1
|
Coriati A, Ma X, Sykes J, Stanojevic S, Ruseckaite R, Lemonnier L, Dehillotte C, Tate J, Byrnes CA, Bell SC, Burgel PR, Stephenson AL. Beyond borders: cystic fibrosis survival between Australia, Canada, France and New Zealand. Thorax 2023; 78:242-248. [PMID: 36109163 DOI: 10.1136/thorax-2022-219086] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [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: 04/20/2022] [Accepted: 08/23/2022] [Indexed: 11/03/2022]
Abstract
BACKGROUND Life expectancy for people with cystic fibrosis (CF) varies considerably both within and between countries. The objective of this study was to compare survival among countries with single-payer healthcare systems while accounting for markers of disease severity. METHODS This cohort study used data from established national CF registries in Australia, Canada, France and New Zealand from 2015 to 2019. Median age of survival for each of the four countries was estimated using the Kaplan-Meier method. A Cox proportional hazards model was used to compare risk of death between Canada, France and Australia after adjusting for prognostic factors. Due to low number of deaths, New Zealand was not included in final adjusted models. RESULTS Between 2015 and 2019, a total of 14 842 people (3537 Australia, 4434 Canada, 6411 France and 460 New Zealand) were included. The median age of survival was highest in France 65.9 years (95% CI: 59.8 to 76.0) versus 53.3 years (95% CI: 48.9 to 59.8) for Australia, 55.4 years (95% CI: 51.3 to 59.2) for Canada and 54.8 years (95% CI: 40.7 to not available) for New Zealand. After adjusting for individual-level factors, the risk of death was significantly higher in Canada (HR 1.85, 95% CI: 1.48 to 2.32; p<0.001) and Australia (HR 2.08, 95% CI: 1.64 to 2.64; p<0.001) versus France. INTERPRETATION We observed significantly higher survival in France compared with countries with single-payer healthcare systems. The median age of survival in France exceeded 60 years of age despite having the highest proportion of underweight patients which may be due to differences in availability of transplant.
Collapse
Affiliation(s)
- Adèle Coriati
- Department of Respirology, St Michael's Hospital, Toronto, Ontario, Canada
| | - Xiayi Ma
- Department of Respirology, St Michael's Hospital, Toronto, Ontario, Canada
| | - Jenna Sykes
- Department of Respirology, St Michael's Hospital, Toronto, Ontario, Canada
| | - Sanja Stanojevic
- Community Health and Epidemiology, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Rasa Ruseckaite
- Public Health and Preventative Medicine, Monash University, Clayton, Victoria, Australia
| | - Lydie Lemonnier
- Association Vaincre la Mucoviscidose, Paris, Île-de-France, France
| | | | - Jan Tate
- Paediatric Department, Starship Children's Health, Auckland, New Zealand
| | - Catherine Ann Byrnes
- Paediatrics, Child and Youth Health, The University of Auckland School of Medicine, Auckland, New Zealand.,Paediatric Respiratory Department, Starship Children's Health, Auckland, New Zealand
| | - Scott C Bell
- Department of Thoracic Medicine, The Prince Charles Hospital, Chermside, Queensland, Australia.,Children's Health Research Centre, The University of Queensland Faculty of Medicine and Biomedical Sciences, Herston, Queensland, Australia
| | - Pierre Regis Burgel
- Assistance Publique Hôpitaux de Paris, Department of Respiratory Medicine and French Cystic Fibrosis Reference Center, Hopital Cochin Pneumologie, Paris, Île-de-France, France.,Institut Cochin, Université de Paris, Paris, Île-de-France, France.,European Reference Network Respiratory Diseases, Frankfurt, Germany
| | - Anne L Stephenson
- Department of Respirology, St Michael's Hospital, Toronto, Ontario, Canada .,St Michael's Hospital Li Ka Shing Knowledge Institute, Toronto, Ontario, Canada.,Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| |
Collapse
|
2
|
Rousset-Jablonski C, Dalon F, Reynaud Q, Lemonnier L, Dehillotte C, Jacoud F, Berard M, Viprey M, Van Ganse E, Durieu I, Belhassen M. Cancer incidence and prevalence in cystic fibrosis patients with and without a lung transplant in France. Front Public Health 2022; 10:1043691. [PMID: 36483264 PMCID: PMC9723348 DOI: 10.3389/fpubh.2022.1043691] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 10/28/2022] [Indexed: 11/23/2022] Open
Abstract
Background Cystic fibrosis (CF) care and the life expectancy of affected patients have substantially improved in recent decades, leading to an increased number of patients being diagnosed with comorbidities, including cancers. Our objective was to characterize the epidemiology of cancers between 2006 and 2017 in CF patients with and without a lung transplant. Methods Medical records of CF patients from 2006 to 2016 in the French CF Registry were linked to their corresponding claims data (SNDS). The annual prevalence and incidence rates of cancers were estimated from 2006 to 2017 in CF patients without lung transplant and in those with lung transplant after transplantation. Results Of the 7,671 patients included in the French CF Registry, 6,187 patients (80.7%) were linked to the SNDS; among them, 1,006 (16.3%) received a lung transplant. The prevalence of any cancer increased between 2006 and 2017, from 0.3 to 1.0% and from 1.3 to 6.3% in non-transplanted and transplanted patients, respectively. When compared to the general population, the incidence of cancer was significantly higher in both non-transplanted [Standardized Incidence Ratio (SIR) = 2.57, 95%CI 2.05 to 3.17] and transplanted (SIR = 19.76, 95%CI 16.45 to 23.55) patients. The median time between transplant and the first cancer was 3.9 years. Among the 211 incident cancer cases, the most frequent malignant neoplasms were skin neoplasm (48 cases), lung cancers (31 cases), gastro-intestinal (24 cases), and hematologic cancers (17 cases). Conclusion The overall burden of cancer in CF patients is high, particularly following lung transplantation. Therefore, specific follow-up, screening and cancer prevention for CF patients with transplants are necessary.
