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Jarrot PA, Mirouse A, Ottaviani S, Cadiou S, Salmon JH, Liozon E, Parreau S, Michaud M, Terrier B, Gavand PE, Trefond L, Lavoiepierre V, Keraen J, Rekassa D, Bouldoires B, Weitten T, Roche D, Poulet A, Charpin C, Grobost V, Hermet M, Pallure M, Wackenheim C, Karkowski L, Grumet P, Rogier T, Belkefi N, Pestre V, Broquet E, Leurs A, Gautier S, Gras V, Gilet P, Holubar J, Sivova N, Schleinitz N, Durand JM, Castel B, Petrier A, Arcani R, Gramont B, Guilpain P, Lepidi H, Weiller PJ, Micallef J, Saadoun D, Kaplanski G. Polymyalgia rheumatica and giant cell arteritis following COVID-19 vaccination: Results from a nationwide survey. Hum Vaccin Immunother 2024; 20:2334084. [PMID: 38563792 PMCID: PMC10989707 DOI: 10.1080/21645515.2024.2334084] [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: 01/17/2024] [Accepted: 03/19/2024] [Indexed: 04/04/2024] Open
Abstract
We conducted a national in-depth analysis including pharmacovigilance reports and clinical study to assess the reporting rate (RR) and to determine the clinical profile of polymyalgia rheumatica (PMR) and giant cell arteritis (GCA) in COVID-19-vaccinated individuals. First, based on the French pharmacovigilance database, we estimated the RR of PMR and GCA cases in individuals aged over 50 who developed their initial symptoms within one month of receiving the BNT162b2 mRNA, mRNA-1273, ChAdOx1 nCoV-19, and Ad26.COV2.S vaccines. We then conducted a nationwide survey to gather clinical profiles, therapeutic management, and follow-up data from individuals registered in the pharmacovigilance study. A total of 70 854 684 COVID-19 vaccine doses were administered to 25 260 485 adults, among which, 179 cases of PMR (RR 7. 1 cases/1 000 000 persons) and 54 cases of GCA (RR 2. 1 cases/1 000 000 persons) have been reported. The nationwide survey allowed the characterization of 60 PMR and 35 GCA cases. Median time to the onset of first symptoms was 10 (range 2-30) and 7 (range 2-25) days for PMR and GCA, respectively. Phenotype, GCA-related ischemic complications and -large vessel vasculitis as well as therapeutic management and follow-up seemed similar according to the number of vaccine shots received and when compared to the literature data of unvaccinated population. Although rare, the short time between immunization and the onset of first symptoms of PMR and GCA suggests a temporal association. Physician should be aware of this potential vaccine-related phenomenon.
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Affiliation(s)
- Pierre-André Jarrot
- Department of Internal Medicine and Clinical Immunology, Hôpital de La Conception, Assistance Publique-Hôpitaux de Marseille (AP-HM), Marseille, France
- Centre for Cardiovascular and Nutrition Research (C2VN), INRA 1260, INSERM UMR_S1263, Aix-Marseille University, Marseille, France
| | - Adrien Mirouse
- Department of Internal Medicine and Clinical Immunology, Centre de Référence des Maladies Auto-Immunes Systémiques Rares, Centre de Référence des Maladies Auto-Inflammatoires et de l’Amylose inflammatoire (CEREMAIA), Sorbonne Universités, Paris, France
- INSERM, UMR_S 959 Lab, Immunology, Immunotherapeutics, Paris, France
- DMU 3ID, AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Paris, France
| | - Sébastien Ottaviani
- Department of Rheumatology, DMU Locomotion, Hôpital Bichat-Claude Bernard, APHP, Université de Paris, Paris, France
| | - Simon Cadiou
- Department of Rheumatology, CHU de Rennes, Université de Rennes 1, Rennes, France
| | - Jean-Hugues Salmon
- Department of Rheumatology, Hôpital de La Maison Blanche, Université de Reims, Reims, France
| | - Eric Liozon
- Department of Internal Medicine, Hôpital Universitaire de Limoges, Limoges, France
| | - Simon Parreau
- Department of Internal Medicine, Hôpital Universitaire de Limoges, Limoges, France
| | - Martin Michaud
- Department of Internal Medicine, Clinique Saint-Exupery, Toulouse, France
| | - Benjamin Terrier
- National Referral Center for Rare Systemic Autoimmune Disease, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris (AP-HP), Centre, Université Paris Cité, Paris, France
| | | | - Ludovic Trefond
- Department of Internal Medicine, Hôpital Gabriel Montpied, Clermont-Ferrand, France
| | - Virginie Lavoiepierre
- Department of Internal Medicine and Clinical Immunology, Hôpital de La Conception, Assistance Publique-Hôpitaux de Marseille (AP-HM), Marseille, France
| | - Jeremy Keraen
- Department of Internal Medicine, Hôpital de Cornouaille, Quimper, France
| | - Daniel Rekassa
- Department of Rehabilitation, Centre Thermal, Greoux Les Bains, France
| | | | - Thierry Weitten
- Department of Internal Medicine, Hôpital des Alpes du Sud, Gap, France
| | - Damien Roche
- Department of Rheumatology, Hôpital Saint-Joseph, Marseille, France
| | - Antoine Poulet
- Department of Internal Medicine, Hôpital Saint-Joseph, Marseille, France
| | - Caroline Charpin
- Department of Rheumatology, Hôpital Saint-Joseph, Marseille, France
| | - Vincent Grobost
- Department of Internal Medicine, Hôpital Estaing, Clermont-Ferrand, France
| | - Marion Hermet
- Department of Internal Medicine, Hôpital de Vichy, Vichy, France
| | - Magali Pallure
- Department of Rheumatology, Hôpital de Cannes Simone Veil, Cannes, France
| | - Chloe Wackenheim
- Department of Internal Medicine, Medipole Hôpital Privé, Villeurbanne, France
| | - Ludovic Karkowski
- Department of Internal Medicine, Hôpital d’Instruction des Armées Sainte-Anne, Toulon, France
| | - Pierre Grumet
- Department of Internal Medicine, Hôpital des Alpes du Sud, Gap, France
| | - Thomas Rogier
- Department of Internal Medicine and Systemic Disease, Hôpital François Mitterand, Dijon, France
| | - Nabil Belkefi
- Department of Internal Medicine, CH de Melun, Melun, France
| | - Vincent Pestre
- Department of Internal Medicine and Infectious Disease, CH d’Avignon, Avignon, France
| | | | - Amélie Leurs
- Department of Internal Medicine and Infectious Disease, CH de Dunkerque, Dunkerque, France
| | - Sophie Gautier
- Department of Pharmacology, centre régional de pharmacovigilance Nord Pas de Calais, CHRU de Lille, Lille, France
| | - Valérie Gras
- Department of Clinical Pharmacology, Centre régional de pharmacovigilance, service de pharmacologie clinique, CHU Amiens-Picardie, Amiens, France
| | - Pierre Gilet
- Regional Center of Pharmacovigilance, CHRU de Nancy, Hôpital Central, Nancy, France
| | - Jan Holubar
- Department of Internal Medicine, CHU de Nîmes, Nîmes, France
| | - Nadia Sivova
- Department of Internal Medicine, CH de Tourcoing, Tourcoing, France
| | - Nicolas Schleinitz
- Department of Internal Medicine, Hôpital de La Timone, Assistance Publique-Hôpitaux de Marseille (AP-HM), Marseille, France
| | - Jean-Marc Durand
- Department of Internal Medicine, Hôpital de La Timone, Assistance Publique-Hôpitaux de Marseille (AP-HM), Marseille, France
| | - Brice Castel
- Department of Internal Medicine, CH de Tarbes, Tarbes, France
| | | | - Robin Arcani
- Department of Internal Medicine and Therapeutics Department, Hôpital de La Timone, Marseille, France
| | - Baptiste Gramont
- Department of Internal Medicine, CHU de Saint-Etienne, Saint-Etienne, France
| | - Philippe Guilpain
- Department of Internal Medicine, CHU Saint-Eloi, Montpellier, France
| | - Hubert Lepidi
- Pathological Laboratory, Hôpital de La Timone, Assistance Publique-Hôpitaux de Marseille (AP-HM), Marseille, France
| | | | - Joelle Micallef
- Department of Clinical Pharmacology and pharmacosurveillance, Regional Pharmacovigilance Center of Marseille, Hôpital de La Timone, Assistance Publique-Hôpitaux de Marseille (AP-HM), Marseille, France
| | - David Saadoun
- Department of Internal Medicine and Clinical Immunology, Centre de Référence des Maladies Auto-Immunes Systémiques Rares, Centre de Référence des Maladies Auto-Inflammatoires et de l’Amylose inflammatoire (CEREMAIA), Sorbonne Universités, Paris, France
- INSERM, UMR_S 959 Lab, Immunology, Immunotherapeutics, Paris, France
- DMU 3ID, AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Paris, France
| | - Gilles Kaplanski
- Department of Internal Medicine and Clinical Immunology, Hôpital de La Conception, Assistance Publique-Hôpitaux de Marseille (AP-HM), Marseille, France
- Centre for Cardiovascular and Nutrition Research (C2VN), INRA 1260, INSERM UMR_S1263, Aix-Marseille University, Marseille, France
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Trefond L, Zahr N, Lhote R, Pha M, Hié M, Miyara M, Papo M, Moyon Q, Hausfater P, Chasset F, Haroche J, Cohen-Aubart F, Mathian A, Amoura Z. Low plasma belimumab levels as an indicator of poor adherence to belimumab in patients with systemic lupus erythematosus. Ann Rheum Dis 2024; 83:541-543. [PMID: 38123937 DOI: 10.1136/ard-2023-225023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Accepted: 11/28/2023] [Indexed: 12/23/2023]
Affiliation(s)
- Ludovic Trefond
- Assistance Publique-Hôpitaux de Paris (AP-HP), Groupement Hospitalier Pitié-Salpêtrière, Centre de Référence pour le Lupus, le Syndrome des anti-phospholipides et autres maladies auto-immunes rares, Service de Médecine Interne 2, Institut E3M, Paris, France
- CHU Clermont Ferrand, Service de Médecine Interne, Hôpital Gabriel Montpied, Inserm U1071, INRA USC2018, M2iSH, Université Clermont Auvergne, Clermont-Ferrand, France
| | - Noël Zahr
- AP-HP, Sorbonne Université, Pitié-Salpêtrière Hospital, Department of Pharmacology, CIC-1901, Pharmacokinetics and Therapeutic Drug Monitoring Unit, UMR-S 1166, Paris, France
| | - Raphael Lhote
- Assistance Publique-Hôpitaux de Paris (AP-HP), Groupement Hospitalier Pitié-Salpêtrière, Centre de Référence pour le Lupus, le Syndrome des anti-phospholipides et autres maladies auto-immunes rares, Service de Médecine Interne 2, Institut E3M, Paris, France
| | - Micheline Pha
- Assistance Publique-Hôpitaux de Paris (AP-HP), Groupement Hospitalier Pitié-Salpêtrière, Centre de Référence pour le Lupus, le Syndrome des anti-phospholipides et autres maladies auto-immunes rares, Service de Médecine Interne 2, Institut E3M, Paris, France
| | - Miguel Hié
- Assistance Publique-Hôpitaux de Paris (AP-HP), Groupement Hospitalier Pitié-Salpêtrière, Centre de Référence pour le Lupus, le Syndrome des anti-phospholipides et autres maladies auto-immunes rares, Service de Médecine Interne 2, Institut E3M, Paris, France
| | - Makoto Miyara
- Centre d'Immunologie et des Maladies Infectieuses (CIMI-Paris), INSERM, Sorbonne Universite, Paris, France
- Sorbonne Universite, AP-HP, Département d'Immunologie, Groupement Hospitalier Pitié-Salpêtrière, Paris, France
| | - Matthias Papo
- Sorbonne Université, Faculté de Médecine, AP-HP, Groupement Hospitalier Pitié-Salpêtrière, Centre de Référence pour le Lupus, le Syndrome des anti-phospholipides et autres maladies auto-immunes rares, Service de Médecine Interne 2, Institut E3M, Paris, France
| | - Quentin Moyon
- Sorbonne Université, Faculté de Médecine, AP-HP, Groupement Hospitalier Pitié-Salpêtrière, Centre de Référence pour le Lupus, le Syndrome des anti-phospholipides et autres maladies auto-immunes rares, Service de Médecine Interne 2, Institut E3M, Paris, France
| | - Pierre Hausfater
- Sorbonne Université, Faculté de Médecine, AP-HP, Groupement Hospitalier Pitié-Salpêtrière, Centre de Référence pour le Lupus, le Syndrome des anti-phospholipides et autres maladies auto-immunes rares, Service de Médecine Interne 2, Institut E3M, Paris, France
| | - Francois Chasset
- Sorbonne Université, Faculté de Médecine, AP-HP, Service de Dermatologie et Allergologie, Hôpital Tenon, Paris, France
| | - Julien Haroche
- Centre d'Immunologie et des Maladies Infectieuses (CIMI-Paris), INSERM, Sorbonne Universite, Paris, France
- Sorbonne Université, Faculté de Médecine, AP-HP, Groupement Hospitalier Pitié-Salpêtrière, Centre de Référence pour le Lupus, le Syndrome des anti-phospholipides et autres maladies auto-immunes rares, Service de Médecine Interne 2, Institut E3M, Paris, France
| | - Fleur Cohen-Aubart
- Sorbonne Université, Faculté de Médecine, AP-HP, Groupement Hospitalier Pitié-Salpêtrière, Centre de Référence pour le Lupus, le Syndrome des anti-phospholipides et autres maladies auto-immunes rares, Service de Médecine Interne 2, Institut E3M, Paris, France
| | - Alexis Mathian
- Assistance Publique-Hôpitaux de Paris (AP-HP), Groupement Hospitalier Pitié-Salpêtrière, Centre de Référence pour le Lupus, le Syndrome des anti-phospholipides et autres maladies auto-immunes rares, Service de Médecine Interne 2, Institut E3M, Paris, France
- Centre d'Immunologie et des Maladies Infectieuses (CIMI-Paris), INSERM, Sorbonne Universite, Paris, France
| | - Zahir Amoura
- Centre d'Immunologie et des Maladies Infectieuses (CIMI-Paris), INSERM, Sorbonne Universite, Paris, France
- Sorbonne Université, Faculté de Médecine, AP-HP, Groupement Hospitalier Pitié-Salpêtrière, Centre de Référence pour le Lupus, le Syndrome des anti-phospholipides et autres maladies auto-immunes rares, Service de Médecine Interne 2, Institut E3M, Paris, France
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Trefond L, Lhote R, Mathian A, de Chambrun MP, Pha M, Hie M, Miyara M, Papo M, Moyon Q, Taieb D, Saade S, Salem TB, Haroche J, Chasset F, Aubart FC, Zahr N, Amoura Z. Identification of new risk factors for hydroxychloroquine and chloroquine retinopathy in systemic lupus erythematosus patients. Semin Arthritis Rheum 2024; 66:152417. [PMID: 38394986 DOI: 10.1016/j.semarthrit.2024.152417] [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: 09/26/2023] [Revised: 12/20/2023] [Accepted: 02/05/2024] [Indexed: 02/25/2024]
Abstract
BACKGROUND Long-term hydroxychloroquine (HCQ) or chloroquine (CQ) intake causes retinal toxicity in 0.3-8 % of patients with rheumatic diseases. Numerous risk factors have been described, eg, daily dose by weight, treatment duration, chronic kidney disease, concurrent tamoxifen therapy and pre-existing retinal or macular disease. However, those factors cannot explain the entire risk of developing antimalarial retinopathy. OBJECTIVE This study was undertaken to identify new risk factors associated with HCQ or CQ retinopathy (QRNP) in systemic lupus erythematosus (SLE) patients. METHODS This case-control (1:2) study compared SLE patients with QRNP (cases) to those without (controls). Controls were matched for sex and known QRNP risk factors: HCQ and/or CQ treatment duration (±1 year) and age (±5 year) at SLE diagnosis. RESULTS Forty-eight cases were compared to 96 SLE controls. Multivariable logistic-regression analysis retained the following as independent determinants significantly associated with QRNP: concomitant selective serotonin-reuptake inhibitor (SSRI) or serotonin- and norepinephrine-reuptake inhibitor (SNRI) intake (OR [95 % confidence interval] 6.6 [1.2 to 40.9]; p < 0.01); antiphospholipid syndrome (OR=8.9 [2.2 to 41.4] p < 0.01); blood hydroxychloroquine/desethylchloroquine concentration ([HCQ]/[DCQ]) ratio <7.2 (OR 8.4 [2.7 to 30.8]; p < 0.01) or skin phototype ≥4 (OR 5.5 [1.4 to 26.5]; p = 0.02), but not daily HCQ dose, blood [HCQ] or body mass index. CONCLUSION The results of this case-control study identified blood [HCQ]/[DCQ] ratio, concurrent SSRI/SNRI therapy, skin phototype ≥4 and antiphospholipid syndrome as new risk factors for QRNP.
