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Wallimann M, Bouayed K, Cannizzaro E, Kaiser D, Belot A, Merlin E, Poignant S, Wouters C, Hofer F, Saurenmann T, Koryllou A, Carlomagno R, Mejbri M, Hofer M, Theodoropoulou K. Disease evolution in systemic juvenile idiopathic arthritis: an international, observational cohort study through JIRcohort. Pediatr Rheumatol Online J 2023; 21:96. [PMID: 37679749 PMCID: PMC10485973 DOI: 10.1186/s12969-023-00886-9] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2023] [Accepted: 08/31/2023] [Indexed: 09/09/2023] Open
Abstract
BACKGROUND Systemic juvenile idiopathic arthritis (systemic JIA) is a severe disease with both systemic and joint inflammation. This study aims to identify predictors of disease evolution within the systemic JIA population enrolled in the Juvenile Inflammatory Rheumatism cohort (JIRcohort). METHODS Observational patient cohort study with 201 recruited children from 4 countries (3 European, 1 North Africa) from 2005 until 2019, using retrospectively (2005-2015) and prospectively (2015-2019) routine care collected data. RESULTS Sixty-five patients with complete follow-up data for 24 months after first diagnosis were classified as monophasic (n = 23), polyphasic (n = 6) or persistent group (n = 36) corresponding to their evolution (unique flare, recurrent flares, or persistent disease activity respectively). The patients of the persistent group were more likely to have an earlier disease onset, before the age of 6 (OR 2.57, 95%-CI 0.70-9.46), persistence of arthritis at 12-months post-diagnosis (OR 4.45, 95%-CI 0.58-34.20) and higher use of synthetic DMARD (sDMARD, OR 5.28, 95%-CI 1.39-20.01). Other variables like global assessment by physician and by patient and C Reactive Protein levels at 12-months post-diagnosis were assessed but without any predictive value after adjusting for confounding factors. CONCLUSIONS Our results suggest that the earlier disease onset, the persistence of arthritis throughout the first year of disease evolution and the need of sDMARD might predict a persistent disease course.
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Affiliation(s)
- M Wallimann
- Department of Woman, Mother, Child, Unit of Pediatric Immunology, Allergology and Rheumatology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - K Bouayed
- Department of Pediatrics, Unit of Rheumatology and Nephrology, Mother and Child University Hospital A. Harouchi, CHU Ibn Rochd, Casablanca, Morocco
- Faculty of Medicine and Pharmacy, Hassan II University, Casablanca, Morocco
| | - E Cannizzaro
- Department of Pediatrics, Unit of Pediatric Rheumatology, University Children's Hospital, Zurich, Switzerland
| | - D Kaiser
- Department of Pediatrics, Unit of Pediatric Rheumatology, Childrens Hospital Lucerne, Lucerne, Switzerland
| | - A Belot
- Department of Pediatrics, Unit of Pediatric Nephrology, Rheumatology, Dermatology, Hospital Femme Mère Enfant, Hospices Civils de Lyon, Bron, France
| | - E Merlin
- Department of Pediatrics, Clermont-Ferrand University Hospital, Clermont-Ferrand, F-63000, France
| | - S Poignant
- Department of Pediatrics, University Hospital of Nantes, Nantes, France
| | - C Wouters
- Department of Pediatrics, Unit of Pediatric Rheumatology, University Hospital Leuven, Louvain, Belgium
| | - F Hofer
- Fondation Rhumatismes-Enfants-Suisse, Etoy, 1163, Switzerland
| | - T Saurenmann
- Department of Pediatrics, Cantonal Hospital Winterthur, Winterthur, Switzerland
| | - A Koryllou
- Department of Woman, Mother, Child, Unit of Pediatric Immunology, Allergology and Rheumatology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - R Carlomagno
- Department of Woman, Mother, Child, Unit of Pediatric Immunology, Allergology and Rheumatology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - M Mejbri
- Department of Woman, Mother, Child, Unit of Pediatric Immunology, Allergology and Rheumatology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - M Hofer
- Department of Woman, Mother, Child, Unit of Pediatric Immunology, Allergology and Rheumatology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - K Theodoropoulou
- Department of Woman, Mother, Child, Unit of Pediatric Immunology, Allergology and Rheumatology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.
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Shoop-Worrall S, Verstappen S, Costello W, Angevare S, Uziel Y, Wouters C, Wulffraat N, Beesley R. POS0202 CONTROL OF RHEUMATIC DISEASE AND COVID-19: RESULTS FROM THE INTERNATIONAL COVID-19 EUROPEAN PATIENT REGISTRY. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.2618] [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
BackgroundA major concern across rheumatology in recent years is how contracting COVID-19 may impact the control of rheumatic diseases.ObjectivesTo quantify any difference in rheumatic disease control between those who did and did not contract COVID-19 between March and December 2020 and whether rheumatic disease control changed after COVID-19 was contracted.MethodsAdults with rheumatic diseases recruited to the COVID-19 European Patient Registry, a patient-led, online, self-referred prospective cohort recruiting participants from around the globe, were included if enrolled between March and December 2020. Rheumatic disease control was self-reported weekly on a scale of 0 (very poor) to 10 (very well). Dates of contracting COVID-19 were self-reported.Differences in rheumatic disease control trends between those who did and did not contract COVID-19 over the study period were tested via multilevel linear regression. Within those who contracted COVID-19, differences in rheumatic disease control trends were tested via segmented multilevel, multivariable linear regression, adjusting for month of COVID-19 contraction and with the interruption point set at the point of COVID-19 contraction.ResultsOf 3646 adults with rheumatic diseases, the majority were female (89%), most commonly from the UK (82%) and the most common rheumatic disease diagnosis was RA (63%). Between March and December 2020, 3% of the cohort contracted COVID-19 (n=103).Over the study period, rheumatic disease control for adults who did not contract COVID-19 decreased weekly by 0.01 points (95% CI 0.01, 0.02, p<0.001). In those who contracted COVID-19, rheumatic disease control decreased weekly by 0.03 points (95% CI 0.2, 0.05, p<0.001), with a significant weekly difference of 0.86 points between groups (95% CI 0.28, 1.44, p=0.004) (Figure 1a).Figure 1.Trends in rheumatic disease control in those who did and did not contract COVID-19 between March and December 2020 a) overall and b) before and after contracting COVID-19Within those that contracted COVID-19, there were significant differences in rheumatic disease control trends before and after contracting COVID-19 (p=0.001). In the run up to contracting COVID-19, rheumatic disease control significantly decreased weekly by 0.03 points (95% CI 0.02, 0.04, p<0.001), dropped significantly by 0.53 points (95% CI 0.23, 0.83, p=0.001) at the point of COVID contraction and then stabilised with no further reductions or improvement in rheumatic disease control for the remainder of follow-up (p=0.831) (Figure 1b).ConclusionPeople who contracted COVID-19 had initial decreases in rheumatic disease control before contracting the virus, after which their disease control stabilised at a lower level. Those with disease flares should consider increased screening for COVID-19 and COVID-19 mitigation measures. The stabilising lower disease control post-COVID is concerning and should prompt further work into restoring disease control pre-COVID-19 levels.AcknowledgementsThe authors thank all of the participants and families involved in the international COVID-19 European Patient Registry, as well as the team of volunteers who helped translate the surveys. We also thank ENCA, PRES and representatives from the international rheumatology community for their expertise and support.Disclosure of InterestsStephanie Shoop-Worrall: None declared, Suzanne Verstappen: None declared, Wendy Costello: None declared, Saskya Angevare: None declared, Yosef Uziel: None declared, Carine Wouters: None declared, Nico Wulffraat Speakers bureau: Sobi, Grant/research support from: AbbVie, Richard Beesley: None declared
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Vanderbeke L, Van Mol P, Van Herck Y, De Smet F, Humblet-Baron S, Martinod K, Antoranz A, Arijs I, Boeckx B, Bosisio FM, Casaer M, Dauwe D, De Wever W, Dooms C, Dreesen E, Emmaneel A, Filtjens J, Gouwy M, Gunst J, Hermans G, Jansen S, Lagrou K, Liston A, Lorent N, Meersseman P, Mercier T, Neyts J, Odent J, Panovska D, Penttila PA, Pollet E, Proost P, Qian J, Quintelier K, Raes J, Rex S, Saeys Y, Sprooten J, Tejpar S, Testelmans D, Thevissen K, Van Buyten T, Vandenhaute J, Van Gassen S, Velásquez Pereira LC, Vos R, Weynand B, Wilmer A, Yserbyt J, Garg AD, Matthys P, Wouters C, Lambrechts D, Wauters E, Wauters J. Monocyte-driven atypical cytokine storm and aberrant neutrophil activation as key mediators of COVID-19 disease severity. Nat Commun 2021; 12:4117. [PMID: 34226537 PMCID: PMC8257697 DOI: 10.1038/s41467-021-24360-w] [Citation(s) in RCA: 128] [Impact Index Per Article: 42.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2020] [Accepted: 06/14/2021] [Indexed: 02/06/2023] Open
Abstract
Epidemiological and clinical reports indicate that SARS-CoV-2 virulence hinges upon the triggering of an aberrant host immune response, more so than on direct virus-induced cellular damage. To elucidate the immunopathology underlying COVID-19 severity, we perform cytokine and multiplex immune profiling in COVID-19 patients. We show that hypercytokinemia in COVID-19 differs from the interferon-gamma-driven cytokine storm in macrophage activation syndrome, and is more pronounced in critical versus mild-moderate COVID-19. Systems modelling of cytokine levels paired with deep-immune profiling shows that classical monocytes drive this hyper-inflammatory phenotype and that a reduction in T-lymphocytes correlates with disease severity, with CD8+ cells being disproportionately affected. Antigen presenting machinery expression is also reduced in critical disease. Furthermore, we report that neutrophils contribute to disease severity and local tissue damage by amplification of hypercytokinemia and the formation of neutrophil extracellular traps. Together our findings suggest a myeloid-driven immunopathology, in which hyperactivated neutrophils and an ineffective adaptive immune system act as mediators of COVID-19 disease severity.
