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Tron C, Lemaitre F, Locher C, Lecomte T, Tournigand C, Bouhier Leporrier K, Le Sourd S, Metges JP, Tougeron D, Di Fiore F, Hervé C, Heran M, Touchefeu Y, Rousseau BC, Hulin A, Lievre A. 449TiP Evaluation of regorafenib treatment PERSOnalization based on therapeutic drug monitoring in patients with metastatic colorectal cancer (mCRC): RePERSO study. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.1870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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2
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Hervé C, Laneuville P. Inuit Women Working in the Nunavik Justice System: A Relational Perspective on Justice. Études Inuit Studies 2022. [DOI: 10.7202/1096501ar] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
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Callegaro A, Willer DO, Burny W, Hervé C, Kim JH, levin MJ, Zahaf T, Cunningham AL, Didierlaurent A. 26. Is There a Correlation Between Reactogenicity and Immune Responses of the Adjuvanted Recombinant Zoster Vaccine (RZV)? A Post-hoc Analysis. Open Forum Infect Dis 2021. [PMCID: PMC8644461 DOI: 10.1093/ofid/ofab466.228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
RZV (GSK) contains the varicella-zoster virus antigen glycoprotein E (gE) and the adjuvant system AS01B that enhances gE-specific immune responses through stimulating innate immunity. AS01B may contribute to the development of transient local or systemic post-vaccination reactions. A hypothesis that the magnitude of those reactions is predictive of immunogenicity and efficacy (i.e., “no pain, no gain”) remains untested. To evaluate potential correlations between RZV’s reactogenicity and immunogenicity in adults aged ≥ 50 years, a post-hoc analysis was conducted using data from 2 large phase 3 studies (NCT01165177, NCT01165229).
Methods
Reactogenicity was calculated as a single score per symptom (maximum grade recorded over 7 days post-vaccination). A global score obtained by adding each maximum severity for all reported symptoms (multivariate reactogenicity models) and a score for each reactogenicity symptom (univariate reactogenicity models) were estimated.
Results
The analysis included 904 and 147 RZV recipients with completed post-vaccination symptom diary cards and with anti-gE antibody results or cell-mediated immunity (CMI) results, respectively. The global score of reactogenicity post-dose 2 was significantly associated with anti-gE antibody response (p< 0.001, estimate 0.112) although the absolute antibody increase associated with reactogenicity was minimal (1.29-fold increase), while the association with CMI response was not statistically significant (p=0.073, estimate 0.230). There was a weak, but statistically significant association between gE-specific immune responses and the maximum pain post-dose 2 score (p=0.001, estimate 0.041), irrespective of post-vaccination time. Nevertheless, there are observations of immune responses in participants for whom pain was not reported.
Conclusion
A weak but statistically significant correlation was found between injection site pain intensity and immune responses in adult RZV recipients aged ≥ 50 years. However, participants reporting no pain were also able to mount a strong immune response, therefore pain cannot be a surrogate marker to inform on the level of immune response or on likelihood of being protected against herpes zoster.
Funding
GlaxoSmithKline Biologicals SA
Disclosures
Andrea Callegaro, PhD, GSK group of companies (Employee, Shareholder) David O. Willer, PhD, GSK group of companies (Employee, Other Financial or Material Support, Receive GSK shares as part of employment renumeration) Wivine Burny, PhD, GSK group of companies (Employee) Caroline Hervé, PhD, GSK group of companies (Employee) Joon Hyung Kim, MD, GSK group of companies (Employee, Shareholder) myron J. levin, MD, GSK group of companies (Employee, Research Grant or Support) Toufik Zahaf, PhD, GSK group of companies (Employee, Shareholder) Anthony L. Cunningham, F.A.H.M.S., MD, M.B.B.S., B. Med. Sci. (Hons), F.R.A.C.P., F.R.C.P.A., F.A.S.M., GSK group of companies (Grant/Research Support, Advisor or Review Panel member, Speaker’s Bureau) Arnaud Didierlaurent, PhD, GSK group of companies (Other Financial or Material Support, previous employee until 03/2020)Sanofi (Speaker’s Bureau)
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Affiliation(s)
- Andrea Callegaro
- GSK, Rixensart/Wavre, Belgium, Rixensart/Wavre, Brabant Wallon, Belgium
| | | | - Wivine Burny
- GSK, Rixensart/Wavre, Belgium, Rixensart/Wavre, Brabant Wallon, Belgium
| | - Caroline Hervé
- GSK, RIxensart/Wavre, Belgium, braine-l’alleud, Brabant Wallon, Belgium
| | | | - myron J levin
- University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | | | - Anthony L Cunningham
- The Westmead Institute for Medical Research and the Institute’s Centre for Virus Research, The University of Sydney, Sidney, New South Wales, Australia
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Gauvrit M, Jaffré S, Morin J, Hervé C, Alami H, Blanc FX. [Central control malfunction in Wolfram syndrome: Report of one case of difficult weaning]. Rev Mal Respir 2021; 38:946-950. [PMID: 34702600 DOI: 10.1016/j.rmr.2021.09.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Accepted: 09/03/2021] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Wolfram syndrome is a rare autosomal recessive genetic disease characterized by diabetes insipidus, diabetes mellitus, optic atrophy and deafness. A neurodegenerative syndrome is usually associated, including cerebellar ataxia. A few cases of central apnea have been reported in the literature. Here, we report a case of Wolfram syndrome with respiratory symptoms that led to the discovery of central apneas as well as complicated and delayed weaning in an intensive care unit (ICU). OBSERVATION The patient is a 39-year-old woman diagnosed with Wolfram syndrome who was admitted to an ICU for septic shock. She experienced difficult weaning before central apneas were observed while spontaneous ventilation was being attempted. After two extubation failures, cerebral MRI was performed and revealed parenchymatous atrophy of the posterior brain fossa involving the cerebral trunk, cerebellar peduncles, as well as both cerebellum hemispheres and the cerebellar vermis. Even after the patient was tracheotomized, central apneas persisted when the patient breathed spontaneously with her tracheotomy, necessitating nocturnal ventilation. CONCLUSION While central apneas Wolfram syndrome remain rare, they should be systematically investigated due to their association with severe morbimortality.
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Affiliation(s)
- M Gauvrit
- Service de pneumologie, L'institut du thorax, Hôpital G. et R. Laennec, CHU de Nantes, boulevard Jacques-Monod, 44093 Nantes cedex 1, France.
| | - S Jaffré
- Service de pneumologie, L'institut du thorax, Hôpital G. et R. Laennec, CHU de Nantes, boulevard Jacques-Monod, 44093 Nantes cedex 1, France
| | - J Morin
- Service de pneumologie, L'institut du thorax, Hôpital G. et R. Laennec, CHU de Nantes, boulevard Jacques-Monod, 44093 Nantes cedex 1, France
| | - C Hervé
- Service de pneumologie, L'institut du thorax, Hôpital G. et R. Laennec, CHU de Nantes, boulevard Jacques-Monod, 44093 Nantes cedex 1, France; Centre Hospitalier Erdre Loire, 44156 Ancenis, France
| | - H Alami
- Service de pneumologie, L'institut du thorax, Hôpital G. et R. Laennec, CHU de Nantes, boulevard Jacques-Monod, 44093 Nantes cedex 1, France
| | - F-X Blanc
- Service de pneumologie, L'institut du thorax, Hôpital G. et R. Laennec, CHU de Nantes, boulevard Jacques-Monod, 44093 Nantes cedex 1, France; Université de Nantes, 44000 Nantes, France
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Callegaro A, Burny W, Hervé C, Hyung Kim J, Levin MJ, Zahaf T, Cunningham AL, Didierlaurent AM. Association Between Immunogenicity and Reactogenicity: A Post Hoc Analysis of 2 Phase 3 Studies With the Adjuvanted Recombinant Zoster Vaccine. J Infect Dis 2021; 226:1943-1948. [PMID: 34662415 PMCID: PMC9704432 DOI: 10.1093/infdis/jiab536] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Accepted: 10/14/2021] [Indexed: 12/31/2022] Open
Abstract
A recurrent question is whether transient reactions to vaccines translate into better immune responses. Using clinical data from 2 large phase 3 studies of the recombinant zoster vaccine, we observed a small but statistically significant association between the intensity of a frequent side effect (pain) after vaccination and immune responses to vaccination. However, despite the statistical correlation, the impact on the immune response is so small, and the immune response in individuals without pain already sufficient, that pain cannot be a surrogate marker for an appropriate immune response. Reactogenicity cannot be used to predict immunity after vaccination.
