hospital, Fort-de-France, France
| | - Christophe Deligny
- Department of Internal Medicine, Martinique University Hospital, Fort-de-France, France
| | - Benoit Suzon
- Department of Internal Medicine, Martinique University Hospital, Fort-de-France, France
| | - Yves Hatchuel
- Department of General Pediatrics, Competence Centre for Rheumatic, Autoimmune and Systemic diseases in children (RAISE) Antilles-Guyane, EpiCliV Research Unit, University of the French West Indies, Martinique University Hospital, MFME. CHU de la Martinique La Meynard, 97261, Fort-de France, France
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Abel A, Lazaro E, Ralazamahaleo M, Pierrisnard E, Suzon B, Bonnet F, Mercié P, Macey J, Agossou M, Viallard JF, Deligny C, Rivière E. Phenotypic Profiles Among 72 Caucasian and Afro-Caribbean Patients with Antisynthetase Syndrome Involving Anti-PL7 or Anti-PL12 Autoantibodies. Eur J Intern Med 2023; 115:104-113. [PMID: 37330316 DOI: 10.1016/j.ejim.2023.06.012] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Revised: 06/12/2023] [Accepted: 06/13/2023] [Indexed: 06/19/2023]
Abstract
OBJECTIVES Antisynthetase syndrome (ASyS) is a rare autoimmune disease. We aimed to determine clinical, biological, radiological, and evolutive profiles of ASyS patients with anti-PL7 or anti-PL12 autoantibodies. METHODS We performed a retrospective study that included adults with overt positivity for anti-PL7/anti-PL12 autoantibodies and at least one Connors' criterion. RESULTS Among 72 patients, 69% were women, 29 had anti-PL7 and 43 anti-PL12 autoantibodies, median age was 60.3 years, and median follow-up period was 52.2 months. At diagnosis, 76% of patients had interstitial lung disease, 61% had arthritis, 39% myositis, 25% Raynaud's phenomenon, 18% mechanic's hands, and 17% had fever. The most frequent pattern on initial chest computed tomography was non-specific interstitial pneumonia and 67% had fibrosis at last follow-up. During follow-up, 12 patients had pericardial effusion (18%), 19 had pulmonary hypertension (29%), 9 (12.5%) had neoplasms, and 14 (19%) died. Sixty-seven patients (93%) received at least one steroid or immunosuppressive drug. Patients with anti-PL12 autoantibodies were younger (p=0.01) and more frequently exhibited anti-SSA autoantibodies (p=0.01); patients with anti-PL7 autoantibodies had more severe weakness and higher maximum creatine kinase levels (p=0.03 and 0.04, respectively). Initial severe dyspnoea was more common in patients from the West Indies (p=0.009), with lower predicted values of forced vital capacity, forced expiratory volume in 1s, and total lung capacity (p=0.01, p=0.02, p=0.01, respectively) contributing to a more severe 'respiratory' initial presentation. CONCLUSIONS The high mortality and significant numbers of cardiovascular events, neoplasms and lung fibrosis in anti-PL7/12 patients justify close monitoring and question addition of antifibrotic drugs.
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Affiliation(s)
- Aurore Abel
- Department of Internal Medicine, Martinique University Hospital, CEDEX CS, 90632 Fort-de-France, Martinique, France; Department of internal Medicine and Infectious Diseases Department, Haut Leveque Hospital, University Hospital Centre of Bordeaux, F33604 Pessac, France
| | - Estibaliz Lazaro
- Department of internal Medicine and Infectious Diseases Department, Haut Leveque Hospital, University Hospital Centre of Bordeaux, F33604 Pessac, France; Université de Bordeaux, UMR CNRS 5164 Immunoconcept, F33000 Bordeaux, France
| | - Mamy Ralazamahaleo
- Université de Bordeaux, UMR CNRS 5164 Immunoconcept, F33000 Bordeaux, France; CHU de Bordeaux, Laboratoire d'Immunologie et Immunogénétique, Hôpital Pellegrin, F33000 Bordeaux, France
| | - Emma Pierrisnard
- Laboratoire d'immunologie, Cité Hospitalière de Mangot-Vulcin, CHU de Martinique
| | - Benoit Suzon
- Department of Internal Medicine, Martinique University Hospital, CEDEX CS, 90632 Fort-de-France, Martinique, France
| | - Fabrice Bonnet
- CHU de Bordeaux, Service de médecine interne et maladies infectieuses, Hôpital Saint-André, F33000 Bordeaux, France; University Bordeaux, ISPED, Inserm U1219, Bordeaux Population Health Research Center, teamGHIGS. F33000 Bordeaux, France
| | - Patrick Mercié
- Department of Internal Medicine and Clinical Immunology, Saint Andre Hospital, University Hospital Centre of Bordeaux, F33000 Bordeaux, France; Univ. Bordeaux, INSERM, BRIC, U1312, F-33000 Bordeaux,France
| | - Julie Macey
- CHU de Bordeaux, Service d'Imagerie Thoracique et Cardiovasculaire, Service des Maladies Respiratoires, Service d'Exploration Fonctionnelle Respiratoire, Unité de Pneumologie Pédiatrique, CIC 1401, Pessac, France
| | - Moustapha Agossou
- Departement of respiratory care, Martinique University Hospital, CEDEX CS, 90632 Fort-de-France, Martinique, France
| | - Jean-Francois Viallard
- Department of internal Medicine and Infectious Diseases Department, Haut Leveque Hospital, University Hospital Centre of Bordeaux, F33604 Pessac, France; INSERM, Biology of Cardiovascular Diseases, U1034, University of Bordeaux, F33604 Pessac, France
| | - Christophe Deligny
- Department of Internal Medicine, Martinique University Hospital, CEDEX CS, 90632 Fort-de-France, Martinique, France
| | - Etienne Rivière
- Department of internal Medicine and Infectious Diseases Department, Haut Leveque Hospital, University Hospital Centre of Bordeaux, F33604 Pessac, France; INSERM, Biology of Cardiovascular Diseases, U1034, University of Bordeaux, F33604 Pessac, France.
