1
|
Lebrun-Frénay C, Siva A, Sormani MP, Landes-Chateau C, Mondot L, Bovis F, Vermersch P, Papeix C, Thouvenot E, Labauge P, Durand-Dubief F, Efendi H, Le Page E, Terzi M, Derache N, Bourre B, Hoepner R, Karabudak R, De Seze J, Ciron J, Clavelou P, Wiertlewski S, Turan OF, Yucear N, Cohen M, Azevedo C, Kantarci OH, Okuda DT, Pelletier D. Teriflunomide and Time to Clinical Multiple Sclerosis in Patients With Radiologically Isolated Syndrome: The TERIS Randomized Clinical Trial. JAMA Neurol 2023; 80:1080-1088. [PMID: 37603328 PMCID: PMC10442780 DOI: 10.1001/jamaneurol.2023.2815] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [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: 04/10/2023] [Accepted: 06/13/2023] [Indexed: 08/22/2023]
Abstract
Importance Radiologically isolated syndrome (RIS) represents the earliest detectable preclinical phase of multiple sclerosis (MS) punctuated by incidental magnetic resonance imaging (MRI) white matter anomalies within the central nervous system. Objective To determine the time to onset of symptoms consistent with MS. Design, Setting, and Participants From September 2017 to October 2022, this multicenter, double-blind, phase 3, randomized clinical trial investigated the efficacy of teriflunomide in delaying MS in individuals with RIS, with a 3-year follow-up. The setting included referral centers in France, Switzerland, and Turkey. Participants older than 18 years meeting 2009 RIS criteria were randomly assigned (1:1) to oral teriflunomide, 14 mg daily, or placebo up to week 96 or, optionally, to week 144. Interventions Clinical, MRI, and patient-reported outcomes (PROs) were collected at baseline and yearly until week 96, with an optional third year in the allocated arm if no symptoms have occurred. Main outcomes Primary analysis was performed in the intention-to-treat population, and safety was assessed accordingly. Secondary end points included MRI outcomes and PROs. Results Among 124 individuals assessed for eligibility, 35 were excluded for declining to participate, not meeting inclusion criteria, or loss of follow-up. Eighty-nine participants (mean [SD] age, 37.8 [12.1] years; 63 female [70.8%]) were enrolled (placebo, 45 [50.6%]; teriflunomide, 44 [49.4%]). Eighteen participants (placebo, 9 [50.0%]; teriflunomide, 9 [50.0%]) discontinued the study, resulting in a dropout rate of 20% for adverse events (3 [16.7%]), consent withdrawal (4 [22.2%]), loss to follow-up (5 [27.8%]), voluntary withdrawal (4 [22.2%]), pregnancy (1 [5.6%]), and study termination (1 [5.6%]). The time to the first clinical event was significantly extended in the teriflunomide arm compared with placebo, in both the unadjusted (hazard ratio [HR], 0.37; 95% CI, 0.16-0.84; P = .02) and adjusted (HR, 0.28; 95% CI, 0.11-0.71; P = .007) analysis. Secondary imaging end point outcomes including the comparison of the cumulative number of new or newly enlarging T2 lesions (rate ratio [RR], 0.57; 95% CI, 0.27-1.20; P = .14), new gadolinium-enhancing lesions (RR, 0.33; 95% CI, 0.09-1.17; P = .09), and the proportion of participants with new lesions (odds ratio, 0.72; 95% CI, 0.25-2.06; P = .54) were not significant. Conclusion and Relevance Treatment with teriflunomide resulted in an unadjusted risk reduction of 63% and an adjusted risk reduction of 72%, relative to placebo, in preventing a first clinical demyelinating event. These data suggest a benefit to early treatment in the MS disease spectrum. Trial Registration ClinicalTrials.gov Identifier: NCT03122652.
Collapse
Affiliation(s)
- Christine Lebrun-Frénay
- Centre de Ressources et de Compétences Sclerose En Plaques, Neurologie Pasteur 2, CHU de Nice, Université Cote d’Azur, UMR2CA-URRIS, Nice, France
| | - Aksel Siva
- Cerrahpasa School of Medicine, Istanbul University, Istanbul, Turkiye
| | - Maria Pia Sormani
- University of Genoa, Genoa, Italy
- Ospedale Policlinico San Martino Instituti di Ricovero e Cura a Carattere Scientifico, Genoa, Italy
| | - Cassandre Landes-Chateau
- Centre de Ressources et de Compétences Sclerose En Plaques, Neurologie Pasteur 2, CHU de Nice, Université Cote d’Azur, UMR2CA-URRIS, Nice, France
| | - Lydiane Mondot
- Centre de Ressources et de Compétences Sclerose En Plaques, Neurologie Pasteur 2, CHU de Nice, Université Cote d’Azur, UMR2CA-URRIS, Nice, France
| | | | - Patrick Vermersch
- Université de Lille, Inserm, Unit 1172, LilNCog, Centre Hospitalier Universitaire de Lille, Fédération Hospitalo-Universitaire Precise, Lille, France
| | - Caroline Papeix
- Assistance Publique des Hôpitaux de Paris, Pitié-Salpêtrière Hospital, Paris, France
| | - Eric Thouvenot
- Multiple Sclerosis Clinic, Nîmes University Hospital, Nîmes, France
| | - Pierre Labauge
- Multiple Sclerosis Clinic, Montpellier University Hospital, Montpellier, France
| | | | - Husnu Efendi
- Neurology, Kocaeli University Faculty of Medicine, Kocaeli, Turkiye
| | - Emmanuelle Le Page
- Multiple Sclerosis Clinic, Rennes University Hospital, Inserm, CIC1414, Rennes, France
| | - Murat Terzi
- School of Medicine, Neurology, Ondokuz Mayis University, Samsun, Turkiye
| | - Nathalie Derache
- Multiple Sclerosis Clinic, Caen University Hospital, Caen, France
| | - Bertrand Bourre
- Multiple Sclerosis Clinic, Rouen University Hospital, Rouen, France
| | - Robert Hoepner
- Department of Neurology, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland
| | - Rana Karabudak
- Hacettepe University Medical Faculty, School of Medicine, Ankara, Turkiye
| | - Jérôme De Seze
- Strasbourg University Hospital, Clinical Investigation Center, INBSRM 1434, Strasbourg, France
| | - Jonathan Ciron
- Toulouse University Hospital, Centre de Ressources et de Compétences Sclérose en Plaques, Department of Neurology, Université Toulouse III, Infinity, Inserm UMR1291, CNRS UMR5051, Toulouse, France
| | - Pierre Clavelou
- Multiple Sclerosis Clinic, Clermont-Ferrand University Hospital, Clermont-Ferrand, France
| | - Sandrine Wiertlewski
- Centre de Ressources et de Compétences Sclérose en Plaques and Clinical Investigation Center, Inserm, Nantes University Hospital, France
- Transplantation and Immunology Transplantation Center, Inserm, Nantes, France
| | | | - Nur Yucear
- Ege University Medical Faculty, Bornova, Izmir, Turkiye
| | - Mikael Cohen
- Centre de Ressources et de Compétences Sclerose En Plaques, Neurologie Pasteur 2, CHU de Nice, Université Cote d’Azur, UMR2CA-URRIS, Nice, France
| | | | | | - Darin T. Okuda
- The University of Texas Southwestern Medical Center, Dallas
| | | |
Collapse
|
2
|
Carta S, Le Duy D, Rogemond V, Derache N, Chaumont H, Fromont A, Cabasson S, Boudot de la Motte M, Honnorat J, Marignier R. Anti-Argonaute antibodies as a potential biomarker in NMOSD. J Neurol Neurosurg Psychiatry 2023; 94:738-741. [PMID: 36810322 DOI: 10.1136/jnnp-2022-330707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Accepted: 02/07/2023] [Indexed: 02/23/2023]
Abstract
BACKGROUND AND OBJECTIVES Neuromyelitis optica spectrum disorders (NMOSDs) are a group of diseases mainly characterised by recurrent optic neuritis and/or myelitis. Most cases are associated with a pathogenic antibody against aquaporin-4 (AQP4-Ab), while some patients display autoantibodies targeting the myelin oligodendrocyte glycoprotein (myelin oligodendrocyte glycoprotein antibodies (MOG-Abs)). Anti-Argonaute antibodies (Ago-Abs) were first described in patients with rheumatological conditions and were recently reported as a potential biomarker in patients with neurological disorders. The aims of the study were to investigate if Ago-Abs can be detected in NMOSD and to evaluate its clinical usefulness. METHODS Sera from patients prospectively referred to our centre with suspected NMOSD were tested for AQP4-Abs, MOG-Abs and Ago-Abs with cell-based assays. RESULTS The cohort included 104 prospective patients: 43 AQP4-Abs-positive cases, 34 MOG-Abs positive cases and 27 double-negative patients. Ago-Abs were detected in 7 of 104 patients (6.7%). Clinical data were available for six of seven patients. The median age at onset of patients with Ago-Abs was 37.5 [IQR 28.8-50.8]; five of six patients tested positive also for AQP4-Abs. Clinical presentation at onset was transverse myelitis in five patients, while one presented with diencephalic syndrome and experienced a transverse myelitis during follow-up. One case presented a concomitant polyradiculopathy. Median EDSS score at onset was 7.5 [IQR 4.8-8.4]; median follow-up was 40.3 months [IQR 8.3-64.7], and median EDSS score at last evaluation was 4.25 [IQR 1.9-5.5]. CONCLUSION Ago-Abs are present in a subset of patients with NMOSD and, in some cases, represent the only biomarker of an autoimmune process. Their presence is associated with a myelitis phenotype and a severe disease course.
Collapse
Affiliation(s)
- Sara Carta
- Service de Neurologie, Sclérose en Plaques, Pathologies de la Myéline et Neuro-inflammation, Centre de Référence des Maladies Inflammatoires Rares du Cerveau et de la Moelle, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Lyon, France
- Department of Neuroscience, Biomedicine, and Movement Sciences, University of Verona, Verona, Italy
| | - Do Le Duy
- French Reference Centre on Paraneoplastic Neurological Syndrome, Hospices Civils de Lyon, Hôpital Neurologique, Bron, France
- MeLiS-UCBL-CNRS UMR 5284, INSERM U1314, Université Claude Bernard Lyon 1, Lyon, France
| | - Veronique Rogemond
- French Reference Centre on Paraneoplastic Neurological Syndrome, Hospices Civils de Lyon, Hôpital Neurologique, Bron, France
- MeLiS-UCBL-CNRS UMR 5284, INSERM U1314, Université Claude Bernard Lyon 1, Lyon, France
| | | | - Hugo Chaumont
- Department of Neurology, University Hospital of Guadeloupe, Pointe-à-Pitre, France
| | - Agnès Fromont
- Department Neurology, University Hospital of Dijon, Dijon, France
| | - Sebastien Cabasson
- Service de Pédiatrie et Réanimation Pédiatrique, Centre Hospitalier de Pau, Pau, France
| | | | - Jerome Honnorat
- French Reference Centre on Paraneoplastic Neurological Syndrome, Hospices Civils de Lyon, Hôpital Neurologique, Bron, France
- MeLiS-UCBL-CNRS UMR 5284, INSERM U1314, Université Claude Bernard Lyon 1, Lyon, France
| | - Romain Marignier
- Service de Neurologie, Sclérose en Plaques, Pathologies de la Myéline et Neuro-inflammation, Centre de Référence des Maladies Inflammatoires Rares du Cerveau et de la Moelle, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Lyon, France
| |
Collapse
|
3
|
Cohen M, Thomel-Rocchi O, Siva A, Okuda DT, Karabudak R, Efendi H, Terzi M, Carra-Dalliere C, Durand-Dubief F, Thouvenot E, Ciron J, Zephir H, Bourre B, Casez O, De Seze J, Moreau T, Neau JP, Pelletier D, Kantarci O, Tutuncu M, Derache N, Bensa C, Louapre C, Benoit J, Landes-Chateau C, Lebrun-Frenay C. Impact of COVID-19 vaccination or infection on disease activity in a radiologically isolated syndrome cohort: The VaxiRIS study. Mult Scler 2023; 29:1099-1106. [PMID: 37322880 PMCID: PMC10273053 DOI: 10.1177/13524585231179669] [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: 02/15/2023] [Revised: 05/04/2023] [Accepted: 05/14/2023] [Indexed: 06/17/2023]
Abstract
BACKGROUND Vaccination in patients with multiple sclerosis (MS) treated with immunosuppressive drugs is highly recommended. Regarding COVID-19 vaccination, no specific concern has been raised. OBJECTIVES We aimed to evaluate if COVID-19 vaccination or infection increased the risk of disease activity, either radiological or clinical, with conversion to MS in a cohort of people with a radiologically isolated syndrome (RIS). METHODS This multicentric observational study analyzed patients in the RIS Consortium cohort during the pandemic between January 2020 and December 2022. We compared the occurrence of disease activity in patients according to their vaccination status. The same analysis was conducted by comparing patients' history of COVID-19 infection. RESULTS No difference was found concerning clinical conversion to MS in the vaccinated versus unvaccinated group (6.7% vs 8.5%, p > 0.9). The rate of disease activity was not statistically different (13.6% and 7.4%, respectively, p = 0.54). The clinical conversion rate to MS was not significantly different in patients with a documented COVID-19 infection versus non-infected patients. CONCLUSION Our study suggests that COVID-19 infection or immunization in RIS individuals does not increase the risk of disease activity. Our results support that COVID-19 vaccination can be safely proposed and repeated for these subjects.