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Affiliation(s)
- Ludovic Trefond
- Sorbonne Université, Assistance Publique-Hôpitaux de Paris (APHP), Groupe Hospitalier Pitié-Salpêtrière, French National Referral Center for Systemic Lupus Erythematosus, Antiphospholipid Antibody Syndrome and Other Autoimmune Disorders, Service de Médecine Interne 2, Institut E3M, Inserm UMRS, Centre d'Immunologie et des Maladies Infectieuses (CIMI-Paris), Paris, France; Médecine Interne, Centre Hospitalier Universitaire Gabriel-Montpied, M2iSH, Inserm UMR, Université Clermont-Auvergne, 63000 Clermont-Ferrand, France
| | - Raphael Lhote
- Sorbonne Université, Assistance Publique-Hôpitaux de Paris (APHP), Groupe Hospitalier Pitié-Salpêtrière, French National Referral Center for Systemic Lupus Erythematosus, Antiphospholipid Antibody Syndrome and Other Autoimmune Disorders, Service de Médecine Interne 2, Institut E3M, Inserm UMRS, Centre d'Immunologie et des Maladies Infectieuses (CIMI-Paris), Paris, France
| | - Alexis Mathian
- Sorbonne Université, Assistance Publique-Hôpitaux de Paris (APHP), Groupe Hospitalier Pitié-Salpêtrière, French National Referral Center for Systemic Lupus Erythematosus, Antiphospholipid Antibody Syndrome and Other Autoimmune Disorders, Service de Médecine Interne 2, Institut E3M, Inserm UMRS, Centre d'Immunologie et des Maladies Infectieuses (CIMI-Paris), Paris, France
| | - Marc Pineton de Chambrun
- Sorbonne Université, Assistance Publique-Hôpitaux de Paris (APHP), Groupe Hospitalier Pitié-Salpêtrière, French National Referral Center for Systemic Lupus Erythematosus, Antiphospholipid Antibody Syndrome and Other Autoimmune Disorders, Service de Médecine Interne 2, Institut E3M, Inserm UMRS, Centre d'Immunologie et des Maladies Infectieuses (CIMI-Paris), Paris, France
| | - Micheline Pha
- Sorbonne Université, Assistance Publique-Hôpitaux de Paris (APHP), Groupe Hospitalier Pitié-Salpêtrière, French National Referral Center for Systemic Lupus Erythematosus, Antiphospholipid Antibody Syndrome and Other Autoimmune Disorders, Service de Médecine Interne 2, Institut E3M, Inserm UMRS, Centre d'Immunologie et des Maladies Infectieuses (CIMI-Paris), Paris, France
| | - Miguel Hie
- Sorbonne Université, Assistance Publique-Hôpitaux de Paris (APHP), Groupe Hospitalier Pitié-Salpêtrière, French National Referral Center for Systemic Lupus Erythematosus, Antiphospholipid Antibody Syndrome and Other Autoimmune Disorders, Service de Médecine Interne 2, Institut E3M, Inserm UMRS, Centre d'Immunologie et des Maladies Infectieuses (CIMI-Paris), Paris, France
| | - Makoto Miyara
- Sorbonne Université, Assistance Publique-Hôpitaux de Paris (APHP), Groupe Hospitalier Pitié-Salpêtrière, French National Referral Center for Systemic Lupus Erythematosus, Antiphospholipid Antibody Syndrome and Other Autoimmune Disorders, Service de Médecine Interne 2, Institut E3M, Inserm UMRS, Centre d'Immunologie et des Maladies Infectieuses (CIMI-Paris), Paris, France
| | - Matthias Papo
- Sorbonne Université, Assistance Publique-Hôpitaux de Paris (APHP), Groupe Hospitalier Pitié-Salpêtrière, French National Referral Center for Systemic Lupus Erythematosus, Antiphospholipid Antibody Syndrome and Other Autoimmune Disorders, Service de Médecine Interne 2, Institut E3M, Inserm UMRS, Centre d'Immunologie et des Maladies Infectieuses (CIMI-Paris), Paris, France
| | - Quentin Moyon
- Sorbonne Université, Assistance Publique-Hôpitaux de Paris (APHP), Groupe Hospitalier Pitié-Salpêtrière, French National Referral Center for Systemic Lupus Erythematosus, Antiphospholipid Antibody Syndrome and Other Autoimmune Disorders, Service de Médecine Interne 2, Institut E3M, Inserm UMRS, Centre d'Immunologie et des Maladies Infectieuses (CIMI-Paris), Paris, France
| | - Dov Taieb
- Sorbonne Université, Assistance Publique-Hôpitaux de Paris (APHP), Groupe Hospitalier Pitié-Salpêtrière, French National Referral Center for Systemic Lupus Erythematosus, Antiphospholipid Antibody Syndrome and Other Autoimmune Disorders, Service de Médecine Interne 2, Institut E3M, Inserm UMRS, Centre d'Immunologie et des Maladies Infectieuses (CIMI-Paris), Paris, France
| | - Sonia Saade
- Sorbonne Université, Assistance Publique-Hôpitaux de Paris (APHP), Groupe Hospitalier Pitié-Salpêtrière, French National Referral Center for Systemic Lupus Erythematosus, Antiphospholipid Antibody Syndrome and Other Autoimmune Disorders, Service de Médecine Interne 2, Institut E3M, Inserm UMRS, Centre d'Immunologie et des Maladies Infectieuses (CIMI-Paris), Paris, France
| | - Thouraya Ben Salem
- Sorbonne Université, Assistance Publique-Hôpitaux de Paris (APHP), Groupe Hospitalier Pitié-Salpêtrière, French National Referral Center for Systemic Lupus Erythematosus, Antiphospholipid Antibody Syndrome and Other Autoimmune Disorders, Service de Médecine Interne 2, Institut E3M, Inserm UMRS, Centre d'Immunologie et des Maladies Infectieuses (CIMI-Paris), Paris, France
| | - Julien Haroche
- Sorbonne Université, Assistance Publique-Hôpitaux de Paris (APHP), Groupe Hospitalier Pitié-Salpêtrière, French National Referral Center for Systemic Lupus Erythematosus, Antiphospholipid Antibody Syndrome and Other Autoimmune Disorders, Service de Médecine Interne 2, Institut E3M, Inserm UMRS, Centre d'Immunologie et des Maladies Infectieuses (CIMI-Paris), Paris, France
| | - François Chasset
- Sorbonne Université, Faculté de Médecine, APHP, Service de Dermatologie et Allergologie, Hôpital Tenon, Paris, France
| | - Fleur Cohen Aubart
- Sorbonne Université, Assistance Publique-Hôpitaux de Paris (APHP), Groupe Hospitalier Pitié-Salpêtrière, French National Referral Center for Systemic Lupus Erythematosus, Antiphospholipid Antibody Syndrome and Other Autoimmune Disorders, Service de Médecine Interne 2, Institut E3M, Inserm UMRS, Centre d'Immunologie et des Maladies Infectieuses (CIMI-Paris), Paris, France
| | - Noël Zahr
- Service de Pharmacologie, APHP, Groupe Hospitalier Pitié-Salpêtrière, Paris, France
| | - Zahir Amoura
- Sorbonne Université, Assistance Publique-Hôpitaux de Paris (APHP), Groupe Hospitalier Pitié-Salpêtrière, French National Referral Center for Systemic Lupus Erythematosus, Antiphospholipid Antibody Syndrome and Other Autoimmune Disorders, Service de Médecine Interne 2, Institut E3M, Inserm UMRS, Centre d'Immunologie et des Maladies Infectieuses (CIMI-Paris), Paris, France.
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Chehem Daoud Chehem F, de Mornac D, Feuillet F, Liozon E, Samson M, Bonnotte B, de Boysson H, Guffroy A, Balquet MH, Ledoult E, Lavigne C, Trefond L, Smets P, Bodard Q, Fenot M, Richez C, Duffau P, Guillaud C, Espitia O, Agard C. Giant cell arteritis associated with scalp, tongue or lip necrosis: A French multicenter case control study. Semin Arthritis Rheum 2024; 64:152348. [PMID: 38091870 DOI: 10.1016/j.semarthrit.2023.152348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 11/03/2023] [Accepted: 12/05/2023] [Indexed: 01/12/2024]
Abstract
BACKGROUND Scalp, tongue and/or lip necrosis are rare complications of GCA. OBJECTIVES To describe characteristics and outcome of patients with giant cell arteritis (GCA) -related scalp, tongue and/or lip necrosis. METHODS A retrospective nationwide multicenter study included 20 GCA patients with scalp, tongue, and/or lip necrosis diagnosed between 1998 and 2021 and 80 GCA control patients matched for age, sex and management period. Logistic regression analyses were conducted to identify baseline characteristics associated with scalp, tongue and/or lip necrosis. RESULTS Compared to controls, patients with scalp, tongue and/or lip necrosis showed significantly more cranial manifestations (headache, p=0.045; scalp tenderness, p=0.006; jaw claudication, p=0.02). No differences were observed between both groups regarding the occurrence of visual symptoms or large vessel involvement. At diagnosis, GCA patients with necrosis more likely received IV methylprednisolone infusions and higher doses of oral prednisone. There were no differences regarding vascular complications during follow up. Compared to controls, survival was decreased in GCA patients with necrosis (p=0.003). In a multivariable logistic regression model, scalp tenderness [odds ratio (OR) 4.81(95 % CI: 1.57, 14.79), p = 0.006] and cognitive disorder [OR 6.42 (95 % CI: 1.01, 40.60), p=0.048] were identified as factors associated to scalp, tongue, and/or lip necrosis. CONCLUSION Our results suggest that scalp, tongue, and/or lip necrosis is associated to higher mortality in GCA patients. Scalp tenderness and cognitive disorder were significant factors associated to this very rare complication of GCA.