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de Fritsch E, Louis-Sidney F, Felix A, Moinet F, Bagoée C, Henry K, Wolff S, Polomat K, Dramé M, Deligny C, Suzon B. Epidemiology, characteristics, treatments, and outcomes of adult-onset Still's disease in Afro-Caribbeans: Results from a population-based study in Martinique, French West Indies. J Autoimmun 2023; 139:103086. [PMID: 37356346 DOI: 10.1016/j.jaut.2023.103086] [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: 03/13/2023] [Revised: 06/14/2023] [Accepted: 06/19/2023] [Indexed: 06/27/2023]
Abstract
OBJECTIVES To describe the epidemiology, characteristics, response to initial treatment, and outcomes of Adult-Onset Still's disease (AOSD) in the Afro-Caribbean population of Martinique with free and easy access to specialised care. METHODS We conducted a retrospective study from 2004 to 2022 in the island of Martinique, French West-Indies which total population was 354 800 in 2021. Patients were identified from multiple sources including standardised databases. To be included, patients had to be residents of the island and fulfilled Yamaguchi and/or Fautrel's criteria for AOSD, or have a compatible disease course, without a diagnosis of cancer, auto-immune disease or another auto-inflammatory disorder. Date of diagnosis, clinical and biological characteristics, treatments, and outcomes were collected. RESULTS The prevalence was 7.6/100 000 inhabitants in 2021. The mean incidence was 0.4/100 000 during study period. Thirty-three patients (70.6% females) with a median follow-up of 35 months [7.5 to 119] were included. Twenty-six patients (78.8%) had a systemic pattern. Patients with a systemic monocyclic pattern had significantly more polyarticular involvement than patients with systemic polycyclic pattern (p = 0.016). Pulmonary involvement occurred in 51.5% of patients at diagnosis and systemic Pouchot score has been identified as an independent predictive factor for pulmonary involvement; OR of 3.29 [CI 95% 1.20; 9.01]. At first flare, all patients but one received oral glucocorticoids, 11 patients (32.4%) received intravenous glucocorticoids pulse and 12 patients (33%) received anti-IL1 therapy. Nineteen patients (57%) relapsed in a median time of 9 months [6 to 12] Three patients (9%) developed hemophagocytosis lymphohistiocytosis, fatal in 1 case. All deceased patients (n = 4, 11.76%) belonged to the systemic polycyclic pattern, with an event-free survival of 13.6 months [IQR 5.7; 29.5] CONCLUSION: AOSD in the Afro-Caribbean population of Martinique shares some similarities with other ethnic groups, but exhibit differences, such as a high proportion of lung involvement. Comparative studies are needed to confirm these results.
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Affiliation(s)
- Eleonore de Fritsch
- Department of Internal Medicine, Martinique University Hospital, Fort-de France, France
| | - Fabienne Louis-Sidney
- Department of Rheumatology, Martinique University Hospital, Fort-de-France, France; EpiCliV Research Unit, University of French West Indies, Martinique, France
| | - Arthur Felix
- Department of General Pediatrics, Competence Centre for Rare Pediatric Inflammatory Rheumatisms and Systemic Autoimmune Diseases (RAISE) Antilles-Guyane, Martinique University Hospital, Fort-de France, France
| | - Florence Moinet
- Department of Internal Medicine, Martinique University Hospital, Fort-de France, France
| | - Cécile Bagoée
- Department of Internal Medicine, Territorial Hospital Centre of New Caledonia, Nouméa, New Caledonia
| | - Kim Henry
- Department of Infectious Diseases, Cayenne Hospital, Guyane, France
| | - Sophie Wolff
- Department of Internal Medicine, Martinique University Hospital, Fort-de France, France
| | - Katlyne Polomat
- Department of Internal Medicine, Martinique University Hospital, Fort-de France, France
| | - Moustapha Dramé
- EpiCliV Research Unit, University of French West Indies, Martinique, France; Department of Clinical Research and Innovation, Martinique University Hospital, Fort-de-France, France
| | - Christophe Deligny
- Department of Internal Medicine, Martinique University Hospital, Fort-de France, France; EpiCliV Research Unit, University of French West Indies, Martinique, France
| | - Benoit Suzon
- Department of Internal Medicine, Martinique University Hospital, Fort-de France, France; EpiCliV Research Unit, University of French West Indies, Martinique, France.
