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Lévesque H, Viallard JF, Houivet E, Bonnotte B, Voisin S, Le Cam-Duchez V, Maillot F, Lambert M, Liozon E, Hervier B, Fain O, Guillet B, Schmidt J, Luca LE, Ebbo M, Ferreira-Maldent N, Babuty A, Sailler L, Duffau P, Barbay V, Audia S, Benichou J, Graveleau J, Benhamou Y. Cyclophosphamide vs rituximab for eradicating inhibitors in acquired hemophilia A: A randomized trial in 108 patients. Thromb Res 2024; 237:79-87. [PMID: 38555718 DOI: 10.1016/j.thromres.2024.03.012] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Revised: 02/19/2024] [Accepted: 03/07/2024] [Indexed: 04/02/2024]
Abstract
BACKGROUND Acquired hemophilia A (AHA) is a rare autoimmune disorder due to autoantibodies against Factor VIII, with a high mortality risk. Treatments aim to control bleeding and eradicate antibodies by immunosuppression. International recommendations rely on registers and international expert panels. METHODS CREHA, an open-label randomized trial, compared the efficacy and safety of cyclophosphamide and rituximab in association with steroids in patients with newly diagnosed AHA. Participants were treated with 1 mg/kg prednisone daily and randomly assigned to receive either 1.5-2 mg/kg/day cyclophosphamide orally for 6 weeks, or 375 mg/m2 rituximab once weekly for 4 weeks. The primary endpoint was complete remission over 18 months. Secondary endpoints included time to achieve complete remission, relapse occurrence, mortality, infections and bleeding, and severe adverse events. RESULTS Recruitment was interrupted because of new treatment recommendations after 108 patients included (58 cyclophosphamide, 50 rituximab). After 18 months, 39 cyclophosphamide patients (67.2 %) and 31 rituximab patients (62.0 %) were in complete remission (OR 1.26; 95 % CI, 0.57 to 2.78). In the poor prognosis group (FVIII < 1 IU/dL, inhibitor titer > 20 BU mL-1), significantly more remissions were observed with cyclophosphamide (22 patients, 78.6 %) than with rituximab (12 patients, 48.0 %; p = 0.02). Relapse rates, deaths, severe infections, and bleeding were similar in the 2 groups. In patients with severe infection, cumulative doses of steroids were significantly higher than in patients without infection (p = 0.03). CONCLUSION Cyclophosphamide and rituximab showed similar efficacy and safety. As first line, cyclophosphamide seems preferable, especially in poor prognosis patients, as administered orally and less expensive. FUNDING French Ministry of Health. CLINICALTRIALS gov number: NCT01808911.
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Affiliation(s)
- H Lévesque
- Normandie Univ, UNIROUEN, U 1096, CHU Rouen, Department of Internal Medicine, F-76000 Rouen, France.
| | - J F Viallard
- Service de Médecine Interne et Maladies Infectieuses Hôpital Haut-Lévêque, CHU Bordeaux, 5 avenue de Magellan, 33604 Pessac, France
| | - E Houivet
- Department of Biostatistics, CHU Rouen, F-76031 Rouen, France
| | - B Bonnotte
- Service de médecine interne et immunologie clinique, CHU Dijon-Bourgogne, Université de Dijon, F-21079 Dijon, France
| | - S Voisin
- Department of Internal Medicine, CHU Toulouse, F-31059 Toulouse. France
| | - V Le Cam-Duchez
- Normandie Univ, UNIROUEN, Hématologie biologique, F-76031 Rouen, France
| | - F Maillot
- Département de Médecine Interne et immunologie clinique, CHRU Tours, Université de Tours, F-37044 Tours, France
| | - M Lambert
- CHU Lille, Département de Médecine Interne et d'Immunologie Clinique, Centre National de Référence Maladies Systémiques et Auto-immunes Rares Nord et Nord-Ouest de France (CeRAINO), European Reerence Network on Rare Connective Tissue and Musculoskeletal Diseases Network (ReCONNECT), F-59000 Lille, France
| | - E Liozon
- Department of Internal Medicine, Dupuytren Hospital, F-87000 Limoges, France
| | - B Hervier
- Service de Médecine Interne, Hôpital Saint-Louis, APHP, 75010 Paris & INSERM UMR-S 976, Human Immunology, Pathophysiology, Immunotherapy, Saint-Louis Research Institute, F-75000 Paris, France
| | - O Fain
- Sorbonne Université, APHP, Service de Médecine Interne-DMU i3, Hôpital Saint-Antoine, Paris F-75000, France
| | - B Guillet
- Univ Rennes, CHU Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail) - UMR-S 1085, F-35000 Rennes, France
| | - J Schmidt
- Department of Internal Medicine, Amiens University Hospital, F-80000 Amiens, France
| | - L E Luca
- Department of Internal Medicine, Poitiers University Hospital, F-86000 Poitiers, France
| | - M Ebbo
- Service de Médecine Interne, Hôpital La Timone, CHU Marseille, Aix-Marseille Université, F-13000 Marseille, France
| | - N Ferreira-Maldent
- Département de Médecine Interne et immunologie clinique, CHRU Tours, Université de Tours, F-37044 Tours, France
| | - A Babuty
- Service d'Hématologie Biologique, CRC-MHC, CHU de Nantes, Nantes Cedex 1, France
| | - L Sailler
- Department of Internal Medicine, CHU Toulouse, F-31059 Toulouse. France
| | - P Duffau
- Service de Médecine Interne-Immunologie Clinique Hôpital Saint-André, CHU Bordeaux, 1 rue Jean Burguet, 33075 Bordeaux, France
| | - V Barbay
- Normandie Univ, UNIROUEN, Hématologie biologique, F-76031 Rouen, France
| | - S Audia
- Service de médecine interne et immunologie clinique, CHU Dijon-Bourgogne, Université de Dijon, F-21079 Dijon, France
| | - J Benichou
- Department of Biostatistics, CHU Rouen and CESP UMR 1018, University of Rouen and University Paris-Saclay, F-76031 Rouen, France
| | - J Graveleau
- Nantes Université, CHU Nantes, Service de Médecine Interne, Nantes, France
| | - Y Benhamou
- Normandie Univ, UNIROUEN, U 1096, CHU Rouen, Department of Internal Medicine, F-76000 Rouen, France
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Langbour C, Nicolas S, Bigot A, Chu Miow Lin D, Baydoun S, Blasco H, Froissart R, Ferreira-Maldent N, Audemard-Verger A, Maillot F. [McArdle's disease revealed by acute low back pain]. Rev Med Interne 2024:S0248-8663(24)00091-2. [PMID: 38670875 DOI: 10.1016/j.revmed.2024.03.011] [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: 01/08/2024] [Revised: 03/24/2024] [Accepted: 03/31/2024] [Indexed: 04/28/2024]
Abstract
INTRODUCTION McArdle disease, or glycogen storage disease type V (GSD 5), is a rare metabolic myopathy linked to an autosomal recessive myophosphorylase deficiency. CASE REPORT We report the case of a 17-year-old male patient who was referred to the emergency department for the management of acute inflammatory low back pain, without traumatic context, associated with an increase of CK at 66,336 UI/L (N<192UI/L) and a CRP at 202mg/L. The immunological assessment was negative and the spinal MRI showed images in favor of necrotizing fasciitis affecting the erector spinae muscles, among others. Faced with the description of difficulties in practicing physical activities since childhood and a non-ischaemic forearm exercise test showing no elevation in lactacidemia, genetic tests were carried out, finding two heterozygous variants in the PYGM gene: c.1963G>A (p.Glu655Lys) class 5 and c.2178-1G>A class 4, confirming the diagnosis of McArdle disease. DISCUSSION GSD 5 is a disease characterized essentially by muscular fatigability during exercise. The case reported here is original in the clinical circumstances leading to the diagnosis, i.e., inaugural acute low back pain with rhabdomyolysis. This symptomatology had already been described before, but in a patient whose diagnosis was already known. Spinal MRI showed non-specific muscle inflammation and necrosis. Muscle biopsy only found necrosis but no pathological elements typical of the diagnosis. If the symptoms are suggestive, it may be preferable to directly perform a non-ischaemic forearm exercise test, in order to go directly to molecular genetic analysis. There is no specific curative treatment of GSD 5. However, some measures can be implemented to limit the symptoms, such as learning physical exercises, limiting intense efforts and adopting dietary recommendations.
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Affiliation(s)
- C Langbour
- Service de médecine interne, hôpital Bretonneau, CHRU de Tours, 2, boulevard Tonnellé, 37044 Tours cedex, France; Service de rhumatologie, CHRU de Tours, Tours, France.
| | - S Nicolas
- Service de médecine interne, hôpital Bretonneau, CHRU de Tours, 2, boulevard Tonnellé, 37044 Tours cedex, France
| | - A Bigot
- Service de médecine interne, hôpital Bretonneau, CHRU de Tours, 2, boulevard Tonnellé, 37044 Tours cedex, France
| | | | - S Baydoun
- Service de rhumatologie, CHRU de Tours, Tours, France
| | - H Blasco
- Laboratoire de biochimie, CHU de Tours, Tours, France; Université de Tours, Tours, France
| | - R Froissart
- Service de biochimie et biologie moléculaire, CHU de Lyon, Bron, France
| | - N Ferreira-Maldent
- Service de médecine interne, hôpital Bretonneau, CHRU de Tours, 2, boulevard Tonnellé, 37044 Tours cedex, France
| | - A Audemard-Verger
- Service de médecine interne, hôpital Bretonneau, CHRU de Tours, 2, boulevard Tonnellé, 37044 Tours cedex, France; Université de Tours, Tours, France
| | - F Maillot
- Service de médecine interne, hôpital Bretonneau, CHRU de Tours, 2, boulevard Tonnellé, 37044 Tours cedex, France; Université de Tours, Tours, France
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Lim M, Archambeaud A, Ferreira-Maldent N, Cottier JP, Samimi M. Pseudotumoral presentation of neuro-Behçet's disease in a patient receiving apremilast: A precipitating agent? Ann Dermatol Venereol 2024; 151:103251. [PMID: 38417200 DOI: 10.1016/j.annder.2024.103251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 08/31/2023] [Accepted: 01/08/2024] [Indexed: 03/01/2024]
Affiliation(s)
- M Lim
- Department of Dermatology, University Hospital Center of Tours, Tours, France
| | - A Archambeaud
- Department of Internal Medicine, University Hospital Center of Tours, Tours, France
| | - N Ferreira-Maldent
- Department of Internal Medicine, University Hospital Center of Tours, Tours, France
| | - J-P Cottier
- Department of Neuroradiology, University Hospital Center of Tours, Tours, France
| | - M Samimi
- Department of Dermatology, University Hospital Center of Tours, Tours, France.
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Besse MC, Perrotin F, Aouba A, Gallou S, Karras A, Pillebout E, Urbanski G, Allain JS, Merlot C, Humbert S, Ramdani Y, Ferreira-Maldent N, Maillot F, Audemard-Verger A. Pregnancy outcome in patients with a medical history of immunoglobulin A vasculitis: a case-control study. Scand J Rheumatol 2024; 53:36-43. [PMID: 37439394 DOI: 10.1080/03009742.2023.2226518] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Accepted: 06/14/2023] [Indexed: 07/14/2023]
Abstract
OBJECTIVE Data on obstetric outcomes in patients with a history of immunoglobulin A vasculitis (IgA-V) are lacking. The aim of this study was to assess maternal, neonatal, and vasculitis outcomes during pregnancy. METHOD We conducted a French retrospective case-control study. Pregnancies of patients with a history of IgA-V (cases) were retrospectively studied and compared to pregnancies in women who developed IgA-V after their pregnancies and to pregnancies in healthy women (controls). RESULTS Twenty-six pregnancies in patients with a history of IgA-V were included and compared to 15 pregnancies in women who later developed IgA-V and 52 pregnancies in healthy women. Both gestational hypertension and pre-eclampsia were more frequent in the case group than in the other groups (23% vs 0% vs 0%, p < 0.01; 12% vs 7% vs 0%, p = 0.04). Hypertensive disorder of pregnancy occurred more frequently in patients with pre-existing kidney disease (78% vs 12%, p < 0.01). Caesarean section was more often performed in the case group than in the other groups (27% vs 0% vs 10%, p = 0.04). No foetal loss or maternal deaths occurred. There were no differences in delivery term or birth weight. No vasculitis flares were observed during pregnancy. CONCLUSION Women with a history of IgA-V appear to be at higher risk for gestational hypertension and pre-eclampsia, especially in cases with renal involvement; however, both mother and newborn outcomes appear to be favourable.