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Affiliation(s)
| | - Donatienne de Mornac
- Department of internal medicine, Nantes Université, CHU Nantes, Nantes F-44000, France
| | - Fanny Feuillet
- Methodology and Biostatistics Platform, Nantes University Hospital, Nantes, France
| | - Eric Liozon
- Internal Medicine Department, Limoges University Hospital, Limoges, France
| | - Maxime Samson
- Internal Medicine and Clinical Immunology Department, Dijon Bourgogne University Hospital, Dijon, France
| | - Bernard Bonnotte
- Internal Medicine and Clinical Immunology Department, Dijon Bourgogne University Hospital, Dijon, France
| | - Hubert de Boysson
- Internal Medicine Department, Caen University Hospital, Caen, France
| | - Aurélien Guffroy
- Internal Medicine Department, Strasbourg University Hospital, Strasbourg, France
| | | | - Emmanuel Ledoult
- Internal Medicine Department, Lille University Hospital, Lille, France
| | - Christian Lavigne
- Internal Medicine Department, Angers University Hospital, Angers, France
| | - Ludovic Trefond
- Internal Medicine Department, Clermont-Ferrand University Hospital, Clermont-Ferrand, France
| | - Perrine Smets
- Internal Medicine Department, Clermont-Ferrand University Hospital, Clermont-Ferrand, France
| | - Quentin Bodard
- Internal medicine and Infectious Diseases Department, Departmental Hospital Centre, Angoulême, France
| | - Marion Fenot
- Dermatology Department, Departmental Hospital Centre, La Roche Sur Yon, France
| | - Christophe Richez
- University Bordeaux, CNRS, ImmunoConcEpT, UMR 5164, and CHU of Bordeaux, Department of Rheumatology, F-33000 Bordeaux, France
| | - Pierre Duffau
- University Bordeaux, CHU Bordeaux, Department of internal medicine, Bordeaux, France
| | - Constance Guillaud
- Internal Medicine Department, Henri Mondor University Hospital, Créteil, France
| | - Olivier Espitia
- Department of internal medicine, Nantes Université, CHU Nantes, Nantes F-44000, France; L'institut du thorax, INSERM UMR1087/CNRS UMR 6291, Team III Vascular & Pulmonary diseases, F-44000 Nantes, France
| | - Christian Agard
- Department of internal medicine, Nantes Université, CHU Nantes, Nantes F-44000, France.
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Trefond L, Guy L, Darcha C, Gallon A, Thomas-Monier R, Berdugo K, Smets P, Olagne L, Stievenart J, Fayard D, Cathebras P, Aumaitre O, Boyer L, Andre M, Kahn JE. Efficacy of mepolizumab for the treatment of eosinophilic cystitis: a report of two cases. J Investig Allergol Clin Immunol 2023; 34:0. [PMID: 37850410 DOI: 10.18176/jiaci.0954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2023] Open
Affiliation(s)
- L Trefond
- Service de Médecine Interne, CHU Gabriel Montpied, 63000 Clermont-Ferrand, France
- Université Clermont Auvergne, Inserm U1071, M2iSH, USC-INRA 1382, 63000 Clermont-Ferrand, France
| | - L Guy
- Service d'Urologie, CHU Gabriel Montpied, 63000 Clermont-Ferrand, France
| | - C Darcha
- Service d'Anatomopathologie, CHU Estaing, Clermont Ferrand, France
| | - A Gallon
- Service de Radiologie, CHU Gabriel Montpied, 63000 Clermont-Ferrand, France
| | - R Thomas-Monier
- Service de Radiologie, CHU Gabriel Montpied, 63000 Clermont-Ferrand, France
| | - K Berdugo
- Service de Médecine Interne, CHU de Saint-Étienne, France
| | - P Smets
- Service de Médecine Interne, CHU Gabriel Montpied, 63000 Clermont-Ferrand, France
| | - L Olagne
- Service de Médecine Interne, CHU Gabriel Montpied, 63000 Clermont-Ferrand, France
| | - J Stievenart
- Service de Médecine Interne, CHU Gabriel Montpied, 63000 Clermont-Ferrand, France
| | - D Fayard
- Service de Médecine Interne, CHU Gabriel Montpied, 63000 Clermont-Ferrand, France
| | - P Cathebras
- Service de Médecine Interne, CHU de Saint-Étienne, France
| | - O Aumaitre
- Service de Médecine Interne, CHU Gabriel Montpied, 63000 Clermont-Ferrand, France
- Université Clermont Auvergne, Inserm U1071, M2iSH, USC-INRA 1382, 63000 Clermont-Ferrand, France
| | - L Boyer
- Service de Radiologie, CHU Gabriel Montpied, 63000 Clermont-Ferrand, France
| | - M Andre
- Service de Médecine Interne, CHU Gabriel Montpied, 63000 Clermont-Ferrand, France
- Université Clermont Auvergne, Inserm U1071, M2iSH, USC-INRA 1382, 63000 Clermont-Ferrand, France
| | - J E Kahn
- National Reference Center for Hypereosinophilic Syndromes, CEREO, France; Université Paris-Saclay, Assistance Publique - Hôpitaux de Paris, Department of Internal Medicine, Ambroise Paré Hospital, F-92100 Boulogne-Billancourt, France
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Rohmer J, Nguyen Y, Trefond L, Agard C, Allain JS, Berezne A, Charles P, Cohen P, Gondran G, Groh M, Huscenot T, Lacout C, Lazaro E, London J, Maurier F, Mekinian A, Mesbah R, Nubourgh I, Perard L, Puéchal X, Pugnet G, Puyade M, Queyrel V, Roux A, Rouzaud D, Durel CA, Guillevin L, Terrier B. Clinical features and long-term outcomes of patients with systemic polyarteritis nodosa diagnosed since 2005: Data from 196 patients. J Autoimmun 2023; 139:103093. [PMID: 37536165 DOI: 10.1016/j.jaut.2023.103093] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Revised: 06/19/2023] [Accepted: 07/11/2023] [Indexed: 08/05/2023]
Abstract
BACKGROUND The landscape of polyarteritis nodosa (PAN) has substantially changed during the last decades. Recent data regarding causes, characteristics, and prognosis of systemic PAN in the modern era are lacking. METHODS This retrospective study included patients with systemic PAN referred to the French Vasculitis Study Group between 2005 and 2019. Characteristics, associated conditions and outcomes were collected, and predictors of relapse and death were analyzed. RESULTS 196 patients were included. Main clinical symptoms were constitutional (84%), neurological (59%), skin (58%) and musculoskeletal (58%) manifestations. Secondary PAN accounted for 55 (28%) patients, including myelodysplastic syndrome (9%), solid cancer (7%), lymphoma (4%) and autoinflammatory diseases (4%). No patient had active HBV infection. All treated patients (98.5%) received glucocorticoids (GCs), alone (41%) or in combination with immunosuppressants (59%), with remission achieved in 90%. Relapses were independently associated with age >65 years (HR 1.85; 95% CI1.12-3.08), gastrointestinal involvement (1.95; 95% CI1.09-3.52) and skin necrotic lesions (HR 1.95; 95%CI 1.24-3.05). One-, 5- and 10-year overall survival rates were 93%, 87% and 81%, respectively. In multivariate analyses, age >65 years (HR 2.80; 95%CI 1.23-6.37), necrotic purpura (HR 4.16; 95%CI 1.62-10.70), acute kidney injury (HR 4.89; 95% 1.71-13.99) and secondary PAN (HR 2.98; 95%CI 1.29-6.85) were independently associated with mortality. CONCLUSION Landscape of PAN has changed during the last decades, with the disappearance of HBV-PAN and the emergence of secondary PAN. Relapse rate remains high, especially in aged patients with gastrointestinal and cutaneous necrosis, as well as mortality.
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Affiliation(s)
- Julien Rohmer
- Department of Internal Medicine, Hôpital Cochin, AP-HP.Centre, Université Paris Cité, Paris, France
| | - Yann Nguyen
- Department of Internal Medicine, Hôpital Cochin, AP-HP.Centre, Université Paris Cité, Paris, France; Autoimmunity Team, Immunology of Viral Infections and Autoimmune Diseases, INSERM U1184, Université Paris Saclay, Le Kremlin-Bicêtre, France
| | - Ludovic Trefond
- Department of Internal Medicine, CHU, Clermont Ferrand, France
| | - Christian Agard
- Nantes Université, CHU Nantes, Service de médecine interne, F-44000, Nantes, France
| | | | - Alice Berezne
- Department of Internal Medicine, CH, Annecy, Genevois, France
| | - Pierre Charles
- Department of Internal Medicine, Institut Mutualiste Montsouris, Paris, France
| | - Pascal Cohen
- Department of Internal Medicine, Hôpital Cochin, AP-HP.Centre, Université Paris Cité, Paris, France
| | - Guillaume Gondran
- Department of Internal Medicine and dermatology, CHU, Limoges, France
| | - Matthieu Groh
- Department of Internal Medicine, National Reference Center for Hypereosinophilic Syndromes, Foch Hospital, Suresnes, France; University of Lille, INSERM U1286 - INFINITE - Institute for Translational Research in Inflammation, Lille, France
| | - Tessa Huscenot
- Department of Internal Medicine, Hôpital Ambroise Parée, Paris, France
| | - Carole Lacout
- Department of Internal Medicine and Clinical Immunology, CHU, Angers, France
| | - Estibaliz Lazaro
- Department of Internal Medicine, Hôpital Haut Leveque, CHU, Bordeaux, France
| | - Jonathan London
- Department of Internal Medicine, Hôpital de la Croix Saint Simon, Paris, France
| | | | - Arsène Mekinian
- Department of Internal Medicine, Hôpital Saint Antoine, AP-HP, Sorbonne Université, Paris, France
| | - Rafik Mesbah
- Department of Internal Medicine, CH, de Boulogne sur Mer, France
| | - Isabelle Nubourgh
- Department of Internal Medicine, Université libre de Bruxelles, Belgique
| | - Laurent Perard
- Department of Internal Medicine, Hôpital Saint Joseph Saint Luc, Lyon, France
| | - Xavier Puéchal
- Department of Internal Medicine, Hôpital Cochin, AP-HP.Centre, Université Paris Cité, Paris, France
| | - Gregory Pugnet
- Department of Internal Medicine and clinical immunology, CHU, Toulouse, France
| | | | | | - Arthur Roux
- Department of Nephrology, HEGP, Paris, France
| | - Diane Rouzaud
- Department of Internal Medicine, Hôpital Bichat, Paris, France
| | | | - Loïc Guillevin
- Department of Internal Medicine, Hôpital Cochin, AP-HP.Centre, Université Paris Cité, Paris, France
| | - Benjamin Terrier
- Department of Internal Medicine, Hôpital Cochin, AP-HP.Centre, Université Paris Cité, Paris, France; University Paris-Cité, F-75006, Paris, France.
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Trefond L, Billard E, Pereira B, Richard D, Vazeille E, Bonnet R, Barnich N, Andre M. Host-microbiota relationship in the pathophysiology of aseptic abscess syndrome: protocol for a multicentre case-control study (ABSCESSBIOT). BMJ Open 2023; 13:e073776. [PMID: 37541750 PMCID: PMC10407381 DOI: 10.1136/bmjopen-2023-073776] [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: 03/16/2023] [Accepted: 07/13/2023] [Indexed: 08/06/2023] Open
Abstract
INTRODUCTION Aseptic abscess (AA) syndrome is a rare disease whose pathophysiology is unknown. It is often associated with inflammatory bowel disease and characterised by sterile inflammation with collections of neutrophils affecting several organs, especially the spleen. Microbiota are known to influence local and systemic immune responses, and both gut and oral microbiota perturbations have been reported in diseases associated with AA syndrome. However, interactions between these factors have never been studied in AA syndrome. The purpose of this translational case-control study (ABSCESSBIOT) is to investigate gut and/or oral microbiota in patients with AA syndrome compared with healthy controls. Moreover, microbiota associated metabolites quantification and Treg/Th17 balance characterisation will give a mechanistic insight on how microbiota may be involved in the pathophysiology of AA syndrome. METHODS AND ANALYSIS This French multicentre case-control study including 30 French centres (University hospital or regional hospital) aims to prospectively enrol 30 patients with AA syndrome with 30 matched controls and to analyse microbiota profiling (in stools and saliva), microbial metabolites quantification in stools and circulating CD4+ T cell populations. ETHICS AND DISSEMINATION This study protocol was reviewed and approved by an independent French regional review board (n° 2017-A03499-44, Comité de Protection des Personnes Ile de France 1) on 10 October 2022, and declared to the competent French authority (Agence Nationale de Sécurité du Médicament et des produits de santé, France). Oral and written informed consent will be obtained from each included patient and the control participant. Study results will be reported to the scientific community at conferences and in peer-reviewed scientific journals. TRIAL REGISTRATION NUMBER Clinical Trials web-based platform (NCT05537909).