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Affiliation(s)
| | | | | | | | - Myron J Levin
- Departments of Pediatrics and Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | | | - Anthony L Cunningham
- Westmead Institute for Medical Research, Westmead, University of Sydney, Sydney, Australia
| | - Arnaud M Didierlaurent
- Correspondence: Arnaud M. Didierlaurent, PhD, Center of Vaccinology, Department of Pathology and Immunology, Faculty of Medicine, University of Geneva, Centre Medical Universitaire, 1 Michel-Servet, 1211 Geneva 4, Switzerland ()
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Dagnew AF, Klein NP, Hervé C, Kalema G, Di Paolo E, Peterson J, Salaun B, Schuind A. The Adjuvanted Recombinant Zoster Vaccine in Adults Aged ≥65 Years Previously Vaccinated With a Live-Attenuated Herpes Zoster Vaccine. J Infect Dis 2021; 224:1139-1146. [PMID: 32103273 PMCID: PMC8514183 DOI: 10.1093/infdis/jiaa083] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [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: 12/13/2019] [Accepted: 02/25/2020] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Efficacy of the live-attenuated herpes zoster (HZ) vaccine (ZVL) wanes substantially over time. We evaluated immunogenicity and safety of the adjuvanted recombinant zoster vaccine (RZV) in previous ZVL recipients. METHODS Adults aged ≥65 years who were previously vaccinated with ZVL ≥5 years earlier (n = 215) were group-matched with ZVL-naive individuals (n = 215) and vaccinated with RZV. Glycoprotein E (gE)-specific humoral and cell-mediated immune responses and the correlation between them, polyfunctional gE-specific CD4 T-cell responses, safety, and confirmed HZ cases were assessed. RESULTS Through 12 months after dose 2, anti-gE antibody concentrations, gE-specific CD4 T-cell frequencies, and activation marker profiles were similar between groups. Safety outcomes were also similar. No HZ episodes were confirmed. CONCLUSIONS RZV induced strong humoral and polyfunctional cell-mediated immune responses that persisted above prevaccination levels through 1 year after dose 2 in adults aged ≥65 years irrespective of previous ZVL vaccination. The RZV safety profile was not affected. CLINICAL TRIALS REGISTRATION NCT02581410.
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Affiliation(s)
| | - Nicola P Klein
- Kaiser Permanente Vaccine Study Center, Oakland, California, USA
| | | | - George Kalema
- Keyrus Biopharma, Waterloo, Belgium, C/O GSK, Wavre, Belgium
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Pirrotta P, Tavares-Da-Silva F, Co M, Lecrenier N, Hervé C, Stegmann JU. An Analysis of Spontaneously Reported Data of Vesicular and Bullous Cutaneous Eruptions Occurring Following Vaccination with the Adjuvanted Recombinant Zoster Vaccine. Drug Saf 2021; 44:1341-1353. [PMID: 34622421 PMCID: PMC8626369 DOI: 10.1007/s40264-021-01118-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/31/2021] [Indexed: 12/30/2022]
Abstract
Introduction With the approval of the adjuvanted recombinant zoster vaccine (RZV; Shingrix, GSK) in October 2017, GSK established enhanced safety surveillance measures to allow prompt identification of potential safety signals not observed during clinical development. In Germany, cases of vesicular and bullous cutaneous eruptions following RZV vaccination were reported. Objective Our objective was to search and analyse 2.5 years of worldwide spontaneously reported post-marketing data for vesicular and bullous cutaneous eruptions, represented by adverse events suggestive of (1) herpes zoster (HZ) and (2) non-HZ vesicular and bullous cutaneous eruptions, that occurred following RZV vaccination. Methods We conducted a descriptive analysis of all identified reports of HZ and non-HZ vesicular and bullous cutaneous eruptions following RZV vaccination and an observed versus expected (O/E) analysis of reports of HZ that met criteria of varicella zoster virus (VZV) reactivations following RZV vaccination (i.e., time to onset [TTO] of the event < 30 days or missing after any dose). Results Until the data lock point, 32,597,779 RZV doses had been distributed globally. There were 2423 reports of HZ (including complications) identified, of which 645 met the criteria of possible vaccination failure (i.e., TTO of the event ≥ 30 days or missing following a complete RZV vaccination schedule). The O/E analysis of 1928 reports assessed as possible VZV reactivations indicated that the observed number of cases was lower than that expected in the general population. Additionally, 810 reports of non-HZ vesicular and bullous cutaneous eruptions were identified, including injection site rashes attributed to the vaccine’s reactogenicity. Conclusion This review of spontaneously reported post-marketing data did not raise safety concerns regarding the occurrence of vesicular and bullous cutaneous eruptions following vaccination with RZV. Supplementary Information The online version contains supplementary material available at 10.1007/s40264-021-01118-3. Shingles is a disease caused by reactivation of the chickenpox virus. It mostly affects adults aged 50 years and older and patients of all ages who have an impaired immune system. Diagnosis of shingles is often based only on the presence of symptoms such as a typical rash and pain. However, rashes can have various other causes (e.g., allergies, autoimmune diseases, and infections). Consequently, rashes with other causes may be misdiagnosed as shingles. Adults at increased risk of shingles and/or aged 50 years and older may be vaccinated with Shingrix (GSK, Belgium) to protect them from shingles and its complications. Since Shingrix became available in Germany, blister-like skin rashes have been reported that occurred shortly after vaccination. We searched the GSK safety database for reports of blister-like skin rashes that occurred following vaccination with Shingrix and that were spontaneously reported from countries where Shingrix was first marketed. To analyse these reports of rashes, we described the reports that we retrieved, we performed a statistical analysis to quantify whether the number of events assessed as reactivations of the chickenpox virus following Shingrix vaccination was higher than the number of reactivations that would be expected in the general population, and we described possible explanations for the observed rashes and underlying disease mechanisms. Our analyses did not raise safety concerns related to the onset of these rashes after vaccination with Shingrix. This paper raises awareness about the varying causes of rashes since a shingles-like rash that onsets shortly after vaccination with Shingrix is not necessarily caused by vaccination. In conclusion, this analysis shows that caution is needed when evaluating rashes in older adults and that all potential contributing factors (e.g., pre-existing diseases, medication, vaccination) should be considered.
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Affiliation(s)
| | | | - Maribel Co
- GSK, Avenue Fleming 20, 1300, Wavre, Belgium
| | | | - Caroline Hervé
- GSK, Avenue Fleming 20, 1300, Wavre, Belgium
- UCB Pharma, Chemin du Foriest 1, 1420, Braine-l'Alleud, Belgium
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Luna Yolba R, Visentin V, Hervé C, Chiche J, Ricci J, Méneyrol J, Paillasse MR, Alet N. EVT-701 is a novel selective and safe mitochondrial complex 1 inhibitor with potent anti-tumor activity in models of solid cancers. Pharmacol Res Perspect 2021; 9:e00854. [PMID: 34478236 PMCID: PMC8415080 DOI: 10.1002/prp2.854] [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] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Accepted: 07/13/2021] [Indexed: 12/01/2022] Open
Abstract
Targeting the first protein complex of the mitochondrial electron transport chain (MC1) in cancer has become an attractive therapeutic approach in the recent years, given the metabolic vulnerabilities of cancer cells. The anticancer effect exerted by the pleiotropic drug metformin and the associated reduction in hypoxia-inducible factor 1α (HIF-1α) levels putatively mediated by MC1 inhibition led to the development of HIF-1α inhibitors, such as BAY87-2243, with a more specific MC1 targeting. However, the development of BAY87-2243 was stopped early in phase 1 due to dose-independent emesis and thus there is still no clinical proof of concept for the approach. Given the importance of mitochondrial metabolism during cancer progression, there is still a strong therapeutic need to develop specific and safe MC1 inhibitors. We recently reported the synthesis of compounds with a novel chemotype and potent action on HIF-1α degradation and MC1 inhibition. We describe here the selectivity, safety profile and anti-cancer activity in solid tumors of lead compound EVT-701. In addition, using murine models of lung cancer and of Non-Hodgkin's B cell lymphoma we demonstrated that EVT-701 reduced tumor growth and lymph node invasion when used as a single agent therapy. LKB1 deficiency in lung cancer was identified as a potential indicator of accrued sensitivity to EVT-701, allowing stratification and selection of patients in clinical trials. Altogether these results support further evaluation of EVT-701 alone or in combination in preclinical models and eventually in patients.
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Affiliation(s)
| | | | | | - Johanna Chiche
- C3MINSERMUniversité Côte d'Azur, Equipe labellisée Ligue Contre le CancerNiceFrance
| | - Jean‐Ehrland Ricci
- C3MINSERMUniversité Côte d'Azur, Equipe labellisée Ligue Contre le CancerNiceFrance
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Hervé C, Duguet AM, Georges C, Golse B, Cordier B, Galichon B, Zarzavadjian Le Bian A, Alasseur E, Stœklé HC, Gaillard M, Emmanuelli X, Emery S, Di C, Jault-Seseke F, Perez S, Bouffard C, Bommier C. Treating strangeness: Medicine and human dignity at the time of COVID-19. Ethics Med Public Health 2021; 18:100659. [PMID: 34493984 PMCID: PMC8412238 DOI: 10.1016/j.jemep.2021.100659] [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] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Accepted: 03/17/2021] [Indexed: 11/17/2022]
Abstract
The concomitance of a migratory wave and the hospital crisis once again raises the question of the care that the French healthcare system is able to provide to migrants. On the occasion of SFFEM's 19th annual day, we present a synthesis of the research work that has been communicated at that time. Firstly, we will discuss how doctors have been able to overcome strangeness to revive the notion of hospitality according to Levinas; secondly, we will discuss how the hospital is departing from its mission of institutional hospitality because of administrative injunctions; thirdly, we will discuss how ethnomedicine gives us keys to open up to other cultural norms; fourthly, we will see the inadequacy that exists between rights of access to medical care and their effectiveness; finally, the conclusion of Xavier Emmanuelli, founder of the social ambulance service, will remind us how much the values of the French Republic call us to the notion of care and openness to otherness.
