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Huot L, Guerre P, Descotes G, Caffin AG, Herledan C, Ranchon F, Rioufol C. Cost-effectiveness of the ONCORAL multidisciplinary programme for the management of outpatients taking oral anticancer agents at risk of drug-related event: protocol for a pragmatic randomised controlled study. BMJ Open 2024; 14:e074956. [PMID: 38367968 PMCID: PMC10875583 DOI: 10.1136/bmjopen-2023-074956] [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: 04/24/2023] [Accepted: 01/16/2024] [Indexed: 02/19/2024] Open
Abstract
INTRODUCTION The development of oral anticancer agents (OAA) has profoundly changed cancer care, leading patients to manage their chemotherapy treatment on an outpatient basis. The prevention of iatrogenic effects of OAA remains a major concern, especially since their side effects are not less serious than those of intravenous chemotherapy. The ONCORAL programme was set up to secure the management of OAA in cancer patients followed at the Lyon University Hospital. This multidisciplinary programme involves hospital pharmacists, nurses, oncologists, and haematologists, as well as community health professionals. Given the economic stakes that this programme entails for the health system, a medico-economic study was designed. METHODS AND ANALYSIS This is a prospective controlled study, with individual open-label randomisation. A total of 216 outpatients treated with OAA and at risk of developing a drug-related iatrogenic event, will be randomised (2:1) to undergo follow-up in the ONCORAL programme or usual care. The primary outcome will be the estimation of the incremental cost-effectiveness ratio (difference in total costs per quality adjusted life years gained) at 12 months between the two groups. The secondary outcomes will be evaluation of OAA management consequences (relative-dose intensity, adherence, adverse drug events, drug-drug interactions, and proven medication errors), evaluation of overall survival and cancer-related quality of life, and patient-reported outcomes in relation to the treatment. A budget impact analysis will be implemented. Patient and health professional satisfaction regarding the ONCORAL programme will be measured. ETHICS AND DISSEMINATION Approval to conduct this study was obtained from an Ethics Committee (Comité de Protection des Personnes Ile-de-France VI) in October 2019, and from the French data protection agency (Commission Nationale de l'Informatique et des Libertés), according to the French Law. Trial results will be disseminated at clinical conferences and published in peer-reviewed journals. TRIAL REGISTRATION NCT03660670.
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Affiliation(s)
- Laure Huot
- Hospices Civils de Lyon, Pôle de Santé Publique, Service Evaluation Economique en Santé, Lyon, France
- Université Lyon 1, Inserm U1290 Research on Healthcare Performance (RESHAPE), Lyon, France
| | - Pascale Guerre
- Hospices Civils de Lyon, Pôle de Santé Publique, Service Evaluation Economique en Santé, Lyon, France
- Université Lyon 1, Health Systemic Process, EA 4129 Research Unit, Lyon, France
| | - Guillaume Descotes
- Hospices Civils de Lyon, Hôpital Lyon Sud, Unité de Pharmacie Clinique Oncologique, Pierre-Bénite, France
| | - Anne-Gaëlle Caffin
- Hospices Civils de Lyon, Hôpital Lyon Sud, Unité de Pharmacie Clinique Oncologique, Pierre-Bénite, France
| | - Chloé Herledan
- Hospices Civils de Lyon, Hôpital Lyon Sud, Unité de Pharmacie Clinique Oncologique, Pierre-Bénite, France
- Université Lyon 1, CICLY Centre pour l'Innovation et la Cancérologie de Lyon 1-EA3738, Lyon, France
| | - Florence Ranchon
- Hospices Civils de Lyon, Hôpital Lyon Sud, Unité de Pharmacie Clinique Oncologique, Pierre-Bénite, France
- Université Lyon 1, CICLY Centre pour l'Innovation et la Cancérologie de Lyon 1-EA3738, Lyon, France
| | - Catherine Rioufol
- Hospices Civils de Lyon, Hôpital Lyon Sud, Unité de Pharmacie Clinique Oncologique, Pierre-Bénite, France
- Université Lyon 1, CICLY Centre pour l'Innovation et la Cancérologie de Lyon 1-EA3738, Lyon, France
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Herledan C, Falandry C, Huot L, Poletto N, Baudouin A, Cerfon MA, Lorsche L, Bret J, Ranchon F, Rioufol C. Clinical impact and cost-saving analysis of a comprehensive pharmaceutical care intervention in older patients with cancer. J Am Geriatr Soc 2024; 72:567-578. [PMID: 37818698 DOI: 10.1111/jgs.18585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 07/22/2023] [Accepted: 08/19/2023] [Indexed: 10/12/2023]
Abstract
BACKGROUND Hospital admission and discharge are at high risk of drug-related problems (DRPs) in older patients with cancer. This study aimed to assess the clinical and economic impact of a comprehensive pharmaceutical care intervention (RECAP) to optimize drug therapy in patients with cancer ≥75 years admitted to oncology or geriatric wards. METHOD RECAP intervention was defined as follows: at admission and discharge, hospital pharmacists conducted comprehensive medication reconciliation and review, identified relevant DRPs and provided optimization recommendations to prescribers; at discharge, pharmacists also provided patient education and shared information with primary care providers. The impact of the intervention was assessed by the rate of implementation of recommendations by the prescribers and the evolution of polypharmacy rate; a peer review of the clinical significance of DRPs was performed by an expert panel of geriatric oncologists and pharmacists. A cost saving analysis compared cost avoided through resolution of DRPs to cost of pharmacist's time. RESULTS From January 2019 and August 2020, 201 patients were included (median age 80 [75-97] years), 68.7% with solid tumors. DRPs requiring optimization were identified in 70.9% of patients at admission (mean 1.7 DRP/patient) and 47.7% at discharge (0.9 DRP/patient). Most pharmacist recommendations (70.8%) were followed by prescribers, allowing the correction of 1.2 DRP/patient at admission and 0.7 DRP/patient at discharge. Half of resolved DRPs were rated as clinically significant. However, polypharmacy rate was not reduced at discharge. Cost comparison showed $7.2 avoided for $1 invested, with an estimated total net benefit of $354,822 (mean $1766 per patient). CONCLUSIONS The RECAP model significantly reduces DRPs in hospitalized older patients with cancer. The model was cost saving, confirming the value of implementing it in routine practice.
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Affiliation(s)
- Chloé Herledan
- Department of Pharmacy, Groupement Hospitalier Sud, Hospices Civils de Lyon, Pierre-Bénite, France
- EA 3738, CICLY Centre pour l'Innovation en Cancérologie de Lyon, Université Lyon 1, Oullins, France
| | - Claire Falandry
- Institut du Vieillissement, Hospices Civils de Lyon, Lyon, France
- Laboratoire CarMeN, INSERM U1060/ INRAE U1397/Université Lyon 1, Université de Lyon, Pierre-Bénite, France
| | - Laure Huot
- Hospices Civils de Lyon, Pôle de Santé Publique, Service Evaluation Economique en Santé, Lyon, France
- Inserm U1290 Research on Healthcare Performance (RESHAPE), Université Lyon 1, Lyon, France
| | - Nicolas Poletto
- Department of Pharmacy, Groupement Hospitalier Sud, Hospices Civils de Lyon, Pierre-Bénite, France
| | - Amandine Baudouin
- Department of Pharmacy, Groupement Hospitalier Sud, Hospices Civils de Lyon, Pierre-Bénite, France
| | - Marie-Anne Cerfon
- Department of Pharmacy, Groupement Hospitalier Sud, Hospices Civils de Lyon, Pierre-Bénite, France
| | - Laurie Lorsche
- Institut du Vieillissement, Hospices Civils de Lyon, Lyon, France
| | - Judith Bret
- Institut du Vieillissement, Hospices Civils de Lyon, Lyon, France
| | - Florence Ranchon
- Department of Pharmacy, Groupement Hospitalier Sud, Hospices Civils de Lyon, Pierre-Bénite, France
- EA 3738, CICLY Centre pour l'Innovation en Cancérologie de Lyon, Université Lyon 1, Oullins, France
| | - Catherine Rioufol
- Department of Pharmacy, Groupement Hospitalier Sud, Hospices Civils de Lyon, Pierre-Bénite, France
- EA 3738, CICLY Centre pour l'Innovation en Cancérologie de Lyon, Université Lyon 1, Oullins, France
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Taracena-Agarwal ML, Hixson B, Nandakumar S, Girard-Mejia AP, Chen RY, Huot L, Padilla N, Buchon N. The midgut epithelium of mosquitoes adjusts cell proliferation and endoreplication to respond to physiological challenges. BMC Biol 2024; 22:22. [PMID: 38281940 PMCID: PMC10823748 DOI: 10.1186/s12915-023-01769-x] [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] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Accepted: 11/17/2023] [Indexed: 01/30/2024] Open
Abstract
BACKGROUND Hematophagous mosquitoes transmit many pathogens that cause human diseases. Pathogen acquisition and transmission occur when female mosquitoes blood feed to acquire nutrients for reproduction. The midgut epithelium of mosquitoes serves as the point of entry for transmissible viruses and parasites. RESULTS We studied midgut epithelial dynamics in five major mosquito vector species by quantifying PH3-positive cells (indicative of mitotic proliferation), the incorporation of nucleotide analogs (indicative of DNA synthesis accompanying proliferation and/or endoreplication), and the ploidy (by flow cytometry) of cell populations in the posterior midgut epithelium of adult females. Our results show that the epithelial dynamics of post-emergence maturation and of mature sugar-fed guts were similar in members of the Aedes, Culex, and Anopheles genera. In the first three days post-emergence, ~ 20% of cells in the posterior midgut region of interest incorporated nucleotide analogs, concurrent with both proliferative activity and a broad shift toward higher ploidy. In mature mosquitoes maintained on sugar, an average of 3.5% of cells in the posterior midgut region of interest incorporated nucleotide analogs from five to eight days post-emergence, with a consistent presence of mitotic cells indicating constant cell turnover. Oral bacterial infection triggered a sharp increase in mitosis and nucleotide analog incorporation, suggesting that the mosquito midgut undergoes accelerated cellular turnover in response to damage. Finally, blood feeding resulted in an increase in cell proliferation, but the nature and intensity of the response varied by mosquito species and by blood source (human, bovine, avian or artificial). In An. gambiae, enterocytes appeared to reenter the cell cycle to increase ploidy after consuming blood from all sources except avian. CONCLUSIONS We saw that epithelial proliferation, differentiation, and endoreplication reshape the blood-fed gut to increase ploidy, possibly to facilitate increased metabolic activity. Our results highlight the plasticity of the midgut epithelium in mosquitoes' physiological responses to distinct challenges.
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Affiliation(s)
- M L Taracena-Agarwal
- Department of Entomology, College of Agriculture and Life Sciences, Cornell Institute of Host-Microbe Interactions and Disease, Cornell University, Ithaca, NY, 14852, USA
| | - B Hixson
- Department of Entomology, College of Agriculture and Life Sciences, Cornell Institute of Host-Microbe Interactions and Disease, Cornell University, Ithaca, NY, 14852, USA
| | - S Nandakumar
- Department of Entomology, College of Agriculture and Life Sciences, Cornell Institute of Host-Microbe Interactions and Disease, Cornell University, Ithaca, NY, 14852, USA
| | - A P Girard-Mejia
- Grupo de Biología y Control de Vectores, Centro de Estudios en Salud, Universidad del Valle de Guatemala, Guatemala City, 01015, Guatemala
| | - R Y Chen
- Department of Entomology, College of Agriculture and Life Sciences, Cornell Institute of Host-Microbe Interactions and Disease, Cornell University, Ithaca, NY, 14852, USA
| | - L Huot
- Department of Entomology, College of Agriculture and Life Sciences, Cornell Institute of Host-Microbe Interactions and Disease, Cornell University, Ithaca, NY, 14852, USA
| | - N Padilla
- Grupo de Biología y Control de Vectores, Centro de Estudios en Salud, Universidad del Valle de Guatemala, Guatemala City, 01015, Guatemala
| | - N Buchon
- Department of Entomology, College of Agriculture and Life Sciences, Cornell Institute of Host-Microbe Interactions and Disease, Cornell University, Ithaca, NY, 14852, USA.
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Martin T, Guercio A, Besseau H, Huot L, Guerre P, Atfeh J, Piazza L, Pineau J, Sabatier B, Borget I, Martelli N. Hospital-based health technology assessment of innovative medical devices: insights from a nationwide survey in France. Int J Technol Assess Health Care 2023; 39:e58. [PMID: 37732461 DOI: 10.1017/s0266462323000521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/22/2023]
Abstract
OBJECTIVES To better understand the process of hospital acquisition of innovative medical devices (MDs) and the hospital-based health technology assessment (HB-HTA) pathways in France, an in-depth study based on a quantitative approach is needed. The aim of the present study was to assess through a national survey how HB-HTA is currently implemented in French hospitals and to identify its level of formalization. METHODS A quantitative online survey was conducted among hospitals performing HB-HTA in France, with a focus on the acquisition of innovative MDs for individual use. The survey, conducted between March and June 2022, was developed by a scientific board composed of members of the French-speaking Society for HB-HTA. RESULTS Sixty-seven out of 131 surveyed hospitals with HB-HTA activities responded, including 29 university hospitals, 24 nonprofit private hospitals, and 14 local hospitals. Sixty-one respondents (91 percent) reported the existence of a process dedicated to evaluating innovative MDs; of these, 16 declared that their hospitals had a formalized unit with HB-HTA activity. These units were more frequently found in larger hospitals with more than 500 inpatient beds (n = 16, p = 0.0160) and in university hospitals (n = 12, p = 0.0158). No hospital reported any collaboration with HAS, the French national HTA agency. CONCLUSION A diverse range of HB-HTA organizations with different structural levels exist in France for MD procurement linked to the category of hospitals. The study highlights the need for recognition of HB-HTA activity at the regulatory level in France and for direct collaboration between HTA activities performed at local and national levels.