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Affiliation(s)
- Ludovic Trefond
- Inserm U1071, M2iSH, USC-INRA 1382, Université Clermont Auvergne, Clermont-Ferrand, Auvergne-Rhône-Alpes, France
- Médecine Interne, CHU Gabriel Montpied, CHU Clermont-Ferrand, Clermont-Ferrand, France
| | - Elisabeth Billard
- Inserm U1071, M2iSH, USC-INRA 1382, Université Clermont Auvergne, Clermont-Ferrand, Auvergne-Rhône-Alpes, France
| | - Bruno Pereira
- Biostatistics Unit (DRCI), CHU Clermont-Ferrand, Clermont-Ferrand, France
| | - Damien Richard
- Service de Pharmacologie médicale, CHU Clermont-Ferrand, Clermont-Ferrand, France
| | - Emilie Vazeille
- Inserm U1071, M2iSH, USC-INRA 1382, Université Clermont Auvergne, Clermont-Ferrand, Auvergne-Rhône-Alpes, France
| | - Richard Bonnet
- Inserm U1071, M2iSH, USC-INRA 1382, Université Clermont Auvergne, Clermont-Ferrand, Auvergne-Rhône-Alpes, France
- Laboratoire de Bactériologie, CHU Clermont-Ferrand, Clermont-Ferrand, France
| | - Nicolas Barnich
- Inserm U1071, M2iSH, USC-INRA 1382, Université Clermont Auvergne, Clermont-Ferrand, Auvergne-Rhône-Alpes, France
| | - Marc Andre
- Inserm U1071, M2iSH, USC-INRA 1382, Université Clermont Auvergne, Clermont-Ferrand, Auvergne-Rhône-Alpes, France
- Médecine Interne, CHU Gabriel Montpied, CHU Clermont-Ferrand, Clermont-Ferrand, France
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Poirot-Seynaeve X, Smets P, Pereira B, Olagne L, Stievenart J, Sapin V, Aumaitre O, Andre M, Trefond L. Interest of Procalcitonin in ANCA Vasculitides for Differentiation between Flare and Infections. Int J Mol Sci 2023; 24:ijms24065557. [PMID: 36982631 PMCID: PMC10052072 DOI: 10.3390/ijms24065557] [Citation(s) in RCA: 1] [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] [Received: 01/30/2023] [Revised: 02/26/2023] [Accepted: 03/08/2023] [Indexed: 03/17/2023] Open
Abstract
Procalcitonin (PCT) was established as a biomarker to discriminate bacterial infections from other proinflammatory conditions. Our objective was to determine whether PCT is effective in differentiating infection from antineutrophil-cytoplasmic-antibody (ANCA)-associated vasculitides (AAV) flare. In this retrospective, case-control study, PCT and other inflammatory biomarkers of patients with AAV relapse (relapsing group) were compared to infected AAV patients (infected group). In our population of 74 patients with AAV, PCT was significantly higher in the infected group than in the relapsing group (0.2 µg/L [0.08; 0.935] vs. 0.09 µg/L [0.05; 0.2], p < 0.001). Sensitivity and specificity were 53.4% and 73.6%, respectively, for an ideal threshold of 0.2 µg/L. C-reactive protein (CRP) was significantly higher in cases of infection than in relapse (64.7 mg/L [25; 131] vs. 31.5 mg/L, [10.6; 120], p = 0.001). Sensitivity and specificity for infections were 94.2% and 11.3%, respectively. Fibrinogen, white blood cell count, eosinophil count, and neutrophil count were not significantly different. In the multivariate analysis, the relative risk of infection was 2 [1.02; 4.5] (p = 0.04) for a PCT above 0.2 µg/L. In AAV, PCT may be useful for discriminating between infections and flare in patients suffering from AAVs.
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Affiliation(s)
- Xavier Poirot-Seynaeve
- Médecine Interne, CHU Gabriel Montpied, 63000 Clermont-Ferrand, France
- Correspondence: (X.P.-S.); (L.T.)
| | - Perrine Smets
- Médecine Interne, CHU Gabriel Montpied, 63000 Clermont-Ferrand, France
| | - Bruno Pereira
- Biostatistics Unit (DRCI), University Hospital Clermont-Ferrand, 63000 Clermont-Ferrand, France
| | - Louis Olagne
- Médecine Interne, CHU Gabriel Montpied, 63000 Clermont-Ferrand, France
| | - Julien Stievenart
- Médecine Interne, CHU Gabriel Montpied, 63000 Clermont-Ferrand, France
| | - Vincent Sapin
- Biochemisty and Molecular Genetic Department, Biology Center, University Hospital Clermont-Ferrand, 63000 Clermont-Ferrand, France
| | - Olivier Aumaitre
- Médecine Interne, CHU Gabriel Montpied, 63000 Clermont-Ferrand, France
- M2iSH, UMR 1071 Inserm, INRA USC 2018, University of Clermont Auvergne, 63000 Clermont-Ferrand, France
| | - Marc Andre
- Médecine Interne, CHU Gabriel Montpied, 63000 Clermont-Ferrand, France
- M2iSH, UMR 1071 Inserm, INRA USC 2018, University of Clermont Auvergne, 63000 Clermont-Ferrand, France
| | - Ludovic Trefond
- Médecine Interne, CHU Gabriel Montpied, 63000 Clermont-Ferrand, France
- M2iSH, UMR 1071 Inserm, INRA USC 2018, University of Clermont Auvergne, 63000 Clermont-Ferrand, France
- Correspondence: (X.P.-S.); (L.T.)
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Trefond L, Sauret A, Stievenart J, Olagne L, Guelon B, Smets P, Aumaître O, André M. Dr. Trefond et al reply: Giant Cell Arteritis After SARS-CoV-2 Vaccination-Coincidence or Trigger? J Rheumatol 2022; 49:860. [PMID: 35777823 DOI: 10.3899/jrheum.211158.c1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
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Trefond L, Frances C, Costedoat-Chalumeau N, Piette JC, Haroche J, Sailler L, Assaad S, Viallard JF, Jego P, Hot A, Connault J, Galempoix JM, Aslangul E, Limal N, Bonnet F, Faguer S, Chosidow O, Deligny C, Lifermann F, Maria ATJ, Pereira B, Aumaitre O, André M. Aseptic Abscess Syndrome: Clinical Characteristics, Associated Diseases, and up to 30 Years’ Evolution Data on a 71-Patient Series. J Clin Med 2022; 11:jcm11133669. [PMID: 35806955 PMCID: PMC9267245 DOI: 10.3390/jcm11133669] [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] [Received: 05/31/2022] [Revised: 06/13/2022] [Accepted: 06/17/2022] [Indexed: 12/05/2022] Open
Abstract
Aseptic abscess (AA) syndrome is a rare type of inflammatory disorder involving polymorphonuclear neutrophils (PMNs), often associated with inflammatory bowel disease (IBD). This study sought to describe the clinical characteristics and evolution of this syndrome in a large cohort. We included all patients included in the French AA syndrome register from 1999 to 2020. All patients fulfilled the criteria outlined by André et al. in 2007. Seventy-one patients were included, 37 of which were men (52.1%), of a mean age of 34.5 ± 17 years. The abscesses were located in the spleen (71.8%), lymph nodes (50.7%), skin (29.5%), liver (28.1%), lung (22.5), and rarer locations (brain, genitals, kidneys, ENT, muscles, or breasts). Of all the patients, 59% presented with an associated disease, primarily IBD (42%). They were treated with colchicine (28.1%), corticosteroids (85.9%), immunosuppressants (61.9%), and biologics (32.3%). A relapse was observed in 62% of cases, mostly in the same organ. Upon multivariate analysis, factors associated with the risk of relapse were: prescription of colchicine (HR 0.52; 95% CI [0.28–0.97]; p = 0.042), associated IBD (HR 0.57; 95% CI [0.32–0.99]; p = 0.047), and hepatic or skin abscesses at diagnosis (HR 2.14; 95% CI [1.35–3.40]; p = 0.001 and HR 1.78; 95% CI [1.07–2.93]; p = 0.024, respectively). No deaths occurred related to this disease. This large retrospective cohort study with long follow up showed that AA syndrome is a relapsing systemic disease that can evolve on its own or be the precursor of an underlying disease, such as IBD. Of all the available treatments, colchicine appeared to be protective against relapse.
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Affiliation(s)
- Ludovic Trefond
- Médecine Interne, CHU Gabriel Montpied, 63000 Clermont-Ferrand, France; (O.A.); (M.A.)
- M2iSH, UMR 1071 Inserm, INRA USC 2018, University of Clermont Auvergne, 63000 Clermont-Ferrand, France
- Correspondence:
| | - Camille Frances
- Faculté de Médecine, AP-HP, Service de Dermatologie et Allergologie, Hôpital Tenon, Sorbonne Université, 75252 Paris, France;
| | - Nathalie Costedoat-Chalumeau
- APHP, Service de Médecine Interne, Centre de Référence des Maladies Auto-Immunes Systémiques Rares d’Ile de France, Hôpital Cochin, 27 rue du Faubourg St-Jacques, CEDEX 14, 75679 Paris, France;
- INSERM U 1153, Centre of Research in Epidemiology and Statistics Sorbonne Paris Cité (CRESS), Université de Paris, 75006 Paris, France
| | - Jean-Charles Piette
- Service de Médecine Interne, AP-HP Groupe Hospitalier Pitié-Salpêtrière, 75013 Paris, France;
| | - Julien Haroche
- Assistance Publique–Hôpitaux de Paris (AP-HP), Groupement Hospitalier Pitié–Salpêtrière (GHPS), French National Reference Center for Systemic Lupus Erythematosus, Antiphospholipid Antibody Syndrome and Other Autoimmune Disorders, Service de Médecine Interne 2, Institut E3M, Sorbonne Université, 75252 Paris, France;
| | - Laurent Sailler
- Internal Medicine Department, CHU de Toulouse—Hôpital Purpan, 31300 Toulouse, France;
| | | | - Jean-François Viallard
- Hôpital Haut-Lévêque, CHU de Bordeaux, Service de Médecine Interne et Maladies Infectieuses, Université de BORDEAUX, 5 Avenue de Magellan, 33604 Pessac, France;
| | - Patrick Jego
- Irset (Institut de Recherche en Santé, Environnement et Travail)-UMR_S 1085, Inserm, EHESP, University of Rennes, 35000 Rennes, France;
- Department of Internal Medicine, Rennes University Hospital, 35203 Rennes, France
| | - Arnaud Hot
- Service de Médecine Interne, Hôpital Edouard Herriot, Hospices Civils de Lyon, 69437 Lyon, France;
| | - Jerome Connault
- Department of Internal and Vascular Medicine, CHU de Nantes, 44000 Nantes, France;
| | | | - Elisabeth Aslangul
- Service de Médecine Interne, Hôpital Louis-Mourier, Assistance Publique-Hôpitaux de Paris, 92701 Colombes, France;
- UPD5, Université Paris-Descartes, rue de l’École-de-Médecine, 75006 Paris, France
| | - Nicolas Limal
- Département de Médecine Interne, Hôpital Henri Mondor, APHP Université Paris-Est Créteil, 94010 Créteil, France;
| | - Fabrice Bonnet
- Department of Internal Medicine and Infectious Diseases, Bordeaux University Hospital, Saint André Hospital, 33000 Bordeaux, France;
| | - Stanislas Faguer
- Département de Néphrologie et Transplantation d’Organes, Centre de Référence des Maladies Rénales Rares, CHU de Toulouse, 31000 Toulouse, France;
| | - Olivier Chosidow
- Department of Dermatology, APHP, Hôpital Henri-Mondor, 94010 Créteil, France;
- Research Group Dynamic, EA7380, Faculté de Santé de Créteil, Ecole Nationale Vétérinaire d’Alfort, USC ANSES, Université Paris-Est Créteil, 94010 Créteil, France
| | - Christophe Deligny
- Service de Médecine Interne, CHU de Fort de France, 97200 Fort de France, France;
| | | | | | - Bruno Pereira
- Biostatistics Unit (DRCI), University Hospital Clermont-Ferrand, 63000 Clermont-Ferrand, France;
| | - Olivier Aumaitre
- Médecine Interne, CHU Gabriel Montpied, 63000 Clermont-Ferrand, France; (O.A.); (M.A.)
- M2iSH, UMR 1071 Inserm, INRA USC 2018, University of Clermont Auvergne, 63000 Clermont-Ferrand, France
| | - Marc André
- Médecine Interne, CHU Gabriel Montpied, 63000 Clermont-Ferrand, France; (O.A.); (M.A.)
- M2iSH, UMR 1071 Inserm, INRA USC 2018, University of Clermont Auvergne, 63000 Clermont-Ferrand, France
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Fevre N, Smets P, Trefond L, Stievenart J, Rambaud E, Fayard D, Andre M. Artérite à cellules géantes survenant après une maladie de Takayasu : un nouvel argument pour rapprocher les 2 vascularites ? Rev Med Interne 2022. [DOI: 10.1016/j.revmed.2022.03.196] [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: 11/28/2022]
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Berdugo K, Radulescu C, Groh M, Peycelon M, Ciofu C, Clermidi P, Trefond L, Lefèvre G, Lanz C, Yonneau L, Aigrain Y, Chabaud M, Grapin C, Cathébras P, Chartier Kastler E, Berrebi D, Panel K, Kahn J. Cystite à éosinophiles idiopathique : analyse des caractéristiques cliniques, radiologiques, évolutives et de la réponse thérapeutique. Rev Med Interne 2022. [DOI: 10.1016/j.revmed.2022.03.250] [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: 11/24/2022]
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Machado PM, Lawson-Tovey S, Strangfeld A, Mateus EF, Hyrich KL, Gossec L, Carmona L, Rodrigues A, Raffeiner B, Duarte C, Hachulla E, Veillard E, Strakova E, Burmester GR, Yardımcı GK, Gomez-Puerta JA, Zepa J, Kearsley-Fleet L, Trefond L, Cunha M, Mosca M, Cornalba M, Soubrier M, Roux N, Brocq O, Durez P, Conway R, Goulenok T, Bijlsma JW, McInnes IB, Mariette X. Safety of vaccination against SARS-CoV-2 in people with rheumatic and musculoskeletal diseases: results from the EULAR Coronavirus Vaccine (COVAX) physician-reported registry. Ann Rheum Dis 2022; 81:695-709. [PMID: 34972811 PMCID: PMC8720639 DOI: 10.1136/annrheumdis-2021-221490] [Citation(s) in RCA: 107] [Impact Index Per Article: 53.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Accepted: 12/08/2021] [Indexed: 02/06/2023]
Abstract
OBJECTIVES To describe the safety of vaccines against SARS-CoV-2 in people with inflammatory/autoimmune rheumatic and musculoskeletal disease (I-RMD). METHODS Physician-reported registry of I-RMD and non-inflammatory RMD (NI-RMDs) patients vaccinated against SARS-CoV-2. From 5 February 2021 to 27 July 2021, we collected data on demographics, vaccination, RMD diagnosis, disease activity, immunomodulatory/immunosuppressive treatments, flares, adverse events (AEs) and SARS-CoV-2 breakthrough infections. Data were analysed descriptively. RESULTS The study included 5121 participants from 30 countries, 90% with I-RMDs (n=4604, 68% female, mean age 60.5 years) and 10% with NI-RMDs (n=517, 77% female, mean age 71.4). Inflammatory joint diseases (58%), connective tissue diseases (18%) and vasculitis (12%) were the most frequent diagnostic groups; 54% received conventional synthetic disease-modifying antirheumatic drugs (DMARDs), 42% biological DMARDs and 35% immunosuppressants. Most patients received the Pfizer/BioNTech vaccine (70%), 17% AstraZeneca/Oxford and 8% Moderna. In fully vaccinated cases, breakthrough infections were reported in 0.7% of I-RMD patients and 1.1% of NI-RMD patients. I-RMD flares were reported in 4.4% of cases (0.6% severe), 1.5% resulting in medication changes. AEs were reported in 37% of cases (37% I-RMD, 40% NI-RMD), serious AEs in 0.5% (0.4% I-RMD, 1.9% NI-RMD). CONCLUSION The safety profiles of SARS-CoV-2 vaccines in patients with I-RMD was reassuring and comparable with patients with NI-RMDs. The majority of patients tolerated their vaccination well with rare reports of I-RMD flare and very rare reports of serious AEs. These findings should provide reassurance to rheumatologists and vaccine recipients and promote confidence in SARS-CoV-2 vaccine safety in I-RMD patients.