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Affiliation(s)
- L Vanderbeke
- Laboratory of Clinical Bacteriology and Mycology, Department of Microbiology, Immunology and Transplantation, KU Leuven, Leuven, Belgium
| | - P Van Mol
- Laboratory of Translational Genetics, Department of Human Genetics, VIB-KU Leuven, Leuven, Belgium
| | - Y Van Herck
- Laboratory of Experimental Oncology, Department of Oncology, KU Leuven, Leuven, Belgium
| | - F De Smet
- Laboratory for Precision Cancer Medicine, Translational Cell and Tissue Research, Department of Imaging & Pathology, KU Leuven, Leuven, Belgium
| | - S Humblet-Baron
- Adaptive Immunology, Department of Microbiology, Immunology and Transplantation, KU Leuven, Leuven, Belgium
| | - K Martinod
- Centre for Molecular and Vascular Biology, Department of Cardiovascular Sciences, KU Leuven, Leuven, Belgium
| | - A Antoranz
- Laboratory for Precision Cancer Medicine, Translational Cell and Tissue Research, Department of Imaging & Pathology, KU Leuven, Leuven, Belgium
| | - I Arijs
- Laboratory of Translational Genetics, Department of Human Genetics, VIB-KU Leuven, Leuven, Belgium
| | - B Boeckx
- Laboratory of Translational Genetics, Department of Human Genetics, VIB-KU Leuven, Leuven, Belgium
| | - F M Bosisio
- Translational Cell & Tissue Research, Department of Imaging & Pathology, KU Leuven, Leuven, Belgium
| | - M Casaer
- Laboratory of Intensive Care Medicine, Department of Cellular and Molecular Medicine, KU Leuven, Leuven, Belgium
| | - D Dauwe
- Laboratory of Intensive Care Medicine, Department of Cellular and Molecular Medicine, KU Leuven, Leuven, Belgium
| | - W De Wever
- Radiology, Department of Imaging & Pathology, KU Leuven, Leuven, Belgium
| | - C Dooms
- Laboratory of Respiratory Diseases and Thoracic Surgery (BREATHE), Department of Chronic Diseases and Metabolism, KU Leuven, Leuven, Belgium
| | - E Dreesen
- Clinical Pharmacology and Pharmacotherapy, Department of Pharmaceutical and Pharmacological Sciences, KU Leuven, Leuven, Belgium
| | - A Emmaneel
- Department of Applied Mathematics, Computer Science and Statistics, VIB-UGent Center for Inflammation Research, VIB-UGent, Gent, Belgium
| | - J Filtjens
- Laboratory of Immunobiology, Department of Microbiology, Immunology and Transplantation, Rega Institute, KU Leuven, Leuven, Belgium
| | - M Gouwy
- Laboratory of Molecular Immunology, Department of Microbiology, Immunology and Transplantation, Rega Institute, KU Leuven, Leuven, Belgium
| | - J Gunst
- Laboratory of Intensive Care Medicine, Department of Cellular and Molecular Medicine, KU Leuven, Leuven, Belgium
| | - G Hermans
- Laboratory of Intensive Care Medicine, Department of Cellular and Molecular Medicine, KU Leuven, Leuven, Belgium
| | - S Jansen
- Laboratory of Virology and Chemotherapy, Department of Microbiology, Immunology and Transplantation, Rega Institute, KU Leuven, B Leuven, Belgium
| | - K Lagrou
- Laboratory of Clinical Bacteriology and Mycology, Department of Microbiology, Immunology and Transplantation, KU Leuven, Leuven, Belgium
| | - A Liston
- Laboratory of Lymphocyte Signalling and Development, The Babraham Institute, Babraham Research Campus, Cambridge, UK
| | - N Lorent
- Department of Pneumology, University Hospitals Leuven, Leuven, Belgium
| | - P Meersseman
- Laboratory for Clinical Infectious and Inflammatory Disorders, Department of Microbiology, Immunology and Transplantation, KU Leuven, Leuven, Belgium
| | - T Mercier
- Laboratory of Clinical Bacteriology and Mycology, Department of Microbiology, Immunology and Transplantation, KU Leuven, Leuven, Belgium
| | - J Neyts
- Laboratory of Virology and Chemotherapy, Department of Microbiology, Immunology and Transplantation, Rega Institute, KU Leuven, B Leuven, Belgium
| | - J Odent
- Department of Internal Medicine, University Hospitals Leuven, Leuven, Belgium
| | - D Panovska
- Laboratory for Precision Cancer Medicine, Translational Cell and Tissue Research, Department of Imaging & Pathology, KU Leuven, Leuven, Belgium
| | - P A Penttila
- KU Leuven Flow & Mass Cytometry Facility, KU Leuven, Leuven, Belgium
| | - E Pollet
- Department of Internal Medicine, University Hospitals Leuven, Leuven, Belgium
| | - P Proost
- Laboratory of Molecular Immunology, Department of Microbiology, Immunology and Transplantation, Rega Institute, KU Leuven, Leuven, Belgium
| | - J Qian
- Laboratory of Translational Genetics, Department of Human Genetics, VIB-KU Leuven, Leuven, Belgium
| | - K Quintelier
- Department of Applied Mathematics, Computer Science and Statistics, VIB-UGent Center for Inflammation Research, VIB-UGent, Gent, Belgium
| | - J Raes
- Laboratory of Molecular Bacteriology (Rega Institute), Department of Microbiology, Immunology and Transplantation, KU Leuven, and VIB Center for Microbiology, Leuven, Belgium
| | - S Rex
- Anesthesiology and Algology, Department of Cardiovascular Sciences, KU Leuven, Leuven, Belgium
| | - Y Saeys
- Department of Applied Mathematics, Computer Science and Statistics, VIB-UGent Center for Inflammation Research, VIB-UGent, Gent, Belgium
| | - J Sprooten
- Laboratory for Cell Stress & Immunity (CSI), Department of Cellular and Molecular Medicine (CMM), KU Leuven, Leuven, Belgium
| | - S Tejpar
- Molecular Digestive Oncology, Department of Oncology, KU Leuven, Leuven, Belgium
| | - D Testelmans
- Laboratory of Respiratory Diseases and Thoracic Surgery (BREATHE), Department of Chronic Diseases and Metabolism, KU Leuven, Leuven, Belgium
| | - K Thevissen
- Centre of Microbial and Plant Genetics, Department of Microbial and Molecular Systems (M2S), KU Leuven, Leuven, Belgium
| | - T Van Buyten
- Laboratory of Virology and Chemotherapy, Department of Microbiology, Immunology and Transplantation, Rega Institute, KU Leuven, B Leuven, Belgium
| | - J Vandenhaute
- Laboratory of Immunobiology, Department of Microbiology, Immunology and Transplantation, Rega Institute, KU Leuven, Leuven, Belgium
| | - S Van Gassen
- Department of Applied Mathematics, Computer Science and Statistics, VIB-UGent Center for Inflammation Research, VIB-UGent, Gent, Belgium
| | - L C Velásquez Pereira
- Centre for Molecular and Vascular Biology, Department of Cardiovascular Sciences, KU Leuven, Leuven, Belgium
| | - R Vos
- Laboratory of Respiratory Diseases and Thoracic Surgery (BREATHE), Department of Chronic Diseases and Metabolism, KU Leuven, Leuven, Belgium
| | - B Weynand
- Translational Cell & Tissue Research, Department of Imaging & Pathology, KU Leuven, Leuven, Belgium
| | - A Wilmer
- Laboratory for Clinical Infectious and Inflammatory Disorders, Department of Microbiology, Immunology and Transplantation, KU Leuven, Leuven, Belgium
| | - J Yserbyt
- Laboratory of Respiratory Diseases and Thoracic Surgery (BREATHE), Department of Chronic Diseases and Metabolism, KU Leuven, Leuven, Belgium
| | - A D Garg
- Laboratory for Cell Stress & Immunity (CSI), Department of Cellular and Molecular Medicine (CMM), KU Leuven, Leuven, Belgium
| | - P Matthys
- Laboratory of Immunobiology, Department of Microbiology, Immunology and Transplantation, Rega Institute, KU Leuven, Leuven, Belgium
| | - C Wouters
- Adaptive Immunology, Department of Microbiology, Immunology and Transplantation, KU Leuven, Leuven, Belgium
- Laboratory of Immunobiology, Department of Microbiology, Immunology and Transplantation, Rega Institute, KU Leuven, Leuven, Belgium
| | - D Lambrechts
- Laboratory of Translational Genetics, Department of Human Genetics, VIB-KU Leuven, Leuven, Belgium
| | - E Wauters
- Laboratory of Respiratory Diseases and Thoracic Surgery (BREATHE), Department of Chronic Diseases and Metabolism, KU Leuven, Leuven, Belgium.
| | - J Wauters
- Laboratory for Clinical Infectious and Inflammatory Disorders, Department of Microbiology, Immunology and Transplantation, KU Leuven, Leuven, Belgium
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Shoop-Worrall S, Verstappen S, Costello W, Angevare S, Uziel Y, Wouters C, Wulffraat N, Beesley R. AB0681 HOW COMMON IS COVID-19 IN CHILDREN, YOUNG PEOPLE AND ADULTS WITH RHEUMATIC DISEASES? RESULTS FROM THE INTERNATIONAL COVID-19 EUROPEAN PATIENT REGISTRY. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.2535] [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: 11/03/2022]
Abstract
Background:People with rheumatic diseases may be at increased risk of contracting COVID-19 due to their rheumatic disease or immunosuppressive treatments. It is currently unclear what the COVID-19 disease burden is for these people and whether any of their personal or disease characteristics are associated with contracting COVID-19.Objectives:To explore the proportion of, and characteristics associated with, contracting COVID-19 in children and young people (CYP) with rheumatic diseases and adults with rheumatic diseases from March 2020 to December 2020 during the COVID-19 pandemic.Methods:CYP and adults recruited to the international COVID-19 European Patient Registry, a parent-led, online, self-referred prospective cohort recruiting participants from around the globe, were included in current study if enrolled between 20th March 2020 and 30th December 2020. Demographic information was collected at enrolment and rheumatic disease, diagnoses of COVID-19 and lifestyle factors were collected at weekly intervals.The proportion of CYP and adults diagnosed with COVID-19 were assessed separately. Associations between contraction of COVID-19 at any point over follow-up and participant demographics, rheumatic disease and lifestyle factors at enrolment were assessed descriptively and via Mann-Whitney U-tests, Chi-squared tests and Fisher’s exact tests.Results:Within 642 CYP and 3646 adults, the majority were female (67%, 89%) and most commonly from the UK (43%, 82%), respectively. The most frequent diagnoses were polyarticular JIA (37%) in the CYP cohort and RA in the adults (63%). Comorbidities were common (45%, 61%) and the majority were taking one or more immunosuppressive therapies (88%, 92%), respectively. At the time of enrolment, 51% and 54% were practising social distancing, respectively.In both cohorts ~3% contracted COVID-19 at some point during follow-up (n=18 (2.8%) in CYP and n=103 (2.8%) in the adult cohort).In CYP, those who contracted COVID-19 were older (no COVID, median: 10, IQR: 7, 13, vs COVID, median: 14, IQR: 12, 16, p<0.001) and less often had oligoarticular JIA (no COVID: 31%, COVID: 22%) or polyarticular JIA (No COVID: 38%, COVID: 11%). Systemic JIA (no COVID: 7%, COVID: 11%) and enthesitis-related JIA (no COVID: 5%, COVID: 22%) were more common in those who contracted COVID. No other differences between those with and without COVID-19 were observed with respect to country of residence (p=0.335), gender (p=0.624), control of rheumatic disease (p=0.459), comorbidities (p=0.752), immunosuppressive medication (p=0.713) or social distancing (p=0.729).In the adult cohort, those contracting COVID-19 were more commonly from Russia (no COVID: 2%, COVID: 14%) and less commonly from the UK (no COVID: 82%, COVID: 71%, p<0.001). There was greater female representation in those that contracted COVID-19 (no COVID: 88%, COVID: 93%, p=0.022). Although there were no differences in overall presence of comorbidity (p=0.923), kidney disease was overrepresented in those that had contracted COVID-19 (no COVID: 2%, COVID: 8%, p<0.001). Finally, there were lower levels of social distancing in those who contracted COVID (no COVID: 54%, COVID: 44%, p=0.047). There were no significant differences in age (p=0.203), BMI (p=0.617), smoking status (p=0.120), rheumatic disease (p=0.181) and its control (p=0.218) or immunosuppressive use (p=0.208) between those who did and did not contract COVID-19 in the adult cohort.Conclusion:A low proportion of CYP and adults with rheumatic diseases contracted COVID-19 in the 9 months since March 2020. However, given the self-reported nature of the survey and limited testing available across many countries, this study may underestimate the true burden of COVID-19 in the rheumatic disease community. Factors associated with COVID-19 differ between CYP and adults, with age and type of rheumatic disease associated in CYP and gender, kidney comorbidity and social distancing associated in adults.Acknowledgements:The authors thank all of the participants and families involved in the international COVID-19 European Patient Registry, as well as administrators. We also thank the team of volunteers who helped translate the surveys. We also thank ENCA, PRES and representatives from the international rheumatology community for their expertise and support.Disclosure of Interests:Stephanie Shoop-Worrall: None declared, Suzanne Verstappen: None declared, Wendy Costello: None declared, Saskya Angevare: None declared, Yosef Uziel: None declared, Carine Wouters: None declared, Nico Wulffraat Speakers bureau: Sobi, Grant/research support from: AbbVie, Richard Beesley: None declared
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Vanassche T, Engelen MM, Van Thillo Q, Wauters J, Gunst J, Wouters C, Vandenbriele C, Rex S, Liesenborghs L, Wilmer A, Meersseman P, Van den Berghe G, Dauwe D, Verbeke G, Thomeer M, Fivez T, Mesotten D, Ruttens D, Heytens L, Dapper I, Tuyls S, De Tavernier B, Verhamme P. Correction to: A randomized, open-label, adaptive, proof-of-concept clinical trial of modulation of host thromboinflammatory response in patients with COVID-19: the DAWn-Antico study. Trials 2020; 21:1033. [PMID: 33375932 PMCID: PMC7770739 DOI: 10.1186/s13063-020-04991-y] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
An amendment to this paper has been published and can be accessed via the original article.
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Affiliation(s)
- T Vanassche
- Center for Molecular and Vascular Biology, KU Leuven Department of Cardiovascular Sciences, KU Leuven, Leuven, Belgium. .,Department of Cardiovascular Sciences, University Hospitals Leuven, Leuven, Belgium.