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Affiliation(s)
- M-C Besse
- Department of Internal Medicine and Clinical Immunology, CHU de Tours, Tours, France
- Tours University, Tours, France
| | - F Perrotin
- Tours University, Tours, France
- Department of Obstetrics and Gynecology, CHU de Tours, Tours, France
| | - A Aouba
- Department of Internal Medicine and Clinical Immunology, CHU de Caen, Caen, France
| | - S Gallou
- Department of Internal Medicine and Clinical Immunology, CHU de Caen, Caen, France
| | - A Karras
- Department of Nephrology, Hôpital Européen Georges Pompidou, Assistance publique des Hôpitaux de Paris, Paris, France
| | - E Pillebout
- Department of Nephrology, Hôpital Saint Louis, Assistance publique des Hôpitaux de Paris, Paris, France
| | - G Urbanski
- Department of Internal Medicine, CHU d'Angers, Angers, France
| | - J-S Allain
- Department of Internal Medicine, CH de Saint Malo, Saint Malo, France
| | - C Merlot
- Department of Internal Medicine, CHR Orléans, Orléans, France
| | - S Humbert
- Department of Internal Medicine, CHRU de Besancon, Besancon, France
| | - Y Ramdani
- Department of Internal Medicine and Clinical Immunology, CHU de Tours, Tours, France
- Tours University, Tours, France
| | - N Ferreira-Maldent
- Department of Internal Medicine and Clinical Immunology, CHU de Tours, Tours, France
| | - F Maillot
- Department of Internal Medicine and Clinical Immunology, CHU de Tours, Tours, France
- Tours University, Tours, France
| | - A Audemard-Verger
- Department of Internal Medicine and Clinical Immunology, CHU de Tours, Tours, France
- Tours University, Tours, France
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Baud KL, Hankard A, Ramdani Y, Maisons V, Pillebout E, Augusto JF, Jourde-Chiche N, Faguer S, Ferreira-Maldent N, Maillot F, Halimi JM, Terrier B, Audemard-Verger A. Impact of gender on baseline presentation and outcome in adult IgA vasculitis. Rheumatology (Oxford) 2023:kead648. [PMID: 38048626 DOI: 10.1093/rheumatology/kead648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 10/18/2023] [Accepted: 11/08/2023] [Indexed: 12/06/2023] Open
Abstract
OBJECTIVES Adult IgA vasculitis (IgAV) is more common in males, but the potential impact of gender remains unclear. We aimed to describe the impact of gender on presentation and outcome in adult IgAV. METHODS We retrospectively analysed data from a multicentre retrospective cohort of 260 patients (IGAVAS). Comparisons were made according to gender status. RESULTS Data from 259 patients (95 females and 164 males) were analysed. Compared with females, baseline presentation in males was similar for cutaneous involvement (100% vs 100%, p= 1.0), joint involvement (60% vs 63%, p= 0.7), gastrointestinal involvement (57% vs 45%, p= 0.093) and glomerulonephritis (73% vs 64%, p= 0.16). Glomerulonephritis was more severe at baseline in males than in females, with a lower median estimated glomerular filtration rate (eGFR) (90 [IQR 59-105] vs 97 ml/min/1.73m2 [76-116], p= 0.015) and increased median proteinuria (0.84 vs 0.58 g/day, p= 0.01). There were no differences in histological findings in patients who had a kidney biopsy. Methylprednisolone was more frequently used in males (40% vs22%, p= 0.015), as were immunosuppressants, especially cyclophosphamide 24% vs 6%, p= 0.0025) and azathioprine (10% vs 2%, p= 0.038). Analysis of treatment response showed that males had more frequent refractory disease (30% vs 13%, p= 0.004). Long-term outcomes (mortality and progression to chronic kidney failure) did not differ. CONCLUSION Kidney involvement in IgAV appears to more severe in males, which is supported by more intensive treatment contrasting with a lower response rate. This study raises the question of gender as a new prognostic factor in adult IgAV.
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Affiliation(s)
- Kim-Liên Baud
- Department of Internal Medicine, CHU de Tours, Tours, France
| | | | - Yanis Ramdani
- Department of Internal Medicine, CHU de Tours, Tours, France
- University of Tours, Tours, France
| | | | - Evangeline Pillebout
- Department of Nephrology, Hôpital Saint Louis, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France
| | | | - Noémie Jourde-Chiche
- Nephrology, Aix-Marseille Université, C2VN, INSERM, INRAE, AP-HM CHU Conception, Marseille, France
| | | | | | - François Maillot
- Department of Internal Medicine, CHU de Tours, Tours, France
- University of Tours, Tours, France
| | - Jean-Michel Halimi
- Department of Nephrology, CHU de Tours, Tours, France
- Department of Internal Medicine, CHU de Caen, Caen, France
| | - Benjamin Terrier
- Department of Internal Medicine, National Referral Center for Rare Systemic Autoimmune Diseases, Hôpital Cochin Paris, Paris, France
- Paris Cité University, Paris, F-75006, France
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Brunet S, Ramdani Y, Magnant J, Ferreira-Maldent N, Bigot A, Diot E, Besse MC, Maillot F, Audemard-Verger A. [Popliteal pain of unusual cause]. Rev Med Interne 2023; 44:460-461. [PMID: 37258379 DOI: 10.1016/j.revmed.2023.04.441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2023] [Accepted: 04/27/2023] [Indexed: 06/02/2023]
Affiliation(s)
- S Brunet
- Service de médecine interne et immunologie clinique, CHRU Tours, 2, boulevard Tonnellé, 37044 Tours cedex 9, France; Service de rhumatologie, CHRU Tours, 2, boulevard Tonnellé, 37044 Tours cedex 9, France
| | - Y Ramdani
- Service de médecine interne et immunologie clinique, CHRU Tours, 2, boulevard Tonnellé, 37044 Tours cedex 9, France; Université de Tours, Tours, France
| | - J Magnant
- Service de médecine interne et immunologie clinique, CHRU Tours, 2, boulevard Tonnellé, 37044 Tours cedex 9, France
| | - N Ferreira-Maldent
- Service de médecine interne et immunologie clinique, CHRU Tours, 2, boulevard Tonnellé, 37044 Tours cedex 9, France
| | - A Bigot
- Service de médecine interne et immunologie clinique, CHRU Tours, 2, boulevard Tonnellé, 37044 Tours cedex 9, France
| | - E Diot
- Service de médecine interne et immunologie clinique, CHRU Tours, 2, boulevard Tonnellé, 37044 Tours cedex 9, France; Université de Tours, Tours, France
| | - M C Besse
- Service de médecine interne et immunologie clinique, CHRU Tours, 2, boulevard Tonnellé, 37044 Tours cedex 9, France; Université de Tours, Tours, France
| | - F Maillot
- Service de médecine interne et immunologie clinique, CHRU Tours, 2, boulevard Tonnellé, 37044 Tours cedex 9, France; Université de Tours, Tours, France
| | - A Audemard-Verger
- Service de médecine interne et immunologie clinique, CHRU Tours, 2, boulevard Tonnellé, 37044 Tours cedex 9, France; Université de Tours, Tours, France.
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7
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de Frémont GM, Costedoat-Chalumeau N, Lazaro E, Belkhir R, Guettrot-Imbert G, Morel N, Nocturne G, Molto A, Goulenok T, Diot E, Perard L, Ferreira-Maldent N, Le Besnerais M, Limal N, Martis N, Abisror N, Debouverie O, Richez C, Sobanski V, Maurier F, Sauvetre G, Levesque H, Timsit MA, Tieulié N, Orquevaux P, Bienvenu B, Mahevas M, Papo T, Lartigau-Roussin C, Chauvet E, Berthoux E, Sarrot-Reynauld F, Raffray L, Couderc M, Silva NM, Jourde-Chiche N, Belhomme N, Thomas T, Poindron V, Queyrel-Moranne V, Delforge J, Le Ray C, Pannier E, Mariette X, Le Guern V, Seror R. Pregnancy outcomes in women with primary Sjögren's syndrome: an analysis of data from the multicentre, prospective, GR2 study. Lancet Rheumatol 2023; 5:e330-e340. [PMID: 38251600 DOI: 10.1016/s2665-9913(23)00099-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Revised: 03/28/2023] [Accepted: 03/29/2023] [Indexed: 01/23/2024]
Abstract
BACKGROUND Adverse pregnancy outcomes in women with primary Sjögren's syndrome have only been evaluated retrospectively using heterogeneous methods and with contradictory results. We aimed to describe adverse pregnancy, delivery, and birth outcome risks in pregnant women with primary Sjögren's syndrome compared with those of a matched general population in France, and to identify factors predictive of disease flares or adverse pregnancy outcomes. METHODS We conducted a multicentre, prospective, cohort study in France using the GR2 (Groupe de Recherche sur la Grossesse et les Maladies Rares) registry. Women from the GR2 study were eligible if they had conceived before March, 2021, had primary Sjögren's syndrome according to the American College of Rheumatology and European Alliance of Associations for Rheumatology (EULAR) 2016 classification criteria, and had an ongoing pregnancy at 12 weeks of gestation. In women who entered in the registry with pregnancies before 18 weeks of gestation, we sought to identify factors associated with primary Sjögren's syndrome flare (≥3-point increase in EULAR Sjögren's Syndrome Disease Activity Index [ESSDAI] score) or adverse pregnancy outcomes (fetal or neonatal death, placental insufficiency leading to a preterm delivery [<37 weeks of gestation], or small-for-gestational-age birthweight). A matched controlled study compared adverse pregnancy, delivery, and birth outcome rates between pregnant women with primary Sjögren's syndrome from the GR2 registry and matched controls from the general population included in the last French perinatal survey (Enquête Nationale Périnatale 2016). FINDINGS 1944 pregnancies were identified in the GR2 cohort, of which 106 pregnancies in 96 women with primary Sjögren's syndrome were included in this analysis. The median age at pregnancy onset was 33 years (IQR 31-36). 87 (83%) of 105 pregnancies (with ethnicity data) were in White women, 18 (17%) were in Black women; 92 (90%) of 102 had previous systemic activity (ESSDAI score of ≥1; data missing in four pregnancies), and 48 (45%) of 106 had systemic activity at inclusion. Of 93 pregnancies included at week 18 of gestation or earlier, primary Sjögren's syndrome flares occurred in 12 (13%). No baseline parameters were associated with primary Sjögren's syndrome flare. Four twin pregnancies and one medical termination were excluded from the adverse pregnancy outcome analysis; of the remaining 88, adverse pregnancy outcomes occurred in six (7%). Among pregnancies in women with data for antiphospholipid antibodies (n=55), antiphospholipid antibody positivity was more frequent among pregnancies with adverse outcomes (two [50%] of four pregnancies) compared with those without adverse outcomes (two [4%] of 51 pregnancies; p=0·023). Anti-RNP antibody positivity was also more frequent among pregnancies with adverse outcomes than those without, although this was not statistically significant. In the matched controlled study, adverse pregnancy outcomes occurred in nine (9%) of 105 pregnancies in women with primary Sjögren's syndrome and 28 (7%) of the 420 matched control pregnancies; adverse pregnancy outcomes were not significantly associated with primary Sjögren's syndrome (odds ratio 1·31, 95% CI 0·53-2·98; p=0·52). INTERPRETATION Pregnancies in women with primary Sjögren's syndrome had very good prognoses for mothers and fetuses, with no overall increase in adverse pregnancy outcome risk compared with the general population. Women with antiphospholipid antibodies or anti-RNP antibodies require close monitoring, because these factors might be associated with a higher risk of adverse pregnancy outcomes. FUNDING Lupus France, Association des Sclérodermiques de France, Association Gougerot Sjögren, Association Francophone Contre la Polychondrite Chronique Atrophiante, AFM-Telethon, Société Nationale Française de Médecine Interne, Société Française de Rhumatologie, Cochin Hospital, French Health Ministry, Fondation for Research in Rheumatology, Association Prix Véronique Roualet, Union Chimique Belge.
