1
|
Pascart T, Wasik KA, Preda C, Chune V, Torterat J, Prud'homme N, Nassih M, Martin A, Le Masson J, Rodière V, Frogier S, Canova G, Pescheux JP, Shan Sei Fan C, Jauffret C, Claeys P, von Baeyer SL, Castel SE, Emde AK, Yerges-Armstrong L, Fox K, Leask M, Vitagliano JJ, Graf S, Norberciak L, Raynal J, Dalbeth N, Merriman T, Bardin T, Oehler E. The gout epidemic in French Polynesia: a modelling study of data from the Ma'i u'u epidemiological survey. Lancet Glob Health 2024; 12:e685-e696. [PMID: 38485432 DOI: 10.1016/s2214-109x(24)00012-3] [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: 09/04/2023] [Revised: 12/22/2023] [Accepted: 01/09/2024] [Indexed: 03/19/2024]
Abstract
BACKGROUND Gout is the most common cause of inflammatory arthritis worldwide, particularly in Pacific regions. We aimed to establish the prevalence of gout and hyperuricaemia in French Polynesia, their associations with dietary habits, their comorbidities, the prevalence of the HLA-B*58:01 allele, and current management of the disease. METHODS The Ma'i u'u survey was epidemiological, prospective, cross-sectional, and gout-focused and included a random sample of adults from the general adult population of French Polynesia. It was conducted and data were collected between April 13 and Aug 16, 2021. Participants were randomly selected to represent the general adult population of French Polynesia on the basis of housing data collected during the 2017 territorial census. Each selected household was visited by a research nurse from the Ma'i u'u survey who collected data via guided, 1-h interviews with participants. In each household, the participant was the individual older than 18 years with the closest upcoming birthday. To estimate the frequency of HLA-B*58:01, we estimated HLA-B haplotypes on individuals who had whole-genome sequencing to approximately 5× average coverage (mid-pass sequencing). A subset of individuals who self-reported Polynesian ancestry and not European, Chinese, or other ancestry were used to estimate Polynesian-ancestry specific allele frequencies. Bivariate associations were reported for weighted participants; effect sizes were estimated through the odds ratio (OR) of the association calculated on the basis of a logistic model fitted with weighted observations. FINDINGS Among the random sample of 2000 households, 896 participants were included, 140 individuals declined, and 964 households could not be contacted. 22 participants could not be weighted due to missing data, so the final weighted analysis included 874 participants (449 [51·4%] were female and 425 [48·6%] were male) representing the 196 630 adults living in French Polynesia. The estimated prevalence of gout was 14·5% (95% CI 9·9-19·2), representing 28 561 French Polynesian adults, that is 25·5% (18·2-32·8) of male individuals and 3·5% (1·0-6·0) of female individuals. The prevalence of hyperuricaemia was estimated at 71·6% (66·7-76·6), representing 128 687 French Polynesian adults. In multivariable analysis, age (OR 1·5, 95% CI 1·2-1·8 per year), male sex (10·3, 1·8-60·7), serum urate (1·6, 1·3-2·0 per 1 mg/dL), uraturia (0·8, 0·8-0·8 per 100 mg/L), type 2 diabetes (2·1, 1·4-3·1), BMI more than 30 kg/m2 (1·1, 1·0-1·2 per unit), and percentage of visceral fat (1·7, 1·1-2·7 per 1% increase) were associated with gout. There were seven heterozygous HLA-B*58:01 carriers in the full cohort of 833 individuals (seven [0·4%] of 1666 total alleles) and two heterozygous carriers in a subset of 696 individuals of Polynesian ancestry (two [0·1%]). INTERPRETATION French Polynesia has an estimated high prevalence of gout and hyperuricaemia, with gout affecting almost 15% of adults. Territorial measures that focus on increasing access to effective urate-lowering therapies are warranted to control this major public health problem. FUNDING Variant Bio, the French Polynesian Health Administration, Lille Catholic University Hospitals, French Society of Rheumatology, and Novartis.
Collapse
Affiliation(s)
- Tristan Pascart
- Service de Rhumatologie, Hôpital Saint-Philibert, Lille, France.
| | | | - Cristian Preda
- Department of Methodology and Biostatistics, Hôpital Saint-Philibert, Lille, France
| | - Valérie Chune
- Department of Biology, Centre Hospitalier de Polynésie Française, Pape'ete, Tahiti, French Polynesia
| | - Jérémie Torterat
- Institut de la Statistique de Polynésie Française, Papeete, Tahiti, French Polynesia
| | - Nicolas Prud'homme
- Institut de la Statistique de Polynésie Française, Papeete, Tahiti, French Polynesia
| | - Maryline Nassih
- Lille Catholic University and Research Department, Hôpital Saint-Philibert, Lille, France
| | - Agathe Martin
- Lille Catholic University and Research Department, Hôpital Saint-Philibert, Lille, France
| | - Julien Le Masson
- Lille Catholic University and Research Department, Hôpital Saint-Philibert, Lille, France
| | - Vahinetua Rodière
- Lille Catholic University and Research Department, Hôpital Saint-Philibert, Lille, France; Direction de la Santé de Polynésie Française, Papeete, Tahiti, French Polynesia
| | - Sylvain Frogier
- Lille Catholic University and Research Department, Hôpital Saint-Philibert, Lille, France; Direction de la Santé de Polynésie Française, Papeete, Tahiti, French Polynesia
| | - Georges Canova
- Lille Catholic University and Research Department, Hôpital Saint-Philibert, Lille, France; Direction de la Santé de Polynésie Française, Papeete, Tahiti, French Polynesia
| | - Jean-Paul Pescheux
- Lille Catholic University and Research Department, Hôpital Saint-Philibert, Lille, France; Direction de la Santé de Polynésie Française, Papeete, Tahiti, French Polynesia
| | | | | | - Patrick Claeys
- Department of Biology, Centre Hospitalier de Polynésie Française, Pape'ete, Tahiti, French Polynesia
| | | | | | | | | | - Keolu Fox
- Global Health Program, Department of Anthropology and Indigenous Futures Institute, Division of Design and Innovation, University of California San Diego, San Diego, CA, USA; Native BioData Consortium, Eagle Butte, SD, USA
| | - Megan Leask
- Division of Clinical Rheumatology and Immunology, University of Alabama, Birmingham, AL, USA; Department of Microbiology and Immunology, University of Otago, Dunedin, New Zealand
| | | | - Sahara Graf
- Department of Methodology and Biostatistics, Hôpital Saint-Philibert, Lille, France
| | - Laurène Norberciak
- Department of Methodology and Biostatistics, Hôpital Saint-Philibert, Lille, France
| | - Jacques Raynal
- Ministère de la Santé de Polynésie Française, Papeete, Tahiti, French Polynesia
| | - Nicola Dalbeth
- Department of Medicine, University of Auckland, Auckland, New Zealand
| | - Tony Merriman
- Division of Clinical Rheumatology and Immunology, University of Alabama, Birmingham, AL, USA; Department of Microbiology and Immunology, University of Otago, Dunedin, New Zealand
| | - Thomas Bardin
- National Institute of Health and Medical Research U1132, Université Paris-Cité, Hôpital Lariboisière, Paris, France
| | - Erwan Oehler
- Department of Internal Medicine and Infectious Diseases, Centre Hospitalier de Polynésie Française, Pape'ete, Tahiti, French Polynesia
| |
Collapse
|
2
|
Ghossan R, Aitisha Tabesh O, Fayad F, Richette P, Bardin T. Cardiovascular Safety of Febuxostat in Patients With Gout or Hyperuricemia: A Systematic Review of Randomized Controlled Trials. J Clin Rheumatol 2024; 30:e46-e53. [PMID: 38115182 DOI: 10.1097/rhu.0000000000002045] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2023]
Abstract
INTRODUCTION To this date, a causal relationship between febuxostat and cardiovascular disease remains controversial as comparison between trials can be challenging and may lead to misleading conclusions, especially when facing heterogeneous cardiovascular outcomes. We aimed to compare the cardiovascular outcomes in the most pertinent trials of febuxostat compared with controls. METHODS We searched electronic databases using a PICOS-style approach search strategy of randomized controlled trials (RCTs) on cardiovascular outcomes of febuxostat in patients with gout or hyperuricemia. We conducted a quality and risk of bias assessment of the included clinical trials. The definition of major adverse cardiovascular event as well as all reported cardiovascular outcomes were retrieved from every involved trial. RESULTS Of the 1173 records identified from all sources, 20 RCTs were included in the analysis. The mean duration of follow-up was 69.7 ± 81.5 weeks, and febuxostat dose ranged from 10 to 240 mg with 80 mg being the most commonly used dosage. Overall, the quality of evidence deriving from all RCTs showed concerns in most studies (65%). Major adverse cardiovascular event was defined in 7 of the 20 RCTs (35%), and cardiovascular outcome reporting was very heterogeneous. Overall, the data of cardiovascular safety of febuxostat were reassuring. CONCLUSIONS Our systematic review showed high level of concerns in quality assessment domains as well heterogeneous cardiovascular outcomes across included studies. Cardiovascular outcomes in the majority of White males with gout treated with febuxostat were reassuring when compared with allopurinol. Further studies are needed to draw conclusions in patients with severe cardiovascular disease.
Collapse
Affiliation(s)
- Roba Ghossan
- From the Rheumatology Department, Cochin University Hospital, Paris, France
| | - Ouidade Aitisha Tabesh
- Rheumatology Department, Hotel-Dieu de France University Hospital, Saint-Joseph University, Beirut, Lebanon
| | - Fouad Fayad
- Rheumatology Department, Hotel-Dieu de France University Hospital, Saint-Joseph University, Beirut, Lebanon
| | | | | |
Collapse
|
3
|
Ea HK, Kischkel B, Chirayath TW, Klück V, Aparicio C, Loeung HU, Manivet P, Jansen T, Zarka M, Lioté F, Latourte A, Bardin T, Gauffenic A, Vicaut E, Crișan TO, Netea MG, Richette P, Joosten LA. Systemic inflammatory cytokine profiles in patients with gout during flare, intercritical and treat-to-target phases: TNFSF14 as new biomarker. Ann Rheum Dis 2024:ard-2023-225305. [PMID: 38373842 DOI: 10.1136/ard-2023-225305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Accepted: 02/02/2024] [Indexed: 02/21/2024]
Abstract
INTRODUCTION Untreated gout is characterised by monosodium urate (MSU) crystal accumulation responsible for recurrent flares that are commonly separated by asymptomatic phases. Both phases are inflammatory conditions of variable intensity. Gout flares are self-limited inflammatory reactions involving multiple mediators. This study aimed to characterise the inflammatory profiles of gout at different phases. METHODS Using the Olink targeted proteomics, levels of 92 inflammation-related proteins were measured in plasma samples of a prospective gout population (GOUTROS), collected at gout flare (T1), the intercritical phase (T2) and after reaching the target serum urate level under urate-lowering therapy (T3). Results were validated in an independent cohort (OLT1177-05) with plasmas collected at T1 and T2. Ex vivo and in vitro experiments were performed to assess the inflammatory properties of new biomarkers. RESULTS In total, 21 inflammatory new biomarkers were differentially expressed during the three time-points of gout disease. The levels of four of these proteins (interleukin 6 (IL-6), colony-stimulating factor 1, vascular endothelial growth factor A and tumour necrosis factor superfamily 14 (TNFSF14)) were increased during gout flare in an independent cohort. IL-6 and TNFSF14 had the highest fold change in expression during T1 versus T2 or T3. TNFSF14 was produced at the inflamed joint and enhanced the inflammatory response induced by lipopolysaccharide and MSU crystal stimulation. Conversely, TNFSF14 blockade reduced the inflammatory response. Additionally, single nucleotide polymorphisms of TNFSF14 affected the ability of myeloid cells to produce inflammatory cytokines. CONCLUSION Gout flare involves multiple inflammatory mediators that may be used as potential therapeutic targets.
Collapse
Affiliation(s)
- Hang-Korng Ea
- Bioscar, INSERM UMR-1132, hôpital Lariboisière, centre Viggo Petersen, DMU Locomoteur, AP-HP, Universite Paris Cite, Paris, France
| | - Brenda Kischkel
- Internal Medicine, Radboud University Medical Center, Nijmegen, The Netherlands
| | | | - Viola Klück
- Internal Medicine, Radboud University Medical Center, Nijmegen, The Netherlands
| | | | | | - Philippe Manivet
- Assistance Publique-Hôpitaux de Paris, Centre de Ressources Biologiques, Paris, France
| | - Tim Jansen
- Rheumatology, VieCuri, Venlo, The Netherlands
| | - Mylène Zarka
- Bioscar, INSERM UMR-1132, Universite Paris Cite, Paris, France
| | - Frédéric Lioté
- Bioscar, INSERM UMR-1132, hôpital Lariboisière, centre Viggo Petersen, DMU Locomoteur, AP-HP, Universite Paris Cite, Paris, France
| | - Augustin Latourte
- Bioscar, INSERM UMR-1132, hôpital Lariboisière, centre Viggo Petersen, DMU Locomoteur, AP-HP, Universite Paris Cite, Paris, France
| | - Thomas Bardin
- Bioscar, INSERM UMR-1132, hôpital Lariboisière, centre Viggo Petersen, DMU Locomoteur, AP-HP, Universite Paris Cite, Paris, France
| | - Alan Gauffenic
- Bioscar, INSERM UMR-1132, hôpital Lariboisière, centre Viggo Petersen, DMU Locomoteur, AP-HP, Universite Paris Cite, Paris, France
| | - Eric Vicaut
- Unité de recherche clinique, Groupe hospitalier Lariboisiere Fernand-Widal, Paris, France
| | - Tania Octavia Crișan
- Department of Medical Genetics, Universitatea de Medicina si Farmacie Iuliu Hatieganu, Cluj-Napoca, Romania
| | - Mihai G Netea
- Internal Medicine, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Pascal Richette
- Bioscar, INSERM UMR-1132, hôpital Lariboisière, centre Viggo Petersen, DMU Locomoteur, AP-HP, Universite Paris Cite, Paris, France
| | - Leo Ab Joosten
- Internal Medicine, Radboud University Medical Center, Nijmegen, The Netherlands
- Department of Medical Genetics, Universitatea de Medicina si Farmacie Iuliu Hatieganu, Cluj-Napoca, Romania
| |
Collapse
|
4
|
Bardin T, Ducrot YM, Nguyen Q, Letavernier E, Zaworski J, Ea HK, Touzain F, Do MD, Colot J, Barguil Y, Biron A, Resche-Rigon M, Richette P, Collet C. Early-onset gout and rare deficient variants of the lactate dehydrogenase D gene. Rheumatology (Oxford) 2023; 62:3978-3983. [PMID: 37021930 DOI: 10.1093/rheumatology/kead118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 12/16/2022] [Accepted: 02/03/2023] [Indexed: 04/07/2023] Open
Abstract
OBJECTIVES To investigate whether the lactate dehydrogenase D (LDHD) gene deficiency causes juvenile-onset gout. METHODS We used whole-exome sequencing for two families and a targeted gene-sequencing panel for an isolated patient. d-lactate dosages were analysed using ELISA. RESULTS We demonstrated linkage of juvenile-onset gout to homozygous carriage of three rare distinct LDHD variants in three different ethnicities. In a Melanesian family, the variant was (NM_153486.3: c.206C>T; rs1035398551) and, as compared with non-homozygotes, homozygotes had higher hyperuricaemia (P = 0.02), lower fractional clearance of urate (P = 0.002), and higher levels of d-lactate in blood (P = 0.04) and urine (P = 0.06). In a second, Vietnamese, family, very severe juvenile-onset gout was linked to homozygote carriage of an undescribed LDHD variant (NM_153486.3: c.1363dupG) leading to a frameshift followed by a stop codon, p.(AlaGly432fsTer58). Finally, a Moroccan man, with early-onset and high d-lactaturia, whose family was unavailable for testing, was homozygous for another rare LDHD variant [NM_153486.3: c.752C>T, p.(Thr251Met)]. CONCLUSION Rare, damaging LDHD variants can cause autosomal recessive early-onset gout, the diagnosis of which can be suspected by measuring high d-lactate levels in the blood and/or urine.
Collapse
Affiliation(s)
- Thomas Bardin
- INSERM UMRS1132, Université de Paris-Cité, Hôpital Lariboisière, Paris, France
- French-Vietnamese Research Centre on Gout and Chronic Diseases, Viên Gùt, Ho Chi Minh City, Vietnam
| | - Yves-Marie Ducrot
- Centre Médico-Social de Wé, DACAS, Province des îles Loyauté, Lifou, New Caledonia
| | - Quang Nguyen
- French-Vietnamese Research Centre on Gout and Chronic Diseases, Viên Gùt, Ho Chi Minh City, Vietnam
| | | | - Jeremy Zaworski
- Sorbonne University INSERM UMRS1155, Hôpital Tenon, Paris, France
| | - Hang-Korng Ea
- INSERM UMRS1132, Université de Paris-Cité, Hôpital Lariboisière, Paris, France
| | - Fréderic Touzain
- Service de Transfusion Sanguine/Centre de Don du Sang, Centre Hospitalier Territorial, Nouméa, New Caledonia
| | - Minh Duc Do
- Center for Molecular Biomedicine, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Julien Colot
- Laboratoire de Microbiologie, Centre Hospitalier Territorial, Nouméa, New Caledonia
| | - Yann Barguil
- Laboratoire de Microbiologie, Centre Hospitalier Territorial, Nouméa, New Caledonia
| | - Antoine Biron
- Laboratoire de Microbiologie, Centre Hospitalier Territorial, Nouméa, New Caledonia
| | - Matthieu Resche-Rigon
- Department of Biostatistics, Hôpital Saint Louis, APHP Nord and UMR U1153 ECSTRA team INSERM, Université de Paris-Cité, Paris, France
| | - Pascal Richette
- INSERM UMRS1132, Université de Paris-Cité, Hôpital Lariboisière, Paris, France
| | - Corinne Collet
- INSERM UMRS1132, Université de Paris-Cité, Hôpital Lariboisière, Paris, France
| |
Collapse
|
5
|
Abhishek A, Tedeschi SK, Pascart T, Latourte A, Dalbeth N, Neogi T, Fuller A, Rosenthal A, Becce F, Bardin T, Ea HK, Filippou G, FitzGerald J, Iagnocco A, Lioté F, McCarthy GM, Ramonda R, Richette P, Sivera F, Andres M, Cipolletta E, Doherty M, Pascual E, Perez-Ruiz F, So A, Jansen TL, Kohler MJ, Stamp LK, Yinh J, Adinolfi A, Arad U, Aung T, Benillouche E, Bortoluzzi A, Dau J, Maningding E, Fang MA, Figus FA, Filippucci E, Haslett J, Janssen M, Kaldas M, Kimoto M, Leamy K, Navarro GM, Sarzi-Puttini P, Scirè C, Silvagni E, Sirotti S, Stack JR, Truong L, Xie C, Yokose C, Hendry AM, Terkeltaub R, Taylor WJ, Choi HK. The 2023 ACR/EULAR Classification Criteria for Calcium Pyrophosphate Deposition Disease. Arthritis Rheumatol 2023; 75:1703-1713. [PMID: 37494275 PMCID: PMC10543651 DOI: 10.1002/art.42619] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 04/19/2023] [Accepted: 05/23/2023] [Indexed: 07/28/2023]
Abstract
OBJECTIVE Calcium pyrophosphate deposition (CPPD) disease is prevalent and has diverse presentations, but there are no validated classification criteria for this symptomatic arthritis. The American College of Rheumatology (ACR) and EULAR have developed the first-ever validated classification criteria for symptomatic CPPD disease. METHODS Supported by the ACR and EULAR, a multinational group of investigators followed established methodology to develop these disease classification criteria. The group generated lists of candidate items and refined their definitions, collected de-identified patient profiles, evaluated strengths of associations between candidate items and CPPD disease, developed a classification criteria framework, and used multi-criterion decision analysis to define criteria weights and a classification threshold score. The criteria were validated in an independent cohort. RESULTS Among patients with joint pain, swelling, or tenderness (entry criterion) whose symptoms are not fully explained by an alternative disease (exclusion criterion), the presence of crowned dens syndrome or calcium pyrophosphate crystals in synovial fluid are sufficient to classify a patient as having CPPD disease. In the absence of these findings, a score >56 points using weighted criteria, comprising clinical features, associated metabolic disorders, and results of laboratory and imaging investigations, can be used to classify as CPPD disease. These criteria had a sensitivity of 92.2% and specificity of 87.9% in the derivation cohort (190 CPPD cases, 148 mimickers), whereas sensitivity was 99.2% and specificity was 92.5% in the validation cohort (251 CPPD cases, 162 mimickers). CONCLUSION The 2023 ACR/EULAR CPPD disease classification criteria have excellent performance characteristics and will facilitate research in this field.