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Affiliation(s)
- Pedro M Machado
- Centre for Rheumatology & Department of Neuromuscular Diseases, University College London (UCL), London, UK
- National Institute for Health Research (NIHR) University College London Hospitals Biomedical Research Centre, University College London Hospitals NHS Foundation Trust, London, UK
- Department of Rheumatology, Northwick Park Hospital, London North West University Healthcare NHS Trust, London, UK
| | - Saskia Lawson-Tovey
- Centre for Genetics and Genomics Versus Arthritis, Centre for Musculoskeletal Research, University of Manchester, Manchester, UK
- National Institute for Health Research (NIHR) Manchester Biomedical Research Centre, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
| | - Anja Strangfeld
- Epidemiology and Health Care Research, German Rheumatism Research Center (DRFZ Berlin), Berlin, Germany
| | - Elsa F Mateus
- People with Arthritis/Rheumatism in Europe (PARE), European Alliance of Associations for Rheumatology (EULAR), Kilchberg, Switzerland
- Portuguese League Against Rheumatic Diseases (LPCDR), Lisbon, Portugal
| | - Kimme L Hyrich
- Centre for Genetics and Genomics Versus Arthritis, Centre for Musculoskeletal Research, University of Manchester, Manchester, UK
- National Institute for Health Research (NIHR) Manchester Biomedical Research Centre, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
| | - Laure Gossec
- Institut Pierre Louis d'Epidémiologie et de Santé Publique, INSERM, Sorbonne Université, Paris, France
- Department of Rheumatology, Pitié-Salpêtrière hospital, AP-HP, Paris, France
| | | | - Ana Rodrigues
- Reuma.pt, Sociedade Portuguesa de Reumatologia, Lisbon, Portugal
- EpiDoC unit, CEDOC, Nova Medical School, Lisbon, Portugal
- Rheumatology Unit, Hospital dos Lusíadas, Lisbon, Portugal
| | - Bernd Raffeiner
- Department of Rheumatology, Central Hospital of Bolzano, Bolzano, Italy
| | - Catia Duarte
- Reuma.pt, Sociedade Portuguesa de Reumatologia, Lisbon, Portugal
- Department of Rheumatology, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
- Coimbra Institute for Clinical and Biomedical Research, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Eric Hachulla
- Département de Médecine Interne et Immunologie Clinique, CHU Lille, Referral Center for Rare Systemic Autoimmune Diseases North and Northwest of France, INSERM U995, Lille Inflammation Research International Center (LIRIC), University of Lille, Lille, France
| | - Eric Veillard
- Cabinet de Rhumatologie des "Marines de Chasles", Saint Malo, France
| | - Eva Strakova
- Department of Internal Medicine, Faculty Hospital Prešov, Prešov, Slovakia
| | - Gerd R Burmester
- Department of Rheumatology and Clinical Immunology, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Gözde Kübra Yardımcı
- Division of Rheumatology, Department of Internal Medicine, Hacettepe University School of Medicine, Ankara, Turkey
| | - Jose A Gomez-Puerta
- Department of Rheumaology, Hospital Clinic, Barcelona, Spain
- University of Barcelona, Barcelona, Spain
| | - Julija Zepa
- Pauls Stradins Clinical University Hospital, Riga, Latvia
- Riga Stradins University, Riga, Latvia
| | - Lianne Kearsley-Fleet
- Centre for Epidemiology Versus Arthritis, Centre for Musculoskeletal Research, University of Manchester, Manchester, UK
| | - Ludovic Trefond
- Université Clermont Auvergne, CHU Clermont-Ferrand, Service de Médecine Interne, Hôpital Gabriel Montpied, INSERM U1071, Clermont-Ferrand, France
| | - Maria Cunha
- Reuma.pt, Sociedade Portuguesa de Reumatologia, Lisbon, Portugal
- Hospital Garcia de Orta EPE, Almada, Setúbal, Portugal
| | - Marta Mosca
- University of Pisa and Azienda Ospedaliero Universitaria Pisana, Pisa, Italy
| | - Martina Cornalba
- Dipartimento di Reumatologia e Scienze Mediche, ASST Gaetano Pini-CTO, Milan, Italy
| | - Martin Soubrier
- Department of Rheumatology, CHU Clermont-Ferrand, Hopital Gabriel Montpied, Clermont-Ferrand, France
| | - Nicolas Roux
- Service de Rhumatologie, Hôpital Robert Schuman, Metz, France
| | - Olivier Brocq
- Department of Rheumatology, Princess Grace Hospital, Monaco
| | | | - Richard Conway
- Department of Rheumatology, St. James's Hospital, Dublin, Ireland
| | - Tiphaine Goulenok
- Service de Médecine Interne, Hôpital Bichat-Claude Bernard, Assistance Publique Hôpitaux de Paris, Université de Paris, Paris, France
| | - Johannes Wj Bijlsma
- Department of Rheumatology and Clinical Immunology, University Medical Center Utrecht, Utrecht, Netherlands
| | - Iain B McInnes
- Institute of Infection, Immunity and Inflammation, University of Glasgow, Glasgow, UK
| | - Xavier Mariette
- Department of Rheumatology, Université Paris-Saclay, Assistance Publique-Hôpitaux de Paris, Hôpital Bicêtre, INSERM UMR1184, Le Kremlin Bicêtre, Paris, France
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Machado PM, Lawson-Tovey S, Strangfeld A, Mateus E, Hyrich K, Gossec L, Carmona L, Rodrigues A, Raffeiner B, Duarte C, Hachulla E, Veillard E, Strakova E, Burmester GR, Yardimci GK, Gómez-Puerta JA, Zepa J, Kearsley-Fleet L, Trefond L, Cunha MM, Mosca M, Cornalba M, Soubrier M, Roux N, Brocq O, Durez P, Conway R, Goulenok T, Bijlsma JWJ, McInnes I, Mariette X. OA01 Safety of vaccination against SARS-CoV-2 in people with rheumatic and musculoskeletal diseases: results from the EULAR Coronavirus Vaccine (COVAX) physician-reported registry. Rheumatology (Oxford) 2022. [PMCID: PMC9383807 DOI: 10.1093/rheumatology/keac132] [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: 12/03/2022] Open
Abstract
Background/Aims People with inflammatory/autoimmune rheumatic and musculoskeletal diseases (I-RMDs) were excluded from Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) vaccine clinical development programmes; therefore, concerns regarding the safety and effectiveness of SARS-CoV-2 vaccines in this population still exist. Previous studies in people with I-RMDs were small albeit reassuring in terms of the incidence of I-RMD flares and adverse events. Our aim was to describe the safety of vaccines against SARS-CoV-2 in people with I-RMD. Methods Physician-reported registry of I-RMD and non-inflammatory RMD (NI-RMDs) patients vaccinated against SARS-CoV-2. From 5/Feb/2021 to 27/Jul/2021, we collected data on demographics, vaccination, RMD diagnosis, disease activity, immunomodulatory/immunosuppressive treatments, flares, adverse events (AEs) and SARS-CoV-2 breakthrough infections. Data were analysed descriptively. Results The study included 5121 participants from 30 countries, 90% with I-RMDs (n = 4604, 68% female, mean age 60.5 years) and 10% with NI-RMDs (n = 517, 77% female, mean age 71.4). Inflammatory joint diseases (58%), connective tissue diseases (18%) and vasculitis (12%) were the most frequent diagnostic groups; 54% received conventional synthetic disease-modifying anti-rheumatic drugs (DMARDs), 42% biologic DMARDs and 35% immunosuppressants. Most patients received the Pfizer/BioNTech vaccine (70%), 17% AstraZeneca/Oxford and 8% Moderna. In fully vaccinated cases, breakthrough infections were reported in 0.7% of I-RMD patients and 1.1% of NI-RMD patients. I-RMD flares were reported in 4.4% of cases (0.6% severe), 1.5% resulting in medication changes. AEs were reported in 37% of cases (37% I-RMD, 40% NI-RMD), serious AEs in 0.5% (0.4% I-RMD, 1.9% NI-RMD). Conclusion The safety profiles of SARS-CoV-2 vaccines in patients with I-RMD were reassuring, and comparable to patients with NI-RMDs. The majority of patients tolerated their vaccination well with rare reports of I-RMD flare and very rare reports of serious AEs. These findings should provide reassurance to rheumatologists and vaccine recipients, and promote confidence in SARS-CoV-2 vaccine safety in I-RMD patients. Disclosure P.M. Machado: None. S. Lawson-Tovey: None. A. Strangfeld: None. E. Mateus: None. K. Hyrich: None. L. Gossec: None. L. Carmona: None. A. Rodrigues: None. B. Raffeiner: None. C. Duarte: None. E. Hachulla: None. E. Veillard: None. E. Strakova: None. G.R. Burmester: None. G.K. Yardimci: None. J.A. Gómez-Puerta: None. J. Zepa: None. L. Kearsley-Fleet: None. L. Trefond: None. M.M. Cunha: None. M. Mosca: None. M. Cornalba: None. M. Soubrier: None. N. Roux: None. O. Brocq: None. P. Durez: None. R. Conway: None. T. Goulenok: None. J.W.J. Bijlsma: None. I. McInnes: None. X. Mariette: None.