| | - M M Engelen
- Center for Molecular and Vascular Biology, KU Leuven Department of Cardiovascular Sciences, KU Leuven, Leuven, Belgium.,Department of Cardiovascular Sciences, University Hospitals Leuven, Leuven, Belgium
| | | | - J Wauters
- Department of General Internal Medicine, Medical Intensive Care Unit, University Hospitals Leuven, Leuven, Belgium
| | - J Gunst
- Clinical Department and Laboratory of Intensive Care Medicine, Department of Cellular and Molecular Medicine, KU Leuven, Leuven, Belgium
| | - C Wouters
- Pediatric Rheumatology, University Hospitals Leuven, Leuven, Belgium.,Laboratory of Adaptive Immunology & Immunobiology, Department of Microbiology and Immunology, KU Leuven, Leuven, Belgium
| | - C Vandenbriele
- Center for Molecular and Vascular Biology, KU Leuven Department of Cardiovascular Sciences, KU Leuven, Leuven, Belgium.,Department of Cardiovascular Sciences, University Hospitals Leuven, Leuven, Belgium
| | - S Rex
- Department of Cardiovascular Sciences, University Hospitals Leuven, Leuven, Belgium.,Department of Anesthesiology, University Hospitals Leuven, Leuven, Belgium
| | - L Liesenborghs
- Center for Molecular and Vascular Biology, KU Leuven Department of Cardiovascular Sciences, KU Leuven, Leuven, Belgium.,REGA Institute, KU Leuven, Leuven, Belgium
| | - A Wilmer
- Department of General Internal Medicine, Medical Intensive Care Unit, University Hospitals Leuven, Leuven, Belgium
| | - P Meersseman
- Department of General Internal Medicine, Medical Intensive Care Unit, University Hospitals Leuven, Leuven, Belgium
| | - G Van den Berghe
- Clinical Department and Laboratory of Intensive Care Medicine, Department of Cellular and Molecular Medicine, KU Leuven, Leuven, Belgium
| | - D Dauwe
- Clinical Department and Laboratory of Intensive Care Medicine, Department of Cellular and Molecular Medicine, KU Leuven, Leuven, Belgium
| | - G Verbeke
- Interuniversity Institute for Biostatistics and statistical Bioinformatics (I-BioStat), KU Leuven, Leuven, and Hasselt University (UHasselt), Hasselt, Belgium
| | - M Thomeer
- Department of Respiratory Medicine, Ziekenhuis Oost-Limburg, Genk, Belgium.,Department of Medicine and Life Sciences, Hasselt University, Diepenbeek, Belgium
| | - T Fivez
- Department of Medicine and Life Sciences, Hasselt University, Diepenbeek, Belgium.,Department of Anaesthesiology, Intensive Care, Emergency Medicine and Pain Therapy, Ziekenhuis Oost-Limburg, Genk, Belgium
| | - D Mesotten
- Department of Medicine and Life Sciences, Hasselt University, Diepenbeek, Belgium.,Department of Anaesthesiology, Intensive Care, Emergency Medicine and Pain Therapy, Ziekenhuis Oost-Limburg, Genk, Belgium
| | - D Ruttens
- Department of Respiratory Medicine, Ziekenhuis Oost-Limburg, Genk, Belgium
| | - L Heytens
- Department of Anesthestiology, GZA hospital group, Antwerp, Belgium
| | - I Dapper
- Emergency Medicine and Intensive Care, GZA hospital group, Antwerp, Belgium
| | - S Tuyls
- Respiratory Medicine, GZA hospital group, Antwerp, Belgium
| | - B De Tavernier
- Emergency Medicine and Intensive Care, GZA hospital group, Antwerp, Belgium
| | - P Verhamme
- Center for Molecular and Vascular Biology, KU Leuven Department of Cardiovascular Sciences, KU Leuven, Leuven, Belgium.,Department of Cardiovascular Sciences, University Hospitals Leuven, Leuven, Belgium
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Vanassche T, Engelen MM, Van Thillo Q, Wauters J, Gunst J, Wouters C, Vandenbriele C, Rex S, Liesenborghs L, Wilmer A, Meersseman P, Van den Berghe G, Dauwe D, Verbeke G, Thomeer M, Fivez T, Mesotten D, Ruttens D, Heytens L, Dapper I, Tuyls S, De Tavernier B, Verhamme P. A randomized, open-label, adaptive, proof-of-concept clinical trial of modulation of host thromboinflammatory response in patients with COVID-19: the DAWn-Antico study. Trials 2020; 21:1005. [PMID: 33298149 PMCID: PMC7724460 DOI: 10.1186/s13063-020-04878-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [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] [Received: 08/05/2020] [Accepted: 11/06/2020] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND The peak of the global COVID-19 pandemic has not yet been reached, and many countries face the prospect of a second wave of infections before effective vaccinations will be available. After an initial phase of viral replication, some patients develop a second illness phase in which the host thrombotic and inflammatory responses seem to drive complications. Severe COVID-19 disease is linked to high mortality, hyperinflammation, and a remarkably high incidence of thrombotic events. We hypothesize a crucial pathophysiological role for the contact pathway of coagulation and the kallikrein-bradykinin pathway. Therefore, drugs that modulate this excessive thromboinflammatory response should be investigated in severe COVID-19. METHODS In this adaptive, open-label multicenter randomized clinical trial, we compare low molecular weight heparins at 50 IU anti-Xa/kg twice daily-or 75 IU anti-Xa twice daily for intensive care (ICU) patients-in combination with aprotinin to standard thromboprophylaxis in hospitalized COVID-19 patients. In the case of hyperinflammation, the interleukin-1 receptor antagonist anakinra will be added on top of the drugs in the interventional arm. In a pilot phase, the effect of the intervention on thrombotic markers (D-dimer) will be assessed. In the full trial, the primary outcome is defined as the effect of the interventional drugs on clinical status as defined by the WHO ordinal scale for clinical improvement. DISCUSSION In this trial, we target the thromboinflammatory response at multiple levels. We intensify the dose of low molecular weight heparins to reduce thrombotic complications. Aprotinin is a potent kallikrein pathway inhibitor that reduces fibrinolysis, activation of the contact pathway of coagulation, and local inflammatory response. Additionally, aprotinin has shown in vitro inhibitory effects on SARS-CoV-2 cellular entry. Because the excessive thromboinflammatory response is one of the most adverse prognostic factors in COVID-19, we will add anakinra, a recombinant interleukin-1 receptor antagonist, to the regimen in case of severely increased inflammatory parameters. This way, we hope to modulate the systemic response to SARS-CoV-2 and avoid disease progressions with a potentially fatal outcome. TRIAL REGISTRATION The EU Clinical Trials Register 2020-001739-28 . Registered on April 10, 2020.
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Affiliation(s)
- T Vanassche
- Center for Molecular and Vascular Biology, KU Leuven Department of Cardiovascular Sciences, KU Leuven, Leuven, Belgium. .,Department of Cardiovascular Sciences, University Hospitals Leuven, Leuven, Belgium.
| | - M M Engelen
- Center for Molecular and Vascular Biology, KU Leuven Department of Cardiovascular Sciences, KU Leuven, Leuven, Belgium.,Department of Cardiovascular Sciences, University Hospitals Leuven, Leuven, Belgium
| | | | - J Wauters
- Department of General Internal Medicine, Medical Intensive Care Unit, University Hospitals Leuven, Leuven, Belgium
| | - J Gunst
- Clinical Department and Laboratory of Intensive Care Medicine, Department of Cellular and Molecular Medicine, KU Leuven, Leuven, Belgium
| | - C Wouters
- Pediatric Rheumatology, University Hospitals Leuven, Leuven, Belgium.,Laboratory of Adaptive Immunology & Immunobiology, Department of Microbiology and Immunology, KU Leuven, Leuven, Belgium
| | - C Vandenbriele
- Center for Molecular and Vascular Biology, KU Leuven Department of Cardiovascular Sciences, KU Leuven, Leuven, Belgium.,Department of Cardiovascular Sciences, University Hospitals Leuven, Leuven, Belgium
| | - S Rex
- Department of Cardiovascular Sciences, University Hospitals Leuven, Leuven, Belgium.,Department of Anesthesiology, University Hospitals Leuven, Leuven, Belgium
| | - L Liesenborghs
- Center for Molecular and Vascular Biology, KU Leuven Department of Cardiovascular Sciences, KU Leuven, Leuven, Belgium.,REGA Institute, KU Leuven, Leuven, Belgium
| | - A Wilmer
- Department of General Internal Medicine, Medical Intensive Care Unit, University Hospitals Leuven, Leuven, Belgium
| | - P Meersseman
- Department of General Internal Medicine, Medical Intensive Care Unit, University Hospitals Leuven, Leuven, Belgium
| | - G Van den Berghe
- Clinical Department and Laboratory of Intensive Care Medicine, Department of Cellular and Molecular Medicine, KU Leuven, Leuven, Belgium
| | - D Dauwe
- Clinical Department and Laboratory of Intensive Care Medicine, Department of Cellular and Molecular Medicine, KU Leuven, Leuven, Belgium
| | - G Verbeke
- Interuniversity Institute for Biostatistics and statistical Bioinformatics (I-BioStat), KU Leuven, Leuven, and Hasselt University (UHasselt), Hasselt, Belgium
| | - M Thomeer
- Department of Respiratory Medicine, Ziekenhuis Oost-Limburg, Genk, Belgium.,Department of Medicine and Life Sciences, Hasselt University, Diepenbeek, Belgium
| | - T Fivez
- Department of Medicine and Life Sciences, Hasselt University, Diepenbeek, Belgium.,Department of Anaesthesiology, Intensive Care, Emergency Medicine and Pain Therapy, Ziekenhuis Oost-Limburg, Genk, Belgium
| | - D Mesotten
- Department of Medicine and Life Sciences, Hasselt University, Diepenbeek, Belgium.,Department of Anaesthesiology, Intensive Care, Emergency Medicine and Pain Therapy, Ziekenhuis Oost-Limburg, Genk, Belgium
| | - D Ruttens
- Department of Respiratory Medicine, Ziekenhuis Oost-Limburg, Genk, Belgium
| | - L Heytens
- Department of Anesthestiology, GZA hospital group, Antwerp, Belgium
| | - I Dapper
- Emergency Medicine and Intensive Care, GZA hospital group, Antwerp, Belgium
| | - S Tuyls
- Respiratory Medicine, GZA hospital group, Antwerp, Belgium
| | - B De Tavernier
- Emergency Medicine and Intensive Care, GZA hospital group, Antwerp, Belgium
| | - P Verhamme
- Center for Molecular and Vascular Biology, KU Leuven Department of Cardiovascular Sciences, KU Leuven, Leuven, Belgium.,Department of Cardiovascular Sciences, University Hospitals Leuven, Leuven, Belgium
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Brunner H, Tzaribachev N, Louw I, Calvo I, Zapata F, Horneff G, Foeldvari I, Kingsbury D, Gastanaga M, Wouters C, Breedt J, Wong R, Nys M, Askelson M, Zhuo J, Martini A, Lovell DJ, Ruperto N. THU0497 MAINTENANCE OF MINIMAL DISEASE ACTIVITY OR INACTIVE DISEASE STATUS AND PATIENT-REPORTED OUTCOMES IN INDIVIDUAL PAEDIATRIC PATIENTS WITH JUVENILE IDIOPATHIC ARTHRITIS TREATED WITH SUBCUTANEOUS ABATACEPT. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.1540] [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: 11/03/2022]
Abstract