Collapse
Affiliation(s)
- Christine Rousset-Jablonski
- Université Claude Bernard Lyon 1, Research on Healthcare Performance (RESHAPE), INSERM U1290, Lyon, France,Department of Internal Medicine, Cystic Fibrosis Center, Hospices Civils de Lyon, Groupe Hospitalier Sud, Lyon, France,Département de chirurgie, Centre Léon Bérard, Lyon, France,*Correspondence: Christine Rousset-Jablonski
| | | | - Quitterie Reynaud
- Université Claude Bernard Lyon 1, Research on Healthcare Performance (RESHAPE), INSERM U1290, Lyon, France,Department of Internal Medicine, Cystic Fibrosis Center, Hospices Civils de Lyon, Groupe Hospitalier Sud, Lyon, France
| | | | | | - Flore Jacoud
- PELyon, PharmacoEpidemiologie Lyon, Lyon, France
| | | | - Marie Viprey
- Université Claude Bernard Lyon 1, Research on Healthcare Performance (RESHAPE), INSERM U1290, Lyon, France,Health Data Department, Hospices Civils de Lyon, Lyon, France
| | - Eric Van Ganse
- Université Claude Bernard Lyon 1, Research on Healthcare Performance (RESHAPE), INSERM U1290, Lyon, France,PELyon, PharmacoEpidemiologie Lyon, Lyon, France,Respiratory Medicine, Croix-Rousse University Hospital, Lyon, France
| | - Isabelle Durieu
- Université Claude Bernard Lyon 1, Research on Healthcare Performance (RESHAPE), INSERM U1290, Lyon, France,Department of Internal Medicine, Cystic Fibrosis Center, Hospices Civils de Lyon, Groupe Hospitalier Sud, Lyon, France
| | | |
Collapse
|
3
|
Rousset-Jablonski C, Durieu I, Dalon F, Reynaud Q, Lemonnier L, Dehillotte C, Berard M, Jacoud F, Viprey M, Van Ganse E, Belhassen M. Incidence et prévalence des cancers chez les patients atteints de mucoviscidose : données issues du chainage entre le Système national des données de santé (SNDS) et le registre français de la mucoviscidose. Rev Epidemiol Sante Publique 2022. [DOI: 10.1016/j.respe.2022.09.043] [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: 11/06/2022] Open
|
4
|
Corvol H, de Miranda S, Dehillotte C, Lemonnier L, Chiron R, Danner-Boucher I, Hamidfar R, Houdouin V, Macey J, Marguet C, Murris-Espin M, Reynaud Q, Reix P, Gaubert MR, Kemgang A, Burgel PR. Cumulative Incidence and Risk Factors for Severe COVID-19 in French People with Cystic Fibrosis. Clin Infect Dis 2022; 75:2135-2144. [PMID: 35475917 PMCID: PMC9129125 DOI: 10.1093/cid/ciac333] [Citation(s) in RCA: 3] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Revised: 04/08/2022] [Accepted: 04/25/2022] [Indexed: 11/30/2022] Open
Abstract
Background Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections are closely monitored in people with cystic fibrosis (pwCF), with a special emphasis on severe cases. Previous studies used hospitalization rates as proxy for severity. Methods We evaluated data from coronavirus disease 2019 (COVID-19) cases diagnosed in French pwCF followed in one of the 47 French CF center over the first year of the pandemic. Objective criteria were applied for defining severity (e.g., respiratory failure and/or death). Data were compared to those from all French pwCF using the French CF Registry. Results As of April 30, 2021, 223 pwCF were diagnosed with COVID-19, with higher risks in adults (≥18 years, odds ratio [OR] = 2.52, 95% confidence interval [CI] = 1.82-3.48) and post-transplant individuals (OR = 2.68, 95% CI = 1.98-3.63). Sixty (26.9%) patients were hospitalized, with an increased risk in post-transplant individuals (OR = 4.74, 95% CI = 2.49-9.02). In 34 (15%) cases, COVID-19 was considered severe; 28/60 (46.7%) hospitalizations occurred in patients without objective criteria of severity. Severe cases occurred mostly in adults (85.3%) and post-transplant pwCF (61.8%, OR = 6.02, 95% CI = 2.77-13.06). In non-transplanted pwCF, risk factors for severity included low lung function (median ppFEV1 54.6% vs. 75.1%, OR = 1.04, 95% CI = 1.01-1.08) and CF-associated diabetes (OR = 3.26, 95% CI = 1.02-10.4). While most cases recovered without sequelae (n = 204, 91.5%), 16 (13%) were followed for possible sequelae, and three post-transplant females died. Conclusions Severe COVID-19 cases occurred infrequently during the first year of the pandemic in French pwCF. Non-transplanted adults with severe respiratory disease or diabetes and post-transplant individuals were at risk for severe COVID-19. Thus, specific preventive measures should be proposed.