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Affiliation(s)
- Pedro M Machado
- Centre for Rheumatology, University College London, London, UNITED KINGDOM
| | - Saskia Lawson-Tovey
- Centre for Genetics and Genomics Versus Arthritis, University of Manchester, Manchester, UNITED KINGDOM
| | - Anja Strangfeld
- Epidemiology Unit, German Rheumatism Research Center, Berlin, GERMANY
| | - Elsa Mateus
- Portuguese League Against Rheumatic Diseases, European Alliance of Associations for Rheumatology (EULAR), Lisbon, PORTUGAL
| | - Kimme Hyrich
- Centre for Epidemiology Versus Arthritis, The University of Manchester, Manchester, UNITED KINGDOM
| | - Laure Gossec
- Institut Pierre Louis d'Epidémiologie et de Santé Publique, Sorbonne Université, Paris, FRANCE
| | - Loreto Carmona
- Instituto de Salud Musculoesquelética, InMusc, Madrid, SPAIN
| | - Ana Rodrigues
- Reuma.pt, Sociedade Portuguesa de Reumatologia, Lisbon, PORTUGAL
| | - Bernd Raffeiner
- Department of Rheumatology, Central Hospital of Bolzano, Bolzano, ITALY
| | - Cátia Duarte
- Reuma.pt, Sociedade Portuguesa de Reumatologia, Lisbon, PORTUGAL
| | - Eric Hachulla
- Service de Médecine Interne et Immunologie Clinique, University of Lille, Lille, FRANCE
| | - Eric Veillard
- Cabinet de Rhumatologie, Marines de Chasles, Saint Malo, FRANCE
| | - Eva Strakova
- Department of Internal Medicine, Faculty Hospital Prešov, Prešov, SLOVAKIA
| | - Gerd R Burmester
- Department of Rheumatology and Clinical Immunology, Charité, Berlin, GERMANY
| | - Gozde K Yardimci
- Division of Rheumatology, Hacettepe University School of Medicine, Ankara, TURKEY
| | | | - Julija Zepa
- Rheumatology Department, Pauls Stradins Clinical University Hospital, Riga, LATVIA
| | - Lianne Kearsley-Fleet
- Centre for Epidemiology Versus Arthritis, University of Manchester, Manchester, UNITED KINGDOM
| | - Ludovic Trefond
- Service de Médecine Interne, Université Clermont Auvergne, Clermont-Ferrand, FRANCE
| | - Maria M Cunha
- Reuma.pt, Sociedade Portuguesa de Reumatologia, Lisbon, PORTUGAL
| | - Marta Mosca
- Department of Rheumatology, University of Pisa and Azienda Ospedaliero Universitaria Pisana, Pisa, ITALY
| | - Martina Cornalba
- Dipartimento di Reumatologia e Scienze Mediche, ASST Gaetano Pini - CTO, Milan, ITALY
| | - Martin Soubrier
- Service de Rhumatologie, Hopital Gabriel Montpied, Clermont-Ferrand, FRANCE
| | - Nicolas Roux
- Service de Rhumatologie, Hôpital Robert Schuman, Metz, FRANCE
| | - Olivier Brocq
- Rheumatology Department, Princess Grace Hospital, Monaco, MONACO
| | - Patrick Durez
- Centre for Rheumatology, SINT LUC, Brussels, BELGIUM
| | - Richard Conway
- Department of Rheumatology, St. James’s Hospital, Dublin, IRELAND
| | - Tiphaine Goulenok
- Service de Médecine Interne, Hôpital Bichat-Claude Bernard, Paris, FRANCE
| | - Johannes W. J Bijlsma
- Department of Rheumatology and Clinical Immunology, University Medical Center Utrecht, Utrecht, NETHERLANDS
| | - Iain McInnes
- Institute of Infection, Immunity and Inflammation, University of Glasgow, Glasgow, UNITED KINGDOM
| | - Xavier Mariette
- Department of Rheumatology, Université Paris-Saclay, Paris, FRANCE
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Trefond L, Sauret A, Stievenart J, Olagne L, Guelon B, Smets P, Aumaître O, André M. Dr. Trefond et al reply. J Rheumatol 2022; 49:964. [DOI: 10.3899/jrheum.211158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
We thank Conway et al1 for their comments on our article reporting a case of giant cell arteritis (GCA) after SARS-CoV-2 vaccination.2 We agree with Conway et al1 and also emphasize the interest in SARS-CoV-2 vaccination, which had a reassuring safety profile in a cohort of 1519 patients with rheumatic and musculoskeletal diseases.3
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Trefond L, Drumez E, Andre M, Costedoat-Chalumeau N, Seror R, Devaux M, Dernis E, Dieudonne Y, El Mahou S, Lanteri A, Melki I, Queyrel V, Roumier M, Schmidt J, Barnetche T, Thomas T, Cacoub P, Belot A, Aumaitre O, Richez C, Hachulla E. Effet d’un traitement par hydroxychloroquine prescrit comme traitement de fond de rhumatismes inflammatoires chroniques ou maladies auto-immunes systémiques sur les tests diagnostiques et l’évolution de l’infection à SARS CoV-2 : étude de 871 patients ☆. Rev Rhum Ed Fr 2022; 89:192-195. [PMID: 34602813 PMCID: PMC8479511 DOI: 10.1016/j.rhum.2021.09.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Accepted: 05/11/2021] [Indexed: 11/20/2022]
Affiliation(s)
- Ludovic Trefond
- Université Clermont Auvergne, CHU Clermont-Ferrand, Service de Médecine Interne, Hôpital Gabriel Montpied, Inserm U1071, INRA USC2018, M2iSH, 63000 Clermont-Ferrand, France
| | - Elodie Drumez
- University Lille, CHU Lille, ULR 2694 - METRICS: Évaluation des technologies de santé et des pratiques médicales, 59000 Lille, France
| | - Marc Andre
- Université Clermont Auvergne, CHU Clermont-Ferrand, Service de Médecine Interne, Hôpital Gabriel Montpied, Inserm U1071, INRA USC2018, M2iSH, 63000 Clermont-Ferrand, France
| | - Nathalie Costedoat-Chalumeau
- APHP, Service de Médecine Interne, Centre de Référence des Maladies Auto-immunes Systémiques Rares d'Ile de France. Hôpital Cochin, Université de Paris; Inserm U 1153, Centre of Research in Epidemiology and Statistics Sorbonne Paris Cité (CRESS), 27, rue du Faubourg St-Jacques 75679 Paris, France
| | - Raphaèle Seror
- Université Paris-Saclay, Assistance Publique-Hôpitaux de Paris (AP-HP), Service de Rhumatologie, Centre de référence des maladies autoimmunes systémiques rares, Hôpital Bicêtre, Inserm UMR 1184, Le Kremlin-Bicêtre, France
| | - Mathilde Devaux
- Service de Médecine Interne, CHI Poissy Saint-Germain, France
| | | | - Yannick Dieudonne
- Hôpitaux Universitaires de Strasbourg, Department of Clinical Immunology and Internal Medicine, National Reference Centre for Systemic Autoimmune Diseases (CNR RESO), 67000 Strasbourg, France
| | | | | | - Isabelle Melki
- General Paediatrics, Infectious Disease and Internal Medicine Department, Hôpital Robert-Debré, AP-HP, Reference centre for Rheumatic, AutoImmune and Systemic diseases in children (RAISE), Paediatric Haematology-Immunology and Rheumatology Department, Hôpital Necker-Enfants Malades, AP-HP, Laboratory of Neurogenetics and Neuroinflammation, Imagine Institute, Paris, France
| | - Viviane Queyrel
- Service de rhumatologie/Centre de compétence des maladies auto-immunes systémiques rares, Hôpital Pasteur 2, CHU Nice, 30, avenue Voie romaine, 06000 Nice, France
| | | | - Jean Schmidt
- Université de Picardie Jules Verne, CHU Amiens, Service de Médecine Interne et RECIF, Amiens, France
| | - Thomas Barnetche
- Hôpital Pellegrin, CHU de Bordeaux, Service de Rhumatologie, Centre de référence des maladies autoimmunes systémiques rares (RESO), UMR-CNRS 5164, Université de Bordeaux, Bordeaux, France
| | - Thierry Thomas
- Department of Rheumatology, Hôpital Nord, CHU Saint-Étienne, Inserm U1059, Université de Lyon-Université Jean-Monnet, Saint-Étienne, France
| | - Patrice Cacoub
- AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Department of Internal Medicine and Clinical Immunology, Centre de Référence des Maladies Auto-Immunes et Systémiques Rares, Centre de Référence des Maladies Auto-Inflammatoires et de l'Amylose, Sorbonne Université, UPMC Univ Paris 06, UMR 7211, Inflammation-Immunopathology-Biotherapy Department (DHU i2B),INSERM, UMR S 959, CNRS, FRE3632, 75005 Paris, France
| | - Alexandre Belot
- Paediatric Rheumatology, Nephrology, Dermatology Unit, National Reference Centre for Rheumatism and Systemic Autoimmune Diseases in Children (RAISE), Hospices Civils de Lyon, France
| | - Olivier Aumaitre
- Université Clermont Auvergne, CHU Clermont-Ferrand, Service de Médecine Interne, Hôpital Gabriel Montpied, Inserm U1071, INRA USC2018, M2iSH, 63000 Clermont-Ferrand, France
| | - Christophe Richez
- Hôpital Pellegrin, CHU de Bordeaux, Service de Rhumatologie, Centre de référence des maladies autoimmunes systémiques rares (RESO), UMR-CNRS 5164, Université de Bordeaux, Bordeaux, France
| | - Eric Hachulla
- University Lille, Inserm, CHU Lille, Service de Médecine Interne et Immunologie Clinique, Centre de référence des maladies autoimmunes systémiques rares du Nord et Nord-Ouest de France (CeRAINO), U1286 - INFINITE - Institute for Translational Research in Inflammation, 59000 Lille, France
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Mariette X, Lawson-Tovey S, Hachulla E, Veillard E, Trefond L, Soubrier M, Roux N, Brocq O, Durez P, Goulenok T, Gossec L, Strakova E, Burmester G, Kübra Y, Gomez P, Zepa J, Hyrich K, Cunha M, Mosca M, Cornalba M, Mateus E, Carmona L, Rodrigues A, Raffeiner B, Conway R, Strangfeld A, Bijlsma H, McInnes I, Machado P. Tolérance de la vaccination contre le SRAS-CoV-2 chez les patients atteints de maladies rhumatologiques inflammatoires/auto-immunes : résultats du registre EULAR-COVAX chez 5121 patients. Revue du Rhumatisme 2021. [PMCID: PMC8626106 DOI: 10.1016/j.rhum.2021.10.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Sauret A, Stievenart J, Smets P, Olagne L, Guelon B, Aumaître O, André M, Trefond L. Case of Giant Cell Arteritis After SARS-CoV-2 Vaccination: A Particular Phenotype? J Rheumatol 2021; 49:120. [PMID: 34599047 DOI: 10.3899/jrheum.210724] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
We read with great interest the article by Mehta et al about the similarities and discriminators between giant cell arteritis (GCA) and the coronavirus disease 2019 (COVID-19).1 Viruses have been suspected to be implicated in the pathogenesis of GCA, especially the varicella zoster virus,2 but a clear association has not been confirmed.3.
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Affiliation(s)
- Agathe Sauret
- CHU Clermont-Ferrand, Service de Médecine Interne, Hôpital Gabriel Montpied; Université Clermont Auvergne, Inserm U1071, INRA USC2018, M2iSH, Clermont-Ferrand, France. The authors declare no conflicts of interest relevant to this article. Address correspondence Dr. L. Trefond, Médecine Interne, CHU Gabriel Montpied, 58, rue Montalembert 63000 Clermont Ferrand, France.
| | - Julien Stievenart
- CHU Clermont-Ferrand, Service de Médecine Interne, Hôpital Gabriel Montpied; Université Clermont Auvergne, Inserm U1071, INRA USC2018, M2iSH, Clermont-Ferrand, France. The authors declare no conflicts of interest relevant to this article. Address correspondence Dr. L. Trefond, Médecine Interne, CHU Gabriel Montpied, 58, rue Montalembert 63000 Clermont Ferrand, France.
| | - Perrine Smets
- CHU Clermont-Ferrand, Service de Médecine Interne, Hôpital Gabriel Montpied; Université Clermont Auvergne, Inserm U1071, INRA USC2018, M2iSH, Clermont-Ferrand, France. The authors declare no conflicts of interest relevant to this article. Address correspondence Dr. L. Trefond, Médecine Interne, CHU Gabriel Montpied, 58, rue Montalembert 63000 Clermont Ferrand, France.
| | - Louis Olagne
- CHU Clermont-Ferrand, Service de Médecine Interne, Hôpital Gabriel Montpied; Université Clermont Auvergne, Inserm U1071, INRA USC2018, M2iSH, Clermont-Ferrand, France. The authors declare no conflicts of interest relevant to this article. Address correspondence Dr. L. Trefond, Médecine Interne, CHU Gabriel Montpied, 58, rue Montalembert 63000 Clermont Ferrand, France.
| | - Benedicte Guelon
- CHU Clermont-Ferrand, Service de Médecine Interne, Hôpital Gabriel Montpied; Université Clermont Auvergne, Inserm U1071, INRA USC2018, M2iSH, Clermont-Ferrand, France. The authors declare no conflicts of interest relevant to this article. Address correspondence Dr. L. Trefond, Médecine Interne, CHU Gabriel Montpied, 58, rue Montalembert 63000 Clermont Ferrand, France.
| | - Olivier Aumaître
- CHU Clermont-Ferrand, Service de Médecine Interne, Hôpital Gabriel Montpied; Université Clermont Auvergne, Inserm U1071, INRA USC2018, M2iSH, Clermont-Ferrand, France. The authors declare no conflicts of interest relevant to this article. Address correspondence Dr. L. Trefond, Médecine Interne, CHU Gabriel Montpied, 58, rue Montalembert 63000 Clermont Ferrand, France.
| | - Marc André
- CHU Clermont-Ferrand, Service de Médecine Interne, Hôpital Gabriel Montpied; Université Clermont Auvergne, Inserm U1071, INRA USC2018, M2iSH, Clermont-Ferrand, France. The authors declare no conflicts of interest relevant to this article. Address correspondence Dr. L. Trefond, Médecine Interne, CHU Gabriel Montpied, 58, rue Montalembert 63000 Clermont Ferrand, France.
| | - Ludovic Trefond
- CHU Clermont-Ferrand, Service de Médecine Interne, Hôpital Gabriel Montpied; Université Clermont Auvergne, Inserm U1071, INRA USC2018, M2iSH, Clermont-Ferrand, France. The authors declare no conflicts of interest relevant to this article. Address correspondence Dr. L. Trefond, Médecine Interne, CHU Gabriel Montpied, 58, rue Montalembert 63000 Clermont Ferrand, France.