Collapse
Affiliation(s)
| | - Sara K Tedeschi
- Division of Rheumatology, Inflammation and Immunity, Brigham and Women's Hospital, and Harvard Medical School, Boston, Massachusetts
| | - Tristan Pascart
- Department of Rheumatology, Lille Catholic University, Saint-Philibert Hospital, Lille, France
| | - Augustin Latourte
- Université de Paris, INSERM, UMR-S 1132 BIOSCAR, and Service de Rhumatologie, AP-HP, Lariboisière Hospital, Paris, France
| | - Nicola Dalbeth
- Department of Medicine, University of Auckland, Auckland, New Zealand
| | - Tuhina Neogi
- Department of Medicine, Section of Rheumatology, Boston University School of Medicine, Boston, Massachusetts
| | - Amy Fuller
- Academic Rheumatology, University of Nottingham, Nottingham, UK
| | - Ann Rosenthal
- Department of Medicine, Medical College of Wisconsin, Milwaukee
| | - Fabio Becce
- Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Thomas Bardin
- Université de Paris, INSERM, UMR-S 1132 BIOSCAR, and Service de Rhumatologie, AP-HP, Lariboisière Hospital, Paris, France
| | - Hang Korng Ea
- Université de Paris, INSERM, UMR-S 1132 BIOSCAR, and Service de Rhumatologie, AP-HP, Lariboisière Hospital, Paris, France
| | - Georgios Filippou
- Rheumatology Department, IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
| | - John FitzGerald
- David Geffen School of Medicine, University of California, and Veterans Administration for Greater Los Angeles, Los Angeles, California
| | - AnnaMaria Iagnocco
- Academic Rheumatology Center, Università degli Studi di Torino, Turin, Italy
| | - Frédéric Lioté
- Université de Paris, INSERM, UMR-S 1132 BIOSCAR, Service de Rhumatologie, AP-HP, Lariboisière Hospital, and Université Paris Cité, Faculté de Santé, Paris, France
| | - Geraldine M McCarthy
- School of Medicine and Medical Science, University College Dublin, and Mater Misericordiae University Hospital, Dublin, Ireland
| | - Roberta Ramonda
- Rheumatology Unit, Department of Medicine, University of Padova, Padova, Italy
| | - Pascal Richette
- Université de Paris, INSERM, UMR-S 1132 BIOSCAR, and Service de Rhumatologie, AP-HP, Lariboisière Hospital, Paris, France
| | - Francisca Sivera
- Department of Rheumatology, Hospital General Universitario Elda, Elda, Spain, and Department of Clinical Medicine, Universidad Miguel Hernandez, Elche, Spain
| | - Mariano Andres
- Department of Medicine, Rheumatology Section, Hospital General Universitario de Alicante, Universidad Miguel Hernández, Alicante, Spain
| | - Edoardo Cipolletta
- Rheumatology Unit, Department of Clinical and Molecular Sciences, Polytechnic University of Marche, Ancona, Italy
| | - Michael Doherty
- Academic Rheumatology, University of Nottingham, Nottingham, UK
| | - Eliseo Pascual
- Rheumatology Division, Cruces University Hospital, Bilbao, Spain
| | - Fernando Perez-Ruiz
- Arthritis Investigation Group, Biocruces-Bizkaia Health Research Institute, Spain, Department of Medicine, Medicine and Nursing School, University of the Basque Country, and Basque Country Rheumatology Society, Bilbao, Spain
| | - Alexander So
- Lausanne University Hospital, Lausanne, Switzerland
| | - Tim L Jansen
- VieCuri Medical Centre, Venlo, The Netherlands, and Medical Cell BioPhysics Group, University of Twente, Enschede, The Netherlands
| | - Minna J Kohler
- Department of Medicine, Rheumatology Unit, Massachusetts General Hospital, and Harvard Medical School, Boston, Massachusetts
| | - Lisa K Stamp
- Department of Medicine, University of Otago, Christchurch, New Zealand
| | - Janeth Yinh
- Department of Medicine, Rheumatology Unit, Massachusetts General Hospital, and Harvard Medical School, Boston, Massachusetts
| | | | - Uri Arad
- Department of Rheumatology, Te Whatu Ora-Health New Zealand Waikato, Hamilton, New Zealand
| | - Thanda Aung
- Division of Rheumatology, University of California, Los Angeles
| | - Eva Benillouche
- Department of Rheumatology, Lausanne University Hospital, Lausanne, Switzerland
| | - Alessandra Bortoluzzi
- Section of Rheumatology, Department of Medical Sciences, University of Ferrara, Ferrara, Italy, and Azienda Ospedaliera-Universitaria di Ferrara, Cona (FE), Italy
| | - Jonathan Dau
- Department of Medicine, Rheumatology Unit, Massachusetts General Hospital, Boston
| | | | - Meika A Fang
- David Geffen School of Medicine, University of California, and Veterans Administration for Greater Los Angeles, Los Angeles, California
| | - Fabiana A Figus
- Rheumatology Division, Local Health Unit (ASL), Turin-3, Collegno and Pinerolo, Italy
| | - Emilio Filippucci
- Rheumatology Unit, Department of Clinical and Molecular Sciences, Polytechnic University of Marche, Ancona, Italy
| | - Janine Haslett
- Department of Medicine, University of Otago, Christchurch, New Zealand
| | | | - Marian Kaldas
- David Geffen School of Medicine, University of California, Los Angeles
| | - Maryann Kimoto
- David Geffen School of Medicine, University of California, Los Angeles
| | - Kelly Leamy
- Mater Misericordiae University Hospital, Dublin, Ireland
| | | | | | - Carlo Scirè
- Epidemiology Unit, Italian Society for Rheumatology, Milan, Italy
| | - Ettore Silvagni
- Section of Rheumatology, Department of Medical Sciences, University of Ferrara, Ferrara, Italy, and Azienda Ospedaliera-Universitaria di Ferrara, Cona (FE), Italy
| | - Silvia Sirotti
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy
| | - John R Stack
- School of Medicine and Medical Science, University College Dublin, and Mater Misericordiae University Hospital, Dublin, Ireland
| | - Linh Truong
- Division of Rheumatology, University of California, Los Angeles, California
| | - Chen Xie
- Division of Rheumatology, University of California, Los Angeles, California
| | - Chio Yokose
- Harvard Medical School, Boston, Massachusetts
| | - Alison M Hendry
- Department of Medicine, General Medicine and Rheumatology, Middlemore Hospital, Counties Manukau Health District, New Zealand
| | - Robert Terkeltaub
- San Diego Veterans Administration Healthcare Service, and University of California, San Diego
| | - William J Taylor
- Department of Medicine, Rheumatology Unit, Massachusetts General Hospital, and Harvard Medical School, Boston, Massachusetts
| | - Hyon K Choi
- Department of Medicine, Rheumatology Unit, Massachusetts General Hospital, and Harvard Medical School, Boston, Massachusetts
| |
Collapse
|
6
|
Abhishek A, Tedeschi SK, Pascart T, Latourte A, Dalbeth N, Neogi T, Fuller A, Rosenthal A, Becce F, Bardin T, Ea HK, Filippou G, Fitzgerald J, Iagnocco A, Lioté F, McCarthy GM, Ramonda R, Richette P, Sivera F, Andrés M, Cipolletta E, Doherty M, Pascual E, Perez-Ruiz F, So A, Jansen TL, Kohler MJ, Stamp LK, Yinh J, Adinolfi A, Arad U, Aung T, Benillouche E, Bortoluzzi A, Dau J, Maningding E, Fang MA, Figus FA, Filippucci E, Haslett J, Janssen M, Kaldas M, Kimoto M, Leamy K, Navarro GM, Sarzi-Puttini P, Scirè C, Silvagni E, Sirotti S, Stack JR, Truong L, Xie C, Yokose C, Hendry AM, Terkeltaub R, Taylor WJ, Choi HK. The 2023 ACR/EULAR classification criteria for calcium pyrophosphate deposition disease. Ann Rheum Dis 2023; 82:1248-1257. [PMID: 37495237 PMCID: PMC10529191 DOI: 10.1136/ard-2023-224575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 06/14/2023] [Indexed: 07/28/2023]
Abstract
OBJECTIVE Calcium pyrophosphate deposition (CPPD) disease is prevalent and has diverse presentations, but there are no validated classification criteria for this symptomatic arthritis. The American College of Rheumatology (ACR) and EULAR have developed the first-ever validated classification criteria for symptomatic CPPD disease. METHODS Supported by the ACR and EULAR, a multinational group of investigators followed established methodology to develop these disease classification criteria. The group generated lists of candidate items and refined their definitions, collected de-identified patient profiles, evaluated strengths of associations between candidate items and CPPD disease, developed a classification criteria framework, and used multi-criterion decision analysis to define criteria weights and a classification threshold score. The criteria were validated in an independent cohort. RESULTS Among patients with joint pain, swelling, or tenderness (entry criterion) whose symptoms are not fully explained by an alternative disease (exclusion criterion), the presence of crowned dens syndrome or calcium pyrophosphate crystals in synovial fluid are sufficient to classify a patient as having CPPD disease. In the absence of these findings, a score>56 points using weighted criteria, comprising clinical features, associated metabolic disorders, and results of laboratory and imaging investigations, can be used to classify as CPPD disease. These criteria had a sensitivity of 92.2% and specificity of 87.9% in the derivation cohort (190 CPPD cases, 148 mimickers), whereas sensitivity was 99.2% and specificity was 92.5% in the validation cohort (251 CPPD cases, 162 mimickers). CONCLUSION The 2023 ACR/EULAR CPPD disease classification criteria have excellent performance characteristics and will facilitate research in this field.
Collapse
Affiliation(s)
| | - Sara K Tedeschi
- Division of Rheumatology, Inflammation and Immunity, Brigham and Women's Hospital, and Harvard Medical School, Boston, Massachusetts, USA
| | - Tristan Pascart
- Department of Rheumatology, Lille Catholic University, Saint-Philibert Hospital, Lille, France
| | - Augustin Latourte
- Université de Paris, INSERM, UMR-S 1132 BIOSCAR, and Service de Rhumatologie, AP-HP, Lariboisière Hospital, Paris, France
| | - Nicola Dalbeth
- Department of Medicine, University of Auckland, Auckland, New Zealand
| | - Tuhina Neogi
- Department of Medicine, Section of Rheumatology, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Amy Fuller
- Academic Rheumatology, University of Nottingham, Nottingham, UK
| | - Ann Rosenthal
- Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Fabio Becce
- Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Thomas Bardin
- Université de Paris, INSERM, UMR-S 1132 BIOSCAR, and Service de Rhumatologie, AP-HP, Lariboisière Hospital, Paris, France
| | - Hang-Korng Ea
- Université de Paris, INSERM, UMR-S 1132 BIOSCAR, and Service de Rhumatologie, AP-HP, Lariboisière Hospital, Paris, France
| | - Georgios Filippou
- Rheumatology Department, IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
| | - John Fitzgerald
- David Geffen School of Medicine, University of California, Los Angeles, California, USA
- Veterans Administration for Greater Los Angeles, Los Angeles, California, USA
| | - AnnaMaria Iagnocco
- Academic Rheumatology Center, Università degli Studi di Torino, Turin, Italy
| | - Frédéric Lioté
- Université de Paris, INSERM, UMR-S 1132 BIOSCAR, and Service de Rhumatologie, AP-HP, Lariboisière Hospital, Paris, France
- Université Paris Cité, Faculté de Santé, Paris, France
| | - Geraldine M McCarthy
- School of Medicine and Medical Science, University College Dublin, Dublin, Ireland
- Mater Misericordiae University Hospital, Dublin, Ireland
| | - Roberta Ramonda
- Rheumatology Unit, Department of Medicine, University of Padova, Padova, Italy
| | - Pascal Richette
- Université de Paris, INSERM, UMR-S 1132 BIOSCAR, and Service de Rhumatologie, AP-HP, Lariboisière Hospital, Paris, France
| | - Francisca Sivera
- Department of Rheumatology, Hospital General Universitario Elda, Elda, Spain
- Department of Clinical Medicine, Universidad Miguel Hernandez, Elche, Spain
| | - Mariano Andrés
- Department of Medicine, Rheumatology Section, Hospital General Universitario de Alicante, Universidad Miguel Hernández, Alicante, Spain
| | - Edoardo Cipolletta
- Rheumatology Unit, Department of Clinical and Molecular Sciences, Polytechnic University of Marche, Ancona, Italy
| | - Michael Doherty
- Academic Rheumatology, University of Nottingham, Nottingham, UK
| | - Eliseo Pascual
- Rheumatology Division, Cruces University Hospital, Bilbao, Spain
| | - Fernando Perez-Ruiz
- Arthritis Investigation Group, Biocruces-Bizkaia Health Research Institute, Spain, Department of Medicine, Medicine and Nursing School, University of the Basque Country, and Basque Country Rheumatology Society, Bilbao, Spain
| | - Alexander So
- Lausanne University Hospital, Lausanne, Switzerland
| | - Tim L Jansen
- VieCuri Medical Centre, Venlo, The Netherlands
- Medical Cell BioPhysics Group, University of Twente, Enschede, The Netherlands
| | - Minna J Kohler
- Department of Medicine, Rheumatology Unit, Massachusetts General Hospital, and Harvard Medical School, Boston, Massachusetts, USA
| | - Lisa K Stamp
- Department of Medicine, University of Otago, Christchurch, New Zealand
| | - Janeth Yinh
- Department of Medicine, Rheumatology Unit, Massachusetts General Hospital, and Harvard Medical School, Boston, Massachusetts, USA
| | | | - Uri Arad
- Department of Rheumatology, Te Whatu Ora-Health New Zealand Waikato, Hamilton, New Zealand
| | - Thanda Aung
- Division of Rheumatology, University of California, Los Angeles, California, USA
| | - Eva Benillouche
- Department of Rheumatology, Lausanne University Hospital, Lausanne, Switzerland
| | - Alessandra Bortoluzzi
- Section of Rheumatology, Department of Medical Sciences, University of Ferrara, Ferrara, Italy
- Azienda Ospedaliera-Universitaria di Ferrara (Cona FE), Cona FE, Italy
| | - Jonathan Dau
- Department of Medicine, Rheumatology Unit, Massachusetts General Hospital, Boston, Massachusetts, USA
| | | | - Meika A Fang
- David Geffen School of Medicine, University of California, Los Angeles, California, USA
- Veterans Administration for Greater Los Angeles, Los Angeles, California, USA
| | - Fabiana A Figus
- Rheumatology Division, Local Health Unit (ASL), Turin-3, Collegno and Pinerolo, Italy
| | - Emilio Filippucci
- Rheumatology Unit, Department of Clinical and Molecular Sciences, Polytechnic University of Marche, Ancona, Italy
| | - Janine Haslett
- Department of Medicine, University of Otago, Christchurch, New Zealand
| | | | - Marian Kaldas
- David Geffen School of Medicine, University of California, Los Angeles, California, USA
| | - Maryann Kimoto
- David Geffen School of Medicine, University of California, Los Angeles, California, USA
| | - Kelly Leamy
- Mater Misericordiae University Hospital, Dublin, Ireland
| | - Geraldine M Navarro
- Division of Rheumatology, University of California, Los Angeles, California, USA
| | | | - Carlo Scirè
- Epidemiology Unit, Italian Society for Rheumatology, Milan, Italy
| | - Ettore Silvagni
- Section of Rheumatology, Department of Medical Sciences, University of Ferrara, Ferrara, Italy
- Azienda Ospedaliera-Universitaria di Ferrara (Cona FE), Cona FE, Italy
| | - Silvia Sirotti
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy
| | - John R Stack
- School of Medicine and Medical Science, University College Dublin, Dublin, Ireland
- Mater Misericordiae University Hospital, Dublin, Ireland
| | - Linh Truong
- Division of Rheumatology, University of California, Los Angeles, California, USA
| | - Chen Xie
- Division of Rheumatology, University of California, Los Angeles, California, USA
| | - Chio Yokose
- Harvard Medical School, Boston, Massachusetts, USA
| | - Alison M Hendry
- Department of Medicine, General Medicine and Rheumatology, Middlemore Hospital, Counties Manukau Health District, Auckland, New Zealand
| | - Robert Terkeltaub
- San Diego Veterans Administration Healthcare Service, and University of California, San Diego, California, USA
| | - William J Taylor
- Department of Medicine, University of Otago, Christchurch, New Zealand
| | - Hyon K Choi
- Department of Medicine, Rheumatology Unit, Massachusetts General Hospital, and Harvard Medical School, Boston, Massachusetts, USA
| |
Collapse
|
7
|
Pascart T, Robinet P, Ottaviani S, Leroy R, Segaud N, Pacaud A, Grandjean A, Luraschi H, Rabin T, Deplanque X, Maciejasz P, Visade F, Mackowiak A, Baclet N, Maréchaux S, Lefebvre A, Budzik JF, Bardin T, Richette P, Norberciak L, Ducoulombier V, Houvenagel E. Evaluating the safety and short-term equivalence of colchicine versus prednisone in older patients with acute calcium pyrophosphate crystal arthritis (COLCHICORT): an open-label, multicentre, randomised trial. Lancet Rheumatol 2023; 5:e523-e531. [PMID: 38251496 DOI: 10.1016/s2665-9913(23)00165-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 06/07/2023] [Accepted: 06/13/2023] [Indexed: 01/23/2024]
Abstract
BACKGROUND Acute calcium pyrophosphate crystal arthritis causes intense joint pain mainly affecting older people. Because guidance and evidence remain scarce, management of this disease relies on expert opinion. We therefore aimed to compare the safety and short-term equivalence of low-dose colchicine with oral prednisone in older patients with acute calcium pyrophosphate crystal arthritis. METHODS We did an open-label, multicentre, randomised, trial (COLCHICORT) at six hospitals in Paris and northern France. We enrolled patients who were admitted to hospital who were 65 years or older and who presented with acute calcium pyrophosphate crystal arthritis with a symptom duration of less than 36 h. Diagnosis of calcium pyrophosphate crystal arthritis was made by the identification of calcium pyrophosphate crystals on synovial fluid analysis or typical clinical presentation (onset of joint pain and swelling). Key exclusion criteria included absence of calcium pyrophosphate crystals on synovial fluid analysis or a history of gout. Participants were randomly allocated (1:1), using a centralised electronic treatment group allocation module, to receive either colchicine 1·5 mg on day 1 and 1 mg on day 2 (ie, the colchicine group) or oral prednisone 30 mg on days 1 and 2 (ie, the prednisone group). The primary outcome was change in joint pain (measured by visual analogue scale [VAS] from 0 mm to 100 mm) at 24 h. Equivalence was determined whether the 95% CI of the between-group difference at 24 h was within the -13 mm to +13 mm margin in the per-protocol analysis. Adverse events were recorded using the National Cancer Institute Common Terminology Criteria for Adverse Events (version 4.0). This trial is completed and is registered with ClinicalTrials.gov, NCT03128905. FINDINGS Between Feb 5, 2018, and May 7, 2022, 111 patients who were admitted to hospital were randomly assigned (57 [51%] to the colchicine group and 54 [49%] to the prednisone group). 95 (86%) of 111 patients were included in the per-protocol analysis (49 [52%] in the colchicine group and 46 [48%] in the prednisone group). The median age was 88·0 years (IQR 82·0-91·0) and 69 (73%) of 95 participants were women and 26 (27%) were men. Acute calcium pyrophosphate crystal arthritis affected mainly the knee in 46 (48%) of 95 participants, the wrist in 19 (20%), and the ankle in 12 (13%). Pain VAS at baseline was 68 mm (SD 17). At 24 h, change in pain VAS was -36 mm (SD 32) in the colchicine group and -38 mm (SD 23) in the prednisone group. The between-group difference in change in pain VAS at 24 h was -1 mm (95% CI -12 to 10), showing equivalence between the two drugs. In the colchicine group, 12 (22%) of 55 patients had diarrhoea, one (2%) had hypertension, and none had hyperglycaemia. In the prednisone group, three (6%) of 54 had diarrhoea, six (11%) had hypertension, and three (6%) had hyperglycaemia. No deaths occurred in the colchicine group; two deaths occurred in the prednisone group, which were deemed unrelated to prednisone (one due to infectious valvular endocarditis leading to heart failure, and one due to a stroke). INTERPRETATION Colchicine and prednisone exhibit equivalent short-term efficacy for the treatment of acute calcium pyrophosphate crystal arthritis, with different safety profiles in the older population. FUNDING French Inter-regional Hospital Program of Clinical Research.
Collapse
Affiliation(s)
- Tristan Pascart
- Department of Rheumatology, Hôpital Saint-Philibert, Université Catholique de Lille, Lomme, France.
| | - Pierre Robinet
- Department of Geriatrics, Hôpital Saint-Philibert, Université Catholique de Lille, Lomme, France
| | | | - Rémi Leroy
- Department of Rheumatology, Centre Hospitalier de Dunkerque, Dunkirk, France
| | - Nicolas Segaud
- Department of Internal Medicine, Centre Hospitalier d'Armentières, Armentières, France
| | - Aurore Pacaud
- Department of Rheumatology, Hôpital Saint-Philibert, Université Catholique de Lille, Lomme, France
| | - Agathe Grandjean
- Department of Rheumatology, Hôpital Saint-Philibert, Université Catholique de Lille, Lomme, France
| | - Hélène Luraschi
- Department of Rheumatology, Hôpital Saint-Vincent-de-Paul, Université Catholique de Lille, Lille, France
| | - Thibault Rabin
- Department of Rheumatology, Hôpital Saint-Philibert, Université Catholique de Lille, Lomme, France
| | - Xavier Deplanque
- Department of Geriatrics, Hôpital Saint-Vincent-de-Paul, Université Catholique de Lille, Lille, France
| | - Pierre Maciejasz
- Department of Geriatrics, Hôpital Saint-Vincent-de-Paul, Université Catholique de Lille, Lille, France
| | - Fabien Visade
- Department of Geriatrics, Hôpital Saint-Philibert, Université Catholique de Lille, Lomme, France
| | - Alexandre Mackowiak
- Department of Neurology, Hôpital Saint-Philibert, Université Catholique de Lille, Lomme, France
| | - Nicolas Baclet
- Department of Internal Medicine, Hôpital Saint-Vincent-de-Paul, Université Catholique de Lille, Lille, France
| | - Sylvestre Maréchaux
- Department of Cardiology, Hôpital Saint-Philibert, Université Catholique de Lille, Lomme, France
| | - Antoine Lefebvre
- Department of Pharmacy, Hôpital Saint-Philibert, Université Catholique de Lille, Lomme, France
| | - Jean-François Budzik
- Department of Radiology, Hôpital Saint-Philibert, Université Catholique de Lille, Lomme, France
| | - Thomas Bardin
- Department of Rheumatology, Hôpital Lariboisière APHP Paris Nord, INSERM, UMR 1132, Bioscar, Paris, France
| | - Pascal Richette
- Department of Rheumatology, Hôpital Lariboisière APHP Paris Nord, INSERM, UMR 1132, Bioscar, Paris, France
| | - Laurène Norberciak
- Research Department-Biostatistics and Methodology, Hôpital Saint-Philibert, Université Catholique de Lille, Lomme, France
| | - Vincent Ducoulombier
- Department of Rheumatology, Hôpital Saint-Philibert, Université Catholique de Lille, Lomme, France
| | - Eric Houvenagel
- Department of Rheumatology, Hôpital Saint-Philibert, Université Catholique de Lille, Lomme, France
| |
Collapse
|
8
|
Tedeschi SK, Pascart T, Latourte A, Godsave C, Kundakci B, Naden RP, Taylor WJ, Dalbeth N, Neogi T, Perez-Ruiz F, Rosenthal A, Becce F, Pascual E, Andres M, Bardin T, Doherty M, Ea HK, Filippou G, FitzGerald J, Guitierrez M, Iagnocco A, Jansen TL, Kohler MJ, Lioté F, Matza M, McCarthy GM, Ramonda R, Reginato AM, Richette P, Singh JA, Sivera F, So A, Stamp LK, Yinh J, Yokose C, Terkeltaub R, Choi H, Abhishek A. Identifying Potential Classification Criteria for Calcium Pyrophosphate Deposition Disease: Item Generation and Item Reduction. Arthritis Care Res (Hoboken) 2022; 74:1649-1658. [PMID: 33973414 PMCID: PMC8578594 DOI: 10.1002/acr.24619] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Revised: 03/24/2021] [Accepted: 04/06/2021] [Indexed: 11/07/2022]
Abstract
OBJECTIVE Classification criteria for calcium pyrophosphate deposition (CPPD) disease will facilitate clinical research on this common crystalline arthritis. Our objective was to report on the first 2 phases of a 4-phase process for developing CPPD classification criteria. METHODS CPPD classification criteria development is overseen by a 12-member steering committee. Item generation (phase I) included a scoping literature review of 5 literature databases and contributions from a 35-member combined expert committee and 2 patient research partners. Item reduction and refinement (phase II) involved a combined expert committee meeting, discussions among clinical, imaging, and laboratory advisory groups, and an item-rating exercise to assess the influence of individual items toward classification. The steering committee reviewed the modal rating score for each item (range -3 [strongly pushes away from CPPD] to +3 [strongly pushes toward CPPD]) to determine items to retain for future phases of criteria development. RESULTS Item generation yielded 420 items (312 from the literature, 108 from experts/patients). The advisory groups eliminated items that they agreed were unlikely to distinguish between CPPD and other forms of arthritis, yielding 127 items for the item-rating exercise. Fifty-six items, most of which had a modal rating of +/- 2 or 3, were retained for future phases. As numerous imaging items were rated +3, the steering committee recommended focusing on imaging of the knee and wrist and 1 additional affected joint for calcification suggestive of CPP crystal deposition. CONCLUSION A data- and expert-driven process is underway to develop CPPD classification criteria. Candidate items comprise clinical, imaging, and laboratory features.