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Affiliation(s)
- Tess Martin
- Pharmacy Department, Georges Pompidou European Hospital, AP-HP, Paris, France
- Faculty of Pharmacy, Paris-Saclay University, GRADES, Orsay, France
| | - Alessandra Guercio
- Pharmacy Department, Georges Pompidou European Hospital, AP-HP, Paris, France
| | - Hélène Besseau
- Faculty of Pharmacy, Paris-Saclay University, GRADES, Orsay, France
| | - Laure Huot
- Hospices Civils de Lyon, Pôle de Santé Publique, Service Evaluation Economique en santé, Lyon, France
- Université Lyon 1, INSERM U1290 Research on Healthcare Performance RESHAPE, Lyon, France
| | - Pascale Guerre
- Hospices Civils de Lyon, Pôle de Santé Publique, Service Evaluation Economique en santé, Lyon, France
- Lyon University, Univ. Claude Bernard Lyon 1, P2S UR4129, Lyon, France
| | - Jamal Atfeh
- Hospices Civils de Lyon, Pôle de Santé Publique, Service Evaluation Economique en santé, Lyon, France
| | - Laurent Piazza
- Health Economics Unit, Clinical Research Department, Bordeaux University Hospital, Talence, France
| | - Judith Pineau
- Pharmacy Department, Georges Pompidou European Hospital, AP-HP, Paris, France
| | - Brigitte Sabatier
- Pharmacy Department, Georges Pompidou European Hospital, AP-HP, Paris, France
| | - Isabelle Borget
- Gustave Roussy, Office of Biostatistics and Epidemiology, Université Paris-Saclay, Villejuif, France
- Inserm, Université Paris-Saclay, CESP U1018, Oncostat, Certified Ligue Contre le Cancer, Villejuif, France
| | - Nicolas Martelli
- Pharmacy Department, Georges Pompidou European Hospital, AP-HP, Paris, France
- Faculty of Pharmacy, Paris-Saclay University, GRADES, Orsay, France
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Serrier H, Huot L, Brosset S, Batailler C, Ferry T. Cost-effectiveness of a bone substitute delivering gentamicin in the treatment of chronic osteomyelitis of long bones: Protocol for the CONVICTION randomized multicenter study. Front Med (Lausanne) 2023; 10:1116711. [PMID: 37064036 PMCID: PMC10101228 DOI: 10.3389/fmed.2023.1116711] [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] [Received: 12/05/2022] [Accepted: 03/13/2023] [Indexed: 03/31/2023] Open
Abstract
IntroductionChronic osteomyelitis is a serious osteoarticular infection that most often occurs in the long bones, responsible for significant morbidity with the risk of fracture and amputation. Despite advances in both antibiotics and surgical treatment, the probability of recurrence of infection remains at around 20%. Cerament-G (BONESUPPORT AB, Sweden) is a synthetic bone substitute that fills the bone void left by surgery, prevents infection and promotes bone regeneration within this space. Cerament-G also provides the local delivery of high doses of gentamicin over several weeks. Two prospective observational studies described a number of infectious recurrences of 4 and 5% after the use of Cerament-G. Although available in France, Cerament-G is currently not reimbursed and its high cost constitutes a barrier to its use. We hypothesize that the use of Cerament-G will lead to fewer costs to the collectivity while improving patient utility and, as an innovative strategy, will be superior to standard of care on recurrence of infection.Methods and analysisThe Conviction Study is a prospective, multicenter, randomized, single blind study conducted in 14 French Reference Centers for Complex Osteoarticular infections. The main objective is to evaluate the cost-effectiveness of using Cerament-G in the treatment of chronic long bone osteomyelitis by comparing this innovative strategy to standard of care. A cost-utility analysis from the collective perspective will be conducted over a 24-month time horizon after the initial surgery. The outcome for the main medico-economic evaluation will be Quality Adjusted Life Years (QALYs).DiscussionThe study is being conducted throughout the CRIOAc network in France, in referral centers for the management of complex infections which will facilitate patient recruitment. This study has several limitations: the investigators have to be trained to handle the device, and it was impossible to blind the surgeon.ConclusionIf the use of Cerament-G is demonstrated to be superior to leaving the dead space empty during surgery for patients with stage III chronic long bone osteomyelitis, its use will be recommended to improve the prognosis of such patients, and this device may eventually qualify for reimbursement through the French Health Insurance scheme.Ethics and disseminationThis protocol received authorization from the Ethics Committee CPP Sud Méditerranée V on April 27, 2021 (21.03.10.77652) and the French National Agency for Medicines and Health Products on May 6, 2021 (2020-A02299-30). Results will be disseminated to the scientific community through congresses and publication in peer-reviewed journals.
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Affiliation(s)
- Hassan Serrier
- Health Economic Evaluation Service, Hospices Civils de Lyon, Lyon, France
- *Correspondence: Hassan Serrier,
| | - Laure Huot
- Health Economic Evaluation Service, Hospices Civils de Lyon, Lyon, France
- Université Claude Bernard Lyon 1, Research on Healthcare Performance RESHAPE, Lyon, France
| | - Sophie Brosset
- Centre interrégional de référence pour la prise en charge des infections ostéoarticulaires complexes, CRIOAc Lyon, Hospices Civils de Lyon, Lyon, France
- Department of Plastic Surgery, Croix-Rousse Hospital, Lyon University Hospital, Lyon, France
| | - Cécile Batailler
- Centre interrégional de référence pour la prise en charge des infections ostéoarticulaires complexes, CRIOAc Lyon, Hospices Civils de Lyon, Lyon, France
- Department of Orthopaedic Surgery, Croix-Rousse Hospital, Lyon University Hospital, Lyon, France
- Univ Lyon, Claude Bernard Lyon 1 University, Bron, France
| | - Tristan Ferry
- Centre interrégional de référence pour la prise en charge des infections ostéoarticulaires complexes, CRIOAc Lyon, Hospices Civils de Lyon, Lyon, France
- Infectious Diseases, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France
- CIRI–Centre International de Recherche en Infectiologie, Inserm, Université́ Claude Bernard Lyon 1, Ecole Normale Supérieure de Lyon, Univ Lyon, Lyon, France
- Université Claude Bernard Lyon 1, Lyon, France
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Guerre P, Huot L, Colin C, Marrel A, Rabier H. Perspectives in prospective comparative economic evaluations: a systematic review. Expert Rev Pharmacoecon Outcomes Res 2023; 23:273-280. [PMID: 36636778 DOI: 10.1080/14737167.2023.2166491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
INTRODUCTION Depending on countries and health systems, medico-economic assessment guidelines recommend to adopt one or several perspectives. We conducted a systematic literature review in order to assess the fit between the country guidelines and the perspectives announced in the published studies. AREAS COVERED Searches were carried out within the Medline electronic database for records published between 1 January 2000 and 31 August 2020. Only studies from countries in which guidelines recommending a perspective to adopt were available online were selected. EXPERT OPINION A total of 398 studies were included. Among those studies, 212 (54.9%) adopted as a main perspective a public payer perspective, 141 (36.5%) a societal perspective, 25 (6.5%) a hospital perspective, and 8 (2.1%) a patient perspective. Recommendations in terms of perspective were followed by 267 (67.1%) studies, mainly from Canada, the UK, and the Netherlands. Two thirds of the perspectives chosen in studies were in line with the recommendations. While the choice of a perspective does not question the quality of the studies published, it raises the question of the relevance of the perspectives that must be adapted to the question asked, the pathology studied, and the feasibility of the studies.
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Affiliation(s)
- Pascale Guerre
- Hospices Civils de Lyon, Pôle de Santé Publique, Service d'Evaluation Economique en Santé, Lyon, France.,Univ Lyon, Univ Claude Bernard Lyon 1, P2S UR4129, Lyon, France
| | - Laure Huot
- Hospices Civils de Lyon, Pôle de Santé Publique, Service d'Evaluation Economique en Santé, Lyon, France
| | - Cyrille Colin
- Hospices Civils de Lyon, Pôle de Santé Publique, Service d'Evaluation Economique en Santé, Lyon, France.,RESHAPE Inserm U1290, Université Claude Bernard Lyon 1, Lyon, France
| | - Adrien Marrel
- Hospices Civils de Lyon, Pôle de Santé Publique, Service d'Evaluation Economique en Santé, Lyon, France
| | - Hugo Rabier
- Hospices Civils de Lyon, Pôle de Santé Publique, Service d'Evaluation Economique en Santé, Lyon, France.,RESHAPE Inserm U1290, Université Claude Bernard Lyon 1, Lyon, France
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Kodjikian L, Creuzot-Garcher C, Korobelnik JF, Tadayoni R, Delafoy I, Leal C, Bernard L, Decullier E, Huot L, Mathis T. Microperimetry to predict disease progression in eyes at high risk of age-related macular degeneration disease: The PREVISION study. Acta Ophthalmol 2023; 101:e135-e142. [PMID: 36120870 DOI: 10.1111/aos.15260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Revised: 07/29/2022] [Accepted: 09/06/2022] [Indexed: 11/28/2022]
Abstract
PURPOSE The aim of the present study was to determine whether microperimetric parameters could predict the progression of an eye at high risk of age-related macular degeneration (AMD) at 24 months. METHODS We conducted a multicentric prospective non-comparative open-label study including patients with one eye in stage 4 of the Age-Related Eye Disease Study Group (AREDS) classification, and the other eye in AREDS stage 3 (study eye). A microperimetry examination (MAIA™, CenterVue, Padova, Italy) was performed at baseline and every 6 months during the 2-year follow-up. At the end of the follow-up, each study eye was classified as 'progressive' (i.e. AREDS stage 4) or 'non-progressive' (i.e. AREDS stage 3). RESULTS A total of 147 patients were analysed, of which 30.6% progressed from AREDS stage 3 to stage 4. The microperimetry criterion 'mean retinal sensitivity' was significantly different at baseline between non-progressive and progressive eyes (p = 0.022), with lower values for the latter. With a threshold for mean retinal sensitivity set at 24.7 dB, diagnostic sensitivity was 80% [95%CI (65.4-90.4)], specificity was 30.4% [95%CI (21.7-40.3)], positive predictive value was 33.6% [95%CI (24.8-43.4)], and negative predictive value was 77.5% [95%CI (61.5-89.2)]. In the multivariate analysis including microperimetric parameters and other routine ophthalmologic examinations, mean retinal sensitivity was the only predictive parameter statistically associated with progression (p = 0.0004). CONCLUSIONS Our findings are encouraging as regards the use of microperimetry, and mean retinal sensitivity value in particular, to predict the 2-year risk of progression to AREDS stage 4 eye.
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Affiliation(s)
- Laurent Kodjikian
- Service d'Ophtalmologie, Centre Hospitalier Universitaire de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France.,Université Lyon 1, Lyon, France.,UMR5510 MATEIS, CNRS, INSA Lyon, Université Lyon 1, Villeurbanne, France
| | - Catherine Creuzot-Garcher
- Service d'Ophtalmologie, Hôpital Universitaire de Dijon, Dijon, France.,Eye and Nutrition Research Group, Centre des Sciences du Goût et de l'Alimentation, AgroSup Dijon, CNRS, INRAE, Université Bourgogne Franche-Comté, Dijon, France
| | - Jean-François Korobelnik
- Service d'Ophtalmologie, Hôpital Pellegrin, Bordeaux, France.,INSERM, BPH, UMR1219, Université de Bordeaux, Bordeaux, France
| | - Ramin Tadayoni
- Service d'Ophtalmologie, Université de Paris, AP-HP, Hôpital Lariboisière, Paris, France.,Service d'Ophtalmologie, Fondation Ophtalmologique Adolphe de Rothschild, Paris, France
| | - Ivan Delafoy
- Service d'Ophtalmologie, Centre Hospitalier Universitaire de Brest, Brest, France
| | - Cécilia Leal
- Service d'ophtalmologie, Hôpital Pasteur 2, Centre Hospitalier Universitaire de Nice, Nice, France
| | - Lorraine Bernard
- Université Lyon 1, Lyon, France.,Service de Biostatistique et Bioinformatique, Pôle Santé Publique, Hospices Civils de Lyon, Lyon, France.,CNRS, UMR 5558, Laboratoire de Biométrie et Biologie Évolutive, Équipe Biostatistique-Santé, Villeurbanne, France
| | - Evelyne Decullier
- Service Recherche et Épidémiologie Cliniques, Pôle de Santé Publique, Hospices Civils de Lyon, Lyon, France
| | - Laure Huot
- Université Lyon 1, Lyon, France.,Service Recherche et Épidémiologie Cliniques, Pôle de Santé Publique, Hospices Civils de Lyon, Lyon, France
| | - Thibaud Mathis
- Service d'Ophtalmologie, Centre Hospitalier Universitaire de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France.,Université Lyon 1, Lyon, France.,UMR5510 MATEIS, CNRS, INSA Lyon, Université Lyon 1, Villeurbanne, France
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Kodjikian L, Abukhashabah A, Fardeau C, Tadayoni R, Brézin A, Dumas S, Weber M, Bernard L, Loria O, Decullier E, Huot L, Mathis T. Efficacy and safety of Aflibercept for the treatment of inflammatory choroidal neovascularization: The ALINEA study. Acta Ophthalmol 2023; 101:e43-e49. [PMID: 35822428 DOI: 10.1111/aos.15214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Revised: 06/07/2022] [Accepted: 06/26/2022] [Indexed: 01/27/2023]
Abstract
PURPOSE To evaluate mean change in best-corrected visual acuity (BCVA) at 52 weeks in patients with inflammatory choroidal neovascularization (CNV) treated with aflibercept. METHODS We conducted a prospective non-comparative open-label trial. Following one mandatory intravitreal injection of aflibercept, patients were treated under a pro re nata (PRN) dosing regimen with monthly visits. RESULTS A total of 19 patients were included, but one presented exclusion criteria; 16 patients were followed for the whole 52-week study, and data for the primary endpoint analysis were available for 14. At baseline, mean BCVA and mean central retinal thickness (CRT) were 64.53 (±19.64) letters and 351.79 (±97.77) μm, respectively. At 52 weeks, the mean change in BCVA was +9.50 (±12.90) letters [95%CI = +2.05-+16.95]. One patient had lost more than 15-letters at 24 weeks, and another one at 52 weeks. CRT change was -62.77 (±100.73) μm at 24 weeks and -66.53 (±97.47) μm at 52 weeks. There was a mean number of 3.56 (±3.29) intravitreal injections at 52 weeks (min = 1; max = 12). No serious ocular adverse events related to the treatment were reported. CONCLUSIONS Our study shows that aflibercept is clinically effective, both anatomically and functionally in the treatment of inflammatory CNV. Following the first injection, the PRN strategy appears sufficient for treating most choroidal neovessels.