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Lawson-Tovey S, Hyrich KL, Gossec L, Strangfeld A, Carmona L, Raffeiner B, Yardımcı GK, Trefond L, Roux N, Rodrigues A, Papagoras C, Mateus EF, Mariette X, Machado PM. SARS-CoV-2 infection after vaccination in patients with inflammatory rheumatic and musculoskeletal diseases. Ann Rheum Dis 2021; 81:145-150. [PMID: 34489305 DOI: 10.1136/annrheumdis-2021-221217] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Accepted: 08/20/2021] [Indexed: 02/02/2023]
Affiliation(s)
- Saskia Lawson-Tovey
- Centre for Genetics and Genomics Versus Arthritis, Centre for Musculoskeletal Research, University of Manchester, Manchester, UK.,National Institute for Health Research Manchester Biomedical Research Centre, Manchester Academic Health Science Centre, Manchester, UK
| | - Kimme L Hyrich
- National Institute for Health Research Manchester Biomedical Research Centre, Manchester Academic Health Science Centre, Manchester, UK.,Centre for Epidemiology Versus Arthritis, Centre for Musculoskeletal Research, University of Manchester, Manchester, UK
| | - Laure Gossec
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Paris, France.,Rheumatology Department, Pitié-Salpêtrière Hospital, Sorbonne Université, AP-HP, Paris, France
| | - Anja Strangfeld
- German Rheumatism Research Center (DRFZ Berlin), Epidemiology Unit, Berlin, Germany
| | - Loreto Carmona
- Instituto de Salud Musculoesquelética (INMUSC), Madrid, Spain
| | - Bernd Raffeiner
- Department of Rheumatology, Central Hospital of Bolzano, Bolzano, Italy
| | - Gözde Kübra Yardımcı
- Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Ludovic Trefond
- CHU Clermont Ferrand, Service de Médecine Interne, Hôpital Gabriel Montpied, Inserm U1071, INRA USC2018, M2iSH, Université Clermont Auvergne, Clermont-Ferrand, France
| | - Nicolas Roux
- Service de Rhumatologie, Hôpital Robert Schuman, Metz, France
| | - Ana Rodrigues
- Reuma.pt, Sociedade Portuguesa de Reumatologia, Lisboa, Portugal.,EpiDoC Unit, CEDOC, CHRC Campus Nova Medical School, Lisboa, Portugal
| | - Charalampos Papagoras
- First Department of Internal Medicine, University Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece
| | - Elsa F Mateus
- Portuguese League Against Rheumatic Diseases (LPCDR), Lisbon, Portugal.,Standing Committee of People with Arthritis/Rheumatism in Europe (PARE), European League Against Rheumatism, Zurich, Switzerland
| | - Xavier Mariette
- Department of Rheumatology, Université Paris-Saclay, Assistance Publique-Hôpitaux de Paris, Hopital Bicetre, Le Kremlin-Bicetre, France
| | - Pedro M Machado
- Centre for Rheumatology & Department of Neuromuscular Diseases, University College London, London, UK .,National Institute for Health Research (NIHR) University College London Hospitals Biomedical Research Centre, University College London Hospitals NHS Foundation Trust, London, UK.,Department of Rheumatology, Northwick Park Hospital, London North West University Healthcare NHS Trust, London, UK
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20
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Trefond L, Drumez E, Andre M, Costedoat-Chalumeau N, Seror R, Devaux M, Dernis E, Dieudonné Y, El Mahou S, Lanteri A, Melki I, Queyrel V, Roumier M, Schmidt J, Barnetche T, Thomas T, Cacoub P, Belot A, Aumaitre O, Richez C, Hachulla E. Impact of hydroxychloroquine used as DMARD on SARS-CoV-2 tests and infection evolution in a population of 871 patients with inflammatory rheumatic and musculoskeletal diseases. Joint Bone Spine 2021; 88:105226. [PMID: 34051385 PMCID: PMC8152361 DOI: 10.1016/j.jbspin.2021.105226] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Accepted: 05/11/2021] [Indexed: 12/27/2022]
Affiliation(s)
- Ludovic Trefond
- Université Clermont Auvergne, CHU Clermont-Ferrand, Service de Médecine Interne, Hôpital Gabriel Montpied, Inserm U1071, INRA USC2018, M2iSH, 63000 Clermont-Ferrand, France.
| | - Elodie Drumez
- Université de Lille, CHU Lille, ULR 2694-METRICS: Évaluation des technologies de santé et des pratiques médicales, 59000 Lille, France
| | - Marc Andre
- Université Clermont Auvergne, CHU Clermont-Ferrand, Service de Médecine Interne, Hôpital Gabriel Montpied, Inserm U1071, INRA USC2018, M2iSH, 63000 Clermont-Ferrand, France
| | - Nathalie Costedoat-Chalumeau
- APHP, Service de Médecine Interne, Centre de Référence des Maladies Auto-immunes Systémiques Rares d'Ile de France, Hôpital Cochin, Université de Paris, INSERM U 1153, Centre of Research in Epidemiology and Statistics Sorbonne Paris Cité (CRESS), 27 rue du Faubourg St-Jacques, 75679 Paris cedex 14, France
| | - Raphaèle Seror
- Université Paris-Saclay, Assistance Publique-Hôpitaux de Paris (AP-HP), Service de Rhumatologie, Centre de référence des maladies autoimmunes systémiques rares, Hôpital Bicêtre, INSERM UMR 1184, Le Kremlin-Bicêtre, France
| | - Mathilde Devaux
- Service de Médecine Interne, CHI Poissy Saint-Germain, France
| | | | - Yannick Dieudonné
- Hôpitaux universitaires de Strasbourg, Department of Clinical Immunology and Internal Medicine, National Reference Centre for Systemic Autoimmune Diseases (CNR RESO), 67000 Strasbourg, France
| | | | | | - Isabelle Melki
- General Paediatrics, Infectious Disease and Internal Medicine Department, Hôpital Robert-Debré, AP-HP, Reference centre for Rheumatic, AutoImmune and Systemic diseases in children (RAISE), Paediatric Haematology-Immunology and Rheumatology Department, Hôpital Necker-Enfants Malades, Reference centre for Rheumatic, AutoImmune and Systemic diseases in children (RAISE), Laboratory of Neurogenetics and Neuroinflammation, Imagine Institute, Paris, France
| | - Viviane Queyrel
- Service de rhumatologie/Centre de compétence des maladies auto-immunes systémiques rares, Hôpital Pasteur 2, CHU Nice, 30 avenue Voie romaine, 06000 Nice, France
| | | | - Jean Schmidt
- Université de Picardie Jules Verne, CHU Amiens, Service de Médecine Interne et RECIF, Amiens, France
| | - Thomas Barnetche
- Hôpital Pellegrin, CHU de Bordeaux, Service de Rhumatologie, Centre de référence des maladies autoimmunes systémiques rares (RESO), UMR-CNRS 5164, Université de Bordeaux, Bordeaux, France
| | - Thierry Thomas
- Department of Rheumatology, Hôpital Nord, CHU Saint-Étienne, Inserm U1059, Université de Lyon-Université Jean-Monnet, Saint-Étienne, France
| | - Patrice Cacoub
- AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Department of Internal Medicine and Clinical Immunology, 75013, Paris, France; Centre de Référence des Maladies Auto-Immunes et Systémiques Rares, Centre de Référence des Maladies Auto-Inflammatoires et de l'Amylose, Sorbonne Université, UPMC Université de Paris 06, UMR 7211, Inflammation-Immunopathology-Biotherapy Department (DHU i2B), 75005 Paris, France; INSERM, UMR S 959, 75013, Paris, France; CNRS, FRE3632, 75005, Paris, France
| | - Alexandre Belot
- Paediatric Rheumatology, Nephrology, Dermatology Unit, National Reference Centre for Rheumatism and Systemic Autoimmune Diseases in Children (RAISE), Hospices Civils de Lyon, France
| | - Olivier Aumaitre
- Université Clermont Auvergne, CHU Clermont-Ferrand, Service de Médecine Interne, Hôpital Gabriel Montpied, Inserm U1071, INRA USC2018, M2iSH, 63000 Clermont-Ferrand, France
| | - Christophe Richez
- Hôpital Pellegrin, CHU de Bordeaux, Service de Rhumatologie, Centre de référence des maladies autoimmunes systémiques rares (RESO), UMR-CNRS 5164, Université de Bordeaux, Bordeaux, France
| | - Eric Hachulla
- Université de Lille, Inserm, CHU Lille, Service de Médecine Interne et Immunologie Clinique, Centre de référence des maladies autoimmunes systémiques rares du Nord et Nord-Ouest de France (CeRAINO), U1286-INFINITE-Institute for Translational Research in Inflammation, 59000 Lille, France
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21
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Machado PM, Lawson-Tovey S, Hyrich K, Carmona L, Gossec L, Mateus E, Strangfeld A, Raffeiner B, Goulenok T, Brocq O, Cornalba M, Gómez-Puerta JA, Veillard E, Trefond L, Gottenberg JE, Henry J, Durez P, Burmester GR, Mosca M, Hachulla E, Bijlsma H, McInnes I, Mariette X. LB0002 COVID-19 VACCINE SAFETY IN PATIENTS WITH RHEUMATIC AND MUSCULOSKELETAL DISEASE. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.5097] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:The consequences of the COVID-19 outbreak are unprecedented and have been felt by everyone around the world, including people with rheumatic and musculoskeletal diseases (RMDs). With the development of vaccines, the future is becoming brighter. Vaccines are a key pillar of public health and have been proven to prevent many serious diseases. However, vaccination also raises questions, especially for patients with inflammatory RMDs and/or treated with drugs that influence their immune system.Objectives:Our aim was to collect safety data among RMD patients receiving COVID-19 vaccines.Methods:The EULAR COVID-19 Vaccination (COVAX) Registry is an observational registry launched on 5 February 2021. Data are entered voluntarily by clinicians or associated healthcare staff; patients are eligible for inclusion if they have an RMD and have been vaccinated against SARS-CoV-2. Descriptive statistics are presented.Results:As of 27 April 2021, 1519 patients were reported to the registry. The majority were female (68%) and above the age of 60 (57%). Mean age was 63 years (SD 16), ranging from 15 to 97 years. A total of 28 countries contributed to the registry, with France (60%) and Italy (13%) as the highest contributors. The majority (91%) had inflammatory RMDs. Inflammatory joint diseases accounted for 51% of cases, connective tissue diseases 19%, vasculitis 16%, other immune mediated inflammatory diseases 4%, and non-inflammatory/mechanical RMDs 9%. The most frequent individual diagnoses were rheumatoid arthritis (30%), axial spondyloarthritis (8%), psoriatic arthritis (8%), systemic lupus erythematosus (SLE, 7%) and polymyalgia rheumatica (6%). At the time of vaccination, 45% were taking conventional synthetic DMARDs, 36% biological DMARDs, 31% systemic glucocorticoids, 6% other immunosuppressants (azathioprine; mycophenolate; cyclosporine; cyclophosphamide; tacrolimus), and 3% targeted synthetic DMARDs. The most frequent individual DMARDs were methotrexate (29%), TNF-inhibitors (18%), antimalarials (10%) and rituximab (6%). The vaccines administered were: 78% Pfizer, 16% AstraZeneca, 5% Moderna and 1% other/unknown; 66% of cases received two doses and 34% one dose. Mean time from 1st and 2nd dose to case report was 41 days (SD 26) and 26 days (SD 23), respectively. COVID-19 diagnosis after vaccination was reported in 1% (18/1519) of cases. Mean time from first vaccination until COVID-19 diagnosis was 24 days (SD 17). Disease flares were reported by 5% (73/1375) of patients with inflammatory RMDs, with 1.2% (17/1375) classified as severe flares. Mean time from closest vaccination date to inflammatory RMD flare was 5 days (SD 5). The most common flare types were arthritis (35/1375=2.5%), arthralgia (29/1375=2.1%), cutaneous flare (11/1375=0.8%) and increase in fatigue (11/1375=0.8%). Potential vaccine side effects were reported by 31% of patients (467/1519). The majority were typical early adverse events within 7 days of vaccination, namely pain at the site of injection (281/1519=19%), fatigue (171/1519=11%) and headache (103/1519=7%). Organ/system adverse events were reported by 2% (33/1519) but only 0.1% (2/1519) reported severe adverse events, namely a case of hemiparesis in a patient with systemic sclerosis/SLE overlap syndrome (ongoing at the time of reporting), and a case of giant cell arteritis in a patient with osteoarthritis (recovered/resolved without sequelae).Conclusion:The safety profiles for COVID-19 vaccines in RMD patients was reassuring. Most adverse events were the same as in the general population, they were non-serious and involved short term local and systemic symptoms. The overwhelming majority of patients tolerated their vaccination well with rare reports of inflammatory RMD flare (5%; 1.2% severe) and very rare reports of severe adverse events (0.1%). These initial findings should provide reassurance to rheumatologists and vaccine recipients, and promote confidence in COVID-19 vaccine safety in RMD patients, namely those with inflammatory RMDs and/or taking treatments that influence their immune system.Acknowledgements:EULAR COVID-19 Task Force; European Reference Network on rare and Complex Connective Tissue and Musculoskeletal Diseases; European Reference Network on Rare Immunodeficiency, Autoinflammatory and Autoimmune Diseases Network; all rheumatologists contributing to the EULAR COVAX Registry.Disclosure of Interests:Pedro M Machado Consultant of: Abbvie, BMS, Celgene, Eli Lilly, Janssen, MSD, Novartis, Orphazyme, Pfizer, Roche and UCB, all unrelated to this manuscript., Grant/research support from: Orphazyme, unrelated to this manuscript., Speakers bureau: Abbvie, BMS, Celgene, Eli Lilly, Janssen, MSD, Novartis, Orphazyme, Pfizer, Roche and UCB, all unrelated to this manuscript., Saskia Lawson-Tovey: None declared, Kimme Hyrich Grant/research support from: BMS, UCB, and Pfizer, all unrelated to this manuscript., Speakers bureau: Abbvie, Loreto Carmona Consultant of: her institute works by contract for laboratories among other institutions, such as Abbvie Spain, Eisai, Gebro Pharma, Merck Sharp & Dohme España, S.A., Novartis Farmaceutica, Pfizer, Roche Farma, Sanofi Aventis, Astellas Pharma, Actelion Pharmaceuticals España, Grünenthal GmbH, and UCB Pharma, all unrelated to this manuscript., Laure Gossec Grant/research support from: AbbVie, Amgen, BMS, Biogen, Celgene, Gilead, Janssen, Lilly, Novartis, Pfizer, Samsung Bioepis, Sanofi-Aventis, UCB, all unrelated to this manuscript., Speakers bureau: Amgen, Lilly, Janssen, Pfizer, Sandoz, Sanofi, Galapagos, all unrelated to this manuscript., Elsa Mateus Grant/research support from: LPCDR received support for specific activities: grants from Abbvie, Novartis, Janssen-Cilag, Lilly Portugal, Sanofi, Grünenthal S.A., MSD, Celgene, Medac, Pharmakern, GAfPA; grants and non-financial support from Pfizer; non-financial support from Grünenthal GmbH, outside the submitted work., Anja Strangfeld Speakers bureau: AbbVie, MSD, Roche, BMS, and Pfizer, all unrelated with this manuscript., BERND RAFFEINER: None declared, Tiphaine Goulenok: None declared, Olilvier Brocq: None declared, Martina Cornalba: None declared, José A Gómez-Puerta Speakers bureau: AbbVie, BMS, GSK, Janssen, Lilly, MSD, Roche and Sanofi., Eric Veillard: None declared, Ludovic Trefond: None declared, Jacques-Eric Gottenberg: None declared, Julien Henry: None declared, Patrick Durez: None declared, Gerd Rüdiger Burmester: None declared, Marta Mosca: None declared, Eric Hachulla: None declared, Hans Bijlsma: None declared, Iain McInnes: None declared, Xavier Mariette Consultant of: BMS, Galapagos, Gilead, Janssen, Novartis, Pfizer, Sanofi-Aventis, UCB, and grant from Ose, all unrelated to this manuscript.