Collapse
Affiliation(s)
- Sara K. Tedeschi
- Division of Rheumatology, Inflammation and Immunity,
Brigham and Women’s Hospital and Harvard Medical School, Boston, United
States
| | - Tristan Pascart
- Department of Rheumatology, Lille Catholic University,
Lille, France
| | - Augustin Latourte
- Department of Rheumatology, Centre Viggo Petersen,
Hôpital Lariboisière, Université de Paris, Paris, France
| | - Cattleya Godsave
- Department of Academic Rheumatology, University of
Nottingham, Nottingham, United Kingdom
| | - Burak Kundakci
- Department of Academic Rheumatology, University of
Nottingham, Nottingham, United Kingdom
| | - Raymond P. Naden
- Department of Medicine, Auckland City Hospital, Auckland,
New Zealand
| | | | - Nicola Dalbeth
- Department of Medicine, University of Auckland, Auckland,
New Zealand
| | - Tuhina Neogi
- Section of Rheumatology, Boston University School of
Medicine, Boston, MA, United States
| | - Fernando Perez-Ruiz
- Osakidetza, OSI EE-Cruces, Cruces University Hospital,
Biocruces-Bizkaia Health Research Institute and University of the Basque Country,
Basque Country, Spain
| | - Ann Rosenthal
- Department of Rheumatology, Medical College of
Wisconsin, Milwaukee, United States
| | - Fabio Becce
- Department of Radiology, Lausanne University Hospital,
Lausanne, Switzerland
| | - Eliseo Pascual
- Department of Rheumatology, Hospital General
Universitario de Alicante, Alicante Institute of Sanitary and Biomedical Research,
Alicante, Spain
| | - Mariano Andres
- Department of Rheumatology, Hospital General
Universitario de Alicante, Alicante Institute of Sanitary and Biomedical Research,
Alicante, Spain
| | - Thomas Bardin
- Department of Rheumatology, Centre Viggo Petersen,
Hôpital Lariboisière, Université de Paris, Paris, France
| | - Michael Doherty
- Department of Academic Rheumatology, University of
Nottingham, Nottingham, United Kingdom
| | - Hang-Korng Ea
- Department of Rheumatology, Centre Viggo Petersen,
Hôpital Lariboisière, Université de Paris, Paris, France
| | - Georgios Filippou
- Division of Rheumatology, Luigi Sacco University
Hospital, Milan, Italy
| | - John FitzGerald
- Greater Los Angeles VA Healthcare Service and Division
of Rheumatology, David Geffen School of Medicine, University of California-Los
Angeles, Los Angeles, United States
| | - Marwin Guitierrez
- Division of Musculoskeletal and Rheumatic Disorders,
Instituto Nacional de Rehabilitacion, Mexico City, Mexico
| | - Annamaria Iagnocco
- Academic Rheumatology Centre, Dipartimento Scienze
Cliniche e Biologiche, Università degli Studi di Torino, Turin, Italy
| | - Tim L. Jansen
- Department of Rheumatology, VieCuri Medical Center,
Venlo, Noord-Limburg, and University of Twente, Faculty Science & Technology,
Enschede, Netherlands
| | - Minna J. Kohler
- Division of Rheumatology, Allergy, and Immunology,
Massachusetts General Hospital and Harvard Medical School, Boston, United
States
| | - Frédéric Lioté
- Department of Rheumatology, Centre Viggo Petersen,
Hôpital Lariboisière, Université de Paris, Paris, France
| | - Mark Matza
- Division of Rheumatology, Allergy, and Immunology,
Massachusetts General Hospital and Harvard Medical School, Boston, United
States
| | | | - Roberta Ramonda
- Rheumatology Unit, Department of Medicine-DIMED,
University of Padova, Padova, Italy
| | | | - Pascal Richette
- Department of Rheumatology, Centre Viggo Petersen,
Hôpital Lariboisière, Université de Paris, Paris, France
| | - Jasvinder A. Singh
- Division of Rheumatology, University of Alabama at
Birmingham, and Birmingham Veterans Affairs Medical Center, Birmingham, United
States
| | - Francisca Sivera
- Department of Rheumatology, Hospital General
Universitario Elda, Elda, Spain, and Departamento de Medicina, Universidad Miguel
Hernandez, Elche, Spain
| | - Alexander So
- Department of Musculoskeletal Medicine, University
Hospital of Lausanne, Lausanne, Switzerland
| | - Lisa K. Stamp
- Division of Medicine, University of Otago, Christchurch,
New Zealand
| | - Janeth Yinh
- Division of Rheumatology, Allergy, and Immunology,
Massachusetts General Hospital and Harvard Medical School, Boston, United
States
| | - Chio Yokose
- Division of Rheumatology, Allergy, and Immunology,
Massachusetts General Hospital and Harvard Medical School, Boston, United
States
| | - Robert Terkeltaub
- San Diego VA Healthcare Service, Division of
Rheumatology, Allergy and Immunology, University of California-San Diego, San Diego,
United States
| | - Hyon Choi
- Division of Rheumatology, Allergy, and Immunology,
Massachusetts General Hospital and Harvard Medical School, Boston, United
States
| | - Abhishek Abhishek
- Department of Academic Rheumatology, University of
Nottingham, Nottingham, United Kingdom
| |
Collapse
|
9
|
Amic-Desvaud Q, Maillard O, Iacobelli S, Bardin T, Ducrot YM. POS1189 RHEUMATIC FEVER AND CUTANEOUS STREPTOCOCCAL INFECTION: A CASE-CONTROL STUDY IN THE LOYALTY ISLANDS, NEW CALEDONIA. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.4436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundAcute Rheumatic Fever (ARF) and Rheumatic Heart Disease (RHD) remain major public health problems in the South Pacific. Triggering by group A beta hemolytic streptococcal (GAS) skin infection has been suspected but little documented1. Very high incidences of ARF (106/100 000) and cutaneous infections have been reported in the Loyalty islands (New Caledonia), where health care of the 20,000 Melanesian inhabitants is centralized in a few locations and provides an extensive electronic database since 1998, and systematic screening for RHD is regularly performed.ObjectivesTo explore the link between ARF, RHD and skin infections by a retrospective case-control study.MethodsThe study was approved by the New Caledonian committee of Ethics and dealt with patients aged 6 to 26 years, seen from 1998 to 2018. Cases were ARF and/or RHD. Definite ARF was diagnosed according to the Jones criteria2; additional cases with strong clinical suspicion were also included as probable cases. RHD was diagnosed by cardiac ultrasound scan allowing definite and borderline diagnosis2. Sore throat and presumed streptococcal cutaneous infections were diagnosed by an algorithm, previously validated on a sample of 3000 events by an experimented clinician, which identified specific medical terms and ICD-10 codes in the electronic medical records. Each case was matched with 3 controls (without ARF and RHD) of same age, sex and living location. Infections were retrieved from the electronic medical records during the month, 6 months, one year, 5 years preceding the date of the first ARF/RHD diagnosis, for each case with the same index date for its matched control, and since birth. Numbers of infections per these time intervals were compared between cases and controls by univariate and multivariate conditional regression analysis in the total study population and its various subcategories (definite or probable ARF, definite or borderline RHD).Results311 cases of ARF and RHD including 206 definite cases were identified. Polyarthralgias (48%) were the main clinical presentation. Marginal erythema was not seen and Sydenham chorea was rare (6.8%). Mean age of diagnosis was 10.6 ±3.8 years. Skin infection episodes were 3 to 4 times more frequent than sore throats in all studied time-intervals.Multivariate analysis showed an increased exposure to skin infections and sore throats in the year preceding ARF/RHD diagnosis in the whole population of cases as compared to controls (OR 2.18, 95% CI 1.46, 3.26) and 1.54, 95% CI 1.01, 2.36] respectively); skin infections (but not sore throat) were also increased the 206 definite cases (OR 1.34, 95% CI 1.01, 1.80) and in the 220 definite and probable ARF (OR 1.47, 95% CI 1.11, 1.94). In addition we observed a correlation between the seasonality of ARF and skin infections, which were both more frequent during the rainy season, and an overlap of areas with high incidence of ARF and areas with high incidence of skin infections.ConclusionOur results support the hypothesis that GAS skin infections play a role in the pathophysiology of ARF/RHD. In view of these results, there is an urgent need to implement preventive measures to reduce the incidence of skin infections in the Loyalty Islands.References[1]Oliver J, Bennett J, Thomas S, et al. Preceding group A streptococcus skin and throat infections are individually associated with acute rheumatic fever: evidence from New Zealand. BMJ Global Health 2021;6:e007038.[2]Gewitz MH, Baltimore RS, Tani LY et al. American Heart Association Committee on Rheumatic Fever, Endocarditis, and Kawasaki Disease of the Council on Cardiovascular Disease in the Young. Revision of the Jones Criteria for the diagnosis of acute rheumatic fever in the era of Doppler echocardiography: a scientific statement from the American Heart Association. Circulation. 2015 May 19;131(20):1806-18.AcknowledgementsWe would like to thank, Marie-Rose Waia, Emile Gaze, Julien Rannou from Direction de l’Action Communautaire et de l’Action Sociale, Dr Jean-Michel Meunier and Nina Guillot from Agence Sanitaire et Sociale of New CaledoniaDisclosure of InterestsNone declared
Collapse
|
10
|
Chirayath TW, Pham N, Duranton C, Rubera I, Gauffenic A, Cohen Solal M, Latourte A, Bardin T, Richette P, Lioté F, Ea HK. POS1169 THE INFLAMMATION INDUCED BY MONOSODIUM URATE AND CALCIUM PYROPHOSPHATE CRYSTALS DEPENDS ON OSMOLARITY AND AQUAPORIN CHANNELS. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.3571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundThe inflammation induced by monosodium urate (MSU) and calcium pyrophosphate (CPP) crystals is driven by interleukin (IL)-1β production. This later relies on NLRP3 inflammasome which can be activated by variation of ion concentration.ObjectivesTo assess the role of osmolarity and water flux in MSU and CPP crystal-induced inflammation.MethodsIn vitro, THP1 monocytes were stimulated by pyrogen-free synthetic MSU and CPP crystals in iso-, hypo- or hyperosmotic media. Cytokine production was quantified by ELISA in cell culture supernatants. Cell size was measured using video microscopy. The role of aquaporin channels was assessed by pharmacological inhibitor (mercury chloride, HgCl2). In vivo, murine air pouch model was used. MSU and CPP crystals were injected in air pouch of mice treated or not with HgCl2 or mannitol. Osmolarity of mouse sera and patient synovial fluids (SF) were measured using freezing point osmometer. The size of cells collected from SF was assessed with imageJ software.ResultsMSU and CPP crystal-induced IL-1β production was substantially reduced by HgCl2 treatment (MSU 4900 vs 880 pg/ml; CPP 10500 vs 980, p<0.0001) or when cells were cultured in hyperosmotic medium. MSU and CPP crystals induced a transient increase in cell size which was 1.6 and 1.5 bigger after 30 and 100 min of stimulation by MSU and CPP crystals, respectively. After 150 min of stimulation, cell size decreased to their baseline size. Cell size increase was abolished by HgCl2 or hyperosmotic medium. In vivo, MSU and CPP crystal-induced inflammation (assessed by cell infiltration, IL-1β and CXCL2 production in air pouch lavage) was drastically reduced by HgCl2 or mannitol treatment. The serum osmolarity was higher in mannitol-treated mice than untreated mice (320 vs 300 mmosm/L). In patients, cells collected from SF during CPP or MSU crystal-induced flares had a bigger size than cells collected from osteoarthitic SF. The osmolarity of MSU or CPP crystal-containing SF was lower than the osmolarity of osteoarthritic SF (270 vs 310 mmosm/L). Finally, the IL-1β concentration in SF was strongly correlated with cell size and SF osmolarity.ConclusionThese results suggest that the variation of osmolarity plays central role in MSU and CPP crystal-induced inflammation. Deciphering how crystals modulate osmolarity will identify new therapeutic targets.Disclosure of InterestsNone declared
Collapse
|
11
|
Jauffret C, Ottaviani S, Latourte A, Ea HK, Graf S, Lioté F, Bardin T, Richette P, Pascart T. POS1161 CAN DOCTORS TREAT GOUT WELL? INSIGHT ON GOUT MANAGEMENT IN REFERRAL CENTRES. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.2282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundRecent studies have shown a lack of implementation of gout recommendations in primary care. In this context of therapeutic inertia, the French Society of Rheumatology (SFR) published its first recommendations on gout (RECO) in 2020 [1,2], which were deliberately simple and concise.ObjectivesTo determine the profile of patients referred to French gout expert centres, and to examine the results of their management.MethodsThree hundred patients attending a first visit for gout management in three French referral centres were retrospectively included. Visits were performed at baseline (M0) and scheduled for month 6 (M6), month 12 (M12), and month 24 (M24). Data collected included: patient profile; disease activity and treatments; serum urate (SU) level; estimated glomerular filtration rate (eGFR).ResultsPatients were 81% male, mean age 62.2 ± 15.2 years, 42.7% prevalence of eGFR <60ml/min/1.73m2, 28.1% diabetes mellitus, and 25.4% had a history of major cardiovascular event. Management followed French recommendations after the baseline visit in 94.9% of cases. Overall, 50 patients (16.7%) received off-label anakinra for flare treatment or flare prophylaxis. SU levels were below 6.0mg/dL in 59.4% of patients at M6, 67.9% at M12, and 78.6% at M24. At M24, 50% of patients were treated with allopurinol (313 ± 105 mg/d), which exceeded renal restrictions of doses in 61.5% of them, and 48.2% received febuxostat (84 ± 36mg/d). At inclusion, 94% of patients had experienced at least one flare in the previous six months, versus 23.6% at M12, and 13.1% at M24 (of which 8/12 (66.7%) had SU>6.0mg/dL).ConclusionSimple application of gout management guidelines is feasible in clinical practice, and is efficient with a majority of patients achieving SU targets and clinical improvement. A minority of patients in referral centres have ‘difficult-to-treat’ gout requiring specific management.References[1]Latourte A, et al. 2020 Recommendations from the French Society of Rheumatology for the management of gout: Management of acute flares. Joint Bone Spine 2020;87:387-93.[2]Pascart T, et al. 2020 recommendations from the French Society of Rheumatology for the management of gout: Urate-lowering therapy. Joint Bone Spine 2020;87:395- 404.Disclosure of InterestsCharlotte Jauffret: None declared, Sebastien Ottaviani: None declared, Augustin Latourte Consultant of: Novartis, Hang Korng Ea: None declared, Sahara Graf: None declared, Frederic Lioté Grant/research support from: for the European Crystal Network workshops from Astra-Zeneca, Grunenthal, Horizon Pharmaceuticals, Ipsen Pharma, Menarini France and global, Novartis France, Olatec, Selecta, SOBI, Thomas Bardin Consultant of: Astra-Zeneca, Biomex, Grunenthal, Horizon Pharmaceuticals, Ipsen Pharma, Menarini France and global, Novartis France, Savient and Sobi, Pascal Richette: None declared, Tristan Pascart Consultant of: from Novartis, Grant/research support from: from Horizon Pharmaceuticals, Novartis, Variant Bio
Collapse
|
12
|
Bardin T, Ducrot YM, Nguyen Q, Letavernier E, Ea HK, Touzain F, Do DM, Corot J, Barguil Y, Biron A, Richette P, Collet C. POS1165 ASSOCIATION OF LDHD RARE VARIANTS WITH EARLY-ONSET GOUT IN TWO FAMILIES WITH AN ADDITIONAL ASSOCIATION OF RHBG VARIANT IN ONE. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.3016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundElevated lactate is known to favor urine urate reabsorption by the URAT1 urate/anion exchanger. Autosomal recessive gout caused by pathogenic variant in the LDHD gene encoding for D-lactate deshydrogenase has been recently identified in a large consanguineous Bedouin-Israeli kindred (1).ObjectivesWe report here on two families in whom early-onset gout was linked to other variants leading to deficient D-LDH enzymes.MethodsStudies of the two families were approved by appropriate Ethics committees. Whole exome sequencing (WES) was used to identify the genetic cause of familial gout. Dosages of D-lactate were performed on immediately frozen serum and urine samples by ELISA, using a D-lactate colorimetric assay kit (Abcam ab83429).ResultsFamily 1 was Melanesian, living in the Lifou island of New Caledonia. The two index patients were two sisters who developed gout at the age of 13 and 16 years respectively. When seen at the ages of 25 and 27 years, they both had severe gout with frequent polyarticular flares, and multiple tophi and destructive arthropathies in the earliest age of onset one. WES, performed on the 2 affected sisters, their non-consanguine parents, and an unaffected brother, showed that the 2 affected sisters carried homozygous rare variant in DLDH gene (NM_153486.3: c.206 C>T; rs1035398551). This variant was at heterozygote level in both parents and absent in the unaffected brother. It was considered as probably damaging according to in silico prediction software. No association with any other gene was found.The c.206C>T variant in LDHD was searched by Sanger sequencing method in 13 other extended family members. One 23 year-old brother of the two diseased sisters with atypical MTP flares, high uricemia and double contours at US examination of his MTPs, carried the c.206 C>T variant at the homozygous level. Three other heterozygous patients were found; two of whom were male with late-onset gout, the third one being a non-menopausal female with no gout. No variant carrier was found in the other 9 genotyped family members. The 3 homozygous patients for the c.206 C>T variant had very high hyperuricemia (range 738-834 was searched by Sanger sequencing method in 13 other extended family members. One 23 year-old brother of the two diseased sisters with atypical MTP flares, high uricemia and double contours at US examination of had very low or no D-lactate in plasma and urine. L-lactate blood and urine levels were normal in all subjects.Family 2 was Vietnamese, living in a remote area of central Vietnam. The two affected children suffered from an extremely severe, destructive gout, which started at the age of 21 years in a daughter and at the age of 9 in her youngest brother, who had developed for the last 3 years, dysarthria, night shakes, memory loss, urine incontinence and an inability to read and count and died at the age of 34, a few months after being seen by us. WES was performed in the two probands, their father and mother (who denied consanguinity), and an unaffected brother. An undescribed variant in LDHD (NM_153486.3: c.1363dupG) was identified in homozygous level in the 2 juvenile gout patients and at the heterozygous level in their 2 parents and unaffected brother. This variant led to a frameshift followed by a stop codon p.(AlaGly432fsTer58). In addition, the two juvenile gout patients were homozygous for an undescribed frameshift (NR_046115.1: c.1064dup) variant of the RHBG gene encoding for a Rhesus Blood Group family ammonium transporter. The two parents carried the heterozygous variant which was not identified in the non-gout brother.ConclusionWe report on 2 families in whom autosomal recessive juvenile gout was due to rare or undescribed, damaging LDHD gene variants. In addition, we observed in the Vietnamese family, an additional non-described frameshift homozygous variant in RHBG, the pathophysiological role of which deserves to be investigated.References[1]Drabkin M et al. Hyperuricemia and gout caused by missense mutation in D-lactate dehydrogenase. J Clin Invest. 2019;129:5163-5168Disclosure of InterestsThomas Bardin Consultant of: leo Pharma, Yves-Marie Ducrot: None declared, Quang Nguyen: None declared, Emmanuel Letavernier: None declared, Hang-Korng Ea: None declared, Frederic Touzain: None declared, Duc Minh Do: None declared, Julien Corot: None declared, Yan Barguil: None declared, Antoine Biron: None declared, Pascal Richette: None declared, Corinne Collet: None declared
Collapse
|
13
|
Latourte A, Rat AC, Omorou A, Ngueyon-Sime W, Eymard F, Sellam J, Roux C, Ea HK, Cohen-Solal M, Bardin T, Beaudreuil J, Guillemin F, Richette P. Do Glucocorticoid Injections Increase the Risk of Knee Osteoarthritis Progression Over 5 Years? Arthritis Rheumatol 2022; 74:1343-1351. [PMID: 35289131 DOI: 10.1002/art.42118] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Revised: 01/25/2022] [Accepted: 03/09/2022] [Indexed: 12/20/2022]
Abstract
OBJECTIVE Recent findings have demonstrated that intraarticular (IA) glucocorticoid injections can be deleterious for knees with osteoarthritis (OA). This study was undertaken to assess, in a real-life setting, the risk of knee OA progression in patients who received IA glucocorticoid injections over a 5-year follow-up period. METHODS We used marginal structural modeling with inverse probability of treatment weighting to determine the causal association between IA glucocorticoid injections and the 5-year risk of disease progression in patients with symptomatic knee OA from the Knee and Hip Osteoarthritis Long-term Assessment cohort. OA progression was defined as an incident total knee replacement (TKR) and/or radiographic worsening (Kellgren/Lawrence [K/L] grade or joint space narrowing [JSN]). We also examined these outcomes in knees that received IA hyaluronan (IAHA) injections. RESULTS Among the 564 patients with knee OA included in the study sample, 51 (9.0%) and 99 (17.5%) received IA glucocorticoid or IAHA injections, respectively, and 414 (63.1%) did not receive any injection during follow-up. Compared to untreated knees, those treated with IA glucocorticoid injections had a similar risk of incident TKR (hazard ratio [HR] 0.92 [95% confidence interval (95% CI) 0.20, 4.14]; P = 0.91) or K/L grade worsening (HR 1.33 [95% CI 0.64, 2.79]; P = 0.44). IAHA injections had no effect on the risk of TKR (HR 0.81 [95% CI 0.14, 4.63]; P = 0.81) or K/L grade worsening (HR 1.36 [95% CI 0.85, 2.17]; P = 0.20). Similar results were obtained for JSN, and when TKR and radiographic outcomes were combined. CONCLUSION In this study, IA glucocorticoid injections for symptomatic knee OA did not significantly increase the 5-year risk of incident TKR or radiographic worsening. These findings should be interpreted cautiously and replicated in other cohorts.