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Affiliation(s)
- Grégoire Martin de Frémont
- APHP, Hôpital Bicêtre, Service de Rhumatologie, Centre de Référence Maladies Auto-Immunes et Systémiques Rares d'Île-de-France, Inserm UMR 1184, Center for Immunology of Viral Infections and Autoimmune Diseases, Université Paris-Saclay, Le Kremlin-Bicêtre, France
| | - Nathalie Costedoat-Chalumeau
- APHP, Hôpital Cochin, Service de Médecine Interne, Centre de Référence Maladies Auto-Immunes et Systémiques Rares d'Île-de-France, Paris, France; Centre de Recherche Epidémiologie et Biostatistiques de Sorbonne Paris Cité, Université de Paris, Paris, France
| | - Estibaliz Lazaro
- CHU de Bordeaux, Service de Médecine Interne et Maladies Infectieuses, Bordeaux, France
| | - Rakiba Belkhir
- APHP, Hôpital Bicêtre, Service de Rhumatologie, Centre de Référence Maladies Auto-Immunes et Systémiques Rares d'Île-de-France, Inserm UMR 1184, Center for Immunology of Viral Infections and Autoimmune Diseases, Université Paris-Saclay, Le Kremlin-Bicêtre, France
| | - Gaëlle Guettrot-Imbert
- APHP, Hôpital Cochin, Service de Médecine Interne, Centre de Référence Maladies Auto-Immunes et Systémiques Rares d'Île-de-France, Paris, France
| | - Nathalie Morel
- APHP, Hôpital Cochin, Service de Médecine Interne, Centre de Référence Maladies Auto-Immunes et Systémiques Rares d'Île-de-France, Paris, France
| | - Gaétane Nocturne
- APHP, Hôpital Bicêtre, Service de Rhumatologie, Centre de Référence Maladies Auto-Immunes et Systémiques Rares d'Île-de-France, Inserm UMR 1184, Center for Immunology of Viral Infections and Autoimmune Diseases, Université Paris-Saclay, Le Kremlin-Bicêtre, France
| | - Anna Molto
- Centre de Recherche Epidémiologie et Biostatistiques de Sorbonne Paris Cité, Université de Paris, Paris, France; APHP, Hôpital Cochin, Service de Rhumatologie, Centre de Référence Maladies Auto-Immunes et Systémiques Rares d'Île-de-France, Paris, France
| | | | - Elisabeth Diot
- CHU de Tours, Service de Médecine Interne, Tours, France
| | - Laurent Perard
- Hôpital Saint-Joseph, Service de Médecine Interne, Lyon, France
| | | | | | - Nicolas Limal
- APHP, Hôpital Henri-Mondor, Service de Médecine Interne, Créteil, France
| | - Nihal Martis
- CHU de Nice, Hôpital Archet, Service de Médecine Interne, Nice, France
| | - Noémie Abisror
- APHP, Hôpital Saint-Antoine, Service de Médecine Interne, Paris, France
| | | | | | - Vincent Sobanski
- CHU de Lille, Service de Médecine Interne et Immunologie Clinique, Centre de Référence des Maladies Auto-Immunes Systémiques Rares, Inserm U1286, Université de Lille, Lille, France
| | - François Maurier
- Hôpitaux Privés de Metz, Service de Médecine Interne, Metz, France
| | | | - Hervé Levesque
- CHU de Rouen, Service de Médecine Interne, Rouen, France
| | | | | | | | - Boris Bienvenu
- Hôpital Saint-Joseph, Service de Médecine Interne, Marseille, France
| | - Matthieu Mahevas
- APHP, Hôpital Henri-Mondor, Service de Médecine Interne, Créteil, France
| | - Thomas Papo
- APHP, Hôpital Bichat, Service de Médecine Interne, Paris, France
| | | | - Elodie Chauvet
- Polyclinique Médipôle Saint-Roch, Service de Médecine Interne, Cabestany, France
| | - Emilie Berthoux
- Hôpital Saint-Joseph, Service de Médecine Interne, Lyon, France
| | | | - Loïc Raffray
- CHU Félix-Guyon, Service de Médecine Interne, Saint-Denis de la Réunion, France
| | - Marion Couderc
- CHU de Clermont-Ferrand, Service de Rhumatologie, Clermont-Ferrand, France
| | | | - Noémie Jourde-Chiche
- APHM, CHU de la Conception, Centre de Néphrologie et Transplantation Rénale, C2VN, Inserm 1263, Institut National de la Recherche Agronomique (INRA) 1260, Faculté de Pharmacie, Marseille, France
| | | | - Thierry Thomas
- CHU de Saint-Etienne, Service de Médecine Interne, Saint-Etienne, France
| | - Vincent Poindron
- CHU de Strasbourg, Service de Médecine Interne, Strasbourg, France
| | | | - Juliette Delforge
- APHP, Hôpital Jean-Verdier, Service de Médecine Interne, Bobigny, France
| | - Camille Le Ray
- INSERM UMR 1153, Obstetrical, Perinatal and Pediatric Epidemiology Research Team (Epopé), Center for Epidemiology and Statistics, FHU PREMA, Université Paris Cité, Paris, France
| | - Emmanuelle Pannier
- APHP, Hôpital Cochin Port Royal, Maternité Port Royal, Service d'Obstétrique, Université de Paris, Paris, France
| | - Xavier Mariette
- APHP, Hôpital Bicêtre, Service de Rhumatologie, Centre de Référence Maladies Auto-Immunes et Systémiques Rares d'Île-de-France, Inserm UMR 1184, Center for Immunology of Viral Infections and Autoimmune Diseases, Université Paris-Saclay, Le Kremlin-Bicêtre, France
| | - Véronique Le Guern
- APHP, Hôpital Cochin, Service de Médecine Interne, Centre de Référence Maladies Auto-Immunes et Systémiques Rares d'Île-de-France, Paris, France
| | - Raphaèle Seror
- APHP, Hôpital Bicêtre, Service de Rhumatologie, Centre de Référence Maladies Auto-Immunes et Systémiques Rares d'Île-de-France, Inserm UMR 1184, Center for Immunology of Viral Infections and Autoimmune Diseases, Université Paris-Saclay, Le Kremlin-Bicêtre, France.
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8
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Collercandy N, Ramdani Y, Audemard-Verger A, Legot F, Maillot F, Ferreira-Maldent N. Post-infectious vasculitis secondary to Campylobacter coli infection. Int J Infect Dis 2023; 130:71-72. [PMID: 36828235 DOI: 10.1016/j.ijid.2023.02.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 02/16/2023] [Accepted: 02/17/2023] [Indexed: 02/24/2023] Open
Affiliation(s)
- Nived Collercandy
- CHU de Tours, Service de Médecine Interne et Immunologie Clinique, Tours, France
| | - Yanis Ramdani
- CHU de Tours, Service de Médecine Interne et Immunologie Clinique, Tours, France; Université de Tours, Tours, France
| | - Alexandra Audemard-Verger
- CHU de Tours, Service de Médecine Interne et Immunologie Clinique, Tours, France; Université de Tours, Tours, France
| | - Floriane Legot
- CHU de Tours, Service de Médecine Nucléaire, Tours, France
| | - François Maillot
- CHU de Tours, Service de Médecine Interne et Immunologie Clinique, Tours, France; Université de Tours, Tours, France
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Maillet C, Wong So J, Ramdani Y, Bigot A, Ferreira-Maldent N, Chandenier B, Maillot F, Audemard-Verger A. [Scurvy mimicking vasculitis]. Rev Prat 2023; 73:65. [PMID: 36820459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Subscribe] [Scholar Register] [Indexed: 02/24/2023]
Affiliation(s)
- Cécilia Maillet
- Département de médecine interne et immunologue clinique, CHRU Tours, Tours, France
| | - Jonathan Wong So
- Département de médecine interne et immunologue clinique, CHRU Tours, Tours, France
| | - Yanis Ramdani
- Département de médecine interne et immunologue clinique, CHRU Tours, Tours, France. Université de Tours, Tours, France
| | - Adrien Bigot
- Département de médecine interne et immunologue clinique, CHRU Tours, Tours, France
| | | | - Brigitte Chandenier
- Département de médecine interne et immunologue clinique, CHRU Tours, Tours, France
| | - François Maillot
- Département de médecine interne et immunologue clinique, CHRU Tours, Tours, France. Université de Tours, Tours, France
| | - Alexandra Audemard-Verger
- Département de médecine interne et immunologue clinique, CHRU Tours, Tours, France. Université de Tours, Tours, France
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10
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Murarasu A, Guettrot-Imbert G, Le Guern V, Yelnik C, Queyrel V, Schleinitz N, Ferreira-Maldent N, Diot E, Urbanski G, Pannier E, Lazaro E, Souchaud-Debouverie O, Orquevaux P, Belhomme N, Morel N, Chauvet E, Maurier F, Le Besnerais M, Abisror N, Goulenok T, Sarrot-Reynauld F, Deroux A, Pasquier E, de Moreuil C, Bezanahary H, Pérard L, Limal N, Langlois V, Calas A, Godeau B, Lavigne C, Hachulla E, Cohen F, Benhamou Y, Raffray L, de Menthon M, Tieulié N, Poindron V, Mouthon L, Larosa M, Eléfant E, Sentilhes L, Molto A, Deneux-Tharaux C, Costedoat-Chalumeau N. Characterisation of a high-risk profile for maternal thrombotic and severe haemorrhagic complications in pregnant women with antiphospholipid syndrome in France (GR2): a multicentre, prospective, observational study. Lancet Rheumatol 2022; 4:e842-e852. [PMID: 38261392 DOI: 10.1016/s2665-9913(22)00308-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 09/30/2022] [Accepted: 10/03/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND Prospective data about the risks of thrombotic and severe haemorrhagic complications during pregnancy and post partum are unavailable for women with antiphospholipid syndrome. We aimed to assess thrombotic and haemorrhagic events in a prospective cohort of pregnant women with antiphospholipid syndrome. METHODS This multicentre, prospective, observational study was done at 76 centres in France. To be eligible for this study, women had to have diagnosis of antiphospholipid syndrome; have conceived before April 17, 2020; have an ongoing pregnancy that had reached 12 weeks of gestation; and be included in the study before 18 weeks of gestation. Exclusion criteria were active systemic lupus erythematosus nephropathy, or a multifetal pregnancy. Severe haemorrhage was defined as the need for red blood cell transfusion or maternal intensive care unit admission because of bleeding or invasive procedures, defined as interventional radiology or surgery, to control bleeding. The GR2 study is registered with ClinicalTrials.gov, NCT02450396. FINDINGS Between May 26, 2014, and April 17, 2020, 168 pregnancies in 27 centres met the inclusion criteria for the study. 89 (53%) of 168 women had a history of thrombosis. The median term at inclusion was 8 weeks gestation. 16 (10%) of 168 women (95%CI 5-15) had a thrombotic (six [4%] women; 95% CI 1-8) or severe haemorrhagic event (12 [7%] women; 95% CI 4-12). There were no deaths during the study. The main risk factors for thrombotic events were lupus anticoagulant positivity at inclusion (six [100%] of six women with thrombosis vs 78 [51%] of 152 of those with no thrombosis; p=0·030) and placental insufficiency (four [67%] of six women vs 28 [17%] of 162 women; p=0·013). The main risk factors for severe haemorrhagic events were pre-existing maternal hypertension (four [33%] of 12 women vs 11 [7%] of 156 women; p=0·014), lupus anticoagulant positivity at inclusion (12 [100%] of 12 women vs 72 [49%] of 146 women; p<0·0001) and during antiphospholipid history (12 [100%] of 12 women vs 104 [67%] of 156 women; p=0·019), triple antiphospholipid antibody positivity (eight [67%] of 12 women vs 36 [24%] of 147 women; p=0·0040), placental insufficiency (five [42%] of 12 women vs 27 [17%] of 156 women; p=0·038), and preterm delivery at 34 weeks or earlier (five [45%] of 11 women vs 12 [8%] of 145 women; p=0·0030). INTERPRETATION Despite treatment adhering to international recommendations, a proportion of women with antiphospholipid syndrome developed a thrombotic or severe haemorrhagic complication related to pregnancy, most frequently in the post-partum period. Lupus anticoagulant and placental insufficiency were risk factors for these life-threatening complications. These complications are difficult to prevent, but knowledge of the antenatal characteristics associated with them should increase awareness and help physicians manage these high-risk pregnancies. FUNDING Lupus France, association des Sclérodermiques de France, association Gougerot Sjögren, Association Francophone contre la Polychondrite chronique atrophiante, AFM-Telethon, the French Society of Internal Medicine and Rheumatology, Cochin Hospital, the French Health Ministry, FOREUM, the Association Prix Veronique Roualet, and UCB.