Background:Maintenance of clinical response over time has been shown in individual patients (pts) with polyarticular-course juvenile idiopathic arthritis (pJIA) treated with SC abatacept (ABA).1It is unknown whether each individual pt with sustained efficacy also consistently maintains the previously reported shorter-term benefits on patient-reported outcomes (PROs)2,3over time.Objectives:Investigate whether combined efficacy and stringent, optimal PRO responses to ABA treatment are maintained by individual pts with pJIA over time.Methods:In this analysis of the intent-to-treat population, pts in two age cohorts (2–5 and 6–17 yrs) who achieved clinical response to weekly SC ABA (10–<25 kg [50 mg], 25–<50 kg [87.5 mg], ≥50 kg [125 mg]) at Mo 4 (time point of primary pharmacokinetic endpoint4) were followed for 2 yrs. Stringent efficacy outcomes (Juvenile Arthritis Disease Activity Score 27 [JADAS27] minimal disease activity [MDA; ≤3.8] and inactive disease [ID; ≤1] status) were combined with optimal PRO endpoints (childhood [C]HAQ-DI=0, Parental Global Assessment [PaGA] ≤1 and Pain visual analogue scale [VAS] <35). Combined efficacy and PRO responses were analysed at Mos 4, 13 and 21.Results:219 pts entered the study (46 [21.0%] 2–5 yrs; 173 [79.0%] 6–17 yrs); a subgroup of these pts achieved a clinical response at Mo 4 (Table 1). Many pts who achieved JADAS27 MDA or JADAS27 ID combined with optimal PROs at Mo 4 sustained their response at Mo 13, and at both Mo 13 and Mo 21 in the 2–5-yr and 6–17-yr cohorts (Table 1). Across the cohorts, 33–88% of pts maintained a combined JADAS27 MDA with optimal PRO responses through Mo 21. Where estimable, median times to combined efficacy and specific optimal PRO responses were consistent across the cohorts (Table 2; Figs 1, 2).Table 1.Proportion of pts with combined efficacy and optimal PRO responses at Mos 4, 13 and 21EndpointResponders at Mo 4Responders at Mos 4 and 13*Responders at Mos 4, 13 and 21*2–5 yrs (n=46)6–17 yrs (n=173)2–5 yrs6–17 yrs2–5 yrs6–17 yrsJADAS27 MDA and CHAQ-DI=09 (20)34 (20)5/9 (56)25/34 (74)3/9 (33)16/34 (47)JADAS27 MDA and PaGA ≤18 (17)14 (8)8/8 (100)7/14 (50)7/8 (88)5/14 (36)JADAS27 MDA and Pain VAS <35 mm28 (61)70 (41)25/28 (89)58/70 (83)21/28 (75)43/70 (61)JADAS27 ID and CHAQ-DI=07 (15)20 (12)2/7 (29)13/20 (65)1/7 (14)9/20 (45)JADAS27 ID and PaGA ≤16 (13)10 (6)4/6 (67)4/10 (40)4/6 (67)4/10 (40)JADAS27 ID and Pain VAS <35 mm17 (37)31 (18)10/17 (59)22/31 (71)8/17 (47)17/31 (55)Data are n (%) or n/N (%). *% based on n of pts who achieved response at Mo 4 (denominator)Table 2.Kaplan–Meier estimates for median (95% CI) times (mos) to achieving combined efficacy and optimal PRO responsesEndpoint2–5 yrs6–17 yrsJADAS27 MDA and CHAQ-DI=021.5 (6.8, NE)21.5 (13.1, 24.4)JADAS27 MDA and PaGA ≤1NE (15.9, NE)24.6 (24.3, NE)JADAS27 MDA and Pain VAS <35 mm2.8 (1.9, 2.9)3.8 (3.7, 6.6)JADAS27 ID and CHAQ-DI=0NE (18.4, NE)24.4 (18.7, NE)JADAS27 ID and PaGA ≤1NE (21.3, NE)24.6 (24.3, NE)JADAS27 ID and Pain VAS <35 mm3.8 (3.8, 10.3)13.2 (10.3, 15.9)NE=not estimableConclusion:Many individuals with pJIA who achieved stringent efficacy and PRO measures with weekly SC abatacept by Mo 4 sustained them over 2 years. Time to achieve combined efficacy and Pain VAS <35 response was shorter than that for PaGA ≤1 and CHAQ-DI=0.References:[1]Ruperto N, et al.Ann Rheum Dis2019;78:99–100 (abstr OP0056)[2]Brunner H, et al.Arthritis Rheumatol2019;71(suppl 10):abstr 2707[3]Ruperto N, et al.Ann Rheum Dis2017;76:75 (abstr OP0058)[4]Brunner HI, et al.Arthritis Rheumatol2018;70:1144–54Acknowledgments:Katerina Kumpan, PhD, Caudex; funding: Bristol-Myers SquibbDisclosure of Interests: :Hermine Brunner Consultant of: Hoffman-La Roche, Novartis, Pfizer, Sanofi Aventis, Merck Serono, AbbVie, Amgen, Alter, AstraZeneca, Baxalta Biosimilars, Biogen Idec, Boehringer, Bristol-Myers Squibb, Celgene, EMD Serono, Janssen, MedImmune, Novartis, Pfizer, and UCB Biosciences, Speakers bureau: GSK, Roche, and Novartis, Nikolay Tzaribachev: None declared, Ingrid Louw Consultant of: Amgen, Novartis, Pfizer, Roche (advisory boards), Inmaculada Calvo Grant/research support from: Bristol-Myers Squibb, Clementia, GlaxoSmithKline, Hoffman-La Roche, Merck Sharpe & Dohme, Novartis, Pfizer, Sanofi, Speakers bureau: AbbVie, GlaxoSmithKline, Hoffman-La Roche, Novartis, Francisco Zapata: None declared, Gerd Horneff Grant/research support from: AbbVie, Chugai, Merck Sharp & Dohme, Novartis, Pfizer, Roche, Speakers bureau: AbbVie, Bayer, Chugai, Merck Sharp & Dohme, Novartis, Pfizer, Roche, Ivan Foeldvari Consultant of: AbbVie, Amgen, Bristol-Myers Squibb, Chugai, Eli Lilly, Novartis, Pfizer, Daniel Kingsbury: None declared, Maria Gastanaga Grant/research support from: Amgen, Bristol-Myers Squibb, GlaxoSmithKline, Novartis, Pfizer, Roche, Speakers bureau: AbbVie, Roche, Carine Wouters Grant/research support from: GlaxoSmithKline, Pfizer, Roche, Johannes Breedt: None declared, Robert Wong Shareholder of: Bristol-Myers Squibb, Employee of: Bristol-Myers Squibb, Marleen Nys Shareholder of: Bristol-Myers Squibb, Employee of: Bristol-Myers Squibb, Margarita Askelson Consultant of: Bristol-Myers Squibb, Joe Zhuo Shareholder of: Bristol-Myers Squibb, Employee of: Bristol-Myers Squibb, Alberto Martini Consultant of: AbbVie, Eli Lily, EMD Serono, Janssen, Novartis, Pfizer, UCB, Daniel J Lovell Consultant of: Abbott (consulting and PI), AbbVie (PI), Amgen (consultant and DSMC Chairperson), AstraZeneca, Boehringer Ingelheim, Bristol-Myers Squibb (PI), Celgene, Forest Research (DSMB Chairman), GlaxoSmithKline, Hoffman-La Roche, Janssen (co-PI), Novartis (consultant and PI), Pfizer (consultant and PI), Roche (PI), Takeda, UBC (consultant and PI), Wyeth, Employee of: Cincinnati Children’s Hospital Medical Center, Speakers bureau: Wyeth, Nicolino Ruperto Grant/research support from: Bristol-Myers Squibb, Eli Lily, F Hoffmann-La Roche, GlaxoSmithKline, Janssen, Novartis, Pfizer, Sobi (paid to institution), Consultant of: Ablynx, AbbVie, AstraZeneca-Medimmune, Biogen, Boehringer Ingelheim, Bristol-Myers Squibb, Eli Lily, EMD Serono, GlaxoSmithKline, Hoffmann-La Roche, Janssen, Merck, Novartis, Pfizer, R-Pharma, Sanofi, Servier, Sinergie, Sobi, Takeda, Speakers bureau: Ablynx, AbbVie, AstraZeneca-Medimmune, Biogen, Boehringer Ingelheim, Bristol-Myers Squibb, Eli Lily, EMD Serono, GlaxoSmithKline, Hoffmann-La Roche, Janssen, Merck, Novartis, Pfizer, R-Pharma, Sanofi, Servier, Sinergie, Sobi, Takeda
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8
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Poline J, Fogel O, Pajot C, Miceli‐Richard C, Rybojad M, Galeotti C, Grouteau E, Hachulla E, Brissaud P, Cantagrel A, Mazereeuw Hautier J, Melki I, Petit A, Piram M, Sarrabay G, Wouters C, Vignon‐Pennamen M, Bourrat E, Meinzer U. Early‐onset granulomatous arthritis, uveitis and skin rash: characterization of skin involvement in Blau syndrome. J Eur Acad Dermatol Venereol 2019; 34:340-348. [DOI: 10.1111/jdv.15963] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Accepted: 08/26/2019] [Indexed: 01/21/2023]
Affiliation(s)
- J. Poline
- Department of General Pediatrics Paediatric Internal Medicine, Rheumatology and Infectious Diseases National Reference Centre for Rare Paediatric Inflammatory Rheumatisms and Systemic Auto‐immune diseases RAISE Robert Debré University Hospital Assistance Publique‐Hôpitaux de Paris Paris France
- INSERM UMR1149 Université Paris Diderot‐Sorbonne Paris‐Cité Paris France
| | - O. Fogel
- Department of Rheumatology Cochin University Hospital Assistance Publique‐Hôpitaux de Paris ParisFrance
| | - C. Pajot
- Department of Paediatric Nephrology and Internal Medicine Purpan University Hospital Toulouse France
| | - C. Miceli‐Richard
- Department of Rheumatology Cochin University Hospital Assistance Publique‐Hôpitaux de Paris ParisFrance
| | - M. Rybojad
- Department of Dermatology Saint Louis University Hospital Assistance Publique‐Hôpitaux de Paris Paris France
| | - C. Galeotti
- Department of Paediatric Rheumatology National Reference Centre for Auto‐inflammatory Diseases CEREMAIA Kremlin Bicêtre University Hospital Assistance Publique‐Hôpitaux de Paris Kremlin Bicêtre France
| | - E. Grouteau
- Department of Paediatric Emergencies Purpan University Hospital Toulouse France
| | - E. Hachulla
- Department of Internal Medicine and Clinical Immunology Referral Centre for Rare Systemic and Auto‐immunes Diseases C. Huriez University Hospital Lille France
| | - P. Brissaud
- Department of Rheumatology Bichat‐Claude Bernard University Hospital Assistance Publique‐Hôpitaux de Paris Paris France
| | - A. Cantagrel
- Department of Rheumatology Purpan University Hospital Toulouse France
| | - J. Mazereeuw Hautier
- Department of Dermatology Larrey Hospital Paul Sabatier University Toulouse France
| | - I. Melki
- Department of General Pediatrics Paediatric Internal Medicine, Rheumatology and Infectious Diseases National Reference Centre for Rare Paediatric Inflammatory Rheumatisms and Systemic Auto‐immune diseases RAISE Robert Debré University Hospital Assistance Publique‐Hôpitaux de Paris Paris France
| | - A. Petit
- Department of Pediatric Hematology and Oncology Assistance Publique‐Hôpitaux de Paris GH HUEP Armand Trousseau Hospital Paris France
- UMRS_938 CDR Saint‐Antoine Sorbonne Université Paris France
| | - M. Piram
- Department of Paediatric Rheumatology National Reference Centre for Auto‐inflammatory Diseases CEREMAIA Kremlin Bicêtre University Hospital Assistance Publique‐Hôpitaux de Paris Kremlin Bicêtre France
| | - G. Sarrabay
- Department of Medical Genetics Rare diseases and Personalized medicine Rare and Autoinflammatory diseases unit Montpellier University Hospital University of Montpellier Montpellier France
| | - C. Wouters
- Department of Paediatric Rheumatology Leuven University Hospital Leuven Belgium
| | - M.D. Vignon‐Pennamen
- Department of Anatomopathology Saint Louis University Hospital Assistance Publique‐Hôpitaux de Paris Paris France
| | - E. Bourrat
- Department of General Pediatrics Paediatric Internal Medicine, Rheumatology and Infectious Diseases National Reference Centre for Rare Paediatric Inflammatory Rheumatisms and Systemic Auto‐immune diseases RAISE Robert Debré University Hospital Assistance Publique‐Hôpitaux de Paris Paris France
- Department of Dermatology Saint Louis University Hospital Assistance Publique‐Hôpitaux de Paris Paris France
| | - U. Meinzer
- Department of General Pediatrics Paediatric Internal Medicine, Rheumatology and Infectious Diseases National Reference Centre for Rare Paediatric Inflammatory Rheumatisms and Systemic Auto‐immune diseases RAISE Robert Debré University Hospital Assistance Publique‐Hôpitaux de Paris Paris France
- INSERM UMR1149 Université Paris Diderot‐Sorbonne Paris‐Cité Paris France
- Biology and Genetics of Bacterial Cell Wall Unit Pasteur Institute Paris France
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9
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Poline J, Fogel O, Pajot C, Miceli C, Hachulla E, Cantagrel A, Wouters C, Brissaud P, Galeotti C, Mazereeuw-Hautier J, Vignon-Pennamen M, Rybojad M, Meinzer U, Bourrat E. Manifestations cutanées du syndrome de Blau. Ann Dermatol Venereol 2018. [DOI: 10.1016/j.annder.2018.09.485] [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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Brisse E, Imbrechts M, Mitera T, Vandenhaute J, Berghmans N, Boon L, Wouters C, Snoeck R, Andrei G, Matthys P. Lymphocyte-independent pathways underlie the pathogenesis of murine cytomegalovirus-associated secondary haemophagocytic lymphohistiocytosis. Clin Exp Immunol 2018; 192:104-119. [PMID: 29178470 DOI: 10.1111/cei.13084] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [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: 07/31/2017] [Revised: 11/06/2017] [Accepted: 11/20/2017] [Indexed: 12/24/2022] Open
Abstract
Haemophagocytic lymphohistiocytosis (HLH) constitutes a spectrum of immunological disorders characterized by uncontrolled immune activation and key symptoms such as fever, splenomegaly, pancytopenia, haemophagocytosis, hyperferritinaemia and hepatitis. In genetic or primary HLH, hyperactivated CD8+ T cells are the main drivers of pathology. However, in acquired secondary HLH, the role of lymphocytes remains vague. In the present study the involvement of lymphocytes in the pathogenesis of a cytomegalovirus-induced model of secondary HLH was explored. We have previously reported CD8+ T cells to be redundant in this model, and therefore focused on CD4+ helper and regulatory T cells. CD4+ T cells were activated markedly and skewed towards a proinflammatory T helper type 1 transcription profile in mice displaying a severe and complete HLH phenotype. Counter to expectations, regulatory T cells were not reduced in numbers and were, in fact, more activated. Therapeutic strategies targeting CD25high hyperactivated T cells were ineffective to alleviate disease, indicating that T cell hyperactivation is not a pathogenic factor in cytomegalovirus-induced murine HLH. Moreover, even though T cells were essential in controlling viral proliferation, CD4+ T cells, in addition to CD8+ T cells, were dispensable in the development of the HLH-like syndrome. In fact, no T or B cells were required for induction and propagation of HLH disease, as evidenced by the occurrence of cytomegalovirus-associated HLH in severe combined immunodeficient (SCID) mice. These data suggest that lymphocyte-independent mechanisms can underlie virus-associated secondary HLH, accentuating a clear distinction with primary HLH.