Collapse
Affiliation(s)
- Augustin Latourte
- Université de Paris, INSERM, UMR-S 1132 BIOSCAR, and Rheumatology Department, AP-HP, Lariboisière Hospital, Paris, France
| | - Anne-Christine Rat
- Caen Normandie University, UMR-S 1075-Mobilités: Vieillissement, Pathologie, Santé COMETE, Caen, France, Rheumatology Department, CHU Caen, Caen, France, and Université de Lorraine, EA 4360, APEMAC, Nancy, France
| | - Abdou Omorou
- Université de Lorraine, EA 4360, APEMAC, and Inserm CIC 1433 Epidémiologie Clinique, CHRU Nancy, Université de Lorraine Vandoeuvre-lès-Nancy, Nancy, France
| | | | - Florent Eymard
- Rheumatology Department, Henri Mondor Hospital, AP-HP, Créteil, France
| | - Jérémie Sellam
- Rheumatology Department, Sorbonne Université, AP-HP, Saint-Antoine Hospital, Inserm UMRS_938, FHU PaCeMM, Paris, France
| | - Christian Roux
- Rheumatology Department, CHU Pasteur 2, LAMHESS EA6309, UMR7277 iBV CNRS, Nice Sophia Antipolis University, France
| | - Hang-Korng Ea
- Université de Paris, INSERM, UMR-S 1132 BIOSCAR, and Rheumatology Department, AP-HP, Lariboisière Hospital, Paris, France
| | - Martine Cohen-Solal
- Université de Paris, INSERM, UMR-S 1132 BIOSCAR, and Rheumatology Department, AP-HP, Lariboisière Hospital, Paris, France
| | - Thomas Bardin
- Université de Paris, INSERM, UMR-S 1132 BIOSCAR, and Rheumatology Department, AP-HP, Lariboisière Hospital, Paris, France
| | - Johann Beaudreuil
- Université de Paris, INSERM, UMR-S 1132 BIOSCAR, and Physical Medicine and Rehabilitation department, Lariboisière-Fernand Widal hospital, Paris, France
| | - Francis Guillemin
- Université de Lorraine, EA 4360, APEMAC, and Inserm CIC 1433 Epidémiologie Clinique, CHRU Nancy, Université de Lorraine Vandoeuvre-lès-Nancy, Nancy, France
| | - Pascal Richette
- Université de Paris, INSERM, UMR-S 1132 BIOSCAR, and Rheumatology Department, AP-HP, Lariboisière Hospital, Paris, France
| |
Collapse
|
14
|
Vigouroux A, Ostertag A, Crémieux AC, Bardin T, Latourte A, Ea HK, Richette P. Eosinopenia to differentiate crystal-induced and septic arthritis. Ann Rheum Dis 2022; 81:1201-1202. [PMID: 35288377 DOI: 10.1136/annrheumdis-2022-222322] [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: 02/09/2022] [Accepted: 02/24/2022] [Indexed: 11/04/2022]
Affiliation(s)
- Agathe Vigouroux
- Service de Rhumatologie, AP-HP, Hôpital Lariboisière, Paris, France
| | - Agnes Ostertag
- Université de Paris, INSERM, UMR-S 1132 BIOSCAR, Paris, France
| | - Anne-Claude Crémieux
- Infectiology Department, Hopital Saint-Louis, Paris, France.,Université de Paris, FHU PROTHEE, Paris, France
| | - Thomas Bardin
- Service de Rhumatologie, AP-HP, Hôpital Lariboisière, Paris, France.,Université de Paris, INSERM, UMR-S 1132 BIOSCAR, Paris, France
| | - Augustin Latourte
- Service de Rhumatologie, AP-HP, Hôpital Lariboisière, Paris, France.,Université de Paris, INSERM, UMR-S 1132 BIOSCAR, Paris, France
| | - Hang-Korng Ea
- Service de Rhumatologie, AP-HP, Hôpital Lariboisière, Paris, France.,Université de Paris, INSERM, UMR-S 1132 BIOSCAR, Paris, France
| | - Pascal Richette
- Service de Rhumatologie, AP-HP, Hôpital Lariboisière, Paris, France .,Université de Paris, INSERM, UMR-S 1132 BIOSCAR, Paris, France
| |
Collapse
|
15
|
Bardin T, Nguyen QD, Hieu NL, Tran KM, Dalbeth N, Do MD, Ea HK, Richette P, Resche-Rigon M, Bousson V. The shrinking toe sign in gout. Semin Arthritis Rheum 2022; 53:151981. [DOI: 10.1016/j.semarthrit.2022.151981] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Revised: 01/22/2022] [Accepted: 02/08/2022] [Indexed: 12/27/2022]
|
16
|
Son CN, Cai K, Stewart S, Ferrier J, Billington K, Tsai YJJ, Bardin T, Horne A, Stamp LK, Doyle A, Dalbeth N. Development of a radiographic scoring system for new bone formation in gout. Arthritis Res Ther 2021; 23:296. [PMID: 34876237 PMCID: PMC8653557 DOI: 10.1186/s13075-021-02683-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Accepted: 11/16/2021] [Indexed: 11/30/2022] Open
Abstract
Background Features of new bone formation (NBF) are common in tophaceous gout. The aim of this project was to develop a plain radiographic scoring system for NBF in gout. Methods Informed by a literature review, scoring systems were tested in 80 individual 1st and 5th metatarsophalangeal joints. Plain radiography scores were compared with computed tomography (CT) measurements of the same joints. The best-performing scoring system was then tested in paired sets of hand and foot radiographs obtained over 2 years from an additional 25 patients. Inter-reader reproducibility was assessed using intraclass correlation coefficients (ICC). NBF scores were correlated with plain radiographic erosion scores (using the gout-modified Sharp-van der Heijde system). Results Following a series of structured reviews of plain radiographs and scoring exercises, a semi-quantitative scoring system for sclerosis and spur was developed. In the individual joint analysis, the inter-observer ICC (95% CI) was 0.84 (0.76–0.89) for sclerosis and 0.81 (0.72–0.87) for spur. Plain radiographic sclerosis and spur scores correlated with CT measurements (r = 0.65–0.74, P < 0.001 for all analyses). For the hand and foot radiograph sets, the inter-observer ICC (95% CI) was 0.94 (0.90–0.98) for sclerosis score and 0.76 (0.65–0.84) for spur score. Sclerosis and spur scores correlated highly with plain radiographic erosion scores (r = 0.87 and 0.71 respectively), but not with change in erosion scores over 2 years (r = −0.04–0.15). Conclusion A semi-quantitative plain radiographic scoring method for the assessment of NBF in gout is feasible, valid, and reproducible. This method may facilitate consistent measurement of NBF in gout. Supplementary Information The online version contains supplementary material available at 10.1186/s13075-021-02683-9.
Collapse
Affiliation(s)
- Chang-Nam Son
- Keimyung University School of Medicine, Daegu, South Korea. .,Department of Medicine, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand.
| | - Ken Cai
- Department of Medicine, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - Sarah Stewart
- Department of Medicine, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - John Ferrier
- Department of Radiology, Auckland District Health Board, Auckland, New Zealand
| | - Karen Billington
- Department of Radiology, Auckland District Health Board, Auckland, New Zealand
| | - Yun-Jung Jack Tsai
- Department of Radiology, Auckland District Health Board, Auckland, New Zealand
| | - Thomas Bardin
- Department of Rheumatology, Hôpital Lariboisière, Paris, France
| | - Anne Horne
- Department of Medicine, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - Lisa K Stamp
- Department of Medicine, University of Otago Christchurch, Christchurch, New Zealand
| | - Anthony Doyle
- Department of Radiology with Anatomy, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - Nicola Dalbeth
- Department of Medicine, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| |
Collapse
|
17
|
Chabernaud Negrier A, Taihi L, Vicaut E, Richette P, Bardin T, Lioté F, Ea HK, Bousson V. Distribution of bony erosions in feet and performance of two bone erosion scores: A dual-energy computed tomography study of 61 patients with gout. PLoS One 2021; 16:e0259194. [PMID: 34727118 PMCID: PMC8562819 DOI: 10.1371/journal.pone.0259194] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Accepted: 10/14/2021] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVES To assess the distribution of bone erosions and two erosion scores in the feet of patients with gout and analyze the association between erosion scores and monosodium urate (MSU) crystal deposition using dual-energy computed tomography (DECT). MATERIALS AND METHODS We included all patients who underwent DECT of both feet between 2016 and 2019 in our radiology department, with positive detection of MSU deposits. Data on sex, age, treatment, serum urate, and DECT urate volumes were obtained. CT images were analyzed to score bone erosions in 31 sites per foot by using the semi-quantitative method based on the Rheumatoid Arthritis MRI Scoring (RAMRIS) system and the Dalbeth-simplified score. Reproducibility for the two scores was calculated with intraclass correlation coefficients (ICCs). Correlations between clinical features, erosion scores and urate crystal volume were analyzed by the Spearman correlation coefficient (r). RESULTS We studied 61 patients (mean age 62.0 years); 3,751 bones were scored. The first metatarsophalangeal joint and the midfoot were the most involved in terms of frequency and severity of bone erosions. The distribution of bone erosions was not asymmetrical. The intra- and inter-observer reproducibility was similar for the RAMRIS and Dalbeth-simplified scores (ICC 0.93 vs 0.94 and 0.96 vs 0.90). DECT urate volume was significantly correlated with each of the two erosion scores (r = 0.58-0.63, p < 0.001). There was a high correlation between the two scores (r = 0.96, p < 0.001). CONCLUSIONS DECT demonstrates that foot erosions are not asymmetric in distribution and predominate at the first ray and midfoot. The two erosion scores are significantly correlated with DECT urate volume. An almost perfect correlation between the RAMRIS and Dalbeth-simplified scores is observed.
Collapse
Affiliation(s)
| | - Lokmane Taihi
- Service de Radiologie, Hôpital Lariboisière, AP-HP.Nord-Université de Paris, Paris, France
| | - Eric Vicaut
- Unité de Recherche Clinique, Hôpitaux Lariboisière, Fernand Widal, Saint Louis, AP-HP.Nord-Université de Paris, Paris, France
| | - Pascal Richette
- Service de Rhumatologie, INSERM UMR 1132, Hôpital Lariboisière, AP-HP.Nord-Université de Paris, Paris, France
| | - Thomas Bardin
- Service de Rhumatologie, INSERM UMR 1132, Hôpital Lariboisière, AP-HP.Nord-Université de Paris, Paris, France
| | - Frédéric Lioté
- Service de Rhumatologie, INSERM UMR 1132, Hôpital Lariboisière, AP-HP.Nord-Université de Paris, Paris, France
| | - Hang-Korng Ea
- Service de Rhumatologie, INSERM UMR 1132, Hôpital Lariboisière, AP-HP.Nord-Université de Paris, Paris, France
| | - Valérie Bousson
- Service de Radiologie, Hôpital Lariboisière, AP-HP.Nord-Université de Paris, Paris, France
- * E-mail:
| |
Collapse
|
18
|
Bardin T, Magnat E, Clerson P, Richette P, Rouchon B. Epidemiology of gout and hyperuricemia in New Caledonia. Joint Bone Spine 2021; 89:105286. [PMID: 34601114 DOI: 10.1016/j.jbspin.2021.105286] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Accepted: 09/23/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVES New Caledonia is a Pacific island of 270,000 inhabitants with mixed ethnicities, including Polynesians (10.2%), people from European ancestry (27.2%), and Melanesians (39.1%),. This study aimed at determining the prevalence of gout and hyperuricemia in the general population and the various ethnicities of New Caledonia. METHODS A 3-degree random sample of the population aged 18 to 60 years was adjusted according to the 2014 New Caledonia census. Face-to-face planned interviews and physical measurements were performed by trained nurses. All consenting participants underwent capillary measurement of creatinine; all consenting men and only women older than 40 years underwent point-of-care uricemia testing. Gout was defined by a validated algorithm. Two definitions of hyperuricemia were used: capillary level equivalent to plasma uric acid level>360μmol/l (6mg/dl) and>420μmol/l (7mg/dl) and/or urate-lowering drug treatment for both thresholds. RESULTS We included 1144 participants (adjusted mean age 37.7±12.0 years; adjusted sex ratio 50.4% men). The adjusted prevalence of gout was 3.3% (95% confidence interval 2.2-4.9). Prevalence was 6.7% (2.5-16.8), 4.1% (1.8-8.9), and 2.6% (1.4-4.7) for Polynesians, Europeans and Melanesians, respectively, and 1.9% (0.5-6.6) for other ethnicities. Prevalence of hyperuricemia, determined in 658 participants, was 67.0% (61.9-71.6) and 37.0% (32.3-42.0) for the 360- and 420-μmol/l thresholds, respectively, and was significantly greater for Polynesians and Melanesians than Europeans for both thresholds. CONCLUSIONS The prevalence of gout and hyperuricemia in New Caledonia was high, including in patients of European descent.
Collapse
Affiliation(s)
- Thomas Bardin
- Department of Rheumatology, Lariboisière hospital APHP Paris Nord, and Université de Paris, INSERM U1132, Paris, France.
| | | | | | - Pascal Richette
- Department of Rheumatology, Lariboisière hospital APHP Paris Nord, and Université de Paris, INSERM U1132, Paris, France
| | | |
Collapse
|
19
|
Chotard E, Blanchard A, Ostertag A, Latourte A, Gailly G, Frochot V, Lioté F, Bousson V, Richette P, Bardin T, Vargas-Poussou R, Ea HK. Calcium Pyrophosphate Crystal Deposition in a Cohort of 57 Patients with Gitelman Syndrome. Rheumatology (Oxford) 2021; 61:2494-2503. [PMID: 34508565 DOI: 10.1093/rheumatology/keab578] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 07/06/2021] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVE Gitelman syndrome (GS) is the most frequent salt-wasting genetic tubulopathy and a source of hypokalaemia and hypomagnesemia. Chondrocalcinosis (CC) is a frequent feature of GS. The aim of our study was to determine the prevalence, distribution patterns, clinical phenotypes and risk factors of CC in GS. METHODS This prospective study of a cohort of 57 patients with GS included a systematic screening for CC by peripheral joint radiography, cervical spine computerized tomography (CT) and joint ultrasonography. The prevalence of cervical C1-C2 CC by CT was compared between 33 GS patients and sex- and age-matched controls. Clinical and biochemical features were analysed to identify factors associated with CC. RESULTS Mean age of patients was 46.5 ± 12.4 years, 66.7% were women, and 93.0% carried SLC12A3 mutations. Mean serum magnesium level was 0.60 ± 0.30 mmol/l. CC was observed in 79% of patients, with the highest prevalence at the cervical spine (81.8%) followed by the knee (52.6%), wrist (50.9%), ankle (38.6%), temporomandibular joint (36.4%), shoulder (33.3%), hip (22.8%), elbow (14.0%) and sclero-choroid (12.1%). Prevalence of CC at the C1-C2 level was higher in the GS cohort than control group (72.7% vs 9.1%) (adjusted odds ratio 21.0, 95% CI 2.8-156.1, p= 0.003). Independent factors associated with CC were low serum magnesium level and age. CONCLUSION GS was associated with widespread CC, favoured by aging and hypomagnesemia. The C1-C2 level was the most affected site. Follow-up of this unique cohort will help understanding the clinical consequences of CC, especially the precise characterization of pyrophosphate arthropathy.
Collapse
Affiliation(s)
- Emile Chotard
- Université de Paris, INSERM UMR 1132, BIOSCAR, Hôpital Lariboisière, Service de rhumatologie, centre Viggo Petersen, DMU locomotion, APHP, Paris, France
| | - Anne Blanchard
- AP-HP, Hôpital européen Georges Pompidou, service de néphrologie, Paris, France
| | - Agnès Ostertag
- Université de Paris, INSERM UMR 1132, BIOSCAR, Hôpital Lariboisière, Service de rhumatologie, centre Viggo Petersen, DMU locomotion, APHP, Paris, France
| | - Augustin Latourte
- Université de Paris, INSERM UMR 1132, BIOSCAR, Hôpital Lariboisière, Service de rhumatologie, centre Viggo Petersen, DMU locomotion, APHP, Paris, France
| | - Gilles Gailly
- Université de Paris, INSERM UMR 1132, BIOSCAR, Hôpital Lariboisière, Service de rhumatologie, centre Viggo Petersen, DMU locomotion, APHP, Paris, France
| | - Vincent Frochot
- Hôpital Tenon, Service des explorations fonctionnelles multidisciplinaires, Sorbonne université, UMR_S1155, Paris, France
| | - Frédéric Lioté
- Université de Paris, INSERM UMR 1132, BIOSCAR, Hôpital Lariboisière, Service de rhumatologie, centre Viggo Petersen, DMU locomotion, APHP, Paris, France
| | - Valérie Bousson
- Université de Paris, hôpital Lariboisière, Service de radiologie, Paris, France
| | - Pascal Richette
- Université de Paris, INSERM UMR 1132, BIOSCAR, Hôpital Lariboisière, Service de rhumatologie, centre Viggo Petersen, DMU locomotion, APHP, Paris, France
| | - Thomas Bardin
- Université de Paris, INSERM UMR 1132, BIOSCAR, Hôpital Lariboisière, Service de rhumatologie, centre Viggo Petersen, DMU locomotion, APHP, Paris, France
| | - Rosa Vargas-Poussou
- AP-HP, Hôpital européen Georges Pompidou, service de génétique, Paris, France
| | - Hang Korng Ea
- Université de Paris, INSERM UMR 1132, BIOSCAR, Hôpital Lariboisière, Service de rhumatologie, centre Viggo Petersen, DMU locomotion, APHP, Paris, France
| |
Collapse
|
20
|
Tedeschi S, Pascart T, Latourte A, Godsave C, Kundaki B, Naden R, Taylor W, Dalbeth N, Neogi T, Perez-Ruiz F, Rosenthal A, Becce F, Pascual E, Andrés M, Bardin T, Doherty M, Ea HK, Filippou G, Fitzgerald J, Gutierrez M, Iagnocco A, Jansen T, Kohler M, Lioté F, Matza M, Mccarthy G, Ramonda R, Reginato A, Richette P, Singh J, Sivera F, So A, Stamp L, Yinh J, Yokose C, Terkeltaub R, Choi H, Abhishek A. POS1124 IDENTIFYING POTENTIAL CLASSIFICATION CRITERIA FOR CALCIUM PYROPHOSPHATE DEPOSITION DISEASE (CPPD): RESULTS FROM THE INITIAL PHASES. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Background:Classification criteria for calcium pyrophosphate deposition disease (CPPD) will facilitate clinical research on this common crystalline arthritis. ACR/EULAR are jointly sponsoring development of CPPD classification criteria using a multi-phase process.Objectives:To report preliminary results from the first two phases of a four-phase process for developing CPPD classification criteria.Methods:CPPD classification criteria development is overseen by a 12-member Steering Committee. Item generation (Phase I) included a scoping literature review of five literature databases and contributions from a 35-member Combined Expert Committee and two Patient Research Partners. Item reduction and refinement (Phase II) involved a Combined Expert Committee meeting, discussions among Clinical, Imaging, and Laboratory Advisory Groups, and an item rating exercise to assess the influence of individual items toward classification. The Steering Committee reviewed the modal rating score for each item (range -3 [strongly pushes away from CPPD] to +3 [strongly pushes toward CPPD]) to determine items to retain for future phases of criteria development.Results:Item generation yielded 420 items (312 from the literature, 108 from experts/patients). The Advisory Groups eliminated items they agreed were unlikely to distinguish between CPPD and other forms of arthritis, yielding 127 items for the item rating exercise. Fifty-six items, most of which had a modal rating of +/- 2 or 3, were retained for future phases (see Table 1). As numerous imaging items were rated +3, the Steering Committee recommended focusing on imaging of the knee, wrist, and one additional affected joint for calcification suggestive of CPP crystal deposition.Conclusion:The ACR/EULAR CPPD classification criteria working group has adopted both data- and expert-driven approaches, leading to 56 candidate items broadly categorized as clinical, imaging, and laboratory features. Remaining steps for criteria development include domain establishment, item weighting through a multi-criteria decision analysis exercise, threshold score determination, and criteria validation.Table 1.Categories of items retained for future phases of classification criteria developmentAge in decade at symptom onsetAcute inflammatory arthritis (e.g. knee, wrist, 1st MTP joint*)Recurrence and pattern of joint involvement (e.g. 1 self-limited episode, >1 self-limited episode)Physical findings (e.g. palpable subcutaneous tophus*, psoriasis*)Co-morbidities and family history (e.g. Gitelman disease, hemochromatosis, familial CPPD)Osteoarthritis location and features (e.g. 2nd or 3rd MCP joint, wrist)Synovial fluid findings (e.g. CPP crystals present, CPP crystals absent on 1 occasion* or 2 occasions*, monosodium urate crystals present*)Laboratory findings (e.g. hypomagnesemia, hyperparathyroidism, rheumatoid factor*, anti-CCP*)Plain radiograph: calcification in regions of fibro- or hyaline cartilage+Plain radiograph: calcification of the synovial membrane/capsule/tendon+Conventional CT: calcification in regions of fibro- or hyaline cartilage+Conventional CT: calcification of the synovial membrane/capsule/tendon+Ultrasound: CPP crystal deposition in fibro- or hyaline cartilage+Ultrasound: CPP crystal deposition in synovial membrane/capsule/tendons+Dual-energy CT: CPP crystal deposition in fibro- or hyaline cartilage+Dual-energy CT: CPP crystal deposition in synovial membrane/capsule/tendon+*Potential negative predictor +Assessed in the knee, wrist, and/or 1 additional affected jointDisclosure of Interests:Sara Tedeschi Consultant of: NGM Biopharmaceuticals, Tristan Pascart: None declared, Augustin Latourte Consultant of: Novartis, Cattleya Godsave: None declared, Burak Kundaki: None declared, Raymond Naden: None declared, William Taylor: None declared, Nicola Dalbeth Speakers bureau: Abbvie and Janssen, Consultant of: AstraZeneca, Dyve, Selecta, Horizon, Arthrosi, and Cello Health, Tuhina Neogi: None declared, Fernando Perez-Ruiz: None declared, Ann Rosenthal: None declared, Fabio Becce Consultant of: Horizon Therapeutics, Grant/research support from: Siemens Healthineers, Eliseo Pascual: None declared, Mariano Andrés: None declared, Thomas Bardin: None declared, Michael Doherty: None declared, Hang Korng Ea: None declared, Georgios Filippou: None declared, John FitzGerald: None declared, Marwin Gutierrez: None declared, Annamaria Iagnocco: None declared, Tim Jansen Speakers bureau: Abbvie, Amgen, BMS, Grunenthal, Olatec, Sanofi Genzyme, Consultant of: Abbvie, Amgen, BMS, Grunenthal, Olatec, Sanofi Genzyme, Minna Kohler Speakers bureau: Lilly, Consultant of: Novartis, Frederic Lioté: None declared, Mark Matza: None declared, Geraldine McCarthy Consultant of: PK Med, Roberta Ramonda: None declared, Anthony Reginato: None declared, Pascal Richette: None declared, Jasvinder Singh Speakers bureau: Simply Speaking, Consultant of: Crealta/Horizon, Medisys, Fidia, UBM LLC, Trio health, Medscape, WebMD, Adept Field Solutions, Clinical Care options, Clearview healthcare partners, Putnam associates, Focus forward, Navigant consulting, Spherix, Practice Point communications, Francisca Sivera: None declared, Alexander So: None declared, Lisa Stamp: None declared, Janeth Yinh: None declared, Chio Yokose: None declared, Robert Terkeltaub Consultant of: Sobi, Horizon Therapeutics, Astra-Zeneca, Selecta, Grant/research support from: Astra-Zeneca, Hyon Choi: None declared, Abhishek Abhishek Consultant of: NGM Biopharmaceuticals.