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Affiliation(s)
- Anne Murarasu
- Assistance Publique-Hôpitaux de Paris, Service de Médecine Interne, Centre de Référence Maladies Auto-immunes et Systémiques Rares, Hôpital Cochin, Université de Paris, Paris, France; Assistance Publique-Hôpitaux de Paris, Centre for Clinical Epidemiology, Hôpital Hôtel-Dieu, Université de Paris, Centre of Research in Epidemiology and Statistics, Paris, France
| | - Gaëlle Guettrot-Imbert
- Assistance Publique-Hôpitaux de Paris, Service de Médecine Interne, Centre de Référence Maladies Auto-immunes et Systémiques Rares, Hôpital Cochin, Université de Paris, Paris, France
| | - Véronique Le Guern
- Assistance Publique-Hôpitaux de Paris, Service de Médecine Interne, Centre de Référence Maladies Auto-immunes et Systémiques Rares, Hôpital Cochin, Université de Paris, Paris, France
| | - Cécile Yelnik
- Univ Lille, Inserm, CHU Lille, Service de Médecine Interne, U1167 RID-AGE, Lille, France
| | | | - Nicolas Schleinitz
- Service de Médecine Interne, Aix Marseille Université, APHM, Hôpital La Timone, Marseille, France
| | | | | | | | - Emmanuelle Pannier
- Assistance Publique-Hôpitaux de Paris, Service de Maternité Gynécologie Obstétrique Port-Royal, Université de Paris, Hôpital Cochin, Paris, France
| | - Estibaliz Lazaro
- Service de Médecine Interne, Hôpital du Haut-Lévêque, Pessac, France
| | | | | | - Nicolas Belhomme
- Service de Médecine Interne et Immunologie Clinique, Hôpital Sud, Rennes; Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail)-UMR_S 1085, Rennes, France
| | - Nathalie Morel
- Assistance Publique-Hôpitaux de Paris, Service de Médecine Interne, Centre de Référence Maladies Auto-immunes et Systémiques Rares, Hôpital Cochin, Université de Paris, Paris, France
| | - Elodie Chauvet
- Service de Médecine Interne, Centre Hospitalier Saint Jean, Perpignan, France
| | - François Maurier
- Service de Médecine Interne et Immunologie Clinique Groupe Hospitalier UNEOS Site Hôpital Robert Schuman, Vantoux, France
| | - Maëlle Le Besnerais
- Service de Médecine Interne, CHU Rouen, Rouen, France; INSERM U 905, Université de Rouen IFRMP, Institute for Biochemical Research, Centre Hospitalier Universitaire de Rouen, Rouen, France
| | - Noemie Abisror
- Sorbonne Université, Service de Médecine Interne, AP-HP, Hôpital Saint Antoine, Paris, France
| | - Tiphaine Goulenok
- Service de Médecine Interne, Hôpital Bichat Claude Bernard, AP-HP, Paris, France
| | | | - Alban Deroux
- Service de Médecine Interne, CHU Grenoble-Alpes, Grenoble, France
| | | | - Claire de Moreuil
- Service de Médecine Interne et Pneumologie, CHU de Brest, Brest, France
| | | | - Laurent Pérard
- Service de Médecine Interne, Centre Hospitalier Saint Joseph Saint Luc, Lyon, France
| | - Nicolas Limal
- Assistance Publique-Hôpitaux de Paris, Service de Médecine Interne, CHU Henri Mondor, Université Paris-Est Créteil, Créteil, France
| | - Vincent Langlois
- Service de Médecine Interne et Maladies Infectieuses, Hôpital Le Havre, Le Havre, France
| | - Anne Calas
- Service de Médecine Interne, Polyclinique Saint Laurent, Rennes, Frances
| | - Bertrand Godeau
- Assistance Publique-Hôpitaux de Paris, Service de Médecine Interne, CHU Henri Mondor, Université Paris-Est Créteil, Créteil, France
| | | | - Eric Hachulla
- Univ Lille, Inserm, CHU Lille, Service de Médecine Interne et Immunologie Clinique, Centre de référence des maladies autoimmunes systémiques rares du Nord et Nord-Ouest de France (CeRAINO), U1286-INFINITE-Institute for Translational Research in Inflammation, Lille, France
| | - Fleur Cohen
- Sorbonne Université, Assistance Publique Hôpitaux de Paris, Hôpital de la Pitié-Salpêtrière, Service de médecine interne 2, Centre national de référence maladies auto-immunes et systémiques rares, lupus et syndrome des anticorps antiphospholipides, Paris, France
| | - Ygal Benhamou
- Service de Médecine Interne, CHU Rouen, Rouen, France; INSERM U 905, Université de Rouen IFRMP, Institute for Biochemical Research, Centre Hospitalier Universitaire de Rouen, Rouen, France
| | - Loïc Raffray
- Service Médecine Interne et Dermatologie, CHU Réunion-Hôpital Félix Guyon, Saint Denis, France
| | - Mathilde de Menthon
- Assistance Publique Hôpitaux de Paris, Service de Médecine Interne et Immunologie Clinique, Hôpital Bicêtre, Le Kremlin Bicêtre, France
| | | | - Vincent Poindron
- Service d'Immunologie Clinique, Nouvel Hôpital Civil, Strasbourg, France; Centre de référence maladies autoimmunes rares Est Sud Ouest RESO, Strasbourg, France
| | - Luc Mouthon
- Assistance Publique-Hôpitaux de Paris, Service de Médecine Interne, Centre de Référence Maladies Auto-immunes et Systémiques Rares, Hôpital Cochin, Université de Paris, Paris, France
| | | | - Elisabeth Eléfant
- Centre de Reference sur les Agents Tératogènes (CRAT), Hôpital Armand-Trousseau, Paris, France
| | - Loic Sentilhes
- Service de Gynécologie Obstétrique, CHU de Bordeaux, Bordeaux, France
| | - Anna Molto
- Assistance Publique-Hôpitaux de Paris, Centre for Clinical Epidemiology, Hôpital Hôtel-Dieu, Université de Paris, Centre of Research in Epidemiology and Statistics, Paris, France; Assistance Publique-Hôpitaux de Paris, Service de Rhumatologie, Hôpital Cochin, Université de Paris, Paris, France
| | - Catherine Deneux-Tharaux
- Université de Paris, U1153 Centre for Epidemiology and Statistics Sorbonne Paris Cité (CRESS), Obstetrical Perinatal and Pediatric Epidemiology Research Team, EPOPé, INSERM, INRA, Paris, France
| | - Nathalie Costedoat-Chalumeau
- Assistance Publique-Hôpitaux de Paris, Service de Médecine Interne, Centre de Référence Maladies Auto-immunes et Systémiques Rares, Hôpital Cochin, Université de Paris, Paris, France; Assistance Publique-Hôpitaux de Paris, Centre for Clinical Epidemiology, Hôpital Hôtel-Dieu, Université de Paris, Centre of Research in Epidemiology and Statistics, Paris, France.
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11
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Audemard-Verger A, Le Gouge A, Pestre V, Courjon J, Langlois V, Vareil MO, Devaux M, Bienvenu B, Leroy V, Goulabchand R, Colombain L, Bigot A, Guimard T, Douadi Y, Urbanski G, Faucher JF, Maulin L, Lioger B, Talarmin JP, Groh M, Emmerich J, Deriaz S, Ferreira-Maldent N, Cook AR, Lengellé C, Bourgoin H, Mekinian A, Aouba A, Maillot F, Caille A. Efficacy and safety of anakinra in adults presenting deteriorating respiratory symptoms from COVID-19: A randomized controlled trial. PLoS One 2022; 17:e0269065. [PMID: 35925914 PMCID: PMC9351999 DOI: 10.1371/journal.pone.0269065] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Accepted: 05/12/2022] [Indexed: 01/08/2023] Open
Abstract
Objective We aimed to investigate whether anakinra, an interleukin-1receptor inhibitor, could improve outcome in moderate COVID-19 patients. Methods In this controlled, open-label trial, we enrolled adults with COVID-19 requiring oxygen. We randomly assigned patients to receive intravenous anakinra plus optimized standard of care (oSOC) vs. oSOC alone. The primary outcome was treatment success at day 14 defined as patient alive and not requiring mechanical ventilation or extracorporeal membrane oxygenation. Results Between 27th April and 6th October 2020, we enrolled 71 patients (240 patients planned to been enrolled): 37 were assigned to the anakinra group and 34 to oSOC group. The study ended prematurely by recommendation of the data and safety monitoring board due to safety concerns. On day 14, the proportion of treatment success was significantly lower in the anakinra group 70% (n = 26) vs. 91% (n = 31) in the oSOC group: risk difference—21 percentage points (95% CI, -39 to -2), odds ratio 0.23 (95% CI, 0.06 to 0.91), p = 0.027. After a 28-day follow-up, 9 patients in the anakinra group and 3 in the oSOC group had died. Overall survival at day 28 was 75% (95% CI, 62% to 91%) in the anakinra group versus 91% (95% CI, 82% to 100%) (p = 0.06) in the oSOC group. Serious adverse events occurred in 19 (51%) patients in the anakinra group and 18 (53%) in the oSOC group (p = 0·89). Conclusion This trial did not show efficacy of anakinra in patients with COVID-19. Furthermore, contrary to our hypothesis, we found that anakinra was inferior to oSOC in patients with moderate COVID-19 pneumonia.
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Affiliation(s)
- Alexandra Audemard-Verger
- Department of Internal Medicine and Clinical Immunology, CHRU Tours, Tours, France
- University of Tours, Tours, France
- * E-mail:
| | | | - Vincent Pestre
- Department of Internal Medicine and Infectious Diseases, CH Avignon, Avignon, France
| | - Johan Courjon
- Department of Infectious Diseases, Université Côte d’Azur, CHU Nice, Nice, France
| | | | | | - Mathilde Devaux
- Department of Internal Medicine, CH de Poissy, Poissy, France
| | - Boris Bienvenu
- Department of Internal Medicine, Hôpital Saint Joseph, Marseille, France
| | - Vincent Leroy
- Department of Infectious Diseases, Clinique Tessier, Valenciennes, France
| | - Radjiv Goulabchand
- Internal Medicine Department & Department of Infectious and Tropical Diseases, Nîmes University Hospital, University of Montpellier, Nîmes, France
| | - Léa Colombain
- Department of Infectious Diseases, CH de Perpignan, Perpignan, France
| | - Adrien Bigot
- Department of Internal Medicine and Clinical Immunology, CHRU Tours, Tours, France
| | - Thomas Guimard
- Department of Infectious Diseases, CH la Roche sur Yon, La Roche sur Yon, France
| | - Youcef Douadi
- Department of Infectious Diseases, CH Saint Quentin, Saint Quentin, France
| | - Geoffrey Urbanski
- Department of Internal Medicine and Clinical Immunology, CHU Angers, Angers France
| | | | - Laurence Maulin
- Department of Infectious Diseases, CH Aix en Provence, Aix en Provence, France
| | | | | | - Matthieu Groh
- Department of Internal Medicine, Hôpital Foch, Suresnes, France
| | - Joseph Emmerich
- Department of Vascular Medicine, GH Saint Joseph and Université de Paris, INSERM CRESS 1153, Paris, France
| | - Sophie Deriaz
- Department of Internal Medicine and Clinical Immunology, CHRU Tours, Tours, France
| | | | - Ann-Rose Cook
- Department of Internal Medicine and Clinical Immunology, CHRU Tours, Tours, France
| | | | | | - Arsène Mekinian
- Department of Internal Medicine, Hôpital Saint Antoine, Sorbonne Université, Paris, France
| | - Achille Aouba
- Department of Internal Medicine, CHU de Caen, Caen, France
| | - François Maillot
- Department of Internal Medicine and Clinical Immunology, CHRU Tours, Tours, France
- University of Tours, Tours, France
| | - Agnès Caille
- University of Tours, Tours, France
- INSERM CIC1415, CHRU Tours, Tours, France
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12
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Hankard A, Ingen-Housz-Oro S, El Karoui K, Paule R, Lioger B, Brihaye B, Battistella M, Jobard S, Magnant J, Diot E, Bigot A, Ferreira-Maldent N, Deriaz S, Cook AR, Henique H, Maillot F, Aouba A, Audemard-Verger A. IgA vasculitis with underlying monoclonal IgA gammopathy: innovative therapeutic approach targeting plasma cells. A case series. Clin Rheumatol 2022; 41:3119-3123. [PMID: 35713822 DOI: 10.1007/s10067-022-06181-4] [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: 12/08/2021] [Revised: 04/11/2022] [Accepted: 04/13/2022] [Indexed: 11/03/2022]
Abstract
OBJECTIVE There is currently no evidence of the possible benefit of plasma cell-targeting therapies (PCTT) in immunoglobulin A (IgA) monoclonal gammopathy (MG) associated with IgA vasculitis (IgAV). We report the outcome of different PCTT regimens in a cohort of MG-IgAV. METHODS We used a French network to retrospectively describe the outcome of MG-IgAV patients treated with PCTT. RESULTS Five patients were included (mean age 65 years). All patients had severe baseline presentation including extensive necrotic purpura (n = 5), gastrointestinal involvement (n = 2), peripheral neuropathies (n = 2), and glomerulonephritis (n = 1). Two patients had IgA indolent multiple myeloma and three had IgA "MG of undetermined significance." Monotypic IgA deposition in the skin vessels wall was highlighted using an immunofluorescence assay. Cases of vasculitis in three patients (n = 3) were refractory to multiple line therapies, including cyclophosphamide (n = 3) or rituximab. Finally, PCTT including bortezomib plus cyclophosphamide and dexamethasone, bortezomib plus melphalan and prednisone, or bortezomib plus lenalidomide and dexamethasone were proposed, allowing complete remission in 4/5 patients without major adverse drug events. CONCLUSION This study suggests that the MG-IgAV phenotype might be distinctive of usual IgAV (severe and refractory to conventional immunosuppressive regimens) and supports the benefit of PCTT. This study sheds new light on the overall biology of IgAV, strengthening the pathogenic role of the monoclonal IgA component in IgAV.
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Affiliation(s)
| | | | | | - Romain Paule
- Department of Internal Medicine, Hôpital Foch, Suresne, France
| | - Bertrand Lioger
- Department of Internal Medicine, Hôpital de Blois, Blois, France
| | - Benoit Brihaye
- Department of Internal Medicine, CH Saint Quentin, Saint Quentin, France
| | | | - Stéphanie Jobard
- Department of Internal Medicine and Clinical Immunology, CHRU Tours, Tours, France
| | - Julie Magnant
- Department of Internal Medicine and Clinical Immunology, CHRU Tours, Tours, France
| | - Elisabeth Diot
- Department of Internal Medicine and Clinical Immunology, CHRU Tours, Tours, France
| | - Adrien Bigot
- Department of Internal Medicine and Clinical Immunology, CHRU Tours, Tours, France
| | | | - Sophie Deriaz
- Department of Internal Medicine and Clinical Immunology, CHRU Tours, Tours, France
| | - Ann-Rose Cook
- Department of Internal Medicine and Clinical Immunology, CHRU Tours, Tours, France
| | - Hélène Henique
- Department of Internal Medicine and Clinical Immunology, CHRU Tours, Tours, France
| | - Francois Maillot
- Department of Internal Medicine and Clinical Immunology, CHRU Tours, Tours, France.,University of Tours, Tours, France
| | - Achille Aouba
- Department of Internal Medicine, CHU de Caen, Caen, France
| | - Alexandra Audemard-Verger
- Department of Internal Medicine and Clinical Immunology, CHRU Tours, Tours, France. .,University of Tours, Tours, France.