Collapse
Affiliation(s)
- Mikael Cohen
- Department of Neurology, CRC-SEP, CHU de Nice, Pasteur 2 Hospital, Nice, France UR2CA-URRIS, Côte d’Azur University, Nice, France
| | | | - Aksel Siva
- Department of Neurology, Cerrahpasa School of Medicine, Istanbul University, Istanbul, Turkey
| | - Darin T Okuda
- The University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Rana Karabudak
- School of Medicine, Hacettepe University, Ankara, Turkey
| | - Hüsnü Efendi
- School of Medicine, Kocaeli University, Kocaeli, Turkey
| | - Murat Terzi
- School of Medicine, Ondokuz Mayis University, Samsun, Turkey
| | - Clarisse Carra-Dalliere
- Department of Neurology, CRC-SEP, CHU de Montpellier, Gui de Chauliac Hospital, Montpellier, France
| | - Francoise Durand-Dubief
- Service de Neurologie, Sclérose en Plaques, Pathologies de la Myéline et Neuro-Inflammation, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Lyon, France
| | - Eric Thouvenot
- Institut de Génomique Fonctionnelle, Université de Montpellier, Centre National de Recherche Scientifique, Institut National de la Santé et de la Recherche Médicale, Montpellier, France
| | - Jonathan Ciron
- Department of Neurology, Centre de Ressource et Competence Sclérose En Plaques, Centre Hospitalier Universitaire de Toulouse, Institut Toulousain des Maladies Infectieuses et Inflammatoires (Infinity), Institut National de la Santé et de la Recherche Médicale Unité Mixte de Recherche1291, Centre National de Recherche Scientifique Unité Mixte de Recherche 5051, Université Toulouse III, Toulouse, France
| | - Helene Zephir
- Université de Lille, Inserm Unité Mixte de Recherche-S 1172 LilNcog, Centre Hospitalier Universitaire Lille, Fédération Hospitalo-Universitaire Precise, Lille, France
| | | | - Olivier Casez
- Pathologies Inflammatoires du Système Nerveux, Neurologie, CHU Grenoble Alpes, T-RAIG (Translational Research in Autoimmunity and Inflammation Group) TIMC-IMAG, Université de Grenoble-Alpes, CHU Grenoble-Alpes, Grenoble, France
| | - Jérôme De Seze
- Department Clinical Investigation Center, Department of Neurology, Centre Hospitalier Universitaire de Strasbourg, Institut National de la Santé et de la Recherche Médicale, Strasbourg, France
| | - Thibault Moreau
- Department of Neurology, Centre Hospitalier Universitaire de Dijon, Dijon, France
| | - Jean-Philippe Neau
- Department of Neurology, Centre Hospitalier Universitaire de Poitiers, Poitiers, France
| | | | | | - Melih Tutuncu
- Department of Neurology, Cerrahpasa School of Medicine, Istanbul University, Istanbul, Turkey
| | - Nathalie Derache
- Department of Neurology, Centre Hospitalier Universitaire de Caen Normandie, Caen, France
| | - Caroline Bensa
- Neurology Department, CRC-SEP, Hopital Fondation Adolphe de Rothschild, Paris, France
| | - Celine Louapre
- CIC Neurosciences, Department of Neurology, Sorbonne University, Assistance Publique des Hôpitaux de Paris, Pitié-Salpêtrière Hospital, Paris, France
| | - Jeanne Benoit
- Department of Neurology, CRC-SEP, CHU de Nice, Pasteur 2 Hospital, Nice, France UR2CA-URRIS, Côte d’Azur University, Nice, France
| | - Cassandre Landes-Chateau
- Department of Neurology, CRC-SEP, CHU de Nice, Pasteur 2 Hospital, Nice, France UR2CA-URRIS, Côte d’Azur University, Nice, France
| | - Christine Lebrun-Frenay
- Department of Neurology, CRC-SEP, CHU de Nice, Pasteur 2 Hospital, Nice, France UR2CA-URRIS, Côte d’Azur University, Nice, France
| |
Collapse
|
4
|
Pelle J, Briant AR, Branger P, Derache N, Arnaud C, Lebrun-Frenay C, Cohen M, Mondot L, De Seze J, Bigaut K, Collongues N, Kremer L, Ricard D, Bompaire F, Ohlmann C, Sallansonnet-Froment M, Ciron J, Biotti D, Pignolet B, Parienti JJ, Defer G. Real-World Effectiveness of Natalizumab Extended Interval Dosing in a French Cohort. Neurol Ther 2023; 12:529-542. [PMID: 36763307 PMCID: PMC10043118 DOI: 10.1007/s40120-023-00440-5] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Accepted: 01/19/2023] [Indexed: 02/11/2023] Open
Abstract
INTRODUCTION Natalizumab, a therapy for relapsing-remitting multiple sclerosis (RRMS), is associated with a risk of progressive multifocal leukoencephalopathy (PML). Over the last several years, practitioners have used off-label extended interval dosing (EID) of natalizumab to reduce PML risk, despite the absence of a large-scale efficacy evaluation. METHODS We conducted a retrospective, multicenter cohort study among adults with RRMS receiving stable standard interval dosing (SID), defined as a ≥ 12-month consecutive period of ≥ 11 natalizumab infusions/year in France. We compared the 12-month risk difference of remaining relapse-free (primary endpoint) between patients who switched to EID (≤ 9 natalizumab infusions) and those who remained on SID, with a noninferiority margin of - 11%. We used propensity score methods such as inverse probability treatment weighting (IPTW) and 1:1 propensity score matching (PSM). Secondary endpoints were annualized relapse rate, disease progression, and safety. RESULTS Baseline characteristics were similar between patients receiving EID (n = 147) and SID (n = 156). The proportion of relapse-free patients 12 months postbaseline was 142/147 in the EID (96.6%) and 144/156 in the SID group (92.3%); risk difference (95% CI) 4.3% (- 1.3 to 9.8%); p < 0.001 for non-inferiority. There were no significant differences between relapse rates (0.043 vs. 0.083 per year, respectively; p = 0.14) or Expanded Disability Status Scale mean scores (2.43 vs. 2.72, respectively; p = 0.18); anti-JC virus index values were similar (p = 0.23); and no instances of PML were reported. The comparisons using IPTW (n = 306) and PSM (n = 204) were consistent. CONCLUSION These results support the pertinence of using an EID strategy for RRMS patients treated with natalizumab. CLINICAL TRIALS gov identifier (NCT04580381).
Collapse
Affiliation(s)
- Juliette Pelle
- Centre de Ressources et Compétence Sclérose en Plaques (CRCSEP), Service de Neurologie, CHU de la Côte de Nacre, 14000, Caen, France
| | - Anais R Briant
- Unité de Biostatistiques et de Recherche Clinique, CHU de Caen-Cote de Nacre, Caen, France
| | - Pierre Branger
- Centre de Ressources et Compétence Sclérose en Plaques (CRCSEP), Service de Neurologie, CHU de la Côte de Nacre, 14000, Caen, France
| | - Nathalie Derache
- Centre de Ressources et Compétence Sclérose en Plaques (CRCSEP), Service de Neurologie, CHU de la Côte de Nacre, 14000, Caen, France
| | - Charlotte Arnaud
- Centre de Ressources et Compétence Sclérose en Plaques (CRCSEP), Service de Neurologie, CHU de la Côte de Nacre, 14000, Caen, France
| | - Christine Lebrun-Frenay
- Centre de Ressources et Compétence Sclérose en Plaques (CRCSEP), Unité de Recherche Clinique Côte d'azur (UR2CA), Équipe URRIS, CHU Pasteur 2, Nice, France
| | - Mikael Cohen
- Centre de Ressources et Compétence Sclérose en Plaques (CRCSEP), Unité de Recherche Clinique Côte d'azur (UR2CA), Équipe URRIS, CHU Pasteur 2, Nice, France
| | - Lydiane Mondot
- Centre de Ressources et Compétence Sclérose en Plaques (CRCSEP), Unité de Recherche Clinique Côte d'azur (UR2CA), Équipe URRIS, CHU Pasteur 2, Nice, France
| | - Jerome De Seze
- Centre de Ressources et Compétence Sclérose en Plaques (CRCSEP), Département de Neurologie, CHRU de Strasbourg Hôpital de Hautepierre, Strasbourg, France
| | - Kevin Bigaut
- Centre de Ressources et Compétence Sclérose en Plaques (CRCSEP), Département de Neurologie, CHRU de Strasbourg Hôpital de Hautepierre, Strasbourg, France
| | - Nicolas Collongues
- Centre de Ressources et Compétence Sclérose en Plaques (CRCSEP), Département de Neurologie, CHRU de Strasbourg Hôpital de Hautepierre, Strasbourg, France
| | - Laurent Kremer
- Centre de Ressources et Compétence Sclérose en Plaques (CRCSEP), Département de Neurologie, CHRU de Strasbourg Hôpital de Hautepierre, Strasbourg, France
| | - Damien Ricard
- Département de Neurologie, Hôpital d'Instruction des Armées Percy, Service de Santé des Armées, Clamart, France
| | - Flavie Bompaire
- Département de Neurologie, Hôpital d'Instruction des Armées Percy, Service de Santé des Armées, Clamart, France
| | - Charlotte Ohlmann
- Département de Radiologie, Hôpital d'Instruction des Armées Percy, Service de Santé des Armées, Clamart, France
| | - Magali Sallansonnet-Froment
- Département de Neurologie, Hôpital d'Instruction des Armées Percy, Service de Santé des Armées, Clamart, France
| | - Jonathan Ciron
- Centre de Ressources et Compétence Sclérose en Plaques (CRCSEP)-Département des Neurosciences, CHU Toulouse-Purpan, and Toulouse Institute for Infectious and Inflammatory Diseases (Infinity), University of Toulouse, CNRS, INSERM, UPS, Toulouse, France
| | - Damien Biotti
- Centre de Ressources et Compétence Sclérose en Plaques (CRCSEP)-Département des Neurosciences, CHU Toulouse-Purpan, and Toulouse Institute for Infectious and Inflammatory Diseases (Infinity), University of Toulouse, CNRS, INSERM, UPS, Toulouse, France
| | - Beatrice Pignolet
- Centre de Ressources et Compétence Sclérose en Plaques (CRCSEP)-Département des Neurosciences, CHU Toulouse-Purpan, and Toulouse Institute for Infectious and Inflammatory Diseases (Infinity), University of Toulouse, CNRS, INSERM, UPS, Toulouse, France
| | - Jean-Jacques Parienti
- Unité de Biostatistiques et de Recherche Clinique, CHU de Caen-Cote de Nacre, Caen, France
| | - Gilles Defer
- Centre de Ressources et Compétence Sclérose en Plaques (CRCSEP), Service de Neurologie, CHU de la Côte de Nacre, 14000, Caen, France.
| |
Collapse
|
5
|
Defer G, Derache N, Branger P, Arnaud C. Télémédecine et e-santé dans le parcours de soins des patients SEP. Rev Neurol (Paris) 2022. [DOI: 10.1016/j.neurol.2022.02.104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
|
6
|
Coste T, Hervé D, Neau JP, Jouvent E, Ba F, Bergametti F, Lamy M, Cogez J, Derache N, Schneckenburger R, Grelet M, Gollion C, Lanotte L, Lauer V, Layet V, Urbanczyk C, Didic M, Raynouard I, Delaval L, Dassa J, Florea A, Badiu C, Nguyen K, Tournier-Lasserve E. Heterozygous HTRA1 nonsense or frameshift mutations are pathogenic. Brain 2021; 144:2616-2624. [PMID: 34270682 DOI: 10.1093/brain/awab271] [Citation(s) in RCA: 3] [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: 03/25/2021] [Revised: 06/30/2021] [Accepted: 07/01/2021] [Indexed: 11/12/2022] Open
Abstract
Heterozygous missense HTRA1 mutations have been associated with an autosomal dominant cerebral small vessel disease (CSVD) whereas the pathogenicity of heterozygous HTRA1 stop codon variants is unclear. We performed a targeted high throughput sequencing of all known CSVD genes, including HTRA1, in 3853 unrelated consecutive CSVD patients referred for molecular diagnosis. The frequency of heterozygous HTRA1 mutations leading to a premature stop codon in this patient cohort was compared with their frequency in large control databases. An analysis of HTRA1 mRNA was performed in several stop codon carrier patients. Clinical and neuroimaging features were characterized in all probands. Twenty unrelated patients carrying a heterozygous HTRA1 variant leading to a premature stop codon were identified. A highly significant difference was observed when comparing our patient cohort with control databases: gnomAD v3.1.1 [P = 3.12 × 10-17, odds ratio (OR) = 21.9], TOPMed freeze 5 (P = 7.6 × 10-18, OR = 27.1) and 1000 Genomes (P = 1.5 × 10-5). Messenger RNA analysis performed in eight patients showed a degradation of the mutated allele strongly suggesting a haploinsufficiency. Clinical and neuroimaging features are similar to those previously reported in heterozygous missense mutation carriers, except for penetrance, which seems lower. Altogether, our findings strongly suggest that heterozygous HTRA1 stop codons are pathogenic through a haploinsufficiency mechanism. Future work will help to estimate their penetrance, an important information for genetic counselling.
Collapse
Affiliation(s)
- Thibault Coste
- AP-HP, Service de Génétique Moléculaire Neurovasculaire, Hôpital Saint-Louis, France
- Université de Paris, INSERM UMR-1141 Neurodiderot, Paris F-75019, France
| | - Dominique Hervé
- Université de Paris, INSERM UMR-1141 Neurodiderot, Paris F-75019, France
- AP-HP, CERVCO, Service de Neurologie, Hôpital Lariboisière, France
| | - Jean Philippe Neau
- Centre Hospitalier Universitaire de Poitiers, Service de Neurologie, Poitiers, France
| | - Eric Jouvent
- Université de Paris, INSERM UMR-1141 Neurodiderot, Paris F-75019, France
- AP-HP, CERVCO, Service de Neurologie, Hôpital Lariboisière, France
| | - Fatoumata Ba
- AP-HP, Service de Génétique Moléculaire Neurovasculaire, Hôpital Saint-Louis, France
| | | | - Matthias Lamy
- Centre Hospitalier Universitaire de Poitiers, Service de Neurologie, Poitiers, France
| | - Julien Cogez
- Centre Hospitalier Universitaire de Caen, Service de Neurologie, Caen, France
| | - Nathalie Derache
- Centre Hospitalier Universitaire de Caen, Service de Neurologie, Caen, France
| | | | - Maude Grelet
- Centre Hospitalier Intercommunal de Toulon- La Seyne sur mer, Service de Génétique Médicale, Toulon, France
| | - Cédric Gollion
- Centre Hospitalier Universitaire de Toulouse, Service de Neurologie, Toulouse, France
| | - Livia Lanotte
- Hôpital De Hautepierre, Service de Neurologie, Strasbourg, France
| | - Valérie Lauer
- Hôpital De Hautepierre, Unité Neuro-Vasculaire, Strasbourg, France
| | - Valérie Layet
- Groupe Hospitalier Du havre, Service de Génétique Médicale, Le Havre, France
| | - Cédric Urbanczyk
- Centre Hospitalier Départemental La Roche-Sur-Yon, Service de Neurologie, La Roche-Sur-Yon, France
| | - Mira Didic
- APHM, Hôpital Timone Adultes, Service de Neurologie et Neuropsychologie, Marseille, France
- Aix Marseille Université, INSERM, INS, Inst Neurosci Syst, Marseille, France
| | - Igor Raynouard
- Fondation Adolphe de Rothschild, Service de Neurologie, Paris, France
| | - Laure Delaval
- AP-HP, Hôpital Bichat, Service de Médecine Interne, France
| | - Jérémie Dassa
- Centre Hospitalier Emile Roux, Service de Neurologie, Le Puy-en-Velay, France
| | - Alexandru Florea
- Centre Hospitalier Marie Madeleine, Service de Neurologie, Forbach, France
| | - Carmen Badiu
- Centre Hospitalier Metz-Thionville, Service de Neurologie, Metz, France
| | - Karine Nguyen
- APHM, Hôpital Timone Adultes, Département de Génétique, Marseille, France
| | - Elisabeth Tournier-Lasserve
- AP-HP, Service de Génétique Moléculaire Neurovasculaire, Hôpital Saint-Louis, France
- Université de Paris, INSERM UMR-1141 Neurodiderot, Paris F-75019, France
| |
Collapse
|
7
|
Lebrun-Frénay C, Rollot F, Mondot L, Zephir H, Louapre C, Le Page E, Durand-Dubief F, Labauge P, Bensa C, Thouvenot E, Laplaud D, de Seze J, Ciron J, Bourre B, Cabre P, Casez O, Ruet A, Mathey G, Berger E, Moreau T, Al Khedr A, Derache N, Clavelou P, Guennoc AM, Créange A, Neau JP, Tourbah A, Camdessanché JP, Maarouf A, Callier C, Vermersch P, Kantarci O, Siva A, Azevedo C, Makhani N, Cohen M, Pelletier D, Okuda D, Vukusic S. Risk Factors and Time to Clinical Symptoms of Multiple Sclerosis Among Patients With Radiologically Isolated Syndrome. JAMA Netw Open 2021; 4:e2128271. [PMID: 34633424 PMCID: PMC8506228 DOI: 10.1001/jamanetworkopen.2021.28271] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
IMPORTANCE Younger age, oligoclonal bands, and infratentorial and spinal cord lesions are factors associated with an increased 10-year risk of clinical conversion from radiologically isolated syndrome (RIS) to multiple sclerosis (MS). Whether disease-modifying therapy is beneficial for individuals with RIS is currently unknown. OBJECTIVES To evaluate the 2-year risk of a clinical event (onset of clinical symptoms of MS) prospectively, identify factors associated with developing an early clinical event, and simulate the sample size needed for a phase III clinical trial of individuals with RIS meeting 2009 RIS criteria. DESIGN, SETTING, AND PARTICIPANTS This cohort study used data on prospectively followed-up individuals with RIS identified at 1 of 26 tertiary centers for MS care in France that collect data for the Observatoire Français de la Sclérose en Plaques database. Participants were aged 10 to 80 years with 2 or more magnetic resonance imaging (MRI) scans after study entry and an index scan after 2000. All diagnoses were validated by an expert group, whose review included a double centralized MRI reading. Data were analyzed from July 2020 to January 2021. EXPOSURE Diagnosis of RIS. MAIN OUTCOMES AND MEASURES Risk of clinical event and associated covariates at index scan were analyzed among all individuals with RIS. Time to the first clinical event was compared by covariates, and sample size estimates were modeled based on identified risk factors. RESULTS Among 372 individuals with RIS (mean [SD] age at index MRI scan, 38.6 [12.1] years), 354 individuals were included in the analysis (264 [74.6%] women). A clinical event was identified among 49 patients (13.8%) within 2 years, which was associated with an estimated risk of conversion of 19.2% (95% CI, 14.1%-24.0%). In multivariate analysis, age younger than 37 years (hazard ratio [HR], 4.04 [95% CI, 2.00-8.15]; P < .001), spinal cord lesions (HR, 5.11 [95% CI, 1.99-13.13]; P = .001), and gadolinium-enhancing lesions on index scan (HR, 2.09 [95% CI, 1.13-3.87]; P = .02) were independently associated with an increased risk of conversion to MS. Having 2 factors at the time of the index MRI scan was associated with a risk of 27.9% (95% CI, 13.5%-39.9%) of a seminal event within 2 years, increasing to 90.9% (95% CI, 41.1%-98.6%) for individuals with all 3 factors (3 risk factors vs none: HR, 23.34 [95% CI, 9.08-59.96]; P < .001). Overall, with 80% power to detect an effect size of 60% within 24 months, a total of 160 individuals with RIS were needed assuming an event rate of 20%. CONCLUSIONS AND RELEVANCE This study found that age younger than age 37 years, spinal cord involvement, and gadolinium-enhancing lesions on index MRI scan were associated with earlier clinical disease and relevant to the number of enrolled patients needed to detect a potential treatment effect.