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Suzon B, Goulabchand R, Louis-Sidney F, Maria A, Najjari R, Chauvet E, Le Quellec A, Bessis D, Guilpain P. Subcutaneous tissue involvement in idiopathic inflammatory myopathies: Systematic literature review including three new cases and hypothetical mechanisms. Autoimmun Rev 2023; 22:103284. [PMID: 36736986 DOI: 10.1016/j.autrev.2023.103284] [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: 01/03/2023] [Accepted: 01/29/2023] [Indexed: 02/04/2023]
Abstract
INTRODUCTION Involvement of subcutaneous tissue in idiopathic inflammatory myopathies (IIM) is poorly known. METHODS We conducted a systematic review of the literature regarding panniculitis and lipodystrophy/lipoatrophy in juvenile and adult IIM via PubMed/Medline, Embase and Scopus databases. Three local observations are included in this review. Epidemiological, clinical, paraclinical and therapeutic data were collected. RESULTS Panniculitis appears to be more common in adults than in juveniles. It was mainly localised in the upper and lower limbs. Panniculitis improved in most cases with steroids and panniculitis and myositis had a similar course in 83.3% and 72.2% of cases in juveniles and adults, respectively. Lipodystrophy appeared to be more frequent in juveniles and was only observed in dermatomyositis in both juveniles and adults. Lipodystrophy was mainly partial in juveniles and adults. The median time from myositis to the diagnosis of lipodystrophy was 6 years [0-35] and 2.5 years [0-10] in juveniles and adults, respectively. Lipodystrophy was associated with anti-TIF1 gamma auto-antibody positivity, a polycyclic/chronic course of myositis and the occurrence of calcinosis and might be an indicator of poor disease control. CONCLUSION Adipose tissue involvement, particularly lipodystrophy, occurs almost exclusively in dermatomyositis. The insidious onset and lack of awareness of the diagnosis may underestimate its prevalence. Larger studies are needed to identify possible risk factors in these patients, to better potential underlying pathophysiological process, in order to discuss potential therapeutic targets.
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Affiliation(s)
- Benoit Suzon
- Department of Internal Medicine, Martinique University Hospital, Fort-de-France, Martinique, France; EpiCliV Research Unit, University of French West Indies, Fort-de-France, Martinique, France
| | - Radjiv Goulabchand
- Department of Internal Medicine, Nîmes University Hospital, France; Institute for Regenerative Medicine and Biotherapy, INSERM U1183, Montpellier, France
| | - Fabienne Louis-Sidney
- EpiCliV Research Unit, University of French West Indies, Fort-de-France, Martinique, France; Department of Rheumatology, Martinique University Hospital, France
| | - Alexandre Maria
- Institute for Regenerative Medicine and Biotherapy, INSERM U1183, Montpellier, France; Department of Internal Medicine and Immuno-Oncologie (MedI(2)O), Montpellier University Hospital, France; Montpellier-1 University, Faculty of Medicine, France
| | - Redwann Najjari
- Department of Internal Medicine and Multi-Organic Diseases, Montpelier University Hospital, France
| | - Elodie Chauvet
- Department of Internal Medicine and Multi-Organic Diseases, Montpelier University Hospital, France
| | - Alain Le Quellec
- Department of Internal Medicine and Multi-Organic Diseases, Montpelier University Hospital, France
| | - Didier Bessis
- Department of Dermatology, Montpellier University Hospital, France
| | - Philippe Guilpain
- Institute for Regenerative Medicine and Biotherapy, INSERM U1183, Montpellier, France; Montpellier-1 University, Faculty of Medicine, France; Department of Internal Medicine and Multi-Organic Diseases, Montpelier University Hospital, France.
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Suzon B, Rivière S, Schiffmann A, Rivet V, Flori N, Guilpain P, Maria ATJ. Long-term home parenteral nutrition in systemic sclerosis-related intestinal failure is feasible but unveils occult cardiac disease. Nutrition 2023; 110:112009. [PMID: 36965242 DOI: 10.1016/j.nut.2023.112009] [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: 11/15/2022] [Revised: 02/03/2023] [Accepted: 02/16/2023] [Indexed: 02/25/2023]
Abstract
OBJECTIVE The aim of this study was to compare safety and efficacy of long-term home parenteral nutrition between patients with systemic sclerosis and intestinal failure (IF) and controls with IF from another etiology. METHODS A retrospective study was conducted in a referral center for systemic sclerosis (SSc) in Montpellier, France. Patients followed between 1985 and 2020 with SSc-related IF were included and compared with control patients with IF from another etiology. The patients included had to be treated for ≥4 wk by home parenteral nutrition (HPN). Primary outcome was occurrence of HPN-related complications. Secondary outcomes included duration of parenteral nutrition, body mass index at 12 mo, and survival. RESULTS Cumulative duration of HPN was 23 397 catheter days. HPN resulted in body mass index increase in both groups. There was no statistical difference regarding catheter-related bloodstream infections and thrombosis between the groups, despite use of immunosuppressive drugs and autologous hematopoietic stem cell transplantation in patients with SSc. However, the patients with SSc had significantly more HPN-related cardiac overload than the controls (P < 0.0001). Overloads occurred in SSc patients with and without cardiac disease, arguing for comprehensive hemodynamic screening in this condition. CONCLUSION Long-term HPN in SSc-related IF is feasible but unveils occult cardiac disease.