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13
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Bourguiba R, Kyheng M, Koné-Paut I, Rouzaud D, Avouac J, Devaux M, Abdallah NA, Fautrel B, Ferreira-Maldent N, Langlois V, Ledoult E, Nielly H, Queyrel V, Sellam J, Tieulie N, Chazerain P, Evon P, Labreuche J, Savey L, Hentgen V, Grateau G, Georgin-Lavialle S. COVID-19 infection among patients with autoinflammatory diseases: a study on 117 French patients compared with 1545 from the French RMD COVID-19 cohort: COVIMAI - the French cohort study of SARS-CoV-2 infection in patient with systemic autoinflammatory diseases. RMD Open 2022; 8:rmdopen-2021-002063. [PMID: 35537796 PMCID: PMC9091487 DOI: 10.1136/rmdopen-2021-002063] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Accepted: 02/04/2022] [Indexed: 11/04/2022] Open
Abstract
Objective There is little known about SARS-CoV-2 infection in patients with systemic autoinflammatory disease (SAID). This study aimed to describe epidemiological features associated with severe disease form and death. Mortality between patients with and without SAID hospitalised for SARS-CoV-2 infection was compared. Methods A national multicentric prospective cohort study was conducted from the French Rheumatic and Musculoskeletal Diseases (RMD) COVID-19 cohort. Patients with SAID were matched with patients with non-SAID on age±7 years, gender and number of comorbidities to consider important confounding factors. Impact of SAID on severity of SARS-CoV-2 infection was analysed using multinomial logistic regression for severity in three classes (mild, moderate and severe with mild status as reference). Fine-Gray regression model for length of hospital stay and binomial logistic regression model for risk of death at 30 days. Results We identified 117 patients with SAID (sex ratio 0.84, 17 children) and compared them with 1545 patients with non-autoinflammatory immune-mediated inflammatory disorders (non-SAID). 67 patients had a monogenic SAID (64 with familial Mediterranean fever). Other SAIDs were Behçet’ disease (n=21), undifferentiated SAID (n=16), adult-onset Still disease (n=9) and systemic-onset juvenile idiopathic arthritis (n=5). Ten adults developed severe form (8.6%). Six patients died. All children had a benign disease. After matching on age±7 years, sex and number of comorbidities, no significant difference between the two groups in length of stay and the severity of infection was noted. Conclusion As identified in the whole French RMD COVID-19 cohort, patients with SAID on corticosteroids and with multiple comorbidities are prone to develop more severe COVID-19 forms.
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Affiliation(s)
- Rim Bourguiba
- Sorbonne University, AP-HP, Tenon Hospital, Internal Medicine Department, 4 rue de la Chine, 75020, Paris, France; national Reference center for autoinflammatory diseases and AA amyloidosis (CEREMAIA), Tenon Hospital, Paris, France
| | - Maeva Kyheng
- Univ. Lille, CHU Lille, ULR 2694 - METRICS : évaluation des technologies de santé et des pratiques médicales, F-59000 Lille, France, CHU Lille, Département de Biostatistiques, F-59000 Lille, France, Université de Lille, Lille, France
| | - Isabelle Koné-Paut
- Service de Rhumatologie Pédiatrique, Centre de Référence des Maladies Auto-Inflammatoires de l'enfant, Hôpital Bicêtre, AP HP, Université Paris Sud, Bicètre, France
| | - Diane Rouzaud
- Department of internal medicine, Bichat hospital, Paris, France, Bichat Hospital, Paris, France
| | - Jerome Avouac
- Université de Paris, Service de Rhumatologie, Hôpital Cochin, AP-HP.CUP, Paris, France, Hôpital Cochin, Paris, France
| | - Mathilde Devaux
- CHI Poissy-Saint-Germain-en-Laye, Saint-Germain-en-Laye, France
| | - Nassim Ait Abdallah
- Unité de Médecine Interne: Maladies Auto-immunes et Pathologie Vasculaire (UF 04), Centre de Reference des Maladies autoimmunes systemiques Rares d'Ile-de-France MATHEC, AP-HP, Hopital Saint-Louis, Paris, France, Université de Paris, IRSL, Recherche clinique appliquée à l'hématologie, EA, Paris, France, Hôpital Saint-Louis, Paris, France
| | - Bruno Fautrel
- Sorbonne Université - Assistance Publique Hôpitaux de Paris, Pitié Salpêtrière University Hospital, Dept of Rhumatology, Reference Center for Rare Diseases CEREMAIA (ERN RITA), Paris, France. ii) Pierre Louis Institute of Epidemiology and Public Health, INSERM UMRS 1136, PEPITES team, Assistance Publique-Hopitaux de Paris, Paris, France
| | | | | | - Emmanuel Ledoult
- Service de Médecine Interne, Centre de Référence des Maladies Auto-immunes et Systémiques Rares du Nord et Nord-Ouest de France (CeRAINO), CHU Lille, F-59000 Lille, France 2- Inserm, U1286, F-59000 Lille, France, CHRU de Lille, Lille, France
| | - Hubert Nielly
- Hôpital d'Instructions des Armées Bégin, Saint Mande, France
| | | | - Jérémie Sellam
- Rheumatology, INSERM UMRS_938, Sorbonnes Université UPMC Univ Paris 06, St-Antoine Hospital, DHU i2B, Paris, France
| | - Nathalie Tieulie
- Service de Rhumatologie, Hôpital Pasteur, Centre Hospitalier Universitaire, Université de Nice Sophia Antipolis, Nice, France
| | - Pascal Chazerain
- Internal Medicine and Rheumatology, Groupe Hospitalier Diaconesses Croix Saint Simon, Paris, France
| | - Philippe Evon
- Internal Medecine department, CH de Bar-Le-Duc, Bar-le-Duc, France
| | | | - Léa Savey
- Sorbonne University, AP-HP, Tenon Hospital, Internal Medicine Department, 4 rue de la Chine, 75020, Paris, France; national Reference center for autoinflammatory diseases and AA amyloidosis (CEREMAIA), Tenon Hospital, Paris, France
| | - Veronique Hentgen
- CeReMAI-Departement of Pediatrics Department of general pediatrics, Andre Mignot hospital, Versailles, CEREMAIA, France, Hôpital Mignot, Le Chesnay, France
| | - Gilles Grateau
- Sorbonne University, AP-HP, Tenon Hospital, Internal Medicine Department, 4 rue de la Chine, 75020, Paris, France; national Reference center for autoinflammatory diseases and AA amyloidosis (CEREMAIA), Tenon Hospital, Paris, France
| | - Sophie Georgin-Lavialle
- Sorbonne University, AP-HP, Tenon Hospital, Internal Medicine Department, 4 rue de la Chine, 75020, Paris, France; national Reference center for autoinflammatory diseases and AA amyloidosis (CEREMAIA), Tenon Hospital, Paris, France
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14
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Nasri I, Ramdani Y, Lemaignen A, Ferreira-Maldent N, Bigot A, Boucaud A, Maillot F, Audemard-Verger A. [Multiple liver lesions]. Rev Med Interne 2021; 43:57-58. [PMID: 34922782 DOI: 10.1016/j.revmed.2021.05.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Accepted: 05/30/2021] [Indexed: 11/16/2022]
Affiliation(s)
- I Nasri
- Service de médecine interne et immunologie, université de Tours, CHRU, Tours, France
| | - Y Ramdani
- Service de médecine interne et immunologie, université de Tours, CHRU, Tours, France; Service de maladies infectieuses, CHRU Tours, Tours, France
| | - A Lemaignen
- Service de maladies infectieuses, CHRU Tours, Tours, France; Université de Tours, Tours, France
| | - N Ferreira-Maldent
- Service de médecine interne et immunologie, université de Tours, CHRU, Tours, France
| | - A Bigot
- Service de médecine interne et immunologie, université de Tours, CHRU, Tours, France
| | - A Boucaud
- Service de médecine interne et immunologie, université de Tours, CHRU, Tours, France
| | - F Maillot
- Service de médecine interne et immunologie, université de Tours, CHRU, Tours, France; Service de maladies infectieuses, CHRU Tours, Tours, France
| | - A Audemard-Verger
- Service de médecine interne et immunologie, université de Tours, CHRU, Tours, France; Service de maladies infectieuses, CHRU Tours, Tours, France.
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15
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Yanis R, Bergua C, Christelle B, Maillot F, Bigot A, Beurier P, Ferreira-Maldent N, Diot E, Gouilleux-Gruart V. Neonatal Fc receptor expression in lymphoid and myeloid cells in systemic lupus erythematosus. Lupus 2021; 30:1938-1945. [PMID: 34634960 DOI: 10.1177/09612033211045049] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
The neonatal Fc receptor (FcRn) is a ubiquitously expressed protein historically involved in IgG and albumin recycling. Recent data suggest an involvement in the pathophysiology of antibody-mediated autoimmune diseases. Among them, systemic lupus erythematosus (SLE) implies clinical and biological abnormalities of innate and adaptive circulating immune cells, potentially involving newly described functions of FcRn. In this study, FcRn expression was assessed by flow cytometry in peripheral blood leukocytes of 41 SLE patients with either active or inactive disease and 32 healthy donors. FcRn expression in B cells, natural killer cells, and T cells of SLE patients was statistically lower as compared to healthy donors. Conversely, FcRn level was statistically higher in non-classical monocyte subpopulations (CD14+CD16+ monocytes) of SLE patients versus healthy donors providing an interesting perspective to further explore its role in SLE pathophysiology.
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Affiliation(s)
- Ramdani Yanis
- Groupement Innovation et Ciblage Cellulaire EA, 26928Tours University, Tours, France.,Internal Medicine Unit, 26928University Hospital of Tours, Tours, France
| | - Cécile Bergua
- Groupement Innovation et Ciblage Cellulaire EA, 26928Tours University, Tours, France
| | | | - François Maillot
- Internal Medicine Unit, 26928University Hospital of Tours, Tours, France
| | - Adrien Bigot
- Internal Medicine Unit, 26928University Hospital of Tours, Tours, France
| | - Pauline Beurier
- Internal Medicine Unit, 26928University Hospital of Tours, Tours, France
| | | | - Elisabeth Diot
- Internal Medicine Unit, 26928University Hospital of Tours, Tours, France
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16
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Coulongeat M, Baglo T, Faucheux L, Vayne C, Maillot F, Ferreira-Maldent N, Pouplard C. Hémophilie A acquise : le ratio Facteur VIII/Facteur Von Willebrand, un marqueur plus spécifique de rémission. Rev Med Interne 2021. [DOI: 10.1016/j.revmed.2021.03.293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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17
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Carvalho-Schneider C, Laurent E, Lemaignen A, Beaufils E, Bourbao-Tournois C, Laribi S, Flament T, Ferreira-Maldent N, Bruyère F, Stefic K, Gaudy-Graffin C, Grammatico-Guillon L, Bernard L. Follow-up of adults with noncritical COVID-19 two months after symptom onset. Clin Microbiol Infect 2020; 27:258-263. [PMID: 33031948 PMCID: PMC7534895 DOI: 10.1016/j.cmi.2020.09.052] [Citation(s) in RCA: 422] [Impact Index Per Article: 105.5] [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: 06/26/2020] [Revised: 09/23/2020] [Accepted: 09/26/2020] [Indexed: 01/08/2023]
Abstract
Objectives To describe the clinical evolution and predictors of symptom persistence during 2 months' follow-up in adults with noncritical coronavirus disease 2019 (COVID-19). Methods We performed descriptive clinical follow-up (day (D) 7, D30 and D60) of 150 patients with noncritical COVID-19 confirmed by real-time reverse transcriptase PCR at Tours University Hospital from 17 March to 3 June 2020, including demographic, clinical and laboratory data collected from the electronic medical records and by phone call. Persisting symptoms were defined by the presence at D30 or D60 of at least one of the following: weight loss ≥5%, severe dyspnoea or asthenia, chest pain, palpitations, anosmia/ageusia, headache, cutaneous signs, arthralgia, myalgia, digestive disorders, fever or sick leave. Results At D30, 68% (103/150) of patients had at least one symptom; and at D60, 66% (86/130) had symptoms, mainly anosmia/ageusia: 59% (89/150) at symptom onset, 28% (40/150) at D30 and 23% (29/130) at D60. Dyspnoea concerned 36.7% (55/150) patients at D30 and 30% (39/130) at D60. Half of the patients (74/150) at D30 and 40% (52/130) at D60 reported asthenia. Persistent symptoms at D60 were significantly associated with age 40 to 60 years old, hospital admission and abnormal auscultation at symptom onset. At D30, severe COVID-19 and/or dyspnoea at symptom onset were additional factors associated with persistent symptoms. Conclusions Up to 2 months after symptom onset, two thirds of adults with noncritical COVID-19 had complaints, mainly anosmia/ageusia, dyspnoea or asthenia. A prolonged medical follow-up of patients with COVID-19 seems essential, whatever the initial clinical presentation.