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Affiliation(s)
- E Brisse
- Laboratory of Immunobiology, Rega Institute, KU Leuven, Leuven, Belgium
| | - M Imbrechts
- Laboratory of Immunobiology, Rega Institute, KU Leuven, Leuven, Belgium
| | - T Mitera
- Laboratory of Immunobiology, Rega Institute, KU Leuven, Leuven, Belgium
| | - J Vandenhaute
- Laboratory of Immunobiology, Rega Institute, KU Leuven, Leuven, Belgium
| | - N Berghmans
- Laboratory of Molecular Immunology, Rega Institute, KU Leuven, Leuven, Belgium
| | - L Boon
- Epirus Biopharmaceuticals Netherlands, Utrecht, the Netherlands
| | - C Wouters
- Laboratory of Pediatric Immunology, University Hospital Gasthuisberg, KU Leuven, Leuven, Belgium
| | - R Snoeck
- Laboratory of Virology and Chemotherapy, Rega Institute, KU Leuven, Leuven, Belgium
| | - G Andrei
- Laboratory of Virology and Chemotherapy, Rega Institute, KU Leuven, Leuven, Belgium
| | - P Matthys
- Laboratory of Immunobiology, Rega Institute, KU Leuven, Leuven, Belgium
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11
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Papa R, Consolaro A, Minoia F, Caorsi R, Magnano G, Gattorno M, Ravelli A, Picco P, Pillon R, Marafon DP, Meli L, Bracaglia C, Taddio A, De Benedetti F, Turan E, Kilic SS, Itoh Y, Shigemori T, Yamanishi S, Nagasaki H, Tarakci E, Arman N, Tarakci D, Akgul YS, Kasapcopur O, Wilson E, Lythgoe H, Smith E, Preston J, Beresford MW, Spiegel LR, Stinson J, Connelly M, Huber A, Luca N, Tsimicalis A, Luca S, Tajuddin N, Berard R, Barsalou J, Campillo S, Feldman B, Tse S, Dancey P, Duffy C, Johnson N, McGrath P, Shiff N, Tucker L, Victor C, Spiegel LR, Lalloo C, Harris L, Cafazzo J, Tucker L, Houghton K, Feldman B, Luca N, Laxer R, Stinson J, Arman N, Tarakci E, Kasapcopur O, Rooney M, Campbell R, Wright C, Armbrust W, Lelieveld O, Tuinstra J, Wulffraat N, Bos J, Cappon J, van Rossum M, Hagedoorn M, Vermé A, Lampela Y, Ozdogan AH, Ugurlu S, Barut K, Androvic A, Kasapçopu O, Wilson E, Etheridge J, Smith E, Dobson K, Kemp S, Beresford MW, Horne A, Palmblad K, Höglund M, Stepanenko N, Salugina S, Fedorov E, Nikishina I, Kaleda M, Arman N, Tarakci E, Barut K, Adrovic A, Sahin S, Kasapcopur O, Arman N, Tarakci E, Kasapcopur O, Toumoulin L, Frossard J, Archimbaut S, Paitier A, Guastalli R, Czitrom SG, Charuvanij S, Chaiyadech C, Miyamae T, Yamanaka H, Picard C, Thouvenin G, Kannengiesser C, Dubus JC, Jeremiah N, Rieux-Laucat F, Crestani B, Secq V, Ménard C, Reynaud-Gaubert M, Thivolet-Bejui F, Reix P, Belot A, Batu ED, Sonmez HE, Erden A, Taskiran EZ, Karadag O, Kalyoncu U, Oncel İ, Kaplan B, Arici ZS, Temucin CM, Topaloglu H, Bilginer Y, Alikasifoglu M, Ozen S, Van Eyck L, De Langhe E, Jéru I, Van Nieuwenhove E, Lagou V, Baker PJ, Garcia-Perez J, Dooley J, De Somer L, Sciot R, Jeandel PY, Ruuth-Praz J, Copin B, Medley-Hashim M, Megarbane A, Savic S, Goris A, Amselem S, Liston A, Masters S, Wouters C, Okamoto N, Sugita Y, Shabana K, Murata T, Tamai H, Ferenczová J, Banóova E, Mrážik P, Vargova V, Bajramovic D, Novacki KS, Potocki K, Frkovic M, Jelusic M, Nikishina I, Kostareva O, Arsenyeva S, Kaleda M, Shapovalenko A, Jans L, Herregods N, Jaremko J, Joos R, Dehoorne J, Herregods N, Jaremko J, Baraliakos X, Dehoorne J, Joos R, Jans L, Ramiro S, Casasola-Vargas JC, van der Heijde D, Landewé R, Burgos-Vargas R, Burgos-Vargas R, Tse SM, Horneff G, Unnebrink K, Anderson JK, Kisaarslan AP, Sözeri B, Gündüz Z, Zararsız G, Poyrazoğlu H, Düşünsel R, Ouchi K, Akioka S, Kubo H, Nakagawa N, Hosoi H, Lamot L, Borovecki F, Kapitanovic S, Gotovac K, Vidovic M, Lamot M, Bosak EP, Harjacek M, Russo RA, Katsicas MM, Vargas RB, Ortiz-Peyegahud AL, Pingping Z, Yikun M, Jun Q, Yutong J, Jieruo G, Kostik MM, Ekaterina S, Avrusin I, Korin Y, Kopchak O, Isupova E, Chikova I, Tatyana P, Dubko M, Masalova V, Snegireva L, Kornishina T, Kalashnikova O, Chasnyk V, Kostik MM, Chikova I, Isupova E, Dubko M, Masalova V, Snegireva L, Kornishina T, Likhacheva T, Kalashnikova O, Chasnyk V, Ruperto N, Brunner HI, Quartier P, Constantin T, Alexeeva E, Schneider R, Kone-Paut I, Schikler K, Marzan K, Wulffraat N, Padeh S, Chasnyk V, Wouters C, Kuemmerle-Deschner JB, Kallinich T, Lauwerys B, Haddad E, Nasonov E, Trachana M, Vougiouka O, Leon K, Speziale A, Lheritier K, Vritzali E, Martini A, Lovell D, Ter Haar N, Scholman R, de Jager W, Tak T, Leliefeld P, Vastert B, de Roock S, Ter Haar N, Scholman R, de Jager W, de Ganck A, Ryter N, Lavric M, Foell D, de Roock S, Vastert B, Modica RF, Lomax KG, Batzel P, Cassanas A, Elder ME, Denisova R, Alexeeva E, Valieva S, Bzarova T, Isayeva K, Sleptsova T, Lomakina O, Chomahidze A, Soloshenko M, Shingarova M, Kachshenko E, De Jager W, Vastert SJ, Mijnheer G, Prakken BJ, Wulffraat NM, Sönmez HE, Karhan AN, Batu ED, Bilginer Y, Arıcı ZS, Gümüş E, Demir H, Yüce A, Özen S, Ahluwalia J, Bharti B, Rajpal S, Uppal V, Walia A, Samlok SS, Kumar N, Valões CC, Molinari BC, Pitta ACG, Gormezano NW, Farhat SC, Kozu K, Sallum AM, Appenzeller S, Sakamoto AP, Terreri MT, Pereira RM, Magalhães CS, Barbosa CM, Gomes FH, Bonfá E, Silva CA, Ozturk K, Ekinci Z, Helal M, Cabrera N, Belot A, Lega JC, Drai J, Ecochard R, Shpitonkova OV, Podchernyaeva NS, Kostina YO, Dashkova NG, Osminina MK, Yucel G, Sahin S, Adrovic A, Barut K, Tarakci E, Arvas A, Moorthy N, Kasapcopur O, Dimou P, Midgley A, Peak M, Satchell SC, Wright RD, Beresford MW, Corkhill R, Smith EM, Beresford MW, Bhattad S, Rawat A, Singh S, Gupta A, Suri D, de Boer M, Kuijpers T, Bhattad S, Rawat A, Gupta A, Suri D, Pandiarajan V, Singh S, Sandal S, Rawat A, Gupta A, Singh S, Giraldo S, Sanguino R, Diaz AS, Uzuner S, Sahin S, Durcan G, Adrovic A, Barut K, Kilicoglu AG, Bilgic A, Bahali K, Kasapcopur O, Sahin S, Adrovic A, Barut K, Durmus S, Uzun H, Kasapcopur O, Sahin S, Adrovic A, Barut K, Canpolat N, Caliskan S, Sever L, Kasapcopur O, Sato T, Kimura F, Suwairi W, Abdwani R, Al Rowais A, Al qanatish J, Al Asiri A, Ozturk K, Ekinci Z, Gaidar E, Kostik M, Dubko M, Masalova V, Serogodskaya E, Snegireva L, Nikitina T, Chasnyk V, Kalashnikova O, Isupova E, Sardar E, Dusser P, Rousseau A, Labetoulle M, Barreau E, Bodaghi B, Kone-Paut I, Foeldvari I, Anton J, Bou R, Angeles-Han S, Bangsgaard R, Brumm G, Constantin T, Edelsten C, Klotsche J, Minden K, Miserocchi E, Nielsen S, Simonini G, Heiligenhaus A, Foeldvari I, Anton J, Bou R, Angeles-Han S, Bangsgaard R, Brumm G, Constantin T, Edelsten C, Klotsche J, Minden K, Miserocchi E, Nielsen S, Simonini G, Heiligenhaus A, Foeldvari I, Anton J, Bou R, Angeles-Han S, Bangsgaard R, Brumm G, Constantin T, Edelsten C, Klotsche J, Minden K, Miserocchi E, Nielsen S, Simonini G, Heiligenhaus A, Foeldvari I, Anton J, Bou R, Angeles-Han S, Bangsgaard R, Brumm G, Constantin T, Edelsten C, Klotsche J, Minden K, Miserocchi E, Nielsen S, Simonini G, Heiligenhaus A, Angarita JMM, Bou R, de Vicuña CG, Hernandez MV, Adan A, Llorens V, Alcobendas R, Noval S, Robledillo JCL, Valls I, Pinedo MC, Fonollosa A, de Inocencio J, Tejada P, Bravo B, Torribio M, de Yebenes MJG, Antón J, Argolini LM, Pontikaki I, Borghi MO, Cesana L, Miserocchi E, Castiglioni B, Gattinara M, Meroni P, Quartier P, Despert V, Poignant S, Baptiste A, Elie C, Kone-Paut I, Belot A, Kodjikian L, Monnet D, Weber M, Bodaghi B, Moal L, Rousseau A, Pham L, Barreau E, Titah C, Dureau P, Labetoulle M, Bodaghi B, Czitrom SG, Cecchin V, Zannin ME, Ferrari D, Comacchio F, Pontikaki I, Bracaglia C, Cimaz R, Falcini F, Petaccia A, Viola S, Breda L, La Torre F, Vittadello F, Martini G, Zulian F, Galeotti C, Sarrabay G, Fogel O, Touitou I, Bodaghi B, Miceli-Richard C, Koné-Paut I, Etayari H, Soad H, El Kadry I, Eatamadi H, AlAlgawi K, Al Maini M, Khawaja K, Van den Berghe S, de Schryver I, Raes A, Joos R, Dehoorne J, Teixeira LLC, Duarte A, Sousa S, Vinagre F, Santos MJ, Shevchenko NS, Bogmat LF, Demyanenko MV, Ramchurn NR, Friswell M, James RA, Wedderburn LR, Edelsten C, Pattani R, Pilkington CA, Compeyrot-Lacassagne S, James RA, Compeyrot-Lacassagne S, Edelsten C, Pattani R, Pilkington CA, Wedderburn LR, Villarreal AV, Acevedo N, Faugier E, Maldonado R, Yılmaz D, Uysal HB, Fedorov E, Salugina S, Kamenets E, Zaharova E, Radenska-Lopovok S, Nascimento J, Sofia H, Zilhão C, Almeida R, Guedes M, Ozturk K, Deveci M, Ekinci Z, Rodionovskaya S, Vinnikova V, Salugina S, Fedorov E, Tsymbal I, Olesińska E, Postępski J, Mroczkowska-Juchkiewicz A, Pawłowska-Kamieniak A, Chrapko B, Ključevšek D, Emeršič N, Toplak N, Avčin T, Rokhlina F, Glazyrina G, Kolyadina N, Kim K, Eom S, Kim D, Rhim J, Ricci F, Montesano P, Bonafini B, Medeghini V, Parissenti I, Meini A, Cattalini M, Airò P, Panko N, Shevchenko N, Lebec I, Zajceva Y, Rostlund S, André M, Hara T, Kishi T, Tani Y, Hanaya A, Miyamae T, Nagata S, Yamanaka H, Selmanovic V, Omercahic-Dizdarevic A, Cengic A, Cosickic A, Dizdarević AO, Lepri G, Picco P, Malattia C, Bellucci E, Matucci-Cerinic M, Falcini F, Dubko M, Solovyev A, Fedotova E, Maldonado R, Faugier E, Villarreal AV, Acevedo N, Diaz T, Ramirez Y, Giani T, Marino A, Simonini G, Cimaz R, Hunt D, Al Obaidi M, Veli V, Papadopoulou C, Kammermeier J, Olesińska E, Poluha A, Postępski J, Bharmappanavara GC, Kelly A, Shaw L, Giani T, Ferrara G, Luzzati M, Marino A, Giovannini M, Simonini G, Cimaz R, Jurado L, Giraldo S, Chamorro J, Sarmiento L, Diaz AS, Medeghini V, Ricci F, Montesano P, Bonafini B, Parissenti I, Meini A, Conversano E, Cattalini M, Gicchino MF, Macchini G, Granato C, Tirelli A, Olivieri AN, Perica M, Bukovac LT, Bogmat LF, Shevchenko NS, Demyanenko MV, Sinaei R, Parvaneh VJ, Shiari R, Rahmani K, Mehregan FF, Yeganeh MH, Penadés IC, Montesinos BL, Fernández MIG, Vidal AR, Rao AP, Romana A, Raghuram J, Kumar A, Suri D, Gupta V, Rawat A, Singh S, Comak E, Aksoy GK, Yılmaz A, Atalay A, Koyun M, Artan R, Akman S, Gicchino MF, Macchini G, Granato C, Olivieri AN, Kaleda MI, Nikishina IP, Soloviev SK, Malievsky VA, Nikolaeva EV, Giani T, Marino A, Simonini G, Cimaz R, Gazda A, Kołodziejczyk B, Rutkowska-Sak L, Mauro A, Giani T, Simonini G, Cimaz R, Gicchino MF, Marzuillo P, Guarino S, Olivieri AN, La Manna A. Proceedings of the 23rd Paediatric Rheumatology European Society Congress: part three. Pediatr Rheumatol Online J 2017. [PMCID: PMC5461520 DOI: 10.1186/s12969-017-0143-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/05/2023] Open
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De Benedetti F, Anton J, Gattorno M, Lachmann H, Kone-Paut I, Ozen S, Frenkel J, Simon A, Zeft A, Ben-Chetrit E, Hoffman HM, Joubert Y, Lheritier K, Speziale A, Guido J, Caorsi R, Penco F, Grossi A, Insalaco A, Alessio M, Conti G, Marchetti F, Tommasini A, Martino S, Gallizzi R, Salis A, Schena F, Caroli F, Martini A, Damonte G, Ceccherini I, Gattorno M, Frémond ML, Uggenti C, Van Eyck L, Melki I, Duffy D, Bondet V, Rose Y, Neven B, Crow Y, Rodero MP, Kusche Y, Roth J, Barczyk-Kahlert K, Ferrara G, Chiocchetti A, Polizzi S, Vuch J, Vozzi D, Mondino A, Valencic E, Pastore S, Taddio A, Faletra F, Dianzani U, Ramenghi U, Tommasini A, Zhou Q, Yu X, Demirkaya E, Deuitch N, Stone D, Tsai W, Ombrello A, Romeo T, Remmers EF, Chae J, Gadina M, Welch S, Ozen S, Topaloglu R, Abinun M, Kastner DL, Aksentijevich I, Vairo D, Ferraro RM, Zani G, Galli J, De Simone M, Cattalini M, Fazzi E, Giliani S, Omoyinmi E, Standing A, Rowczenio D, Keylock A, Gomes SM, Price-Kuehne F, Nanthapisal S, Murphy C, 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Filocamo G, Omenetti A, Frenkel J, Lachmann HJ, Ozen S, Ruperto N, Gattorno M, Insalaco A, Moneta G, Pardeo M, Passarelli C, Celani C, Messia V, De Benedetti F, Cherqaoui B, Rossi-Semerano L, Dusser P, Hentgen V, Koné-Paut I, Grimwood C, Dusser P, Rossi L, Paut IK, Hentgen V, Lasigliè D, Ferrera D, Amico G, Di Duca M, Caorsi R, Lepore L, Insalaco A, Cattalini M, Obici L, Consolini R, Ravazzolo R, Martini A, Ceccherini I, Nishikomori R, Arostegui J, Gattorno M, Borghini S, Penco F, Petretto A, Lavarello C, Inglese E, Omenetti A, Finetti M, Pastorino C, Bertoni A, Gattorno M, Vanoni F, Federici S, Ozen S, Frenkel J, Lachmann H, Martini A, Ruperto N, Gattorno M, Hofer M, Kuemmerle-Deschner JB, Hoffman HM, Hawkins PN, van der Poll T, Walker UA, Speziale A, Joubert Y, Tilson HH, Kuemmerle-Deschner J, Ozen S, Tyrrell PN, Koné-Paut I, Goldbach-Mansky R, Lachmann H, Blank N, Hoffman HM, Weissbarth-Riedel E, Huegle B, Kallinich T, Gattorno M, Gul A, ter Haar NM, Oswald M, Dedeoglu F, Benseler SM, Hanaya A, Miyamae T, Kawamoto M, Tani Y, Hara T, Kawaguchi Y, Nagata S, Yamanaka H, Ćosićkić A, Skokić F, Čolić B, Suljendić S, Kozlova A, Mersiyanova I, Panina M, Hachtryan L, Burlakov V, Raikina E, Maschan A, Shcherbina A, Acar B, Albayrak M, Sozeri B, Sahin S, Barut K, Adrovic A, Inan N, Sevgi S, Kasapcopur O, Andreasen CM, Jurik AG, Glerup MB, Høst C, Mahler BT, Hauge EM, Herlin T, Lazea C, Damian L, Lazar C, Manasia R, Stephenson CM, Prajapati V, Miettunen PM, Yılmaz D, Tokgöz Y, Bulut Y, Çakmak H, Sönmez F, Comak E, Aksoy GK, Koyun M, Akman