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Affiliation(s)
- Laurent Kodjikian
- Hospices Civils de Lyon, Service d'Ophtalmologie, Centre Hospitalier Universitaire de la Croix-Rousse, Lyon, France.,Université Lyon 1, Lyon, France.,UMR5510 MATEIS, CNRS, INSA Lyon, Université Lyon 1, Villeurbanne, France
| | - Amro Abukhashabah
- Hospices Civils de Lyon, Service d'Ophtalmologie, Centre Hospitalier Universitaire de la Croix-Rousse, Lyon, France.,Ophthalmology Department, King Abdulaziz University, Rabigh, Saudi Arabia
| | - Christine Fardeau
- Ophthalmology Department, Reference Center for Rare Diseases, La Pitié-Salpêtriètre Hospital, Paris-Sorbonne University, Paris, France
| | - Ramin Tadayoni
- Université de Paris, Service d'Ophtalmologie, AP-HP, Hôpital Lariboisière, Paris, France.,Service d'Ophtalmologie, Fondation Ophtalmologique Adolphe de Rothschild, Paris, France
| | - Antoine Brézin
- Hôpital Cochin, Service d'Ophtalmologie, Université de Paris, Paris, France
| | | | - Michel Weber
- Hôpital Universitaire Centre Nantes, Nantes, France
| | - Lorraine Bernard
- Université Lyon 1, Lyon, France.,Pôle de Santé Publique, Service de Biostatistique et Bioinformatique, Hospices Civils de Lyon, Lyon, France.,CNRS, UMR5558, Laboratoire de Biométrie et Biologie Evolutive, Equipe Biostatistique-Santé, Villeurbane, France
| | - Olivier Loria
- Hospices Civils de Lyon, Service d'Ophtalmologie, Centre Hospitalier Universitaire de la Croix-Rousse, Lyon, France.,UMR5510 MATEIS, CNRS, INSA Lyon, Université Lyon 1, Villeurbanne, France
| | - Evelyne Decullier
- Pôle de Santé Publique, Service Recherche et Epidémiologie Cliniques, Hospices Civils de Lyon, Lyon, France
| | - Laure Huot
- Université Lyon 1, Lyon, France.,Pôle de Santé Publique, Service Recherche et Epidémiologie Cliniques, Hospices Civils de Lyon, Lyon, France
| | - Thibaud Mathis
- Hospices Civils de Lyon, Service d'Ophtalmologie, Centre Hospitalier Universitaire de la Croix-Rousse, Lyon, France.,Université Lyon 1, Lyon, France.,UMR5510 MATEIS, CNRS, INSA Lyon, Université Lyon 1, Villeurbanne, France
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9
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Kodjikian L, Tadayoni R, Souied EH, Baillif S, Milazzo S, Dumas S, Uzzan J, Bernard L, Decullier E, Huot L, Mathis T. EFFICACY AND SAFETY OF AFLIBERCEPT FOR THE TREATMENT OF IDIOPATHIC CHOROIDAL NEOVASCULARIZATION IN YOUNG PATIENTS: The INTUITION Study. Retina 2022; 42:290-297. [PMID: 34620799 DOI: 10.1097/iae.0000000000003310] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE To evaluate the mean change in visual acuity at 52 weeks in patients with idiopathic choroidal neovascularization treated with aflibercept. METHODS We conducted a prospective noncomparative open-label Phase-II trial. The dosage regimen evaluated in this study was structured into two periods: (1) from inclusion to 20 weeks: a treat-and-extend period composed of three mandatory intravitreal injections, and complementary intravitreal injections performed if needed; (2) from 21 weeks to 52 weeks: a pro re nata period composed of intravitreal injections performed only if needed. RESULTS A total of 19 patients were included, and 16 completed the 52-week study. At baseline, the mean best corrected visual acuity was 66.56 (±20.72) letters (≈20/50 Snellen equivalent), and the mean central retinal thickness was 376.74 µm (±93.77). At 52 weeks, the mean change in the best-corrected visual acuity was +19.50 (±19.36) letters [95% confidence interval = +9.18 to +29.82]. None of the patients included lost ≥15 letters at 24 weeks or 52 weeks. The mean change in central retinal thickness was -96.78 µm (±104.29) at 24 weeks and -86.22 µm (±112.27) at 52 weeks. The mean number of intravitreal injections was 5.4 (±3.0) at 52-weeks. No ocular serious adverse events related to the treatment were reported. CONCLUSION The present analysis shows clinically significant functional and anatomical treatment effect of aflibercept in case of idiopathic choroidal neovascularization. The treat-and-extend regimen proposed after the first injection seems adequate to treat most neovessels.
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Affiliation(s)
- Laurent Kodjikian
- Hospices Civils de Lyon, Centre Hospitalier Universitaire de la Croix-Rousse, Service d'Ophtalmologie, France
- Université Lyon 1, Lyon, France
- UMR-CNRS 5510, Matéis, Villeurbanne, Lyon
| | - Ramin Tadayoni
- Université de Paris, Service d'Ophtalmologie, AP-HP, Hôpital Lariboisière, Paris, France
- Fondation Ophtalmologique Adolphe de Rothschild, Service d'Ophtalmologie, Paris, France
| | - Eric H Souied
- Université Paris Est Créteil, Hôpital Intercommunal de Créteil, Créteil, France
| | - Stéphanie Baillif
- Hôpital Pasteur 2, Centre Hospitalier Universitaire de Nice, Université Côte d'Azur, France
| | - Solange Milazzo
- Hôpital Universitaire d'Amiens-Picardie, Service d'Ophtalmologie, Amiens, France
| | | | - Joël Uzzan
- Clinique Mathilde, Pôle Ophtalmologie, Département Rétine, Rouen, France
| | - Lorraine Bernard
- Université Lyon 1, Lyon, France
- Hospices Civils de Lyon, Pôle de Santé Publique, Service de Biostatistique et Bioinformatique, Lyon, France
- CNRS, UMR5558, Laboratoire de Biométrie et Biologie Evolutive, Equipe Biostatistique-Santé, Villeurbane, France; and
| | - Evelyne Decullier
- Hospices Civils de Lyon, Pôle de Santé Publique, Service Recherche et épidémiologie Cliniques, Lyon, France
| | - Laure Huot
- Hospices Civils de Lyon, Pôle de Santé Publique, Service Recherche et épidémiologie Cliniques, Lyon, France
| | - Thibaud Mathis
- Hospices Civils de Lyon, Centre Hospitalier Universitaire de la Croix-Rousse, Service d'Ophtalmologie, France
- Université Lyon 1, Lyon, France
- UMR-CNRS 5510, Matéis, Villeurbanne, Lyon
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10
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Collomb B, Dubromel A, Caffin AG, Herledan C, Larbre V, Baudouin A, Cerutti A, Couturier L, Maire M, Karlin L, Maucort-Boulch D, Huot L, Dalle S, Bachy E, Ghesquieres H, Salles G, Couraud S, You B, Freyer G, Trillet-Lenoir V, Ranchon F, Rioufol C. Assessment of Patient Reported Outcomes (PROs) in Outpatients Taking Oral Anticancer Drugs Included in the Real-Life Oncoral Program. Cancers (Basel) 2022; 14:cancers14030660. [PMID: 35158928 PMCID: PMC8833408 DOI: 10.3390/cancers14030660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Accepted: 01/25/2022] [Indexed: 12/04/2022] Open
Abstract
Simple Summary Patients receiving oral anticancer agents (OAAs) have a substantial symptom burden. Given the trend toward patient-centered care, the use of patient-reported outcomes (PROs) seems appropriate to secure medication management, and to improve clinical decision-making. The aim of this study was to assess symptoms potentially related to adverse events experienced by cancer outpatients treated by OAAs using PROs. In total, 407 questionnaires were completed by 63 patients, in which 2333 symptoms were reported. Almost three-quarters (74.6%) reported at least one high-level symptom. The symptoms most commonly experienced were fatigue, various psychological disorders and general pain. This initiative is the first step in the implementation of symptom assessment by PROs in patients treated by OAAs. The results highlight the need for close coordination between community and hospital health professionals, and the integration of patient self-reporting systems in oncologic clinical practice. Abstract Background In previous studies, patient-reported outcomes (PROs) have been shown to improve survival in cancer patients. The aim of the present study was to assess symptoms potentially related to adverse events experienced by cancer outpatients treated by oral anticancer agents (OAAs) using PROs. Methods Between September 2018 and May 2019, outpatients starting OAAs were included in a 12-week follow-up to assess 15 symptoms listed in the National Cancer Institute PRO Common Terminology Criteria for Adverse Events, using a 5-point scale of severity or frequency. Patients were requested to alert a referral nurse or pharmacist when they self-assessed high-level (level 3 or 4) symptoms. Results 407 questionnaires were completed by 63 patients in which 2333 symptoms were reported. Almost three-quarters (74.6%) reported at least one high-level symptom. The symptoms that were most commonly experienced were fatigue (>9 in 10 patients; 13.2% of symptoms declared), various psychological disorders (>9 in 10 patients; 28.6% of symptoms declared) and general pain (>8 in 10 patients; 9.4% of symptoms declared). Conclusion PROs are appropriate to detect potential adverse events in cancer outpatients treated by OAAs. This study is the first step for integrating the patient’s perspective in a digital e-health device in routine oncology care.