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Affiliation(s)
- C Hervé
- Société Française et Francophone d'Éthique Médicale, 45, rue des Saints-Pères, 75006 Paris, France
- Hôpital Foch, 40, rue Worth, 92150 Suresnes, France
| | - A-M Duguet
- Médecine légale, Université Paul Sabatier Toulouse III, Toulouse, France
| | - C Georges
- Assistance Publique-Hôpitaux de Paris, 1, avenue Claude Vellefaux, 75010 Paris, France
| | - B Golse
- Necker Enfants Malades, 149, rue de Sèvres, 75015 Paris, France
| | - B Cordier
- Hôpital Foch, 40, rue Worth, 92150 Suresnes, France
| | - B Galichon
- Service des Urgences, Hôpital Lariboisière, 2, rue Ambroise Paré, 75010 Paris, France
| | - A Zarzavadjian Le Bian
- Service de chirurgie digestive, Hôpital Avicenne, 125, rue de Stalingrad, 93000 Bobigny, France
| | - E Alasseur
- 3, place de Fontenoy, 75007 Paris, France
| | - H-C Stœklé
- Société Française et Francophone d'Éthique Médicale, 45, rue des Saints-Pères, 75006 Paris, France
- Hôpital Foch, 40, rue Worth, 92150 Suresnes, France
| | - M Gaillard
- Société Française et Francophone d'Éthique Médicale, 45, rue des Saints-Pères, 75006 Paris, France
| | - X Emmanuelli
- Fondateur du SAMU social, Ancien secrétaire d'Etat à l'action humanitaire d'urgence, 51 Rue Ledru Rollin, 94200 Ivry-sur-Seine, France
| | - S Emery
- Hôpital Corentin Celton, AP-HP, 4, Parvis Corentin Celton, 92130 Issy-les-Moulineaux, France
| | - C Di
- Hôpital Cochin, 27, rue du Faubourg-Saint-Jacques, 75014 Paris, France
| | | | - S Perez
- 20, avenue George Sand, 93210 Saint-Denis, France
| | - C Bouffard
- Université de Sherbrooke, 3001, 12 avenue Nord Sherbrooke, J1H 5N4 Québec, Canada
| | - C Bommier
- Société Française et Francophone d'Éthique Médicale, 45, rue des Saints-Pères, 75006 Paris, France
- Hôpital Saint Louis, Assistance publique-Hôpitaux de Paris, 1, avenue Claude Vellefaux, 75010 Paris, France
- Université de Paris, 12, rue de l'Ecole de Médecine, 75006 Paris, France
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10
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Dagnew AF, Rausch D, Hervé C, Zahaf T, Levin MJ, Schuind A. Efficacy and serious adverse events profile of the adjuvanted recombinant zoster vaccine in adults with pre-existing potential immune-mediated diseases: a pooled post hoc analysis on two parallel randomized trials. Rheumatology (Oxford) 2021; 60:1226-1233. [PMID: 32910152 PMCID: PMC7937016 DOI: 10.1093/rheumatology/keaa424] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Revised: 06/18/2020] [Indexed: 12/22/2022] Open
Abstract
Abstract Objective In the ZOE-50 (NCT01165177) and ZOE-70 (NCT01165229) phase 3 clinical trials, the adjuvanted recombinant zoster vaccine (RZV) demonstrated ≥90% efficacy in preventing herpes zoster (HZ) in all age groups ≥50 years. Given the increased HZ risk associated with certain underlying autoimmune diseases or their treatment regimes, we conducted a post hoc analysis of RZV’s efficacy against HZ and safety profile [specifically, the occurrence of serious adverse events (SAEs)] in ZOE-50/70 participants who reported pre-existing potential immune-mediated diseases (pIMDs) at enrolment and were not on immunosuppressive therapies. Methods Adults aged ≥50 (ZOE-50) and ≥70 (ZOE-70) years were randomized to receive two doses of RZV or placebo 2 months apart. In this subgroup analysis of participants with at least one pIMD at enrolment, the efficacy was calculated for two-dose recipients who did not develop confirmed HZ before 30 days post-dose 2. SAE occurrence was evaluated for all participants who received at least one dose. Results Of the 14 645 RZV and 14 660 placebo recipients from the ZOE-50/70 studies, 983 and 960, respectively, reported at least one pre-existing pIMD at enrolment and were included in these analyses. The most frequent pre-existing conditions were psoriasis, spondyloarthropathy and RA. Efficacy against HZ was 90.5% (95% CI: 73.5, 97.5%) overall with the lowest being 84.4% (95% CI: 30.8, 98.3%) in the 70–79-year-old age group. SAEs and fatal SAEs were similar between RZV and placebo recipients. Conclusion In ZOE-50/70 participants with pre-existing pIMDs, RZV was highly efficacious against HZ and SAE incidence was similar between RZV and placebo recipients. Trial registration ClinicalTrials.gov, https://clinicaltrials.gov, NCT01165177 (ZOE-50), NCT01165229 (ZOE-70).
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Affiliation(s)
| | | | | | | | - Myron J Levin
- Departments of Pediatrics and Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
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Affiliation(s)
- C Bommier
- Société Française et Francophone d'Éthique Medicale, 45, rue des Saints-Pères, 75006 Paris, France.,Hôpital Saint Louis, 1, av. Claude Vellefaux, 75010 Paris, France
| | - H-C Stœklé
- Société Française et Francophone d'Éthique Medicale, 45, rue des Saints-Pères, 75006 Paris, France.,Hôpital Foch, 40 Rue Worth, 92150 Suresnes, France
| | - C Hervé
- Société Française et Francophone d'Éthique Medicale, 45, rue des Saints-Pères, 75006 Paris, France.,Hôpital Foch, 40 Rue Worth, 92150 Suresnes, France
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12
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Ivasilevitch A, Stoeklé HC, Hervé C. COVID-19 and vaccination, or the new misfortunes of the precautionary principle. ACTA ACUST UNITED AC 2021; 18:100665. [PMID: 33816738 PMCID: PMC7997699 DOI: 10.1016/j.jemep.2021.100665] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Revised: 03/24/2021] [Accepted: 03/24/2021] [Indexed: 11/25/2022]
Affiliation(s)
- A Ivasilevitch
- Laboratory of Business Law and New Technologies (DANTE) (UR4498), Paris-Saclay University (UVSQ), Montigny-Le-Bretonneux, France.,Department of Ethics and Scientific Integrity, Foch Hospital, Suresnes, France
| | - H-C Stoeklé
- Department of Ethics and Scientific Integrity, Foch Hospital, Suresnes, France
| | - C Hervé
- Department of Ethics and Scientific Integrity, Foch Hospital, Suresnes, France.,University of Paris, Paris, France.,International Academy of Medical Ethics and Public Health, University of Paris, Paris, France.,Veterinary Academy of France, Paris, France
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Schmader KE, Levin MJ, Chen M, Matthews S, Riley ME, Woo W, Hervé C, Grupping K, Schuind AE, Oostvogels L, Curran D. Impact of Reactogenicity After Two Doses of Recombinant Zoster Vaccine Upon Physical Functioning and Quality of Life: An Open Phase III Trial in Older Adults. J Gerontol A Biol Sci Med Sci 2021; 76:485-490. [PMID: 32530462 PMCID: PMC7907492 DOI: 10.1093/gerona/glaa127] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Herpes zoster may significantly impact quality of life (QoL) in older adults. The recombinant zoster vaccine (RZV) is efficacious in adults aged ≥50 and older and is associated with increased reactogenicity compared to placebo. We report here on the impact of reactogenicity of the second RZV dose on the QoL and physical functioning (PF) of vaccine recipients, and summarize findings following both doses. METHOD In this single-arm study, 401 adults aged ≥50 and older were enrolled to receive two RZV doses 2 months apart. Change in mean Short Form Survey-36 (SF-36) PF and EuroQol-5 Dimension (EQ-5D) scores, reactogenicity, safety, productivity loss, and healthcare resource utilization were evaluated. RESULTS In total, 391 (97.5%) participants received dose 2. Post-dose 2, the most common solicited local symptoms were injection site pain (75.1%), erythema (22.4%), and swelling (13.9%), and the most common systemic symptoms were fatigue (46.3%), headache (37.5%), and myalgia (32.9%). Grade 3 solicited (local and systemic) adverse events were reported by 61 (15.6%) participants and were associated with a transient clinically significant decrease in SF-36 PF score on Days 1-2 post-dose 2 that recovered by Day 3. Overall, no clinically important reduction in mean SF-36 PF scores was observed from baseline to post-dose 2 (mean change -0.4), and no quality-adjusted-life-year loss was recorded. CONCLUSIONS Overall, QoL and PF of RZV vaccinees were not affected by vaccine-related reactogenicity. A transient reduction was observed in the first 2 days after RZV vaccination in individuals with Grade 3 adverse events. No safety concerns were identified.