S, Arıkan Y, Terzioğlu E, Özdeş ON, Keser İ, Koçak H, Bingöl A, Yılmaz A, Artan R, De Benedetti F, Anton J, Gattorno M, Lachmann H, Kone-Paut I, Ozen S, Frenkel J, Simon A, Zeft A, Ben-Chetrit E, Hoffman HM, Joubert Y, Lheritier K, Speziale A, Guido J, Xu X, Mehregan FF, Ziaee V, Moradinejad MH, Ferrara G, Pastore S, Insalaco A, Pardeo M, Tommasini A, La Torre F, Alizzi C, Cimaz R, Finetti M, Gattorno M, D’Adamo P, Taddio A, Lachmann H, Simon A, Anton J, Gattorno M, Kone-Paut I, Ozen S, Frenkel J, Ben-Chetrit E, Hoffman H, Zeft A, Joubert Y, Lheritier K, Speziale A, Junge G, Gregson J, De Benedetti F, Sargsyan H, Sargsyan H, Zengin H, Fidanci BE, Kaymakamgil C, Konukbay D, Simsek D, Batu ED, Yildiz D, Gok F, Ozen S, Demirkaya E, Stoler I, Freytag J, Orak B, Seib C, Esmann L, Seipelt E, Gohar F, Foell D, Wittkowski H, Kallinich T, Dursun I, Tulpar S, Yel S, Kartal D, Borlu M, Bastug F, Poyrazoglu H, Gunduz Z, Kose K, Yuksel ME, Calıskan A, Cekgeloglu AB, Dusunsel R, Bouchalova K, Franova J, Schuller M, Macku M, Theodoropoulou K, Carlomagno R, von Scheven-Gête A, Poloni C, Hofer M, Damian LO, Cosma D, Radulescu A, Vasilescu D, Rogojan L, Lazar C, Rednic S, Lupse M, De Somer L, Moens P, Wouters C, Zavala RG, Pedraz LM, Cuadros EN, Rego GDC, Cardona ALU, Zavala RG, Pedraz LM, Cuadros EN, Rego GDC, Cardona ALU, Forno ID, Pieropan S, Viapiana O, Gatti D, Dallagiacoma G, Caramaschi P, Biasi D, Windschall D, Trauzeddel R, Lehmann H, Ganser G, Berendes R, Haller M, Krumrey-Langkammerer M, Nimtz-Talaska A, Schoof P, Trauzeddel RF, Nirschl C, Quesada-Masachs E, Blancafort CA, Barril SM, Caballero CM, Aguiar F, Fonseca R, Alves D, Vieira A, Vieira A, Dias JA, Brito I, Susic G, Milic V, Radunovic G, Boricic I, Marteau P, Adamsbaum C, Rossi-Semerano L, De Bandt M, Lemelle I, Deslandre C, Tran TA, Lohse A, Solau-Gervais E, Pillet P, Bader-Meunier B, Wipff J, Gaujoux-Viala C, Breton S, Devauchelle-Pensec V, Gran S, Fehler O, Zenker S, Schäfers M, Roth J, Vogl T, Czitrom SG, Foell D, Holzinger D, Lanni S, Van Dijkhuizen EHP, Manzoni SM, Marafon DP, Magnaguagno F, de Horatio LT, Ter Haar NM, Littooij AS, Vastert SJ, De Benedetti F, Ravelli A, Martini A, Malattia C, Teixeira VA, Campanilho-Marques R, Mourão AF, Ramos FO, Costa M, Madan WA, Killeen OG, Vidal AR, Delgado DS, Fernandez MIG, Montesinos BL, Penades IC, Kozhevnikov A, Pozdeeva N, Konev M, Melchenko E, Kenis V, Novik G, Sozeri B, Kısaarslan AP, Gunduz Z, Poyrazoglu H, Dusunsel R, Lerkvaleekul B, Jaovisidha S, Sungkarat W, Chitrapazt N, Fuangfa P, Ruangchaijatuporn T, Vilaiyuk S, Pradsgaard DØ, Hørlyck A, Spannow AH, Heuck CW, Herlin T, Diaz T, Garcia F, De La Cruz L, Rubio N, Świdrowska-Jaros J, Smolewska E, Lamot M, Lamot L, Vidovic M, Bosak EP, Rados I, Harjacek M, Tzaribachev N, Louka P, Hagoug R, Trentin C, Kubassova O, Hinton M, Boesen M, Oshlianska OA, Chaikovsky IA, Mjasnikov G, Kazmirchyk A, Garagiola U, Borzani I, Cressoni P, Corona F, Dzsida E, Farronato G, Garagiola U, Cressoni P, Corona F, Petaccia A, Dzsida E, Farronato G, Gagro A, Pasini AM, Roic G, Vrdoljak O, Lujic L, Zutelija-Fattorini M, Esser MM, Abraham DR, Kinnear C, Durrheim G, Urban M, Hoal E, Crow Y, Oshlianska OA. Proceedings of the 23rd Paediatric Rheumatology European Society Congress: part one. Pediatr Rheumatol Online J 2017. [PMCID: PMC5461530 DOI: 10.1186/s12969-017-0141-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
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Ruperto N, Brunner H, Quartier P, Constantin T, Alexeeva E, Kone-Paut I, Marzan K, Wulffraat N, Schneider R, Padeh S, Chasnyk V, Wouters C, Kuemmerle-Deschner J, Kallinich T, Lauwerys B, Haddad E, Nasonov E, Trachana M, Vougiouka O, Leon K, Speziale A, Lheritier K, Martini A, Lovell D. THU0579 Treating To Target with Canakinumab in Patients with Active Systemic Juvenile Idiopathic Arthritis: Results from The Long-Term Extension The Phase III Pivotal Trial. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.2658] [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: 11/04/2022]
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Ruperto N, Brunner H, Quartier P, Constantin T, Alexeeva E, Schneider R, Kone-Paut I, Schikler K, Marzan K, Wulffraat N, Padeh S, Chasnyk V, Wouters C, Kuemmerle-Deschner J, Kallinich T, Lauwerys B, Haddad E, Nasonov E, Trachana M, Vougiouka O, Leon K, Speziale A, Lheritier K, Martini A, Lovell D. THU0215 Long-Term Efficacy and Safety of Canakinumab in Patients with Systemic Juvenile Idiopathic Arthritis (SJIA): 5-Year Follow-up of An Open-Label Trial. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.3835] [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: 11/03/2022]
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Jéru I, Van Eyck L, Lagou V, Ruuth-Praz J, Copin B, Cochet E, Liston A, Goris A, Amselem S, Wouters C. A heterozygous variant in MEFV in a familial autoinflammatory syndrome with PAPA-like features. Pediatr Rheumatol Online J 2015. [PMCID: PMC4599930 DOI: 10.1186/1546-0096-13-s1-p68] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Bodemer C, Fraitag S, de Peufeilhoux L, Melki I, Bourrat E, Boccara O, Neven B, Wouters C, Hadj-Rabia S, Bader-Meunier B. Panniculites de l’enfant : de nouveaux cadres nosologiques. Ann Dermatol Venereol 2015. [DOI: 10.1016/j.annder.2015.10.100] [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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ter Haar N, Oswald M, Jeyaratnam J, Anton J, Barron K, Brogan P, Cantarini L, Galeotti C, Grateau G, Hentgen V, Hofer M, Kallinich T, Kone-Paut I, Lachmann H, Ozdogan H, Ozen S, Russo R, Simon A, Uziel Y, Wouters C, Feldman B, Vastert B, Wulffraat N, Benseler S, Frenkel J, Gattorno M, Kuemmerle-Deschner J. Recommendations for the management of autoinflammatory diseases. Pediatr Rheumatol Online J 2015. [PMCID: PMC4600050 DOI: 10.1186/1546-0096-13-s1-p133] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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Horneff G, Ruperto N, Brunner H, Quartier P, Constantin T, Alexeeva E, Kone-Paut I, Marzan K, Wulffraat N, Schneider R, Padeh S, Chasnyk V, Wouters C, Deschner JK, Kallinich T, Lauwerys B, Haddad E, Nasonov E, Trachana M, Vougiouka O, Abrams K, Leon K, Lheritier K, Martini A, Lovell D. Long term efficacy and safety of canakinumab in children with systemic juvenile idiopathic arthritis with and without fever. Pediatr Rheumatol Online J 2015. [PMCID: PMC4596972 DOI: 10.1186/1546-0096-13-s1-o83] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Heckman PRA, Wouters C, Prickaerts J. Phosphodiesterase inhibitors as a target for cognition enhancement in aging and Alzheimer's disease: a translational overview. Curr Pharm Des 2015; 21:317-31. [PMID: 25159073 DOI: 10.2174/1381612820666140826114601] [Citation(s) in RCA: 113] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2014] [Accepted: 08/25/2014] [Indexed: 11/22/2022]
Abstract
Phosphodiesterase inhibitors (PDE-Is) enhance cAMP and/or cGMP signaling via reducing the degradation of these cyclic nucleotides. Since both cAMP and cGMP signaling are essential in a variety of cellular functions, including neuroplasticity and neuroprotection, PDE-Is are receiving increased attention as possible targets for treatment of age-related cognitive decline as well as Alzheimer's disease (AD). In this review we will give a translational overview of the preclinical and clinical data on PDE-Is and cognition enhancement focusing on aging and AD. PDE2, 4 and 5 inhibitors improved memory performance in both aged animals and models of AD. Treatment with a PDE3-I or PDE7-I has not been tested in aged animals yet, but in mouse models of AD both PDE-Is improved memory performance. Unfortunately, there are no peer-reviewed studies on the effects of PDE-I treatment in aged human subjects except the possible positive effect on memory impairment of the PDE1-I vinpocetine. Three other types of PDE-Is have been tested on cognition in mild to moderate AD patients: the PDE3-I cilostazol is being tested as a co-treatment to the acetylcholinesterase inhibitor donepezil, but with inconsistent results; the PDE4-I MK-0952 has been tested, although the outcome has not been disclosed yet; and the PDE9-I PF- 04447943 was reported to have no effects on cognition. Obviously, the demonstration of clinical proof of concept for cognition enhancing effects of PDE-Is and the generation of isoform selective PDE-Is are the final hurdles to overcome in developing safe and efficacious novel PDE-Is for the treatment of age-associated cognitive decline or AD.
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Affiliation(s)
| | | | - J Prickaerts
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University, 6200 MD Maastricht, The Netherlands.
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Bader-Meunier B, Melki I, Touzot F, Casanova JL, Neven B, Quartier P, Wouters C, Fraitag S, Bodemer C. AB0967 Auto-Inflammatory Diseases Are a Main Cause of Early-Onset Panniculitis. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.4745] [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: 11/04/2022]
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Ruperto N, Brunner H, Quartier P, Constantin T, Alexeeva E, Kone-Paut I, Marzan K, Wulffraat N, Schneider R, Padeh S, Chasnyk V, Wouters C, Kummerle Deschner J, Kallinich T, Lauwerys B, Haddad E, Nasonov E, Trachana M, Vougiouka O, Abrams K, Leon K, Lheritier K, Martini A, Lovell D. FRI0496 Efficacy and Safety of Canakinumab in Children with Systemic Juvenile Idiopathic Arthritis with and Without Fever. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.2050] [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: 11/04/2022]
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De Benedetti F, Ruperto N, Brunner H, Keane C, Wells C, Wang J, Calvo I, Cuttica R, Ravelli A, Schneider R, Eleftheriou D, Wouters C, Xavier R, Zemel L, Baildam E, Burgos-Vargas R, Dolezalova P, Garay S, Joos R, Grom A, Wulffraat N, Zuber Z, Zulian F, Martini A, Lovell D. THU0508 Safety and Efficacy of Tocilizumab in Patients with Systemic Juvenile Idiopathic Arthritis: 5-Year Data from Tender, A Phase 3 Clinical Trial. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.3186] [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: 11/04/2022]
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Horne A, Minoia F, Davì S, Bovis F, Rosina S, Lehmberg K, Weitzman S, Insalaco A, Wouters C, Shenoi S, Espada G, Ozen S, Anton J, Khubchandani R, Russo R, Ruperto N, Martini A, Cron R, Ravelli A. SAT0486 Macrophage Activation Syndrome and Familial Hemophagocytic Lymphohistiocytosis: Is Their Clinical Phenotype Really Similar? Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.5288] [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: 11/03/2022]
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Woerner A, Uettwiller F, Melki I, Mouy R, Wouters C, Bader-Meunier B, Quartier P. Biological treatment in systemic juvenile idiopathic arthritis: achievement of inactive disease or clinical remission on a first, second or third biological agent. RMD Open 2015; 1:e000036. [PMID: 26509061 PMCID: PMC4613174 DOI: 10.1136/rmdopen-2014-000036] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [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] [Received: 12/11/2014] [Revised: 03/23/2015] [Accepted: 04/12/2015] [Indexed: 01/16/2023] Open
Abstract
OBJECTIVES To analyse the effect of biological agents (BAs) in terms of achieving inactive disease (ID) or clinical remission (CR) in patients with systemic juvenile idiopathic arthritis (SJIA), to describe effects of switching or discontinuing a BA and to assess the proportion of patients able to maintain ID or CR off steroids and after withdrawing BA therapy. METHODS Retrospective study in a French paediatric rheumatology reference centre using the CEMARA (CEntre des MAladies RAres) register. RESULTS Seventy-seven patients were included with a cumulative follow-up of 245.5 patient-years (median 1.1, range 0.5-8.0). On a first BA, ID was achieved in 37 patients, including 1 patient out of 12 patients on etanercept, 26 patients out of 51 on anakinra and 7 out of 10 on canakinumab. One patient on abatacept and two patients on tocilizumab also achieved ID. Switching of BA was common. The switch to a second (n=34), third (n=18) or fourth (n=4) BA resulted in ID in a further 13 patients, either on canakinumab (n=6) or tocilizumab (n=7). At last follow-up, 40 patients were in CR (27 patients off steroids, 5 patients having never received steroid treatment), either on (n=29) or off (n=11) BA. CONCLUSIONS In this series of patients with SJIA, interleukin-1 inhibitors were associated with a higher proportion of ID than tumour necrosis factor inhibitors when used as first BA. Switching allowed some patients to achieve ID when treated with canakinumab or tocilizumab. CR was eventually achieved in more than half of the patients.