Collapse
Affiliation(s)
- Christine Lebrun-Frénay
- Centre de Resssource et Competence Sclérose En Plaques Nice, Unité Recherche Clinique Cote d'Azur Unité de Recherche sur le Syndrome Radiologique Isolé, Université Nice Côte d’Azur, Neurologie Centre Hospitalier Universitaire Pasteur 2, Nice, France
| | - Fabien Rollot
- Centre des Neurosciences de Lyon, Observatoire Français de la Sclérose en Plaques, Institut National de la Santé et de la Recherche Médicale 1028 et Centre National de Recherche Scientifique Unité Mixte de Recherche 5292, Lyon, France Université Claude Bernard Lyon 1, Lyon, France
- European Database for Multiple Sclerosis Foundation, Lyon, France
- Université Claude Bernard Lyon 1, Faculté de Médecine Lyon Est, Lyon, France
| | - Lydiane Mondot
- Centre de Resssource et Competence Sclérose En Plaques Nice, Unité Recherche Clinique Cote d'Azur Unité de Recherche sur le Syndrome Radiologique Isolé, Université Nice Côte d’Azur, Neurologie Centre Hospitalier Universitaire Pasteur 2, Nice, France
| | - Helene Zephir
- Université de Lille, Inserm Unité Mixte de Recherche-S 1172 LilNcog, Centre Hospitalier Universitaire Lille, Fédération Hospitalo-Universitaire Precise, Lille, France
| | - Celine Louapre
- Sorbonne University, Department of Neurology, Assistance Publique des Hôpitaux de Paris, Pitié-Salpêtrière Hospital, Paris, France
| | - Emmanuelle Le Page
- Centre Hospitalier Universitaire Pontchaillou, Centre d'Investigation Clinique 1414 Institut National de la Santé et de la Recherche Médicale, Rennes, France
| | - Françoise Durand-Dubief
- Service de Neurologie, Sclérose en Plaques, Pathologies de la Myéline et Neuro-Inflammation, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Lyon, France
| | - Pierre Labauge
- Centre de Ressources et Competences Sclerose En Plaques, Centre Hospitalier Universitaire de Montpellier, Montpellier, France
- University of Montpellier, Montpellier, France
| | - Caroline Bensa
- Department of Neurology, Fondation Rothschild, Paris, France
| | - Eric Thouvenot
- Department of Neurology, Centre Hospitalier Universitaire de Nîmes, Nîmes, France; Institut de Génomique Fonctionnelle, Université de Montpellier, Centre National de Recherche Scientifique, Institut National de la Santé et de la Recherche Médicale, Montpellier, France
| | - David Laplaud
- Service de Neurologie, Centre d'Investigation Clinique 015 Institut National de la Santé et de la Recherche Médicale, Nantes, France; Institut National de la Santé et de la Recherche Médicale 1064, Nantes, France
| | - Jerome de Seze
- Department Clinical Investigation Center, Department of Neurology, Centre Hospitalier Universitaire de Strasbourg, Institut National de la Santé et de la Recherche Médicale 1434, Strasbourg, France
| | - Jonathan Ciron
- Department of Neurology, Centre de Resssource et Competence Sclérose En Plaques, Centre Hospitalier Universitaire de Toulouse; Institut Toulousain des Maladies Infectieuses et Inflammatoires (Infinity), Institut National de la Santé et de la Recherche Médicale Unité Mixte de Recherche1291, Centre National de Recherche Scientifique Unité Mixte de Recherche 5051, Université Toulouse III Toulouse, France
| | - Bertrand Bourre
- Department of Neurology, Centre Hospitalier Universitaire de Rouen, Rouen, France
| | - Philippe Cabre
- Department of Neurology, Centre Hospitalier Universitaire de la Martinique, Fort-de-France, France
| | - Olivier Casez
- Department of Neurology, Centre Hospitalier Universitaire Grenoble Alpes, Grenoble, France
| | - Aurélie Ruet
- Centre de Resssource et Competence Sclérose En Plaques, Neurology Department, Centre Hospitalier Universitaire of Bordeaux, Bordeaux, France; Université Bordeaux, Institut National de la Santé et de la Recherche Médicale, Neurocentre Magendie, U1215, Bordeaux, France
| | - Guillaume Mathey
- Department of Neurology, Nancy University Hospital, Nancy, France; Université de Lorraine, Equipe Avenir 4360 Adaptation, Mesure et Evaluation en Sante Approches Interdisciplinaires, Vandoeuvre-Lès-Nancy, Nancy, France
| | - Eric Berger
- Department of Neurology, Centre Hospitalier Universitaire de Besançon, Besançon, France
| | - Thibault Moreau
- Department of Neurology, Centre Hospitalier Universitaire de Dijon, EA4184, Dijon, France
| | - Abdulatif Al Khedr
- Department of Neurology, Centre Hospitalier Universitaire d’Amiens, Amiens, France
| | - Nathalie Derache
- Department of Neurology, Centre Hospitalier Universitaire de Caen Normandie, Caen, France
| | - Pierre Clavelou
- Department of Neurology, Neuro-Dol, Centre Hospitalier Universitaire Clermont-Ferrand, Université Clermont Auvergne, Institut National de la Santé et de la Recherche Médicale U1107, Clermont-Ferrand, France
| | - Anne-Marie Guennoc
- Department of Neurology, Centre Hospitalier Universitaire de Tours, Hôpital Bretonneau, Centre de Resssource et Competence Sclérose En Plaques, Tours, France
| | - Alain Créange
- Department of Neurology, Assistance Publique des Hôpitaux de Paris, Hôpital Henri Mondor, Université Paris Est, Créteil, France
| | - Jean-Philippe Neau
- Department of Neurology, Centre Hospitalier Universitaire de Poitiers, Poitiers, France
| | - Ayman Tourbah
- Department of Neurology, Hôpital Raymond Poincaré, Garches, Unité de Formation de Recherche Simone Veil, Institut National de la Santé et de la Recherche Médicale U1195, Assistance Publique Hopitaux de Paris, Université Paris Saclay, France
| | - Jean-Philippe Camdessanché
- Department of Neurology, Centre Hospitalier Universitaire de Saint-Étienne, Hôpital Nord, Saint-Étienne, France
| | - Adil Maarouf
- Department of Neurology, Centre Hospitalier Universitaire Timone, Marseille, France
| | - Celine Callier
- Centre de Resssource et Competence Sclérose En Plaques Nice, Unité Recherche Clinique Cote d'Azur Unité de Recherche sur le Syndrome Radiologique Isolé, Université Nice Côte d’Azur, Neurologie Centre Hospitalier Universitaire Pasteur 2, Nice, France
| | - Patrick Vermersch
- Université de Lille, Inserm Unité Mixte de Recherche-S 1172 LilNcog, Centre Hospitalier Universitaire Lille, Fédération Hospitalo-Universitaire Precise, Lille, France
| | | | - Aksel Siva
- Department of Neurology, Istanbul University Cerrahpasa School of Medicine, Turkey
| | | | - Naila Makhani
- Departments of Pediatrics and Neurology, Yale School of Medicine, New Haven, Connecticut
| | - Mikael Cohen
- Centre de Resssource et Competence Sclérose En Plaques Nice, Unité Recherche Clinique Cote d'Azur Unité de Recherche sur le Syndrome Radiologique Isolé, Université Nice Côte d’Azur, Neurologie Centre Hospitalier Universitaire Pasteur 2, Nice, France
| | | | - Darin Okuda
- University of Texas Southwestern Medical Center, Dallas
| | - Sandra Vukusic
- Université Claude Bernard Lyon 1, Faculté de Médecine Lyon Est, Lyon, France
- Service de Neurologie, Sclérose en Plaques, Pathologies de la Myéline et Neuro-Inflammation, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Lyon, France
| |
Collapse
|
8
|
Deschamps R, Pique J, Ayrignac X, Collongues N, Audoin B, Zéphir H, Ciron J, Cohen M, Aboab J, Mathey G, Derache N, Laplaud D, Thouvenot E, Bourre B, Ruet A, Durand-Dubief F, Touitou V, Vignal-Clermont C, Papeix C, Gout O, Marignier R, Maillart E. The long-term outcome of MOGAD: An observational national cohort study of 61 patients. Eur J Neurol 2021; 28:1659-1664. [PMID: 33528851 DOI: 10.1111/ene.14746] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 01/04/2021] [Accepted: 01/09/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND AND OBJECTIVE The prognosis in myelin oligodendrocyte glycoprotein (MOG) antibody-associated disease (MOGAD) is a matter of debate. Our aim was to assess the long-term outcomes of patients with MOGAD. METHODS We retrospectively analysed the clinical and paraclinical data of patients from the French nationwide observatory study NOMADMUS who tested positive for MOG antibodies (MOG-IgG) and who had clinical follow-up of at least 8 years from their first episode. RESULTS Sixty-one patients (median [range] age at onset 27 [3-69] years), with a median (mean; range) follow-up of 177 (212.8; 98-657) months, were included. Among 58 patients with a relapsing course, 26.3% relapsed in the first year after onset. Of the 61 patients, 90.2% experienced at least one episode of optic neuritis. At last visit, the median (mean; range) Expanded Disability Status Scale (EDSS) score was 1 (2.12; 0-7.5), 12.5% had an EDSS score ≥6 and 37.5% had an EDSS score ≥3. Of 51 patients with final visual acuity (VA) data available, 15.7% had VA ≤0.1 in at least one eye and 25.5% had VA ≤0.5 in at least one eye. Bilateral blindness (VA ≤0.1) was present in 5.9% of patients. Finally, 12.5% of patients presented bladder dysfunction requiring long-term urinary catheterization. No factor associated significantly with a final EDSS score ≥3 or with final VA ≤0.1 was found. CONCLUSION Overall long-term favourable outcomes were achieved in a majority of our patients, but severe impairment, in particular visual damage, was not uncommon.
Collapse
Affiliation(s)
- Romain Deschamps
- Department of Neurology, Hôpital Fondation Adolphe de Rothschild, Paris Cedex 19, France
| | - Julie Pique
- Service de Neurologie, Sclérose en Plaques, Pathologies de la Myéline et Neuro-Inflammation, Centre de référence des Maladies Inflammatoires Rares du Cerveau et de la Moelle (MIRCEM), Hôpital Neurologique Pierre Wertheimer, Lyon University Hospital, Lyon, France
| | - Xavier Ayrignac
- Department of Neurology, University Hospital of Montpellier, Montpellier, France
| | - Nicolas Collongues
- Department of Neurology, University Hospital of Strasbourg, Strasbourg, France
| | - Bertrand Audoin
- Department of Neurology, Pôle de Neurosciences Cliniques, APHM, Hôpital de la Timone, Aix Marseille University, Marseille, France
| | - Hélène Zéphir
- Department of Neurology, U 1172, CRC-SEP, University Hospital of Lille, Lille, France
| | - Jonathan Ciron
- Department of Neurology, University Hospital of Toulouse, Toulouse, France
| | - Mikael Cohen
- Unité de Recherche Clinique Cote d'Azur, UR2CA, CRC-SEP, Hôpital Pasteur 2 Neurologie, URRIS, Nice, France
| | - Jennifer Aboab
- Department of Internal Medecine, Centre Hospitalier National d'Ophtalmologie des XV-XX, Paris, France
| | - Guillaume Mathey
- Department of Neurology, University Hospital of Nancy, Nancy, France
| | - Nathalie Derache
- Department of Neurology, University Hospital of Caen, Caen, France
| | - David Laplaud
- Department of Neurology, CRTI-Inserm U1064, CIC004, University Hospital of Nantes, Nantes, France
| | - Eric Thouvenot
- Department of Neurology, University Hospital of Nimes, Nimes, France
| | - Bertrand Bourre
- Department of Neurology, University Hospital of Rouen, Rouen, France
| | - Aurélie Ruet
- Department of Neurology, University Hospital of Bordeaux, Bordeaux, France
| | - Françoise Durand-Dubief
- Service de Neurologie, Sclérose en Plaques, Pathologies de la Myéline et Neuro-Inflammation, Centre de référence des Maladies Inflammatoires Rares du Cerveau et de la Moelle (MIRCEM), Hôpital Neurologique Pierre Wertheimer, Lyon University Hospital, Lyon, France
| | - Valérie Touitou
- Department of Ophtalmology, AP-HP, Hôpital Pitié-Salpêtrière, Paris, France
| | | | - Caroline Papeix
- Department of Neurology, Centre de référence des maladies inflammatoires rares du cerveau et de la moelle (MIRCEM), AP-HP, Hôpital Pitié-Salpêtrière, Paris, France
| | - Olivier Gout
- Department of Neurology, Hôpital Fondation Adolphe de Rothschild, Paris Cedex 19, France
| | - Romain Marignier
- Service de Neurologie, Sclérose en Plaques, Pathologies de la Myéline et Neuro-Inflammation, Centre de référence des Maladies Inflammatoires Rares du Cerveau et de la Moelle (MIRCEM), Hôpital Neurologique Pierre Wertheimer, Lyon University Hospital, Lyon, France
| | - Elisabeth Maillart
- Department of Neurology, Centre de référence des maladies inflammatoires rares du cerveau et de la moelle (MIRCEM), AP-HP, Hôpital Pitié-Salpêtrière, Paris, France
| | | |
Collapse
|
9
|
Derache N, Hauchard K, Seguin F, Ohannessian R, Defer G. Retrospective evaluation of regional telemedicine team meetings for multiple sclerosis (MS) patients: Experience from the Caen MS expert center in Normandy, France. Rev Neurol (Paris) 2020; 177:407-413. [PMID: 33272563 DOI: 10.1016/j.neurol.2020.06.020] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Revised: 05/01/2020] [Accepted: 06/09/2020] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Multiple sclerosis (MS) is a demyelinating disease requiring multidisciplinary care coordination. Recent development of diagnosis criteria and disease modifying treatments have encouraged the setup of regional team meetings by MS expert centers, known as CRC Sep, to improve the quality of care provided to patients with complex cases. The CRC Sep in Caen initiated regional telemedicine meetings named Télé-SEP, operating since 2016. The objective of this study was to evaluate the Télé-SEP used by neurologists, on MS patient care management in Normandy. METHODS An internal ex-itinere evaluation was conducted with a retrospective descriptive observational study from July 2016 to June 2018. The Télé-SEP meetings were organized with 41 neurologists using a regional telemedicine platform (Therap-e). Data were collected from online records and a declarative voluntary survey. Twenty indicators were classified in the categories: volume of activity, clinical profile, quality and impact. RESULTS Fifteen meetings were organized with a median of 13 senior neurologists. One hundred forty MS cases were discussed and there was a 33% increase in the second year of Télé-SEP. Median patient age was 44 years with a 72-month median length of disease. Most patient cases required second-line treatment. Relapsing remitting MS was diagnosed in 51.4% of cases. Télé-SEP satisfaction rate was 4.5/5 and 96% of neurologists applied the medical decisions and recommendations given in the meetings. CONCLUSION Without Télé-SEP, 54.5% of patients would have been referred to a physical expert consultation in the CRC Sep. This study showed the feasibility and relevance of regional telemedicine team meetings for MS cases in the Normandy region.