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22
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Trefond L, Smets P, Beltzung F, Olagne L, Bardy A, Aumaître O, André M. Digestive vasculitis: a rare but severe complication of NXP2 dermatomyositis. Rheumatology (Oxford) 2021; 60:e165-e166. [PMID: 33313929 DOI: 10.1093/rheumatology/keaa740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Revised: 09/17/2020] [Accepted: 10/19/2020] [Indexed: 11/12/2022] Open
Affiliation(s)
- Ludovic Trefond
- Médecine Interne, CHU Gabriel Montpied.,M2iSH, UMR 1071 Inserm, INRA USC 2018, University of Clermont Auvergne
| | | | | | | | - Antoine Bardy
- Médecine Interne, CH Moulins, Clermont Ferrand, France
| | - Olivier Aumaître
- Médecine Interne, CHU Gabriel Montpied.,M2iSH, UMR 1071 Inserm, INRA USC 2018, University of Clermont Auvergne
| | - Marc André
- Médecine Interne, CHU Gabriel Montpied.,M2iSH, UMR 1071 Inserm, INRA USC 2018, University of Clermont Auvergne
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23
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Trefond L, Frances C, Nathalie C, Piette J, Assaad S, Sailler L, Viallard J, Jego P, Connault J, Galempoix J, Aumaître O, Andre M. Syndrome des abcès aseptiques : série française de 71 patients. Rev Med Interne 2020. [DOI: 10.1016/j.revmed.2020.10.047] [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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24
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Monghal V, Trefond L, Smets P, Tollis E, Olagne L, Aumaître O, Andre M. Carotidodynie révélant une rechute de granulomatose avec polyangéite. Rev Med Interne 2020. [DOI: 10.1016/j.revmed.2020.10.317] [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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25
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Noureddine J, Trefond L, Smets P, Tollis E, Olagne L, Aumaître O, Andre M. Angiœdème histaminique et belimumab : à propos de deux cas. Rev Med Interne 2020. [DOI: 10.1016/j.revmed.2020.10.311] [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: 11/24/2022]
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26
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Trefond L, Rieu V, Grobost V, Resseguier AS, Lemaire A, Le Guenno G, Ruivard M. Des paupières lourdes. Rev Med Interne 2020; 41:569-570. [DOI: 10.1016/j.revmed.2020.04.013] [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: 12/28/2019] [Revised: 02/10/2020] [Accepted: 04/05/2020] [Indexed: 10/23/2022]
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27
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Papo M, Cohen-Aubart F, Trefond L, Bauvois A, Amoura Z, Emile JF, Haroche J. Systemic Histiocytosis (Langerhans Cell Histiocytosis, Erdheim-Chester Disease, Destombes-Rosai-Dorfman Disease): from Oncogenic Mutations to Inflammatory Disorders. Curr Oncol Rep 2019; 21:62. [PMID: 31115724 DOI: 10.1007/s11912-019-0810-6] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
PURPOSE OF REVIEW Provide an overview of recent progress in decoding the pathogenesis and treatment of systemic histiocytoses. RECENT FINDINGS Advances in molecular techniques over the last few years, enabling the identification of several MAPK mutations in lesion histiocytes, have revolutionized our understanding of histiocytosis that led to a revised classification and new treatments. Since the 2010 discovery of the BRAFV600E mutation in 57% of Langerhans cell histiocytosis (LCH) lesions, several other kinase mutations have been found, mostly in the MAPK pathway, and also in other key signaling pathways, in LCH, Erdheim-Chester Disease (ECD) and, less frequently, Destombes-Rosai-Dorfman disease (RDD). Those revolutionary breakthroughs enhanced our understanding of the pathogenesis of histiocytosis and led to trials with targeted therapies that demonstrated notable efficacy.
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Affiliation(s)
- Matthias Papo
- Assistance Publique-Hôpitaux de Paris, Service de Médecine Interne 2, Centre National de Références des Histiocytoses, Hôpital Pitié-Salpêtrière, Sorbonne Université, 47-83, Boulevard de l'Hôpital, 75651, Paris Cedex 13, France
| | - Fleur Cohen-Aubart
- Assistance Publique-Hôpitaux de Paris, Service de Médecine Interne 2, Centre National de Références des Histiocytoses, Hôpital Pitié-Salpêtrière, Sorbonne Université, 47-83, Boulevard de l'Hôpital, 75651, Paris Cedex 13, France
| | - Ludovic Trefond
- Assistance Publique-Hôpitaux de Paris, Service de Médecine Interne 2, Centre National de Références des Histiocytoses, Hôpital Pitié-Salpêtrière, Sorbonne Université, 47-83, Boulevard de l'Hôpital, 75651, Paris Cedex 13, France
| | - Adeline Bauvois
- Assistance Publique-Hôpitaux de Paris, Service de Médecine Interne 2, Centre National de Références des Histiocytoses, Hôpital Pitié-Salpêtrière, Sorbonne Université, 47-83, Boulevard de l'Hôpital, 75651, Paris Cedex 13, France
| | - Zahir Amoura
- Assistance Publique-Hôpitaux de Paris, Service de Médecine Interne 2, Centre National de Références des Histiocytoses, Hôpital Pitié-Salpêtrière, Sorbonne Université, 47-83, Boulevard de l'Hôpital, 75651, Paris Cedex 13, France
| | - Jean-François Emile
- EA4340-BECCOH, Versailles University, & Département de Pathologie, Hôpital Ambroise Paré, AP-HP, 9 Avenue Charles de Gaulle, 92100, Boulogne, France
| | - Julien Haroche
- Assistance Publique-Hôpitaux de Paris, Service de Médecine Interne 2, Centre National de Références des Histiocytoses, Hôpital Pitié-Salpêtrière, Sorbonne Université, 47-83, Boulevard de l'Hôpital, 75651, Paris Cedex 13, France.
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28
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Durel CA, Hot A, Trefond L, Aumaitre O, Pugnet G, Samson M, Abad S, Belot A, Blanchard-Delaunay C, Cohen P, Cohen-Aubard F, Cottin V, Crestani B, Moreuil CD, Durupt S, Garzaro M, Girszyn N, Godeau B, Hachulla E, Jamilloux Y, Jego P, Killian M, Lazaro E, Le Gallou T, Liozon E, Martin T, Papo T, Perlat A, Pillet P, Guillevin L, Terrier B. Orbital mass in ANCA-associated vasculitides: data on clinical, biological, radiological and histological presentation, therapeutic management, and outcome from 59 patients. Rheumatology (Oxford) 2019; 58:1565-1573. [DOI: 10.1093/rheumatology/kez071] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2018] [Revised: 02/04/2019] [Indexed: 12/15/2022] Open
Abstract
Abstract
Objective
Orbital mass is a rare and sight-threatening manifestation of ANCA-associated vasculitides, which remains a therapeutic challenge. We aimed to describe the presentation, therapeutic management and outcome of ANCA-associated vasculitides-related orbital mass.
Methods
We conducted a French nationwide retrospective study of patients with orbital mass in the setting of ANCA-associated vasculitides according to ACR criteria and/or Chapel Hill Consensus Conference definitions.
Results
Fifty-nine patients [33 women, median age 46 (range 7–90) years] were included. Fifty-six (95%) patients had granulomatosis with polyangiitis, two eosinophilic granulomatosis with polyangiitis and one microscopic polyangiitis. Orbital mass was unilateral in 47 (80%) cases, and seemed to develop from ENT involvement in most cases. Orbital mass biopsy was available in 32 (54%) patients, showing lymphoplasmacytic infiltration in 65%, fibrosis in 55%, granulomas in 48% and vasculitis in 36%. All patients but one received glucocorticoids as first-line therapy associated with immunosuppressive agents in 82%, mainly cyclophosphamide. Response to therapy was noted in 52% of patients treated with cyclophosphamide compared with 91% of those treated with rituximab. Twenty-seven (46%) patients required a second-line therapy because of relapse (59%) or refractory course (41%). Sequelae included visual impairment in 28%, with definitive blindness in 17%. Refractory course was associated with PR3-ANCA positivity, visual loss and contiguous pachymeningitis.
Conclusion
Orbital mass is associated with refractory course and high frequency of sequelae, especially blindness. Refractory course is associated with PR3-ANCA positivity, visual loss and contiguous pachymeningitis.
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Affiliation(s)
| | - Arnaud Hot
- Department of Internal Medicine, Hôpital Edouard Herriot, Lyon
| | - Ludovic Trefond
- Department of Internal Medicine, Hôpital Gabriel Montpied, Clermont-Ferrand
| | - Olivier Aumaitre
- Department of Internal Medicine, Hôpital Gabriel Montpied, Clermont-Ferrand
| | - Gregory Pugnet
- Department of Internal Medicine, Hôpital Purpan, Toulouse
| | - Maxime Samson
- Department of Internal Medicine and Clinical Immunology, CHU Dijon Bourgogne, Dijon
| | - Sébastien Abad
- AP-HP, Hôpital Avicennes, Department of Internal Medicine, Université Paris 13, Sorbonne, Paris Cité, Faculté de Médecine Bobigny, Paris
| | - Alexandre Belot
- Department of Pediatric Nephrology, Rheumatology, Dermatology, National Referral Center for Inflammatory Rheumatism and Autoimmune Diseases, Hôpital Femme Mère Enfant, Bron
| | | | - Pascal Cohen
- Department of Internal Medicine, Hôpital Cochin, Paris
| | - Fleur Cohen-Aubard
- Department of Internal Medicine, National Referral Center for Systemic and Autoimmune Diseases, Hôpital de la Pitié-Salpêtrière, Paris
| | - Vincent Cottin
- Department of Respiratory Medicine, National Reference Center for Rare Pulmonary Diseases, Lyon
| | | | - Claire De Moreuil
- Department of Internal Medicine, Hôpital de la Cavale Blanche, Brest
| | - Stéphane Durupt
- Department of Internal Medicine, Centre Hospitalier Lyon Sud, Lyon
| | | | - Nicolas Girszyn
- Department of Internal Medicine, Hôpital Charles Nicolle, Rouen
| | - Bertrand Godeau
- Department of Internal Medicine, Referral Center for Adult Autoimmune Cytopenias, Hôpital Henri Mondor, Créteil
| | - Eric Hachulla
- Department of Internal Medicine, Hôpital Claude Huriez, National Referral Center for Systemic Autoimmune Diseases North and North-West of France, Université de Lille, Lille
| | - Yvan Jamilloux
- Department of Internal Medicine, Hôpital de la Croix-Rousse, Lyon
| | - Patrick Jego
- Department of Internal Medicine, Hôpital Sud, Rennes
| | - Martin Killian
- Department of Internal Medicine, Hôpital Nord, Saint-Etienne
| | - Estibaliz Lazaro
- Department of Internal Medicine, Hôpital Haut-Lévêque, CHU de Bordeaux, Pessac
| | | | - Eric Liozon
- Department of Internal Medicine, Hôpital de Limoges, Limoges
| | - Thierry Martin
- Department of Clinical Immunology, HIV, and Internal Medicine, National Referral Center for Systemic and Autoimmune Diseases RESO, Nouvel Hôpital Civil, Strasbourg
| | - Thomas Papo
- Department of Internal Medicine, Hôpital Bichat, Paris
| | | | - Pascal Pillet
- Department of Medical Pediatrics, CHU de Bordeaux – GH Pellegrin, Bordeaux
| | - Loïc Guillevin
- Department of Internal Medicine, National Referral Center for Systemic and Autoimmune Diseases, Hôpital de la Pitié-Salpêtrière, Paris
- Hôpital Cochin, National Referral Center for Systemic and Autoimmune Diseases, Paris
- Faculté de Médecine Paris Descartes, Université Paris Descartes, Paris, France
| | - Benjamin Terrier
- Department of Internal Medicine, National Referral Center for Systemic and Autoimmune Diseases, Hôpital de la Pitié-Salpêtrière, Paris
- Hôpital Cochin, National Referral Center for Systemic and Autoimmune Diseases, Paris
- Faculté de Médecine Paris Descartes, Université Paris Descartes, Paris, France
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Durel C, Hot A, Trefond L, Pugnet G, Samson M, Guillevin L, Terrier B. Pseudo-tumeurs inflammatoires orbitaires au cours des vascularites associées aux ANCA : étude rétrospective portant sur 57 patients. Rev Med Interne 2017. [DOI: 10.1016/j.revmed.2017.03.078] [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]
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