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Affiliation(s)
- Claudia Carvalho-Schneider
- Service de Médecine Interne et Maladies Infectieuses (S2MI), Centre Hospitalier Universitaire de Tours, Tours, France.
| | - Emeline Laurent
- Epidémiologie des Données cliniques en Centre-Val de Loire (EpiDcliC), Centre Hospitalier Universitaire de Tours, Tours, France; Equipe de Recherche 'Education Ethique Santé' (EE1 EES), Université de Tours, Tours, France
| | - Adrien Lemaignen
- Service de Médecine Interne et Maladies Infectieuses (S2MI), Centre Hospitalier Universitaire de Tours, Tours, France
| | - Emilie Beaufils
- Centre Mémoire Ressources et Recherche (CMRR), Centre Hospitalier Universitaire de Tours, Tours, France
| | | | - Saïd Laribi
- Service d'urgences et Faculté de Médecine, Centre Hospitalier Universitaire de Tours, Tours, France
| | - Thomas Flament
- Service de Pneumologie, Centre Hospitalier Universitaire de Tours, Tours, France
| | | | - Franck Bruyère
- Service d'urologie, Centre Hospitalier Universitaire de Tours, Tours, France
| | - Karl Stefic
- Laboratoire de Virologie, Centre Hospitalier Universitaire de Tours, Tours, France; Unité INSERM U1259, Université de Tours, Tours, France
| | - Catherine Gaudy-Graffin
- Laboratoire de Virologie, Centre Hospitalier Universitaire de Tours, Tours, France; Unité INSERM U1259, Université de Tours, Tours, France
| | - Leslie Grammatico-Guillon
- Epidémiologie des Données cliniques en Centre-Val de Loire (EpiDcliC), Centre Hospitalier Universitaire de Tours, Tours, France; Unité INSERM U1259, Université de Tours, Tours, France
| | - Louis Bernard
- Service de Médecine Interne et Maladies Infectieuses (S2MI), Centre Hospitalier Universitaire de Tours, Tours, France
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18
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Mekinian A, Saadoun D, Vicaut E, Thietart S, Lioger B, Jego P, Bleibtreu A, Limal N, Connault J, Gottenberg JE, Lhorte P, Bertola JP, Delforge J, Ferreira-Maldent N, Perlat A, Talib Z, Vautier M, Savey L, Quiere I, Cacoub P, Fain O. Tocilizumab in treatment-naïve patients with Takayasu arteritis: TOCITAKA French prospective multicenter open-labeled trial. Arthritis Res Ther 2020; 22:218. [PMID: 32943098 PMCID: PMC7500024 DOI: 10.1186/s13075-020-02311-y] [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] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Accepted: 09/04/2020] [Indexed: 02/03/2023] Open
Abstract
Objectives To assess long-term efficacy of tocilizumab in treatment-naive patients with Takayasu arteritis (TAK). Methods Prospective open-labeled trial in naïve patients with TAK who received steroids at the dose of 0.7 mg/kg/day and 7 infusions of 8 mg/kg/month of tocilizumab. The primary endpoint was the number of patients who discontinued steroids after 7 infusions of tocilizumab. Secondary endpoints included disease activity and the number of relapses during 18-month follow-up. Results Thirteen patients with TAK were included, with a median age of 32 years [19–45] and 12 (92%) females. Six (54%) patients met the primary end-point. A significant decrease of disease activity was observed after 6 months of tocilizumab therapy: decrease of median NIH scale (3 [3, 4] at baseline, versus 1 [0–2] after 6 months; p < 0.001), ITAS-2010 score (5 [2–7] versus 3 [0–8]; p = 0.002), and ITAS-A score (7 [4–10] versus 4 [1–15]; p = 0.0001)]. During the 12-month follow-up after tocilizumab discontinuation, a relapse occurred among 5 patients (45%) out of 11 in which achieved remission after 6 months of tocilizumab. Conclusion Tocilizumab seems an effective steroid sparing therapy in TAK, but maintenance therapy is necessary. Trial registration ClinicalTrials.gov NCT02101333. Registered on 02 April 2014.
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Affiliation(s)
- Arsene Mekinian
- Sorbonne Universités AP-HP, Hôpital Saint Antoine, service de médecine interne et Inflammation-Immunopathology-Biotherapy Department (DMU 3iD), Faculté de Médecine Sorbonne Université, F-75012, Paris, France.
| | - David Saadoun
- Sorbonne Universités AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Département de Médecine Interne et Immunologie Clinique, National center for Autoimmune Systemic rare disease ; National center for Autoinflammatory diseases and amyloidosis, Inflammation-Immunopathology-Biotherapy Department (DMU 3iD), INSERM, UMR_S 959, F-75013, Paris, France.,CNRS, FRE3632, F-75005, Paris, France.,CNRS, F-75013, Paris, France
| | - Eric Vicaut
- Unité de Recherche Clinique Saint-Louis-Lariboisière, APHP, Hôpital Saint Louis, Paris, France
| | - Sara Thietart
- Sorbonne Universités AP-HP, Hôpital Saint Antoine, service de médecine interne et Inflammation-Immunopathology-Biotherapy Department (DMU 3iD), Faculté de Médecine Sorbonne Université, F-75012, Paris, France
| | | | - Patrick Jego
- Service de Médecine Interne, CHU Rennes, Rennes, France
| | - Alexandre Bleibtreu
- AP-HP, service de médecine interne, Hôpital Jean Verdier, Faculté de Paris 13, 93000, Paris, France
| | - Nicolas Limal
- AP-HP, service de médecine interne, Hôpital Mondor, Université Paris Est-Créteil (UPEC), Paris, France
| | | | - Jacques-Eric Gottenberg
- Inserm UMR_1109, Fédération de Médecine Translationnelle, Université de Strasbourg, Strasbourg, France.,Service de rhumatologie, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - Pauline Lhorte
- Service de Médecine Interne et vasculaire, CHU Montpellier, Montpellier, France
| | | | - Juliette Delforge
- AP-HP, service de médecine interne, Hôpital Jean Verdier, Faculté de Paris 13, 93000, Paris, France
| | | | | | - Zohra Talib
- Unité de Recherche Clinique Saint-Louis-Lariboisière, APHP, Hôpital Saint Louis, Paris, France
| | - Matthieu Vautier
- Sorbonne Universités AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Département de Médecine Interne et Immunologie Clinique, National center for Autoimmune Systemic rare disease ; National center for Autoinflammatory diseases and amyloidosis, Inflammation-Immunopathology-Biotherapy Department (DMU 3iD), INSERM, UMR_S 959, F-75013, Paris, France.,CNRS, FRE3632, F-75005, Paris, France.,CNRS, F-75013, Paris, France
| | - Léa Savey
- Sorbonne Universités AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Département de Médecine Interne et Immunologie Clinique, National center for Autoimmune Systemic rare disease ; National center for Autoinflammatory diseases and amyloidosis, Inflammation-Immunopathology-Biotherapy Department (DMU 3iD), INSERM, UMR_S 959, F-75013, Paris, France.,CNRS, FRE3632, F-75005, Paris, France.,CNRS, F-75013, Paris, France
| | - Isabelle Quiere
- Service de rhumatologie, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - Patrice Cacoub
- Sorbonne Universités AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Département de Médecine Interne et Immunologie Clinique, National center for Autoimmune Systemic rare disease ; National center for Autoinflammatory diseases and amyloidosis, Inflammation-Immunopathology-Biotherapy Department (DMU 3iD), INSERM, UMR_S 959, F-75013, Paris, France.,CNRS, FRE3632, F-75005, Paris, France.,CNRS, F-75013, Paris, France
| | - Olivier Fain
- Sorbonne Universités AP-HP, Hôpital Saint Antoine, service de médecine interne et Inflammation-Immunopathology-Biotherapy Department (DMU 3iD), Faculté de Médecine Sorbonne Université, F-75012, Paris, France
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Keraen J, Bigot A, Bergemer-Fouquet AM, Diot E, Ferreira-Maldent N, Erra B, Giret C, Maillot F. Calves vasculitis revealing a relapse of polyarteritis nodosa: the gaiters sign. Rheumatology (Oxford) 2020; 59:98. [PMID: 31079153 DOI: 10.1093/rheumatology/kez174] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
| | | | | | | | | | - Benoit Erra
- Nuclear Medicine Department, University of Tours, Tours, France
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20
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Murarasu A, Guettrot Imbert G, Le Guern V, Pasquier E, Yelnik C, Queyrel V, Schleinitz N, Ferreira-Maldent N, Langlois V, Urbanski G, Deneux-Tharaux C, Costedoat-Chalumeau N. Complications thrombotiques et hémorragiques au cours de la grossesse et du post-partum chez 119 patientes porteuses d’un syndrome des antiphospholipides et incluses dans le GR2. Rev Med Interne 2019. [DOI: 10.1016/j.revmed.2019.10.092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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21
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Pernot B, Gyan E, Maillot F, Hodges P, Ertault M, Ferreira-Maldent N. Lymphomas diagnosed in an internal medicine department compared to lymphomas diagnosed in other departments: Clinical and outcome differences. Medicine (Baltimore) 2018; 97:e13228. [PMID: 30461623 PMCID: PMC6392786 DOI: 10.1097/md.0000000000013228] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Lymphomas are common malignancies with highly variable clinical presentations and prognosis. Prognostic value of clinical presentation at onset is still questioned. The objective of this study was to compare the disease presentation and the outcome of lymphomas diagnosed in an Internal Medicine Department of a University Hospital to disease presentation and outcome of patients who were referred to the Hematology Department of the same institution by other departments or healthcare facilities.This retrospective monocentric observational study included 37 patients. They were matched to 73 patients, who were referred to the Hematology Department, according to age, histology, and Ann Arbor stage. The demographics, clinical and biological presentations, overall survival, and progression-free survival were compared.Patients diagnosed with lymphoma in the Internal Medicine Department were more likely to be febrile (67.5% vs 21.9%; P < .001) and have higher inflammatory markers (mean C-reactive protein 86.6 vs 56.3 mg/L; P = .02). The median overall survival of these patients was poorer (P < .001), even in the subset of patients treated with standard treatment, and remained shorter in multivariable analysis (P = .002). The specific treatment started earlier (20.2 vs 37.5 days; P = .006), but was more frequently palliative (37.8% vs 19.2%; P = .04). There was no significant difference in median progression-free survival.Lymphomas diagnosed in an Internal Medicine Department had aggressive clinical presentations and a poorer outcome, despite an early start of conventional treatment.
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Affiliation(s)
- Benoit Pernot
- Geriatrics Department, Hospital Center André Gibotteau, Boulevard Kennedy, Vendôme
| | - Emmanuel Gyan
- Hematology Department, University Hospital Center of Tours, Boulevard Tonnelé, Tours
| | - François Maillot
- Internal Medicine Department, University Hospital Center of Tours, Université François Rabelais, France
| | - Penelope Hodges
- Internal Medicine Department, University Hospital Center of Tours, Université François Rabelais, France
| | - Marjan Ertault
- Hematology Department, University Hospital Center of Tours, Boulevard Tonnelé, Tours
| | - Nicole Ferreira-Maldent
- Internal Medicine Department, University Hospital Center of Tours, Université François Rabelais, France
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Ponard A, Ferreira-Maldent N, Ertault M, Delain M, Amraoui K, Regina S, Jonville-Béra AP, Hérault O, Colombat P, Gyan E. Glycemic dysregulation in a patient with type 2 diabetes treated with 5-azacitidine: a case report. J Med Case Rep 2018; 12:199. [PMID: 29966534 PMCID: PMC6029345 DOI: 10.1186/s13256-018-1690-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2017] [Accepted: 04/13/2018] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Diabetes and myelodysplastic syndrome are two conditions that may coexist in a single patient, since both diseases are prevalent in the elderly. The pathophysiology of myelodysplastic syndrome involves recurrent genetic mutations, especially in genes controlling epigenetic regulation. Although the pathophysiology of diabetes is not well understood, several studies suggest a role of epigenetics in type 2 diabetes. CASE PRESENTATION We report here for the first time the case of a 75-year-old Caucasian man who was treated for both diabetes and acute myeloid leukemia secondary to myelodysplastic syndrome, with a temporal association between glycemic dysregulation and the intake of 5-azacitidine. In fact, 2-3 days after starting each 7-day cycle of 5-azacitidine, he reported higher blood glucose levels, requiring an increased dose of self-administered insulin. CONCLUSION This observation could help to understand the pathophysiology of these two conditions and could encourage physicians to monitor blood glucose levels in patients under hypomethylating agent with a history of diabetes.