Collapse
Affiliation(s)
- N Derache
- Service de Neurologie, Réseau Bas-Normand Pour la Prise en Charge de la SEP, Centre de Ressources et de Compétences SEP France, Avenue de la Côte de Nacre, 14000 Caen, France
| | | | - F Seguin
- GCS Normand'e Santé, Caen, France
| | | | - G Defer
- Service de Neurologie, Réseau Bas-Normand Pour la Prise en Charge de la SEP, Centre de Ressources et de Compétences SEP France, Avenue de la Côte de Nacre, 14000 Caen, France
| |
Collapse
|
10
|
Vukusic S, Rollot F, Casey R, Pique J, Marignier R, Mathey G, Edan G, Brassat D, Ruet A, De Sèze J, Maillart E, Zéphir H, Labauge P, Derache N, Lebrun-Frenay C, Moreau T, Wiertlewski S, Berger E, Moisset X, Rico-Lamy A, Stankoff B, Bensa C, Thouvenot E, Heinzlef O, Al-Khedr A, Bourre B, Vaillant M, Cabre P, Montcuquet A, Wahab A, Camdessanché JP, Tourbah A, Guennoc AM, Hankiewicz K, Patry I, Nifle C, Maubeuge N, Labeyrie C, Vermersch P, Laplaud DA. Progressive Multifocal Leukoencephalopathy Incidence and Risk Stratification Among Natalizumab Users in France. JAMA Neurol 2020; 77:94-102. [PMID: 31479149 DOI: 10.1001/jamaneurol.2019.2670] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
Importance Risk of developing progressive multifocal leukoencephalopathy (PML) is the major barrier to using natalizumab for patients with multiple sclerosis (MS). To date, the association of risk stratification with PML incidence has not been evaluated. Objective To describe the temporal evolution of PML incidence in France before and after introduction of risk minimization recommendations in 2013. Design, Setting, and Participants This observational study used data in the MS registry OFSEP (Observatoire Français de la Sclérose en Plaques) collected between April 15, 2007, and December 31, 2016, by participating MS expert centers and MS-dedicated networks of neurologists in France. Patients with an MS diagnosis according to current criteria, regardless of age, were eligible, and those exposed to at least 1 natalizumab infusion (n = 6318) were included in the at-risk population. A questionnaire was sent to all centers, asking for a description of their practice regarding PML risk stratification. Data were analyzed in July 2018. Exposures Time from the first natalizumab infusion to the occurrence of PML, natalizumab discontinuation plus 6 months, or the last clinical evaluation. Main Outcomes and Measures Incidence was the number of PML cases reported relative to the person-years exposed to natalizumab. A Poisson regression model for the 2007 to 2016 period estimated the annual variation in incidence and incidence rate ratio (IRR), adjusted for sex and age at treatment initiation and stratified by period (2007-2013 and 2013-2016). Results In total, 6318 patients were exposed to natalizumab during the study period, of whom 4682 (74.1%) were female, with a mean (SD [range]) age at MS onset of 28.5 (9.1 [1.1-72.4]) years; 45 confirmed incident cases of PML were diagnosed in 22 414 person-years of exposure. The crude incidence rate for the whole 2007 to 2016 period was 2.00 (95% CI, 1.46-2.69) per 1000 patient-years. Incidence significantly increased by 45.3% (IRR, 1.45; 95% CI, 1.15-1.83; P = .001) each year before 2013 and decreased by 23.0% (IRR, 0.77; 95% CI, 0.61-0.97; P = .03) each year from 2013 to 2016. Conclusions and Relevance The results of this study suggest, for the first time, a decrease in natalizumab-associated PML incidence since 2013 in France that may be associated with a generalized use of John Cunningham virus serologic test results; this finding appears to support the continuation and reinforcement of educational activities and risk-minimization strategies in the management of disease-modifying therapies for multiple sclerosis.
Collapse
Affiliation(s)
- Sandra Vukusic
- Université Claude Bernard Lyon 1, Faculté de Médecine Lyon Est, Lyon, France.,Service de Neurologie, Sclérose en Plaques, Pathologies de la Myéline et Neuro-Inflammation, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Lyon/Bron, France.,Centre des Neurosciences de Lyon, Observatoire Français de la Sclérose en Plaques, INSERM 1028 et CNRS UMR5292, Lyon, France
| | - Fabien Rollot
- Université Claude Bernard Lyon 1, Faculté de Médecine Lyon Est, Lyon, France.,Université Claude Bernard Lyon 1, Lyon, France.,Hospices Civils de Lyon, Lyon, France.,EDMUS Foundation, Lyon/Bron, France
| | - Romain Casey
- Université Claude Bernard Lyon 1, Faculté de Médecine Lyon Est, Lyon, France.,Université Claude Bernard Lyon 1, Lyon, France.,Hospices Civils de Lyon, Lyon, France.,EDMUS Foundation, Lyon/Bron, France
| | - Julie Pique
- Université Claude Bernard Lyon 1, Faculté de Médecine Lyon Est, Lyon, France.,Service de Neurologie, Sclérose en Plaques, Pathologies de la Myéline et Neuro-Inflammation, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Lyon/Bron, France
| | - Romain Marignier
- Université Claude Bernard Lyon 1, Faculté de Médecine Lyon Est, Lyon, France.,Service de Neurologie, Sclérose en Plaques, Pathologies de la Myéline et Neuro-Inflammation, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Lyon/Bron, France.,Centre des Neurosciences de Lyon, FLUID Team, INSERM 1028 et CNRS UMR5292, Lyon, France
| | - Guillaume Mathey
- Department of Neurology, Nancy University Hospital, Nancy, France.,Université de Lorraine, EA 4360 APEMAC, Vandoeuvre-Lès-Nancy, Nancy, France
| | - Gilles Edan
- CHU Pontchaillou, CIC1414 INSERM, Rennes, France
| | - David Brassat
- Department of Neurology, CHU de Toulouse, Toulouse, France
| | - Aurélie Ruet
- University of Bordeaux, Bordeaux, France.,INSERM U1215, Neurocentre Magendie, Bordeaux, France.,CHU de Bordeaux, CIC Bordeaux CIC1401, Bordeaux, France
| | - Jérôme De Sèze
- Clinical Investigation Center, Department of Neurology, CHU de Strasbourg, INSERM 1434, Strasbourg, France
| | - Elisabeth Maillart
- Department of Neurology, Assistance Publique des Hôpitaux de Paris, Pitié-Salpêtrière Hospital, Paris, France
| | - Hélène Zéphir
- LIRIC (Lille Inflammation Research International Center), University of Lille, CHU de Lille, INSERM UMR995, Lille, France
| | - Pierre Labauge
- CHU de Montpellier, MS Unit, Montpellier, France.,University of Montpellier (MUSE), Montpellier, France
| | | | | | - Thibault Moreau
- Department of Neurology, CHU de Dijon, EA4184, Dijon, France
| | - Sandrine Wiertlewski
- CHU de Nantes, Service de Neurologie, CIC015 INSERM, Nantes, France.,INSERM CR1064, Nantes, France
| | - Eric Berger
- Department of Neurology, CHU de Besançon, Besançon, France
| | - Xavier Moisset
- Department of Neurology, Neuro-Dol, CHU Clermont-Ferrand, Université Clermont Auvergne, INSERM U1107, Clermont-Ferrand, France
| | - Audrey Rico-Lamy
- Pôle de Neurosciences Cliniques, Service de Neurologie, APHM, Hôpital de la Timone, Marseille, France.,CRMBM UMR 7339, CNRS, Aix-Marseille Université, Marseille, France
| | - Bruno Stankoff
- Brain and Spine Institute, Sorbonne Universités, UPMC Paris 06, ICM, Hôpital de la Pitié Salpêtrière, INSERM UMR S 1127, CNRS UMR 7225, Paris, France.,Department of Neurology, AP-HP, Saint-Antoine Hospital, Paris, France
| | - Caroline Bensa
- Department of Neurology, Fondation Rothschild, Paris, France
| | - Eric Thouvenot
- Department of Neurology, CHU de Nîmes, Nîmes, France.,Institut de Génomique Fonctionnelle, UMR5203, INSERM 1191, Université de Montpellier, Montpellier, France
| | | | | | | | | | - Philippe Cabre
- Department of Neurology, CHU de la Martinique, Fort-de-France, France
| | - Alexis Montcuquet
- Department of Neurology, CHU de Limoges, Hôpital Dupuytren, Limoges, France
| | - Abir Wahab
- Department of Neurology, Assistance Publique des Hôpitaux de Paris, Hôpital Henri Mondor, Université Paris Est, Créteil, France
| | | | - Ayman Tourbah
- Department of Neurology, CHU de Reims, Faculté de Médecine de Reims, URCA, Reims, France.,LPN EA 2027 Université Paris 8, Saint-Denis, France
| | - Anne-Marie Guennoc
- Department of Neurology, CHU de Tours, Hôpital Bretonneau, CRC SEP, Tours, France
| | - Karolina Hankiewicz
- Department of Neurology, Hôpital Pierre Delafontaine, Centre Hospitalier de Saint-Denis, Saint-Denis, France
| | - Ivania Patry
- Department of Neurology, Hôpital Sud Francilien, Corbeil-Essonnes, France
| | - Chantal Nifle
- Department of Neurology, Centre Hospitalier de Versailles, Le Chesnay, France
| | - Nicolas Maubeuge
- Department of Neurology, CHU de Poitiers, Hôpital La Milétrie, Poitiers, France
| | - Céline Labeyrie
- Department of Neurology, CHU de Bicêtre, Le Kremlin-Bicêtre, France
| | - Patrick Vermersch
- LIRIC (Lille Inflammation Research International Center), University of Lille, CHU de Lille, INSERM UMR995, Lille, France
| | - David-Axel Laplaud
- CHU de Nantes, Service de Neurologie, CIC015 INSERM, Nantes, France.,INSERM CR1064, Nantes, France
| | | |
Collapse
|
11
|
Cohen M, Mondot L, Bucciarelli F, Pignolet B, Laplaud DA, Wiertlewski S, Brochet B, Ruet A, Defer G, Derache N, Vermersch P, Zephir H, Debouverie M, Mathey G, Berger E, Cappé C, Labauge P, Carra C, De Seze J, Bigaut K, Brassat D, Lebrun-Frenay C. BEST-MS: A prospective head-to-head comparative study of natalizumab and fingolimod in active relapsing MS. Mult Scler 2020; 27:1556-1563. [PMID: 33124504 DOI: 10.1177/1352458520969145] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND There are few head-to-head studies to compare highly active treatments in multiple sclerosis (MS). OBJECTIVE The aim of this study was to compare the effectiveness between natalizumab (NTZ) and fingolimod (FTY) in active relapsing-remitting MS. METHOD Best Escalation STrategy in Multiple Sclerosis (BEST-MS) is a multicentric, prospective study with a 12-month follow-up including patients with active MS. Treatment choice was at the discretion of physician. Clinical and magnetic resonance imaging (MRI) data were collected at baseline and at 12 months. The primary outcome was the proportion of patients reaching no evidence of disease activity (NEDA) at 12 months. Secondary outcomes included annualized relapse rate and MRI activity. RESULTS A total of 223 patients were included (NTZ: 109 and FTY: 114). Treatment groups were well balanced at baseline. Proportion of NEDA patients was 47.8% in NTZ group versus 30.4% in FTY group (p = 0.015). This superiority was driven by annualized relapse rate and MRI activity. In the multivariate analysis, treatment group was the only factor associated with NEDA at 12 months with a lower probability in FTY group (odds ratio (OR) = 0.49, p = 0.029). CONCLUSION BEST-MS is a prospective study that compared head-to-head the effectiveness of NTZ and FTY in active relapsing-remitting MS. Our results suggest a superiority of NTZ over FTY.
