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Chartier N, Epstein J, Soudant M, Dahan C, Michaud M, Pittion-Vouyovitch S, Guillemin F, Debouverie M, Mathey G. Clinical follow-up of 411 patients with relapsing and progressive multiple sclerosis 10 years after discontinuing mitoxantrone treatment: a real-life cohort study. Eur J Neurol 2018; 25:1439-1445. [PMID: 29996003 DOI: 10.1111/ene.13748] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2017] [Accepted: 06/19/2018] [Indexed: 11/28/2022]
Abstract
BACKGROUND AND PURPOSE Mitoxantrone (MITOX) has been used to treat patients with aggressive multiple sclerosis (MS) for decades. We aimed to describe the effectiveness and adverse events over 10 years post-MITOX in patients with relapsing and progressive MS from an exhaustive real-life database. METHODS Data from patients who received MITOX before 1 January 2006 were collected from the MS Lorraine registry. Expanded Disability Status Scale (EDSS) scores and annual relapse rates (ARRs) year by year during follow-up and the year prior to MITOX were compared. Time to the first relapse and a 1-point increase in EDSS score were used in Cox multivariate models to find associations with potential predictive factors. RESULTS A total of 411 patients were included. The ARR for the 155 relapsing patients had decreased from 2.0 (SD 1.20) the year before treatment to 0.3 (SD 0.31) by year 10 (P < 0.0001). The EDSS score increased from 2.8 (SD 1.44) to 4.8 (SD 1.90) by year 10 (P < 0.0001). A high ARR at MITOX initiation was associated with a longer time to a 1-point increase in EDSS score (hazard ratio, 0.81; 95% confidence interval, 0.67-0.99; P = 0.04). The EDSS score in 256 progressive patients increased from 5.0 (SD 1.33) to 6.5 (SD 1.26) by year 10 (P < 0.0001). We identified four cases of acute myeloid leukemias. CONCLUSIONS Patients with the most active forms of MS are the most likely to benefit from MITOX in the long term.
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Affiliation(s)
- N Chartier
- Department of Neurology, Nancy University Hospital, Nancy, France
| | - J Epstein
- CIC-EC Inserm 1433, Vandoeuvre-Lès-Nancy, France.,Université de Lorraine, EA 4360 Apemac, Vandoeuvre-Lès-Nancy, France
| | - M Soudant
- CIC-EC Inserm 1433, Vandoeuvre-Lès-Nancy, France
| | - C Dahan
- Department of Neurology, Nancy University Hospital, Nancy, France
| | - M Michaud
- Department of Neurology, Nancy University Hospital, Nancy, France
| | | | - F Guillemin
- CIC-EC Inserm 1433, Vandoeuvre-Lès-Nancy, France.,Université de Lorraine, EA 4360 Apemac, Vandoeuvre-Lès-Nancy, France
| | - M Debouverie
- Department of Neurology, Nancy University Hospital, Nancy, France.,Université de Lorraine, EA 4360 Apemac, Vandoeuvre-Lès-Nancy, France
| | - G Mathey
- Department of Neurology, Nancy University Hospital, Nancy, France.,Université de Lorraine, EA 4360 Apemac, Vandoeuvre-Lès-Nancy, France
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Dahan C, Le Chapelain L, Beis JM, Kandel M, Paysant J. Supernumerary phantom limbs in a paraplegic patient. Ann Phys Rehabil Med 2012. [DOI: 10.1016/j.rehab.2012.07.434] [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: 11/16/2022]
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3
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Dahan C, Le Chapelain L, Beis JM, Kandel M, Paysant J. Membres fantômes surnuméraires chez un patient paraplégique. Ann Phys Rehabil Med 2012. [DOI: 10.1016/j.rehab.2012.07.430] [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: 10/27/2022]
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Troudi W, Uhrhammer N, Sibille C, Dahan C, Mahfoudh W, Bouchlaka Souissi C, Jalabert T, Chouchane L, Bignon YJ, Ben Ayed F, Ben Ammar Elgaaied A. Contribution of the BRCA1 and BRCA2 mutations to breast cancer in Tunisia. J Hum Genet 2007; 52:915-920. [PMID: 17922257 DOI: 10.1007/s10038-007-0195-5] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2007] [Accepted: 08/30/2007] [Indexed: 11/29/2022]
Abstract