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Affiliation(s)
- Benoit Suzon
- Department of Internal Medicine, Martinique University Hospital, Martinique, France; EpiCliV Research Unit, University of the French West Indies, Fort-de-France, Martinique, France
| | - Sophie Rivière
- Department of Internal Medicine and Multi-Organic Diseases, Montpellier University Hospital, Montpellier, France
| | - Auelie Schiffmann
- Department of Internal Medicine and Multi-Organic Diseases, Montpellier University Hospital, Montpellier, France
| | - Valérian Rivet
- Internal Medicine and Clinical Immunopathology, ICUT-Oncopôle, Toulouse, France
| | - Nicolas Flori
- Clinical Nutrition, Gastroenterology and Endoscopy, Montpellier Cancer Institute, Montpellier, France
| | - Philippe Guilpain
- Department of Internal Medicine and Multi-Organic Diseases, Montpellier University Hospital, Montpellier, France; Montpellier University, Medical School, Montpellier, France; Institute for Regenerative Medicine and Biotherapy (IRMB), Saint Eloi Hospital, Montpellier University Hospital, Montpellier, France
| | - Alexandre Thibault Jacques Maria
- Montpellier University, Medical School, Montpellier, France; Institute for Regenerative Medicine and Biotherapy (IRMB), Saint Eloi Hospital, Montpellier University Hospital, Montpellier, France; Internal Medicine & Immuno-Oncology (MedI2O), Montpellier University Hospital, Montpellier, France.
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Suzon B, Louis-Sidney F, Aglaé C, Henry K, Bagoée C, Wolff S, Moinet F, Emal-Aglae V, Polomat K, Debandt M, Deligny C, Couturier A. La néphropathie lupique en Martinique : un exemple de bon pronostic à long terme dans une population afro-descendante. Rev Med Interne 2022. [DOI: 10.1016/j.revmed.2022.10.074] [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: 12/12/2022]
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Suzon B, Barast T, Merle S, Deligny C, Louis Sidney F. Étude des changements d’orientation de carrière chez les étudiants du troisième cycle de médecine de l’UFR santé des Antilles et liens avec les facteurs stresseurs notamment ceux concernant l’enseignement. Rev Med Interne 2022. [DOI: 10.1016/j.revmed.2022.10.110] [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: 12/12/2022]
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de Fritsch E, Louis-Sidney F, Moinet F, Polomat K, Bagoee C, Henry K, Wolff S, Félix A, Drame M, Deligny C, Suzon B. La maladie de Still de l’adulte dans la population afro-descendante : épidémiologie et caractéristiques des patients suivis en Martinique. Rev Med Interne 2022. [DOI: 10.1016/j.revmed.2022.10.035] [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: 12/12/2022]
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Felix A, Delion F, Suzon B, Pallara-Sirven S, Elenga N, Quartier P, Louis-Sidney F, Dramé M, Hatchuel Y. Systemic juvenile idiopathic arthritis in French Afro-Caribbean children, a retrospective cohort study. Pediatr Rheumatol Online J 2022; 20:98. [PMID: 36384585 PMCID: PMC9668386 DOI: 10.1186/s12969-022-00766-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Accepted: 11/04/2022] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION The epidemiology and clinical presentation of systemic juvenile idiopathic arthritis (sJIA) in the Afro-Caribbean population is not well described. METHODS Retrospective study conducted between January 2000 and January 2022 in the French Overseas Departments of America. Clinical data were obtained from multiple sources: computerized hospital archives, registries of referring pediatricians, and the French National Registry for rare diseases. The disease studied was sJIA defined according to international criteria. RESULTS Twenty-five patients were identified. Mean age at diagnosis was 7.5 years (range: 1.2-14.9 years) and mean duration of follow-up was 5.2 years (range: 0.5-16 years). All patients had joint involvement at diagnosis with 68% presenting inflammatory arthritis and 32% inflammatory joint pain. Sixteen percent had coronary involvement at onset. More than half (52%) suffered from macrophage activation syndrome (MAS) during childhood (32% at onset). The mean number of flares in childhood was 2 (Range: 1-5). Sixty-eight percent of patients had disease control during childhood without biotherapy. The most frequent second line treatment was anakinra (7/8). There was no difference in clinical or biological severity according to gender. The median duration of treatment during childhood was 5 months (range: 2-144) and 72% had a cumulative treatment duration of less than one year. CONCLUSION These patients of Afro-Caribbean origin suffering from sJIA showed some specificities, such as a higher rate of MAS and coronary involvement at onset. The incidence per year was stable over a 20-year period. Overall outcomes during childhood were similar to western countries.