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Affiliation(s)
- Bastien Collomb
- Unité de Pharmacie Clinique Oncologique, Groupement Hospitalier Sud, Hospices Civils de Lyon, 69495 Lyon, France
| | - Amélie Dubromel
- Unité de Pharmacie Clinique Oncologique, Groupement Hospitalier Sud, Hospices Civils de Lyon, 69495 Lyon, France
| | - Anne Gaëlle Caffin
- Unité de Pharmacie Clinique Oncologique, Groupement Hospitalier Sud, Hospices Civils de Lyon, 69495 Lyon, France
| | - Chloé Herledan
- Unité de Pharmacie Clinique Oncologique, Groupement Hospitalier Sud, Hospices Civils de Lyon, 69495 Lyon, France
- CICLY Centre pour l'Innovation en Cancérologie de Lyon, Université Lyon 1-EA 3738, 69921 Lyon, France
| | - Virginie Larbre
- Unité de Pharmacie Clinique Oncologique, Groupement Hospitalier Sud, Hospices Civils de Lyon, 69495 Lyon, France
- CICLY Centre pour l'Innovation en Cancérologie de Lyon, Université Lyon 1-EA 3738, 69921 Lyon, France
| | - Amandine Baudouin
- Unité de Pharmacie Clinique Oncologique, Groupement Hospitalier Sud, Hospices Civils de Lyon, 69495 Lyon, France
| | - Ariane Cerutti
- Unité de Pharmacie Clinique Oncologique, Groupement Hospitalier Sud, Hospices Civils de Lyon, 69495 Lyon, France
| | - Laurence Couturier
- Unité de Pharmacie Clinique Oncologique, Groupement Hospitalier Sud, Hospices Civils de Lyon, 69495 Lyon, France
| | - Magali Maire
- Unité de Pharmacie Clinique Oncologique, Groupement Hospitalier Sud, Hospices Civils de Lyon, 69495 Lyon, France
| | - Lionel Karlin
- Department of Hematology, Groupement Hospitalier Sud, Hospices Civils de Lyon, 69495 Lyon, France
| | - Delphine Maucort-Boulch
- Department of Statistics and Bioinformatics, Hospices Civils de Lyon, 69002 Lyon, France
- CNRS UMR 5558, Laboratoire de Biométrie et Biologie Evolutive, Equipe Biostatistique-Santé, 69622 Lyon, France
| | - Laure Huot
- Cellule Innovation, Département de la Recherche Clinique et de L'innovation, Hospices Civils de Lyon, 69002 Lyon, France
| | - Stéphane Dalle
- Dermatology Department, Groupement Hospitalier Lyon Sud, Hospices Civils de Lyon, 69495 Lyon, France
| | - Emmanuel Bachy
- Department of Hematology, Groupement Hospitalier Sud, Hospices Civils de Lyon, 69495 Lyon, France
| | - Hervé Ghesquieres
- Department of Hematology, Groupement Hospitalier Sud, Hospices Civils de Lyon, 69495 Lyon, France
| | - Gilles Salles
- Department of Hematology, Groupement Hospitalier Sud, Hospices Civils de Lyon, 69495 Lyon, France
| | - Sébastien Couraud
- CICLY Centre pour l'Innovation en Cancérologie de Lyon, Université Lyon 1-EA 3738, 69921 Lyon, France
- Department of Pneumology, Groupement Hospitalier Sud, Hospices Civils de Lyon, 69495 Lyon, France
| | - Benoit You
- CICLY Centre pour l'Innovation en Cancérologie de Lyon, Université Lyon 1-EA 3738, 69921 Lyon, France
- Department of Oncology, Groupement Hospitalier Sud, Hospices Civils de Lyon, 69495 Lyon, France
| | - Gilles Freyer
- CICLY Centre pour l'Innovation en Cancérologie de Lyon, Université Lyon 1-EA 3738, 69921 Lyon, France
- Department of Oncology, Groupement Hospitalier Sud, Hospices Civils de Lyon, 69495 Lyon, France
| | - Véronique Trillet-Lenoir
- CICLY Centre pour l'Innovation en Cancérologie de Lyon, Université Lyon 1-EA 3738, 69921 Lyon, France
- Department of Oncology, Groupement Hospitalier Sud, Hospices Civils de Lyon, 69495 Lyon, France
| | - Florence Ranchon
- Unité de Pharmacie Clinique Oncologique, Groupement Hospitalier Sud, Hospices Civils de Lyon, 69495 Lyon, France
- CICLY Centre pour l'Innovation en Cancérologie de Lyon, Université Lyon 1-EA 3738, 69921 Lyon, France
| | - Catherine Rioufol
- Unité de Pharmacie Clinique Oncologique, Groupement Hospitalier Sud, Hospices Civils de Lyon, 69495 Lyon, France
- CICLY Centre pour l'Innovation en Cancérologie de Lyon, Université Lyon 1-EA 3738, 69921 Lyon, France
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11
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Pham TT, Mabrut E, Cochard P, Chardon P, Serrier H, Valour F, Huot L, Tod M, Leboucher G, Chidiac C, Ferry T. Cost of off-label antibiotic therapy for bone and joint infections: a 6-year prospective monocentric observational cohort study in a referral centre for management of complex osteo-articular infections. J Bone Jt Infect 2021; 6:337-346. [PMID: 34513571 PMCID: PMC8428084 DOI: 10.5194/jbji-6-337-2021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Accepted: 08/25/2021] [Indexed: 11/20/2022] Open
Abstract
Introduction:
Costs related to bone and joint infection (BJI) management are increasing
worldwide, particularly due to the growing use of off-label antibiotics that are expensive treatments (ETs), in conjunction with increasing incidence of multi-drug-resistant pathogens. The aim of this study was to evaluate the whole costs related to these treatments during the patient route, including those attributed to the rehabilitation centre (RC) stay in one regional referral centre in France. The total annual cost of ETs for managing complex BJIs in France was then estimated. Material and methods:
A prospective monocentric observational study was conducted from 2014 to 2019 in a referral centre for BJI management (CRIOAc – Centre de Référence des Infections OstéoArticulaires complexes). Costs related to expensive treatments (“old” ETs, i.e. ceftaroline, ertapenem, daptomycin, colistin, tigecycline, and linezolid and “new” ETs, defined as those used since 2017, including ceftobiprole, ceftazidime-avibactam, ceftolozane-tazobactam, tedizolid, and dalbavancin) were prospectively recorded. In all cases, the use of these ETs was validated during multidisciplinary meetings. Results:
Of the 3219 patients treated, 1682 (52.3 %) received at least one ET, and 21.5 % of patients who received ET were managed in RCs. The overall cost of ETs remained high but stable (EUR 1 033 610 in 2014; EUR 1 129 862 in 2019), despite the increase of patients treated by ETs (from 182 in 2014 to 512 in 2019) and in the cumulative days of treatment (9739 to 16 191 d). Daptomycin was the most prescribed molecule (46.2 % of patients in 2014 and 56.8 % in 2019, with 53.8 % overall), but its cost has decreased since this molecule was genericized in 2018; the same trend was observed for linezolid. Thus, costs for old ETs decreased overall, from EUR 1 033 610 in 2014 to EUR 604 997 in 2019, but global costs remained stable due to new ET utilization accounting for 46.5 % of overall costs in 2019. Tedizolid, used as suppressive antimicrobial therapy, represented 77.5 % of total new ET costs. In our centre, dalbavancin was never used. The cost paid by RCs for ETs and the duration of ET remained stable overall between 2016 and 2019. Conclusions:
A high consumption of off-label ET is required to treat patients with BJIs in a CRIOAc, and the consequence is a high cost of antimicrobial therapy for these patients, estimated to be almost EUR 10 million in France annually. Costs associated with ET utilization remained stable over the years. On the one hand, the introduction of the generic drugs of daptomycin and linezolid has significantly decreased the share of old ETs, but, on the other hand, the need for new ETs to treat infections associated with more resistant pathogens has not led to decrease in the overall costs. A drastic price reduction of generic drugs is essential to limit the costs associated with more complex BJIs.
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Affiliation(s)
- Truong-Thanh Pham
- Infectious Diseases Department, Croix-Rousse Hospital, Hospices Civils de Lyon, 69004 Lyon, France.,French Referral Centre for complex Bone and Joint Infections, CRIOAc Lyon, 69000 Lyon, France.,Division of Infectious Diseases, Department of Medicine, Geneva University Hospitals, 1205 Geneva, Switzerland
| | - Eugénie Mabrut
- French Referral Centre for complex Bone and Joint Infections, CRIOAc Lyon, 69000 Lyon, France
| | - Philippe Cochard
- Hauteville Public Hospital Centre, 01110 Hauteville-Lompnes, France
| | - Paul Chardon
- Val Rosay Rehabilitation Centre, 69370 Saint-Didier-Au-Mont-d'Or, France
| | - Hassan Serrier
- Pôle de Santé publique, Hospices Civils de Lyon, 69003 Lyon, France.,Cellule Innovation, Département de la Recherche Clinique et de l'innovation, Hospices Civils de Lyon, 69003 Lyon, France
| | - Florent Valour
- Infectious Diseases Department, Croix-Rousse Hospital, Hospices Civils de Lyon, 69004 Lyon, France.,French Referral Centre for complex Bone and Joint Infections, CRIOAc Lyon, 69000 Lyon, France.,Centre International de Recherche en Infectiologie (CIRI), Inserm U1111, CNRS UMR5308, ENS de Lyon, UCBL1, 69007 Lyon, France
| | - Laure Huot
- Pôle de Santé publique, Hospices Civils de Lyon, 69003 Lyon, France.,Cellule Innovation, Département de la Recherche Clinique et de l'innovation, Hospices Civils de Lyon, 69003 Lyon, France
| | - Michel Tod
- Service de Pharmacie, Hospices Civils de Lyon, Lyon, France
| | | | - Christian Chidiac
- Infectious Diseases Department, Croix-Rousse Hospital, Hospices Civils de Lyon, 69004 Lyon, France.,French Referral Centre for complex Bone and Joint Infections, CRIOAc Lyon, 69000 Lyon, France.,Centre International de Recherche en Infectiologie (CIRI), Inserm U1111, CNRS UMR5308, ENS de Lyon, UCBL1, 69007 Lyon, France
| | - Tristan Ferry
- Infectious Diseases Department, Croix-Rousse Hospital, Hospices Civils de Lyon, 69004 Lyon, France.,French Referral Centre for complex Bone and Joint Infections, CRIOAc Lyon, 69000 Lyon, France.,Centre International de Recherche en Infectiologie (CIRI), Inserm U1111, CNRS UMR5308, ENS de Lyon, UCBL1, 69007 Lyon, France
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12
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Pham T, Mabrut E, Cochard P, Chardon P, Serrier H, Valour F, Huot L, Tod M, Leboucher G, Ferry T. Coût des antibiothérapies hors AMM dans les infections ostéo-articulaires : étude prospective observationnelle sur 6 ans dans un Centre de référence pour la prise en charge des IOA complexes (CRIOAc). Infect Dis Now 2021. [DOI: 10.1016/j.idnow.2021.06.196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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13
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Abbas MA, Jahromi KE, Nematollahi M, Krebbers R, Liu N, Woyessa G, Bang O, Huot L, Harren FJM, Khodabakhsh A. Fourier transform spectrometer based on high-repetition-rate mid-infrared supercontinuum sources for trace gas detection. Opt Express 2021; 29:22315-22330. [PMID: 34265999 DOI: 10.1364/oe.425995] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Accepted: 05/14/2021] [Indexed: 06/13/2023]
Abstract
We present a fast-scanning Fourier transform spectrometer (FTS) in combination with high-repetition-rate mid-infrared supercontinuum sources, covering a wavelength range of 2-10.5 µm. We demonstrate the performance of the spectrometer for trace gas detection and compare various detection methods: baseband detection with a single photodetector, baseband balanced detection, and synchronous demodulation at the repetition rate of the supercontinuum source. The FTS uses off-the-shelf optical components and provides a minimum spectral resolution of 750 MHz. It achieves a noise equivalent absorption sensitivity of ∼10-6 cm-1 Hz-1/2 per spectral element, by using a 31.2 m multipass absorption cell.
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14
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Kodjikian L, Rezkallah A, Decullier E, Aulagner G, Huot L, Mathis T. Early Predictive Factors of Visual Loss at 1 Year in Neovascular Age-Related Macular Degeneration under Anti-Vascular Endothelial Growth Factor. Ophthalmol Retina 2021; 6:109-115. [PMID: 33991711 DOI: 10.1016/j.oret.2021.04.015] [Citation(s) in RCA: 2] [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: 12/19/2020] [Revised: 04/15/2021] [Accepted: 04/20/2021] [Indexed: 01/07/2023]
Abstract
PURPOSE To evaluate early predictive factors of visual loss in patients treated with anti-vascular endothelial growth factor (VEGF) injections under an as-needed regimen for neovascular age-related macular degeneration (AMD). DESIGN Post hoc analysis from the randomized controlled trial Groupe d'Evaluation Français Avastin versus Lucentis (GEFAL). PARTICIPANTS A total of 393 patients with neovascular AMD. METHODS The present analysis is based on 1-year data from patients included in the study. Patients were separately categorized according to the best-corrected visual acuity (BCVA) change at 3 months and 1 year into 3 trajectories: (1) patients with no vision loss ≥5 letters at 3 months and 1 year (absence of loss ≥5 letters); (2) patients with no vision loss ≥5 letters at 3 months but loss ≥5 letters at 1 year (secondary loss ≥5 letters); and (3) patients with vision loss ≥5 letters at 3 months and 1 year (initial loss ≥5 letters). MAIN OUTCOME MEASURES The following factors were evaluated at baseline and 3 months: age, sex, BCVA, presence of fluid, central macular thickness, angiographic choroidal neovascularization (CNV) subtype, CNV area measured in disc area on fluorescein angiography, and number of intravitreal injections. RESULTS An absence of loss ≥5 letters was found in 225 patients (57.3%), a secondary loss ≥5 letters after 3 months was found in 109 patients (27.7%), and an initial loss ≥5 letters was found in 59 patients (15%). Baseline characteristics were comparable among the 3 groups except for the total CNV area, which was larger in the initial and secondary loss groups (P = 0.0412). At 3 months, a significant association was found between presence of subretinal fluid (SRF) (P = 0.0318) and vision loss ≥5 letters, and an even stronger significant association between the presence of intraretinal fluid (IRF) (P = 0.0066) and vision loss ≥5 letters. CONCLUSIONS In the present study, we found that a large CNV area at baseline was significantly associated with initial or secondary loss of visual acuity ≥5 letters despite anti-VEGF injection. The presence of fluid, both SRF and IRF, at 3 months was found in patients with poorer trajectories.
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Affiliation(s)
- Laurent Kodjikian
- Service d'Ophtalmologie, Hôpital Universitaire de la Croix-Rousse, Hospices Civils de Lyon, Université Lyon 1, Lyon, France; UMR-CNRS 5510 Matéis, Villeurbane, France.
| | - Amina Rezkallah
- Service d'Ophtalmologie, Hôpital Universitaire de la Croix-Rousse, Hospices Civils de Lyon, Université Lyon 1, Lyon, France
| | - Evelyne Decullier
- Hospices Civils de Lyon, Pôle Santé Publique, Service recherche et épidémiologie Cliniques, Lyon, France; Université de Lyon, Université Lyon 1, Lyon, France
| | - Gilles Aulagner
- Pharmacie Centrale des Hospices Civils de Lyon, Hospices Civils de Lyon, Université Lyon 1, Lyon, France
| | - Laure Huot
- Hospices Civils de Lyon, Pôle Santé Publique, Service recherche et épidémiologie Cliniques, Lyon, France; Université de Lyon, Université Lyon 1, Lyon, France
| | - Thibaud Mathis
- Service d'Ophtalmologie, Hôpital Universitaire de la Croix-Rousse, Hospices Civils de Lyon, Université Lyon 1, Lyon, France; UMR-CNRS 5510 Matéis, Villeurbane, France
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15
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Serrier H, Julien C, Batailler C, Mabrut E, Brochier C, Thevenon S, Maynard-Muet M, Henry A, Lustig S, Huot L, Ferry T. Economic Study of 2-Stage Exchange in Patients With Knee or Hip Prosthetic Joint Infection Managed in a Referral Center in France: Time to Use Innovative(s) Intervention(s) at the Time of Reimplantation to Reduce the Risk of Superinfection. Front Med (Lausanne) 2021; 8:552669. [PMID: 34041248 PMCID: PMC8142816 DOI: 10.3389/fmed.2021.552669] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [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: 04/16/2020] [Accepted: 03/22/2021] [Indexed: 12/12/2022] Open
Abstract
Objective: Chronic prosthetic joint infections (PJI) are serious complications in arthroplasty leading to prosthesis exchange and potential significant costs for health systems, especially if a subsequent new infection occurs. This study assessed the cost of chronic PJI managed with 2-stage exchange at the Lyon University Hospital, CRIOAc Lyon reference center, France. A threshold analysis was then undertaken to determine the reimbursement tariff of a hypothetical preventive device usable at the time of reimplantation, which possibly enables health insurance to save money according to the risk reduction of subsequent new infection. This analysis was also performed for a potential innovative device already available on the market, a dual antibiotic loaded bone cement used to fix cemented prosthesis that releases high concentrations of gentamicin and vancomycin locally (G+V cement). Method: Patients >18 years, admitted for a hip or knee chronic PJI managed with 2-stage exchange, between January 1, 2013, and December 31, 2015, were retrospectively identified. Following, resource consumption in relation to inpatient hospital stay, hospitalization at home, rehabilitation care, outpatient antibiotic treatments, imaging, laboratory analysis, and consultations were identified and collected from patient records and taken into account in the evaluation. Costs were assessed from the French health insurance perspective over the 2 years following prosthesis reimplantation. Results: The study included 116 patients (median age 67 y; 47% hip prosthesis). Mean cost of chronic PJI was estimated over the 2 years following prosthesis reimplantation at €21,324 for all patients, and at €51,697 and €15,745 for patients with (n = 18) and without (n = 98) a subsequent new infection after reimplantation, respectively. According to the threshold analysis the reimbursement tariff (i) should not exceed €2,820 for a device which can reduce the risk of a new infection by 50% and (ii) was between €2,988 and €3,984 if the G + V cement can reduce the risk of a new infection by 80% (this reduction risk is speculative and has to be confirmed by clinical trials). Conclusion: This study revealed that chronic PJI requiring a 2-stage revision is costly, with significant costs in relation to the reimplantation procedure (about 15 k€). However, following reimplantation the rate of subsequent new infection remained high, and the cost of reimplantation following a new infection is considerable, reaching 50k€ per patient. These first cost estimates of managing chronic PJI with 2-stage exchange in France underline the economic interest of preventing new infections.