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Affiliation(s)
- Kenneth E Schmader
- Division of Geriatrics, Duke University Medical Center and GRECC, Durham Veterans Affairs Medical Center, North Carolina
| | - Myron J Levin
- Departments of Pediatrics and Medicine, University of Colorado Anschutz Medical Campus, Aurora
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Stoeklé HC, Ivasilevitch A, Hervé C. COVID-19: For changing biomedical research standards teaching, is bioethics the solution? ACTA ACUST UNITED AC 2021; 16:100628. [PMID: 33521217 PMCID: PMC7833895 DOI: 10.1016/j.jemep.2021.100628] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Accepted: 01/11/2021] [Indexed: 11/29/2022]
Affiliation(s)
- H-C Stoeklé
- Department of Ethics and Scientific Integrity, Foch Hospital, Suresnes, France
| | - A Ivasilevitch
- Department of Ethics and Scientific Integrity, Foch Hospital, Suresnes, France.,Laboratory of Business Law and New Technologies (DANTE) (EA4498), Paris-Saclay University (UVSQ), Montigny-Le-Bretonneux, France
| | - C Hervé
- Department of Ethics and Scientific Integrity, Foch Hospital, Suresnes, France.,University of Paris, Paris, France.,International Academy of Medical Ethics and Public Health, University of Paris, Paris, France
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Bernard V, Blancart C, Lefèbvre M, Eschapasse E, Hervé C, Guéry R, Blanc X, Gouraud M, Coutherut J, Biron C. Bilan des actions de dépistage de la tuberculose-maladie menées en 2019 auprès des migrants primo-arrivants. Med Mal Infect 2020. [DOI: 10.1016/j.medmal.2020.06.300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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16
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Hervé C. [Historical setting of a dialogue between two pioneers of ethical reflection during the COVID-19 period]. Ethics Med Public Health 2020; 14:100528. [PMID: 32835051 PMCID: PMC7241339 DOI: 10.1016/j.jemep.2020.100528] [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] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Affiliation(s)
- C Hervé
- Académie internationale éthique, médecine et politiques publiques (IAMEPH), université de Paris, 45, rue des Saints-Pères, 75006 Paris, France
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Hervé C, Forest C, Noûs C, Haiech J. Plaidoyer pour une culture scientifique ouverte et socialement responsable. Ethics, Medicine and Public Health 2020; 14:100526. [PMID: 32835049 PMCID: PMC7351387 DOI: 10.1016/j.jemep.2020.100526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Accepted: 05/14/2020] [Indexed: 11/24/2022]
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18
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Hastie A, Catteau G, Enemuo A, Mrkvan T, Salaun B, Volpe S, Smetana J, Rombo L, Schwarz T, Pauksens K, Hervé C, Bastidas A, Schuind A. Immunogenicity of the adjuvanted recombinant zoster vaccine: persistence and anamnestic response to additional doses administered 10 years after primary vaccination. J Infect Dis 2020; 224:2025-2034. [PMID: 32502272 PMCID: PMC8672743 DOI: 10.1093/infdis/jiaa300] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [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: 03/26/2020] [Accepted: 06/10/2020] [Indexed: 11/14/2022] Open
Abstract
Background The adjuvanted recombinant zoster vaccine (RZV) is highly immunogenic and efficacious in adults ≥50 years of age. We evaluated (1) long-term immunogenicity of an initial 2-dose RZV schedule, by following up adults vaccinated at ≥60 years of age and by modeling, and (2) immunogenicity of 2 additional doses administered 10 years after initial vaccination. Methods Persistence of humoral and cell-mediated immune (CMI) responses to 2 initial RZV doses was assessed through 10 years after initial vaccination, and modeled through 20 years using a Piecewise, Power law and Fraser model. The immunogenicity and safety of 2 additional RZV doses were also evaluated. Results Seventy adults were enrolled. Ten years after initial vaccination, humoral and CMI responses were approximately 6-fold and 3.5-fold, respectively, above those before the initial vaccination levels. Predicted immune persistence through 20 years after initial vaccination was similar across the 3 models. Sixty-two participants (mean age [standard deviation], 82.6 [4.4] years) received ≥1 additional RZV dose. Strong anamnestic humoral and CMI responses were elicited by 1 additional dose, without further increases after a second additional dose. Conclusions Immune responses to an initial 2-dose RZV course persisted for many years in older adults. Strong anamnestic immune responses can be induced by additional dosing 10 years after the initial 2-dose course. Clinical Trials Registration NCT02735915.
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Affiliation(s)
- Andrew Hastie
- GSK, Rockville, Maryland, USA
- Correspondence: Andrew Hastie, 14200 Shady Grove Rd, Rockville, MD, 20850 ()
| | | | | | | | | | | | - Jan Smetana
- Faculty of Military Health Sciences, University of Defence, Hradec Kralove, Czech Republic
| | - Lars Rombo
- Centre for Clinical Research, Eskilstuna, Sweden
- Uppsala University, Sweden
| | - Tino Schwarz
- Klinikum Wuerzburg Mitte, Standort Juliusspital, Wuerzburg, Germany
| | - Karlis Pauksens
- Department of Infectious Diseases, Uppsala University Hospital, Uppsala, Sweden
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Affiliation(s)
- C Hervé
- Hôpital Foch, Suresnes, France.,Université de Paris, Paris, France.,Académie internationale d'éthique, médecine et politique publique, université de Paris, Paris, France
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20
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Colindres R, Wascotte V, Brecx A, Clarke C, Hervé C, Kim JH, Levin MJ, Oostvogels L, Zahaf T, Schuind A, Cunningham AL. Post hoc analysis of reactogenicity trends between dose 1 and dose 2 of the adjuvanted recombinant zoster vaccine in two parallel randomized trials. Hum Vaccin Immunother 2020; 16:2628-2633. [PMID: 32347767 PMCID: PMC7733973 DOI: 10.1080/21645515.2020.1741312] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
In two large clinical trials (ZOE-50 [NCT01165177] and ZOE-70 [NCT01165229]), two doses of the adjuvanted recombinant zoster vaccine (RZV) demonstrated >90% efficacy against herpes zoster in adults ≥50 years of age. Solicited adverse events (AEs) were collected for 7 days post-each dose in a study sub-cohort. The incidence of reported solicited AEs was higher for RZV compared to placebo recipients. Since reactogenicity may contribute to a person's willingness to be vaccinated, knowing about expected reactogenicity might help keep high compliance with the second dose. This post hoc analysis assessed the intensity of solicited AEs post-dose 2 reported to the same event's intensity post-dose 1. Intensity was graded from 0 to 3, grade 3 indicating the highest severity. Of the vaccinees who did not experience a specific AE post-dose 1, 72.6-91.7% did not experience the same event after dose 2. Although the frequency of grade 3 AEs post-dose 2 was the highest in participants reporting the same AEs at grade 3 post-dose 1, 65.8-89.3% of vaccinees with grade 3 specific AEs post-dose 1 reported the same AEs at lower intensity post-dose 2. These data can help inform health-care professionals about the frequency and intensity of AEs post-dose 2 with respect to post-dose 1.
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Affiliation(s)
- Romulo Colindres
- GSK , Rockville, MD, USA.,independent Biotech and Vaccines Consultant
| | | | | | | | | | | | - Myron J Levin
- Departments of Pediatrics and Medicine, University of Colorado Anschutz Medical Campus , Aurora, CO, USA
| | | | | | | | - Anthony L Cunningham
- The Westmead Institute for Medical Research, University of Sydney , Sydney, Australia
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Tavares-Da-Silva F, Co MM, Dessart C, Hervé C, López-Fauqued M, Mahaux O, Van Holle L, Stegmann JU. Review of the initial post-marketing safety surveillance for the recombinant zoster vaccine. Vaccine 2020; 38:3489-3500. [DOI: 10.1016/j.vaccine.2019.11.058] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2019] [Revised: 11/20/2019] [Accepted: 11/21/2019] [Indexed: 01/04/2023]
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22
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Tahri S, Barateau A, Gobeli M, Leseur J, Williaume D, Crevoisier R, Hervé C, Trifard E, Lafond C, Perichon N. 39 Evaluation and comparison of CT-CBCT deformable image registration quality of two software for cervical cancer treatment. Phys Med 2019. [DOI: 10.1016/j.ejmp.2019.09.120] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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23
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Colindres R, Wascotte V, Brecx A, Clarke C, Hervé C, Hyung Kim J, Levin MJ, Oostvogels L, Zahaf T, Schuind A, Cunningham AL. 2780. Reactogenicity Profile of Adjuvanted Recombinant Zoster Vaccine after Dose 2 According to the Intensity of the Same Event Experienced after Dose 1. Open Forum Infect Dis 2019. [PMCID: PMC6810576 DOI: 10.1093/ofid/ofz360.2457] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
In the pivotal clinical trials, ZOE-50 (NCT01165177) and ZOE-70 (NCT01165229), the adjuvanted recombinant zoster vaccine (RZV) showed high efficacy against herpes zoster and postherpetic neuralgia. The incidence of reported solicited events was higher in RZV compared with placebo recipients.
Methods
In these phase III, observer-blind, placebo-controlled trials conducted in 18 countries, adults ≥50 years of age (YOA, ZOE-50) and ≥70 YOA (ZOE-70), randomized 1:1, received 2 doses of RZV or placebo 2 months apart. Injection-site and general events were solicited for 7 days after each dose via diary cards in a participant subset. For this post-hoc analysis, ZOE-50 and ZOE-70 data from participants having completed the diary cards for both RZV doses were pooled. The intensity of each solicited event after dose 2 was stratified by the intensity of the same event after dose 1.