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Affiliation(s)
- A Woerner
- Department of Paediatric Immunology, Hematology and Rheumatology and Institut IMAGINE , Hôpital Necker-Enfants Malades, Assistance Publique Hôpitaux de Paris , Paris , France ; Department of Pediatric Rheumatology , University of Basel, University Children's Hospital , Basel , Switzerland
| | - F Uettwiller
- Department of Paediatric Immunology, Hematology and Rheumatology and Institut IMAGINE , Hôpital Necker-Enfants Malades, Assistance Publique Hôpitaux de Paris , Paris , France ; Clocheville Hospital , Tours , France
| | - I Melki
- Department of Paediatric Immunology, Hematology and Rheumatology and Institut IMAGINE , Hôpital Necker-Enfants Malades, Assistance Publique Hôpitaux de Paris , Paris , France ; Department of Pediatrics , Hôpital Robert Debré, Assistance Publique Hôpitaux de Paris , Paris , France
| | - R Mouy
- Department of Paediatric Immunology, Hematology and Rheumatology and Institut IMAGINE , Hôpital Necker-Enfants Malades, Assistance Publique Hôpitaux de Paris , Paris , France
| | - C Wouters
- Department of Paediatric Immunology, Hematology and Rheumatology and Institut IMAGINE , Hôpital Necker-Enfants Malades, Assistance Publique Hôpitaux de Paris , Paris , France ; Department of Microbiology and Immunology, Pediatric Immunology and Pediatric Rheumatology , KU Leuven-University of Leuven, University Hospitals Leuven , Leuven , Belgium
| | - B Bader-Meunier
- Department of Paediatric Immunology, Hematology and Rheumatology and Institut IMAGINE , Hôpital Necker-Enfants Malades, Assistance Publique Hôpitaux de Paris , Paris , France
| | - P Quartier
- Department of Paediatric Immunology, Hematology and Rheumatology and Institut IMAGINE , Hôpital Necker-Enfants Malades, Assistance Publique Hôpitaux de Paris , Paris , France ; Université Paris-Descartes , Paris , France
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Vastert S, Boom V, Ravelli A, Martini A, Foster H, Wulffraat N, Anton J, Constantin T, Dolezalova P, Horneff G, Lahdenne P, Magnussen B, Minden K, Nistala K, Quartier P, Rumbla I, Ruperto N, Piccolo VR, Russo R, Uziel S, Wouters C. Share – Workpackage 5: evidence based recommendations for diagnosis and treatment of juvenile idiopathic arthritis. Pediatr Rheumatol Online J 2014. [PMCID: PMC4191152 DOI: 10.1186/1546-0096-12-s1-p171] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Reinards THCM, Albers HM, Brinkman DMC, Kamphuis SSM, van Rossum MAJ, Girschick HJ, Wouters C, Hoppenreijs EPAH, Saurenmann RK, Hinks A, Ellis JA, Bakker E, Verduijn W, Slagboom P, Huizinga TWJ, Toes REM, Houwing-Duistermaat JJ, ten Cate R, Schilham MW. CD226 (DNAM-1) is associated with susceptibility to juvenile idiopathic arthritis. Ann Rheum Dis 2014; 74:2193-8. [PMID: 25057181 DOI: 10.1136/annrheumdis-2013-205138] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [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: 12/23/2013] [Accepted: 07/11/2014] [Indexed: 01/08/2023]
Abstract
OBJECTIVES Juvenile idiopathic arthritis (JIA) is considered a complex genetic autoimmune disease. We investigated the association of genetic variants previously implicated in JIA, autoimmunity and/or immunoregulation, with susceptibility to JIA. METHODS A genetic association study was performed in 639 JIA patients and 1613 healthy controls of northwest European descent. Ninety-three single nucleotide polymorphisms (SNP) were genotyped in a candidate gene approach. Results of the entire JIA patient group (all subtypes) were compared with results obtained, alternatively, with a clinically homogeneous patient group including only oligoarticular and rheumatoid factor (RF) negative polyarticular JIA patients (n=493). Meta-analyses were performed for all SNPs that have been typed in other Caucasian JIA cohorts before. RESULTS SNPs in or near PTPN22, VTCN1, the IL2-IL21 region, ANKRD55 and TNFA were confirmed to be associated with JIA (p<0.05), strengthening the evidence for involvement of these genes in JIA. In the majority of these replicated SNPs, effect sizes were larger when analysing a homogeneous patient cohort than when analysing all subtypes. We identified two novel associations with oligoarticular and RF-negative polyarticular JIA: CD226 rs763361 (OR 1.30, 95% CI 1.12 to 1.51, p=0.0006) and CD28 rs1980422 (OR 1.29, 95% CI 1.07 to 1.55, p=0.008). Meta-analyses including reported studies confirmed the association of both SNPs with susceptibility to JIA (OR 1.16, p=0.001 and OR 1.18, p=0.001, for rs763361 and rs1980422, respectively). CONCLUSIONS The CD226 gene has been identified as novel association with JIA, and a SNP near CD28 as a suggestive association. Both genes are probable candidate risk factors, since they are involved in costimulation of T cells.
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Affiliation(s)
- T H C M Reinards
- Department of Pediatrics/Pediatric Rheumatology, Leiden University Medical Center, Leiden, The Netherlands
| | - H M Albers
- Department of Pediatrics/Pediatric Rheumatology, Leiden University Medical Center, Leiden, The Netherlands
| | - D M C Brinkman
- Department of Pediatrics/Pediatric Rheumatology, Rijnland Hospital, Leiderdorp, The Netherlands
| | - S S M Kamphuis
- Department of Pediatrics/Pediatric Rheumatology, Erasmus MC Sophia Children's Hospital, Rotterdam, The Netherlands
| | - M A J van Rossum
- Department of Pediatrics/Pediatric Rheumatology, Academic Medical Centre/Emma Children's Hospital and Reade (Jan van Breemen location), Amsterdam, The Netherlands
| | - H J Girschick
- Vivantes Children's Hospital, Berlin-Friedrichshain, Germany
| | - C Wouters
- University Hospital Gasthuisberg, Leuven, Belgium
| | - E P A H Hoppenreijs
- Department of Pediatrics/Pediatric Rheumatology, St Maartenskliniek and Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
| | - R K Saurenmann
- Zürich University Children's Hospital, Zürich, Switzerland
| | - A Hinks
- Arthritis Research UK Epidemiology Unit, Manchester Academic Health Science Centre, The University of Manchester, Manchester, UK
| | - J A Ellis
- Department of Pediatrics, The University of Melbourne, Melbourne, Australia Murdoch Childrens Research Institute, Royal Children's Hospital, Parkville, Australia
| | - E Bakker
- Centre for Human and Clinical Genetics/Laboratory for Diagnostic Genome Analysis, Leiden University Medical Center, Leiden, The Netherlands
| | - W Verduijn
- Department of Immunohematology and Bloodtransfusion, Leiden University Medical Center, Leiden, The Netherlands
| | - P Slagboom
- Department of Molecular Epidemiology, Leiden University Medical Center, Leiden, The Netherlands
| | - T W J Huizinga
- Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands
| | - R E M Toes
- Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands
| | | | - R ten Cate
- Department of Pediatrics/Pediatric Rheumatology, Leiden University Medical Center, Leiden, The Netherlands
| | - M W Schilham
- Department of Pediatrics/Laboratory for Immunology, Leiden University Medical Center, Leiden, The Netherlands
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Brunner H, Ruperto N, Tzaribachev N, Horneff G, Wouters C, Panaviene V, Chasnyk V, Abud-Mendoza C, Cuttica R, Reiff A, Maldonado-Velázquez M, Rubio-Perez N, Alexeeva E, Joos R, Keltsev V, Nasonov E, Kingsbury D, Bandeira M, Silverman E, Weller-Heinemann F, van Royen-Kerkhof A, Mendelsohn A, Kim L, Lovell D, Martini A. A148: A Multi-Center, Double-Blind, Randomized-Withdrawal Trial of Subcutaneous Golimumab in Pediatric Patients With Active Polyarticular Course Juvenile Idiopathic Arthritis Despite Methotrexate Therapy: Week 48 Results. Arthritis Rheumatol 2014. [DOI: 10.1002/art.38569] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Hermine Brunner
- Pediatric Rheumatology Collaborative Study Group [PRCSG] & Pediatric Rheumatology International Trials Organization (PRINTO); Cincinnati OH
| | | | | | | | | | | | | | | | | | | | | | | | | | - R. Joos
- PRINTO & PRCSG; Gent Belgium
| | | | | | | | | | | | | | | | | | - Lilianne Kim
- Janssen Research & Development, LLC.; Spring House PA
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De Benedetti F, Brunner H, Ruperto N, Kenwright A, Devlin C, Calvo I, Cuttica R, Ravelli A, Schneider R, Eleftheriou D, Wouters C, Xavier R, Zemel L, Baildam E, Burgos-Vargas R, Dolezalova P, Garay S, Joos R, Grom A, Wulffraat N, Zuber Z, Zulian F, Lovell D, Martini A. FRI0328 Efficacy and safety of tocilizumab (TCZ) in patients with systemic juvenile idiopathic arthritis (SJIA): 2-year data from tender, a phase 3 clinical trial. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2012-eular.2785] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Albers HM, Reinards THCM, Brinkman DMC, Kamphuis SSM, van Rossum MAJ, Hoppenreijs EPAH, Girschick HJ, Wouters C, Saurenmann RK, Bakker E, Verduijn W, Slagboom P, Huizinga TWJ, Toes REM, Houwing-Duistermaat JJ, ten Cate R, Schilham MW. Genetic variation in VTCN1 (B7-H4) is associated with course of disease in juvenile idiopathic arthritis. Ann Rheum Dis 2013; 73:1198-201. [PMID: 24347572 DOI: 10.1136/annrheumdis-2013-204466] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [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: 12/15/2022]
Abstract
OBJECTIVE The course of disease in juvenile idiopathic arthritis (JIA) is unpredictable with episodes of activity and remission. In order to identify predictive factors, 93 SNPs, JIA subtype, age at onset and ANA status were studied in relation to disease course. METHODS Genetic and clinical parameters were analysed in a cohort of 272 Caucasian patients with persistent oligoarthritis (n=129), extended oligoarthritis (n=57) and rheumatoid factor negative polyarthritis (n=86). Categories of disease course (remitting (n=65), intermediate (n=96) and unremitting (n=111)) were designed based on the cumulative time spent in active disease in the first 2 years. RESULTS Univariate analysis revealed association of the course of disease with JIA subtype (p=5.7*10(-5)) and three SNPs; VTCN1 rs10 923 223 (p=4.4*10(-5)), VTCN1 rs12 046 117 (p=0.017) and CDK6 rs42 041 (p=0.038). In a subsequent multivariate ordinal logistic regression analysis, VTCN1 rs10 923 223 (OR 0.41, 95%-CI 0.26 to 0.63) and JIA subtype (OR 3.8, 95%-CI 2.0 to 7.2; OR 2.5, 95%-CI 1.4 to 4.2, for extended oligoarthritis and RF-negative polyarthritis vs persistent oligoarthritis, respectively) were the strongest independent factors for course of disease. CONCLUSIONS This study provides evidence that VTCN1, encoding B7-H4, is associated with course of disease in selected subtypes of JIA. VTCN1 might be useful in predicting the course of disease.