Collapse
|
21
|
Ea HK, Gauffenic A, Nguyen QD, Pham NG, Olivier O, Frochot V, Bazin D, Le NH, Marty C, Ostertag A, Cohen-Solal M, Laredo JD, Richette P, Bardin T. Calcium Pyrophosphate Dihydrate Crystal Deposition in Gouty Tophi. Arthritis Rheumatol 2020; 73:324-329. [PMID: 32909692 DOI: 10.1002/art.41515] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Accepted: 08/25/2020] [Indexed: 12/13/2022]
Abstract
OBJECTIVE The coexistence of calcium pyrophosphate dihydrate (CPPD) and monosodium urate monohydrate crystals in gouty tophi has rarely been reported. We undertook this study to investigate CPPD crystal deposits in a series of surgically removed gouty tophi and to identify factors associated with these deposits. METHODS Twenty-five tophi from 22 gout patients were analyzed using polarized light microscopy, field emission scanning electron microscopy (FESEM), and μ Fourier transform infrared (μFTIR) spectroscopy. RESULTS Tophi consisted of multiple lobules separated by fibrous septa and surrounded by a foreign-body giant cell reaction. CPPD crystal aggregates were identified in 9 of 25 tophi from 6 patients. CPPD crystals were dispersed or highly compacted, localized at the edge or inside the tophus lobules, with some lobules completely filled with crystals. Both monoclinic and triclinic CPPD crystal phases were identified using FESEM and μFTIR. Compared to patients without CPPD, those with CPPD-containing tophi were older (mean 60.5 years versus 47.2 years; P = 0.009), and had longer-term gout duration (mean 17.0 years versus mean 9.0 years; P < 0.05) and tophi duration (mean 10.0 years versus mean 4.6 years; P < 0.01). None of the patients had radiographic chondrocalcinosis of the knee or wrist. CONCLUSION CPPD crystal formation seems to be a late and frequent event of tophus maturation, occurring more frequently with aging, and could contribute to the speed of tophus dissolution and the apparent persistence of tophus sometimes observed even after effective, long-lasting urate-lowering therapy.
Collapse
Affiliation(s)
- Hang-Korng Ea
- Université de Paris, INSERM UMR 1132, Hôpital Lariboisière, AP-HP, Paris, France
| | - Alan Gauffenic
- Université de Paris, INSERM UMR 1132, Hôpital Lariboisière, AP-HP, Paris, France
| | - Quang Dinh Nguyen
- Vien Gut Medical Center and French-Vietnamese Research Center on Gout and Chronic Diseases, Ho Chi Minh City, Vietnam
| | - Nhu G Pham
- Vien Gut Medical Center and French-Vietnamese Research Center on Gout and Chronic Diseases, Ho Chi Minh City, Vietnam
| | - Océane Olivier
- Université de Paris, INSERM UMR 1132, Hôpital Lariboisière, AP-HP, Paris, France
| | - Vincent Frochot
- Hôpital Tenon and Sorbonne Université, UMR S1155, Paris, France
| | - Dominique Bazin
- Institut de Chimie Physique, Université Paris-Saclay, CNRS UMR 8000, Orsay, France
| | - Nghia H Le
- Vien Gut Medical Center and French-Vietnamese Research Center on Gout and Chronic Diseases, Ho Chi Minh City, Vietnam
| | - Caroline Marty
- Université de Paris, INSERM UMR 1132, Hôpital Lariboisière, AP-HP, Paris, France
| | - Agnès Ostertag
- Université de Paris, INSERM UMR 1132, Hôpital Lariboisière, AP-HP, Paris, France
| | - Martine Cohen-Solal
- Université de Paris, INSERM UMR 1132, Hôpital Lariboisière, AP-HP, Paris, France
| | | | - Pascal Richette
- Université de Paris, INSERM UMR 1132, Hôpital Lariboisière, AP-HP, Paris, France
| | - Thomas Bardin
- Université de Paris, INSERM UMR 1132, Hôpital Lariboisière, AP-HP, Paris, France, and Vien Gut Medical Center and French-Vietnamese research center on gout and chronic diseases, Ho Chi Minh City, Vietnam
| |
Collapse
|
22
|
Affiliation(s)
- Thomas Bardin
- Department of Rheumatology, Hôpital Lariboisière APHP Paris Nord and Université de Paris, INSERM, UMR 1132, Bioscar, F-75010 Paris, France; French Vietnamese Research Center on Gout and Chronic Diseases, Vien Gut Medical Center, Ho Chi Minh City, Vietnam.
| | - Pascal Richette
- Department of Rheumatology, Hôpital Lariboisière APHP Paris Nord and Université de Paris, INSERM, UMR 1132, Bioscar, F-75010 Paris, France
| |
Collapse
|
23
|
Ebstein E, Forien M, Norkuviene E, Richette P, Mouterde G, Daien C, Ea HK, Brière C, Lioté F, Petraitis M, Bardin T, Ora J, Dieudé P, Ottaviani S. UltraSound evaluation in follow-up of urate-lowering therapy in gout phase 2 (USEFUL-2): Duration of flare prophylaxis. Joint Bone Spine 2020; 87:647-651. [PMID: 32979555 DOI: 10.1016/j.jbspin.2020.09.014] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [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] [Accepted: 10/15/2019] [Indexed: 01/22/2023]
Abstract
OBJECTIVES To determine whether changes in ultrasonography (US) features of monosodium urate crystal deposition is associated with the number of gouty flares after stopping gout flare prophylaxis. METHODS We performed a 1-year multicentre prospective study including patients with proven gout and US features of gout. The first phase of the study was a 6-month US follow-up after starting urate-lowering therapy (ULT) with gout flare prophylaxis. After 6 months of ULT, gout flare prophylaxis was stopped, followed by a clinical follow-up (M6 to 12) and ULT was maintained. Outcomes were the proportion of relapsing patients between M6 and M12 according to changes of US features of gout and determining a threshold decrease in tophus size according to the probability of relapse. RESULTS We included 79 gouty patients [mean (±SD) age 61.8±14 years, 91% males, median disease duration 4 (IQR 1.5;10) years]. Among the 49 completers at M12, 23 (47%) experienced relapse. Decrease in tophus size ≥50% at M6 was more frequent without than with relapse (54% vs. 26%, P=0.049). On ROC curve analysis, a threshold decrease of 50.8% in tophus size had the best sensitivity/specificity ratio to predict relapse [AUC 0.649 (95% confidence interval 0.488; 0.809)]. Probability of relapse was increased for patients with a decrease in tophus size <50% between M0 and M6 [OR 3.35 (95% confidence interval 0.98; 11.44)]. CONCLUSION A high reduction in US tophus size is associated with lower probability of relapse after stopping gout prophylaxis. US follow-up may be useful for managing ULT and gout flare prophylaxis.
Collapse
Affiliation(s)
- Esther Ebstein
- Rheumatology Department, DHU FIRE, Pôle infection immunité, Bichat Hospital (AP-HP), 75018 Paris, France
| | - Marine Forien
- Rheumatology Department, DHU FIRE, Pôle infection immunité, Bichat Hospital (AP-HP), 75018 Paris, France
| | - Eleonora Norkuviene
- Rheumatology Department, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Pascal Richette
- Rheumatology Department, centre Viggo Petersen, pole appareil locomoteur, Lariboisière Hospital (AP-HP); Inserm UMR 1132, USPC, 75010 Paris, France
| | - Gaël Mouterde
- Rheumatology Department, Lapeyronie hospital, EA 2415, Montpellier University, 34090 Montpellier, France
| | - Claire Daien
- Rheumatology Department, Lapeyronie hospital, EA 2415, Montpellier University, 34090 Montpellier, France
| | - Hang-Korng Ea
- Rheumatology Department, centre Viggo Petersen, pole appareil locomoteur, Lariboisière Hospital (AP-HP); Inserm UMR 1132, USPC, 75010 Paris, France
| | - Claire Brière
- Rheumatology Department, centre Viggo Petersen, pole appareil locomoteur, Lariboisière Hospital (AP-HP); Inserm UMR 1132, USPC, 75010 Paris, France
| | - Frédéric Lioté
- Rheumatology Department, centre Viggo Petersen, pole appareil locomoteur, Lariboisière Hospital (AP-HP); Inserm UMR 1132, USPC, 75010 Paris, France
| | - Mykolas Petraitis
- Rheumatology Department, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Thomas Bardin
- Rheumatology Department, centre Viggo Petersen, pole appareil locomoteur, Lariboisière Hospital (AP-HP); Inserm UMR 1132, USPC, 75010 Paris, France
| | - Jérémy Ora
- Rheumatology Department, centre Viggo Petersen, pole appareil locomoteur, Lariboisière Hospital (AP-HP); Inserm UMR 1132, USPC, 75010 Paris, France
| | - Philippe Dieudé
- Rheumatology Department, DHU FIRE, Pôle infection immunité, Bichat Hospital (AP-HP), 75018 Paris, France
| | - Sébastien Ottaviani
- Rheumatology Department, DHU FIRE, Pôle infection immunité, Bichat Hospital (AP-HP), 75018 Paris, France.
| |
Collapse
|
24
|
Bardin T, Nguyen QD, Tran KM, Le NH, Do MD, Richette P, Letavernier E, Correas JM, Resche-Rigon M. A cross-sectional study of 502 patients found a diffuse hyperechoic kidney medulla pattern in patients with severe gout. Kidney Int 2020; 99:218-226. [PMID: 32898570 DOI: 10.1016/j.kint.2020.08.024] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Revised: 08/18/2020] [Accepted: 08/27/2020] [Indexed: 12/27/2022]
Abstract
We have previously shown that ultrasonography can detect hyperechogenic crystal deposits in the kidney medulla of patients with gout. In this cross-sectional study we investigated the frequency and clinical correlates of hyperechogenic kidney medulla in 502 consecutive primary consultants for gout (ACR/EULAR criteria) at the Vien Gut medical center in Ho Chi Minh City, Vietnam. None of these patients received urate-lowering drugs. Kidney medulla echogenicity on B-mode ultrasonography was compared to that of the kidney cortex. Overall, 36% patients showed a hyperechoic pattern of Malpighi pyramids. On univariate analysis, the pattern was significantly associated with age, estimated gout duration, steroid-dependency, clinical tophi, urate arthropathy, double contour thickness at the scanned joints, coronary heart disease, arterial hypertension, hyperuricemia, proteinuria, leukocyturia, and decreased estimated glomerular filtration rate. On multivariable analysis, the hyperechoic pattern was associated with estimated disease duration, clinical tophi, urate arthropathy, double contour thickness and decreased estimated glomerular filtration rate. No hyperechoic pattern was observed in 515 consecutive consultants without gout. Thus, hyperechoic kidney medulla was frequently demonstrated in Vietnamese patients with tophaceous gout and associated with features of tubulointerstitial nephritis. This finding revives the hypothesis of microcrystalline nephropathy of gout, predominantly seen in untreated gouty patients, which could be an important target for urate-lowering therapy.
Collapse
Affiliation(s)
- Thomas Bardin
- French-Vietnamese Research Center on Gout and Chronic Diseases, Vien Gut Medical Center, Ho Chi Minh City, Vietnam; Department of Rheumatology, Hôpital Lariboisière APHP, Paris, France; Université de Paris, INSERM U1132, Paris, France.
| | - Quang D Nguyen
- French-Vietnamese Research Center on Gout and Chronic Diseases, Vien Gut Medical Center, Ho Chi Minh City, Vietnam
| | - Khoy M Tran
- French-Vietnamese Research Center on Gout and Chronic Diseases, Vien Gut Medical Center, Ho Chi Minh City, Vietnam
| | - Nghia H Le
- French-Vietnamese Research Center on Gout and Chronic Diseases, Vien Gut Medical Center, Ho Chi Minh City, Vietnam
| | - Minh D Do
- Center for Molecular Biomedicine, University of Medicine and Pharmacy at Ho Chi Min City, Vietnam
| | - Pascal Richette
- Department of Rheumatology, Hôpital Lariboisière APHP, Paris, France; Université de Paris, INSERM U1132, Paris, France
| | - Emmanuel Letavernier
- Department of Physiology, Hôpital Tenon, APHP, Paris, France; Sorbonne Université and INSERM, UMR S 1155, Hôpital Tenon, Paris, France
| | - Jean-Michel Correas
- Department of Radiology, Hôpital Necker, APHP, Paris, France; Université de Paris, Paris, France
| | - Mathieu Resche-Rigon
- French-Vietnamese Research Center on Gout and Chronic Diseases, Vien Gut Medical Center, Ho Chi Minh City, Vietnam; Department of Biostatistics, Hôpital Saint Louis, APHP, Paris, France; Université de Paris, UMR U1153 ECSTRA team INERM, Paris, France
| |
Collapse
|
25
|
Bousson V, Bardin T, Ea HK. Answer to Checa « Coexistence of gout and chondrocalcinosis instead? », Joint Bone Spine 2020. doi:10.1016/j.jbspin.2020.07.007. Joint Bone Spine 2020; 87:678-679. [PMID: 32771437 DOI: 10.1016/j.jbspin.2020.07.010] [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: 06/28/2020] [Accepted: 07/16/2020] [Indexed: 10/23/2022]
Affiliation(s)
- Valérie Bousson
- Service de radiologie ostéo-Articulaire, hôpital Lariboisière, AP-HP-Nord, université de Paris, 2, rue Ambroise-Paré, 75010 Paris, France.
| | - Thomas Bardin
- Service de radiologie ostéo-Articulaire, hôpital Lariboisière, AP-HP-Nord, université de Paris, 2, rue Ambroise-Paré, 75010 Paris, France
| | - Hang-Korng Ea
- Service de radiologie ostéo-Articulaire, hôpital Lariboisière, AP-HP-Nord, université de Paris, 2, rue Ambroise-Paré, 75010 Paris, France
| |
Collapse
|
26
|
Do MD, Mai TP, Do AD, Nguyen QD, Le NH, Le LGH, Hoang VA, Le AN, Le HQ, Richette P, Resche-Rigon M, Bardin T. Risk factors for cutaneous reactions to allopurinol in Kinh Vietnamese: results from a case-control study. Arthritis Res Ther 2020; 22:182. [PMID: 32746911 PMCID: PMC7397637 DOI: 10.1186/s13075-020-02273-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [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: 02/21/2020] [Accepted: 07/20/2020] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVE The aim of this study was to investigate risk factors for cutaneous adverse reactions (CARs) in Kinh Vietnamese. METHODS All patients were prospectively recruited in Ho Chi Minh City. Presence of the HLA-B*58:01 allele was determined by real-time PCR-sequence-specific amplification by using the PG5801 Detection Kit (Pharmigene, Taipei). Patients with severe (SCARs) and mild (MCARs) CARs and controls were compared for differences in features prospectively collected, and odds ratios (ORs) with 95% confidence intervals (CIs) were estimated. RESULTS On comparing 32 patients with SCARs and 395 tolerant controls, we identified eight strong risk factors: increased age (OR 15.1 [95% CI 5.8-40.1], P < 0.0001), female sex (OR 333 [40-43,453], P < 0.0001), allopurinol for asymptomatic hyperuricemia (OR 955 [120-125,847], P < 0.0001), allopurinol starting dose > 150 mg (OR 316 [101-122], P < 0.0001), diuretics intake (OR 304 [35-40,018], P < 0.0001), eGFR < 60 ml/min/1.73 m2 (OR 100 [32-353], P < 0.0001), history of allopurinol-induced skin reaction (OR 78 [6-10,808], P = 0.004), and HLA-B*58:01 carriage (OR 147 [45-746], P < 0.0001). HLA-B*58:01 allele frequency in controls was 7.3%. For MCARs (n = 74), risk factors were eGFR < 60 ml/min/1.73 m2 (OR 4.9 [1.61-14.6], P = 0.006), history of allopurinol-induced skin reaction (OR 27 [2-3777], P = 0.01), and asymptomatic hyperuricemia (OR 27 [2-3777], P = 0.01). CONCLUSION This study confirmed 8 risk factors, including HLA-B*58:01, for SCARs and identified 3 risk factors for MCARs in Kinh Vietnamese. HLA-B*58:01 genotyping could guide the indication for allopurinol in Kinh Vietnamese patients with gout.
Collapse
Affiliation(s)
- Minh Duc Do
- Center for Molecular Biomedicine, University of Medicine and Pharmacy, at Ho Chi Minh City, Vietnam
| | - Thao Phuong Mai
- Department of Physiology, Pathophysiology and Immunology, Faculty of Medicine, University of Medicine and Pharmacy, Ho Chi Minh City, Vietnam
| | - Anh Duy Do
- Department of Physiology, Pathophysiology and Immunology, Pham Ngoc Thach University of Medicine, Ho Chi Minh City, Vietnam
| | - Quang Dinh Nguyen
- French Vietnamese Research Center on Gout and Chronic Diseases, Vien Gut Medical Centre, Ho Chi Minh City, Vietnam
| | - Nghia Hieu Le
- French Vietnamese Research Center on Gout and Chronic Diseases, Vien Gut Medical Centre, Ho Chi Minh City, Vietnam
| | - Linh Gia Hoang Le
- Center for Molecular Biomedicine, University of Medicine and Pharmacy, at Ho Chi Minh City, Vietnam
| | - Vu Anh Hoang
- Center for Molecular Biomedicine, University of Medicine and Pharmacy, at Ho Chi Minh City, Vietnam
| | - Anh Ngoc Le
- Department of Scientific Research, Cho Ray Hospital, Ho Chi Minh City, Vietnam
| | - Hung Quoc Le
- Department of Tropical Disease, Cho Ray Hospital, Ho Chi Minh City, Vietnam
| | - Pascal Richette
- Université de Paris, U1132, INSERM, 75010, Paris, France.,Department of Rheumatology, AP-HP, Lariboisière hospital, 2 rue A. Paré, 75010, Paris, France
| | - Matthieu Resche-Rigon
- Université de Paris, ECSTRRA Team U1153, INSERM, 75010, Paris, France.,Department of Biostatistics, AP-HP, Saint-Louis hospital, 75010, Paris, France
| | - Thomas Bardin
- French Vietnamese Research Center on Gout and Chronic Diseases, Vien Gut Medical Centre, Ho Chi Minh City, Vietnam. .,Université de Paris, U1132, INSERM, 75010, Paris, France. .,Department of Rheumatology, AP-HP, Lariboisière hospital, 2 rue A. Paré, 75010, Paris, France.
| |
Collapse
|
27
|
Renaudin F, Orliaguet L, Castelli F, Fenaille F, Prignon A, Alzaid F, Combes C, Delvaux A, Adimy Y, Cohen-Solal M, Richette P, Bardin T, Riveline JP, Venteclef N, Lioté F, Campillo-Gimenez L, Ea HK. Gout and pseudo-gout-related crystals promote GLUT1-mediated glycolysis that governs NLRP3 and interleukin-1β activation on macrophages. Ann Rheum Dis 2020; 79:1506-1514. [PMID: 32699039 DOI: 10.1136/annrheumdis-2020-217342] [Citation(s) in RCA: 57] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2020] [Revised: 05/25/2020] [Accepted: 06/25/2020] [Indexed: 12/21/2022]
Abstract
OBJECTIVE Macrophage activation by monosodium urate (MSU) and calcium pyrophosphate (CPP) crystals mediates an interleukin (IL)-1β-dependent inflammation during gout and pseudo-gout flare, respectively. Since metabolic reprogramming of macrophages goes along with inflammatory responses dependently on stimuli and tissue environment, we aimed to decipher the role of glycolysis and oxidative phosphorylation in the IL-1β-induced microcrystal response. METHODS Briefly, an in vitro study (metabolomics and real-time extracellular flux analysis) on MSU and CPP crystal-stimulated macrophages was performed to demonstrate the metabolic phenotype of macrophages. Then, the role of aerobic glycolysis in IL-1β production was evaluated, as well in vitro as in vivo using 18F-fluorodeoxyglucose positron emission tomography imaging and glucose uptake assay, and molecular approach of glucose transporter 1 (GLUT1) inhibition. RESULTS We observed that MSU and CPP crystals led to a metabolic rewiring toward the aerobic glycolysis pathway explained by an increase in GLUT1 plasma membrane expression and glucose uptake on macrophages. Also, neutrophils isolated from human synovial fluid during gout flare expressed GLUT1 at their plasma membrane more frequently than neutrophils isolated from bloodstream. Both glucose deprivation and treatment with either 2-deoxyglucose or GLUT1 inhibitor suppressed crystal-induced NLRP3 activation and IL-1β production, and microcrystal inflammation in vivo. CONCLUSION In conclusion, we demonstrated that GLUT1-mediated glucose uptake is instrumental during the inflammatory IL-1β response induced by MSU and CPP crystals. These findings open new therapeutic paths to modulate crystal-related inflammation.
