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Grolleau C, Bettuzzi T, Wang L, Wolkenstein P, Sbidian E, Ortonne N. Guttate psoriasis shares histological features with pustular psoriasis and often shows neutrophil exocytosis and pustules. Pathology 2024; 56:606-608. [PMID: 38101958 DOI: 10.1016/j.pathol.2023.10.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Revised: 09/12/2023] [Accepted: 10/03/2023] [Indexed: 12/17/2023]
Affiliation(s)
- Chloé Grolleau
- Department of Dermatology, Saint Louis Hospital, Paris, France; Department of Dermatology, Henri Mondor Hospital, Créteil, France.
| | - Thomas Bettuzzi
- Department of Dermatology, Henri Mondor Hospital, Créteil, France
| | - Luojun Wang
- Department of Pathology, Henri Mondor Hospital, Créteil, France
| | | | - Emilie Sbidian
- Department of Dermatology, Henri Mondor Hospital, Créteil, France
| | - Nicolas Ortonne
- Department of Pathology, Henri Mondor Hospital, Créteil, France
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Matei I, Bettuzzi T, Peiffer B, Ingen-Housz-Oro S, Sbidian E, Lebrun-Vignes B. Evolution of the spectrum of drugs associated with acute generalized exanthematous pustulosis over time: a pharmacovigilance study. J Am Acad Dermatol 2024:S0190-9622(24)00750-3. [PMID: 38762011 DOI: 10.1016/j.jaad.2024.05.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Revised: 04/30/2024] [Accepted: 05/05/2024] [Indexed: 05/20/2024]
Affiliation(s)
- Ilaria Matei
- Service de Dermatologie, Hôpital Henri Mondor, AP-HP, Créteil, France
| | - Thomas Bettuzzi
- Service de Dermatologie, Hôpital Henri Mondor, AP-HP, Créteil, France; EpiDermE, Université Paris Est Créteil Val de Marne, Créteil, France; Centre de référence dermatoses bulleuses toxiques et toxidermies graves TOXIBUL, Créteil, France.
| | - Bastien Peiffer
- DMU Medecine, Hôpitaux Universitaires Henri Mondor, Assistance Publique-Hôpitaux de Paris (AP-HP), Créteil, France
| | - Saskia Ingen-Housz-Oro
- Service de Dermatologie, Hôpital Henri Mondor, AP-HP, Créteil, France; EpiDermE, Université Paris Est Créteil Val de Marne, Créteil, France; Centre de référence dermatoses bulleuses toxiques et toxidermies graves TOXIBUL, Créteil, France
| | - Emilie Sbidian
- Service de Dermatologie, Hôpital Henri Mondor, AP-HP, Créteil, France; EpiDermE, Université Paris Est Créteil Val de Marne, Créteil, France; CIC Centre d'investigation clinique 1430, Inserm, Créteil, France
| | - Bénédicte Lebrun-Vignes
- EpiDermE, Université Paris Est Créteil Val de Marne, Créteil, France; Service de pharmacologie médicale, Centre Régional de Pharmacovigilance, Hôpital Pitié-Salpêtrière, AP-HP.Sorbonne Université, Paris, France
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Hoisnard L, Meyer A, Dray-Spira R, Weill A, Zureik M, Sbidian E. Risk of gastrointestinal perforation in patients with rheumatic diseases exposed to janus kinase inhibitors versus adalimumab: nationwide cohort study. Arthritis Rheumatol 2024. [PMID: 38699822 DOI: 10.1002/art.42862] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Revised: 03/20/2024] [Accepted: 04/08/2024] [Indexed: 05/05/2024]
Abstract
OBJECTIVE To compare the risk of gastrointestinal perforation (GIP), a rare but serious adverse event, in patients initiating a Janus kinase inhibitor (JAKi; tofacitinib, baricitinib, upadacitinib or filgotinib) versus adalimumab (tumor necrosis factor inhibitor) among a comprehensive real-world population of patients with rheumatic diseases. METHODS We conducted a nationwide population-based cohort study of the French national health data system, the exposed group initiating a JAKi and the comparison group adalimumab. We included all individuals with a rheumatic disease who had their first dispensation of these treatments from July 2017 to December 2021. The primary endpoint was the occurrence of GIP (end of follow-up May 2022). Weighted hazard ratios (wHRs) were estimated with the inverse probability of treatment weighting method to account for confounding factors. Concomitant administration of systemic corticosteroids, non-steroidal anti-inflammatory drugs and proton pump inhibitors were time-varying variables. RESULTS The cohort included 39,758 patients: 12,335 and 27,423 in the JAKi and adalimumab groups (mean age 58.2 and 47.3 years; female 