Results
Solicited injection-site and general events were recorded for both RZV doses by 4,676 and 4,668 vaccinees, respectively (Figure 1). Of 1,235 vaccinees with no injection-site event at dose 1, 881 (71.3%) reported no injection-site event and 20 (1.6%) reported a grade 3 event after dose 2. A total of 433 (9.3%) vaccinees reported a grade 3 injection-site event, either after dose 1 or dose 2. Of 244 vaccinees with grade 3 injection-site events at dose 1, 79 (32.4%) also reported a grade 3 event after dose 2. Of 2,312 vaccinees with no general event at dose 1, 1,617 (69.9%) reported no general event and 67 (2.9%) reported a grade 3 event after dose 2. A total of 499 (10.7%) vaccinees reported a grade 3 general event, either after dose 1 or dose 2. Of 222 vaccinees with grade 3 general events at dose 1, 81 (36.5%) also reported a grade 3 general event after dose 2. In general, vaccinees who did not experience a certain event after dose 1, did not experience this event after dose 2 either. Most vaccinees reporting a specific event at high intensity after dose 1, reported the same event at a lower intensity (or not at all) after dose 2 (Figures 2 and 3).
Conclusion
While not powered to predict event intensity of the second RZV dose, our data provides an overview of event intensity after RZV dose 2 according to the intensity of the same event experienced after dose 1.
Funding: GlaxoSmithKline Biologicals SA.
Disclosures
All authors: No reported disclosures.
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Affiliation(s)
| | | | | | | | | | | | - Myron J Levin
- University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | | | | | | | - Anthony L Cunningham
- The Westmead Institute for Medical Research and the Institute’s Centre for Virus Research, The University of Sydney, Sidney, New South Wales, Australia
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24
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Schmader KE, Levin MJ, Chen M, Matthews S, Riley M, Woo W, Hervé C, Grupping K, Schuind A, Oostvogels L, Curran D. 2778. Impact of Reactogenicity on Quality of Life and Physical Functioning in Adults ≥50 Years Receiving Both Doses of the Adjuvanted Recombinant Zoster Vaccine. Open Forum Infect Dis 2019. [PMCID: PMC6810498 DOI: 10.1093/ofid/ofz360.2455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Background The adjuvanted recombinant zoster vaccine (RZV) is efficacious in preventing herpes zoster in adults ≥ 50 years. The current study investigates whether the vaccinees’ quality of life (QoL) and physical functioning (PF) are impacted by local and systemic reactions due to RZV. In a previous report of this phase III, open-label, multicenter study (NCT02979639), overall PF and QoL were not significantly affected by a first RZV dose. [1] Here we report the results from the same study after a second RZV dose and safety results from dose 1 up to study end. Methods Adults aged ≥ 50 years were to receive 2 doses of RZV 2 months apart. Changes in mean Short Form health survey (SF-36) PF score between pre- and post-each RZV dose for 7 days, QoL, reactogenicity and safety were assessed. Results 401 adults received dose 1 and 391 received dose 2 of RZV. Post-second RZV dose, the reported solicited local symptoms were pain (75.1%), erythema (22.4%) and swelling (13.9%), and the most frequent solicited systemic symptoms were fatigue (46.3%), headache (37.5%) and myalgia (32.9%). Grade 3 solicited symptoms were reported by 7.2% (local) and 11.1% (general) of participants, and 5 (1.2%) participants reported reactogenicity triggering medical attention post-second RZV dose. From first dose up to study end, 14 (3.5%) participants reported 21 serious adverse events, none related to RZV. In days 1–2, post-second RZV dose, a transient, clinically-important decrease in SF-36 PF score (table) was seen in those reporting grade 3 solicited symptoms, which impacted activities such as walking and climbing stairs. Overall, during the 7 days post-second RZV dose, a mean change of −0.4 points was observed from the mean baseline score, indicating the PF was not clinically meaningfully impacted. No overall quality-adjusted-life-year loss was recorded. Conclusion Overall, the QoL and PF of adults ≥ 50 years were not affected post-second RZV dose; a transient impact was observed in adults with grade 3 reactogenicity. These results and the observed reactogenicity and safety profile are consistent with first RZV dose results, as well as that of previous studies with the RZV vaccine in adults of similar age. Funding: GlaxoSmithKline Biologicals SA. 1. Schmader et al., Abstract 2488, IDWeek 2018 ![]()
Disclosures All authors: No reported disclosures.
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Affiliation(s)
| | - Myron J Levin
- University of Colorado Anschutz Medical Campus, Aurora, Colorado
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Bastidas A, Catteau G, Volpe S, Mrkvan T, Enemuo A, Smetana J, Schwarz T, Rombo L, Pauksens K, Berengier E, Hervé C, Oostvogels L, Schuind A. 2905. Long-term Immunological Persistence of the Adjuvanted Recombinant Zoster Vaccine: Clinical Data and Mathematical Modeling. Open Forum Infect Dis 2019. [PMCID: PMC6808880 DOI: 10.1093/ofid/ofz359.183] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Background Methods Results Conclusion Disclosures
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Affiliation(s)
| | | | | | | | | | - Jan Smetana
- Faculty of Military Health Sciences, University of Defense, Hradec Kralove, Kralovehradecky Kraj, Czech Republic
| | - Tino Schwarz
- Klinikum Wuerzburg Mitte, Standort Juliusspital, Wuerzburg, Baden-Wurttemberg, Germany
| | - Lars Rombo
- Department of Infectious Diseases, Uppsala University, Eskilstuna, Sodermanlands Lan, Sweden
| | - Karlis Pauksens
- Department of Infectious Diseases, Uppsala University Hospital, Uppsala, Uppsala Lan, Sweden
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Tavares-Da-Silva F, Miranda Co M, Dessart C, Hervé C, López-Fauqued M, Mahaux O, Van Holle L, Stegmann JU. 2776. Post-marketing Safety Surveillance for the Adjuvanted Recombinant Zoster Vaccine: Review of Spontaneous Reports Since Introduction. Open Forum Infect Dis 2019. [PMCID: PMC6810355 DOI: 10.1093/ofid/ofz360.2453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Background The adjuvanted recombinant zoster vaccine (RZV, GSK), indicated for the prevention of herpes zoster (HZ) in adults ≥ 50 years of age, received its first marketing authorization in October 2017. We reviewed the post-marketing spontaneous adverse event (AE) reports submitted to GSK’s worldwide safety database since RZV introduction. Methods Descriptive analyses were conducted on all spontaneous reports involving RZV from October 13, 2017 to February 10, 2019. Observed-to-expected analyses were performed for the outcomes of interest: all-cause mortality and the 2 most commonly reported potential immune-mediated diseases, Guillain–Barré syndrome (GBS) and Bell’s palsy. Data mining was done to detect quantitative signals by identifying RZV-AE pairings with disproportionate reporting or evidence of an unexpected time-to-onset distribution. Results Most of the15,638 spontaneous reports received were medically verified (75.2%), originated from the United States (81.7%) and were non-serious (95.3%). Reports were mainly from individuals 50–69 years old (62.1%) and females (66.7%), when documented (Figure 1). Of all reports, 12,059 (77.1%) described signs/symptoms and 3,579 (22.9%) described vaccination errors, majority of which were without associated signs/symptoms (2,961; 82.7%). Overall, the most commonly reported signs/symptoms were consistent with vaccine reactogenicity (such as injection-site reactions, pyrexia, pain, chills, headache, fatigue), which were previously reported after RZV (Table 1). The observed reporting rates of outcomes of interest likely represent temporary associated events that are occurring as background incidence in the general population. No unexpected reporting patterns were detected overall. The proportion of RZV vaccination errors over time, by country, is shown in Figure 2. Overall, most reports described errors in vaccine preparation and reconstitution (29.7%) (Table 2). Conclusion Overall, the safety profile of RZV, following the first year of post-marketing use, is reassuring and consistent with that observed in clinical trials. Ongoing surveillance will continue to monitor RZV safety, as it is an early stage in the implementation, when real-life data are limited. Funding: GlaxoSmithKline Biologicals SA. ![]()
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Disclosures All authors: No reported disclosures.
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Alvina H, Hervé C, Yves DJ, James W I, Patrice P, Andreoletti O. Abnormal prion proteins. J Neurol Sci 2019. [DOI: 10.1016/j.jns.2019.10.194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Hervé C, Laupèze B, Del Giudice G, Didierlaurent AM, Tavares Da Silva F. The how's and what's of vaccine reactogenicity. NPJ Vaccines 2019; 4:39. [PMID: 31583123 PMCID: PMC6760227 DOI: 10.1038/s41541-019-0132-6] [Citation(s) in RCA: 267] [Impact Index Per Article: 53.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Accepted: 08/02/2019] [Indexed: 12/12/2022] Open
Abstract
Reactogenicity represents the physical manifestation of the inflammatory response to vaccination, and can include injection-site pain, redness, swelling or induration at the injection site, as well as systemic symptoms, such as fever, myalgia, or headache. The experience of symptoms following vaccination can lead to needle fear, long-term negative attitudes and non-compliant behaviours, which undermine the public health impact of vaccination. This review presents current knowledge on the potential causes of reactogenicity, and how host characteristics, vaccine administration and composition factors can influence the development and perception of reactogenicity. The intent is to provide an overview of reactogenicity after vaccination to help the vaccine community, including healthcare professionals, in maintaining confidence in vaccines by promoting vaccination, setting expectations for vaccinees about what might occur after vaccination and reducing anxiety by managing the vaccination setting.