Collapse
Affiliation(s)
- Harriet Corvol
- Pediatric Respiratory Department and Pediatric CF Center, Assistance Publique Hôpitaux de Paris (APHP), Hôpital Trousseau, Paris, France.,Sorbonne Université, Centre de Recherche Saint-Antoine, Paris, France
| | - Sandra de Miranda
- Pulmonology Department and CF Center, Hôpital Foch, Suresnes, France
| | | | | | - Raphael Chiron
- CF Center, Hôpital Arnaud de Villeneuve, CHU de Montpellier, Montpellier, France
| | - Isabelle Danner-Boucher
- Pulmonology Department and Adult CF Center, Institut du Thorax, CHU de Nantes, Nantes, France
| | | | - Véronique Houdouin
- Pediatric Pulmonology Department and Pediatric CF Center, APHP, Hôpital Robert Debré, Paris, France
| | - Julie Macey
- Respiratory Medicine and CF Center, CHU de Bordeaux, Bordeaux, France
| | - Christophe Marguet
- Pediatric Respiratory Disease and CF Center, CIC Inserm 1404, Inserm U3111, FHU RESPIR, Rouen University Hospital, Rouen, France
| | - Marlène Murris-Espin
- CF Center and Service de Pneumologie Pôle des Voies Respiratoires, CHU de Toulouse, Toulouse, France
| | - Quitterie Reynaud
- Internal Medicine Department and adult CF center, Hospices Civils de Lyon, Research on Healthcare Performance (RESHAPE), INSERM U1290, Université de Lyon, Lyon, France.,ERN-Lung CF Network, Frankfurt, Germany
| | - Philippe Reix
- Pediatric CF Center, Hospices Civils de Lyon, UMR 5558 CNRS Equipe EMET, Université Claude Bernard Lyon 1, Lyon, France
| | - Martine Reynaud Gaubert
- Respiratory Medicine and adult CF center, Assistance Publique Hôpitaux de Marseille, Aix-Marseille Université UM63, Institut de Recherche pour le Développement, Marseille, France
| | - Astrid Kemgang
- Sorbonne Université, Centre de Recherche Saint-Antoine, Paris, France
| | - Pierre-Régis Burgel
- Respiratory Medicine and National Reference CF Center, AP-HP, Hôpital Cochin, Paris, France.,Université de Paris, Institut Cochin, Inserm U-1016, Paris, France.,ERN-Lung CF Network, Frankfurt, Germany
| | | |
Collapse
|
5
|
Coriati A, Sykes J, Lemonnier L, Ma X, Stanojevic S, Dehillotte C, Carlier N, Stephenson AL, Burgel PR. The impact of the high emergency lung transplantation program in cystic fibrosis in France: insight from a comparison with Canada. Eur Respir J 2021; 59:13993003.00014-2021. [PMID: 34140297 DOI: 10.1183/13993003.00014-2021] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Accepted: 06/03/2021] [Indexed: 11/05/2022]
Abstract
INTRODUCTION France implemented a high emergency lung transplantation (HELT) program nationally in 2007. A similar program does not exist in Canada. The objectives of our study were to compare health outcomes within France as well as between Canada and France before and after the HELT program in a population with Cystic Fibrosis (CF). METHODS This population-based cohort study utilised data from the French and Canadian CF registries. A cumulative incidence curve assessed time to transplant with death without transplant as competing risks. The Kaplan-Meier method was used to estimate post-transplant survival. RESULTS Between 2002 and 2016, there were 1075 (13.0%) people with CF in France and 555 (10.2%) people with CF in Canada who underwent lung transplantation. The proportion of lung transplant increased in France after the HELT program was initiated (4.5% versus 10.1%) whereas deaths pre-transplant decreased from 85.3% in the pre-HELT to 57.1% in the post-HELT period. Between 2008-2016, people in France were significantly more likely to receive a transplant (Hazard Ratio (HR) 1.56, 95% CI 1.37-1.77, p<0.001) than die (HR 0.55, 95% CI 0.46-0.66, p<0.001) compared to Canada. Post-transplant survival was similar between the countries and there was no difference in survival when comparing pre- and post-HELT period in France. CONCLUSION Following the implementation of the HELT program, people living with CF in France were more likely to receive a transplant than die. Post-transplant survival in the post-HELT period in France did not change compared to the pre-HELT period, despite potentially sicker patients being transplanted, and is comparable to Canada.