76% and 58%; rheumatoid arthritis 85.3% and 27.3%, and psoriatic arthritis/axial spondyloarthritis 14.7% and 72.7%). During follow-up, 38 and 42 GIPs occurred in the JAKi and adalimumab groups, incidence rates were 2.1 (95% CI 1.5-2.8) and 1.1 (0.8-1.5) per 1000 person-years respectively. Rates of GIP did not differ between JAKi and adalimumab groups : wHR 1.1 (95% CI 0.7-1.9) (p=0.65). Despite lack of power in some subgroup analyses, results were consistent whatever the JAKi or rheumatic disease subgroup. CONCLUSION In this nationwide cohort study, the rates of GIP did not differ between groups of patients initiating JAKi and adalimumab treatment. These results need to be confirmed in other observational studies.
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Affiliation(s)
- Lea Hoisnard
- Fédération Hospitalo-Universitaire TRUE InnovaTive theRapy for immUne disordErs, Assistance Publique-Hôpitaux de Paris (AP-HP), Henri Mondor Hospital, F-94010, Créteil, France
- INSERM, Centre d'Investigation Clinique 1430, F-94010, Créteil, France
- EpiDermE Epidemiology in Dermatology and Evaluation of Therapeutics, EA7379, Paris Est Créteil University UPEC, F-94010, Créteil, France
| | - Antoine Meyer
- EPI-PHARE Scientific Interest Group in Epidemiology of Health Products, French National Agency for Medicines and Health Products Safety, French National Health Insurance, 93200, Saint-Denis, France
- Department of Gastroenterology, Assistance Publique-Hôpitaux de Paris (AP-HP), Bicêtre University Hospital, Paris-Saclay University, Le Kremlin Bicêtre, France
| | - Rosemary Dray-Spira
- EPI-PHARE Scientific Interest Group in Epidemiology of Health Products, French National Agency for Medicines and Health Products Safety, French National Health Insurance, 93200, Saint-Denis, France
| | - Alain Weill
- EPI-PHARE Scientific Interest Group in Epidemiology of Health Products, French National Agency for Medicines and Health Products Safety, French National Health Insurance, 93200, Saint-Denis, France
| | - Mahmoud Zureik
- EPI-PHARE Scientific Interest Group in Epidemiology of Health Products, French National Agency for Medicines and Health Products Safety, French National Health Insurance, 93200, Saint-Denis, France
| | - Emilie Sbidian
- Fédération Hospitalo-Universitaire TRUE InnovaTive theRapy for immUne disordErs, Assistance Publique-Hôpitaux de Paris (AP-HP), Henri Mondor Hospital, F-94010, Créteil, France
- INSERM, Centre d'Investigation Clinique 1430, F-94010, Créteil, France
- EpiDermE Epidemiology in Dermatology and Evaluation of Therapeutics, EA7379, Paris Est Créteil University UPEC, F-94010, Créteil, France
- EPI-PHARE Scientific Interest Group in Epidemiology of Health Products, French National Agency for Medicines and Health Products Safety, French National Health Insurance, 93200, Saint-Denis, France
- Department of Dermatology, Assistance Publique-Hôpitaux de Paris (AP-HP), Henri Mondor Hospital, F-94010, Créteil, France
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Bastard L, Claudepierre P, Penso L, Sbidian E, Pina Vegas L. Risk of serious infection associated with different classes of targeted therapies used in psoriatic arthritis: a nationwide cohort study from the French Health Insurance Database (SNDS). RMD Open 2024; 10:e003865. [PMID: 38485454 PMCID: PMC10941117 DOI: 10.1136/rmdopen-2023-003865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Accepted: 02/20/2024] [Indexed: 03/17/2024] Open
Abstract
OBJECTIVE To assess the risk of serious infection associated with different targeted therapies for psoriatic arthritis (PsA) in real-world settings. METHODS This nationwide cohort study used the administrative healthcare database of the French health insurance scheme linked to the hospital discharge database to identify all adults with PsA who were new users of targeted therapies (adalimumab, etanercept, golimumab, certolizumab pegol, infliximab, secukinumab, ixekizumab, ustekinumab, and tofacitinib) from 1 January 2015 to 30 June 2021. The primary outcome was a serious infection (ie, requiring hospitalisation), in a time-to-event analysis using propensity score-weighted Cox models, with adalimumab as the comparator, estimating weighted HRs (wHRs) and their 95% CIs. RESULTS A total of 12 071 patients were included (mean age 48.7±12.7 years; 6965 (57.7%) women). We identified 367 serious infections (3.0% of patients), with a crude incidence rate of 17.0 per 1000 person-years (95% CI, 15.2 to 18.7). After inverse propensity score weighting and adjustment for time-dependent covariates and calendar year, risk of serious infection was significantly lower for new users of etanercept (wHR 0.72; 95% CI, 0.53 to 0.97) or ustekinumab (wHR, 0.57; 95% CI, 0.35 to 0.93) than adalimumab new users. This risk was not statistically modified with the other targeted therapies. CONCLUSIONS The incidence of serious infection was low for PsA patients who were new users of targeted therapies in real-world settings. Relative to adalimumab new users, this risk was lower among new users of etanercept and ustekinumab and unmodified for the other molecules.
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Affiliation(s)
- Léa Bastard
- Epidemiology in Dermatology and Evaluation of Therapeutics (EpiDermE), University Paris-Est Créteil Val de Marne, Créteil, France
- Rheumatology, Hospital Henri Mondor, Créteil, France
| | - Pascal Claudepierre
- Epidemiology in Dermatology and Evaluation of Therapeutics (EpiDermE), University Paris-Est Créteil Val de Marne, Créteil, France
- Rheumatology, Hospital Henri Mondor, Créteil, France
| | - Laetitia Penso
- Epidemiology in Dermatology and Evaluation of Therapeutics (EpiDermE), University Paris-Est Créteil Val de Marne, Créteil, France
| | - Emilie Sbidian
- Epidemiology in Dermatology and Evaluation of Therapeutics (EpiDermE), University Paris-Est Créteil Val de Marne, Créteil, France
- Dermatology, Hospital Henri Mondor, Créteil, France
- Clinical Investigation Center 1430, INSERM, Créteil, France
| | - Laura Pina Vegas
- Epidemiology in Dermatology and Evaluation of Therapeutics (EpiDermE), University Paris-Est Créteil Val de Marne, Créteil, France
- Rheumatology, Hospital Henri Mondor, Créteil, France
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Jourdain H, Hoisnard L, Sbidian E, Zureik M. Persistence and safety of anti-TNF biosimilars versus originators in immune-mediated inflammatory diseases: an observational study on the French National Health Data System. RMD Open 2024; 10:e003531. [PMID: 38453213 PMCID: PMC10921511 DOI: 10.1136/rmdopen-2023-003531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Accepted: 01/20/2024] [Indexed: 03/09/2024] Open
Abstract
OBJECTIVES Biosimilar-originator equivalence has been demonstrated in phase 3 trials in a few indications of infliximab, etanercept and adalimumab. The objective of our study was to compare the persistence and safety of biosimilars versus originators in all the licensed indications of these molecules. METHODS We used data from the French National Health Data System (SNDS), covering 99% of the French population, to identify infliximab, etanercept and adalimumab initiators from biosimilar launch (January 2015, May 2016 and October 2018, respectively) to 30 June 2021. Patients were then followed for 1 year. Treatment persistence (duration without treatment discontinuation or modification) and safety (including severe infections, all-cause hospitalisation and death) were compared between originator and biosimilar users by Cox regressions weighting the populations on the inverse probability of treatment. Analyses were performed by molecule, by disease and by biosimilar product. RESULTS From January 2015 to June 2021, 86 776 patients were included in the study: 22 670, 24 442 and 39 664 patients had initiated infliximab, etanercept and adalimumab, respectively; 49 752 (53%) were biosimilar initiators. We did not find any risk of discontinuation (HRs were below or around 1, here all pathologies and products together: infliximab 0.88 (0.80-0.97), etanercept 0.85 (0.81-0.90) and adalimumab 0.96 (0.91-1.00)) or safety event (infection: infliximab 0.97 (0.78-1.21), etanercept 1.04 (0.81-1.33) and adalimumab 0.98 (0.83-1.16); hospitalisation: infliximab 1.08 (0.96-1.23), etanercept 0.99 (0.87-1.11) and adalimumab 0.91 (0.83-0.99)) associated with biosimilar versus originator use. CONCLUSIONS Our study shows reassuring results regarding the persistence and safety of biosimilar tumour necrosis factor-alpha inhibitors compared with originators in all licensed indications.