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Laupèze B, Hervé C, Di Pasquale A, Tavares Da Silva F. Adjuvant Systems for vaccines: 13 years of post-licensure experience in diverse populations have progressed the way adjuvanted vaccine safety is investigated and understood. Vaccine 2019; 37:5670-5680. [PMID: 31420171 DOI: 10.1016/j.vaccine.2019.07.098] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2018] [Revised: 05/09/2019] [Accepted: 07/22/2019] [Indexed: 01/11/2023]
Abstract
Adjuvant Systems (AS) are combinations of immune stimulants that enhance the immune response to vaccine antigens. The first vaccine containing an AS (AS04) was licensed in 2005. As of 2018, several vaccines containing AS04, AS03 or AS01 have been licensed or approved by regulatory authorities in some countries, and included in vaccination programs. These vaccines target diverse viral and parasitic diseases (hepatitis B, human papillomavirus, malaria, herpes zoster, and (pre)pandemic influenza), and were developed for widely different target populations (e.g. individuals with renal impairment, girls and young women, infants and children living in Africa, adults 50 years of age and older, and the general population). Clearly, the safety profile of one vaccine in one target population cannot be extrapolated to another vaccine or to another target population, even for vaccines containing the same adjuvant. Therefore, the assessment of adjuvant safety poses specific challenges. In this review we provide a historical perspective on how AS were developed from the angle of the challenges encountered on safety evaluation during clinical development and after licensure, and illustrate how these challenges have been met to date. Methods to evaluate safety of adjuvants have evolved based on the availability of new technologies allowing a better understanding of their mode of action, and new ways of collecting and assessing safety information. Since 2005, safety experience with AS has accumulated with their use in diverse vaccines and in markedly different populations, in national immunization programs, and in a pandemic setting. Thirteen years of experience using antigens combined with AS attest to their acceptable safety profile. Methods developed to assess the safety of vaccines containing AS have progressed the way we understand and investigate vaccine safety, and have helped set new standards that will guide and support new candidate vaccine development, particularly those using new adjuvants. FOCUS ON THE PATIENT: What is the context? Adjuvants are immunostimulants used to modulate and enhance the immune response induced by vaccination. Since the 1990s, adjuvantation has moved toward combining several immunostimulants in the form of Adjuvant System(s) (AS), rather than relying on a single immunostimulant. AS have enabled the development of new vaccines targeting diseases and/or populations with special challenges that were previously not feasible using classical vaccine technology. What is new? In the last 13 years, several AS-containing vaccines have been studied targeting different diseases and populations. Over this period, overall vaccine safety has been monitored and real-life safety profiles have been assessed following routine use in the general population in many countries. Moreover, new methods for safety assessment, such as a better determination of the mode of action, have been implemented in order to help understand the safety characteristics of AS-containing vaccines. What is the impact? New standards and safety experience accumulated over the last decade can guide and help support the safety assessment of new candidate vaccines during development.
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Oostvogels L, Heineman TC, Johnson RW, Levin MJ, McElhaney JE, Van den Steen P, Zahaf T, Dagnew AF, Chlibek R, Diez-Domingo J, Gorfinkel IS, Hervé C, Hwang SJ, Ikematsu H, Kalema G, Lal H, McNeil SA, Mrkvan T, Pauksens K, Smetana J, Watanabe D, Weckx LY, Cunningham AL. Medical conditions at enrollment do not impact efficacy and safety of the adjuvanted recombinant zoster vaccine: a pooled post-hoc analysis of two parallel randomized trials. Hum Vaccin Immunother 2019; 15:2865-2872. [PMID: 31216205 PMCID: PMC6930113 DOI: 10.1080/21645515.2019.1627818] [Citation(s) in RCA: 9] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Revised: 05/10/2019] [Accepted: 05/27/2019] [Indexed: 12/30/2022] Open
Abstract
In two pivotal efficacy studies (ZOE-50; ZOE-70), the adjuvanted recombinant zoster vaccine (RZV) demonstrated >90% efficacy against herpes zoster (HZ).Adults aged ≥50 or ≥70 years (ZOE-50 [NCT01165177]; ZOE-70 [NCT01165229]) were randomized to receive 2 doses of RZV or placebo 2 months apart. Vaccine efficacy and safety were evaluated post-hoc in the pooled (ZOE-50/70) population according to the number and type of selected medical conditions present at enrollment.At enrollment, 82.3% of RZV and 82.7% of placebo recipients reported ≥1 of the 15 selected medical conditions. Efficacy against HZ ranged from 84.5% (95% Confidence Interval [CI]: 46.4-97.1) in participants with respiratory disorders to 97.0% (95%CI: 82.3-99.9) in those with coronary heart disease. Moreover, efficacy remained >90% irrespective of the number of selected medical conditions reported by a participant.As indicated by the similarity of the point estimates, this post-hoc analysis suggests that RZV efficacy remains high in all selected medical conditions, as well as with increasing number of medical conditions. No safety concern was identified by the type or number of medical conditions present at enrollment.
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Affiliation(s)
| | | | | | - Myron J. Levin
- Departments of Pediatrics and Medicine, University of Colorado, Anschutz Medical Campus, Aurora, CO, USA
| | | | | | | | | | - Roman Chlibek
- Faculty of Military Health Sciences, University of Defense, Hradec Kralove, Czech Republic
| | - Javier Diez-Domingo
- Fundación para el Fomento de la Investigación Sanitaria y Biomédica, Valencia, Spain
| | | | | | - Shinn-Jang Hwang
- Department of Family Medicine, Taipei Veterans General Hospital and National Yang Ming University School of Medicine, Taipei, Taiwan
| | | | - George Kalema
- Keyrus Biopharma, Waterloo, Belgium, on behalf of GSK
| | | | - Shelly A. McNeil
- Canadian Center for Vaccinology, IWK Health Center and Nova Scotia Health Authority, Dalhousie, University, Halifax, Canada
| | | | - Karlis Pauksens
- Department of Infectious Diseases, Uppsala University Hospital, Uppsala, Sweden
| | - Jan Smetana
- Faculty of Military Health Sciences, University of Defense, Hradec Kralove, Czech Republic
| | - Daisuke Watanabe
- Department of Dermatology, Aichi Medical University, Nagakute, Japan
| | - Lily Yin Weckx
- Department of Pediatrics, Federal University of Sao Paulo, Sao Paulo, Brazil
| | - Anthony L. Cunningham
- The Westmead Institute for Medical Research, Westmead, University of Sydney, Sydney, NSW, Australia
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31
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Bernard P, Robert C, Lefebvre M, Lecomte R, Gaborit B, Eschapasse E, Hervé C, Gouraud M, Raffi F, Biron C. Complexité du dépistage de la tuberculose maladie chez les migrants primo-arrivants non-stabilisés. Med Mal Infect 2019. [DOI: 10.1016/j.medmal.2019.04.117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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32
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Barateau A, Trifard E, Perichon N, Hervé C, Williaume D, Leseur J, Simon A, De Crevoisier R, Lafond C. EP-2003 Evaluation of three methods to calculate the dose on CBCT in case of IMRT for cervical cancer. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)32423-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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33
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Maréchal C, Lal H, Poder A, Ferguson M, Enweonye I, Heineman TC, Hervé C, Rheault P, Talli J, Wauters D, Oostvogels L. Corrigendum to 'Immunogenicity and safety of the adjuvanted recombinant zoster vaccine co-administered with the 23-valent pneumococcal polysaccharide vaccine in adults ≥50 years of age: A randomized trial' [Vaccine 36 (2018) 4278-4286]. Vaccine 2019; 37:1252-1253. [PMID: 30711316 DOI: 10.1016/j.vaccine.2019.01.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Céline Maréchal
- Business and Decision Life Sciences for GSK, Wavre, Belgium.
| | | | - Airi Poder
- Clinical Research Center, Tartu, Estonia
| | | | | | | | | | | | - Jaak Talli
- Innomedica Medical Center, Tallinn, Estonia
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34
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Lafond C, Laffont S, Bellec J, Henry O, Perdrieux M, Jouyaux F, Perichon N, Delaby N, Hervé C. 64 Management of the medical physics students in internship: Feedback of Centre Eugène Marquis (Regional Cancer Center of Rennes/France). Phys Med 2018. [DOI: 10.1016/j.ejmp.2018.09.077] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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35
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Charlier P, Hervé C. Proposal for the creation of an international day of tribute to body donors. Clin Anat 2018; 31:1187. [PMID: 30171637 DOI: 10.1002/ca.23257] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2018] [Accepted: 08/06/2018] [Indexed: 11/09/2022]
Affiliation(s)
- Philippe Charlier
- University of Versailles-Saint-Quentin (DANTE Laboratory), Montigny Le Bretonneux, France
| | - C Hervé
- University of Versailles-Saint-Quentin (DANTE Laboratory), Montigny Le Bretonneux, France
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36
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Barateau A, Perichon N, Hervé C, Henry O, Castelli J, Chajon E, De Crevoisier R, Lafond C. PO-0962: CBCT dose calculation in head and neck adaptive radiotherapy: accuracy assessment of four methods. Radiother Oncol 2018. [DOI: 10.1016/s0167-8140(18)31272-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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37
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Lesnik M, J. Sanchez-Guerrero J, De Crouy Chanel O, Hervé C, Guerlain J, Périé S. Peak inspiratory flow as predictor for tracheotomy. Eur Ann Otorhinolaryngol Head Neck Dis 2018; 135:3-6. [DOI: 10.1016/j.anorl.2017.06.009] [Citation(s) in RCA: 6] [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] [Indexed: 11/26/2022]
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38
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Ollivet C, Guigui C, Hervé C, Rialle V. What Do Family Caregivers of Alzheimer’s Disease Patients Desire in Smart Home Technologies? Methods Inf Med 2018. [DOI: 10.3414/me9102] [Citation(s) in RCA: 76] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Summary
Objectives:
The authors’ aim was to investigate the representations, wishes, and fears of family caregivers (FCs) regarding 14 innovative technologies (IT) for care aiding and burden alleviation, given the severe physical and psychological stress induced by dementia care, and the very slow uptake of these technologies in our society.