Collapse
Affiliation(s)
- Adèle Coriati
- Department of Respirology, St. Michael's Hospital, Toronto, Ontario, Canada
| | - Jenna Sykes
- Department of Respirology, St. Michael's Hospital, Toronto, Ontario, Canada
| | | | - Xiayi Ma
- Department of Respirology, St. Michael's Hospital, Toronto, Ontario, Canada
| | - Sanja Stanojevic
- Department of Community Health and Epidemiology, Dalhousie University, Halifax, NS, Canada
| | | | - Nicolas Carlier
- Hôpital Cochin, Assistance Publique Hopitaux de Paris, Paris, France.,ERN-Lung Cystic Fibrosis network
| | - Anne L Stephenson
- Department of Respirology, St. Michael's Hospital, Toronto, Ontario, Canada.,Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada.,Keenan Research Centre, Li Ka Shing Knowledge Institute of St Michael's Hospital, Toronto, Ontario, Canada.,Co-senior authors
| | - Pierre-Régis Burgel
- Hôpital Cochin, Assistance Publique Hopitaux de Paris, Paris, France .,ERN-Lung Cystic Fibrosis network.,Université de Paris and Institut Cochin, Inserm U1016, Paris, France.,Co-senior authors
| |
Collapse
|
6
|
Burgel PR, Durieu I, Chiron R, Mely L, Prevotat A, Murris-Espin M, Porzio M, Abely M, Reix P, Marguet C, Macey J, Sermet-Gaudelus I, Corvol H, Bui S, Biouhee T, Hubert D, Munck A, Lemonnier L, Dehillotte C, Silva JD, Paillasseur JL, Martin C. Clinical response to lumacaftor-ivacaftor in patients with cystic fibrosis according to baseline lung function. J Cyst Fibros 2021; 20:220-227. [DOI: 10.1016/j.jcf.2020.06.012] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2020] [Revised: 06/04/2020] [Accepted: 06/04/2020] [Indexed: 01/08/2023]
|
7
|
Rousset-Jablonski C, Dalon F, Reynaud Q, Lemonnier L, Dehillotte C, Berard M, Jacoud F, Viprey M, Van Ganse E, Belhassen M, Durieu I. WS08.2 Cancer incidence and prevalence among patients with cystic fibrosis: data from the National French Cystic Fibrosis Registry. J Cyst Fibros 2021. [DOI: 10.1016/s1569-1993(21)00958-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
|
8
|
Coriati A, Sykes J, Stanojevic S, Lemonnier L, Dehillotte C, Burgel PR, Stephenson A. WS23.6 Impact of the French high emergency program in cystic fibrosis: survival comparison between France and Canada. J Cyst Fibros 2020. [DOI: 10.1016/s1569-1993(20)30280-0] [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]
|
9
|
Guet-Revillet H, Dehillotte C, Lemonnier-Videau L, Segonds C. P093 The epidemiology of cystic fibrosis-associated infections with the Burkholderia cepacia complex has evolved over the 2003–2015 period in France: B. cepacia and cystic fibrosis Registry data analysis. J Cyst Fibros 2020. [DOI: 10.1016/s1569-1993(20)30428-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
10
|
Sasorith S, Bareil C, Lemonnier L, Dehillotte C, Farge A, Audrezet MP, Ferec C, Girodon E, Bienvenu T, Fanen P, Mekki C, Bieth E, Gaston V, Fergelot P, Reboul MP, Dufernez F, Pagin A, Lalau G, Malinge MC, Cabet F, Bergougnoux A, Claustres M, Raynal C. WS21.3 Overview of shared benefits from the 6-year long collaboration between the French Cystic Fibrosis Registry and the CFTR-France genetics database. J Cyst Fibros 2020. [DOI: 10.1016/s1569-1993(20)30271-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
11
|
Desmazes-Dufeu N, Coltey B, Birnbaum D, Serrero M, Dehillotte C, Lemonnier L. ePS2.04 Gastrointestinal surgery in adult patients with cystic fibrosis: observational French prospective study over 11 years. J Cyst Fibros 2020. [DOI: 10.1016/s1569-1993(20)30294-0] [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: 10/24/2022]
|
12
|