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Affiliation(s)
- H M Albers
- Department of Paediatrics/Paediatric Rheumatology, Leiden University Medical Center, , Leiden, The Netherlands
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Federici S, Frenkel J, Ozen S, Antòn J, Arostegui JI, De Benedetti F, Dolezalova P, Girschick H, Hentgen V, Hofer M, Lachmann H, Koné-Paut I, Kuemmerle-Deschner J, Neven B, Ozdogan H, Rose C, Simon A, Stojanov S, Toplak N, Touitou I, Vesely R, Woo P, Wouters C, Ruperto N, Martini A, Gattorno M. PReS-FINAL-2337: The eurofever registry: 3 years of enrollment. Pediatr Rheumatol Online J 2013. [PMCID: PMC4044970 DOI: 10.1186/1546-0096-11-s2-p327] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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31
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Reinards TH, Albers H, Brinkman D, Kamphuis S, Van Rossum M, Hoppenreijs E, Girschick H, Wouters C, Saurenmann R, Toes R, Huizinga T, Houwing-Duistermaat J, Schilham M, Ten Cate R. PReS-FINAL-2109: Genetic variations in patients with juvenile idiopathic arthritis and uveitis. Pediatr Rheumatol Online J 2013. [PMCID: PMC4044289 DOI: 10.1186/1546-0096-11-s2-p121] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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Woerner A, Uettwiller F, Melki I, Bader-Meunier B, Mouy R, Wouters C, Quartier P. PReS-FINAL-2133: Drug survival and switching of biological agents in systemic juvenile idiopathic arthritis. Pediatr Rheumatol Online J 2013. [PMCID: PMC4042445 DOI: 10.1186/1546-0096-11-s2-p146] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Rose CD, Cimaz R, Thomee C, Khubchandani R, Espada G, Russo R, Harjacek M, Bader-Meunier B, Brissaud P, Wulffraat N, Vastert S, Merino R, Naranjo-Hernandez A, Oliveira-Knupp S, Mackensen F, Arostegui J, Anton J, Fernandez-Martin J, Wouters C. PW03-016 – Blau prospective cohort study: articular outcomes. Pediatr Rheumatol Online J 2013. [PMCID: PMC3952171 DOI: 10.1186/1546-0096-11-s1-a242] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Rose CD, Cimaz R, Thomee C, Khubchandani R, Espada G, Russo R, Harjacek M, Bader-Meunier B, Brissaud P, Wulffraat N, Vastert S, Merino R, Naranjo-Hernandez A, Knupp SO, Mackenson F, Arostegui J, Lopez JA, Fernandez-Martin J, Wouters C. OR3-002 – Blau Syndrome cohort study: ocular outcome. Pediatr Rheumatol Online J 2013. [PMCID: PMC3953341 DOI: 10.1186/1546-0096-11-s1-a4] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Chastang MC, Desjonqueres M, Hentgen V, Maire PQD, Grateau G, Kone-Paut I, Bader-Meunier B, Wouters C, Lemelle I, Cochat P. PW02-016 - 41 cases of TRAPS, a rare autoinflammatory disease. Pediatr Rheumatol Online J 2013. [PMCID: PMC3952102 DOI: 10.1186/1546-0096-11-s1-a156] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Bollen E, Vanmierlo T, Akkerman S, Wouters C, Steinbusch H, Prickaerts J. 7,8-Dihydroxyflavone improves memory consolidation processes in rats and mice. Behav Brain Res 2013; 257:8-12. [DOI: 10.1016/j.bbr.2013.09.029] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2013] [Revised: 09/08/2013] [Accepted: 09/13/2013] [Indexed: 01/20/2023]
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Boiu S, Neven B, Compeyrot-Lacassagne S, Mouy R, Wouters C, Bader-Meunier B, Gattorno M, Quartier P. P03-018 - Diversity in presenting manifestations of AUTOINFL. Pediatr Rheumatol Online J 2013. [PMCID: PMC3952212 DOI: 10.1186/1546-0096-11-s1-a216] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Van den Wyngaert T, Delforge M, Doyen C, Duck L, Wouters K, Delabaye I, Wouters C, Wildiers H. Prospective observational study of treatment pattern, effectiveness and safety of zoledronic acid therapy beyond 24 months in patients with multiple myeloma or bone metastases from solid tumors. Support Care Cancer 2013; 21:3483-90. [PMID: 23955094 DOI: 10.1007/s00520-013-1934-0] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2013] [Accepted: 08/05/2013] [Indexed: 11/24/2022]
Abstract
PURPOSE To study the treatment patterns, effectiveness and safety of zoledronic acid (ZOL) beyond 2 years of therapy, given the paucity of data on long-term treatment in daily clinical practice. METHODS Patients with multiple myeloma (MM) or solid tumor bone metastases (STM) and at least 24 months of regular q3-4w ZOL therapy were followed prospectively for an additional 18 months beyond the 24 months required for study entry. End-points included ZOL exposure, incidence of skeletal related events (SRE), and safety. RESULTS In all, 298 evaluable patients were enrolled. The mean continuation rate of ZOL was 90.6%. Exposure to ZOL decreased with time in all patients, but was lower (50.0% vs. 67.6%; p<0.001) and with higher discontinuation rates (incidence rate ratio [IRR]=1.95; p=0.002) in MM compared to the STM group. ZOL suppressed the rate of SREs similarly during the study as compared to before inclusion (0.12 vs. 0.13 events per person-year; p=0.7). At 18 months, 84.5% remained SRE-free. In STM patients, persistent ZOL therapy was associated with lower SRE risk (hazard ratio [HR]=0.42; p=0.01), but not in MM. Renal deterioration occurred in 3.7% and osteonecrosis of the jaw (ONJ) developed in 6.0%, with dental trauma increasing ONJ risk (HR=4.67; p=0.002). CONCLUSIONS Beyond 2 years of therapy, treatment patterns of ZOL were heterogeneous and SRE rates were low. The safety profile of ZOL was acceptable, and interrupting ZOL in patients with solid tumors was associated with a higher risk of SREs.
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Affiliation(s)
- T Van den Wyngaert
- Department of Nuclear Medicine, Antwerp University Hospital, Wilrijkstraat 10, 2650, Edegem, Belgium,
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Ruperto N, Brunner H, Quartier P, Constantin T, Wulffraat N, Horneff G, Brik R, McCann L, Kasapcopur O, Rutkowska-Sak L, Schneider R, Berkun Y, Calvo I, Erguven M, Goffin L, Hofer M, Kallinich T, Knupp S, Uziel Y, Viola S, Nistala K, Wouters C, Cimaz R, Ferrandiz M, Flato B, Luz Gamir M, Kone-Paut I, Grom A, Magnusson B, Ozen S, Sztajnbok F, Lheritier K, Kim D, Abrams K, Martini A, Lovell D. AB1182 Efficacy and safety of canakinumab, fully human anti-interleukin-1beta antibody, in systemic juvenile idiopathic arthritis. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2012-eular.1180] [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: 11/04/2022]
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Naselli A, Frenkel J, Ozen S, Konè-Paut I, Lachmann H, Woo P, De Benedetti F, Hofer M, Neven B, Dolezalova P, Kümmerle-Deschner J, Hentgen V, Touitou I, Simon A, Wouters C, Toplak N, Anton J, Stojanov S, Girschick H, Vesely R, Arostegui J, Rose C, Ozdogan H, Ruperto N, Martini A, Gattorno M. OP0175 The eurofever registry for autoinflammatory disease: Update on enrollment after 2 years. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2012-eular.1858] [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: 11/04/2022]
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Put K, Avau A, Mitera T, Put S, Bader-Meunier B, Quartier P, Wouters C, Matthys P. THU0290 Peripheral mononuclear cells of systemic juvenile idiopathic arthritis patients have no intrinsic defect in interferon-gamma signaling. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2012-eular.2255] [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: 11/03/2022]
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Brachi S, De Somer L, Lambot K, Martini G, Bader-Meunier B, Zulian F, Wouters C. SAT0483 Dry Synovitis: A Unique Entity? A Multicenter Study. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2013-eular.2207] [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: 11/03/2022]
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Avau A, Mitera T, Put K, Put S, Tousseyn T, Billiau A, Wouters C, Matthys P. OP0054 Complete freund’s adjuvant induces, in interferon-gamma-deficient mice, a chronic inflammatory disease reminiscent of systemic juvenile idiopathic arthritis. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2012-eular.1737] [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: 11/04/2022]
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Breton S, Lambot K, Elie C, Quartier P, Wouters C, Gitiaux C, Bodemer C, Brunelle F, Bader-Meunier B. AB1120 Juvenile dermatomyositis: A MRI scoring system to assess acute inflammation and damage. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2012-eular.1118] [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: 11/04/2022]
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Boiu S, Neven B, Compeyrot-Lacassagne S, Mouy R, Wouters C, Gattorno M, Quartier P. AB1201 Diversity in clinical manifestations of autoinflammatory syndromes in a french paediatric rheumatology referral center. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2012-eular.1199] [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: 11/04/2022]
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Van den Wyngaert T, Delforge M, Doyen C, Duck L, Wouters K, Delabaye I, Wouters C, Wildiers H. Abstract P3-13-01: Prospective study of treatment pattern, effectiveness, and safety of zoledronic acid (ZOL) therapy beyond 24 months: subgroup analysis of patients (pts) with metastatic bone disease (MBD) from breast cancer (BC). Cancer Res 2012. [DOI: 10.1158/0008-5472.sabcs12-p3-13-01] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Trial data documenting ZOL treatment in pts with MBD from BC is currently limited to approximately 2 years of therapy.
Materials and Methods: The prospective multicenter LOTUZ trial studied pts with multiple myeloma or MBD from a solid tumor (n = 298), and with at least 24 months of regular q3-4w ZOL therapy. Follow-up was 18 months and ZOL could be continued, interrupted or stopped at the discretion of the treating physician. End-points included ZOL exposure (% of expected per-label cumulative dose) and persistence (no treatment interruptions > 45 days), incidence of skeletal related events (SRE), and safety. Here we present the results for the subgroup of BC pts.
Results: A total of 157 women (median age 62y; range 38 — 87y) were included in this analysis (204 person-years follow-up). The mean continuation rate of ZOL at any visit was 92.1% (95% CI 90.3 — 93.9), even though only 37.0% of pts who completed follow-up (n = 108) received uninterrupted per-label ZOL therapy. On average, exposure to ZOL decreased with 2.23% per 3 months on study (95% CI 0.93 — 3.54; p = 0.001). ZOL infusions were extended beyond 15 minutes in 36.1% (95% CI 33.7 — 38.6), and the treatment interval exceeded 4 weeks in 28.4% of pts (95% CI 19.6 — 38.6). Overall, ZOL continued to suppress the rate of SREs similarly during the 18 months study period (0.127 per person-year) as compared to the 18 months before inclusion (0.135 per person-year; p = 0.8). Radiation to bone occurred most frequently (46.2%) out of a total of 26 observed SREs. At 18 months, 83.3% (95% CI 75.6 — 88.8) of pts were SRE free. Both higher exposure to ZOL (HR 0.76 per 20% increase; 95% CI 0.62 — 0.93; p = 0.009) and persistent ZOL therapy (HR 0.26; 95% CI 0.11 — 0.60; p = 0.002) were associated with significantly lower SRE risk, compared to pts receiving lower dosed or interrupted therapy. Renal deterioration occurred in 6 pts (event rate 0.03 per person-year; 95% CI 0.01 — 0.07), with a numerically higher risk when ZOL dose was not adjusted for renal function (HR 3.54; 95% CI 0.65 — 19.4; p = 0.14), as observed in 11.5% of pts. Symptomatic hypocalcemia was not reported, even though adherence to supplemental calcium and vitamin D was only 15.9%. Acute phase reactions were infrequent (9.5%) and ONJ developed in 7 pts (4.5%). Invasive dental procedures or trauma numerically increased ONJ risk (HR 2.87; p = 0.3), with a risk of ONJ of 11.1% (95% CI 0.2 — 48.2%) after any of these events.
Conclusion: The continuation rate of ZOL beyond two years of therapy is high and ZOL demonstrated continued effectiveness in maintaining low SRE rates. Nevertheless, ZOL treatment patterns were heterogeneous and deviating from per-label ZOL therapy resulted in a higher SRE risk. The long-term safety profile of ZOL was favorable, but adequate prevention strategies for ONJ remain important.
Citation Information: Cancer Res 2012;72(24 Suppl):Abstract nr P3-13-01.
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Affiliation(s)
- T Van den Wyngaert
- Antwerp University Hospital; University Hospitals Leuven; C.H.U. Mont – Godinne; Clinique St-Pierre; Novartis Pharmaceuticals
| | - M Delforge
- Antwerp University Hospital; University Hospitals Leuven; C.H.U. Mont – Godinne; Clinique St-Pierre; Novartis Pharmaceuticals
| | - C Doyen
- Antwerp University Hospital; University Hospitals Leuven; C.H.U. Mont – Godinne; Clinique St-Pierre; Novartis Pharmaceuticals
| | - L Duck
- Antwerp University Hospital; University Hospitals Leuven; C.H.U. Mont – Godinne; Clinique St-Pierre; Novartis Pharmaceuticals
| | - K Wouters
- Antwerp University Hospital; University Hospitals Leuven; C.H.U. Mont – Godinne; Clinique St-Pierre; Novartis Pharmaceuticals
| | - I Delabaye
- Antwerp University Hospital; University Hospitals Leuven; C.H.U. Mont – Godinne; Clinique St-Pierre; Novartis Pharmaceuticals
| | - C Wouters
- Antwerp University Hospital; University Hospitals Leuven; C.H.U. Mont – Godinne; Clinique St-Pierre; Novartis Pharmaceuticals
| | - H Wildiers
- Antwerp University Hospital; University Hospitals Leuven; C.H.U. Mont – Godinne; Clinique St-Pierre; Novartis Pharmaceuticals
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van den Wyngaert T, Delforge M, Doyen C, Duck L, Wouters K, Delabaye I, Wouters C, Wildiers H. Prospective Study of Treatment Pattern, Effectiveness, and Safety of Zoledronic Acid (ZOL) Therapy Beyond 24 Months in Patients (PTS) with Multiple Myeloma (MM) or Solid Tumor Bone Metastasis (STM). Ann Oncol 2012. [DOI: 10.1016/s0923-7534(20)34129-6] [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] Open
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Wipff J, Dumitrescu MA, Lorrot M, Kettani S, Faye A, Lacassagne S, Bader-Meunier B, Mouy R, Wouters C, Desjonquères M, Jean S, Despert V, Duquesne A, Quartier P, Job-Deslandre C. Création d’une cohorte française d’ostéites chroniques multifocales récidivantes : premiers résultats. Arch Pediatr 2012. [DOI: 10.1016/j.arcped.2012.03.025] [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: 11/29/2022]
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Meyts I, De Somer L, Bossuyt X, Morren MA, Devriendt K, Wouters C. Rothmund-Thomson syndrome: Immuno-osseous challenges. Pediatr Rheumatol Online J 2011. [PMCID: PMC3194683 DOI: 10.1186/1546-0096-9-s1-p312] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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De Somer L, Lambot K, Wouters C, Bader-Meunier B. Juvenile idiopathic arthritis with dry synovitis: clinical and imaging aspects in a cohort of 6 patients. Pediatr Rheumatol Online J 2011. [PMCID: PMC3194528 DOI: 10.1186/1546-0096-9-s1-p173] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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