Collapse
Affiliation(s)
- Felix Renaudin
- Universite de Paris, Paris, France.,INSERM, UMR-S 1132, F-75010, Paris, France
| | - Lucie Orliaguet
- Universite de Paris, Paris, France.,INSERM, Immunity and Metabolism in Diabetes Laboratory, Centre de Recherche des Cordelier, Paris, France
| | - Florence Castelli
- Service de Pharmacologie et immunoanalyse (SPI), Laboratoire d'Etude du Métabolisme des Médicaments, CEA, INRAE, Université Paris Saclay, Gif-Sur-Yvette, France
| | - François Fenaille
- Service de Pharmacologie et immunoanalyse (SPI), Laboratoire d'Etude du Métabolisme des Médicaments, CEA, INRAE, Université Paris Saclay, Gif-Sur-Yvette, France
| | - Aurelie Prignon
- UMS28 Phénotypage du Petit Animal, Laboratoire d'Imagerie Moléculaire Positonique (LIMP), F-75020, Sorbonne Université, Paris, France
| | - Fawaz Alzaid
- Universite de Paris, Paris, France.,INSERM, Immunity and Metabolism in Diabetes Laboratory, Centre de Recherche des Cordelier, Paris, France
| | - Christele Combes
- UMR 5085 INPT-UPS-CNRS, Université de Toulouse, ENSIACET, F-31000, Toulouse, France
| | - Aurélie Delvaux
- Service de Pharmacologie et immunoanalyse (SPI), Laboratoire d'Etude du Métabolisme des Médicaments, CEA, INRAE, Université Paris Saclay, Gif-Sur-Yvette, France
| | - Yasmina Adimy
- Service de Pharmacologie et immunoanalyse (SPI), Laboratoire d'Etude du Métabolisme des Médicaments, CEA, INRAE, Université Paris Saclay, Gif-Sur-Yvette, France
| | - Martine Cohen-Solal
- Universite de Paris, Paris, France.,Bone and Joint Laboratory, INSERM U1132, Paris, France
| | - Pascal Richette
- Universite de Paris, Paris, France.,INSERM, UMR-S 1132, F-75010, Paris, France
| | - Thomas Bardin
- Universite de Paris, Paris, France.,INSERM, UMR-S 1132, F-75010, Paris, France
| | - Jean-Pierre Riveline
- Universite de Paris, Paris, France.,INSERM, Immunity and Metabolism in Diabetes Laboratory, Centre de Recherche des Cordelier, Paris, France
| | - Nicolas Venteclef
- Universite de Paris, Paris, France.,INSERM, Immunity and Metabolism in Diabetes Laboratory, Centre de Recherche des Cordelier, Paris, France
| | - Frédéric Lioté
- Universite de Paris, Paris, France.,INSERM, UMR-S 1132, F-75010, Paris, France
| | | | - Hang-Korng Ea
- Universite de Paris, Paris, France .,INSERM, UMR-S 1132, F-75010, Paris, France
| |
Collapse
|
28
|
|
29
|
Ea HK, Olivier O, Pham NN, Frochot V, Bazin D, Marty C, Ostertag A, Laredo JD, Richette P, Nguyen QD, Bardin T. THU0422 CALCIUM PYROPHOSPHATE CRYSTAL DEPOSITION WITHIN TOPHUS LOBULE: A FREQUENT ASSOCIATION OBSERVED IN LONG-TIME COURSE TOPHI. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.6057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:Calcium pyrophosphate (CPP) crystals and monosodium urate (MSU) crystals are frequently found in the same synovial fluids of gouty patients suggesting an interaction in crystal formation and deposition. This association has never been reported in tophus.Objectives:we aimed to describe the prevalence of CPP crystal deposition in tophus and to determine the associated risk factors.Methods:22 tophi consecutively harvested were fixed in 4% paraformaldehyde and embedded in paraffin. 5-µm thick sections were analyzed by compensated polarized microscopy (CPM) after hematoxylin and eosin staining. Characterization of CPP crystals were performed by scan electronic microscopy (SEM) and Fourier transform infrared (FTIR) spectroscopy. Clinical characteristics were compared between patients having tophus with CPP deposition and patients having tophus without CPP crystals.Results:All tophi appeared multi-lobulated depositions of MSU crystals separated by fibrous tissue and surrounded by a foreign giant cell reaction. CPP crystals were identified in few lobules of 5 tophi (22.7%) harvested from 3 great toes, 1 elbow bursa and 1 finger of 5 patients. CPP crystals formed aggregate deposition within the lobule of MSU crystals. Both monoclinic and triclinic CPP crystal phases were identified by CPM, SEM and FTIR. Tophi were harvested from 22 male gouty patients with a mean age of 50.8 (28-66) years and a mean BMI of 24.2 kg/m2 (18.9-29.4). Mean serum urate level (SUL) was 499 ± 107 µmol/L. 59% of patients had chronic renal disease stage 2 or 3, 40.9% dyslipidemia, 22.7% type 2 diabetes mellitus, 13.6% hypertension and 50% obesity. Patients with tophi containing CPP deposition were older (61.2 [56-66] vs 47.8 [28-64] years, p=0.009) and had a longer gout duration (19 [10-31] vs 9 [3-20] years, p= 0.007) and tophus duration (11.4 [8-16] vs 4.5 [1-9] years, p< 0.0001) than patients with tophi alone. Tophi did not display calcification on radiographies performed before surgery. However, the density of tophi containing CPP crystal deposition was higher than the density of tophi without CPP crystals (51 [25-100] vs 21.5% [0-40], p=0.009). The proportion of bone erosion and gout arthropathy was similar between the two groups. Similarly, no difference was observed for SUL (467 ± 43 vs 509 ± 109 µmol/L), estimated glomerular filtration rate (76.6 ± 11.9 vs 74.9 ± 15.7 ml/min/1.73m2) and prevalence of comorbidities. Interestingly, no calcification was detected on knee and wrist radiographies of patients with tophi containing CPP deposition.Conclusion:These results reported for the first time, in a small sample size, that CPP crystal deposition occurred within tophus lobules. They suggested that long-time course tophi might act as a facilitating agent of CPP nucleation. This hypothesis needs specific confirmation studiesDisclosure of Interests: :None declared
Collapse
|
30
|
Latourte A, Pascart T, Flipo RM, Chalès G, Coblentz-Baumann L, Cohen-Solal A, Ea HK, Grichy J, Letavernier E, Lioté F, Ottaviani S, Sigwalt P, Vandecandelaere G, Richette P, Bardin T. 2020 Recommendations from the French Society of Rheumatology for the management of gout: Management of acute flares. Joint Bone Spine 2020; 87:387-393. [PMID: 32422339 DOI: 10.1016/j.jbspin.2020.05.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Accepted: 05/07/2020] [Indexed: 12/21/2022]
Abstract
OBJECTIVE To develop French Society of Rheumatology-endorsed recommendations for the management of gout flares. METHODS These evidence-based recommendations were developed by 9 rheumatologists (academic or community-based), 3 general practitioners, 1 cardiologist, 1 nephrologist and 1 patient, using a systematic literature search, one physical meeting to draft recommendations and 2 Delphi rounds to finalize them. RESULTS A set of 4 overarching principles and 4 recommendations was elaborated. The overarching principles emphasize the importance of patient education, including the need to auto-medicate for gout flares as early as possible, if possible within the first 12h after the onset, according to a pre-defined treatment. Patients must know that gout is a chronic disease, often requiring urate-lowering therapy in addition to flare treatment. Comorbidities and the risk of drug interaction should be screened carefully in every patient as they may contraindicate some anti-inflammatory treatments. Colchicine must be early prescribed at the following dosage: 1mg then 0.5mg one hour later, followed by 0.5mg,2 to 3 times/day over the next days. In case of diarrhea, which is the first symptom of colchicine poisoning, dosage must be reduced. Colchicine dosage must also be reduced in patients with chronic kidney disease or taking drugs, which interfere with its metabolism. Other first-line treatment options are systemic/intra-articular corticosteroids, or non-steroidal anti-inflammatory agents (NSAIDs). IL-1 inhibitors can be considered as a second-line option in case of failure, intolerance or contraindication to colchicine, corticosteroids and NSAIDs. They are contraindicated in cases of infection and neutrophil blood count should be monitored. CONCLUSION These recommendations aim to provide strategies for the safe use of anti-inflammatory agents, in order to improve the management of gout flares.
Collapse
Affiliation(s)
- Augustin Latourte
- Service de rhumatologie, hôpital Lariboisière, AP-HP, 2, rue Ambroise-Paré, 75010 Paris, France; Inserm U1132 BIOSCAR, université de Paris, Paris, France
| | - Tristan Pascart
- Service de rhumatologie, université de Lille, GH de l'institut catholique de Lille, Lille, France; EA4490, physiopathologie des maladies osseuses inflammatoires, université de Lille, Lille, France
| | - René-Marc Flipo
- Service de rhumatologie, université de Lille, CHU de Lille, Lille, France
| | | | | | - Alain Cohen-Solal
- Service de cardiologie, hôpital Lariboisière, AP-HP, Paris, France; Inserm U942 MASCOT, université de Paris, Paris, France
| | - Hang-Korng Ea
- Service de rhumatologie, hôpital Lariboisière, AP-HP, 2, rue Ambroise-Paré, 75010 Paris, France; Inserm U1132 BIOSCAR, université de Paris, Paris, France
| | | | - Emmanuel Letavernier
- Service de physiologie, hôpital Tenon, AP-HP, Paris, France; Inserm U1155, UPMC Université Paris 6, Sorbonne Universités, Paris, France
| | - Frédéric Lioté
- Service de rhumatologie, hôpital Lariboisière, AP-HP, 2, rue Ambroise-Paré, 75010 Paris, France; Inserm U1132 BIOSCAR, université de Paris, Paris, France
| | | | - Pierre Sigwalt
- Service de rhumatologie, hôpital Lariboisière, AP-HP, 2, rue Ambroise-Paré, 75010 Paris, France; Inserm U1132 BIOSCAR, université de Paris, Paris, France
| | | | - Pascal Richette
- Service de rhumatologie, hôpital Lariboisière, AP-HP, 2, rue Ambroise-Paré, 75010 Paris, France; Inserm U1132 BIOSCAR, université de Paris, Paris, France
| | - Thomas Bardin
- Service de rhumatologie, hôpital Lariboisière, AP-HP, 2, rue Ambroise-Paré, 75010 Paris, France; Inserm U1132 BIOSCAR, université de Paris, Paris, France.
| |
Collapse
|
31
|
Pascart T, Latourte A, Flipo RM, Chalès G, Coblentz-Baumann L, Cohen-Solal A, Ea HK, Grichy J, Letavernier E, Lioté F, Ottaviani S, Sigwalt P, Vandecandelaere G, Richette P, Bardin T. 2020 recommendations from the French Society of Rheumatology for the management of gout: Urate-lowering therapy. Joint Bone Spine 2020; 87:395-404. [PMID: 32422338 DOI: 10.1016/j.jbspin.2020.05.002] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Accepted: 05/07/2020] [Indexed: 12/16/2022]
Abstract
OBJECTIVE To develop French Society of Rheumatology-endorsed recommendations for the management of urate-lowering therapy (ULT). METHODS Evidence-based recommendations were developed by 9 rheumatologists (academic or community-based), 3 general practitioners, 1 cardiologist, 1 nephrologist and 1 patient, using a systematic literature search, one physical meeting to draft recommendations and two Delphi rounds to finalize them. RESULTS A set of 3 overarching principles and 5 recommendations was elaborated. The overarching principles emphasize the importance of patient education, especially the need for explaining the objective of lowering serum urate (SU) level to obtain crystal dissolution, clinical symptoms disappearance and avoidance of complications. ULT is indicated as soon as the diagnosis of gout is established. SU level must be decreased below 300μmol/l (50mg/l) in all gout patients or at least below 360μmol/l (60ml/l) when the 300μmol/l target cannot be reached, and must be maintained at these targets and monitored life-long. The choice of the ULT primarily relies on renal function: in patients whose estimated glomerular filtration rate (eGFR) is above 60ml/min/1.73m2, first-line ULT is allopurinol; in those with eGFR between 30 and 60ml/min/1.73m2, allopurinol use must be cautious and febuxostat can be considered as an alternative; and in those whose eGFR is below 30ml/min/1.73m2, allopurinol must be avoided and febuxostat should be preferred. Prophylaxis of ULT-induced gout flares involves progressive increase of ULT dosage and low-dose colchicine for at least 6 months. Cardiovascular risk factors and diseases, the metabolic syndrome and chronic kidney disease must be screened and managed. CONCLUSION These recommendations aim to provide simple and clear guidance for the management of ULT in France.
Collapse
Affiliation(s)
- Tristan Pascart
- Service de rhumatologie, université de Lille, GH de l'institut catholique de Lille, Lille, France; EA4490, physiopathologie des maladies osseuses inflammatoires, université de Lille, Lille, France
| | - Augustin Latourte
- Service de rhumatologie, hôpital Lariboisière, AP-HP, 2, rue Ambroise-Paré, 75010 Paris, France; Inserm U1132 BIOSCAR, université de Paris, Paris, France
| | - René-Marc Flipo
- Service de rhumatologie, université de Lille, CHU de Lille, Lille, France
| | | | | | - Alain Cohen-Solal
- Service de cardiologie, hôpital Lariboisière, AP-HP, Paris, France; Inserm U942 MASCOT, université de Paris, Paris, France
| | - Hang-Korng Ea
- Service de rhumatologie, hôpital Lariboisière, AP-HP, 2, rue Ambroise-Paré, 75010 Paris, France; Inserm U1132 BIOSCAR, université de Paris, Paris, France
| | | | - Emmanuel Letavernier
- Service de physiologie, hôpital Tenon, AP-HP, Paris, France; Inserm U1155, UPMC Université Paris 6, Sorbonne Universités, Paris, France
| | - Frédéric Lioté
- Service de rhumatologie, hôpital Lariboisière, AP-HP, 2, rue Ambroise-Paré, 75010 Paris, France; Inserm U1132 BIOSCAR, université de Paris, Paris, France
| | | | - Pierre Sigwalt
- Service de rhumatologie, hôpital Lariboisière, AP-HP, 2, rue Ambroise-Paré, 75010 Paris, France; Inserm U1132 BIOSCAR, université de Paris, Paris, France
| | | | - Pascal Richette
- Service de rhumatologie, hôpital Lariboisière, AP-HP, 2, rue Ambroise-Paré, 75010 Paris, France; Inserm U1132 BIOSCAR, université de Paris, Paris, France
| | - Thomas Bardin
- Service de rhumatologie, hôpital Lariboisière, AP-HP, 2, rue Ambroise-Paré, 75010 Paris, France; Inserm U1132 BIOSCAR, université de Paris, Paris, France.
| |
Collapse
|
32
|
Latourte A, Rat A, Ngueyon Sime W, Ea H, Bardin T, Mazières B, Roux C, Guillemin F, Richette P. Chondrocalcinosis of the Knee and the Risk of Osteoarthritis Progression: Data From the Knee and Hip Osteoarthritis Long‐term Assessment Cohort. Arthritis Rheumatol 2020; 72:726-732. [DOI: 10.1002/art.41186] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Accepted: 12/03/2019] [Indexed: 12/11/2022]
Affiliation(s)
- Augustin Latourte
- Lariboisière HospitalAP‐HPINSERM U1132UFR de Médecine, and Paris Diderot University Paris France
| | - Anne‐Christine Rat
- INSERM CIC 1433Centre Hospitalier Régional Nancy, and Université de LorraineCentre Hospitalier Régional Nancy Vandoeuvre‐lès‐Nancy France
| | - Willy Ngueyon Sime
- INSERM CIC 1433Centre Hospitalier Régional Nancy, and Université de Lorraine Vandoeuvre‐lès‐Nancy France
| | - Hang‐Korng Ea
- Lariboisière HospitalAP‐HPINSERM U1132UFR de Médecine, and Paris Diderot University Paris France
| | - Thomas Bardin
- Lariboisière HospitalAP‐HPINSERM U1132UFR de Médecine, and Paris Diderot University Paris France
| | - Bernard Mazières
- Centre Hospitalier Universitaire Toulouse and Paul Sabatier University Toulouse France
| | - Christian Roux
- Centre Hospitalier Universitaire Pasteur 2Le Laboratoire Motricité Humaine Expertise Sport Santé EA6309UMR 7277Centre National de la Recherche Scientifique, and University of Nice Sophia Antipolis Sophia Antipolis France
| | - Francis Guillemin
- INSERM CIC 1433Centre Hospitalier Régional Nancy, and Université de Lorraine Vandoeuvre‐lès‐Nancy France
| | - Pascal Richette
- Lariboisière HospitalAP‐HPINSERM U1132UFR de Médecine, and Paris Diderot University Paris France
| |
Collapse
|
33
|
Latourte A, Ea HK, Frazier A, Blanchard A, Lioté F, Marotte H, Bardin T, Richette P. Tocilizumab in symptomatic calcium pyrophosphate deposition disease: a pilot study. Ann Rheum Dis 2020; 79:1126-1128. [DOI: 10.1136/annrheumdis-2020-217188] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Revised: 03/13/2020] [Accepted: 03/17/2020] [Indexed: 01/09/2023]
|
34
|
Abstract
PURPOSE OF REVIEW Concerns about the cardiovascular safety of febuxostat lead to reconsideration of the place of febuxostat in the management of gout. RECENT FINDINGS The CARES trial is a randomized controlled trial mandated by the FDA to compare the cardiovascular safety of febuxostat and allopurinol in the management of gout. About 6190 patients with gout and major cardiovascular disease, randomly assigned to allopurinol or febuxostat, were prospectively followed up for a median of 32 months. No difference was noted in the occurrence of the primary end-point event, a composite of cardiovascular death, nonfatal myocardial infarction, nonfatal stroke, or unstable angina with urgent revascularization, but cardiovascular death was significantly more common in the febuxostat group (4.3%) as compared with the allopurinol group (3.2%) (P = 0.03). SUMMARY Present guidelines on the management of gout should be revised in view of recent findings. Allopurinol could be recommended as the sole first-line urate-lowering drug (ULD) in patients with no contraindication. In patients contraindicated to allopurinol, uricosurics could be preferred to febuxostat as first-line ULDs in patients with cardiovascular disease/risk factors and no history of uric acid stones.
Collapse
Affiliation(s)
- Thomas Bardin
- Department of Rheumatology, Hôpital Lariboisière, APHP.,Université Paris Diderot.,INSERM U 1132, Paris, France
| | - Pascal Richette
- Department of Rheumatology, Hôpital Lariboisière, APHP.,Université Paris Diderot.,INSERM U 1132, Paris, France
| |
Collapse
|
35
|
Ebstein E, Forien M, Norkuviene E, Richette P, Mouterde G, Daien C, Ea HK, Brière C, Lioté F, Petraitis M, Bardin T, Ora J, Dieudé P, Ottaviani S. Ultrasound evaluation in follow-up of urate-lowering therapy in gout: the USEFUL study. Rheumatology (Oxford) 2020; 58:410-417. [PMID: 30285127 DOI: 10.1093/rheumatology/key303] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2018] [Accepted: 08/22/2018] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVES We aimed to determine the ability of ultrasonography (US) to show disappearance of urate deposits in gouty patients requiring urate-lowering therapy (ULT). METHODS We performed a 6-month multicentre prospective study including patients with: proven gout; presence of US features of gout (tophus and/or double contour sign) at the knee and/or first metatarsophalangeal joints; and no current ULT. US evaluations were performed at baseline and at months 3 and 6 (M3, M6) after starting ULT. Outcomes were: the change in US features of gout at M6 according to final (M6) serum urate (SU) level (high, > 360 μmol/l, i.e. > 6 mg/dl; low, 300-360 μmol/l, i.e. 5-6 mg/dl; very low, < 300 μmol/l, i.e. < 5 mg/dl); and correlation between changed US features and final SU level. RESULTS We included 79 gouty patients (mean ± s.d., age 61.8 (14) years, 91% males, disease duration 6.3 (6.1) years). Baseline SU level was 530 ± 97 µmol/l (i.e. 8.9 mg/dl ± 1.6mg/dl). At least one US tophus and double contour sign was observed in 74 (94%) and 68 (86%) patients, respectively. Among the 67 completers at M6, 18 and 39 achieved a very low and low SU level, respectively. We found a significant decrease in US features of gout among patients with the lowest SU level (P < 0.001). Final M6 SU level was positively correlated with decreased size of tophus (r = 0.54 [95% CI: 0.34, 0.70], P < 0.0001), and inversely correlated with proportion of double contour sign disappearance (r=-0.59 [-0.74, -0.40]). CONCLUSION US can show decreased urate deposition after ULT, which is correlated with decreased SU level. The responsiveness of US in gout is demonstrated and can be useful for gout follow-up and adherence to ULT.
Collapse
Affiliation(s)
- Esther Ebstein
- Rheumatology Department, DHU FIRE, Pôle Infection Immunité, Bichat Hospital (APHP), Paris, France
| | - Marine Forien
- Rheumatology Department, DHU FIRE, Pôle Infection Immunité, Bichat Hospital (APHP), Paris, France
| | - Eleonora Norkuviene
- Rheumatology Department, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Pascal Richette
- Rheumatology Department, Centre Viggo Petersen, Pole Appareil Locomoteur, Lariboisière Hospital (AP-HP), Inserm UMR 1132, USPC, Paris, France
| | - Gaël Mouterde
- Rheumatology Department, Lapeyronie Hospital, EA 2415, Montpellier University, Montpellier, France
| | - Claire Daien
- Rheumatology Department, Lapeyronie Hospital, EA 2415, Montpellier University, Montpellier, France
| | - Hang-Korng Ea
- Rheumatology Department, Centre Viggo Petersen, Pole Appareil Locomoteur, Lariboisière Hospital (AP-HP), Inserm UMR 1132, USPC, Paris, France
| | - Claire Brière
- Rheumatology Department, Centre Viggo Petersen, Pole Appareil Locomoteur, Lariboisière Hospital (AP-HP), Inserm UMR 1132, USPC, Paris, France
| | - Frédéric Lioté
- Rheumatology Department, Centre Viggo Petersen, Pole Appareil Locomoteur, Lariboisière Hospital (AP-HP), Inserm UMR 1132, USPC, Paris, France
| | - Mykolas Petraitis
- Rheumatology Department, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Thomas Bardin
- Rheumatology Department, Centre Viggo Petersen, Pole Appareil Locomoteur, Lariboisière Hospital (AP-HP), Inserm UMR 1132, USPC, Paris, France
| | - Jérémy Ora
- Rheumatology Department, Centre Viggo Petersen, Pole Appareil Locomoteur, Lariboisière Hospital (AP-HP), Inserm UMR 1132, USPC, Paris, France
| | - Philippe Dieudé
- Rheumatology Department, DHU FIRE, Pôle Infection Immunité, Bichat Hospital (APHP), Paris, France
| | - Sébastien Ottaviani
- Rheumatology Department, DHU FIRE, Pôle Infection Immunité, Bichat Hospital (APHP), Paris, France
| |
Collapse
|
36
|
Bousson V, Bardin T, Zeitoun D, Sverzut JM, Ea HK. Monosodium urate deposition in the articular cartilage and meniscus can mimic chondrocalcinosis. Joint Bone Spine 2020; 87:95-96. [DOI: 10.1016/j.jbspin.2019.06.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2019] [Accepted: 06/24/2019] [Indexed: 12/27/2022]
|
37
|
Maheu E, Avouac B, Dreiser RL, Bardin T. A single intra-articular injection of 2.0% non-chemically modified sodium hyaluronate vs 0.8% hylan G-F 20 in the treatment of symptomatic knee osteoarthritis: A 6-month, multicenter, randomized, controlled non-inferiority trial. PLoS One 2019; 14:e0226007. [PMID: 31821355 PMCID: PMC6903764 DOI: 10.1371/journal.pone.0226007] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [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: 03/11/2019] [Accepted: 11/16/2019] [Indexed: 01/27/2023] Open
Abstract
OBJECTIVES The aim of the study was to demonstrate the non-inferiority of a single intra-articular injection of 2.0% non-chemically modified sodium hyaluronate (SH) vs 0.8% hylan G-F 20 (control) in symptomatic knee osteoarthritis. DESIGN This was a double-blind, randomized, controlled trial conducted in patients with painful tibiofemoral osteoarthritis (American College of Rheumatology criteria) with insufficient response or intolerance to first-line analgesics and regular non-steroidal anti-inflammatory drugs. Subjects received a single intra-articular injection of either SH or hylan G-F 20. The primary outcome was the 6-month change from baseline in the Western Ontario and McMaster Universities Osteoarthritis Index pain subscale (WOMAC A), with a pre-specified lower margin for non-inferiority of 8 mm. RESULTS Of the 292 patients randomized (SH: 144), 288 received an injection (SH: 142), 266 completed the study (SH: 134). In the Per Protocol dataset (SH: 113, control: 112), the WOMAC A change at 6 months was -34.3 mm (95% confidence interval (CI): -37.8, -30.8) and -36.2 mm (95% CI: -40.3, -32.1) for the SH and hylan G-F 20 patients, respectively (P = 0.5). The intergroup difference was -1.9 mm (95% CI: -7.3, 3.5). Results were similar in the Full Analysis Set (SH: 139, control: 141) with a difference between the groups of -2.9 mm (95% CI: -7.9, 2.2). A total of 31.3% of the injected patients reported a treatment-emergent adverse event, including injection site reactions (pain, inflammation or effusion) which occurred in 8.5% of the SH patients vs 13.0% of the hylan G-F 20 patients. No serious reactions were reported. CONCLUSIONS This clinical trial demonstrated the non-inferiority of a single intra-articular injection of SH vs hylan G-F 20 on the WOMAC A change from baseline at 6 months.