Burgel PR, Munck A, Durieu I, Chiron R, Mely L, Prevotat A, Murris-Espin M, Porzio M, Abely M, Reix P, Marguet C, Macey J, Sermet-Gaudelus I, Corvol H, Bui S, Lemonnier L, Dehillotte C, Da Silva J, Paillasseur JL, Hubert D, Mounard J, Poulet C, Rames C, Person C, Troussier F, Urban T, Dalphin ML, Dalphin JC, Pernet D, Richaud-Thiriez B, Bui S, Fayon M, Macey-Caro J, Campbell K, Laurans M, Borderon C, Heraud MC, Labbé A, Montcouquiol S, Bassinet L, Remus N, Fanton A, Houzel-Charavel A, Huet F, Perez-Martin S, Boldron-Ghaddar A, Scalbert M, Mely L, Camara B, Llerena C, Pin I, Quétant S, Cottereau A, Deschildre A, Gicquello A, Perez T, Stervinou-Wemeau L, Thumerelle C, Wallaert B, Wizla N, Languepin J, Ménétrey C, Dupuy-Grasset M, Bazus L, Buchs C, Jubin V, Werck-Gallois MC, Mainguy C, Perrin T, Reix P, Toutain-Rigolet A, Durieu I, Durupt S, Reynaud Q, Nove-Josserand R, Baravalle-Einaudi M, Coltey B, Dufeu N, Dubus JC, Stremler N, Caimmi D, Chiron R, Billon Y, Derelle J, Kieffer S, Pichon AS, Schweitzer C, Tatopoulos A, Abbes S, Bihouée T, Danner-Boucher I, David V, Haloun A, Tissot A, Leroy S, Bailly-Piccini C, Clément A, Corvol H, Tamalet A, Burgel PR, Honoré I, Hubert D, Kanaan R, Martin C, Bailly C, Chédevergne F, De Blic J, Fauroux B, Le Bourgeois M, Sermet-Gaudelus I, Delaisi B, Gérardin M, Munck A, Abély M, Ravoninjatovo B, Belleguic C, Desrues B, Brinchault G, Dagorne M, Deneuville E, Lefeuvre S, Dirou A, Le Bihan J, Ramel S, Dominique S, Marguet C, Payet A, Kessler R, Porzio M, Rosner V, Weiss L, de Miranda S, Grenet D, Hamid A, Picard C, Brémont F, Didier A, Labouret G, Mittaine M, Murris-Espin M, Têtu L, Cosson L, Giraut C, Henriet AC, Mankikian J, Marchand S, Hugé S, Storni V, Coirier-Duet E. Real-Life Safety and Effectiveness of Lumacaftor–Ivacaftor in Patients with Cystic Fibrosis. Am J Respir Crit Care Med 2020; 201:188-197. [DOI: 10.1164/rccm.201906-1227oc] [Citation(s) in RCA: 61] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Pierre-Régis Burgel
- Université de Paris, Institut Cochin, INSERM U1016, Paris, France
- Respiratory Medicine and National Reference Cystic Fibrosis Reference Center, Cochin Hospital, Assistance Publique–Hôpitaux de Paris (AP-HP), Paris, France
- ERN-Lung CF Network
| | - Anne Munck
- Hôpital Robert Debré, AP-HP, Paris, France
| | - Isabelle Durieu
- ERN-Lung CF Network
- Centre de Référence Adulte de la Mucoviscidose, Service de Médecine Interne, Hospices Civils de Lyon, Pierre Bénite, France
- Université de Lyon, Équipe d’Accueil Health Services and Performance Research (HESPER) 7425, Lyon, France
| | - Raphaël Chiron
- Cystic Fibrosis Center, Hôpital Arnaud de Villeneuve, Centre Hospitalier Universitaire de Montpellier, Université de Montpellier, Montpellier, France
| | - Laurent Mely
- Hôpital Renée Sabran, Cystic Fibrosis Center, Giens, France
| | - Anne Prevotat
- CHU-Lille, Cystic Fibrosis Center, Service de Pneumologie et Immuno-allergologie, Hôpital Calmette and Université de Lille, Lille, France
| | - Marlene Murris-Espin
- Cystic Fibrosis Center, Service de Pneumologie, Pôle des Voies Respiratoires, Hôpital Larrey, CHU de Toulouse, Toulouse, France
| | - Michele Porzio
- Department of Respiratory Medicine and Cystic Fibrosis Center, Federation of Translational Medicine of Strasbourg, University Hospitals, Strasbourg, France
| | - Michel Abely
- Department of Pediatrics A and Cystic Fibrosis Center, American Memorial Hospital, Reims, France
| | - Philippe Reix
- UMR 5558 CNRS, Equipe EMET, Université Claude Bernard Lyon 1, Lyon, France
- Cystic Fibrosis Center, Hospices Civils de Lyon, Lyon, France
| | - Christophe Marguet
- Pediatric Respiratory Disease and Cystic Fibrosis Center, Hospital, UNIROUEN, INSERM EA 2656, Rouen University Hospital, Université de Normandie, Rouen, France
| | - Julie Macey
- Respiratory Medicine and Cystic Fibrosis Center, CHU de Bordeaux, Bordeaux, France
| | - Isabelle Sermet-Gaudelus
- ERN-Lung CF Network
- Pediatric Respiratory Disease and Cystic Fibrosis Center, National Reference Cystic Fibrosis Reference Center, Hôpital Necker Enfants Malades, Paris France