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Affiliation(s)
- A. Felix
- grid.412874.c0000 0004 0641 4482Department of Pediatrics, Martinique University Hospital, Fort-de-France, France ,grid.412874.c0000 0004 0641 4482MFME. CHU de La Martinique La Meynard, 97261 Fort-de-France, France
| | - F. Delion
- Department of Pediatrics, Guadeloupe University Hospital, Pointe-À-Pitre, France
| | - B. Suzon
- grid.412874.c0000 0004 0641 4482Department of Internal Medicine, Martinique University Hospital, Fort-de-France, France
| | - S. Pallara-Sirven
- grid.412874.c0000 0004 0641 4482Department of Pediatrics, Martinique University Hospital, Fort-de-France, France
| | - N. Elenga
- Department of Pediatrics, Andrée Rosemon Hospital, Cayenne, France
| | - P. Quartier
- grid.412134.10000 0004 0593 9113Department of Pediatric Rheumatology, Necker Hospital, Paris, France
| | - F. Louis-Sidney
- grid.410528.a0000 0001 2322 4179Department of Rheumatology, Martinique University Hospital, Fort-de-France, France
| | - M. Dramé
- grid.412874.c0000 0004 0641 4482Department of Clinical Research and Innovation, Martinique University Hospital, Fort-de-France, France
| | - Y. Hatchuel
- grid.412874.c0000 0004 0641 4482Department of Pediatrics, Martinique University Hospital, Fort-de-France, France
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Felix A, Delion F, Suzon B, Martin E, Ogrizek A, Mohamed Sahnoun M, Hospice C, Armougon A, Cuadro E, Elenga N, Dramé M, Bader-Meunier B, Deligny C, Hatchuel Y. Systemic lupus of pediatric onset in Afro-Caribbean children: a cohort study in the French West Indies and French Guiana. Pediatr Rheumatol Online J 2022; 20:95. [PMID: 36371201 PMCID: PMC9652926 DOI: 10.1186/s12969-022-00759-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Accepted: 10/29/2022] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Systemic diseases of pediatric onset are more frequent in the Afro-Caribbean population. We performed a study of patients followed in the French overseas departments of America (FOAD) for pediatric systemic lupus erythematosus (pSLE). The aims were to describe the clinical and biological specificities during childhood in this population. METHODS A retrospective study was conducted between January 2000 and September 2021. Patients with pSLE were identified from multiple sources: computerized hospital archives, registry of referring pediatricians, adult specialists in internal medicine and the French National Registry for rare diseases. We studied SLE with pediatric onset defined by international criteria. RESULTS Overall, 2148 patients were identified, of whom 54 were included. The average follow-up was 8.3 years (range: 0.3-25 years). We observed an increase in new diagnoses over time. At onset, pSLE patients had a median of 10 SLICC criteria (range: 4-12), and the median EULAR/ACR 2019 score was 38 (12-54). At onset, one third of patients had renal involvement, 15% had neurolupus and 41% cardiac involvement. During childhood, 54% had renal involvement, and 26% suffered from neurolupus. Patients suffered a median of 3 flares during childhood, and 26% had more than 5 flares. Patients with younger age at onset had worse outcomes than those who were older at diagnosis, i.e., more flares (median 5, p = 0.02) and requiring an average of 4 background therapies (p = 0.04). CONCLUSION The outcomes of Afro-Caribbean patients were similar to those in Western population, but with worse disease activity at onset. Further studies should be performed to identify the genetic and environmental factors in this population.
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Affiliation(s)
- Arthur Felix
- Department of Pediatrics, Martinique University Hospital, MFME. CHU de La Martinique, La Meynard 97261, Fort-de France, France.