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Affiliation(s)
| | - Christell Julien
- Department of Medical Information, Hospices Civils de Lyon, Lyon, France
| | - Cécile Batailler
- Centre Interrégional de Référence Pour la Prise en Charge des Infections Ostéo-Articulaires Complexes (CRIOAc Lyon), Hospices Civils de Lyon, Lyon, France
- Department of Orthopaedic and Sport Surgery, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France
- Université Claude Bernard Lyon 1, Lyon, France
| | - Eugénie Mabrut
- Centre Interrégional de Référence Pour la Prise en Charge des Infections Ostéo-Articulaires Complexes (CRIOAc Lyon), Hospices Civils de Lyon, Lyon, France
| | | | - Sylvie Thevenon
- Clinical Research Centre, Hospices Civils de Lyon, Lyon, France
| | | | - Agnes Henry
- Hospital Pharmacy, Hospices Civils de Lyon, Lyon, France
| | - Sébastien Lustig
- Centre Interrégional de Référence Pour la Prise en Charge des Infections Ostéo-Articulaires Complexes (CRIOAc Lyon), Hospices Civils de Lyon, Lyon, France
- Department of Orthopaedic and Sport Surgery, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France
- Université Claude Bernard Lyon 1, Lyon, France
| | - Laure Huot
- Innovation Unit, Hospices Civils de Lyon, Lyon, France
| | - Tristan Ferry
- Centre Interrégional de Référence Pour la Prise en Charge des Infections Ostéo-Articulaires Complexes (CRIOAc Lyon), Hospices Civils de Lyon, Lyon, France
- Université Claude Bernard Lyon 1, Lyon, France
- Infectious Diseases Department, Hospices Civils de Lyon, Lyon, France
- CIRI – Centre International de Recherche en Infectiologie, Inserm, U1111, Université Claude Bernard Lyon 1, CNRS, UMR5308, Ecole Normale Supérieure de Lyon, Univ Lyon, Lyon, France
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Decullier E, Tang PV, Huot L, Maisonneuve H. Why an automated tracker finds poor sharing of clinical trial results for an academic sponsor: a bibliometric analysis. Scientometrics 2021. [DOI: 10.1007/s11192-020-03775-0] [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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Périchou J, Ranchon F, Herledan C, Huot L, Larbre V, Carpentier I, Lazareth A, Karlin L, Beny K, Vantard N, Schwiertz V, Caffin AG, Baudouin A, Sesques P, Brisou G, Ghesquières H, Salles G, Rioufol C. Immunomodulatory drugs in multiple myeloma: Impact of the SCARMET (Self CARe and MEdication Toxicity) educational intervention on outpatients' knowledge to manage adverse effects. PLoS One 2020; 15:e0243309. [PMID: 33275634 PMCID: PMC7717911 DOI: 10.1371/journal.pone.0243309] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Accepted: 11/18/2020] [Indexed: 12/18/2022] Open
Abstract
Long-term multiple myeloma therapy by immunomodulatory drugs (IMiDs) raises the question of management of adverse effects. The aim of this study is to assess the impact of an educational session for patients on the acquisition of knowledge to manage hematologic and thromboembolic adverse effects of IMiDs. In this prospective single-center study, patients attended an educational session with a hospital clinical pharmacist and a nurse. The primary endpoint was the patient's level of knowledge for the management of IMiDs adverse effects, assess with a dedicated questionnaire administered before the session then 1 and 6 months after. Assessment of knowledge was combined with self-assessment of certainty. The secondary endpoints were adherence and IMiD treatment satisfaction. 50 patients were included. Patient knowledge increased at 1 month (p<0.001) despite a loss of knowledge at 6 months (p<0.05). Six months after the educational intervention, the number of patients with skills considered satisfactory by the pharmacist and nurse increased (p<0.01). Most patients showed satisfactory adherence, with medication possession ratio ≥ 80%. The Self CARe and MEdication Toxicity (SCARMET) study highlighted the impact of multidisciplinary follow-up in multiple myeloma patients to improve knowledge of toxicity self-management.
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Affiliation(s)
- Juliette Périchou
- Unité de Pharmacie Clinique Oncologique, Groupement Hospitalier Sud, Hospices Civils de Lyon, Pierre-Bénite, France
- Université Lyon 1- EMR 3738, Lyon, France
| | - Florence Ranchon
- Unité de Pharmacie Clinique Oncologique, Groupement Hospitalier Sud, Hospices Civils de Lyon, Pierre-Bénite, France
- Université Lyon 1- EMR 3738, Lyon, France
| | - Chloé Herledan
- Unité de Pharmacie Clinique Oncologique, Groupement Hospitalier Sud, Hospices Civils de Lyon, Pierre-Bénite, France
- Université Lyon 1- EMR 3738, Lyon, France
| | - Laure Huot
- Département de la Recherche Clinique et de l’Innovation, Cellule Innovation, Hospices Civils de Lyon, Lyon, France
| | - Virginie Larbre
- Unité de Pharmacie Clinique Oncologique, Groupement Hospitalier Sud, Hospices Civils de Lyon, Pierre-Bénite, France
- Université Lyon 1- EMR 3738, Lyon, France
| | | | - Anne Lazareth
- Hematology Department, Groupement Hospitalier Sud, Hospices Civils de Lyon, Pierre-Bénite, France
| | - Lionel Karlin
- Hematology Department, Groupement Hospitalier Sud, Hospices Civils de Lyon, Pierre-Bénite, France
| | - Karen Beny
- Pharmacie Centrale, Hospices Civils de Lyon, Pierre-Bénite, France
| | - Nicolas Vantard
- Unité de Pharmacie Clinique Oncologique, Groupement Hospitalier Sud, Hospices Civils de Lyon, Pierre-Bénite, France
- Université Lyon 1- EMR 3738, Lyon, France
| | - Vérane Schwiertz
- Unité de Pharmacie Clinique Oncologique, Groupement Hospitalier Sud, Hospices Civils de Lyon, Pierre-Bénite, France
- Université Lyon 1- EMR 3738, Lyon, France
| | - Anne Gaelle Caffin
- Unité de Pharmacie Clinique Oncologique, Groupement Hospitalier Sud, Hospices Civils de Lyon, Pierre-Bénite, France
- Université Lyon 1- EMR 3738, Lyon, France
| | - Amandine Baudouin
- Unité de Pharmacie Clinique Oncologique, Groupement Hospitalier Sud, Hospices Civils de Lyon, Pierre-Bénite, France
- Université Lyon 1- EMR 3738, Lyon, France
| | - Pierre Sesques
- Hematology Department, Groupement Hospitalier Sud, Hospices Civils de Lyon, Pierre-Bénite, France
| | - Gabriel Brisou
- Hematology Department, Groupement Hospitalier Sud, Hospices Civils de Lyon, Pierre-Bénite, France
| | - Hervé Ghesquières
- Hematology Department, Groupement Hospitalier Sud, Hospices Civils de Lyon, Pierre-Bénite, France
| | - Gilles Salles
- Hematology Department, Groupement Hospitalier Sud, Hospices Civils de Lyon, Pierre-Bénite, France
- Centre de Recherche en Cancérologie de Lyon, INSERM 1052 CNRS 5286, Université Lyon 1, Lyon, France
| | - Catherine Rioufol
- Unité de Pharmacie Clinique Oncologique, Groupement Hospitalier Sud, Hospices Civils de Lyon, Pierre-Bénite, France
- Université Lyon 1- EMR 3738, Lyon, France
- * E-mail:
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Vlaeminck V, Rebillard X, Lamy P, Potiron E, Colin P, Irani J, Roumiguié M, Vincendeau S, Cussenot O, Colombel M, De La Taille A, Delagarde V, Lepers S, Guechot J, Armand-Labit V, Bendavid C, Dupuis M, Subtil F, Huot L, Ruffion A. Clinical value of the integration of Prostate Health Index (PHI) in multiparametric MRI-based diagnostic strategies to detect clinically-significant prostate cancer. Results from the French prospective multicenter PHI-1 study. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)32914-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Bochaton T, Huot L, Elbaz M, Delmas C, Aissaoui N, Farhat F, Mewton N, Bonnefoy E. Mechanical circulatory support with the Impella® LP5.0 pump and an intra-aortic balloon pump for cardiogenic shock in acute myocardial infarction: The IMPELLA-STIC randomized study. Arch Cardiovasc Dis 2020; 113:237-243. [DOI: 10.1016/j.acvd.2019.10.005] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Revised: 10/04/2019] [Accepted: 10/15/2019] [Indexed: 10/25/2022]
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Adenot I, Camus D, Épis de Fleurian AA, Tassy D, Bourguignon S, Chabin N, Chambrin PY, Costagliola D, Huot L, Joly AS, Le Lous G, Martelli N, Orlikowski D, Petit V, Puc C, Roussel C, Wilquin-Bequet F. Early patient access to health technologies: Is innovation needed for early management? Therapie 2020; 75:71-83. [DOI: 10.1016/j.therap.2019.11.008] [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] [Received: 11/05/2019] [Accepted: 11/18/2019] [Indexed: 11/29/2022]
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Adenot I, Camus D, Epis de Fleurian AA, Tassy D, Bourguignon S, Chabin N, Chambrin PY, Costagliola D, Huot L, Joly AS, Le Lous G, Martelli N, Orlikowski D, Petit V, Puc C, Roussel C, Wilquin-Bequet F. Accès précoce des patients aux technologies de santé : faut-il innover en vue d’une prise en charge précoce ? Therapie 2020; 75:57-69. [DOI: 10.1016/j.therap.2019.11.004] [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] [Received: 11/05/2019] [Accepted: 11/18/2019] [Indexed: 10/25/2022]
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Gory B, Berge J, Bonafé A, Pierot L, Spelle L, Piotin M, Biondi A, Cognard C, Mounayer C, Sourour N, Barbier C, Desal H, Herbreteau D, Chabert E, Brunel H, Ricolfi F, Anxionnat R, Decullier E, Huot L, Turjman F, Barreau X, Menegon P, Marnat G, Costalat V, Gascou G, Dargazanli C, Soize S, Metaxas G, Moret J, Ikka L, Caroff J, Rouchaud A, Mihaela C, Benachour N, Blanc R, Redjem H, Pomero E, Januel AC, Darcout J, Guenego A, Tall P, Bonneville F, Saleme S, Clarençon F, Bourcier R, Narata AP, Bibi R, Bracard S, Derelle AL, Tonnelet R, Liao L, Kulcsar Z, Taschner C. Flow Diverters for Intracranial Aneurysms. Stroke 2019; 50:3471-3480. [DOI: 10.1161/strokeaha.119.024722] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [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
Background and Purpose—
Flow diverters are used for endovascular therapy of intracranial aneurysms. We did a nationwide prospective study to investigate the safety and effectiveness of flow diversion at 12 months.
Methods—
DIVERSION was a national prospective cohort study including all flow diverters placement between October 2012 and February 2014 in France. The primary end point was the event-free survival rate at 12 months, defined as the occurrence of morbidity (intracranial hemorrhage, ischemic stroke, noncerebral hemorrhage, or neurological deficit due to mass effect), retreatment, or death within 12 months post-treatment. A quality control was carried out on 100% of the collected data and of at least 10% of the included patients in each center, chosen at random. All reported serious events were adjudicated by an independent Data Safety and Monitoring Board. Satisfactory occlusion was defined as 3 or 4 on Kamran scale by an independent imaging core laboratory at 12 months.
Results—
We enrolled 398 patients harboring 477 intracranial aneurysms. At least 1 morbidity-mortality event was noted in 95 of 408 interventions representing an event-free survival rate of 75.7% (95% CI, 71.1–79.7). The rate of permanent-related serious events and mortality was 5.9% and 1.2% at 12 months, respectively. Multivariate analysis showed that high baseline blood pressure (hazard ratio, 2.54; 95% CI, 1.35–4.79;
P
=0.039), diabetes mellitus (hazard ratio, 3.70; 95% CI, 1.60–8.6;
P
=0.0022), and larger aneurysms (hazard ratio, 1.07; 95% CI, 1.04–1.11;
P
<0.0001) were associated with the occurrence of a neurological deficit. The satisfactory occlusion rate at 12 months was 79.9%, and the absence of high baseline blood pressure (odds ratio, 2.01; 95% CI, 1.12–3.71;
P
=0.0193) and postprocedural satisfactory occlusion (odds ratio, 2.75; 95% CI, 1.49–5.09;
P
=0.0012) were associated with a 12-month satisfactory occlusion.
Conclusions—
A satisfactory occlusion was achieved in almost 80% of cases after flow diverter treatment with a permanent-related serious event and mortality rates of 5.9% and 1.2% at 12 months, respectively.