- INSERM U 1151, Institut Necker Enfants Malades, Paris, France
| | - Harriet Corvol
- Sorbonne Université, Centre de Recherche Saint-Antoine, Paris, France
- Pediatric Respiratory Disease and Cystic Fibrosis Center, Hôpital Trousseau, AP-HP, Paris, France
| | - Stéphanie Bui
- Pediatric Respiratory Disease and Cystic Fibrosis Center and CIC 1401, CHU de Bordeaux, Bordeaux, France
| | | | | | - Jennifer Da Silva
- Université de Paris, Institut Cochin, INSERM U1016, Paris, France
- ERN-Lung CF Network
- URC-CIC Paris Descartes Necker Cochin, AP-HP, Hôpital Cochin, Paris, France; and
| | | | - Dominique Hubert
- Respiratory Medicine and National Reference Cystic Fibrosis Reference Center, Cochin Hospital, Assistance Publique–Hôpitaux de Paris (AP-HP), Paris, France
- ERN-Lung CF Network
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
13
|
Mainbourg S, Durieu I, Dehillotte C, Reynaud Q. Extra-respiratory comorbidities and transplantation in the French cystic fibrosis registry. Expert Rev Respir Med 2019; 13:799-802. [DOI: 10.1080/17476348.2019.1638768] [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] [Indexed: 02/08/2023]
Affiliation(s)
- Sabine Mainbourg
- Department of Internal Medicine Adult Cystic Fibrosis Care Center, Hospices Civils de Lyon, Lyon, France
- EA HESPER 7425, Université Claude Bernard Lyon 1, Lyon, France
| | - Isabelle Durieu
- Department of Internal Medicine Adult Cystic Fibrosis Care Center, Hospices Civils de Lyon, Lyon, France
- EA HESPER 7425, Université Claude Bernard Lyon 1, Lyon, France
| | | | - Quitterie Reynaud
- Department of Internal Medicine Adult Cystic Fibrosis Care Center, Hospices Civils de Lyon, Lyon, France
- EA HESPER 7425, Université Claude Bernard Lyon 1, Lyon, France
| |
Collapse
|
14
|
Willaume M, Dehillotte C, Lemonnier L, Troussier F. P064 Comparison of the characteristics of patients enrolled in the 2016 French Cystic Fibrosis Registry according to the value of their sweat test. J Cyst Fibros 2019. [DOI: 10.1016/s1569-1993(19)30358-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
|
15
|
Burgel PR, Lemonnier L, Dehillotte C, Sykes J, Stanojevic S, Stephenson AL, Paillasseur JL. Cluster and CART analyses identify large subgroups of adults with cystic fibrosis at low risk of 10-year death. Eur Respir J 2019; 53:13993003.01943-2018. [PMID: 30578399 DOI: 10.1183/13993003.01943-2018] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2017] [Accepted: 12/14/2018] [Indexed: 12/12/2022]
Abstract
Our goal was to identify subgroups of adults with cystic fibrosis (CF) at low risk of death within 10 years.Factor analysis for mixed data followed by Ward's cluster analysis was conducted using 25 variables from 1572 French CF adults in 2005. Rates of death by subgroups were analysed over 10 years. An algorithm was developed using CART (classification and regression tree) analysis to provide rules for the identification of subgroups of CF adults with low rates of death within 10 years. This algorithm was validated in 1376 Canadian CF adults.Seven subgroups were identified by cluster analysis in French CF adults, including two subgroups with low (∼5%) rates of death at 10 years: one subgroup (22% of patients) was composed of patients with nonclassic CF, the other subgroup (17% of patients) was composed of patients with classic CF but low rates of Pseudomonas aeruginosa infection and diabetes. An algorithm based on CART analysis of data in 2005 allowed us to identify most French adults with low rates of death. When tested using data from Canadian CF adults in 2005, the algorithm identified 287 out of 1376 (21%) patients at low risk (10-year death: 7.7%).Large subgroups of CF adults share low risk of 10-year mortality.