| | - Frederique Delion
- Department of Pediatrics, Guadeloupe University Hospital, Pointe-À-Pitre, France
| | - Benoit Suzon
- grid.412874.c0000 0004 0641 4482Department of Internal Medicine, Martinique University Hospital, Fort-de France, France
| | - Elise Martin
- Department of Pediatrics, Andrée Rosemon Hospital, Cayenne, France
| | - Anais Ogrizek
- grid.412874.c0000 0004 0641 4482Department of Pediatrics, Martinique University Hospital, MFME. CHU de La Martinique, La Meynard 97261, Fort-de France, France
| | - M’hamed Mohamed Sahnoun
- Department of Pediatrics, Centre Hospitalier de L’ouest Guyanais, St-Laurent-du-Maroni, France
| | - Claudia Hospice
- grid.412874.c0000 0004 0641 4482Department of Pediatrics, Martinique University Hospital, MFME. CHU de La Martinique, La Meynard 97261, Fort-de France, France
| | - Aurelie Armougon
- grid.412874.c0000 0004 0641 4482Department of Pediatrics, Martinique University Hospital, MFME. CHU de La Martinique, La Meynard 97261, Fort-de France, France
| | - Emma Cuadro
- Department of Pediatrics, Andrée Rosemon Hospital, Cayenne, France
| | - Narcisse Elenga
- Department of Pediatrics, Andrée Rosemon Hospital, Cayenne, France
| | - Moustapha Dramé
- grid.412874.c0000 0004 0641 4482Department of Clinical Research and Innovation, Martinique University Hospital, Fort-de-France, France
| | - Brigitte Bader-Meunier
- grid.412134.10000 0004 0593 9113Department of Pediatric Rheumatology, Necker Hospital, Paris, France
| | - Christophe Deligny
- grid.412874.c0000 0004 0641 4482Department of Internal Medicine, Martinique University Hospital, Fort-de France, France
| | - Yves Hatchuel
- grid.412874.c0000 0004 0641 4482Department of Pediatrics, Martinique University Hospital, MFME. CHU de La Martinique, La Meynard 97261, Fort-de France, France
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Suzon B, Louis-Sidney F, Aglaé C, Henry K, Bagoée C, Wolff S, Moinet F, Emal-Aglaé V, Polomat K, DeBandt M, Deligny C, Couturier A. Good Long-Term Prognosis of Lupus Nephritis in the High-Income Afro-Caribbean Population of Martinique with Free Access to Healthcare. J Clin Med 2022; 11:jcm11164860. [PMID: 36013099 PMCID: PMC9410092 DOI: 10.3390/jcm11164860] [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: 03/28/2022] [Revised: 05/12/2022] [Accepted: 05/18/2022] [Indexed: 11/16/2022] Open
Abstract
Lupus nephritis (LN) has been described as having worse survival and renal outcomes in African-descent patients than Caucasians. We aimed to provide long-term population-based data in an Afro-descendant cohort of LN with high income and easy and free access to specialized healthcare. Study design: We performed a retrospective population-based analysis using data from 2002–2015 of 1140 renal biopsies at the University Hospital of Martinique (French West Indies). All systemic lupus erythematosus patients with a diagnosis of LN followed for at least 12 months in Martinique or who died during this period were included. Results: A total of 89 patients were included, of whom 68 (76.4%) had proliferative (class III or IV), 17 (19.1%) had membranous (class V), and 4 (4.5%) had class I or II lupus nephritis according to the ISN/RPS classification. At a mean follow-up of 118.3 months, 51.7% of patients were still in remission. The rates of end-stage renal disease were 13.5%, 19.1%, and 21.3% at 10, 15, and 20 years of follow-up, respectively, and mortality rates were 4.5%, 5.6%, and 7.9% at 10, 15, and 20 years of follow-up, respectively. Conclusions: The good survival of our Afro-descendant LN patients, similar to that observed in Caucasians, shades the burden of ethnicity but rather emphasizes and reinforces the importance of optimizing all modifiable factors associated with poor outcome, especially socioeconomics.
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Affiliation(s)
- Benoit Suzon
- Department of Internal Medicine, Martinique University Hospital, CEDEX CS, 90632 Fort-de-France, Martinique, France
- Correspondence:
| | - Fabienne Louis-Sidney
- Department of Rheumatology, Martinique University Hospital, CEDEX CS, 90632 Fort-de-France, Martinique, France
| | - Cédric Aglaé
- Department of Nephrology, Martinique University Hospital, CEDEX CS, 90632 Fort-de-France, Martinique, France
| | - Kim Henry
- Department of Internal Medicine, Martinique University Hospital, CEDEX CS, 90632 Fort-de-France, Martinique, France
| | - Cécile Bagoée
- Department of Internal Medicine, Martinique University Hospital, CEDEX CS, 90632 Fort-de-France, Martinique, France
| | - Sophie Wolff
- Department of Internal Medicine, Martinique University Hospital, CEDEX CS, 90632 Fort-de-France, Martinique, France
| | - Florence Moinet
- Department of Internal Medicine, Martinique University Hospital, CEDEX CS, 90632 Fort-de-France, Martinique, France
| | - Violaine Emal-Aglaé
- Department of Nephrology, Martinique University Hospital, CEDEX CS, 90632 Fort-de-France, Martinique, France
| | - Katlyne Polomat
- Department of Internal Medicine, Martinique University Hospital, CEDEX CS, 90632 Fort-de-France, Martinique, France
| | - Michel DeBandt
- Department of Rheumatology, Martinique University Hospital, CEDEX CS, 90632 Fort-de-France, Martinique, France
| | - Christophe Deligny
- Department of Internal Medicine, Martinique University Hospital, CEDEX CS, 90632 Fort-de-France, Martinique, France
| | - Aymeric Couturier
- Department of Internal Medicine, Martinique University Hospital, CEDEX CS, 90632 Fort-de-France, Martinique, France
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Suzon B, Goulabchand R, Maria A, Najjari R, Le Quellec A, Bessis D, Louis-Sidney F, Guilpain P. Atteintes du tissu adipeux au cours des myopathies inflammatoires : revue systématique de la littérature augmentée de trois observations. Rev Med Interne 2022. [DOI: 10.1016/j.revmed.2022.03.279] [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: 11/30/2022]