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Affiliation(s)
- Benjamin Gory
- From the Department of Diagnostic and Therapeutic Neuroradiology, INSERM U1254, University Hospital of Nancy, France (B.G., R.A.)
| | - Jerome Berge
- Department of Neuroradiology, CHU de Bordeaux, France (J.B.)
| | - Alain Bonafé
- Department of Neuroradiology, Hôpital Gui de Chauliac, Montpellier, France (A. Bonafé)
| | | | - Laurent Spelle
- Department of Interventional Neuroradiology, CHU Bicêtre, Le Kremlin Bicêtre, France (L.S.)
| | - Michel Piotin
- Department of Interventional Neuroradiology, Rothschild Fondation, Paris, France (M.P.)
| | - Alessandra Biondi
- Department of Neuroradiology and Endovascular Therapy, CHU Besançon, France (A. Biondi)
| | - Christophe Cognard
- Department of Diagnostic and Therapeutic Neuroradiology, CHU Toulouse, France (C.C.)
| | - Charbel Mounayer
- Department of Interventional Neuroradiology, CHU Limoges, France (C.M.)
| | - Nader Sourour
- Department of Interventional Neuroradiology, Pitié-Salpêtrière Hospital, Paris, France (N.S.)
| | | | - Hubert Desal
- Department of Neuroradiology, CHU Nantes, France (H.D.)
| | | | - Emmanuel Chabert
- Department of Neuroradiology, CHU Clermont-Ferrand, France (E.C.)
| | - Hervé Brunel
- Department of Neuroradiology, CHU Marseille, France (H.B.)
| | | | - René Anxionnat
- From the Department of Diagnostic and Therapeutic Neuroradiology, INSERM U1254, University Hospital of Nancy, France (B.G., R.A.)
| | - Evelyne Decullier
- Pôle Information Médicale Evaluation Recherche, Unité de Recherche clinique (E.D., L.H.), Hospices Civils de Lyon, France
| | - Laure Huot
- Pôle Information Médicale Evaluation Recherche, Unité de Recherche clinique (E.D., L.H.), Hospices Civils de Lyon, France
| | - Francis Turjman
- Department of Interventional Neuroradiology (F.T.), Hospices Civils de Lyon, France
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Fargier E, Ranchon F, Huot L, Guerre P, Safar V, Dony A, Hequet N, Bachy E, Savouroux S, Fronteau C, Tomaré P, Tournamille JF, Schwiertz V, Vantard N, Le Gouill S, Gyan E, Salles G, Rioufol C. SMABcare study: subcutaneous monoclonal antibody in cancer care: cost-consequence analysis of subcutaneous rituximab in patients with follicular lymphoma. Ann Hematol 2017; 97:123-131. [DOI: 10.1007/s00277-017-3147-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2017] [Accepted: 09/28/2017] [Indexed: 10/18/2022]
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Ferry T, Serrier H, Laurent F, Mabrut E, Fessy MH, Chidiac C, Huot L, Lustig S, Valour F. Microbiological Epidemiology in Patients Experiencing Microbiological or Clinical Failure Following Reimplantation After a Two-Stage Exchange Strategy for Hip or Knee Prosthetic Joint Infection (PJI). Open Forum Infect Dis 2017. [PMCID: PMC5632058 DOI: 10.1093/ofid/ofx163.081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Patients with late PJI are at risk for superinfection at the time of reimplantation. Different commercially available antibiotic-loaded cements (gentamicin, vancomycin, gentamicin+clindamycin [G+C], gentamicin+vancomycin [G+V]) could be used for the fixation of the new prosthesis and could be effective to treat or prevent superinfection. We aim to determine the microbiological epidemiology in patients experiencing failure following reimplantation to establish, based on the drug susceptibilities, which cement could be the most active.
Methods
Prospective cohort study including all patients with a two-stage exchange in 2013–2015. Microbiological failure was defined by positive culture at the time of reimplantation. Clinical failure was defined by patients with clinical signs of infection requiring a new surgery.
Results
We included 117 patients (median age 70 years). Fourteen patients (12%) experienced a failure: seven patients with microbiological failure (four CoNS, one P. acnes, one corynebacterium, and three Candida albicans); seven patients with a clinical relapse requiring a new surgery (three Enterobacteriaceae, two P. aeruginosa, one streptococcus spp., one CoNS, one P. acnes, one E. faecalis). Considering the use of a vancomycin-loaded cement, this antibiotic was inactive on Candida (n = 3) and Gram-negative isolates (n = 5). Considering the use of gentamicin, this antibiotic was inactive on Candida (n = 3) and five bacterial isolates. These five letter isolates were also not susceptible to Clindamycin. Considering the use of G+V, this combination was inactive on Candida (n = 3) and only one bacterial isolate (a gentamicin-resistant K. pneumonia). Consequently, the vancomycin-, gentamicin- and G+C-loaded cements may effectively treat or prevent 42.9% of superinfections, only. Conversely, the G+V-loaded cement may effectively treat or prevent 71.4% of them.
Conclusion
Considering the commercially available antibiotic loaded: none of the Candida albicans superinfection could be locally treated, and the G+V-loaded cement could treat or prevent most bacterial superinfections.
Disclosures
T. Ferry, HERAEUS: Consultant, Speaker honorarium. S. Lustig, Heraeus: Consultant, Consulting fee
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Affiliation(s)
- Tristan Ferry
- Inserm 1111, UCBL1, Hospices Civils de Lyon, Lyon, France
| | - Hassan Serrier
- Hospices Civils de Lyon - Cellule Innovation, Lyon, France
| | - Frederic Laurent
- Laboratory of Bacteriology, Regional Reference Center for Bji, Hospices Civils de Lyon, Lyon, France
| | - Eugenie Mabrut
- ID Department, Regional Reference Center for Bji, Hospices Civils de Lyon, Lyon, France
| | - Michel-Henri Fessy
- Hospices Civils de Lyon - Centre Hospitalier Lyon Sud, Pierre-Benite, France
| | - Christian Chidiac
- ID Department, Regional Reference Center for Bji, Hospices Civils de Lyon, Lyon, France
| | - Laure Huot
- Hospices Civils de Lyon - Cellule Innovation, Lyon, France
| | - Sébastien Lustig
- Orthopaedic Surgery, Regional Reference Center for Bji, Hospices Civils de Lyon, Lyon, France
| | - Florent Valour
- ID Department, Regional Reference Center for Bji, Hospices Civils de Lyon, Lyon, France
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Gory B, Huot L, Riva R, Labeyrie PE, Levrier O, Lebedinsky A, Brunel H, Gauvrit JY, Blanc R, Chabert E, Derex L, Emery E, Nicolas A, Desal H, Rodesch G, Turjman F. One-year efficacy and safety of the Trufill DCS Orbit and Orbit Galaxy detachable coils in the endovascular treatment of intracranial aneurysms: Results from the TRULINE study. Interv Neuroradiol 2017; 23:485-491. [PMID: 28675350 DOI: 10.1177/1591019917717576] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background and purpose No series reported the mid-term results of Trufill DCS Orbit and Orbit Galaxy detachable coils with independent evaluation. We present the one-year safety and efficacy of these coils in real-life routine clinical practice. Methods A total of 167 patients with 167 aneurysms (39.1% ruptured) were enrolled in the prospective TRULINE study. The primary endpoint was the safety, assessed by the combined morbidity-mortality rate observed since the time of the procedure and up to one-year follow-up. For safety, primary analyses were performed on intent-to-treat population (attempted coils procedure) and all adverse events have been reviewed by an independent Data Safety Monitoring Board. For efficacy, primary analyses were performed on the per-protocol population (patients treated with more than 70% of Trufill coils and not retreated during the follow-up period) and an independent core laboratory evaluated angiographic results. Results At one-year post-procedure, neurologic impairment was observed in 6.5% (95% confidence interval: 3.5-11.8) of the patients, and 2.6% (95% confidence interval: 1.0-6.8) had a permanent neurological deterioration. Three deaths were observed, unrelated to the procedure or coils. At one year, complete occlusion was seen in 52 aneurysms (54.2%), neck remnant in 28 aneurysms (29.2%), and aneurysm remnant in 16 aneurysms (16.7%). During the one-year follow-up, the overall incidence of recurrence was 30.2% with a mean interval of 13.8 ± 4.5 months and the retreatment for major recanalization was needed in nine patients (6.3%). Conclusions The TRULINE study confirms that endovascular coiling with Trufill DCS Orbit and Orbit Galaxy detachable coils is safe and effective.
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Affiliation(s)
- Benjamin Gory
- 1 Department of Interventional Neuroradiology, Hôpital Neurologique Pierre Wertheimer, France
| | - Laure Huot
- 2 Hospices Civils de Lyon, Cellule Innovations-DRCI, France
| | - Roberto Riva
- 1 Department of Interventional Neuroradiology, Hôpital Neurologique Pierre Wertheimer, France
| | - Paul E Labeyrie
- 1 Department of Interventional Neuroradiology, Hôpital Neurologique Pierre Wertheimer, France
| | | | | | - Hervé Brunel
- 5 Department of Neuroradiology, Timone University Hospital, France
| | - Jean-Yves Gauvrit
- 6 Department of Neuroradiology, Pontchaillou University Hospital, France
| | - Raphael Blanc
- 7 Department of Interventional Neuroradiology, Rothschild Fondation, France
| | - Emmanuel Chabert
- 8 Department of Neuroradiology, Gabriel Montpied University Hospital, France
| | - Laurent Derex
- 9 Department of Neurology, Stroke Unit, Hôpital Neurologique Pierre Wertheimer, France
| | - Evelyne Emery
- 10 Department of Neurosurgery, Caen University Hospital, France
| | | | - Hubert Desal
- 12 Department of Neuroradiology, Nord Laennec Hospital, France
| | | | - Francis Turjman
- 1 Department of Interventional Neuroradiology, Hôpital Neurologique Pierre Wertheimer, France
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Mabrut E, Cochard P, Chardon P, Serrier H, Huot L, Tod M, Valour F, Leboucher G, Chidiac C, Ferry T. Coût des antibiothérapies hors AMM dans les infections ostéoarticulaires (IOA) : étude prospective sur 2 ans dans un Centre de référence pour la prise en charge des IOA complexes (CRIOAc). Med Mal Infect 2017. [DOI: 10.1016/j.medmal.2017.03.218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Gory B, Huot L, Riva R, Labeyrie PE, Levrier O, Lebedinsky A, Brunel H, Gauvrit JY, Blanc R, Chabert E, Derex L, Emery E, Nicolas A, Desal H, Rodesch G, Not D, Mistretta F, Turjman F. Efficacité et sécurité à long terme des microspires d’embolisation Trufill DCS Orbit ® et Orbit Galaxy ® dans le traitement endovasculaire des anévrismes intracrâniens : résultats de l’étude TRULINE. Rev Epidemiol Sante Publique 2017. [DOI: 10.1016/j.respe.2017.04.048] [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: 10/19/2022] Open
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Dervaux B, Le Fur C, Dubois S, Josseran A, Baseilhac É, Baumstark L, Blin O, Bresse X, Debroucker F, Delaitre O, Detournay B, Diebolt V, Durand-Zaleski I, Gaudin AF, Huot L, Jeanblanc G, Launois R, Levesque K, Levy-Bachelot L. Quel impact budgétaire pour l’arrivée d’un nouveau traitement ou d’une nouvelle technologie de santé ? Therapie 2017; 72:81-91. [DOI: 10.1016/j.therap.2016.12.002] [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] [Received: 12/09/2016] [Accepted: 12/12/2016] [Indexed: 11/16/2022]
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Dervaux B, Le Fur C, Dubois S, Josseran A, Baseilhac É, Baumstark L, Blin O, Bresse X, Debroucker F, Delaitre O, Detournay B, Diebolt V, Durand-Zaleski I, Gaudin AF, Huot L, Jeanblanc G, Launois R, Levesque K, Levy-Bachelot L. What is the budget impact of a new treatment or new health technology arriving on the market? Therapie 2017; 72:93-103. [DOI: 10.1016/j.therap.2016.12.003] [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] [Received: 12/09/2016] [Accepted: 12/12/2016] [Indexed: 10/20/2022]
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Turjman F, Levrier O, Combaz X, Bonafé A, Biondi A, Desal H, Bracard S, Mounayer C, Riva R, Chapuis F, Huot L, Armoiry X, Gory B. EVIDENCE Trial: design of a phase 2, randomized, controlled, multicenter study comparing flow diversion and traditional endovascular strategy in unruptured saccular wide-necked intracranial aneurysms. Neuroradiology 2014; 57:49-54. [PMID: 25280445 DOI: 10.1007/s00234-014-1439-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2014] [Accepted: 09/21/2014] [Indexed: 10/24/2022]
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Kodjikian L, Decullier E, Souied EH, Girmens JF, Durand EE, Chapuis FR, Huot L. Bevacizumab and ranibizumab for neovascular age-related macular degeneration: an updated meta-analysis of randomised clinical trials. Graefes Arch Clin Exp Ophthalmol 2014; 252:1529-37. [PMID: 25142373 PMCID: PMC4180904 DOI: 10.1007/s00417-014-2764-6] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2014] [Revised: 07/18/2014] [Accepted: 07/30/2014] [Indexed: 02/08/2023] Open
Abstract
Purpose Neovascular age-related macular degeneration (AMD) is the main cause of central vision loss among individuals aged 50 years or older in developed countries. The aim of this study was to review systematically the effect of bevacizumab compared to ranibizumab in patients with AMD at 1 year. Methods A systematic review was performed on Medline, Embase, and the Cochrane Library and Trial registers to October 2013. Eligibility criteria for selecting studies were randomised controlled trials (RCT) comparing bevacizumab with ranibizumab in patients with neovascular AMD. Odds ratio (OR) and mean difference (MD) estimates were synthesized under fixed- and random-effects models. Heterogeneity was assessed using the Q statistic and I2. Results Five RCTs were included, representing 2,686 randomised patients. The meta-analysis confirmed the non-inferiority of bevacizumab compared to ranibizumab for change in visual acuity at 1 year (MD 0.57 letters, −1.80 to 0.66, p = 0.37, I2 = 0 %). Better anatomical results were found for ranibizumab. Bevacizumab was associated with a 34 % increase in the number of patients with at least one serious systemic adverse event (OR 1.34, 1.08 to 1.66, p = 0.01, I2 = 0 %). Conclusions The pooled evidence confirmed that, compared with ranibizumab, bevacizumab was associated with equivalent effects on visual acuity at 1 year and with a higher risk of systemic serious adverse events. The current available data do not show which types of adverse events occur more frequently. In practice, bevacizumab should be used under a risk-management plan until further studies have been carried out to assess accurately the increased risk of systemic adverse events.