Collapse
Affiliation(s)
- Emmanuel Maheu
- Department of Rheumatology, AP-HP, Hôpital Saint-Antoine, Paris, France, Private office, Paris, France
- * E-mail:
| | - Bernard Avouac
- Department of Rheumatology, CHU Henri Mondor, Créteil, France (currently: rheumatologist, consultant, Paris, France)
| | | | - Thomas Bardin
- Department of Rheumatology, AP-HP, Hôpital Lariboisière, Université Paris Diderot, Paris, France
| |
Collapse
|
38
|
Bursill D, Taylor WJ, Terkeltaub R, Kuwabara M, Merriman TR, Grainger R, Pineda C, Louthrenoo W, Edwards NL, Andrés M, Vargas-Santos AB, Roddy E, Pascart T, Lin CT, Perez-Ruiz F, Tedeschi SK, Kim SC, Harrold LR, McCarthy G, Kumar N, Chapman PT, Tausche AK, Vazquez-Mellado J, Gutierrez M, da Rocha Castelar-Pinheiro G, Richette P, Pascual E, Fisher MC, Burgos-Vargas R, Robinson PC, Singh JA, Jansen TL, Saag KG, Slot O, Uhlig T, Solomon DH, Keenan RT, Scire CA, Biernat-Kaluza E, Dehlin M, Nuki G, Schlesinger N, Janssen M, Stamp LK, Sivera F, Reginato AM, Jacobsson L, Lioté F, Ea HK, Rosenthal A, Bardin T, Choi HK, Hershfield MS, Czegley C, Choi SJ, Dalbeth N. Gout, Hyperuricemia, and Crystal-Associated Disease Network Consensus Statement Regarding Labels and Definitions for Disease Elements in Gout. Arthritis Care Res (Hoboken) 2019; 71:427-434. [PMID: 29799677 DOI: 10.1002/acr.23607] [Citation(s) in RCA: 59] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2017] [Accepted: 05/22/2018] [Indexed: 01/30/2023]
Abstract
OBJECTIVE The language currently used to describe gout lacks standardization. The aim of this project was to develop a consensus statement on the labels and definitions used to describe the basic disease elements of gout. METHODS Experts in gout (n = 130) were invited to participate in a Delphi exercise and face-to-face consensus meeting to reach consensus on the labeling and definitions for the basic disease elements of gout. Disease elements and labels in current use were derived from a content analysis of the contemporary medical literature, and the results of this analysis were used for item selection in the Delphi exercise and face-to-face consensus meeting. RESULTS There were 51 respondents to the Delphi exercise and 30 attendees at the face-to-face meeting. Consensus agreement (≥80%) was achieved for the labels of 8 disease elements through the Delphi exercise; the remaining 3 labels reached consensus agreement through the face-to-face consensus meeting. The agreed labels were monosodium urate crystals, urate, hyperuric(a)emia, tophus, subcutaneous tophus, gout flare, intercritical gout, chronic gouty arthritis, imaging evidence of monosodium urate crystal deposition, gouty bone erosion, and podagra. Participants at the face-to-face meeting achieved consensus agreement for the definitions of all 11 elements and a recommendation that the label "chronic gout" should not be used. CONCLUSION Consensus agreement was achieved for the labels and definitions of 11 elements representing the fundamental components of gout etiology, pathophysiology, and clinical presentation. The Gout, Hyperuricemia, and Crystal-Associated Disease Network recommends the use of these labels when describing the basic disease elements of gout.
Collapse
Affiliation(s)
- David Bursill
- University of Auckland, Auckland, New Zealand, and Adelaide Medical School, University of Adelaide, South Australia, Australia
| | - William J Taylor
- University of Otago, Wellington, and Hutt Valley District Health Board, Lower Hutt, New Zealand
| | - Robert Terkeltaub
- Veterans Affairs Medical Center and University of California, San Diego
| | - Masanari Kuwabara
- Toranomon Hospital, Tokyo, Japan, and University of Colorado Denver, Aurora
| | | | - Rebecca Grainger
- University of Otago, Wellington, and Hutt Valley District Health Board, Lower Hutt, New Zealand
| | - Carlos Pineda
- Instituto Nacional Rehabilitación Luis Guillermo Ibarra Ibarra, Mexico City, Mexico
| | | | | | - Mariano Andrés
- Hospital Universitario de Alicante and Universidad Miguel Hernández, Alicante, Spain
| | | | | | - Tristan Pascart
- Lille Catholic University and Saint-Philibert Hospital, Lomme, France
| | | | - Fernando Perez-Ruiz
- University of the Basque Country, Biscay, and Cruces University Hospital and Biocruces Health Research Institute, Baracaldo, Spain
| | - Sara K Tedeschi
- Harvard Medical School, and Brigham and Women's Hospital, Boston, Massachusetts
| | - Seoyoung C Kim
- Harvard Medical School, and Brigham and Women's Hospital, Boston, Massachusetts
| | - Leslie R Harrold
- Corrona, LLC, Waltham, and University of Massachusetts Medical School, Worcester
| | - Geraldine McCarthy
- Mater Misericordiae University Hospital and University College, Dublin, Ireland
| | | | | | - Anne-Kathrin Tausche
- University Hospital Carl Gustav Carus, Technical University Dresden, Dresden, Germany
| | | | | | | | - Pascal Richette
- Hôpital Lariboisière, Assistance Publique-Hopitaux de Paris, and INSERM UMR-1132 and Université Paris Diderot, Paris, France
| | - Eliseo Pascual
- Hospital Universitario de Alicante and Universidad Miguel Hernández, Alicante, Spain
| | - Mark C Fisher
- Harvard Medical School and Massachusetts General Hospital Boston
| | - Ruben Burgos-Vargas
- Hospital General de México and Universidad Nacional Autónoma de México, Mexico City, Mexico
| | - Philip C Robinson
- University of Queensland School of Medicine and Royal Brisbane and Women's Hospital, Herston, Queensland, Australia
| | - Jasvinder A Singh
- Veterans Affairs Medical Center, Birmingham, and University of Alabama at Birmingham
| | | | | | - Ole Slot
- Rigshospitalet Glostrup, Glostrup, Denmark
| | | | - Daniel H Solomon
- Harvard Medical School, and Brigham and Women's Hospital, Boston, Massachusetts
| | | | - Carlo Alberto Scire
- University of Ferrara, Ferrara, and Italian Society for Rheumatology, Milan, Italy
| | | | - Mats Dehlin
- Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | | | | | | | | | | | - Anthony M Reginato
- Warren Alpert School of Medicine at Brown University, Providence, Rhode Island
| | | | - Frédéric Lioté
- Hôpital Lariboisière, Assistance Publique-Hopitaux de Paris, and INSERM UMR-1132 and Université Paris Diderot, Paris, France
| | - Hang-Korng Ea
- Hôpital Lariboisière, Assistance Publique-Hopitaux de Paris, and INSERM UMR-1132 and Université Paris Diderot, Paris, France
| | - Ann Rosenthal
- Medical College of Wisconsin and the Clement J. Zablocki Veterans Affairs Medical Center, Milwaukee
| | - Thomas Bardin
- Hôpital Lariboisière, Assistance Publique-Hopitaux de Paris, and INSERM UMR-1132 and Université Paris Diderot, Paris, France
| | - Hyon K Choi
- Harvard Medical School and Massachusetts General Hospital Boston
| | | | - Christine Czegley
- Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany
| | - Sung Jae Choi
- University of California, San Diego, and Korea University Ansan Hospital, Ansan, South Korea
| | | |
Collapse
|
39
|
James-Belin E, Lasbleiz S, Haddad A, Morchoisne O, Ostertag A, Yelnik A, Laredo JD, Bardin T, Orcel P, Richette P, Beaudreuil J. Shoulder adhesive capsulitis: diagnostic value of active and passive range of motion with volume of gleno-humeral capsule as a reference. Eur J Phys Rehabil Med 2019; 56:438-443. [PMID: 31742369 DOI: 10.23736/s1973-9087.19.05890-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND The diagnosis of adhesive capsulitis is currently based on restricted range of motion (ROM) but its diagnostic value has only been rarely investigated. AIM The aim of this study is to assess the diagnostic value of active global and passive gleno-humeral ROM to diagnose shoulder adhesive capsulitis. DESIGN Cross-sectional descriptive study. SETTING One French center for Rehabilitation Medicine. POPULATION Patients referred for treatment of shoulder adhesive capsulitis in our center were included. Inclusion criteria were: shoulder pain; limitation of active global ROM (abduction or flexion <180°); limitation of passive gleno-humeral ROM (abduction or flexion <90° or 25% reduction at less of lateral rotation versus the opposite shoulder); no gleno-humeral arthropathy on radiography. METHODS The volume of the gleno-humeral capsule was assessed during a procedure of arthro-distension. The reference criterion for adhesive capsulitis was a volume <12 mL. We analyzed the correlation between the parameters of mobility and the volume of the gleno-humeral capsule; and the positive predictive value (PPV) of inclusion criteria, with the reference criterion for the diagnosis of adhesive capsulitis. RESULTS We included 38 patients. Passive gleno-humeral ROM in abduction only was correlated with volume of the gleno-humeral capsule: r=0.33, P=0.043. The PPV of inclusion criteria was 82% for the diagnosis of shoulder adhesive capsulitis. Rather than 90°, when we considered 80°, 60° and 40° as the threshold of passive gleno-humeral ROM in abduction, the PPV increased from 83% to 100%. CONCLUSIONS Passive gleno-humeral ROM in abduction is correlated with volume of the gleno-humeral capsule. The PPV is high for active global and passive gleno-humeral ROM for diagnosis of shoulder adhesive capsulitis. CLINICAL REHABILITATION IMPACT Limitation of active and passive shoulder ROM, especially passive abduction gleno-humeral, is a good criterion to diagnose shoulder adhesive capsulitis, in patients with shoulder pain and no gleno-humeral arthropathy on radiography.
Collapse
Affiliation(s)
- Etienne James-Belin
- Department of Rheumatology, Lariboisière-Fernand Widal Hospital, AP-HP, Paris 7 University, Paris, France - .,Department of Physical and Rehabilitation Medicine, Lariboisière-Fernand Widal Hospital, AP-HP, Paris 7 University, Paris, France -
| | - Sandra Lasbleiz
- Department of Rheumatology, Lariboisière-Fernand Widal Hospital, AP-HP, Paris 7 University, Paris, France
| | - Albert Haddad
- Department of Rheumatology, Lariboisière-Fernand Widal Hospital, AP-HP, Paris 7 University, Paris, France
| | - Odile Morchoisne
- Department of Physical and Rehabilitation Medicine, Lariboisière-Fernand Widal Hospital, AP-HP, Paris 7 University, Paris, France
| | - Agnès Ostertag
- Department of Rheumatology, Lariboisière-Fernand Widal Hospital, AP-HP, Paris 7 University, Paris, France
| | - Alain Yelnik
- Department of Physical and Rehabilitation Medicine, Lariboisière-Fernand Widal Hospital, AP-HP, Paris 7 University, Paris, France
| | - Jean-Denis Laredo
- Department of Musculoskeletal Radiology, Lariboisière-Fernand Widal Hospital, AP-HP, Paris 7 University, Paris, France
| | - Thomas Bardin
- Department of Rheumatology, Lariboisière-Fernand Widal Hospital, AP-HP, Paris 7 University, Paris, France
| | - Philippe Orcel
- Department of Rheumatology, Lariboisière-Fernand Widal Hospital, AP-HP, Paris 7 University, Paris, France
| | - Pascal Richette
- Department of Rheumatology, Lariboisière-Fernand Widal Hospital, AP-HP, Paris 7 University, Paris, France
| | - Johann Beaudreuil
- Department of Rheumatology, Lariboisière-Fernand Widal Hospital, AP-HP, Paris 7 University, Paris, France.,Department of Physical and Rehabilitation Medicine, Lariboisière-Fernand Widal Hospital, AP-HP, Paris 7 University, Paris, France
| |
Collapse
|
40
|
Ferrari M, Lellouche H, Roulot E, Yelnik A, Bardin T, Orcel P, Richette P, Beaudreuil J. Iterative percutaneous needle aponeurotomy for Dupuytren's disease: Functional outcome at 5-year follow-up. Joint Bone Spine 2019; 87:273-274. [PMID: 31669810 DOI: 10.1016/j.jbspin.2019.10.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Accepted: 10/07/2019] [Indexed: 11/17/2022]
Affiliation(s)
- Maeva Ferrari
- Unité Rhumatologique des Affections de la Main (URAM), department of rheumatology, Viggo-Petersen Center, university hospital Lariboisière-Fernand-Widal, Paris university, 75010, France
| | - Henri Lellouche
- Unité Rhumatologique des Affections de la Main (URAM), department of rheumatology, Viggo-Petersen Center, university hospital Lariboisière-Fernand-Widal, Paris university, 75010, France
| | - Eric Roulot
- Unité Rhumatologique des Affections de la Main (URAM), department of rheumatology, Viggo-Petersen Center, university hospital Lariboisière-Fernand-Widal, Paris university, 75010, France
| | - Alain Yelnik
- Department of physical medicine and rehabilitation, university hospital Lariboisière-Fernand-Widal, Paris university, Paris, 75010, France
| | - Thomas Bardin
- Unité Rhumatologique des Affections de la Main (URAM), department of rheumatology, Viggo-Petersen Center, university hospital Lariboisière-Fernand-Widal, Paris university, 75010, France
| | - Philippe Orcel
- Unité Rhumatologique des Affections de la Main (URAM), department of rheumatology, Viggo-Petersen Center, university hospital Lariboisière-Fernand-Widal, Paris university, 75010, France
| | - Pascal Richette
- Unité Rhumatologique des Affections de la Main (URAM), department of rheumatology, Viggo-Petersen Center, university hospital Lariboisière-Fernand-Widal, Paris university, 75010, France
| | - Johann Beaudreuil
- Unité Rhumatologique des Affections de la Main (URAM), department of rheumatology, Viggo-Petersen Center, university hospital Lariboisière-Fernand-Widal, Paris university, 75010, France; Department of physical medicine and rehabilitation, university hospital Lariboisière-Fernand-Widal, Paris university, Paris, 75010, France.
| |
Collapse
|
41
|
Bursill D, Taylor WJ, Terkeltaub R, Abhishek A, So AK, Vargas-Santos AB, Gaffo AL, Rosenthal A, Tausche AK, Reginato A, Manger B, Sciré C, Pineda C, van Durme C, Lin CT, Yin C, Albert DA, Biernat-Kaluza E, Roddy E, Pascual E, Becce F, Perez-Ruiz F, Sivera F, Lioté F, Schett G, Nuki G, Filippou G, McCarthy G, da Rocha Castelar Pinheiro G, Ea HK, Tupinambá HDA, Yamanaka H, Choi HK, Mackay J, ODell JR, Vázquez Mellado J, Singh JA, Fitzgerald JD, Jacobsson LTH, Joosten L, Harrold LR, Stamp L, Andrés M, Gutierrez M, Kuwabara M, Dehlin M, Janssen M, Doherty M, Hershfield MS, Pillinger M, Edwards NL, Schlesinger N, Kumar N, Slot O, Ottaviani S, Richette P, MacMullan PA, Chapman PT, Lipsky PE, Robinson P, Khanna PP, Gancheva RN, Grainger R, Johnson RJ, Te Kampe R, Keenan RT, Tedeschi SK, Kim S, Choi SJ, Fields TR, Bardin T, Uhlig T, Jansen T, Merriman T, Pascart T, Neogi T, Klück V, Louthrenoo W, Dalbeth N. Gout, Hyperuricaemia and Crystal-Associated Disease Network (G-CAN) consensus statement regarding labels and definitions of disease states of gout. Ann Rheum Dis 2019; 78:1592-1600. [PMID: 31501138 DOI: 10.1136/annrheumdis-2019-215933] [Citation(s) in RCA: 50] [Impact Index Per Article: 10.0] [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: 06/23/2019] [Revised: 08/09/2019] [Accepted: 08/11/2019] [Indexed: 11/04/2022]
Abstract
OBJECTIVE There is a lack of standardisation in the terminology used to describe gout. The aim of this project was to develop a consensus statement describing the recommended nomenclature for disease states of gout. METHODS A content analysis of gout-related articles from rheumatology and general internal medicine journals published over a 5-year period identified potential disease states and the labels commonly assigned to them. Based on these findings, experts in gout were invited to participate in a Delphi exercise and face-to-face consensus meeting to reach agreement on disease state labels and definitions. RESULTS The content analysis identified 13 unique disease states and a total of 63 unique labels. The Delphi exercise (n=76 respondents) and face-to-face meeting (n=35 attendees) established consensus agreement for eight disease state labels and definitions. The agreed labels were as follows: 'asymptomatic hyperuricaemia', 'asymptomatic monosodium urate crystal deposition', 'asymptomatic hyperuricaemia with monosodium urate crystal deposition', 'gout', 'tophaceous gout', 'erosive gout', 'first gout flare' and 'recurrent gout flares'. There was consensus agreement that the label 'gout' should be restricted to current or prior clinically evident disease caused by monosodium urate crystal deposition (gout flare, chronic gouty arthritis or subcutaneous tophus). CONCLUSION Consensus agreement has been established for the labels and definitions of eight gout disease states, including 'gout' itself. The Gout, Hyperuricaemia and Crystal-Associated Disease Network recommends the use of these labels when describing disease states of gout in research and clinical practice.
Collapse
Affiliation(s)
- David Bursill
- Department of Health and Medical Sciences, The University of Adelaide, Adelaide, South Australia, Australia
| | - William J Taylor
- Department of Medicine, University of Otago, Wellington, New Zealand.,Wellington Regional Rheumatology Unit, Hutt Valley District Health Board, Lower Hutt, New Zealand
| | - Robert Terkeltaub
- Department of Rheumatology, UCSD/ VA Medical Center, San Diego, California, USA
| | - Abhishek Abhishek
- Department of Academic Rheumatology, University of Nottingham, Nottingham, UK
| | - Alexander K So
- Department of Musculoskeletal Medicine, Service de RMR, Lausanne, Switzerland
| | - Ana Beatriz Vargas-Santos
- Department of Internal Medicine, Rheumatology Unit, State University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Angelo Lino Gaffo
- Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Ann Rosenthal
- Division of Rheumatology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA.,Translational Research Unit, Clement J Zablocki VA Medical Center, Milwaukee, Wisconsin, USA
| | - Anne-Kathrin Tausche
- Department of Rheumatology, University Hospital 'Carl Gustav Carus' of the Technical University Dresden, Dresden, Germany
| | - Anthony Reginato
- Division of Rheumatology, The Warren Alpert School of Medicine at Brown University, Providence, Rhode Island, USA
| | - Bernhard Manger
- Rheumatology and Immunology, Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Carlo Sciré
- Section of Rheumatology, Department of Medical Sciences, University of Ferrara, Ferrara, Italy.,Epidemiology Unit, Italian Society for Rheumatology, Milan, Italy
| | - Carlos Pineda
- Department of Rheumatology, Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra, Mexico City, Mexico
| | - Caroline van Durme
- Department of Internal Medicine, Division of Rheumatology, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Ching-Tsai Lin
- Division of Allergy, Immunology and Rheumatology, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Congcong Yin
- Department of Immunology and Dermatology, Henry Ford Health System, Detroit, Michigan, USA
| | - Daniel Arthur Albert
- Department of Rheumatology, Dartmouth-Hitchcock Medical Center, Hanover, New Hampshire, USA
| | - Edyta Biernat-Kaluza
- Outpatient Rheumatology Clinic, Nutritional and Lifestyle Medicine Centre, ORLIK, Warsaw, Poland
| | - Edward Roddy
- Research Institute for Primary Care and Health Sciences, Keele University, Keele, UK
| | - Eliseo Pascual
- Department of Rheumatology, Hospital General Universitario de Alicante, Alicante, Spain.,Departamento de Medicina Clínica, Universidad Miguel Hernández, Alicante, Spain
| | - Fabio Becce
- Department of Diagnostic and Interventional Radiology, University of Lausanne, Lausanne, Switzerland
| | - Fernando Perez-Ruiz
- Rheumatology Division, Cruces University Hospital, Baracaldo, Spain.,Department of Medicine, University of the Basque Country, Biscay, Spain.,Investigation Group for Arthritis, Biocruces Health Research Institute, Baracaldo, Spain
| | - Francisca Sivera
- Department of Rheumatology, Hospital General Universitario Elda, Elda, Spain
| | - Frédéric Lioté
- Department of Rhumatologie, Hôpital Lariboisière, Assistance Publique-Hopitaux de Paris, Paris, France.,Department of Rhumatologie, INSERM UMR-1132 and Université Paris Diderot, Paris, France
| | - Georg Schett
- Department of Internal Medicine III, Friedrich-Alexander University Erlangen-Nürnberg and Universitatsklinikum Erlangen, Erlangen, Germany
| | - George Nuki
- Insititute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, UK
| | - Georgios Filippou
- Section of Rheumatology, Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | - Geraldine McCarthy
- Department of Rheumatology, Mater Misericordiae University Hospital, Dublin, Ireland.,School of Medicine and Medical Science, University College Dublin, Dublin, Ireland
| | | | - Hang-Korng Ea
- Department of Rheumatology, Hôpital Lariboisière, Paris, France
| | | | - Hisashi Yamanaka
- Institute of Rheumatology, Tokyo Women's Medical University Hospital, Tokyo, Japan.,School of Medicine, Tokyo Women's Medical University, Tokyo, Japan
| | - Hyon K Choi
- Section of Rheumatology and Clinical Epidemiology, Harvard Medical School and Massachusetts General Hospital, Boston, Massachusetts, USA
| | - James Mackay
- President and CEO, Aristea Therapeutics, San Diego, California, USA
| | - James R ODell
- Division of Rheumatology, University of Nebraska Medical Center, Omaha, Nebraska, USA
| | - Janitzia Vázquez Mellado
- Department of Rheumatology, Hospital General de Mexico and Universidad Nacional Autónoma de México, Mexico City, Mexico
| | - Jasvinder A Singh
- Department of Medicine at School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA.,Medicine Service, Birmingham Veterans Affairs Medical Center, Birmingham, Alabama, USA.,Division of Epidemiology at School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - John D Fitzgerald
- Department of Medicine/Rheumatology, David Geffen School of Medicine at the University of California, Los Angeles, Los Angeles, California, USA
| | - Lennart T H Jacobsson
- Department of Rheumatology and Inflammation Research, Institute of Medicine, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Leo Joosten
- Department of Internal Medicine, Radboud University Medical Center Nijmegen, Nijmegen, The Netherlands
| | - Leslie R Harrold
- Department of Medicine, University of Massachusetts Medical School, Worcester, Massachusetts, USA.,Chief Scientific Officer, Corrona, LLC, Southborough, Massachusetts, USA
| | - Lisa Stamp
- Department of Medicine, Otago University, Christchurch, New Zealand
| | - Mariano Andrés
- Department of Rheumatology, Hospital Universitario de Alicante, Alicante, Spain.,Departamento de Medicina Clínica, Universidad Miguel Hernández, Alicante, Spain
| | - Marwin Gutierrez
- Division of Musculoskeletal and Rheumatic Diseases, Instituto Nacional Rehabilitación, México City, México
| | - Masanari Kuwabara
- Division of Renal Diseases and Hypertension, University of Colorado Denver School of Medicine, Aurora, Colorado, USA.,Department of Cardiology, Toranomon Hospital, Minato-ku, Japan
| | - Mats Dehlin
- Department of Rheumatology and Inflammation Research, Sahlgrenska Academy, University of Göteborg, Göteborg, Sweden
| | - Matthijs Janssen
- Department of Rheumatology, VieCuri Medical Centre, Venlo, The Netherlands
| | - Michael Doherty
- Department of Academic Rheumatology, University of Nottingham, Nottingham, UK
| | - Michael S Hershfield
- Division of Rheumatology, Duke University Medical Center, Durham, North Carolina, USA
| | - Michael Pillinger
- Department of Rheumatology/Medicine, New York University School of Medicine, New York City, New York, USA
| | | | - Naomi Schlesinger
- Department of Medicine, Rutgers-Robert Wood Johnson Medical School, New Brunswick, New Jersey, USA
| | - Nitin Kumar
- Department of Internal Medicine, Division of Cardiovascular Medicine, University of Michigan, Ann Arbor, Detroit, Michigan, USA
| | - Ole Slot
- Department of Rheumatology, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spinal Disorders, Rigshospitalet Glostrup, Glostrup, Denmark
| | - Sebastien Ottaviani
- Department of Rheumatology, Bichat-Claude Bernard Hospital, University of Sorbonne Paris Cité, Paris, France
| | - Pascal Richette
- Service de Rhumatologie, Hôpital Lariboisière, Assistance Publique-Hopitaux de Paris, and INSERM UMR-1132 and Université de Paris, Paris, France
| | - Paul A MacMullan
- Division of Rheumatology, University of Calgary, Calgary, Alberta, Canada
| | - Peter T Chapman
- Department of Rheumatology, Immunology and Allergy, Canterbury District Health Board, Christchurch, New Zealand
| | - Peter E Lipsky
- CEO and CMO, AMPEL BioSolutions, LLC, Charlottesville, Virginia, USA
| | - Philip Robinson
- School of Clinical Medicine, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
| | - Puja P Khanna
- Department of Rheumatology, University of Michigan, Ann Arbor, Michigan, USA
| | - Rada N Gancheva
- Clinic of Rheumatology, University Hospital 'St. Ivan Rilski', Sofia, Bulgaria
| | - Rebecca Grainger
- Department of Medicine, University of Otago, Wellington, Wellington, New Zealand.,Wellington Regional Rheumatology Unit, Hutt Valley District Health Board, Lower Hutt, New Zealand
| | - Richard J Johnson
- Division of Renal Diseases and Hypertension, University of Colorado Denver, Denver, Colorado, USA
| | - Ritch Te Kampe
- Department of Internal Medicine, Division of Rheumatology, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Robert T Keenan
- Division of Rheumatology, Duke University School of Medicine, Durham, North Carolina, USA
| | - Sara K Tedeschi
- Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital, Boston, Massachusetts, USA.,Arthritis Center, Harvard Medical School, Boston, Massachusetts, USA
| | - Seoyoung Kim
- Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Sung Jae Choi
- Division of Rheumatology, Department of Internal Medicine, Korea University Medical College, Ansan, South Korea
| | - Theodore R Fields
- Weill Cornell Medical College, Hospital for Special Surgery, New York City, New York, USA
| | - Thomas Bardin
- Department of Rheumatology, Hôpital Lariboisière, Assistance Publique-Hopitaux de Paris, and INSERM UMR-1132 and Université de Paris, Paris, France
| | - Till Uhlig
- Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway
| | - Tim Jansen
- Department of Rheumatology, VieCuri Medical Centre, Venlo, The Netherlands
| | - Tony Merriman
- Department of Biochemistry, University of Otago, Dunedin, New Zealand
| | - Tristan Pascart
- Department of Rheumatology, Lille Catholic University, Saint-Philibert Hospital, Lomme, France
| | - Tuhina Neogi
- Section of Rheumatology, Department of Medicine, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Viola Klück
- Department of Internal Medicine, Radboud Institute for Molecular Life Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Worawit Louthrenoo
- Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Nicola Dalbeth
- Department of Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| |
Collapse
|
42
|
Richette P, Doherty M, Pascual E, Barskova V, Becce F, Castaneda J, Coyfish M, Guillo S, Jansen T, Janssens H, Lioté F, Mallen CD, Nuki G, Perez-Ruiz F, Pimentao J, Punzi L, Pywell A, So AK, Tausche AK, Uhlig T, Zavada J, Zhang W, Tubach F, Bardin T. 2018 updated European League Against Rheumatism evidence-based recommendations for the diagnosis of gout. Ann Rheum Dis 2019; 79:31-38. [DOI: 10.1136/annrheumdis-2019-215315] [Citation(s) in RCA: 135] [Impact Index Per Article: 27.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2019] [Revised: 04/24/2019] [Accepted: 04/25/2019] [Indexed: 12/12/2022]
Abstract
Although gout is the most common inflammatory arthritis, it is still frequently misdiagnosed. New data on imaging and clinical diagnosis have become available since the first EULAR recommendations for the diagnosis of gout in 2006. This prompted a systematic review and update of the 2006 recommendations. A systematic review of the literature concerning all aspects of gout diagnosis was performed. Recommendations were formulated using a Delphi consensus approach. Eight key recommendations were generated. A search for crystals in synovial fluid or tophus aspirates is recommended in every person with suspected gout, because demonstration of monosodium urate (MSU) crystals allows a definite diagnosis of gout. There was consensus that a number of suggestive clinical features support a clinical diagnosis of gout. These are monoarticular involvement of a foot or ankle joint (especially the first metatarsophalangeal joint); previous episodes of similar acute arthritis; rapid onset of severe pain and swelling; erythema; male gender and associated cardiovascular diseases and hyperuricaemia. When crystal identification is not possible, it is recommended that any atypical presentation should be investigated by imaging, in particular with ultrasound to seek features suggestive of MSU crystal deposition (double contour sign and tophi). There was consensus that a diagnosis of gout should not be based on the presence of hyperuricaemia alone. There was also a strong recommendation that all people with gout should be systematically assessed for presence of associated comorbidities and risk factors for cardiovascular disease, as well as for risk factors for chronic hyperuricaemia. Eight updated, evidence-based, expert consensus recommendations for the diagnosis of gout are proposed.