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Fabienne LS, Costecalde C, Dramé M, Deligny C, Numeric P, Blettery M, Petit C, De Bandt M, Suzon B. AB0359 TOCILIZUMAB IN AFRO-CARIBBEAN RHEUMATOID ARTHRITIS: THE MARTINICAN EXPERIENCE. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.2948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundMortality and morbidity related to rheumatoid arthritis (RA) has remarkably improved over the last twenty years since using biologics DMARDs1. However, their effectiveness remains questionable in Afro-descendants (AD) due to their large under-representation in RA clinical trials2,3. Martinique is a French Caribbean region with a majority of AD population4, with free access to healthcare, including biotherapies, and a unique university hospital and rheumatology unit.ObjectivesTo evaluate effectiveness of Tocilizumab (TCZ), an interleukin-6 inhibitor, in an afro descendant RA population.MethodsRetrospective cohort of 171 patients who received at least 1 infusion of Tocilizumab (IV TCZ) at Martinique University Hospital Center between 2008 and 2019. Inclusion Criteria: Patients over 18 y/o meeting RA 2010 ACR/EULAR criteria, having received at least 4 courses of IV TCZ starting at 8mg/kg every 4 weeks, with available baseline clinical/biological data. Exclusion criteria: Patients having received subcutaneous TCZ (SC TCZ) prior to IV TCZ, not living in Martinique. Primary endpoint was proportion of patients in remission (R) and low disease activity (LDA) according to DAS28 CRP at 12, 24, 36 weeks. Secondary endpoint was proportion of patients achieving good (GR) and moderate (MR) EULAR response criteria 5 at 12, 24 and 36 weeks, and TCZ retention at 1 year defined as the proportion of patient receiving TCZ at 1 year follow up.ResultsOut of 171 patients receiving IV TCZ, we identified 138 RA and 80 patients met inclusion criteria: 90% were women, mean age was 56.8 (± 11.8) y/o, mean duration of RA was 11.6 (± 8.9) years, ACPA and Rheumatoid Factor were positive in 72.1% and 73% of cases, 69.6% of patients had erosions and 77.8% had received at least 1 biologic prior to IV TCZ. At baseline, 8 patients were in R, 8 had LDA but presented steroid dependency over 10 mg per day of prednisone and mean dose of prednisone was 6.9 (+/- 6.7) mg per day.At 12, 24, 36 weeks, R was achieved in 44.8%, 55.2% and 51.2% of patients and LDA in 37.3%, 17.2% and 20.9%, respectively (Figure 1). At 12, 24, 36 weeks, GR was achieved in 44.8 %, 60.3% and 48.8% of patients respectively, MR was achieved in 20.9%, 20.7% and 27.9% of patients respectively (Figure 1) and mean dose of prednisone per day was 5.1 (± 4.9) mg, 4.9 (± 5.6) mg and 3.3 (± 5.1) mg respectively. At 1 year, 78.8% of patients were still on TCZ. During follow up: 15 patients experienced 19 infectious events; 6 patients liver cytolysis; 12 patients neutropenia. No patient died.ConclusionThis is the first study evaluating efficacy and safety of TCZ in an AD RA cohort. TCZ is safe and effective in our AD population with comparable data observed in other ethnicities6,7.References[1]Lacaille, D., Avina-Zubieta, J. A., Sayre, E. C. & Abrahamowicz, M. Improvement in 5-year mortality in incident rheumatoid arthritis compared with the general population—closing the mortality gap. Ann. Rheum. Dis.76, 1057–1063 (2017).[2]Strait, A. et al. Demographic Characteristics of Participants in Rheumatoid Arthritis Randomized Clinical Trials: A Systematic Review. JAMA Netw. Open2, e1914745 (2019).[3]Dunbar-Jacob, J. et al. Factors associated with attrition of African Americans during the recruitment phase of a clinical trial examining adherence among individuals with rheumatoid arthritis: Attrition of African Americans. Arthritis Care Res.51, 422–428 (2004).[4]Levinson, D. Ethnic Groups Worldwide : a ready handbook. (1998).[5]Fransen, J. & van Riel, P. L. C. M. The Disease Activity Score and the EULAR Response Criteria. Rheum. Dis. Clin. N. Am.35, 745–757 (2009).[6]Gottenberg, J.-E. et al. Comparative effectiveness of rituximab, abatacept, and tocilizumab in adults with rheumatoid arthritis and inadequate response to TNF inhibitors: prospective cohort study. BMJ l67 (2019) doi:10.1136/bmj.l67.[7]Mori, S. et al. Retention of tocilizumab with and without methotrexate during maintenance therapy for rheumatoid arthritis: the ACTRA-RI cohort study. Rheumatology58, 1274–1284 (2019).Disclosure of InterestsNone declared
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Louis-Sidney F, Kahn V, Suzon B, De Bandt M, Deligny C, Arfi S, Jean-Baptiste G. Epidemiology and Characteristics of Spondyloarthritis in the Predominantly Afro-Descendant Population of Martinique, a French Caribbean Island. J Clin Med 2022; 11:jcm11051299. [PMID: 35268390 PMCID: PMC8910895 DOI: 10.3390/jcm11051299] [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: 12/17/2021] [Revised: 02/02/2022] [Accepted: 02/16/2022] [Indexed: 02/01/2023] Open
Abstract
(1) Background: The prevalence of Spondyloarthritis (SpA) varies significantly in different regions and ethnic groups due several factors such as heterogeneity in study populations, the diversity of classification criteria used in epidemiological studies, the prevalence variability of HLA-B27 or disparity in healthcare access. To our knowledge, there is no data on SpA in Martinique, a French region in the Caribbean with a predominantly Afro-descendant population and a high level of healthcare. (2) Methods: This was a retrospective study of all SpA patients treated at the Fort de France University Hospital between 1 January 1997 and 1 January 2008. (3) Results: In our cohort of 86 SpA patients, age at diagnosis was late (41 years old), ankylosing spondylitis (AS) was the most frequent sub-type (60.5%), inflammatory bowel disease was the most frequent extra articular feature (23.3%) and no one had personal familial history of the disease. Inflammatory syndrome concerned 55.6% of patients, no one was positive for HIV and HLA-B27 positivity was low (42.2%). However, HLA-B27 was statistically associated with AS. Out of 64 patients, 41 had sacroiliitis. (4) Conclusion: To our knowledge, this is the first comprehensive descriptive study of SpA subtypes in Martinique, a French region in the Caribbean. We report clinical and biological similarities in our SpA cohort with those of sub-Saharan Africa and with SpA subtypes reported in Afro-descendant populations.