Collapse
Affiliation(s)
- Mikael Cohen
- Service de Neurologie, CRCSEP, Unité de Recherche Clinique Cote d'Azur (UR2CA), Centre Hospitalier Universitaire Pasteur 2, Nice, France
| | - Lydiane Mondot
- Service de Radiologie, Unité de Recherche Clinique Cote d'Azur (UR2CA), Centre Hospitalier Universitaire Pasteur 2, Nice, France
| | - Florence Bucciarelli
- Neurosciences Department, CRCSEP, University Hospital of Toulouse, Toulouse, France/INSERM U1043-CNRS UMR 5282, Centre de Physiopathologie Toulouse, Toulouse, France
| | - Béatrice Pignolet
- Neurosciences Department, CRCSEP, University Hospital of Toulouse, Toulouse, France/INSERM U1043-CNRS UMR 5282, Centre de Physiopathologie Toulouse, Toulouse, France
| | - David-Axel Laplaud
- CRTI-INSERM U1064, CIC 1413, Service de Neurologie, CHU Nantes, Nantes, France
| | | | - Bruno Brochet
- Service de Neurologie, CRC SEP, Centre Hospitalier Universitaire (CHU) de Bordeaux, Bordeaux, France
| | - Aurélie Ruet
- Service de Neurologie, CRC SEP, Centre Hospitalier Universitaire (CHU) de Bordeaux, Bordeaux, France
| | - Gilles Defer
- Service de Neurologie, CHU de Caen, Avenue de la Côte de Nacre, Caen, France
| | - Nathalie Derache
- Service de Neurologie, CHU de Caen, Avenue de la Côte de Nacre, Caen, France
| | | | - Hélène Zephir
- Univ. Lille, INSERM U1172, CHU Lille, FHU Imminent, Lille, France
| | - Marc Debouverie
- CHRU-Nancy, INSERM, Université de Lorraine, CIC, Epidémiologie Clinique, Nancy, France
| | - Guillaume Mathey
- CHRU-Nancy, INSERM, Université de Lorraine, CIC, Epidémiologie Clinique, Nancy, France
| | - Eric Berger
- Service de Neurologie, CHU de Besançon, Besançon, France
| | - Chrystelle Cappé
- Centre d'investigation clinique, CHU de Besançon, Besançon, France
| | | | | | - Jérôme De Seze
- Clinical Investigation Center, Department of Neurology, CHU de Strasbourg, INSERM 1434, Strasbourg, France
| | - Kevin Bigaut
- Clinical Investigation Center, Department of Neurology, CHU de Strasbourg, INSERM 1434, Strasbourg, France
| | - David Brassat
- Neurosciences Department, CRCSEP, University Hospital of Toulouse, Toulouse, France/INSERM U1043-CNRS UMR 5282, Centre de Physiopathologie Toulouse, Toulouse, France
| | - Christine Lebrun-Frenay
- Service de Neurologie, CRCSEP, Unité de Recherche Clinique Cote d'Azur (UR2CA), Centre Hospitalier Universitaire Pasteur 2, Nice, France
| |
Collapse
|
12
|
Peyro-Saint-Paul L, Derache N, Ficheux M, Allouche S, Parienti JJ, Calocer F, Le Caignec F, Fedrizzi S, Defer G. Severe bone pain with teriflunomide: Five case reports and review of the French pharmacovigilance database. Therapie 2020; 75:503-506. [DOI: 10.1016/j.therap.2019.07.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Revised: 05/06/2019] [Accepted: 07/22/2019] [Indexed: 10/26/2022]
|
13
|
Branger P, Parienti JJ, Derache N, Kassis N, Assouad R, Maillart E, Defer G. Relapses During High-Dose Biotin Treatment in Progressive Multiple Sclerosis: a Case-Crossover and Propensity Score-Adjusted Prospective Cohort. Neurotherapeutics 2020; 17:989-993. [PMID: 32557122 PMCID: PMC7641290 DOI: 10.1007/s13311-020-00880-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
High-dose biotin (HDB) is a therapy used in non-active progressive multiple sclerosis (PMS). Some reports have suggested that HDB treatment may be associated with an increased risk of relapse. We evaluate the relationship between exposure to HDB for treating PMS and the risk of relapse. We screened for PMS patients prospectively registered in a French regional cohort being part of the OFSEP national registry. In a case-crossover design among patients who received HDB, we first compared number of relapses before and after initiation of HDB. Second, time to the first clinical relapse was compared between patients who received HDB (biotin group) and a control group using a Cox survival analysis after a propensity score (PS) matching (1:1) and inverse probability of treatment weighting (IPTW) method. In the 42 PMS patients who received HDB, the number of relapses was statistically and clinically significant higher after biotin initiation than before biotin initiation (incident rate ratio [IRR] 7.4, 95% confidence interval [CI] 3.5-15.9, p < 0.0001). With the PS matching method, the risk of relapse was significantly higher in the biotin group compared to the control group (hazard ratio [HR] 4.3, 95% CI 1.4-13.3, p = 0.01). The IPTW method with 440 control patients revealed consistent results (HR 5.1, 95% CI 2.3-11.3, p < 0.0001). In our non-randomized study, HDB treatment for PMS was associated with an increased risk of relapse. The follow-up of PMS patients initiating HDB should include careful assessment of clinical and radiological activity to monitor the potential pro-inflammatory effect of biotin.
Collapse
Affiliation(s)
- Pierre Branger
- Department of Neurology, CHU de Caen, F-14000, Caen, France.
| | - Jean-Jacques Parienti
- Department of Clinical Research and Biostatistics, CHU de Caen, F-14000, Caen, France
| | | | - Nizam Kassis
- Department of Neurology, CHP du Cotentin, F-50102, Cherbourg-en-Cotentin, France
| | - Rana Assouad
- Department of Neurology, GH Pitié-Salpêtrière, F-75013, Paris VI, France
| | - Elisabeth Maillart
- Department of Neurology, GH Pitié-Salpêtrière, F-75013, Paris VI, France
| | - Gilles Defer
- Department of Neurology, CHU de Caen, F-14000, Caen, France
| |
Collapse
|
14
|
Maillart E, Durand-Dubief F, Louapre C, Audoin B, Bourre B, Derache N, Ciron J, Collongues N, de Sèze J, Cohen M, Lebrun-Frenay C, Hadhoum N, Zéphir H, Deschamps R, Carra-Dallière C, Labauge P, Kerschen P, Montcuquet A, Wiertlewski S, Laplaud D, Runavot G, Vukusic S, Papeix C, Marignier R. Outcome and risk of recurrence in a large cohort of idiopathic longitudinally extensive transverse myelitis without AQP4/MOG antibodies. J Neuroinflammation 2020; 17:128. [PMID: 32326965 PMCID: PMC7178729 DOI: 10.1186/s12974-020-01773-w] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2020] [Accepted: 03/16/2020] [Indexed: 12/23/2022] Open
Abstract
Background Longitudinally extensive transverse myelitis (LETM) is classically related to aquaporin (AQP4)-antibodies (Ab) neuromyelitis optica spectrum disorders (NMOSD) or more recently to myelin oligodendrocyte glycoprotein (MOG)-Ab associated disease. However, some patients remain negative for any diagnosis, despite a large work-up including AQP4-Ab and MOG-Ab. Data about natural history, disability outcome, and treatment are limited in this group of patients. We aimed to (1) describe clinical, biological, and radiological features of double seronegative LETM patients; (2) assess the clinical course and identify prognostic factors; and (3) assess the risk of recurrence, according to maintenance immunosuppressive therapy. Methods Retrospective evaluation of patients with a first episode of LETM, tested negative for AQP-Ab and MOG-Ab, from the French nationwide observatory study NOMADMUS. Results Fifty-three patients (median age 38 years (range 16–80)) with double seronegative LETM were included. Median nadir EDSS at onset was 6.0 (1–8.5), associated to a median EDSS at last follow-up of 4.0 (0–8). Recurrence was observed in 24.5% of patients in the 18 following months, with a median time to first relapse of 5.7 months. The risk of recurrence was lower in the group of patients treated early with an immunosuppressive drug (2/22, 9%), in comparison with untreated patients (10/31, 32%). Conclusions A first episode of a double seronegative LETM is associated to a severe outcome and a high rate of relapse in the following 18 months, suggesting that an early immunosuppressive treatment may be beneficial in that condition.
Collapse
Affiliation(s)
- Elisabeth Maillart
- Department of Neurology; Centre de Référence des Maladies Inflammatoires Rares du Cerveau et de la Moelle, AP-HP, Hôpital Pitié-Salpêtrière, Paris, France.
| | - Françoise Durand-Dubief
- Service de neurologie, sclérose en plaques, pathologies de la myéline et neuro-inflammation, and Centre de Référence des Maladies Inflammatoires Rares du Cerveau et de la Moelle, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, 69677, Lyon/Bron, France
| | - Céline Louapre
- Department of Neurology; Centre de Référence des Maladies Inflammatoires Rares du Cerveau et de la Moelle, AP-HP, Hôpital Pitié-Salpêtrière, Paris, France
| | - Bertrand Audoin
- APHM, Hôpital de la Timone, Pôle de Neurosciences Cliniques, Service de Neurologie, Marseille, France
| | - Bertrand Bourre
- Department of Neurology, University Hospital of Rouen, Rouen, France
| | - Nathalie Derache
- Department of Neurology, University Hospital of Caen, Caen, France
| | - Jonathan Ciron
- Department of Neurology, University Hospital of Toulouse, Toulouse, France
| | - Nicolas Collongues
- Department of Neurology, University Hospital of Strasbourg, Strasbourg, France
| | - Jérome de Sèze
- Department of Neurology, University Hospital of Strasbourg, Strasbourg, France
| | - Mikael Cohen
- Centre de Ressources et Compétence Sclerose en plaques (CRCSEP); Unité de Recherche Clinique Côte d'azur (UR2CA), CHU Pasteur 2, Nice, France
| | - Christine Lebrun-Frenay
- Centre de Ressources et Compétence Sclerose en plaques (CRCSEP); Unité de Recherche Clinique Côte d'azur (UR2CA), CHU Pasteur 2, Nice, France
| | - Nawel Hadhoum
- Department of Neurology, University Hospital of Lille, Lille, France
| | - Hélène Zéphir
- Department of Neurology, University Hospital of Lille, Lille, France
| | - Romain Deschamps
- Department of Neurology, Fondation Ophtalmologique Adolphe de Rothschild, 25-29, rue Manin, 75940, Paris cedex 19, France
| | | | - Pierre Labauge
- Department of Neurology, University Hospital of Montpellier, Montpellier, France
| | - Philippe Kerschen
- Department of Neurology, University Hospital of Luxembourg, Luxembourg, Luxembourg
| | - Alexis Montcuquet
- Department of Neurology, University Hospital of Limoges, Limoges, France
| | | | - David Laplaud
- Department of Neurology, University Hospital of Nantes, Nantes, France
| | - Gwenaëlle Runavot
- Department of Neurology, University Hospital of Saint-Pierre, Saint-Pierre, La Réunion, France
| | - Sandra Vukusic
- Service de neurologie, sclérose en plaques, pathologies de la myéline et neuro-inflammation, and Centre de Référence des Maladies Inflammatoires Rares du Cerveau et de la Moelle, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, 69677, Lyon/Bron, France
| | - Caroline Papeix
- Department of Neurology; Centre de Référence des Maladies Inflammatoires Rares du Cerveau et de la Moelle, AP-HP, Hôpital Pitié-Salpêtrière, Paris, France
| | - Romain Marignier
- Service de neurologie, sclérose en plaques, pathologies de la myéline et neuro-inflammation, and Centre de Référence des Maladies Inflammatoires Rares du Cerveau et de la Moelle, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, 69677, Lyon/Bron, France
| | | |
Collapse
|
15
|
Lebrun C, Vukusic S, Abadie V, Achour C, Ader F, Alchaar H, Alkhedr A, Andreux F, Androdias G, Arjmand R, Audoin B, Audry D, Aufauvre D, Autreaux C, Ayrignac X, Bailbe M, Benazet M, Bensa C, Bensmail D, Berger E, Bernady P, Bertagna Y, Biotti D, Blanchard-Dauphin A, Bonenfant J, Bonnan M, Bonnemain B, Borgel F, Botelho-Nevers E, Boucly S, Bourre B, Boutière C, Branger P, Brassat D, Bresch S, Breuil V, Brochet B, Brugeilles H, Bugnon P, Cabre P, Camdessanché JP, Carra-Dalière C, Casez O, Chamouard JM, Chassande B, Chataignier P, Chbicheb M, Chenet A, Ciron J, Clavelou P, Cohen M, Colamarino R, Collongues N, Coman I, Corail PR, Courtois S, Coustans M, Creange A, Creisson E, Daluzeau N, Davenas C, De Seze J, Debouverie M, Depaz R, Derache N, Divio L, Douay X, Dulau C, Durand-Dubief F, Edan G, Elias Z, Fagniez O, Faucher M, Faucheux JM, Fournier M, Gagneux-Brunon A, Gaida P, Galli P, Gallien P, Gaudelus J, Gault D, Gayou A, Genevray M, Gentil A, Gere J, Gignoux L, Giroux M, Givron P, Gout O, Grimaud J, Guennoc AM, Hadhoum N, Hautecoeur P, Heinzlef O, Jaeger M, Jeannin S, Kremer L, Kwiatkowski A, Labauge P, Labeyrie C, Lachaud S, Laffont I, Lanctin-Garcia C, Lannoy J, Lanotte L, Laplaud D, Latombe D, Lauxerois M, Le Page E, Lebrun-Frenay C, Lejeune P, Lejoyeux P, Lemonnier B, Leray E, Loche CM, Louapre C, Lubetzki C, Maarouf A, Mada B, Magy L, Maillart E, Manchon E, Marignier R, Marque P, Mathey G, Maurousset A, Mekies C, Merienne M, Michel L, Milor AM, Moisset X, Montcuquet A, Moreau T, Morel N, Moussa M, Naudillon JP, Normand M, Olive P, Ouallet JC, Outteryck O, Pacault C, Papeix C, Patry I, Peaureaux D, Pelletier J, Pichon B, Pittion S, Planque E, Pouget MC, Pourcher V, Radot C, Robert I, Rocher F, Ruet A, Ruet A, Saint-Val C, Salle JY, Salmon A, Sartori E, Schaeffer S, Stankhof B, Taithe F, Thouvenot E, Tizon C, Tourbah A, Tourniaire P, Vaillant M, Vermersch P, Vidil S, Wahab A, Warter MH, Wiertlewski S, Wiplosz B, Wittwer B, Zaenker C, Zephir H. Immunization and multiple sclerosis: Recommendations from the French Multiple Sclerosis Society. Rev Neurol (Paris) 2019; 175:341-357. [DOI: 10.1016/j.neurol.2019.04.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2019] [Revised: 03/31/2019] [Accepted: 04/11/2019] [Indexed: 10/26/2022]
|
16
|
Ciron J, Cobo-Calvo A, Audoin B, Bourre B, Brassat D, Cohen M, Collongues N, Deschamps R, Durand-Dubief F, Laplaud D, Maillart E, Papeix C, Zephir H, Bereau M, Brochet B, Carra-Dallière C, Derache N, Gagou-Scherer C, Henry C, Kerschen P, Mathey G, Maubeuge N, Maurousset A, Montcuquet A, Moreau T, Prat C, Taithe F, Thouvenot E, Tourbah A, Rollot F, Vukusic S, Marignier R. Frequency and characteristics of short versus longitudinally extensive myelitis in adults with MOG antibodies: A retrospective multicentric study. Mult Scler 2019; 26:936-944. [PMID: 31148523 DOI: 10.1177/1352458519849511] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVES We aim to (1) determine the frequency and distinctive features of short myelitis (SM) and longitudinally extensive transverse myelitis (LETM) in a cohort of adults with myelin oligodendrocyte glycoprotein (MOG)-antibody (Ab)-associated myelitis and (2) determine baseline prognostic factors among MOG-Ab-positive patients whose disease started with myelitis. MATERIAL AND METHODS We retrospectively analyzed clinical and paraclinical variables from a multicentric French cohort of adults with MOG-Ab-associated myelitis. At last follow-up, patients were classified into two groups according to the severity of the Expanded Disability Status Scale (EDSS) as ⩽2.5 or ⩾3.0. RESULTS Seventy-three patients with at least one episode of myelitis over disease course were included; among them, 28 (38.4%) presented with SM at the time of the first myelitis. Motor and sphincter involvement was less frequently observed in SM (51.9% and 48.2%, respectively) than in LETM patients (83.3% and 78.6%, respectively), p = 0.007 and p = 0.017; 61% of LETM patients displayed brain lesions compared to 28.6% in the SM group, p = 0.008, and the thoracic segment was more frequently involved in the LETM (82.2%) than in the SM group (39.3%), p < 0.001. EDSS at last follow-up was higher in LETM (median 3.0 (interquartile range: 2.0-4.0)) compared to SM patients (2.0, (1.0-3.0)), p = 0.042. Finally, a higher EDSS at onset was identified as the only independent risk factor for EDSS ⩾3.0 (odds ratio, 1.40, 95% confidence interval (CI): 1.01-1.95, p = 0.046). CONCLUSION SM in MOG-Ab-associated disease is not rare. The severity at onset was the only independent factor related to the final prognosis in MOG-Ab-associated myelitis.