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Affiliation(s)
- Laurent Kodjikian
- Service d'ophtalmologie, Hospices Civils de Lyon, Groupement Hospitalier Nord, Hôpital de la Croix-Rousse, 103 Grande Rue de la Croix-Rousse, F-69317, Lyon Cedex 04, France,
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Abstract
BACKGROUND The fate of clinical research projects funded by a grant has been investigated, but there is no information on the projects which did not receive funding. The fate of these projects is not known: do they apply for and/or receive funding from other sources or are they carried out without specific funding? PURPOSE The aim of the study was to describe all clinical research projects submitted to a French national funding scheme (PHRC 2000) and to assess project initiation, completion and publication status taking into account whether or not they received funding. METHODS This study is a retrospective cohort. The initial project characteristics were retrieved from the submission files and follow-up information was collected from the primary investigator. The percentages of projects started, completed and published were studied. RESULTS A total of 481 projects were studied. Follow-up information was obtained for 366. Overall, 185 projects were initiated (51%); 139 of them were funded by the PHRC 2000 or other sources. The most commonly cited reason for not initiating a project was a lack of funding. Subsequently, 121 of the projects initiated were completed (65%). Accrual difficulties were the main reason cited to explain why studies were stopped prematurely or were still ongoing. Finally, 88 of the completed projects were published (73%). Amongst the completed projects, the only factor explaining publication was the statistical significance of the results. CONCLUSIONS Obtainment of funding was a determining factor for project initiation. However, once initiated, the funding did not influence completion or publication.
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Affiliation(s)
- Evelyne Decullier
- Hospices Civils de Lyon, Pôle Information Médicale Evaluation Recherche, Unité de Recherche Clinique, Lyon, France
- Université de Lyon, RECIF, EAM Santé Individu Société 4128, Lyon, France
- Université Lyon 1, Lyon, France
| | - Laure Huot
- Hospices Civils de Lyon, Pôle Information Médicale Evaluation Recherche, Unité de Recherche Clinique, Lyon, France
- Université de Lyon, RECIF, EAM Santé Individu Société 4128, Lyon, France
- Université Lyon 1, Lyon, France
| | - François R. Chapuis
- Hospices Civils de Lyon, Pôle Information Médicale Evaluation Recherche, Unité de Recherche Clinique, Lyon, France
- Université de Lyon, RECIF, EAM Santé Individu Société 4128, Lyon, France
- Université Lyon 1, Lyon, France
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Abstract
Background To investigate fraud and errors, scientists have studied cohorts of retraction notices. These researches have been performed using a PubMed search on publication type “retraction of publication” which retrieves the notices of the retractions. We assessed the stability of the indexation of retraction notices over a 15-month period and what was the time-lag to get stability. Findings A search on notices of retraction issued in 2008 was repeated every 3 months during 15 months from February 2011. The first search resulted in 237 notices of retraction. Throughout the study period, 14 discrepancies with the initial search were observed (6%). We found that the number of retraction notices became stable 35 months after the retraction. Conclusions The time-lag observed in this study has to be taken into account when performing a PubMed search.
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Affiliation(s)
- Evelyne Decullier
- Hospices Civils de Lyon, Pôle Information Médicale Evaluation Recherche, Unité de Recherche Clinique, Lyon F-69003, France.
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Decullier E, Huot L, Samson G, Maisonneuve H. Visibility of retractions: a cross-sectional one-year study. BMC Res Notes 2013; 6:238. [PMID: 23782596 PMCID: PMC3691605 DOI: 10.1186/1756-0500-6-238] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2012] [Accepted: 06/11/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Retraction in Medline medical literature experienced a tenfold increase between 1999 and 2009, however retraction remains a rare event since it represents 0.02% of publications. Retractions used to be handled following informal practices until they were formalized in 2009 by the Committee on Publication Ethics (COPE). The objective of our study was to describe the compliance to these guidelines. METHODS All retractions published in 2008 were identified using the Medline publication type "retraction of publication". The notices of retraction and the original articles were retrieved. For each retraction, we identified the reason for retraction, the country of affiliation of the first author, the time to retraction, the impact factor of the journal and the mention of retraction on the original article. RESULTS Overall, 244 retractions were considered for analysis. Formal retraction notices could not be retrieved for 9. Of the 235 retractions available (96%), the reason was not detailed for 21 articles (9%). The most cited reasons were mistakes (28%), plagiarism (20%), fraud (14%) and overlap (11%). The original paper or its location was found for 233 retractions (95%). Of these, 22% were available with no mention of the retraction. CONCLUSION A standard retraction form could be helpful, with a check list of major reason, leaving the editor free to provide the reader with any further information. Original articles should remain available with a clear mention of the retraction.
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Affiliation(s)
- Evelyne Decullier
- Hospices Civils de Lyon, Pôle Information Médicale Evaluation Recherche, Unité de Recherche Clinique, Lyon F-69003, France.
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Tian TV, Tomavo N, Huot L, Flourens A, Bonnelye E, Flajollet S, Hot D, Leroy X, de Launoit Y, Duterque-Coquillaud M. Identification of novel TMPRSS2:ERG mechanisms in prostate cancer metastasis: involvement of MMP9 and PLXNA2. Oncogene 2013; 33:2204-14. [PMID: 23708657 DOI: 10.1038/onc.2013.176] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2012] [Revised: 02/27/2013] [Accepted: 03/18/2013] [Indexed: 12/17/2022]
Abstract
Prostate cancer (PCa) is one of the major public health problems in Western countries. Recently, the TMPRSS2:ERG gene fusion, which results in the aberrant expression of the transcription factor ERG, has been shown to be the most common gene rearrangement in PCa. Previous studies have determined the contributions of this fusion in PCa disease initiation and/or progression in vitro and in vivo. In this study on TMPRSS2:ERG regulation in PCa, we used an androgen receptor and TMPRSS2:ERG fusion double-negative PCa cell model: PC3c. In three cell clones with different TMPRSS2:ERG expression levels, ectopic expression of the fusion resulted in significant induction of cell migration and invasion in a dose-dependent manner. In agreement with this phenotype, high-throughput microarray analysis revealed that a set of genes, functionally associated with cell motility and invasiveness, were deregulated in a dose-dependent manner in TMPRSS2:ERG-expressing cells. Importantly, we identified increased MMP9 (Metalloproteinase 9) and PLXNA2 (Plexin A2) expression in TMPRSS2:ERG-positive PCa samples, and their expression levels were significantly correlated with ERG expression in a PCa cohort. In line with these findings, there was evidence that TMPRSS2:ERG directly and positively regulates MMP9 and PLXNA2 expression in PC3c cells. Moreover, PLXNA2 upregulation contributed to TMPRSS2:ERG-mediated enhancements of PC3c cell migration and invasion. Furthermore, and importantly, PLXNA2 expression was upregulated in metastatic PCa tumors compared with localized primary PCa tumors. This study provides novel insights into the role of the TMPRSS2:ERG fusion in PCa metastasis.
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Affiliation(s)
- T V Tian
- 1] Institut de Biologie de Lille, CNRS UMR8161, Lille, France [2] Institut Pasteur de Lille/IFR142, Lille, France [3] Université de Lille Nord de France, Lille, France [4] Faculté de Médecine Henri Warembourg, Université du Droit et de la Santé Lille II, Lille, France
| | - N Tomavo
- 1] Institut de Biologie de Lille, CNRS UMR8161, Lille, France [2] Institut Pasteur de Lille/IFR142, Lille, France [3] Université de Lille Nord de France, Lille, France
| | - L Huot
- 1] Institut Pasteur de Lille/IFR142, Lille, France [2] Université de Lille Nord de France, Lille, France [3] Centre d'Infection et d'Immunité de Lille (CIIL), INSERM U1019, CNRS UMR8204, Lille, France
| | - A Flourens
- 1] Institut de Biologie de Lille, CNRS UMR8161, Lille, France [2] Institut Pasteur de Lille/IFR142, Lille, France [3] Université de Lille Nord de France, Lille, France
| | | | - S Flajollet
- 1] Institut de Biologie de Lille, CNRS UMR8161, Lille, France [2] Institut Pasteur de Lille/IFR142, Lille, France [3] Université de Lille Nord de France, Lille, France
| | - D Hot
- 1] Institut Pasteur de Lille/IFR142, Lille, France [2] Université de Lille Nord de France, Lille, France [3] Centre d'Infection et d'Immunité de Lille (CIIL), INSERM U1019, CNRS UMR8204, Lille, France
| | - X Leroy
- 1] Université de Lille Nord de France, Lille, France [2] Faculté de Médecine Henri Warembourg, Université du Droit et de la Santé Lille II, Lille, France [3] Centre hospitalier régional et universitaire de Lille, Institut de Pathologie, Lille, France
| | - Y de Launoit
- 1] Institut de Biologie de Lille, CNRS UMR8161, Lille, France [2] Institut Pasteur de Lille/IFR142, Lille, France [3] Université de Lille Nord de France, Lille, France
| | - M Duterque-Coquillaud
- 1] Institut de Biologie de Lille, CNRS UMR8161, Lille, France [2] Institut Pasteur de Lille/IFR142, Lille, France [3] Université de Lille Nord de France, Lille, France
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Milleret R, Huot L, Nicolini P, Creton D, Roux A, Decullier E, Chapuis F, Camelot G. Great Saphenous Vein Ablation with Steam Injection: Results of a Multicentre Study. Eur J Vasc Endovasc Surg 2013; 45:391-6. [DOI: 10.1016/j.ejvs.2013.01.027] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2012] [Accepted: 01/12/2013] [Indexed: 11/28/2022]
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Huot L, Decullier E, Aulagner G, Chapuis F. Structure de soutien à l’évaluation clinique des dispositifs médicaux : expérience pilote en région Rhône-Alpes. Annales Pharmaceutiques Françaises 2012; 70:264-70. [DOI: 10.1016/j.pharma.2012.08.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2012] [Revised: 07/19/2012] [Accepted: 08/21/2012] [Indexed: 11/28/2022]
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Huot L, Decullier E, Maes-Beny K, Chapuis FR. Medical device assessment: scientific evidence examined by the French national agency for health - a descriptive study. BMC Public Health 2012; 12:585. [PMID: 22853740 PMCID: PMC3490794 DOI: 10.1186/1471-2458-12-585] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2011] [Accepted: 06/15/2012] [Indexed: 11/10/2022] Open
Abstract
Background Scientific evidence supports decision-making on the use of implantable medical devices (IMDs) in clinical practice, but IMDs are thought to be far less investigated than drugs. In the USA, studies have shown that approval process of high-risk medical devices was often based on insufficiently robust studies, suggesting that evidence prior to marketing may not be adequate. This study aimed to ascertain level of evidence available for IMDs access to reimbursement in France. Methods The objective was to examine the scientific evidence used for IMDs assessment by the French National Authority for Health. We collected all public documents summarising supportive clinical data and opinions concerning IMDs issued in 2008. An opinion qualifies the expected benefit (EB) of the IMD assessed as sufficient or insufficient, and if sufficient, the level of improvement of the expected benefit (IEB) on a scale from major (level I) to no improvement (level V). For each opinion, the study with the highest level of evidence of efficacy data, and its design were collected, or, where no studies were available, any other data sources used to establish the opinion. Results One hundred and two opinions were analysed, with 72 reporting at least one study used for assessment (70.6%). When considering the study with the highest level of evidence: 34 were clinical non-comparative studies (47.2%); 29 were clinical comparative studies of which 25 randomised controlled trials (40.3%); 5 were meta-analyses of randomised controlled trials (6.9%); and 4 were systematic literature reviews (5.6%). The opinions were significantly different according to the study design (p < 0.001). The most frequent design for insufficient EB, IEB level V and IEB level IV was a non-comparative study (10/19, 52.6%; 15/24, 62.5%; and 8/15, 53.3%; respectively). For the 30 opinions with no supporting clinical study, 16 (53.3%) were based on an expert-based process, 9 (30.0%) were based on the conclusions of a previous opinion (all concluding IEB level V), and 5 (16.7%) reported no data (concluding insufficient EB for 4 and IEB level V for 1). Conclusions This study confirmed that level of evidence of clinical evaluation of IMDs is low and needs to be improved.
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Affiliation(s)
- Laure Huot
- Hospices Civils de Lyon, Pôle Information Médicale Evaluation Recherche, Unité de Recherche Clinique, Lyon, 69003, France.