Collapse
Affiliation(s)
| | | | | | - Jenna Sykes
- Adult CF Program, Dept of Medicine, University of Toronto, St Michael's Hospital, Li Ka Shing Knowledge Institute, Keenan Research Centre, Toronto, ON, Canada.,Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
| | - Sanja Stanojevic
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada.,The Hospital for Sick Children, Division of Respiratory Medicine, Toronto, ON, Canada
| | - Anne L Stephenson
- Adult CF Program, Dept of Medicine, University of Toronto, St Michael's Hospital, Li Ka Shing Knowledge Institute, Keenan Research Centre, Toronto, ON, Canada.,Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
| | | |
Collapse
|
16
|
Vongthilath R, Richaud Thiriez B, Dehillotte C, Lemonnier L, Guillien A, Degano B, Dalphin ML, Dalphin JC, Plésiat P. Clinical and microbiological characteristics of cystic fibrosis adults never colonized by Pseudomonas aeruginosa: Analysis of the French CF registry. PLoS One 2019; 14:e0210201. [PMID: 30620748 PMCID: PMC6324790 DOI: 10.1371/journal.pone.0210201] [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] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Accepted: 12/18/2018] [Indexed: 01/13/2023] Open
Abstract
Pseudomonas aeruginosa is the main cause of chronic airway infection in cystic fibrosis (CF). However, for unclear reasons some patients are never colonized by P. aeruginosa. The objectives of this study were to better define the clinical, genetic, and microbiological characteristics of such a subpopulation and to identify predictive factors of non-colonization with P. aeruginosa. The French CF patient registry 2013–2014 was used to identify CF patients aged ≥ 20 years. The clinical outcomes, CF Transmembrane conductance Regulator (CFTR) genotypes, and microbiological data of patients reported positive at least once for P. aeruginosa (“Pyo” group, n = 1,827) were compared to those of patients with no history of P. aeruginosa isolation (“Never” group, n = 303). Predictive factors of non-colonization by P. aeruginosa were identified by multivariate logistic regression model with backward selection. Absence of aspergillosis (odds ratio (OR) [95% CI] = 1.64 [1.01–2.66]), absence of diabetes (2.25 [1.21–4.18]), pancreatic sufficiency (1.81 [1.30–2.52]), forced expiratory volume 1 (FEV1) ≥ 80% (3.03 [2.28–4.03]), older age at CF diagnosis (1.03 [1.02–1.04]), and absence of F508del/F508del genotype (2.17 [1.48–3.19]) were predictive clinical factors associated with absence of infection (“Never” group). Microbiologically, this same group was associated with more frequent detection of Haemophilus influenzae and lower rates of Stenotrophomonas maltophilia, Achromobacter xylosoxidans and Aspergillus spp. (all p<0.01) in sputum. This study strongly suggests that the absence of pulmonary colonization by P. aeruginosa in a minority of CF adults (14.2%) is associated with a milder form of the disease. Recent progress in the development of drugs to correct CFTR deficiency thus may be decisive in the control of P. aeruginosa lung infection.
Collapse
Affiliation(s)
- Réchana Vongthilath
- Department of Respiratory Medicine, University Hospital Jean Minjoz, Besançon, France
| | | | | | - Lydie Lemonnier
- Medical Department of Vaincre La Mucoviscidose, Paris, France
| | - Alicia Guillien
- Department of Physiology, University Hospital Jean Minjoz, Besançon, France
| | - Bruno Degano
- Department of Physiology, University Hospital Jean Minjoz, Besançon, France
- EA3920, University of Franche-Comté, Besançon, France
| | - Marie-Laure Dalphin
- Department of Pediatric Medicine, University Hospital Jean Minjoz, Besançon, France
| | - Jean-Charles Dalphin
- Department of Respiratory Medicine, University Hospital Jean Minjoz, Besançon, France
- UMR/CNRS 6249 Chrono-Environnement, University of Franche-Comté, Besançon, France
| | - Patrick Plésiat
- UMR/CNRS 6249 Chrono-Environnement, University of Franche-Comté, Besançon, France
- Department of Bacteriology, University Hospital Jean Minjoz, Besançon, France
- * E-mail:
| |
Collapse
|
17
|
L'hostis C, Dehillotte C, Lemonnier L, Bellis G, Rault G, Ramel S, Burgel PR, Férec C, Scotet V. EPS5.02 Estimation of survival of cystic fibrosis patients in France by two different methods. J Cyst Fibros 2018. [DOI: 10.1016/s1569-1993(18)30262-5] [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: 10/14/2022]
|
18
|
Abstract
BACKGROUND The PHARE-M care quality improvement program, modeled on the US Cystic Fibrosis Quality Improvement Program, was introduced at 14 cystic fibrosis centers (CFCs) in the French Cystic Fibrosis Network between 2011 and 2013. The pilot phase assessments attested the progressive adherence of the teams and improvements in care management. The PHARE-M Performance research project aims at assessing in 2015 the impact of the PHARE-M program on patient health indicators at trained versus untrained centers. It also sought to identify contextual factors that could account for variability in the performance of the PHARE-M among the trained centers. METHODS A mixed methodology combining: a quantitative experimental study: a comparison, using a mixed model for repeated data (from 2011 to 2015), of the average changes over time in forced expiratory volume in 1 s (FEV1) and body mass index (BMI) between two groups of patients included in a closed cohort (non-transplant patients, continuous follow-up at one participating CFC, and a CF-causing mutation), one having benefitted from the PHARE-M program and the other not having done so, and a realistic study: a characterization of the impact on care management and an identification of mechanisms through which the PHARE-M intervention improved the team's effectiveness in different CFC contexts; this required modeling the intervention, context, and impact on care management with respect to the criteria of the chronic care model (CCM); this was done using a self-administered questionnaire given to professionals and patients/parents supplemented with focus groups. CONCLUSION Although the study population was controlled, it may be difficult to establish a causal relationship between the differences in the changes over time in patient health indicators in the two groups of patients and the PHARE-M intervention as it is often the case in complex interventions rolled out in adaptive environments. The analysis of factors associated with variations in the impact of the PHARE-M at the different trained CFCs required the adoption of instruments validated in other contexts; these could be useful for assessing the performance of other interventions in healthcare practices at CFCs in France.