Collapse
Affiliation(s)
- Jonathan Ciron
- Department of Neurology, Centre de Ressources et Compétences Sclérose en Plaques, Toulouse University Hospital, Toulouse, France
| | - Alvaro Cobo-Calvo
- Pathologies de la Myéline et Neuro-inflammation, Hôpital Neurologique Pierre Wertheimer Hospices Civils de Lyon, Lyon, France; Centre de Référence des Maladies Inflammatoires Rares du Cerveau et de la Moelle and INSERM U1028, CNRS UMR 5292, Lyon 1 University, Center for Research in Neuroscience of Lyon, Lyon, France
| | - Bertrand Audoin
- Department of Neurology, Hôpital de La Timone, APHM, Marseille, France; Aix-Marseille University, Marseille, France
| | - Bertrand Bourre
- Department of Neurology, Rouen University Hospital, Rouen, France
| | - David Brassat
- Department of Neurology, Centre de Ressources et Compétences Sclérose en Plaques, Toulouse University Hospital, Toulouse, France
| | - Mikael Cohen
- Centre de Ressources et Compétences SEP, Neurologie, Université Nice Côte d'Azur, CHU Pasteur 2, Nice, France
| | - Nicolas Collongues
- Department of Neurology, Strasbourg University Hospital, Strasbourg, France
| | - Romain Deschamps
- Department of Neurology, Fondation A. De Rothschild, Paris, France
| | - Françoise Durand-Dubief
- Department of Neurology, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Lyon, France
| | - David Laplaud
- Department of Neurology, Nantes University Hospital, Nantes, France
| | - Elisabeth Maillart
- Department of Neurology, Pitié-Salpêtrière Hospital, APHP, Paris, France
| | - Caroline Papeix
- Department of Neurology, Pitié-Salpêtrière Hospital, APHP, Paris, France
| | - Hélène Zephir
- Department of Neurology, Lille University Hospital, Lille, France; LIRIC UMR 995, Lille, France
| | - Matthieu Bereau
- Department of Neurology, Besançon University Hospital, Besançon, France
| | - Bruno Brochet
- Department of Neurology, Bordeaux University Hospital, Bordeaux, France
| | | | | | | | - Carole Henry
- Department of Neurology, Paris Saint-Denis Hospital, Paris, France
| | | | - Guillaume Mathey
- Department of Neurology, Nancy University Hospital, Nancy, France
| | - Nicolas Maubeuge
- Department of Neurology, Poitiers University Hospital, Poitiers, France
| | - Aude Maurousset
- Department of Neurology, Tours University Hospital, Tours, France
| | - Alexis Montcuquet
- Department of Neurology, Limoges University Hospital, Limoges, France
| | - Thibault Moreau
- Department of Neurology, Dijon University Hospital, Dijon, France
| | - Christophe Prat
- Department of Neurology, Angoulême Hospital, Angoulême, France
| | - Frédéric Taithe
- Department of Neurology, Clermont-Ferrand University Hospital, Clermont-Ferrand, France
| | - Eric Thouvenot
- Department of Neurology, Nîmes University Hospital, Nîmes, France
| | - Ayman Tourbah
- CHU de Reims and Université Reims Champagne Ardenne, LPN, EA 2027 Université Paris 8, Saint-Denis, France
| | - Fabien Rollot
- Claude Bernard Lyon 1 University, Villeurbanne, France
| | - Sandra Vukusic
- Pathologies de la Myéline et Neuro-inflammation, Hôpital Neurologique Pierre Wertheimer Hospices Civils de Lyon, Bron, France; Centre de Référence des Maladies Inflammatoires Rares du Cerveau et de la Moelle and INSERM U1028, CNRS UMR 5292, Lyon 1 University, Center for Research in Neuroscience of Lyon, Lyon, France
| | - Romain Marignier
- Service de Neurologie, Sclérose en Plaques, Pathologies de la Myéline et Neuro-inflammation, Hôpital Neurologique Pierre Wertheimer Hospices Civils de Lyon, Bron, France; Centre de Référence des Maladies Inflammatoires Rares du Cerveau et de la Moelle and INSERM U1028, CNRS UMR 5292, Lyon 1 University, Center for Research in Neuroscience of Lyon, Lyon, France
| |
Collapse
|
17
|
Derache N, Dufay A, Lebarbey C. Organization of care for multiple sclerosis in France. Rev Neurol (Paris) 2018; 174:475-479. [DOI: 10.1016/j.neurol.2018.01.366] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Accepted: 01/04/2018] [Indexed: 11/25/2022]
|
18
|
Cobo-Calvo A, Ruiz A, Maillart E, Audoin B, Zephir H, Bourre B, Ciron J, Collongues N, Brassat D, Cotton F, Papeix C, Durand-Dubief F, Laplaud D, Deschamps R, Cohen M, Biotti D, Ayrignac X, Tilikete C, Thouvenot E, Brochet B, Dulau C, Moreau T, Tourbah A, Lebranchu P, Michel L, Lebrun-Frenay C, Montcuquet A, Mathey G, Debouverie M, Pelletier J, Labauge P, Derache N, Coustans M, Rollot F, De Seze J, Vukusic S, Marignier R. Clinical spectrum and prognostic value of CNS MOG autoimmunity in adults. Neurology 2018; 90:e1858-e1869. [DOI: 10.1212/wnl.0000000000005560] [Citation(s) in RCA: 300] [Impact Index Per Article: 50.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2017] [Accepted: 02/27/2018] [Indexed: 11/15/2022] Open
Abstract
ObjectiveTo describe clinical and radiologic features associated with myelin oligodendrocyte glycoprotein antibodies (MOG-Ab) in a large French nationwide adult cohort, to assess baseline prognostic features of MOG-Ab-associated diseases after a first acute demyelinating syndrome, and to evaluate the clinical value of MOG-Ab longitudinal analysis.MethodsClinical data were obtained from 197 MOG-Ab-positive patients ≥18 years of age. Complete imaging data were available in 108, and 54 serum samples were eligible for longitudinal evaluation. For survival analysis comparison, 169 aquaporin-4 antibody (AQP4-Ab)-positive patients from the NOMADMUS database were included.ResultsMedian age at onset was 36.46 (range 18.0–76.8) years, and patients were predominantly white (92.9%) with male:female ratio, 1.1. Clinical phenotype at onset included optic neuritis or myelitis in 90.86%, isolated brainstem or encephalopathy syndromes in 6.6%, and a combination of syndromes in 2.5%. Distinctive brain MRI findings in MOG-Ab-positive patients were thalamic and pontine lesions. Cortical and leptomeningeal lesions were found in 16.3% and 6.1%, respectively. The probability of reaching a first relapse after 2 and 5 years was 44.8% and 61.8%, respectively. MOG-Ab-positive patients were at lower risk at presentation of further clinical relapse (hazard ratio [HR] 0.45, 95% confidence interval [CI] 0.26–0.79) compared to AQP4-Ab-positive individuals. MOG-Ab-positive individuals had a lower risk of reaching Disability Status Scale score of 3.0 (HR 0.46, 95% CI 0.22–0.94) and visual acuity of 20/100 (HR 0.23, 95% CI 0.07–0.72). Finally, MOG-Ab titers were higher at relapse than in remission (p = 0.009).ConclusionIn adults, MOG-Ab-associated disease extends beyond clinical and radiologic abnormalities in the optic nerve and spinal cord. Despite the relapsing course, the overall visual and motor outcome is better compared with AQP4-Ab-positive patients.
Collapse
|
19
|
Lavie C, Rollot F, Durand-Dubief F, Marignier R, Ionescu I, Casey R, Moreau T, Tourniaire P, Hutchinson M, D’Hooghe MB, Laplaud DA, Clavelou P, De Sèze J, Debouverie M, Brassat D, Pelletier J, Lebrun-Frenay C, Le Page E, Castelnovo G, Berger E, Hautecoeur P, Heinzlef O, Durelli L, Clerico M, Trojano M, Patti F, Vukusic S, Alpérovitch A, Carton H, d’Hooghe M, Hommes O, Hutchinson M, Adeleine P, Biron A, Cortinovis-Tourniaire P, Grimaud J, Hours M, Moreau T, Vukusic S, Confavreux C, Chauplannaz G, Confavreux C, Cortinovis-Tourniaire P, Grimaud J, Latombe D, Moreau T, Clanet M, Lau G, Rumbach L, Goas J, Rouhart F, Mazingue A, Roullet E, Madigand M, Hautecoeur P, Brunet P, Edan G, Allaire C, Riffault G, Leche J, Benoit T, Simonin C, Ziegler F, Baron J, Rivrain Y, Dumas R, Loche D, Bourrin J, Huttin B, Delisse B, Gibert I, Boulay C, Verceletto M, Durand G, Bonneviot G, Gil R, Hedreville M, Belair C, Poitevin R, Devoize J, Wyremblewski P, Delestre F, Setiey A, Comi G, Filippi M, Ghezzi A, Martinelli V, Rossi P, Zaffaroni M, Tola M, Amato M, Fioretti C, Meucci G, Inglese M, Mancardi G, Gambi D, Thomas A, Cavazzuti M, Citterio A, Heltberg A, Hansen H, Fernandez O, Romero F, Arbizu T, Hernandez J, De Andres de Frutos C, Geffner Sclarky D, Aladro Benito Y, Reyes Yanes P, Aguilar M, Burguera J, Yaya R, Bonakim Dib W, Arzua-Mouronte D, d’Hooghe M, Sindic C, Carton H, Medaer R, Roose H, Geens K, Guillaume D, Van Zandycke M, Janssens J, Cornette M, Mol L, Weilbach F, Flachenecker P, Hartung H, Haas J, Tendolkar I, Sindrn E, Kölmel H, Reichel D, Rauch M, Preuss S, Poser S, Mauch E, Strausser-Fuchs S, Kolleger H, Hawkins S, Howell S, Rees J, Thompson A, Johnson M, Boggild M, Gregory R, Bates D, Bone I, Hutchinson M, Polman C, Frequin S, Jongen P, Hommes O, Correia de Sa J, Rio M, Huber S, Lechner-Scott J, Kappos L, Ionescu I, Cornu C, Confavreux C, Vukusic S, El-Etr M, Baulieu E, El-Etr M, Schumacher M, Ionescu I, Confavreux C, Cornu C, Vukusic S, Hartung H, Miller D, Hutchinson M, Pugeat M, d’Archangues C, Conard J, Ménard J, Sitruk-Ware R, Pelissier C, Dat S, Belaïsch-Allard J, Athéa N, Büschsenschutz D, Lyon-Caen O, Gonsette R, Boissel J, Ffrench P, Durand-Dubief F, Cotton F, Pachai C, Bracoud L, Vukusic S, Ionescu I, Androdias G, Marignier R, Chauplannaz G, Laplaud D, Wiertlewski S, Lanctin-Garcia C, Moreau T, Couvreur G, Madinier G, Clavelou P, Taithe F, Aufauvre D, Guy N, Ferrier A, De Sèze J, Collongues N, Debouverie M, Viala F, Brassat D, Gerdelat-Mas A, Henry P, Pelletier J, Rico-Lamy A, Lebrun-Frenay C, Lepage E, Deburghraeve V, Edan G, Castelnovo G, Berger E, Hautecoeur P, Blondiau M, Heinzlef O, Coustans M, Clerc C, Rieu L, Lauxerois M, Hinzelin G, Ouallet J, Minier D, Vion P, Gromaire-Fayolle N, Derache N, Thouvenot E, Sallansonnet-Froment M, Tourniaire P, Toureille L, Borgel F, Stankoff B, Grimaud J, Moroianu C, Guennoc A, Tournier-Gervason C, Peysson S, Trojano M, Patti F, D’Amico E, Motti L, Zaffaroni M, Durelli L, Tavella A. Neuraxial analgesia is not associated with an increased risk of post-partum relapses in MS. Mult Scler 2018; 25:591-600. [DOI: 10.1177/1352458518763080] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background: Obstetrical analgesia remains a matter of controversy because of the fear of neurotoxicity of local anesthetics on demyelinated fibers or their potential relationship with subsequent relapses. Objective: To assess the impact of neuraxial analgesia on the risk of relapse during the first 3 months post-partum, with a focus on women who experienced relapses during pregnancy. Methods: We analyzed data of women followed-up prospectively during their pregnancies and at least 3 months post-partum, collected in the Pregnancy in Multiple Sclerosis (PRIMS) and Prevention of Post-Partum Relapses with Progestin and Estradiol in Multiple Sclerosis (POPARTMUS) studies between 1992–1995 and 2005–2012, respectively. The association of neuraxial analgesia with the occurrence of a post-partum relapse was estimated by logistic regression analysis. Results: A total of 389 women were included, 215 from PRIMS and 174 from POPARTMUS. In total, 156 women (40%) had neuraxial analgesia. Overall, 24% experienced a relapse during pregnancy and 25% in the 3 months post-partum. Women with a pregnancy relapse were more likely to have a post-partum relapse (odds ratio (OR) = 1.83, p = 0.02), independently of the use of neuraxial analgesia. There was no association between neuraxial analgesia and post-partum relapse (OR = 1.08, p = 0.78). Conclusion: Neuraxial analgesia was not associated with an increased risk of post-partum relapses, whatever multiple sclerosis (MS) activity during pregnancy.