Hereditary breast cancer accounts for 3-8% of all breast cancers, with mutations in the BRCA1 and BRCA2 genes responsible for up to 30% of these. To investigate the prevalence of BRCA1 and BRCA2 gene mutations in breast cancer patients with affected relatives in Tunisia, we studied 36 patients who had at least one first degree relative with breast and/or ovarian cancer Thirty-four 34 patients were suggestive of the BRCA1 mutation and two were suggestive of the BRCA2 mutation, based on the presence of male breast cancer detected in their corresponding pedigrees. Four mutations in BRCA1 were detected, including a novel frame-shift mutation (c.211dupA) in two unrelated patients and three other frameshift mutations--c.4041delAG, c.2551delG and c.5266dupC. Our study is the first to describe the c.5266dupC mutation in a non-Jewish Ashkenazi population. Two frameshift mutations (c.1309del4 and c.5682insA) were observed in BRCA2. Nineteen percent (7/36) of the familial cases had deleterious mutations of the BRCA1 or BRCA2 genes. Almost all patients with deleterious mutations of BRCA1 reported a family history of breast and/or ovarian cancer in the index case or in their relatives. Our data are the first to contribute to information on the mutation spectrum of BRCA genes in Tunisia, and we give a recommendation for improving clinical genetic testing policy.
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Affiliation(s)
- Wafa Troudi
- Laboratory of Genetics, Immunology and Human Pathology, Faculty of Sciences of Tunis, Universitaire El Manar I, 1060, Tunis, Tunisia. .,Salah Azaiez Institute of Carcinology of Tunis, Boulevard 09 Avril, 1006, Bab Saadoun, Tunisia.
| | - N Uhrhammer
- Laboratoire Diagnostic Génétique et Moléculaire, Centre Jean-Perrin, 63011, Clermont-Ferrand Cedex 01, France
| | - C Sibille
- Laboratory of Molecular Genetic of Hereditary Pathologies, Center of Human Genetics UCL, Avenue E. Mounier - Entrée F, 1200, Brussels, Belgium
| | - C Dahan
- Laboratory of Molecular Genetic of Hereditary Pathologies, Center of Human Genetics UCL, Avenue E. Mounier - Entrée F, 1200, Brussels, Belgium
| | - W Mahfoudh
- Laboratory of Molecular Immuno-Oncology, Faculty of Medicine, Monastir University, Avenue Avicenne, Monastir 5019 Cedex, Tunisia
| | - C Bouchlaka Souissi
- Laboratory of Genetics, Immunology and Human Pathology, Faculty of Sciences of Tunis, Universitaire El Manar I, 1060, Tunis, Tunisia
| | - T Jalabert
- Laboratoire Diagnostic Génétique et Moléculaire, Centre Jean-Perrin, 63011, Clermont-Ferrand Cedex 01, France
| | - L Chouchane
- Laboratory of Molecular Immuno-Oncology, Faculty of Medicine, Monastir University, Avenue Avicenne, Monastir 5019 Cedex, Tunisia
| | - Y J Bignon
- Laboratoire Diagnostic Génétique et Moléculaire, Centre Jean-Perrin, 63011, Clermont-Ferrand Cedex 01, France
| | - F Ben Ayed
- Salah Azaiez Institute of Carcinology of Tunis, Boulevard 09 Avril, 1006, Bab Saadoun, Tunisia
| | - A Ben Ammar Elgaaied
- Laboratory of Genetics, Immunology and Human Pathology, Faculty of Sciences of Tunis, Universitaire El Manar I, 1060, Tunis, Tunisia
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Abstract
OBJECTIVES Seasonal and circadian rhythms are observed in cardiovascular diseases. Seasonal variation in acute intestinal vasculopathy has never been investigated. This report describes the seasonal variation of acute intestinal vasculopathy mortality in the French population. METHODS All deaths that occurred among French adults over the period 1987-1996 (N = 20,830) for acute intestinal vasculopathy (International Classification of Diseases, Ninth Revision code 557.0) were examined retrospectively. Cumulated monthly averages were expressed as the percentage above or below the average monthly value during the entire study period. RESULTS Deaths for acute intestinal vasculopathy peaked in January (15% above the trend), and were lowest in July (11% below the trend), both in the overall population (Roger's test: p < 0.001) and in subgroups defined by age (>69 yr old) and sex. Compared to other subgroups, the >90 yr old individuals had a higher incidence of acute intestinal vasculopathy with a greater amplitude of seasonal variation (p < 0.001). CONCLUSIONS Awareness of higher risk during winter would help to reduce the high mortality from acute intestinal vasculopathy. A better understanding of this seasonal pattern would allow practitioners to improve early diagnosis and treatment.