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Affiliation(s)
- Antoine Ponard
- Service d'hématologie et thérapie cellulaire, Centre hospitalier universitaire, 2 boulevard Tonnellé, 37044, Tours, France.,Faculté de Médecine, Université François Rabelais, Tours, France
| | | | - Marjan Ertault
- Service d'hématologie et thérapie cellulaire, Centre hospitalier universitaire, 2 boulevard Tonnellé, 37044, Tours, France
| | - Martine Delain
- Service d'hématologie et thérapie cellulaire, Centre hospitalier universitaire, 2 boulevard Tonnellé, 37044, Tours, France
| | - Kamel Amraoui
- Service d'hématologie et thérapie cellulaire, Centre hospitalier universitaire, 2 boulevard Tonnellé, 37044, Tours, France
| | - Sandra Regina
- Pôle Santé Léonard de Vinci, Chambray-les-Tours, France
| | - Annie-Pierre Jonville-Béra
- Centre régional de pharmacovigilance, Service de pharmacologie clinique, Centre hospitalier universitaire, Tours, France
| | - Olivier Hérault
- Service d'hématologie biologique, Centre hospitalier universitaire, Tours, France.,Laboratoire LNOx, ERL CNRS 7001, Université de Tours, Tours, France.,Faculté de Médecine, Université François Rabelais, Tours, France
| | - Philippe Colombat
- Service d'hématologie et thérapie cellulaire, Centre hospitalier universitaire, 2 boulevard Tonnellé, 37044, Tours, France.,Service d'hématologie biologique, Centre hospitalier universitaire, Tours, France.,Faculté de Médecine, Université François Rabelais, Tours, France
| | - Emmanuel Gyan
- Service d'hématologie et thérapie cellulaire, Centre hospitalier universitaire, 2 boulevard Tonnellé, 37044, Tours, France. .,Service d'hématologie biologique, Centre hospitalier universitaire, Tours, France. .,Laboratoire LNOx, ERL CNRS 7001, Université de Tours, Tours, France. .,Faculté de Médecine, Université François Rabelais, Tours, France.
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Million M, Bardin N, Bessis S, Nouiakh N, Douliery C, Edouard S, Angelakis E, Bosseray A, Epaulard O, Branger S, Chaudier B, Blanc-Laserre K, Ferreira-Maldent N, Demonchy E, Roblot F, Reynes J, Djossou F, Protopopescu C, Carrieri P, Camoin-Jau L, Mege JL, Raoult D. Thrombosis and antiphospholipid antibody syndrome during acute Q fever: A cross-sectional study. Medicine (Baltimore) 2017; 96:e7578. [PMID: 28723794 PMCID: PMC5521934 DOI: 10.1097/md.0000000000007578] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Q fever is a neglected and potentially fatal disease. During acute Q fever, antiphospholipid antibodies are very prevalent and have been associated with fever, thrombocytopenia, acquired heart valve disease, and progression to chronic endocarditis. However, thrombosis, the main clinical criterion of the 2006 updated classification of the antiphospholipid syndrome, has not been assessed in this context. To test whether thrombosis is associated with antiphospholipid antibodies and whether the criteria for antiphospholipid syndrome can be met in patients with acute Q fever, we conducted a cross-sectional study at the French National Referral Center for Q fever.Patients included were diagnosed with acute Q fever in our Center between January 2007 and December 2015. Each patient's history and clinical characteristics were recorded with a standardized questionnaire. Predictive factors associated with thrombosis were assessed using a rare events logistic regression model. IgG anticardiolipin antibodies (IgG aCL) assessed by an enzyme-linked immunosorbent assay were tested on the Q fever diagnostic serum. A dose-dependent relationship between IgG aCL levels and thrombosis was tested using a receiver operating characteristic (ROC) analysis.Of the 664 patients identified for inclusion in the study, 313 (47.1%) had positive IgG aCL and 13 (1.9%) were diagnosed with thrombosis. Three patients fulfilled the antiphospholipid syndrome criteria. After multiple adjustments, only positive IgG aCL (relative risk, 14.46 [1.85-113.14], P = .011) were independently associated with thrombosis. ROC analysis identified a dose-dependent relationship between IgG aCL levels and occurrence of thrombosis (area under curve, 0.83, 95%CI [0.73-0.93], P < .001).During acute Q fever, antiphospholipid antibodies are associated with thrombosis, thrombocytopenia, and acquired valvular heart disease. Antiphospholipid antibodies should be systematically assessed in acute Q fever patients. Hydroxychloroquine, which has been previously shown to antagonize IgG aCL pathogenic properties, should be tested in acute Q fever patients with anticardiolipin antibodies to prevent antiphospholipid-associated complications.Key Point: In addition to fever, thrombocytopenia and acquired valvular heart disease, antiphospholipid antibodies are associated with thrombosis during acute Q fever.
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Affiliation(s)
- Matthieu Million
- URMITE, Aix Marseille Université, UM63, CNRS 7278, IRD 198, INSERM 1095, IHU - Méditerranée Infection
| | - Nathalie Bardin
- URMITE, Aix Marseille Université, UM63, CNRS 7278, IRD 198, INSERM 1095, IHU - Méditerranée Infection
- Aix Marseille Univ, APHM, INSERM, VRCM, UMR_S 1076, Laboratoire d’Immunologie, Marseille
| | - Simon Bessis
- URMITE, Aix Marseille Université, UM63, CNRS 7278, IRD 198, INSERM 1095, IHU - Méditerranée Infection
| | - Nadia Nouiakh
- URMITE, Aix Marseille Université, UM63, CNRS 7278, IRD 198, INSERM 1095, IHU - Méditerranée Infection
| | - Charlaine Douliery
- URMITE, Aix Marseille Université, UM63, CNRS 7278, IRD 198, INSERM 1095, IHU - Méditerranée Infection
| | - Sophie Edouard
- URMITE, Aix Marseille Université, UM63, CNRS 7278, IRD 198, INSERM 1095, IHU - Méditerranée Infection
| | - Emmanouil Angelakis
- URMITE, Aix Marseille Université, UM63, CNRS 7278, IRD 198, INSERM 1095, IHU - Méditerranée Infection
| | | | - Olivier Epaulard
- Service de maladies infectieuses, Centre Hospitalier Universitaire de Grenoble, Grenoble
| | | | - Bernard Chaudier
- Service de médecine interne et tropicale, Hôpital d’Instruction des Armées Laveran, Marseille
| | | | | | | | - France Roblot
- Service de médecine interne et maladies infectieuses, CHU de Poitiers, Inserm, Poitiers
| | - Jacques Reynes
- Service de maladies infectieuses, CHU de Montpellier, Montpellier
| | | | | | | | - Laurence Camoin-Jau
- URMITE, Aix Marseille Université, UM63, CNRS 7278, IRD 198, INSERM 1095, IHU - Méditerranée Infection
- Laboratoire d’Hématologie, CHU Timone, APHM, Marseille, France
| | - Jean-Louis Mege
- URMITE, Aix Marseille Université, UM63, CNRS 7278, IRD 198, INSERM 1095, IHU - Méditerranée Infection
- Aix Marseille Univ, APHM, INSERM, VRCM, UMR_S 1076, Laboratoire d’Immunologie, Marseille
| | - Didier Raoult
- URMITE, Aix Marseille Université, UM63, CNRS 7278, IRD 198, INSERM 1095, IHU - Méditerranée Infection
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Journaud M, Ferreira-Maldent N, Gouilleux Gruart V, Maillot F. Signification clinique des anticorps antiphospholipides d’isotype M isolé : étude rétrospective sur 186 patients porteurs d’anticorps anticardiolipine et anti-ß2-glycoprotéine I. Rev Med Interne 2017. [DOI: 10.1016/j.revmed.2017.03.052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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25
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Jobard S, Magnant J, Blasco H, Ferreira-Maldent N, Griffoul I, Diot E, Maillot F. Quality of life of patients treated for giant cell arteritis: a case-control study. Clin Rheumatol 2017; 36:2055-2062. [PMID: 28405843 DOI: 10.1007/s10067-017-3619-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2017] [Accepted: 03/27/2017] [Indexed: 11/28/2022]
Abstract
The objective of the study was to assess the quality of life (QOL) of patients with giant cell arteritis (GCA), following high dose of corticosteroids (CS). Thirty patients with GCA who had stopped CS or who were under long-term low dose of CS were included and matched to 60 controls. QOL was measured by the SF-36 score and a specific questionnaire. GCA patients had no impairment of QOL compared to controls according to SF-36. Most of them (57%) estimated that their general condition was improved following treatment. Patients with GCA complications or CS therapy side effects had no significant impairment of their QOL compared with patients without complications or adverse effects. Only the patients who had gained weight had a lower score on the domain "Vitality" (VT; p = 0.013). Walking difficulties were the most frequent complaints. They were associated with impaired scores on the physical summary score (p = 0.0340) and on the "General Health" (GH; p = 0.005) and "Physical Functioning" (PF, p = 0.0298) domains. Falls among GCA patients were associated with altered scores on the domain VT (p = 0.0058) and on the mental summary score if they had fallen at least three times (p = 0.0460). GCA patients following high dose of CS or under long-term low doses of CS have no significant impairment of their QOL compared to controls. GCA complications, including visual impairment, do not seem to have any major impact on QOL.
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Affiliation(s)
- Stéphanie Jobard
- CHRU de Tours, Service de Médecine Interne, Université François-Rabelais, 2 boulevard Tonnellé, 37044 Cedex 9, Tours, France.
| | - Julie Magnant
- CHRU de Tours, Service de Médecine Interne, Université François-Rabelais, 2 boulevard Tonnellé, 37044 Cedex 9, Tours, France
| | - Hélène Blasco
- CHRU de Tours, Laboratoire de biochimie et biologie moléculaire, Inserm U930, Université François-Rabelais, Tours, France
| | - Nicole Ferreira-Maldent
- CHRU de Tours, Service de Médecine Interne, Université François-Rabelais, 2 boulevard Tonnellé, 37044 Cedex 9, Tours, France
| | - Isabelle Griffoul
- CHRU de Tours, Service de Rhumatologie, Université François-Rabelais, Tours, France
| | - Elisabeth Diot
- CHRU de Tours, Service de Médecine Interne, Université François-Rabelais, 2 boulevard Tonnellé, 37044 Cedex 9, Tours, France
| | - François Maillot
- CHRU de Tours, Service de Médecine Interne, Université François-Rabelais, 2 boulevard Tonnellé, 37044 Cedex 9, Tours, France
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26
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Comarmond C, Jego P, Veyssier-Belot C, Marie I, Mekinian A, Elmaleh-Sachs A, Leroux G, Saadoun D, Oziol E, Fraisse T, Hyvernat H, Thiercein-Legrand MF, Sarrot-Reynauld F, Ferreira-Maldent N, de Menthon M, Goujard C, Khau D, Nguen Y, Monnier S, Michon A, Castel B, Decaux O, Piette JC, Cacoub P. Cessation of oral anticoagulants in antiphospholipid syndrome. Lupus 2017; 26:1291-1296. [DOI: 10.1177/0961203317699285] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Objective To study the outcome of patients with antiphospholipid syndrome (APS) after oral anticoagulant treatment cessation. Methods We performed a retrospective study of patients with APS experiencing cessation of oral anticoagulant and enrolled in a French multicentre observational cohort between January 2014 and January 2016. The main outcome was the occurrence of recurrent thrombotic event after oral anticoagulation cessation. Results Forty four APS patients interrupted oral anticoagulation. The median age was 43 (27–56) years. The median duration of anticoagulation was 21 (9–118) months. Main causes of oral anticoagulant treatment cessation were switch from vitamin K antagonists to aspirin in 15 patients, prolonged disappearance of antiphospholipid antibodies in ten, bleeding complications in nine and a poor therapeutic adherence in six. Eleven (25%) patients developed a recurrent thrombotic event after oral anticoagulation cessation, including three catastrophic APS and one death due to lower limb ischemia. Antihypertensive treatment required at time of oral anticoagulants cessation seems to be an important factor associated with recurrent thrombosis after oral anticoagulant cessation (15.2% in patients with no relapse versus 45.5% in patients with recurrent thrombosis, p = 0.038). Oral anticoagulant treatment was re-started in 18 (40.9%) patients. Conclusion The risk of a new thrombotic event in APS patients who stopped their anticoagulation is high, even in those who showed a long lasting disappearance of antiphospholipid antibodies. Except for the presence of treated hypertension, this study did not find a particular clinical or biological phenotype for APS patients who relapsed after anticoagulation cessation. Any stopping of anticoagulant in such patients should be done with caution.