Collapse
Affiliation(s)
- Caroline Lavie
- Service de Neurologie A, Hôpital Pierre Wertheimer,
Hospices Civils de Lyon, Lyon, France
| | - Fabien Rollot
- Observatoire Français de la Sclérose en Plaques (OFSEP),
Lyon, France
| | | | - Romain Marignier
- Service de Neurologie A, Hôpital Pierre Wertheimer,
Hospices Civils de Lyon, Lyon, France/Centre de Recherche en Neurosciences de Lyon,
INSERM U1028, CNRS UMR5292, Equipe Neuro-Oncologie et Neuro-Inflammation, Lyon, France;
Université de Lyon 1, Lyon, France
| | - Iuliana Ionescu
- Service de Neurologie A, Hôpital Pierre Wertheimer,
Hospices Civils de Lyon, Lyon, France
| | - Romain Casey
- Observatoire Français de la Sclérose en Plaques (OFSEP),
Lyon, France
| | - Thibault Moreau
- Department of Neurology, EA4184, University Hospital of
Dijon, Dijon, France
| | | | - Michael Hutchinson
- School of Medicine and Medical Science, University College
Dublin, Dublin, Ireland/Department of Neurology, St Vincent’s University Hospital,
Dublin, Ireland
| | - Marie Béatrice D’Hooghe
- National MS Center Melsbroek, Melsbroek, Belgium; Center
for Neurosciences, Vrije Universiteit Brussel (VUB), Brussel, Belgium
| | - David-Axel Laplaud
- Service de Neurologie, CHU de Nantes, CIC015 INSERM,
Nantes, France/INSERM UMR1064, Nantes, France
| | - Pierre Clavelou
- Service de Neurologie, CHU de Clermont-Ferrand,
Clermont-Ferrand, France/INSERM UMR1107, Clermont Université, Université d’Auvergne,
Neuro-Dol, Clermont-Ferrand, France
| | - Jérôme De Sèze
- Department of Neurology, Clinical Investigation Center
INSERM 1434, Hôpitaux Universitaires de Strasbourg, FMTS INSERM 1119, Strasbourg,
France
| | - Marc Debouverie
- EA 4360 APEMAC, University of Lorraine, Nancy,
France/Department of Neurology, Nancy University Hospital, Nancy, France
| | - David Brassat
- Pôle Neurosciences, CHU Toulouse Purpan, Toulouse,
France/INSERM U1043, CNRS UMR 5282, Université Toulouse III, Toulouse, France
| | - Jean Pelletier
- Service de Neurologie, Hôpital de la Timone, Pôle de
Neurosciences Cliniques, AP-HM, Aix-Marseille Université, Marseille, France/CNRS,
Aix-Marseille Université, CRMBM UMR7339, Marseille, France
| | | | - Emmanuelle Le Page
- Clinical Neuroscience Centre, CIC-P 1414 INSERM, Rennes
University Hospital, Rennes, France
| | | | - Eric Berger
- Department of Neurology, CHU Besançon, Besançon,
France
| | - Patrick Hautecoeur
- Service de Neurologie, Groupement des Hôpitaux de
l’Institut Catholique de Lille, Lille, France
| | - Olivier Heinzlef
- Department of Neurology, Hôpital CHI de
Poissy/Saint-Germain-en-Laye, Paris, France
| | - Luca Durelli
- Division of Neurology, Department of Clinical and
Biological Sciences, University of Torino, San Luigi Gonzaga University Hospital,
Orbassano, Italy
| | - Marinella Clerico
- Division of Neurology, Department of Clinical and
Biological Sciences, University of Torino, San Luigi Gonzaga University Hospital,
Orbassano, Italy
| | - Maria Trojano
- Department of Basic Medical Sciences, Neuroscience and
Sense Organs, University of Bari Aldo Moro, Bari, Italy
| | - Francesco Patti
- Department of Medical and Surgical Sciences, and Advanced
Technologies, G.F. Ingrassia, Multiple Sclerosis Center, University of Catania, Catania,
Italy
| | - Sandra Vukusic
- Service de Neurologie A, Hôpital Pierre Wertheimer,
Hospices Civils de Lyon, Lyon, France/Observatoire Français de la Sclérose en Plaques
(OFSEP), Lyon, France/Centre de Recherche en Neurosciences de Lyon, INSERM U1028, CNRS
UMR5292, Equipe Neuro-Oncologie et Neuro-Inflammation, Lyon, France/Université de Lyon
1, Lyon, France
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
20
|
Derache N, Seguin F, Hauchard K, Defer G. Télé-SEP : mise en place d’une plate-forme de télé expertise pour la prise en charge de la sclérose en plaques au sein de la Normandie occidentale. Rev Neurol (Paris) 2017. [DOI: 10.1016/j.neurol.2017.01.219] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
21
|
Pignolet B, Schwab N, Schneider-Hohendorf T, Bucciarelli F, Biotti D, Averseng-Peaureaux D, Outteryck O, Ongagna JC, de Sèze J, Brochet B, Ouallet JC, Debouverie M, Pittion S, Defer G, Derache N, Hautecoeur P, Tourbah A, Labauge P, Castelnovo G, Clavelou P, Berger E, Pelletier J, Rico A, Zéphir H, Laplaud D, Wiertlewski S, Camu W, Thouvenot E, Casez O, Moreau T, Fromont A, Vukusic S, Papeix C, Vermersch P, Comabella M, Lebrun-Frenay C, Wiendl H, Brassat D. CD62L test at 2 years of natalizumab predicts progressive multifocal leukoencephalopathy. Neurology 2016; 87:2491-2494. [DOI: 10.1212/wnl.0000000000003401] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2016] [Accepted: 09/06/2016] [Indexed: 11/15/2022] Open
|
22
|
Cogez J, Etard O, Derache N, Defer G. Cutaneous and Mixed Nerve Silent Period Recordings in Symptomatic Paroxysmal Kinesigenic Dyskinesia. Open Neurol J 2016; 10:9-14. [PMID: 27330574 PMCID: PMC4891988 DOI: 10.2174/1874205x01610010009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2014] [Revised: 12/01/2014] [Accepted: 12/11/2014] [Indexed: 11/22/2022] Open
Abstract
Objective: The underlying neurophysiologic mechanism responsible for secondary paroxysmal kinesigenic
dyskinesia (PKD) is still unclear. Here, we study the pathogenesis of PKD in two patients with a
demyelinating lesion in the spinal cord. Methods: Electromyogram recordings from affected arms of
two patients with spinal cord lesions presenting PKD were compared with our laboratory standards.
The cutaneous silent period (CuSP), mixed nerve silent period (MnSP) and coincidence period (CiP), defined
as the common period between the CuSP and MnSP, were recorded. Results: A large decrease in the MnSP and disappearance
of the CiP were observed in our patients, which was secondary to simultaneous extinction of the third portion of the MnSP,
while the CuSP was normal. The MnSP and CiP were normal after recovery. Conclusions: Our results demonstrate that the third portion
of the MnSP and the CuSP do not correspond to the same physiologic process.
These findings suggest that PKD patients have abnormal spinal interneuron integration.
Collapse
Affiliation(s)
- Julien Cogez
- CHU de Caen, Service de Neurologie, CHU de Caen, Caen, F-14000, France
| | - Olivier Etard
- CHU de Caen, Service D'explorations Fonctionnelles du Systeme Nerveux, Caen, F-14000, France; Université de Caen Basse-Normandie, UFR de Médecine, Caen, F-14000, France
| | - Nathalie Derache
- CHU de Caen, Service de Neurologie, CHU de Caen, Caen, F-14000, France; INSERM, INSERM U923, CHU de Caen, Caen, F-14000, France
| | - Gilles Defer
- CHU de Caen, Service de Neurologie, CHU de Caen, Caen, F-14000, France
| |
Collapse
|
23
|
Siri A, Carra-Dalliere C, Ayrignac X, Pelletier J, Audoin B, Pittion-Vouyovitch S, Debouverie M, Lionnet C, Viala F, Sablot D, Brassat D, Ouallet JC, Ruet A, Brochet B, Taillandier L, Bauchet L, Derache N, Defer G, Cabre P, de Seze J, Lebrun Frenay C, Cohen M, Labauge P. Isolated tumefactive demyelinating lesions: diagnosis and long-term evolution of 16 patients in a multicentric study. J Neurol 2015; 262:1637-45. [DOI: 10.1007/s00415-015-7758-8] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2015] [Revised: 04/17/2015] [Accepted: 04/20/2015] [Indexed: 12/31/2022]
|
24
|
Li L, Chevanne D, Dress D, Creveuil C, Defer G, Derache N. Influence de la fampridine sur la fatigue et la qualité de vie dans la sclérose en plaque. Rev Neurol (Paris) 2015. [DOI: 10.1016/j.neurol.2015.01.168] [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: 10/23/2022]
|
25
|
Ayrignac X, Carra-Dalliere C, Menjot de Champfleur N, Denier C, Aubourg P, Bellesme C, Castelnovo G, Pelletier J, Audoin B, Kaphan E, de Seze J, Collongues N, Blanc F, Chanson JB, Magnin E, Berger E, Vukusic S, Durand-Dubief F, Camdessanche JP, Cohen M, Lebrun-Frenay C, Brassat D, Clanet M, Vermersch P, Zephir H, Outteryck O, Wiertlewski S, Laplaud DA, Ouallet JC, Brochet B, Goizet C, Debouverie M, Pittion S, Edan G, Deburghgraeve V, Le Page E, Verny C, Amati-Bonneau P, Bonneau D, Hannequin D, Guyant-Maréchal L, Derache N, Louis Defer G, Moreau T, Giroud M, Guennoc AM, Clavelou P, Taithe F, Mathis S, Neau JP, Magy L, Devoize JL, Bataillard M, Masliah-Planchon J, Dorboz I, Tournier-Lasserve E, Levade T, Boespflug Tanguy O, Labauge P. Adult-onset genetic leukoencephalopathies: A MRI pattern-based approach in a comprehensive study of 154 patients. Brain 2014; 138:284-92. [DOI: 10.1093/brain/awu353] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
|
26
|
Vandendriessche A, Zephir H, Vermersch P, De Seze J, Derache N, Maltete D, Bourre B. Application des critères MacDonald 2010 pour le diagnostic de sclérose en plaques à une cohorte de patients présentant un syndrome cliniquement isolé médullaire. Rev Neurol (Paris) 2014. [DOI: 10.1016/j.neurol.2014.01.322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
27
|
Hanoux V, Coulbault L, Derache N, Cabre P, De Seze J, Marignier R, Rudolf G, Emmanuelle Dugué A, Allouche S, Defer G. No evidence for genetic association between glutamate transporter EAAT2 and Devic's neuromyelitis optica in caucasians and afro-caribbeans. Mult Scler Relat Disord 2014; 3:89-93. [PMID: 25877978 DOI: 10.1016/j.msard.2013.06.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2012] [Revised: 05/20/2013] [Accepted: 06/21/2013] [Indexed: 11/16/2022]
Abstract
Devic's neuromyelitis optica (NMO) is a severe inflammatory and autoimmune disease producing demyelinating lesions. Recent data suggest that a complex genetic component could be involved. While impairment of glutamate homeostasis has emerged as a contributing etiological factor in NMO, a genetic alteration of Excitatory Amino Acid Transporter 2 (EAAT2/SLC1A2), the major glutamate transporter in the Central Nervous System (CNS), could contribute to glutamate excitotoxicity and then must be considered. We evaluated whether mutations and/or single nucleotide polymorphisms (SNPs) in EAAT2 gene, are associated with susceptibility to NMO. We studied a cohort of NMO sporadic cases including afro-caribbean patients (n=81; French cohort of Devic's neuromyelitis optica-NOMADMUS cohort) and compared to control subjects (n=56). We sequenced the whole coding region of EAAT2 gene and splicing consensus sequences flanking each exon. The results obtained from all NMO samples did not show any novel mutations and/or SNPs both in the coding region and splicing sites of EAAT2 gene compared to controls subjects. We reported three synonymous SNPs (rs752949, rs1042113 and rs7102949) but only rs7102949 was found in afro-caribbean. Genotype frequencies did not differ between patients and controls for the three SNPs in caucasians and afro-caribbeans (rs752949: p=0.71 and p=0.37, respectively; rs1042113: p=0.73 and p=0.35, respectively; rs7102949: p=0.08 in afro-caribbeans). Our data showed no evidence for a genetic association between EAAT2 gene and Devic's neuromyelitis optica.
Collapse
Affiliation(s)
- Vincent Hanoux
- Caen University Hospital, Department of Biochemistry, Caen F-14000, France.
| | - Laurent Coulbault
- Caen University Hospital, Department of Biochemistry, Caen F-14000, France; Université de Caen Basse-Normandie, Medical School, Caen F-14000, France.
| | - Nathalie Derache
- Caen University Hospital, Department of Neurology, Caen F-14000, France; INSERM U1077 and Ecole Pratique des Hautes Etudes, UMR-S1077, Caen F-14000, France.
| | - Philippe Cabre
- Fort de France University Hospital, Department of Neurology, Fort de France, F-97261 Martinique, France.
| | - Jérôme De Seze
- Strasbourg University Hospital, Department of Neurology, Strasbourg F-67085, France.
| | - Romain Marignier
- Hospices Civils de Lyon, Department of Neurology and EDMUS Coordinating Center, Lyon F-69677, France; INSERM U1028, Lyon Neuroscience Research Center, Neuro-Inflammation and Neuro-Oncology Team, Lyon F-69000, France.
| | - Gabrielle Rudolf
- Strasbourg University Hospital, Department of Neurology, Strasbourg F-67085, France.
| | - Audrey Emmanuelle Dugué
- Caen University Hospital, Department of Biostatistics and Clinical Research, Caen F-14000, France.
| | - Stéphane Allouche
- Caen University Hospital, Department of Biochemistry, Caen F-14000, France; Université de Caen Basse-Normandie, Medical School, Caen F-14000, France.
| | - Gilles Defer
- Caen University Hospital, Department of Neurology, Caen F-14000, France; INSERM U919, Serine Proteases and Pathophysiology of the Neurovascular Unit, GIP Cyceron, Université de Caen Basse-Normandie, Caen F-14000, France..
| | | |
Collapse
|
28
|
Derache N, Grassiot B, Mézenge F, Emmanuelle Dugué A, Desgranges B, Constans JM, Defer GL. Fatigue is associated with metabolic and density alterations of cortical and deep gray matter in Relapsing-Remitting-Multiple Sclerosis patients at the earlier stage of the disease: A PET/MR study. Mult Scler Relat Disord 2013; 2:362-9. [DOI: 10.1016/j.msard.2013.03.005] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2012] [Revised: 03/08/2013] [Accepted: 03/12/2013] [Indexed: 12/27/2022]
|
29
|
Nicolas G, Pottier C, Charbonnier C, Guyant-Maréchal L, Le Ber I, Pariente J, Labauge P, Ayrignac X, Defebvre L, Maltête D, Martinaud O, Lefaucheur R, Guillin O, Wallon D, Chaumette B, Rondepierre P, Derache N, Fromager G, Schaeffer S, Krystkowiak P, Verny C, Jurici S, Sauvée M, Vérin M, Lebouvier T, Rouaud O, Thauvin-Robinet C, Rousseau S, Rovelet-Lecrux A, Frebourg T, Campion D, Hannequin D. Phenotypic spectrum of probable and genetically-confirmed idiopathic basal ganglia calcification. ACTA ACUST UNITED AC 2013; 136:3395-407. [PMID: 24065723 DOI: 10.1093/brain/awt255] [Citation(s) in RCA: 154] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Idiopathic basal ganglia calcification is characterized by mineral deposits in the brain, an autosomal dominant pattern of inheritance in most cases and genetic heterogeneity. The first causal genes, SLC20A2 and PDGFRB, have recently been reported. Diagnosing idiopathic basal ganglia calcification necessitates the exclusion of other causes, including calcification related to normal ageing, for which no normative data exist. Our objectives were to diagnose accurately and then describe the clinical and radiological characteristics of idiopathic basal ganglia calcification. First, calcifications were evaluated using a visual rating scale on the computerized tomography scans of 600 consecutively hospitalized unselected controls. We determined an age-specific threshold in these control computerized tomography scans as the value of the 99th percentile of the total calcification score within three age categories: <40, 40-60, and >60 years. To study the phenotype of the disease, patients with basal ganglia calcification were recruited from several medical centres. Calcifications that rated below the age-specific threshold using the same scale were excluded, as were patients with differential diagnoses of idiopathic basal ganglia calcification, after an extensive aetiological assessment. Sanger sequencing of SLC20A2 and PDGFRB was performed. In total, 72 patients were diagnosed with idiopathic basal ganglia calcification, 25 of whom bore a mutation in either SLC20A2 (two families, four sporadic cases) or PDGFRB (one family, two sporadic cases). Five mutations were novel. Seventy-one per cent of the patients with idiopathic basal ganglia calcification were symptomatic (mean age of clinical onset: 39 ± 20 years; mean age at last evaluation: 55 ± 19 years). Among them, the most frequent signs were: cognitive impairment (58.8%), psychiatric symptoms (56.9%) and movement disorders (54.9%). Few clinical differences appeared between SLC20A2 and PDGFRB mutation carriers. Radiological analysis revealed that the total calcification scores correlated positively with age in controls and patients, but increased more rapidly with age in patients. The expected total calcification score was greater in SLC20A2 than PDGFRB mutation carriers, beyond the effect of the age alone. No patient with a PDGFRB mutation exhibited a cortical or a vermis calcification. The total calcification score was more severe in symptomatic versus asymptomatic individuals. We provide the first phenotypical description of a case series of patients with idiopathic basal ganglia calcification since the identification of the first causative genes. Clinical and radiological diversity is confirmed, whatever the genetic status. Quantification of calcification is correlated with the symptomatic status, but the location and the severity of the calcifications don't reflect the whole clinical diversity. Other biomarkers may be helpful in better predicting clinical expression.