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Affiliation(s)
- F Boulay
- Department of Public Health and Medical Information, Nice Teaching Hospital, France
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Queille-Roussel C, Dahan C, Poncet M, Schaefer H, Revuz J, De Prost Y, Guillaume JC, Ortonne JP, Czernielewski J. [Clinical trials in dermatology. Evaluation of the tolerability and efficacy of a topical anti-inflammatory treatment in atopic dermatitis]. Therapie 1991; 46:193-6. [PMID: 1792650] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Study designs for assessment of topical anti-inflammatory drugs in atopic dermatitis are discussed. Atopic dermatitis is a chronic disease with symmetrically distributed lesions. In order to avoid individual and spontaneous variation and to obtain an early impression of the efficacy of a new topical drug, bilaterally paired lesions can be used. Further drug development requires controlled double-blind parallel group design. General recommendations regarding inclusion criteria, and the measurement of efficacy and safety parameters are presented. Methods available for data evaluation and the particularities of different clinical designs are discussed.
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Affiliation(s)
- C Queille-Roussel
- Centre de Pharmacologie Clinique Appliquée à la Dermatologie, (C.P.C.A.D.), Hôpital Pasteur, Nice
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Dahan C, Queille-Roussel C, Verschoore M, Schaefer H, Revuz J, De Prost Y, Guillaume JC, Ortonne JP, Czernielewski J. [Clinical trials in dermatology. Evaluation of the tolerability and efficacy of a topical antipsoriatic treatment]. Therapie 1991; 46:197-200. [PMID: 1792651] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
There has been considerable variations between different authors in the evaluation of antipsoriatic therapies. Improvement homogeneity must be achieved in this field. The main specific methods have been investigated: inclusion criteria, assessment of disease progress and safety parameters in phase II and III clinical trials, evaluating antipsoriatic treatment.
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Affiliation(s)
- C Dahan
- Centre de Pharmacologie Clinique Appliquée à la Dermatologie, (C.P.C.A.D.), Hôpital Pasteur, Nice
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Queille-Roussel C, Dahan C, Duteil L, Schaefer H, Revuz J, De Prost Y, Guillaume JC, Ortonne JP, Czernielewski J. [Clinical trials in dermatology. Evaluation of the tolerability and efficacy of a topical antifungal agent in the treatment of superficial mycoses]. Therapie 1991; 46:201-4. [PMID: 1792652] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
There is no single method for evaluating topical antifungal drugs. The localisation and the type of fungal, determine the treatment duration (from few days to several months). The main methodological characteristics of clinical trials in tinea pedis treatment (athlete's foot type) are reported. Aspects related to other clinical forms such as tinea versicolor and onychomycosis are also described. In any case, the main criteria of activity remains the mycological examination based on KOH microbiology and culture performed at the end of the treatment and again afterwards.
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Affiliation(s)
- C Queille-Roussel
- Centre de Pharmacologie Clinique Appliquée à la Dermatologie (CPCAD), Hôpital Pasteur, Nice
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