Collapse
|
43
|
Moshrif A, Laredo JD, Bassiouni H, Abdelkareem M, Richette P, Rigon MR, Bardin T. Spinal involvement with calcium pyrophosphate deposition disease in an academic rheumatology center: A series of 37 patients. Semin Arthritis Rheum 2019; 48:1113-1126. [DOI: 10.1016/j.semarthrit.2018.10.009] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2018] [Revised: 09/17/2018] [Accepted: 10/09/2018] [Indexed: 11/25/2022]
|
44
|
Gottenberg JE, Morel J, Perrodeau E, Bardin T, Combe B, Dougados M, Flipo RM, Saraux A, Schaeverbeke T, Sibilia J, Soubrier M, Vittecoq O, Baron G, Constantin A, Ravaud P, Mariette X. Comparative effectiveness of rituximab, abatacept, and tocilizumab in adults with rheumatoid arthritis and inadequate response to TNF inhibitors: prospective cohort study. BMJ 2019; 364:l67. [PMID: 30679233 PMCID: PMC6344892 DOI: 10.1136/bmj.l67] [Citation(s) in RCA: 52] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
OBJECTIVE To compare the effectiveness and safety of three non-tumour necrosis factor (TNF) α inhibitors (rituximab, abatacept, and tocilizumab) in the treatment of rheumatoid arthritis. DESIGN Population based prospective study. SETTING 53 university and 54 non-university clinical centres in France. PARTICIPANTS 3162 adults (>18 years) with rheumatoid arthritis according to 1987 American College of Rheumatology criteria, enrolled in one of the three French Society of Rheumatology registries; who had no severe cardiovascular disease, active or severe infections, or severe immunodeficiency, with follow-up of at least 24 months. INTERVENTION Initiation of intravenous rituximab, abatacept, or tocilizumab for rheumatoid arthritis. MAIN OUTCOME MEASURE The primary outcome was drug retention without failure at 24 months. Failure was defined as all cause death; discontinuation of rituximab, abatacept, or tocilizumab; initiation of a new biologic or a combination of conventional disease modifying antirheumatic drugs; or increase in corticosteroid dose >10 mg/d compared with baseline at two successive visits. Because of non-proportional hazards, treatment effects are presented as life expectancy difference without failure (LEDwf), which measures the difference between average duration of survival without failure. RESULTS Average durations of survival without failure were 19.8 months for rituximab, 15.6 months for abatacept, and 19.1 months for tocilizumab. Average durations were greater with rituximab (LEDwf 4.1, 95% confidence interval 3.1 to 5.2) and tocilizumab (3.5, 2.1 to 5.0) than with abatacept, and uncertainty about tocilizumab compared with rituximab was substantial (-0.7, -1.9 to 0.5). No evidence was found of difference between treatments for mean duration of survival without death, presence of cancer or serious infections, or major adverse cardiovascular events. CONCLUSION Among adults with refractory rheumatoid arthritis followed-up in routine practice, rituximab and tocilizumab were associated with greater improvements in outcomes at two years compared with abatacept.
Collapse
MESH Headings
- Abatacept/administration & dosage
- Abatacept/adverse effects
- Adult
- Antibodies, Monoclonal, Humanized/administration & dosage
- Antibodies, Monoclonal, Humanized/adverse effects
- Antirheumatic Agents/administration & dosage
- Antirheumatic Agents/adverse effects
- Arthritis, Rheumatoid/diagnosis
- Arthritis, Rheumatoid/drug therapy
- Arthritis, Rheumatoid/epidemiology
- Biological Factors/therapeutic use
- Cohort Studies
- Drug Monitoring/methods
- Drug Monitoring/statistics & numerical data
- Drug Resistance
- Drug Therapy, Combination/methods
- Drug Therapy, Combination/statistics & numerical data
- Female
- France/epidemiology
- Humans
- Male
- Outcome Assessment, Health Care
- Prospective Studies
- Rituximab/administration & dosage
- Rituximab/adverse effects
- Survival Analysis
- Tumor Necrosis Factor-alpha/antagonists & inhibitors
Collapse
Affiliation(s)
- Jacques-Eric Gottenberg
- Department of Rheumatology, 1 avenue Molière, Strasbourg University Hospital, National Centre For Rare Systemic Autoimmune Diseases, 67000 Strasbourg, France
- CNRS UPR3572, Immunologie, Immunopathologie et Chimie Thérapeutique, Institut de Biologie Moléculaire et Cellulaire, 15 rue René Descartes, Strasbourg University, 67000 Strasbourg, France
| | - Jacques Morel
- Department of Rheumatology, Montpellier University Hospital, Montpellier, France
| | - Elodie Perrodeau
- Department of Epidemiology and Public Health, Hotel Dieu, Assistance Publique des Hôpitaux de Paris (APHP), Paris, France
| | - Thomas Bardin
- Department of Rheumatology, Lariboisière Hospital, Paris, France
| | - Bernard Combe
- Department of Rheumatology, Montpellier University Hospital, Montpellier, France
| | | | - Rene-Marc Flipo
- Department of Rheumatology, University Hospital, Lille, France
| | - Alain Saraux
- Department of Rheumatology, University Hospital, Brest, France
| | | | - Jean Sibilia
- Department of Rheumatology, 1 avenue Molière, Strasbourg University Hospital, National Centre For Rare Systemic Autoimmune Diseases, 67000 Strasbourg, France
| | - Martin Soubrier
- Department of Rheumatology, University Hospital, Clermont Ferrand, France
| | | | - Gabriel Baron
- Department of Epidemiology and Public Health, Hotel Dieu, Assistance Publique des Hôpitaux de Paris (APHP), Paris, France
| | | | - Philippe Ravaud
- Department of Epidemiology and Public Health, Hotel Dieu, Assistance Publique des Hôpitaux de Paris (APHP), Paris, France
| | - Xavier Mariette
- Department of Rheumatology, Université Paris Sud, AP-HP, Hôpitaux Universitaires Paris-Sud, Center for Immunology of viral infections and autoimmune diseases (IMVA), INSERM U1184, Le Kremlin Bicêtre, France
| |
Collapse
|
45
|
Loustau C, Rosine N, Forien M, Ottaviani S, Juge PA, Lioté F, Bardin T, Richette P, Dieudé P, Richez C, Bannwarth B, Schaeverbeke T, Ea HK, Truchetet ME. Effectiveness and safety of anakinra in gout patients with stage 4–5 chronic kidney disease or kidney transplantation: A multicentre, retrospective study. Joint Bone Spine 2018; 85:755-760. [DOI: 10.1016/j.jbspin.2018.03.015] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2017] [Accepted: 03/04/2018] [Indexed: 10/17/2022]
|
46
|
Bardin T, Tran KM, Nguyen QD, Sarfati M, Richette P, Vo NT, Bousson V, Correas JM. Renal medulla in severe gout: typical findings on ultrasonography and dual-energy CT study in two patients. Ann Rheum Dis 2018; 78:433-434. [PMID: 30269050 DOI: 10.1136/annrheumdis-2018-214174] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Revised: 09/05/2018] [Accepted: 09/07/2018] [Indexed: 11/03/2022]
Affiliation(s)
- Thomas Bardin
- French-Vietnamese Research Center on Gout and Chronic diseases, Vien Gut Medical Clinic, Ho Chi Minh City, Vietnam .,Rheumatology Department, Hôpital Lariboisière APHP, Paris, France.,Université Paris Diderot, INSERM U1132, Paris, France
| | - Khoi Minh Tran
- French-Vietnamese Research Center on Gout and Chronic diseases, Vien Gut Medical Clinic, Ho Chi Minh City, Vietnam
| | - Quang Dinh Nguyen
- French-Vietnamese Research Center on Gout and Chronic diseases, Vien Gut Medical Clinic, Ho Chi Minh City, Vietnam
| | - Marine Sarfati
- Rheumatology Department, Hôpital Lariboisière APHP, Paris, France
| | - Pascal Richette
- Rheumatology Department, Hôpital Lariboisière APHP, Paris, France.,Université Paris Diderot, INSERM U1132, Paris, France
| | | | - Valérie Bousson
- Université Paris Diderot, CNRS UMR 7052, Paris, France.,Radiology Department, Hôpital Lariboisière APHP, Paris, France
| | - Jean-Michel Correas
- Radiology Department, Hôpital Necker APHP, Paris, France.,Paris Descartes University, Paris, France
| |
Collapse
|
47
|
Sigaux J, Abdelkefi I, Bardin T, Laredo JD, Ea HK, UreñaTorres P, Cohen-Solal M. Tendon thickening in dialysis-related joint arthritis is due to amyloid deposits at the surface of the tendon. Joint Bone Spine 2018; 86:233-238. [PMID: 30243785 DOI: 10.1016/j.jbspin.2018.08.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Accepted: 08/24/2018] [Indexed: 11/17/2022]
Abstract
OBJECTIVES Beta-2-microglobulin (β2M) dialysis-related amyloidosis (DRA), a disabiliting joint disease, has been initially reported in patients under long-term dialysis. The incidence and prevalence has significantly decreased with the improvement in dialysis techniques. Here, we attempted to clarify the clinical and MRI features to improve the diagnosis. METHODS We retrospectively reviewed the files of 19 patients under dialysis treatment referred for suspicion of β2M DRA. The diagnosis was based on MRI criteria (low signal intensity on both T1- and T2-weighted MR sequences). MRI analysis included a scoring of the several joint lesions. Scores were quantified according to a severity scale (0 to 3). RESULTS Patients had a mean age of 66.0 ± 10.5 years and mean dialysis duration of 23.7 ± 10.5 years. DRA affected mainly large joints (shoulder in 73.7%, hip in 47.3%) and spine (36.8%). MRI images for 8 shoulders, 8 hips, and 3 spines were analysed. Amyloid synovitis was present in all cases, with high mean scores in the three sites. In all joints, the most common lesions were tendon thickening (68.4%) and bone erosions (68.4%). The mean tendon thickening score was high, particularly at the shoulders and also at the spine. Bone erosions were most frequent in the shoulder and pelvis. CONCLUSION In patients under long-term dialysis, β2M DRA involves large joints but also the spine. Special awareness should be drawn by the thickening of the tendon. MRI is required to characterize the pattern of the lesions and to achieve the diagnosis.
Collapse
Affiliation(s)
- Johanna Sigaux
- Department of rheumatology, hôpital Lariboisière, 75010 Paris, France; University Paris 7, 75013 Paris, France
| | - Imen Abdelkefi
- Department of rheumatology, hôpital Lariboisière, 75010 Paris, France; University Paris 7, 75013 Paris, France
| | - Thomas Bardin
- Department of rheumatology, hôpital Lariboisière, 75010 Paris, France; University Paris 7, 75013 Paris, France
| | - Jean-Denis Laredo
- Department of bone and joint imaging, hôpital Lariboisière and university, 75010 Paris, France
| | - Hang-Korng Ea
- Department of rheumatology, hôpital Lariboisière, 75010 Paris, France; University Paris 7, 75013 Paris, France
| | - Pablo UreñaTorres
- Ramsay-Générale de santé, clinique du Landy, 93400 Saint Ouen, France; Department of nephrology and dialysis and department of renal physiology, necker hospital, 75015 Paris, France; University of Paris Descartes, 75006 Paris, France
| | - Martine Cohen-Solal
- Department of rheumatology, hôpital Lariboisière, 75010 Paris, France; University Paris 7, 75013 Paris, France.
| |
Collapse
|
48
|
Beaudreuil J, Ferrari M, Lellouche H, Roulot E, Yelnik A, Bardin T, Orcel P, Richette P. Iterative percutaneous needle aponeurotomy for Dupuytren's disease: Functional results at 5-year follow-up. Ann Phys Rehabil Med 2018. [DOI: 10.1016/j.rehab.2018.05.041] [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: 10/28/2022]
|
49
|
Bassiouni H, Aly H, Zaky K, Abaza N, Bardin T. Probing The Relation Between Vitamin D Deficiency and Progression of Medial Femoro-tibial Osteoarthitis of the Knee. Curr Rheumatol Rev 2018; 13:65-71. [PMID: 27041085 DOI: 10.2174/1573397112666160404124532] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2015] [Revised: 12/30/2015] [Accepted: 03/31/2016] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To compare serum 25 OH vitamin D (25 (OH) D) levels between medial femoro-tibial knee osteoarthritis (OA) patients and controls, and to detect structural progression in patients with mild to moderate knee osteoarthritis in relation to baseline 25(OH) D levels in a oneyear longitudinal prospective cohort study. METHODS Thirty eight patients with medial femoro-tibial knee OA according to the ACR criteria and no knee malalignement, and 20 age, sex and BMI-matched pain free controls were included in the vitamin D study. All included OA patients had radiographic Kellgren and Lawrence grades 2 or 3. Baseline serum levels of 25(OH) D, and the "Benefiting from ultraviolet index "(BFUI) score were determined; serum parathormone, total alkaline phosphatase, calcium and phosphorus were measured. In the OA progression study, OA patients were divided into 2 groups according to 25 (OH) D level using a cutoff of 10 ng/ml to identify their status. MRIs were done at baseline and repeated after 12 months with scoring system according to Boston Leeds osteoarthritis knee score (BLOKS). During the study period, the patients were not supplemented with 25(OH)D. RESULTS The mean values of Vitamin D were statistically lower in the OA patient group than in controls (8.64 ± 6.42 vs. 14.84±0.87 pg/mL, P =0.0295). The BFUI score overall correlated with 25 (OH) D status. Eight patients did not complete the study so only thirty OA patients underwent the 2 MRIs. Of those, 21 had 25(OH) D levels <10 ng/ml, while 9 had levels >10 ng/ml. A significant progression of the medial meniscal grading from baseline to 1 year was seen in the patients with 25(OH)D levels <10 ng/ml as compared to the others (Wilcoxon Z= -3.556 P<0.001). CONCLUSION 25 (OH) D levels were significantly decreased in knee OA patients. Significant deterioration of the medial menisci was observed in OA patients with 25 (OH)D levels <10 ng/ml suggesting that Vit D deficiency may play a role in the progression of medial femoro-tibial OA.
Collapse
Affiliation(s)
- Hassan Bassiouni
- Department of Rheumatology, Al-Hussein Hospital, Al-Azhar University, Cairo 11651,. Egypt
| | | | | | | | | |
Collapse
|
50
|
Fabre S, Clerson P, Launay JM, Gautier JF, Vidal-Trecan T, Riveline JP, Platt A, Abrahamsson A, Miner JN, Hughes G, Richette P, Bardin T. Accuracy of the HumaSens plus point-of-care uric acid meter using capillary blood obtained by fingertip puncture. Arthritis Res Ther 2018; 20:78. [PMID: 29720236 PMCID: PMC5932794 DOI: 10.1186/s13075-018-1585-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2017] [Accepted: 03/28/2018] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND The uric acid (UA) level in patients with gout is a key factor in disease management and is typically measured in the laboratory using plasma samples obtained after venous puncture. This study aimed to assess the reliability of immediate UA measurement with capillary blood samples obtained by fingertip puncture with the HumaSensplus point-of-care meter. METHODS UA levels were measured using both the HumaSensplus meter in the clinic and the routine plasma UA method in the biochemistry laboratory of 238 consenting diabetic patients. HumaSensplus capillary and routine plasma UA measurements were compared by linear regression, Bland-Altman plots, intraclass correlation coefficient (ICC), and Lin's concordance coefficient. Values outside the dynamic range of the meter, low (LO) or high (HI), were analyzed separately. The best capillary UA thresholds for detecting hyperuricemia were determined by receiver operating characteristic (ROC) curves. The impact of potential confounding factors (demographic and biological parameters/treatments) was assessed. Capillary and routine plasma UA levels were compared to reference plasma UA measurements by liquid chromatography-mass spectrometry (LC-MS) for a subgroup of 67 patients. RESULTS In total, 205 patients had capillary and routine plasma UA measurements available. ICC was 0.90 (95% confidence interval (CI) 0.87-0.92), Lin's coefficient was 0.91 (0.88-0.93), and the Bland-Altman plot showed good agreement over all tested values. Overall, 17 patients showed values outside the dynamic range. LO values were concordant with plasma values, but HI values were considered uninterpretable. Capillary UA thresholds of 299 and 340 μmol/l gave the best results for detecting hyperuricemia (corresponding to routine plasma UA thresholds of 300 and 360 μmol/l, respectively). No significant confounding factor was found among those tested, except for hematocrit; however, this had a negligible influence on the assay reliability. When capillary and routine plasma results were discordant, comparison with LC-MS measurements showed that plasma measurements had better concordance: capillary UA, ICC 0.84 (95% CI 0.75-0.90), Lin's coefficient 0.84 (0.77-0.91); plasma UA, ICC 0.96 (0.94-0.98), Lin's coefficient 0.96 (0.94-0.98). CONCLUSIONS UA measurements with the HumaSensplus meter were reasonably comparable with those of the laboratory assay. The meter is easy to use and may be useful in the clinic and in epidemiologic studies.
Collapse
Affiliation(s)
- Stéphanie Fabre
- Inserm U1132, Rheumatology Department, Lariboisière Hospital, Paris Diderot University, 2 rue Ambroise Paré, 75010 Paris, France
| | | | - Jean-Marie Launay
- Inserm U942, Biochemistry and Molecular Biology Department, Lariboisière Hospital, Paris Diderot University, Paris, France
| | | | | | | | - Adam Platt
- Precision Medicine and Genomics, IMED Biotech Unit, AstraZeneca, Cambridge, UK
| | - Anna Abrahamsson
- Precision Medicine and Genomics, IMED Biotech Unit, AstraZeneca, Cambridge, UK
| | | | - Glen Hughes
- Precision Medicine and Genomics, IMED Biotech Unit, AstraZeneca, Cambridge, UK
| | - Pascal Richette
- Inserm U1132, Rheumatology Department, Lariboisière Hospital, Paris Diderot University, 2 rue Ambroise Paré, 75010 Paris, France
| | - Thomas Bardin
- Inserm U1132, Rheumatology Department, Lariboisière Hospital, Paris Diderot University, 2 rue Ambroise Paré, 75010 Paris, France
| |
Collapse
|