Collapse
|
19
|
Hubert D, Dehillotte C, Munck A, David V, Baek J, Mely L, Dominique S, Ramel S, Danner Boucher I, Lefeuvre S, Reynaud Q, Colomb-Jung V, Bakouboula P, Lemonnier L. Retrospective observational study of French patients with cystic fibrosis and a Gly551Asp-CFTR mutation after 1 and 2years of treatment with ivacaftor in a real-world setting. J Cyst Fibros 2017; 17:89-95. [PMID: 28711222 DOI: 10.1016/j.jcf.2017.07.001] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [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: 04/03/2017] [Revised: 07/03/2017] [Accepted: 07/03/2017] [Indexed: 11/16/2022]
Abstract
BACKGROUND Ivacaftor has been shown to improve lung function and body weight in patients with CF and a gating mutation. Real-world evaluation is warranted to examine its safety and effectiveness over the long term. METHODS A retrospective observational multicentre study collected clinical data in the year before and the 2years after ivacaftor initiation in patients with CF and a Gly551Asp-CFTR mutation. RESULTS Fifty-seven patients were included. Mean absolute change in FEV1% predicted improved from baseline to Year 1 (8.4%; p<0.001) and Year 2 (7.2%; p=0.006). Statistically significant benefits were observed with increased body mass index, fewer Pseudomonas aeruginosa and Staphylococcus aureus positive cultures, and decreased IV antibiotics and maintenance treatment prescriptions (including azithromycin, Dornase alpha and nutritional supplements). No significant adverse events were reported. CONCLUSION The clinical benefits of ivacaftor reported in previous clinical trials were confirmed in a real-world setting two years post-initiation, also reducing treatment burden.
Collapse
Affiliation(s)
- Dominique Hubert
- Pulmonary Department, Adult CF Centre, Cochin Hospital, AP-HP, Paris, France; Université Paris Descartes, Sorbonne Paris Cité, Paris, France.
| | | | - Anne Munck
- Pediatric CF Centre, Robert Debré Hospital, AP-HP, Paris, France
| | - Valérie David
- Pediatric CF Centre, Hôpital Mère-Enfant, Nantes, France
| | - Jinmi Baek
- Clinical Research Unit, Cochin Hospital, AP-HP, Paris, France
| | | | - Stéphane Dominique
- Pulmonary Department, Adult CF Centre, Charles Nicolle Hospital, Rouen University Hospital, Rouen, France
| | - Sophie Ramel
- CF Centre, Centre héliomarin de Perharidy, Roscoff, France
| | | | | | | | | | | | | |
Collapse
|
20
|
Vongthilath R, Dehillotte C, Lemonnier L, Richaud-Thiriez B, Guillien A, Degano B, Plésiat P, Dalphin JC. Étude PYOnever : caractéristiques des adultes atteints de mucoviscidose indemnes de colonisation pulmonaire par Pseudomonas aeruginosa. Rev Mal Respir 2017. [DOI: 10.1016/j.rmr.2016.10.068] [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] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
21
|
Bareil C, Lemonnier L, Dehillotte C, Colomb-Jung V, Thèze C, Audrézet MP, Férec C, Bienvenu T, Girodon E, Fanen P, Mekki C, Bieth E, Gaston V, Fergelot P, Reboul MP, Kitzis A, Lalau G, Pagin A, Malinge MC, Raynal C, Claustres M. 4 Valuable collaboration between a molecular CFTR database and a national CF registry: the French experience. J Cyst Fibros 2016. [DOI: 10.1016/s1569-1993(16)30244-2] [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]
|
22
|
Bouteloup V, Semaille C, Dehillotte C, Aouba A, May T, Chêne G. Causes de décès des personnes infectées par le virus de l’immunodéficience humaine nées en Afrique subsaharienne, vivant en France (études Mortalité 2000 et 2005). Rev Epidemiol Sante Publique 2011. [DOI: 10.1016/j.respe.2011.02.042] [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] Open
|