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Burillon C, Huot L, Justin V, Nataf S, Chapuis F, Decullier E, Damour O. Cultured autologous oral mucosal epithelial cell sheet (CAOMECS) transplantation for the treatment of corneal limbal epithelial stem cell deficiency. Invest Ophthalmol Vis Sci 2012; 53:1325-31. [PMID: 22064987 DOI: 10.1167/iovs.11-7744] [Citation(s) in RCA: 117] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
PURPOSE Total bilateral corneal limbal epithelial stem cell deficiency (LSCD) cannot be treated with the surgical transplantation of autologous limbus or cultured autologous limbal epithelium. Transplantation of allogenic limbal epithelium is possible but requires immunosuppressive treatments. Cultured autologous oral mucosal epithelial cell sheet (CAOMECS) is a transparent, resistant, viable, and rapidly bioadhesive cell sheet, cultured with the UpCell-Insert technology (CellSeed, Inc., Tokyo, Japan), which allows for grafting onto the patient's corneal stroma without suturing. It has therefore been proposed as an alternative treatment for LSCD. METHODS The objectives were to assess the safety and efficacy of CAOMECS, using a prospective Gehan's design. Safety was measured in terms of ocular adverse events during the study period, and efficacy was measured using a composite criterion based on epithelial defect, punctate epithelial keratopathy, conjunctival epithelium on the cornea, number of vascular pediculi, and vessel activity. RESULTS CAOMECS was found to be safe and effective. In total, 26 eyes of 25 patients received a graft. Two patients experienced serious adverse events classified as not product related. Twenty-five patients were included in the efficacy analysis, as one patient was lost to follow-up. The treatment was found to be effective in 16 of 25 patients at 360 days after grafting. Of the 23 patients who completed follow-up at 360 days, 22 had no ulcers, and 19 showed a decrease in the severity of the punctate epithelial keratopathy. CONCLUSIONS CAOMECS is a well-tolerated and safe tissue-engineered product. These results suggest its efficacy for reconstructing the ocular surface in patients with total bilateral corneal LSCD.
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Affiliation(s)
- Carole Burillon
- Service d'Ophtalmologie, Hôpital Edouard Herriot, 5 Place d'Arsonval, 69 437 Lyon Cedex 03, France.
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Huot L, Decullier E, Aulagner G, Chapuis FR. [Medical device evaluation: what are the needs?]. Presse Med 2010; 39:1097-8. [PMID: 20634034 DOI: 10.1016/j.lpm.2010.06.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2010] [Revised: 06/02/2010] [Accepted: 06/07/2010] [Indexed: 11/20/2022] Open
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Ranchon F, Hédoux S, Laville M, Fouque D, Decullier E, Chapuis F, Huot L. [Direct medical cost of erythropoiesis-stimulating agents in anaemia treatment of chronic renal failure patient: a literature review]. Nephrol Ther 2010; 6:97-104. [PMID: 20097148 DOI: 10.1016/j.nephro.2009.10.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2009] [Revised: 10/22/2009] [Accepted: 10/22/2009] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Management of anaemia in chronic renal insufficiency (CRI) represents an important medico-economic challenge because of the great number of patients and the cost of the erythropoiesis-stimulating agent (ESA). The aim of this study was to identify determinants of the costs associated with these treatments in order to choose, with equal efficacy, the most efficient ASE. METHOD A bibliographic research was realised by Medline database interrogation. RESULTS Among the direct medical costs, five studies showed that acquisition of epoetine alfa (EA) compared to darbepoetin alfa (DA) was less expensive. Concerning the costs associated with the route of administration, the subcutaneous injection (SC) of epoetine allowed a gain in costs because of the decrease of doses compared to the intravenous (IV) route. The switch from EA in SC to DA in IV, for hemodialysis patients, was associated with a reduction of the number of injections and with a treatment's cost lower by DA than by EA. Costs related to the regimen of administration, notably those related to nursing, medical and pharmaceutical time, were negligible towards those associated to the acquisition of the ASE. Finally, the costs of the therapeutic follow-up and treatment of the adverse effects of the ASE were similar between the EA and the DA. CONCLUSION The costs associated with the prices of acquisition of the ASE, negotiated by the structure of care, represent the most important part of the direct medical costs.
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Affiliation(s)
- Florence Ranchon
- Unité de recherche clinique, hospices civils de Lyon, pôle information médicale évaluation recherche, 69003 Lyon, France
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Carvalho CM, Huot L, Charlois AL, Khalfallah SA, Chapuis F, Froehlich P. Prognostic factors of recurrent respiratory papillomatosis from a registry of 72 patients. Acta Otolaryngol 2009; 129:462-70. [PMID: 19235575 DOI: 10.1080/00016480902737986] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
CONCLUSIONS The database revealed severity factors relating to human papillomavirus (HPV) type and age at diagnosis. While not exhaustive, the database is easy to use and could serve for a European multicentre epidemiological study. OBJECTIVES To propose a database as a starting point for a national registry and to estimate prognostic factors in recurrent respiratory papillomatosis (RRP). MATERIALS AND METHODS This was a retrospective study carried out in a tertiary care teaching hospital. From January 2005 to July 2007, epidemiological, clinical and treatment information on patients undergoing endoscopy for RRP in the department was entered in a database. Data were collected on three forms: the first comprised information about disease history before assessment in the department, the second about the disease and its treatment in the department, and the third about evolution after treatment. RESULTS Data on 72 patients were entered into an RRP database between January 2005 and July 2007. In all, 82% had already been treated for RRP in a different centre; 24 had juvenile-onset (JORRP) and 48 adult-onset (AORRP) papillomatosis. Cidovir injections had been administered to 91% of the patients. Histology found nine cases of dysplasia, one of carcinoma in situ and one of invasive carcinoma. Subglottic and tracheal locations were significantly more frequent in JORRP than in AORRP, as were the maximum Derkay scores and annual numbers of endoscopies. Patients with type 11 HPV had significantly more endoscopies per year than those with type 6.
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Bensemain F, Hot D, Ferreira S, Dumont J, Bombois S, Maurage CA, Huot L, Hermant X, Levillain E, Hubans C, Hansmannel F, Chapuis J, Hauw JJ, Schraen S, Lemoine Y, Buée L, Berr C, Mann D, Pasquier F, Amouyel P, Lambert JC. Evidence for induction of the ornithine transcarbamylase expression in Alzheimer's disease. Mol Psychiatry 2009; 14:106-16. [PMID: 17893704 DOI: 10.1038/sj.mp.4002089] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
To more rapidly identify candidate genes located within chromosomal regions of interest defined by genome scan studies in Alzheimer's disease (AD), we have developed a customized microarray containing all the ORFs (n=2741) located within nine of these regions. Levels of gene expression were assessed in total RNA from brain tissue of 12 controls and 12 AD patients. Of all genes showing differential expression, we focused on the ornithine transcarbamylase (OTC) gene on Xp21.1., a key enzyme of the urea cycle which we found to be expressed in AD brains but not in controls, as confirmed by RT-PCR. We also detected mRNA expression of all the other urea cycle enzymes in AD brains. Immunochemistry experiments revealed that the OTC expression was strictly restricted to vascular endothelial cells in brain. Furthermore, OTC activity was 880% increased in the CSF of probable AD cases compared with controls. We analysed the association of the OTC -389 G/A and -241 A/G promoter polymorphisms with the risk of developing AD. We observed that rare haplotypes may be associated with the risk of AD through a possible modulation of the methylation of the OTC promoter. In conclusion, our results suggest the involvement of a new pathway in AD brains involving the urea cycle.
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Affiliation(s)
- F Bensemain
- INSERM, U744, Institut Pasteur de Lille, Université de Lille 2, Lille, France
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Huot L, Couris CM, Tainturier V, Jaglal S, Colin C, Schott AM. Trends in HRT and anti-osteoporosis medication prescribing in a European population after the WHI study. Osteoporos Int 2008; 19:1047-54. [PMID: 18373055 DOI: 10.1007/s00198-008-0587-1] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2007] [Accepted: 09/19/2007] [Indexed: 11/30/2022]
Abstract
UNLABELLED To assess the prescription patterns of anti-osteoporosis medications, three cross-sectional analyses were performed between 2004 and 2006. Women aged 50 and older were identified from the health insurance claims database of the Rhône-Alpes area. HRT prescriptions decreased while bisphosphonates and raloxifene prescriptions increased, respectively, in different age groups. INTRODUCTION The objective of this study was to assess the prescription patterns of hormone replacement therapy (HRT) and anti-osteoporosis medications (AOM) in post-menopausal French women since the WHI and the revision of the French clinical practice guidelines in 2004. METHODS Three cross-sectional analyses were performed between 2004 and 2006. Women aged 50 and older who had at least one claim for a prescription for HRT, bisphosphonates or raloxifene were identified from health insurance claims database of the Rhône-Alpes area. RESULTS A 39% decrease in the number of women who had HRT was observed (67,241 to 41,024). Twenty-one percent and 18% increases were observed, respectively, for bisphosphonates (39,192 to 47,395) and raloxifene (10,263 to 12,060). HRT and raloxifene were mainly prescribed to women aged 55 to 64 (58% and 39%, respectively), bisphosphonates to women aged 65 to 84 (70%). Ninety-eight percent of women had HRT prescribed by a gynaecologist or a general practitioner (GP). Most AOM were prescribed by a GP; 13% of women had AOM prescribed by a rheumatologist. CONCLUSION Prescriptions for HRT in post-menopausal French women have significantly decreased while bisphosphonates and raloxifene prescriptions have increased, respectively, in different age groups but to a lesser extent than the HRT decrease.
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Affiliation(s)
- L Huot
- Hospices Civils de Lyon, Pole Information Médicale Evaluation Recherche, Unité d'Epidémiologie, Lyon F69003, France
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Huot L, Colin C, Durieu I, Nove-Josserand R, Reix P, Bellon G, Touzet S. P13-7 - Impact économique de la mise en place de recommandations pour la prise en charge de la mucoviscidose à Lyon. Rev Epidemiol Sante Publique 2006. [DOI: 10.1016/s0398-7620(06)76965-6] [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: 11/25/2022] Open
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Huot L, Touzet S, Durieu I, Bellon G, Nove-Josserand R, Colin C. 507 Economic impact of the Cystic Fibrosis management guideline implementation in one region of France. J Cyst Fibros 2006. [DOI: 10.1016/s1569-1993(06)80429-7] [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: 10/24/2022]
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Huot L, Paris A, Bosson JL, Boignard A, Hommel M, Labarère J, Cracowski JL. Evaluation de la satisfaction des participants à une recherche biomédicale. Therapie 2005; 60:539-44. [PMID: 16555490 DOI: 10.2515/therapie:2005075] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE The Grenoble clinical research centre carried out a prospective satisfaction survey of subjects taking part in clinical studies undertaken in its buildings. MATERIALS AND METHODS A questionnaire adapted from Grenoble teaching hospital's inpatient satisfaction survey was sent to 198 subjects. It comprised 24 items pooled in categories on which were calculated average scores. The participation rate of the survey was 82.6%. On the whole, 94.4% of the questioned subjects would accept to take part in a new study if we requested them, and 72.2% were satisfied or very satisfied with their stay; 24% had no opinion. The mean overall satisfaction score was 8.6 (95% confidence interval: 7.6-9.6) out of 10. CONCLUSION This investigation shows that the assumption of responsibility of the subjects by specific personnel and in an adapted place, within the framework of clinical protocol of research, is associated with a high satisfaction of the subjects. However, we still have to improve the transmission of the clinical study results to the patients.
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Affiliation(s)
- Laure Huot
- Centre d'Investigation Clinique, INSERM, Centre Hospitalo-Universitaire de Grenoble, France
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Hot D, Antoine R, Renauld-Mongénie G, Caro V, Hennuy B, Levillain E, Huot L, Wittmann G, Poncet D, Jacob-Dubuisson F, Guyard C, Rimlinger F, Aujame L, Godfroid E, Guiso N, Quentin-Millet MJ, Lemoine Y, Locht C. Differential modulation of Bordetella pertussis virulence genes as evidenced by DNA microarray analysis. Mol Genet Genomics 2003; 269:475-86. [PMID: 12768411 DOI: 10.1007/s00438-003-0851-1] [Citation(s) in RCA: 53] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2002] [Accepted: 04/09/2003] [Indexed: 11/30/2022]
Abstract
The production of most factors involved in Bordetella pertussis virulence is controlled by a two-component regulatory system termed BvgA/S. In the Bvg+ phase virulence-activated genes (vags) are expressed, and virulence-repressed genes (vrgs) are down-regulated. The expression of these genes can also be modulated by MgSO(4) or nicotinic acid. In this study we used microarrays to analyse the influence of BvgA/S or modulation on the expression of nearly 200 selected genes. With the exception of one vrg, all previously known vags and vrgs were correctly assigned as such, and the microarray analyses identified several new vags and vrgs, including genes coding for putative autotransporters, two-component systems, extracellular sigma factors, the adenylate cyclase accessory genes cyaBDE, and two genes coding for components of a type III secretion system. For most of the new vrgs and vags the results of the microarray analyses were confirmed by RT-PCR analysis and/or lacZfusions. The degree of regulation and modulation varied between genes, and showed a continuum from strongly BvgA/S-activated genes to strongly BvgA/S-repressed genes. The microarray analyses also led to the identification of a subset of vags and vrgs that are differentially regulated and modulated by MgSO(4) or nicotinic acid, indicating that these genes may be targets for multiple regulatory circuits. For example, the expression of bilA, a gene predicted to encode an intimin-like protein, was found to be activated by BvgA/S and up-modulated by nicotinic acid. Furthermore, surprisingly, in the strain analysed here, which produces only type 2 fimbriae, the fim3 gene was identified as a vrg, while fim2 was confirmed to be a vag.
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Affiliation(s)
- D Hot
- Laboratoire des Biopuces, Institut Pasteur de Lille, 1 Rue du Prof. Calmette, 59019 Lille, France
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Paré F, Huot L. Effects de la réserpine sur le développement et la croissance de Schistocerca gregaria Forsk. au cours des quatrième et cinquième stades larvaires. CAN J ZOOL 1977. [DOI: 10.1139/z77-264] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Various doses of reserpine were injected in the body cavity of fourth-instar nymphal Schistocerca gregaria. Treatment within 48 h from the beginning of the instar significantly increased its duration, whereas treatment at 72 or 96 h did not affect the duration of the fourth stage. However the length of the fifth stage was markedly increased irrespective of the time of treatment in the preceding stage. Fresh body weight of treated larvae increased almost as fast as in the controls. Thus food intake was affected little or not at all by the treatment. In contrast with isolation, reserpine treatment did not affect body pigmentation. Reserpine treatment, destruction of the pars intercerebralis, and isolation were compared with regard to their effects on the molting process
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