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Affiliation(s)
- C Comarmond
- Département de Médecine Interne et Immunologie Clinique, Assistance Publique-Hôpitaux de Paris (AP-HP), Groupe Hospitalier Pitié-Salpêtrière, Paris, France
- Département Hospitalo-Unviversitaire I2B, UPMC Univ Paris 06, Paris, France
- INSERM UMR 7211, F-75005, Paris, France
- CNRS, UMR 7211, F-75005, Paris, France
| | - P Jego
- Service de Médecine Interne, CHU Rennes, France
| | | | - I Marie
- Service de Médecine Interne, CHU Rouen, France
| | - A Mekinian
- Service de Médecine Interne, CHU Saint-Antoine, Paris, France
| | - A Elmaleh-Sachs
- Département de Médecine Interne et Immunologie Clinique, Assistance Publique-Hôpitaux de Paris (AP-HP), Groupe Hospitalier Pitié-Salpêtrière, Paris, France
| | - G Leroux
- Département de Médecine Interne et Immunologie Clinique, Assistance Publique-Hôpitaux de Paris (AP-HP), Groupe Hospitalier Pitié-Salpêtrière, Paris, France
- Département Hospitalo-Unviversitaire I2B, UPMC Univ Paris 06, Paris, France
| | - D Saadoun
- Département de Médecine Interne et Immunologie Clinique, Assistance Publique-Hôpitaux de Paris (AP-HP), Groupe Hospitalier Pitié-Salpêtrière, Paris, France
- Département Hospitalo-Unviversitaire I2B, UPMC Univ Paris 06, Paris, France
- INSERM UMR 7211, F-75005, Paris, France
- CNRS, UMR 7211, F-75005, Paris, France
| | - E Oziol
- Service de Médecine Interne, CH Béziers, France
| | - T Fraisse
- Service de Médecine Interne, CH Ales, France
| | - H Hyvernat
- Service de Médecine Interne, CHU Nice, France
| | | | | | | | - M de Menthon
- Service de Médecine Interne, CHU Saint-Louis, Paris, France
| | - C Goujard
- Service de Médecine Interne et d'Immunologie Clinique, CHU Bicêtre, Le Kremlin-Bicêtre, France
| | - D Khau
- Service de Médecine Interne, CH Versailles, France
| | - Y Nguen
- Département de Médecine Interne et Immunologie Clinique, Assistance Publique-Hôpitaux de Paris (AP-HP), Groupe Hospitalier Pitié-Salpêtrière, Paris, France
| | - S Monnier
- Service de Médecine Interne, CH Versailles, France
| | - A Michon
- Service de Médecine Intern, CHU Georges Pompidou, Paris, France
| | - B Castel
- Département de Médecine Interne et Immunologie Clinique, Assistance Publique-Hôpitaux de Paris (AP-HP), Groupe Hospitalier Pitié-Salpêtrière, Paris, France
| | - O Decaux
- Service de Médecine Interne, CHU Rennes, France
| | - J-C Piette
- Département de Médecine Interne et Immunologie Clinique, Assistance Publique-Hôpitaux de Paris (AP-HP), Groupe Hospitalier Pitié-Salpêtrière, Paris, France
- Département Hospitalo-Unviversitaire I2B, UPMC Univ Paris 06, Paris, France
| | - P Cacoub
- Département de Médecine Interne et Immunologie Clinique, Assistance Publique-Hôpitaux de Paris (AP-HP), Groupe Hospitalier Pitié-Salpêtrière, Paris, France
- Département Hospitalo-Unviversitaire I2B, UPMC Univ Paris 06, Paris, France
- INSERM UMR 7211, F-75005, Paris, France
- CNRS, UMR 7211, F-75005, Paris, France
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27
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Thoreau B, Gouaillier-Vulcain F, Machet L, Mateus C, Robert C, Ferreira-Maldent N, Maillot F, Lioger B. Acute Lower Limb Ischaemia and Diabetes in a Patient Treated with Anti-PD1 Monoclonal Antibody for Metastatic Melanoma. Acta Derm Venereol 2017; 97:408-409. [PMID: 27377178 DOI: 10.2340/00015555-2504] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Benjamin Thoreau
- Service de Medecine Interne, Hôpital Bretonneau, 2 Boulevard Tonnellé, FR-37044 Tours, France
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28
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Lioger B, Ferreira-Maldent N, Cottier JP, Debiais S, Gyan E, Maillot F. Rituximab for Sjögren syndrome-associated type II mixed cryoglobulinemic cerebral vasculitis. Neurol Neuroimmunol Neuroinflamm 2016; 3:e253. [PMID: 27458597 PMCID: PMC4949984 DOI: 10.1212/nxi.0000000000000253] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/08/2016] [Accepted: 05/11/2016] [Indexed: 11/15/2022]
Affiliation(s)
- Bertrand Lioger
- Service de Médecine Interne (B.L., N.F.-M., F.M.), Service de Radiologie Générale, Diagnostique et Thérapeutique Neuroradiologie (J.P.C.), Service de Neurologie (S.D.), and Service d'Hématologie et Thérapie Cellulaire (E.G.), CHRU de Tours; CNRS UMR 7292 (B.L.), INSERM U 930 (J.P.C.), and INSERM U 1069 (F.M.), Université François Rabelais de Tours; and CIC INSERM U1415 (E.G.), Tours, France
| | - Nicole Ferreira-Maldent
- Service de Médecine Interne (B.L., N.F.-M., F.M.), Service de Radiologie Générale, Diagnostique et Thérapeutique Neuroradiologie (J.P.C.), Service de Neurologie (S.D.), and Service d'Hématologie et Thérapie Cellulaire (E.G.), CHRU de Tours; CNRS UMR 7292 (B.L.), INSERM U 930 (J.P.C.), and INSERM U 1069 (F.M.), Université François Rabelais de Tours; and CIC INSERM U1415 (E.G.), Tours, France
| | - Jean Philippe Cottier
- Service de Médecine Interne (B.L., N.F.-M., F.M.), Service de Radiologie Générale, Diagnostique et Thérapeutique Neuroradiologie (J.P.C.), Service de Neurologie (S.D.), and Service d'Hématologie et Thérapie Cellulaire (E.G.), CHRU de Tours; CNRS UMR 7292 (B.L.), INSERM U 930 (J.P.C.), and INSERM U 1069 (F.M.), Université François Rabelais de Tours; and CIC INSERM U1415 (E.G.), Tours, France
| | - Séverine Debiais
- Service de Médecine Interne (B.L., N.F.-M., F.M.), Service de Radiologie Générale, Diagnostique et Thérapeutique Neuroradiologie (J.P.C.), Service de Neurologie (S.D.), and Service d'Hématologie et Thérapie Cellulaire (E.G.), CHRU de Tours; CNRS UMR 7292 (B.L.), INSERM U 930 (J.P.C.), and INSERM U 1069 (F.M.), Université François Rabelais de Tours; and CIC INSERM U1415 (E.G.), Tours, France
| | - Emmanuel Gyan
- Service de Médecine Interne (B.L., N.F.-M., F.M.), Service de Radiologie Générale, Diagnostique et Thérapeutique Neuroradiologie (J.P.C.), Service de Neurologie (S.D.), and Service d'Hématologie et Thérapie Cellulaire (E.G.), CHRU de Tours; CNRS UMR 7292 (B.L.), INSERM U 930 (J.P.C.), and INSERM U 1069 (F.M.), Université François Rabelais de Tours; and CIC INSERM U1415 (E.G.), Tours, France
| | - François Maillot
- Service de Médecine Interne (B.L., N.F.-M., F.M.), Service de Radiologie Générale, Diagnostique et Thérapeutique Neuroradiologie (J.P.C.), Service de Neurologie (S.D.), and Service d'Hématologie et Thérapie Cellulaire (E.G.), CHRU de Tours; CNRS UMR 7292 (B.L.), INSERM U 930 (J.P.C.), and INSERM U 1069 (F.M.), Université François Rabelais de Tours; and CIC INSERM U1415 (E.G.), Tours, France
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Beurier P, Biogeau J, Ferreira-Maldent N, Jonville-Bera A, Ollier S, Maillot F, Lioger B. Thrombopénie secondaire à l’administration de fer injectable : analyse de la Banque nationale de pharmacovigilance et revue systématique de la littérature. Rev Med Interne 2016. [DOI: 10.1016/j.revmed.2016.04.202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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30
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Desgrouas M, Chilles M, Gochard A, Jeffredo S, Gavrylova N, Assor P, Calvez J, Bongrani A, Ferreira-Maldent N, Maillot F, Lioger B. Ganglionopathie autonomique auto-immune et syndrome d’Evans associés à un clone lymphocytaire B circulant de signification indéterminée : petit mais costaud. Rev Med Interne 2016. [DOI: 10.1016/j.revmed.2016.04.047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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31
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Thoreau B, Gouaillier-Vulcain F, Machet L, Mateus C, Ferreira-Maldent N, Maillot F, Lioger B. Ischémie aiguë d’un membre inférieur chez un patient traité par anticorps monoclonal anti-PD1 pour un mélanome métastasique. Rev Med Interne 2015. [DOI: 10.1016/j.revmed.2015.03.022] [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]
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32
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Bauvois A, Magnant J, Le Lez M, Monjanel H, Gyan E, Ferreira-Maldent N, Maillot F, Lioger B. Le fond d’œil (FO) : un examen hématologique peu invasif à propos de deux cas. Rev Med Interne 2014. [DOI: 10.1016/j.revmed.2014.03.296] [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: 11/30/2022]
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Lioger B, Debiais S, Lauvin MA, Bonnaud I, Maillot F, Ferreira-Maldent N. Anticardiolipin antibodies-associated stroke in primary CMV infection. Eur J Neurol 2014; 20:e105-6. [PMID: 23829236 DOI: 10.1111/ene.12179] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2013] [Accepted: 03/25/2013] [Indexed: 11/29/2022]
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Maillot F, Rivol M, Magnant J, Favre X, Ferreira-Maldent N, Potin J. Prise en charge d’une grossesse homocystinurique. Rev Med Interne 2012. [DOI: 10.1016/j.revmed.2012.03.335] [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]
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35
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Lioger B, Debiais S, Mutinelli-Szymanski P, Gyan E, Maillot F, Ferreira-Maldent N. Vascularite cérébrale au cours d’une cryoglobulinémie mixte de type 2 sans VHC. Rev Med Interne 2011. [DOI: 10.1016/j.revmed.2011.10.264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Desmidt T, Hachemi ME, Remenieras JP, Lecomte P, Ferreira-Maldent N, Patat F, Camus V. Ultrasound Brain Tissue Pulsatility is decreased in middle aged and elderly type 2 diabetic patients with depression. Psychiatry Res 2011; 193:63-4. [PMID: 21592742 DOI: 10.1016/j.pscychresns.2011.01.002] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2010] [Revised: 11/29/2010] [Accepted: 01/06/2011] [Indexed: 11/28/2022]
Abstract
We used Tissue Pulsatility Imaging (TPI) to compare the Brain Tissue Pulsatility (BTP) in depressed (n=11) and non-depressed (n=13) type-2 diabetic non-demented patients aged 50 years and older. Both maximum and mean BTP were significantly decreased in depressed diabetic subjects compared to non-depressed diabetic subjects.
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Debiais S, Bonnaud I, Ferreira-Maldent N, Mercier E, de Toffol B. Neuropsychiatric disorders revealing primary antiphospholipid syndrome in an elderly patient. Neurology 2009; 72:1362-3. [PMID: 19365060 DOI: 10.1212/wnl.0b013e3181a0fd69] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- S Debiais
- Department of Neurology, CHRU Tours, 2 Boulevard Tonnelle, 37044 Tours cedex, France.
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Nikol S, Baumgartner I, Van Belle E, Diehm C, Visoná A, Capogrossi MC, Ferreira-Maldent N, Gallino A, Graham Wyatt M, Dinesh Wijesinghe L, Fusari M, Stephan D, Emmerich J, Pompilio G, Vermassen F, Pham E, Grek V, Coleman M, Meyer F. Therapeutic Angiogenesis With Intramuscular NV1FGF Improves Amputation-free Survival in Patients With Critical Limb Ischemia. Mol Ther 2008; 16:972-978. [DOI: 10.1038/mt.2008.33] [Citation(s) in RCA: 252] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2007] [Accepted: 02/05/2008] [Indexed: 12/17/2022] Open
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Ferreira-Maldent N, Maillot F, Quilliet L, Guilmot JL, Charbonnier B. [Dilated cardiomyopathy, diabetes and deafness related to a mutation of mitochondrial DNA]. Arch Mal Coeur Vaiss 2007; 100:149-52. [PMID: 17474502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
Mitochondrial diseases may cause hypertrophic cardiomyopathy or, less commonly, dilated cardiomyopathy. The authors describe a case of a 46 year old woman with dilated cardiomyopathy associated with diabetes and deafness. This association is suggestive of the MIDD syndrome and the demonstration of metabolic abnormalities (raised serum lactic acid, abnormal lactate/pyruvate ratio) was compatible with a mitochondrial disease. This diagnosis was confirmed by finding an A3243G mutation of the mitochondrial DNA.
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Affiliation(s)
- N Ferreira-Maldent
- Service de Médecine Interne, Médecine Vasculaire et Diabétologie, Groupement de Médecine Interne, CHU Bretonneau, 37044 Tours 9
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Abstract
Drug addiction which entails cardiovascular risks unknown or misknown to physicians, currently involves an increasing number of miscellaneous drugs, existing in manifold forms. There appears to be no bounds on the way of intake. All territories of the body may be affected with more or less severity. In young people, the cardiac, coronary, cerebral and peripheral vascular systems are generally involved. Two illicit drugs, cannabis and cocaine, showing a permanent increase in misuse, prevail. This drug addiction comes along with intercurrent pathologies which have their own vascular toxicity, especially HIV infection. Moreover, the advent of new illicit substances emphasizes the complexity of the clinical presentations. These complex situations have a real social and medical impact. We are currently in a phase of permanently increasing risk of cardiovascular complications. The pathophysiological mechanisms involved are intertwined and complicated by the frequent association of polytoxicomania or by the effects excipients added to these drugs: direct vascular toxicity, angeitis, arterial and venous thrombosis. Arsenic, a common component of these drugs, is also found in cigarettes; arsenic toxicity mainly affects the lower limbs. Treatment of these complications is non-specific; the ideal solution being weaning which, unfortunately in this peculiar population of patients, may entail serious complications due to the misuse of substitution products.
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Affiliation(s)
- O Vandhuick
- Unité d'Echo-Doppler et de Médecine Vasculaire, CHU La Cavale Blanche, 29609 Brest Cedex, France
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