Collapse
|
30
|
Outteryck O, Ongagna J, Brochet B, Rumbach L, Lebrun-Frenay C, Debouverie M, Zéphir H, Ouallet J, Berger E, Cohen M, Pittion S, Laplaud D, Wiertlewski S, Cabre P, Pelletier J, Rico A, Defer G, Derache N, Camu W, Thouvenot E, Moreau T, Fromont A, Tourbah A, Labauge P, Castelnovo G, Clavelou P, Casez O, Hautecoeur P, Papeix C, Lubetzki C, Fontaine B, Couturier N, Bohossian N, Clanet M, Vermersch P, de Sèze J, Brassat D. A prospective observational post-marketing study of natalizumab-treated multiple sclerosis patients: clinical, radiological and biological features and adverse events. The BIONAT cohort. Eur J Neurol 2013; 21:40-8. [DOI: 10.1111/ene.12204] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2013] [Accepted: 04/30/2013] [Indexed: 11/29/2022]
Affiliation(s)
- O. Outteryck
- Neurologie; Université de Lille Nord de France (EA2686); Hôpital Roger Salengro CHRU Lille; Lille France
| | | | - B. Brochet
- Neurologie; CHU Pellegrin; Bordeaux France
| | - L. Rumbach
- Neurologie; CHU Besançon; Besançon France
| | | | | | - H. Zéphir
- Neurologie; Université de Lille Nord de France (EA2686); Hôpital Roger Salengro CHRU Lille; Lille France
| | | | - E. Berger
- Neurologie; CHU Besançon; Besançon France
| | - M. Cohen
- Neurologie; Hôpital Pasteur; Nice France
| | | | | | | | - P. Cabre
- Neurologie; CHU Fort de France; Fort de France France
| | - J. Pelletier
- Neurologie; Hôpital de la Timone; Marseille France
| | - A. Rico
- Neurologie; Hôpital de la Timone; Marseille France
| | - G. Defer
- Neurologie; CHU Caen; Caen France
| | | | - W. Camu
- Neurologie; CHU Montpellier; Montpellier France
| | | | | | | | | | - P. Labauge
- Neurologie; CHU Montpellier; Montpellier France
| | | | - P. Clavelou
- Neurologie; CHRU Clermont Ferrand; Clermont Ferrand France
| | - O. Casez
- Neurologie; CHU Grenoble; Grenoble France
| | | | - C. Papeix
- Neurologie; Hôpital de la Salpêtrière; Paris France
| | - C. Lubetzki
- Neurologie; Hôpital de la Salpêtrière; Paris France
| | - B. Fontaine
- Neurologie; Hôpital de la Salpêtrière; Paris France
| | - N. Couturier
- Pole des neurosciences CHU Purpan; INSERM U1043; Toulouse France
| | - N. Bohossian
- Pole des neurosciences CHU Purpan; INSERM U1043; Toulouse France
| | - M. Clanet
- Pole des neurosciences CHU Purpan; INSERM U1043; Toulouse France
| | - P. Vermersch
- Neurologie; Université de Lille Nord de France (EA2686); Hôpital Roger Salengro CHRU Lille; Lille France
| | - J. de Sèze
- Neurologie; Hôpital Civil; Strasbourg France
| | - D. Brassat
- Pole des neurosciences CHU Purpan; INSERM U1043; Toulouse France
| | | |
Collapse
|
31
|
Tordjman MA, Chantepie S, Defer G, Derache N. Atteinte multiple des nerfs crâniens et méningite : leucémie lymphoïde chronique et/ou maladie de Lyme : à propos d’un cas. Rev Neurol (Paris) 2013. [DOI: 10.1016/j.neurol.2013.01.414] [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: 11/27/2022]
|
32
|
Collongues N, Derache N, Blanc F, Labauge P, de Seze J, Defer G. Inflammatory-like presentation of CADASIL: a diagnostic challenge. BMC Neurol 2012; 12:78. [PMID: 22905984 PMCID: PMC3488471 DOI: 10.1186/1471-2377-12-78] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2011] [Accepted: 08/16/2012] [Indexed: 11/11/2022] Open
Abstract
Background CADASIL is an autosomal dominant genetic leukoencephalopathy linked to mutations in the Notch3 gene. In rare cases, widespread brain lesions on T2 MRI mimicking multiple sclerosis are observed. From a national registry of 268 patients with adult-onset leukodystrophy, we identified two patients with an atypical presentation of CADASIL without co-occurrence of another systemic disease. Case presentations Patient 1 experienced progressive gait disability and patient 2 relapsing optic neuritis and sensory-motor deficit in the leg. Both patients responded to corticotherapy and patient 2 was also responsive to glatiramer acetate. No oligoclonal bands were found in the CSF, and MRI showed myelitis and lesions with gadolinium enhancement in brain (patient 1) or incomplete CADASIL phenotype (patient 2). Conclusions In rare cases, an inflammatory-like process can occur in CADASIL. In these patients, immunomodulatory treatments, including corticosteroids, could be effective.
Collapse
Affiliation(s)
- Nicolas Collongues
- Department of Neurology, Strasbourg University Hospital, 1, Avenue Molière, 67000, Strasbourg, France.
| | | | | | | | | | | |
Collapse
|
33
|
|
34
|
Defer G, Mariotte D, Derache N, Toutirais O, Lamotte G, Legros H, Cauquelin B, Le Mauff B. Increase of Infusion Interval Do Not Impair Natalizumab Efficacy in RR-MS Patients: A Pilot Study Based on Monthly Monitoring of CD49d (P06.166). Neurology 2012. [DOI: 10.1212/wnl.78.1_meetingabstracts.p06.166] [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: 11/15/2022] Open
|
35
|
Derache N, Mondou A, Makouri R, Desgranges B, Defer G. Influence of Emotional Valence on Verbal Episodic Memory in Multiple Sclerosis (P04.110). Neurology 2012. [DOI: 10.1212/wnl.78.1_meetingabstracts.p04.110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
|
36
|
Dilly D, Kamsu. N J, Derache N, Defer G. Encéphalomyélite aiguë disséminée au cours d’un traitement par agoniste de la GnRH. Rapport d’un cas. Rev Neurol (Paris) 2012. [DOI: 10.1016/j.neurol.2012.01.109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
|
37
|
Lefilliatre M, Mondou A, Makouri R, Desgranges B, Derache N, Defer G. Influence de l’émotion sur la mémoire épisodique dans la sclérose en plaques. Rev Neurol (Paris) 2012. [DOI: 10.1016/j.neurol.2012.01.121] [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]
|
38
|
Defer G, Mariotte D, Derache N, Toutirais O, Legros H, Cauquelin B, Le Mauff B. CD49d expression as a promising biomarker to monitor natalizumab efficacy. J Neurol Sci 2011; 314:138-42. [PMID: 22050952 DOI: 10.1016/j.jns.2011.10.005] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2011] [Revised: 10/04/2011] [Accepted: 10/06/2011] [Indexed: 10/15/2022]
Abstract
Natalizumab (Tysabri™), a monoclonal antibody against the α4-integrin of VLA-4 (CD49d) antigen of leukocytes, is highly effective in multiple sclerosis (MS). The most common reason for treatment failure is the development of neutralizing antibodies (NAbs). According to health authorities Nabs testing is recommended in case of relapse or repeated infusion reactions. However NAbs may develop in clinically asymptomatic patients. In this study we investigated if CD49d expression could serve as a biomarker of natalizumab bioavailability and treatment response. In a cohort of 49 natalizumab treated relapsing-remitting MS, followed over 2 years, CD49d expression was determined on peripheral blood mononuclear cells (PBMCs) before each infusion and compared to NAbs and serum natalizumab levels. In a majority of patients (41/49) the CD49d expression in PBMCs was strongly inhibited (>50%) after the first infusion and maintained at low levels throughout the treatment period. In contrast, in eight patients (16%) there was an early recovery of CD49d expression to pre-treatment levels related to NABs development. While three cases experienced hypersensitivity reactions, three others were identified solely on the basis of an undiminished level of CD49d, with neither infusion reaction nor clinical worsening. These 3 patients had very high levels of NAbs and no detectable serum natalizumab. Two additional patients had early but transient recovery of CD49d expression. These patients had low levels of transient Nabs and returned to significant CD49d inhibition after few natalizumab infusions. We suggest that monitoring of CD49d expression can be used as a surrogate biomarker of natalizumab efficiency. If the CD49d expression is sustained at pre-treatment levels, patients should be tested for persistent NAbs and considered for treatment interruption.
Collapse
Affiliation(s)
- Gilles Defer
- CHU de Caen, Department of Neurology, Caen, F-14000, France.
| | | | | | | | | | | | | |
Collapse
|
39
|
Collongues N, Marignier R, Zéphir H, Blanc F, Vukusic S, Outteryck O, Fleury M, Ruet A, Borgel F, Thouvenot E, Moreau T, Defer G, Derache N, Pelletier J, Audoin B, Debouverie M, Labauge P, Gout O, Camu W, Brassat D, Brochet B, Vermersch P, Confavreux C, Seze JD. High-risk syndrome for neuromyelitis optica: a descriptive and comparative study. Mult Scler 2011; 17:720-4. [DOI: 10.1177/1352458510396923] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background: Neuromyelitis optica (NMO) frequently begins with a monofocal episode of optic neuritis or myelitis. A concept named high-risk syndrome (HRS) for NMO has been proposed for patients with monofocal episodes and NMO-IgG antibodies. Objective: To describe HRS patients and compare them with NMO patients. Methods: We identified 30 patients with HRS: 18 with extensive myelitis (HRM) and 12 with optic neuritis (HRON), in a database pooling patients from 25 centres in France. Clinical, laboratory/magnetic resonance imaging (MRI) data and outcome were analysed and compared with a national cohort of 125 NMO patients extracted from the same database. Results: Mean follow-up was 4.8 years. Mean age at onset was 42.8 years (range: 12.4–70) with a female:male ratio of 0.9. Asymptomatic lesions were report on visual evoked potentials in 4/8 tested HRM patients and on spinal cord MRI in 2/7 HRON patients. Three patients died, two owing to a cervical lesion. HRS and NMO patients had similar clinical/paraclinical data, except for a predominance of men in the HRS group and a later mean age at onset in the HRM subgroup. Conclusion: The description of HRS patients is compatible with a monofocal form of NMO. Asymptomatic lesions could be included in a new set of NMO diagnostic criteria.
Collapse
Affiliation(s)
- N Collongues
- Strasbourg University Hospital, Strasbourg, France
| | | | - H Zéphir
- Lille University Hospital, Lille, France
| | - F Blanc
- Strasbourg University Hospital, Strasbourg, France
| | - S Vukusic
- Lyon University Hospital, Lyon, France
| | | | - M Fleury
- Strasbourg University Hospital, Strasbourg, France
| | - A Ruet
- Bordeaux University Hospital, Bordeaux, France
| | - F Borgel
- Grenoble University Hospital, Grenoble, France
| | - E Thouvenot
- Montpellier University Hospital, Montpellier, France
| | - T Moreau
- Dijon University Hospital, Dijon, France
| | - G Defer
- Caen University Hospital, Caen, France
| | - N Derache
- Caen University Hospital, Caen, France
| | - J Pelletier
- Marseille University Hospital, Marseille, France
| | - B Audoin
- Marseille University Hospital, Marseille, France
| | | | - P Labauge
- Nîmes University Hospital, Nîmes, France
| | - O Gout
- Rothschild Foundation Hospital, Paris, France
| | - W Camu
- Montpellier University Hospital, Montpellier, France
| | - D Brassat
- Toulouse University Hospital, Toulouse, France
| | - B Brochet
- Bordeaux University Hospital, Bordeaux, France
| | | | | | - J de Seze
- Strasbourg University Hospital, Strasbourg, France
| |
Collapse
|
40
|
Abstract
Taking in charge cognitive disorders is a new concept in the global care of MS patients. Cognitive disorders are observed in the all forms of the disease, sometimes early on in the evolution. These disorders can be evaluated in details even detected despite any complain in the patient. Because of the lack of clear demonstration that disease-modifying treatments could act on cognition, new specific therapeutic issues have emerged during last years. This article first discusses relationships between disease-modifying treatments and cognition for the different forms of the disease, then analyse the effects of symptomatic drug therapy especially the use of anticholinesterasics. In the last part of the article new issues about antagonists of excitatory amino-acids and individual or group cognitive training are discussed. Recent functional imaging data concerning cerebral adaptation and their modifications by drug or non-drug procedures in MS patients suggest interesting therapeutic development in a next future.
Collapse
Affiliation(s)
- G-L Defer
- Département de neurologie, CHU de Caen, 14033 Caen Cedex, France.
| | | | | |
Collapse
|
41
|
Derache N, Marié RM, Constans JM, Defer GL. Reduced thalamic and cerebellar rest metabolism in relapsing-remitting multiple sclerosis, a positron emission tomography study: correlations to lesion load. J Neurol Sci 2006; 245:103-9. [PMID: 16647086 DOI: 10.1016/j.jns.2005.09.017] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.4] [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: 05/20/2005] [Revised: 09/02/2005] [Accepted: 09/19/2005] [Indexed: 10/24/2022]
Abstract
Magnetic resonance imaging (MRI) is the main tool for detecting central nervous system lesions in MS. However, classical anatomical MRI is unable to assess exactly disease related injury in normal-appearing brain tissue and to give information about the functional consequences of the disease, explaining weak correlation frequently observed between lesion load and clinical data. Recently, functional brain imaging techniques have provided new insights concerning pathophysiological processes of the disease. Among them Positron Emission Tomography (PET), a sensitive technique to evaluate functional consequences of tissue injury in other neurological diseases, has rarely been used in MS. Seventeen Relapsing-Remitting (RR-) MS patients with low disability at the early stage of the disease underwent measurements of cerebral metabolic rate of glucose (rCMRglu) in resting state by PET using [(18)F] fluorodeoxyglucose (FDG) and assessment of regional cortical and white matter lesion volume (LV), using an in-house-developed semi-automatic method, was done at the same time on MRI. rCMRglu of MS patients was compared with rCMRglu of 18 normal control subjects using univariate SPM99 analysis through Matlab 5 and correlations between rCMRglu and LV were tested using multivariate linear regression using SPM99. Statistical threshold was set at p<0.05 corrected for multiple comparisons and correlations. Compared to controls, reduced rCMRglu was found in the right thalamus (p<0.001), in bilateral cerebellum (p<0.05 for right and p<0.01 for left) and the posterior part of left inferior parietal cortex (p<0.05). In addition, higher rCMRglu in patients compared to controls was observed in left inferior frontal cortex, left (anterior part) and right inferior parietal cortex (p<0.001). rCMRglu in right thalamus correlates negatively with different LV: total LV, total juxtacortical and/or overlapping cortico-subcortical LV, total and frontal deep white matter LV. rCMRglu of the right superior frontal cortex negatively correlated with total and parieto-occipital deep white matter LV. The results of this study, performed in a group of recent RR-MS patients with low disability, suggest that demyelinating lesions in MS mainly have a remote effect on cortical, basal ganglia and cerebellum metabolism and that regional cortical compensatory mechanisms may be observed concurrently.
Collapse
Affiliation(s)
- Nathalie Derache
- Service de Neurologie, Centre Hospitalier Universitaire, 14000 Caen, France
| | | | | | | |
Collapse
|
42
|
Affiliation(s)
- I Le Ber
- Service de Neurologie, CHU Côte de Nacre, Caen, France
| | | | | | | | | | | |
Collapse
|