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Affiliation(s)
- Fabienne Louis-Sidney
- Service de Rhumatologie, CHU de Fort de France, 97200 Fort de France, Martinique, France; (V.K.); (M.D.B.); (G.J.-B.)
- Correspondence:
| | - Valentine Kahn
- Service de Rhumatologie, CHU de Fort de France, 97200 Fort de France, Martinique, France; (V.K.); (M.D.B.); (G.J.-B.)
| | - Benoit Suzon
- Service de Médecine Interne, CHU de Fort de France, 97200 Fort de France, Martinique, France; (B.S.); (C.D.); (S.A.)
| | - Michel De Bandt
- Service de Rhumatologie, CHU de Fort de France, 97200 Fort de France, Martinique, France; (V.K.); (M.D.B.); (G.J.-B.)
| | - Christophe Deligny
- Service de Médecine Interne, CHU de Fort de France, 97200 Fort de France, Martinique, France; (B.S.); (C.D.); (S.A.)
| | - Serge Arfi
- Service de Médecine Interne, CHU de Fort de France, 97200 Fort de France, Martinique, France; (B.S.); (C.D.); (S.A.)
| | - Georges Jean-Baptiste
- Service de Rhumatologie, CHU de Fort de France, 97200 Fort de France, Martinique, France; (V.K.); (M.D.B.); (G.J.-B.)
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Rivet V, Maria A, Rivière S, Radjiv G, Suzon B, Henneton P, Rullier P, Konaté A, Schiffmann A, Sultan A, Le Quellec A, Guilpain P. Description de l’état nutritionnel chez 120 patients atteints de sclérodermie systémique suivis au CHRU de Montpellier. Rev Med Interne 2019. [DOI: 10.1016/j.revmed.2019.03.065] [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: 10/26/2022]
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Suzon B, Rivière S, Rivet V, Goulabchand R, Altwegg R, Schiffmann A, Flori N, Senesse P, Le Quellec A, Guilpain P, Maria A. Nutrition parentérale dans la sclérodermie systémique : à propos de 6 patients atteints de pseudo occlusion intestinale suivis au CHU de Montpellier. Rev Med Interne 2019. [DOI: 10.1016/j.revmed.2019.03.066] [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: 11/26/2022]
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Suzon B, Radjiv G, Guilpain P, Le Quellec A, Maria A, Dufour S, Mura F, Schneider C, Konaté A, Rivière S. Neuro-Behçet malgré les anti-TNF alpha : à propos de 3 cas. Rev Med Interne 2018. [DOI: 10.1016/j.revmed.2018.03.131] [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: 11/25/2022]
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Suzon B, Arnaud E, Galy C, Broner J. [Hands and feet lesions]. Rev Med Interne 2017; 40:56-57. [PMID: 28942058 DOI: 10.1016/j.revmed.2017.08.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2017] [Revised: 08/13/2017] [Accepted: 08/24/2017] [Indexed: 10/18/2022]
Affiliation(s)
- B Suzon
- Service de médecine interne, CHU Carémeau Nîmes, place du Professeur-Robert-Debré, 30000 Nîmes, France.
| | - E Arnaud
- Service de médecine interne, CHU Carémeau Nîmes, place du Professeur-Robert-Debré, 30000 Nîmes, France
| | - C Galy
- Service d'oto-rhino-laryngologie, CHU Carémeau Nîmes, place du Professeur-Robert-Debré, 30000 Nîmes, France
| | - J Broner
- Service de médecine interne, CHU Carémeau Nîmes, place du Professeur-Robert-Debré, 30000 Nîmes, France
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Suzon B, Broner J, Arnaud E. Des bulles hémorragiques : association entre une hémophilie A acquise auto-immune et une pemphigoïde bulleuse. Rev Med Interne 2017. [DOI: 10.1016/j.revmed.2017.03.297] [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: 12/01/2022]
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