Methods:
A cluster sample survey based on a selfadministered questionnaire was carried out on data collected from 270 families of patients with Alzheimer’s disease or related disorders, located in the greater Paris area. Multiple Correspondence Analysis was used in addition to usual statistical tests to identify homogenous FCs clusters concerning the appreciation or rejection of the considered technologies.
Results:
Two opposite clusters were clearly defined: FCs in favor of a substantial use of technology, and those rather or totally hostile. Furthermore the distributions of almost all the answers of appreciations were U-shaped. Significant relations were demonstrated between IT appreciation and FC‘s family or gender statuses (e.g., female FCs appreciated a tracking device for quick recovering of wandering patients more than male FCs: p = 0.0025, N = 195).
Conclusions:
The study provides further evidence of the contrasted perception of technology in dementia care at home, and suggests the development of public debates based on rigorous assessment of practices and a strict ethical aim to protect against misuse.
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Charlier P, Al-Chaer ED, Bou Abdallah F, Massaad C, Hervé C. Peer (and brothers) review? Ethical challenges in author-proposed peer-reviewers. Eur J Intern Med 2018; 47:e24-e25. [PMID: 28826821 DOI: 10.1016/j.ejim.2017.08.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2017] [Revised: 07/27/2017] [Accepted: 08/03/2017] [Indexed: 10/19/2022]
Affiliation(s)
- P Charlier
- Section of Medical Anthropology (UVSQ), UFR of Health Sciences, 2 avenue de la Source de la Bièvre, 78180 Montigny-Le-Bretonneux, France; CASH/Sanitary Unit MA92 & IPES, 403 avenue de la République, 92000 Nanterre, France.
| | - E D Al-Chaer
- Department of Anatomy, Cell Biology and Physiological Sciences, Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - F Bou Abdallah
- Department of Forensic Medicine, Faculty of Medical Sciences, Lebanese University, Hadat, Lebanon
| | - C Massaad
- UMR 8194, University Paris-Descartes, 45 rue des Saints-Pères, 75006 Paris, France
| | - C Hervé
- Department of Medical Ethics and Forensic Medicine (EA 4569), University Paris-Descartes, 45 rue des Saints-Pères, 75006 Paris, France
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40
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Barateau A, Perichon N, Hervé C, Henry O, Crevoisier RD, Lafond C. 43. CBCT dose calculation: accuracy assessment of four different methods. Phys Med 2017. [DOI: 10.1016/j.ejmp.2017.10.068] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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41
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Goupy F, Le Prisé É, Williaume D, Lafond C, Périchon N, Hervé C, Leproust B, de Crevoisier R. Radiothérapie des cancers de prostate avec atteinte des vésicules séminales (de stade T3b) : résultats cliniques. Cancer Radiother 2017. [DOI: 10.1016/j.canrad.2017.08.063] [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: 10/18/2022]
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42
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Charlier P, Bou Abdallah F, Mostefai Dulac Y, Deo S, Jacqueline S, Brun L, Hervé C. ["Palimpsest scar" lesions in a context of torture (Darfur, Sudan)]. Ann Dermatol Venereol 2017; 144:696-699. [PMID: 28728860 DOI: 10.1016/j.annder.2017.06.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2016] [Revised: 02/16/2017] [Accepted: 06/12/2017] [Indexed: 11/15/2022]
Abstract
BACKGROUND As a result of the current exponentially growing refugee population from the Middle-East and East Africa (Sudan, Darfur, Eritrea), clinicians (including forensic pathologists) are seeing atypical skin lesions, mainly of a traumatic nature, but in some cases associated with long-standing lesions related to ethnic practices. PATIENTS AND METHODS A case of torture sequelae is presented herein in a patient originally from Darfur (Sudan): cutaneous incisions were made on old scars several times using a knife. DISCUSSION The clinical presentation of scarification lesions and that of atypically healed wounds (presumably an effect of inflammation induced by the introduction of irritating foreign bodies such as sand, salt, etc.) are completely different: in all cases they indicate a relative timeframe of the facts, which the clinician should not overlook in reconstructing the patient's course and the injuries to which he has been subjected (hence the proposed designation of "palimpsest scar", in the sense that a palimpsest is a manuscript on a parchment that previously contained writing but has been scratched clean to be overwritten). Thus, a "palimpsest scar" constitutes a fresh scar on top of and hiding another (ritual) scar in a context of ethnic cleansing. The diagnostic and clinical significance comes from the importance of differentiating between ethnic-type lesions and those induced by physical violence and abuse in a context of war.
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Affiliation(s)
- P Charlier
- Laboratoire d'éthique médicale et de médecine légale (EA4569), université Paris-Descartes, 45, rue des Saints-Pères, 75006 Paris, France; CASH & IPES, 403, avenue de la République, 92000 Nanterre, France; UFR des sciences de la santé, UVSQ, 2, avenue de la Source-de-la-Bièvre, 78180 Montigny-Le-Bretonneux, France.
| | - F Bou Abdallah
- Laboratoire d'éthique médicale et de médecine légale (EA4569), université Paris-Descartes, 45, rue des Saints-Pères, 75006 Paris, France; Université libanaise, faculté des sciences médicales, Hadat, Liban
| | - Y Mostefai Dulac
- CASH & IPES, 403, avenue de la République, 92000 Nanterre, France
| | - S Deo
- UFR des sciences de la santé, UVSQ, 2, avenue de la Source-de-la-Bièvre, 78180 Montigny-Le-Bretonneux, France
| | - S Jacqueline
- UFR des sciences de la santé, UVSQ, 2, avenue de la Source-de-la-Bièvre, 78180 Montigny-Le-Bretonneux, France
| | - L Brun
- Service d'anatomo-pathologie, hôpital de Parakou, Parakou, Bénin
| | - C Hervé
- Laboratoire d'éthique médicale et de médecine légale (EA4569), université Paris-Descartes, 45, rue des Saints-Pères, 75006 Paris, France; CASH & IPES, 403, avenue de la République, 92000 Nanterre, France
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43
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Richard J, Maitre A, Hervé C, Marques M, Bonneterre V, Barbeau D, Persoons R. Surveillance biologique de l’exposition professionnelle au styrène : déterminants de l’exposition et recommandations de prévention. ARCH MAL PROF ENVIRO 2017. [DOI: 10.1016/j.admp.2017.01.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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44
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Ceccaldi J, Thibert JB, Haddad A, Bouësseau MC, Pottier R, Danic B, Noël S, Monsellier M, Tissot JD, Sannié T, Clavier B, Mamzer MF, Cartron JP, Vernant JP, Hervé C, Garraud O. [Not-for-profit: A report from the fourth annual symposium of ethics held by the National Institute for Blood Transfusion (France)]. Transfus Clin Biol 2017; 24:76-82. [PMID: 28476210 DOI: 10.1016/j.tracli.2017.04.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
The not-for-profit issue has been debated in November 2016 in Paris; this issue is one of the four canonical pillars of ethical blood donation. It is intimately bound to benevolence though it is distinct, as not-for-profit calls for institutions while benevolence calls for individuals. It is indeed intended that voluntary blood donors do not benefit from their donation and are thus non-remunerated. Not-for-profit is essential since it refers to the public character of blood as a putative public resource aimed at being shared as a tribute of solidarity. A central question however is linked to the capacity- or not -of public sectors to ensure that blood components are universally available, with special mention to plasma derived drugs, without the contribution of the for profit, private sector.
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Affiliation(s)
- J Ceccaldi
- Espace bioéthique aquitain, hôpital Saint-André, Bordeaux, France
| | - J-B Thibert
- Établissement français du sang Bretagne, Rennes, France
| | - A Haddad
- Département de biologie clinique et banque de sang, hôpital du Sacré-Cœur, université libanaise, Beyrouth, Liban; EA3064, faculté de médecine de Saint-Étienne, université de Lyon, Saint-Étienne, France
| | | | - R Pottier
- EA4569 université Paris-Descartes, laboratoire d'éthique médicale et de médecine légale, Paris, France; Département des sciences humaines et sociales, université Paris-Sorbonne, Paris, France
| | - B Danic
- Établissement français du sang Bretagne, Rennes, France
| | - S Noël
- Établissement français du sang, Saint-Denis, France
| | - M Monsellier
- Fédération française pour le don de sang bénévole, Paris, France
| | - J-D Tissot
- Transfusion interrégionale CRS, 1066 Epalinges, Suisse; Faculté de biologie et de médecine, université de Lausanne, Suisse
| | - T Sannié
- Association française des hémophiles, Paris, France
| | - B Clavier
- Centre de transfusion sanguine des armées, Clamart, France
| | - M-F Mamzer
- EA4569 université Paris-Descartes, laboratoire d'éthique médicale et de médecine légale, Paris, France; UF d'éthique médicale, hôpital Necker-enfants-malades, AP-HP, Paris, France
| | - J-P Cartron
- Institut national de la transfusion sanguine, Paris, France
| | - J-P Vernant
- Institut national de la transfusion sanguine, Paris, France
| | - C Hervé
- EA4569 université Paris-Descartes, laboratoire d'éthique médicale et de médecine légale, Paris, France
| | - O Garraud
- EA3064, faculté de médecine de Saint-Étienne, université de Lyon, Saint-Étienne, France; Institut national de la transfusion sanguine, Paris, France.
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45
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Charlier P, Bou Abdallah F, Mostefai Y, Brun L, Hervé C. Lésions cutanées de médecine traditionnelle soudanaise. Ann Dermatol Venereol 2017; 144:401-403. [DOI: 10.1016/j.annder.2016.12.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2016] [Revised: 12/04/2016] [Accepted: 12/12/2016] [Indexed: 11/30/2022]
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46
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Perichon N, Couespel S, Hervé C, Henry O, Lafond C, Castelli J, Largent A, Acosta O, Chajon E, De Crevoisier R. EP-1490: A 3-class density method to monitor doses to the parotid glands and spinal cord in oropharynx IMRT. Radiother Oncol 2017. [DOI: 10.1016/s0167-8140(17)31925-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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47
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Affiliation(s)
- P Charlier
- Section of Forensic and Medical Anthropology, UFR of Health Sciences (UVSQ), 2 avenue de la Source de la Bièvre, 78180 Montigny-Le-Bretonneux, France; CASH & IPES, 92000 Nanterre, France; Laboratory of Medical Ethics and Forensic Medicine (EA 4569), University Paris-Descartes, 45 rue des Saints Pères, 75006 Paris, France.
| | - S Deo
- Section of Forensic and Medical Anthropology, UFR of Health Sciences (UVSQ), 2 avenue de la Source de la Bièvre, 78180 Montigny-Le-Bretonneux, France
| | - C Hervé
- CASH & IPES, 92000 Nanterre, France; Laboratory of Medical Ethics and Forensic Medicine (EA 4569), University Paris-Descartes, 45 rue des Saints Pères, 75006 Paris, France
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48
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Charlier P, Deo S, Hassin J, Hervé C. Social death, melancholia, and zombies: Same patterns? Med Hypotheses 2017; 101:59-60. [DOI: 10.1016/j.mehy.2017.03.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2016] [Revised: 02/27/2017] [Accepted: 03/01/2017] [Indexed: 02/05/2023]
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49
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Wang YY, Attané C, Milhas D, Dirat B, Dauvillier S, Guerard A, Gilhodes J, Lazar I, Alet N, Laurent V, Le Gonidec S, Biard D, Hervé C, Bost F, Ren GS, Bono F, Escourrou G, Prentki M, Nieto L, Valet P, Muller C. Mammary adipocytes stimulate breast cancer invasion through metabolic remodeling of tumor cells. JCI Insight 2017; 2:e87489. [PMID: 28239646 DOI: 10.1172/jci.insight.87489] [Citation(s) in RCA: 279] [Impact Index Per Article: 39.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
In breast cancer, a key feature of peritumoral adipocytes is their loss of lipid content observed both in vitro and in human tumors. The free fatty acids (FFAs), released by adipocytes after lipolysis induced by tumor secretions, are transferred and stored in tumor cells as triglycerides in lipid droplets. In tumor cell lines, we demonstrate that FFAs can be released over time from lipid droplets through an adipose triglyceride lipase-dependent (ATGL-dependent) lipolytic pathway. In vivo, ATGL is expressed in human tumors where its expression correlates with tumor aggressiveness and is upregulated by contact with adipocytes. The released FFAs are then used for fatty acid β-oxidation (FAO), an active process in cancer but not normal breast epithelial cells, and regulated by coculture with adipocytes. However, in cocultivated cells, FAO is uncoupled from ATP production, leading to AMPK/acetyl-CoA carboxylase activation, a circle that maintains this state of metabolic remodeling. The increased invasive capacities of tumor cells induced by coculture are completely abrogated by inhibition of the coupled ATGL-dependent lipolysis/FAO pathways. These results show a complex metabolic symbiosis between tumor-surrounding adipocytes and cancer cells that stimulate their invasiveness, highlighting ATGL as a potential therapeutic target to impede breast cancer progression.
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Affiliation(s)
- Yuan Yuan Wang
- Institut de Pharmacologie et de Biologie Structurale (IPBS), Université de Toulouse, CNRS.,Institut des Maladies Métaboliques et Cardiovasculaires (I2MC), Université de Toulouse, INSERM, UPS, Toulouse, France.,Department of Endocrine and Breast Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Camille Attané
- Institut des Maladies Métaboliques et Cardiovasculaires (I2MC), Université de Toulouse, INSERM, UPS, Toulouse, France
| | - Delphine Milhas
- Institut de Pharmacologie et de Biologie Structurale (IPBS), Université de Toulouse, CNRS
| | - Béatrice Dirat
- Institut de Pharmacologie et de Biologie Structurale (IPBS), Université de Toulouse, CNRS.,Institut des Maladies Métaboliques et Cardiovasculaires (I2MC), Université de Toulouse, INSERM, UPS, Toulouse, France
| | - Stéphanie Dauvillier
- Institut de Pharmacologie et de Biologie Structurale (IPBS), Université de Toulouse, CNRS
| | - Adrien Guerard
- Institut de Pharmacologie et de Biologie Structurale (IPBS), Université de Toulouse, CNRS
| | - Julia Gilhodes
- Departement de Biostatistiques, Institut Universitaire du Cancer, Toulouse, France
| | - Ikrame Lazar
- Institut de Pharmacologie et de Biologie Structurale (IPBS), Université de Toulouse, CNRS
| | | | - Victor Laurent
- Institut de Pharmacologie et de Biologie Structurale (IPBS), Université de Toulouse, CNRS
| | - Sophie Le Gonidec
- Institut des Maladies Métaboliques et Cardiovasculaires (I2MC), Université de Toulouse, INSERM, UPS, Toulouse, France
| | | | | | - Frédéric Bost
- Institut National de la Santé et de la Recherche Médicale, U1065, Centre Méditerranéen de Médecine Moléculaire, Nice, France
| | - Guo Sheng Ren
- Department of Endocrine and Breast Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | | | - Ghislaine Escourrou
- Service d'Anatomo-Pathologie, Institut Universitaire du Cancer, Toulouse, France
| | - Marc Prentki
- Departments of Nutrition and Biochemistry and Montreal Diabetes Research Center, CRCHUM and Université de Montréal, Montréal, Quebec, Canada
| | - Laurence Nieto
- Institut de Pharmacologie et de Biologie Structurale (IPBS), Université de Toulouse, CNRS
| | - Philippe Valet
- Institut des Maladies Métaboliques et Cardiovasculaires (I2MC), Université de Toulouse, INSERM, UPS, Toulouse, France
| | - Catherine Muller
- Institut de Pharmacologie et de Biologie Structurale (IPBS), Université de Toulouse, CNRS
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50
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Nasseripour MN, Hervé C, Meningaud JP. Oral surgery in the European Union: challenges of diversity in training and practice. Eur J Dent Educ 2017; 21:6-12. [PMID: 26381572 DOI: 10.1111/eje.12168] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 07/30/2015] [Indexed: 06/05/2023]
Abstract
INTRODUCTION At the crossroads of medicine and dentistry, oral surgery with orthodontics are the only recognised dental specialties by the European Union. The goal of our study is to evaluate the current state of oral surgery in Europe from its teaching to its practice, the hypothesis being that a notable diversity persists despite European Union harmonisation process. MATERIALS AND METHODS To understand the impact of this diversity applied to European Union freedom of movement and its ethical implications for the practice of oral surgery, English and French questionnaires were sent by email to universities and organisations delivering authorisation to practise in France, Germany, Spain, Sweden and United Kingdom chosen based upon inclusion and exclusion criteria. An analysis of documents on these organisations' official websites was also conducted. Demographic information was obtained from the aforementioned organisations. RESULTS The profile of practising oral surgeons is different dependent on the country. The university and hospital trainings conform to European recommendations and span 3-4 years. European Board certification is not required. Continuing education is mandatory only in France, Germany and United Kingdom. As for curricula and scope of practice, no consensus can be derived. DISCUSSION There is potential conflict of interest between European Union principles of freedom of movement and protection of all citizens, as member countries do not uniformly apply Directives and recommendations. A new survey of all European Union oral surgery programmes as well as organisations delivering authorisation to practise is necessary to implement across the board harmonisation of training and practice to insure patient safety in light of the migration of European Union practitioners.
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Affiliation(s)
- M N Nasseripour
- Paris Descartes University, EA 4569: Medical Ethics and Legal Medicine Laboratory, Paris, France
| | - C Hervé
- Paris Descartes University, EA 4569: Medical Ethics and Legal Medicine Laboratory Head, Paris, France
| | - J-P Meningaud
- Plastic, Reconstructive and Esthetic Surgery Department Head, Henri Mondor Hospital, Paris-Est Créteil Val de Marne University, Paris, France
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