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Affiliation(s)
- Hugo Jourdain
- EPI-PHARE, French National Agency for Medicines and Health Products Safety (ANSM) and French National Health Insurance (CNAM), Saint-Denis, France
| | - Léa Hoisnard
- Fédération Hospitalo-Universitaire TRUE InnovaTive theRapy for immUne disordErs, Assistance Publique-Hôpitaux de Paris (AP-HP), Henri Mondor Hospital, Créteil, France
- Centre d'Investigation Clinique 1430, INSERM, Créteil, France
- EpiDermE Epidemiology in Dermatology and Evaluation of Therapeutics, EA7379, Paris Est Créteil University UPEC, Créteil, France
| | - Emilie Sbidian
- EPI-PHARE, French National Agency for Medicines and Health Products Safety (ANSM) and French National Health Insurance (CNAM), Saint-Denis, France
- Fédération Hospitalo-Universitaire TRUE InnovaTive theRapy for immUne disordErs, Assistance Publique-Hôpitaux de Paris (AP-HP), Henri Mondor Hospital, Créteil, France
- Centre d'Investigation Clinique 1430, INSERM, Créteil, France
- EpiDermE Epidemiology in Dermatology and Evaluation of Therapeutics, EA7379, Paris Est Créteil University UPEC, Créteil, France
- Department of Dermatology, Assistance Publique-Hôpitaux de Paris (AP-HP), Henri Mondor Hospital, Créteil, France
| | - Mahmoud Zureik
- EPI-PHARE, French National Agency for Medicines and Health Products Safety (ANSM) and French National Health Insurance (CNAM), Saint-Denis, France
- Anti-Infective Evasion and Pharmacoepidemiology, CESP, University Paris-Saclay - UVSQ, Montigny le Bretonneux, France
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Annabi E, Lalevée S, Bettuzzi T, Demortier J, Papouin B, De Mestier Du Bourg L, Sbidian E, Ingen-Housz-Oro S. Annular eruption with weight loss in a 47-year-old man. Frontline Gastroenterol 2024; 15:177-178. [PMID: 38486674 PMCID: PMC10935518 DOI: 10.1136/flgastro-2023-102507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Accepted: 09/04/2023] [Indexed: 03/17/2024] Open
Affiliation(s)
| | | | | | | | - Barbara Papouin
- Pathology, Hopital Henri Mondor, Creteil, Île-de-France, France
| | | | - Emilie Sbidian
- Dermatology, Hopital Henri Mondor, Creteil, France
- Epidemiology in Dermatology and Evaluation of Therapeutics (EpiDermE) - EA 7379, UPEC, Creteil, France
| | - Saskia Ingen-Housz-Oro
- Dermatology, Hopital Henri Mondor, Creteil, France
- Epidemiology in Dermatology and Evaluation of Therapeutics (EpiDermE) - EA 7379, UPEC, Creteil, France
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Bettuzzi T, Hoisnard L, Beytout Q, Ingen-Housz-Oro S, Sbidian E. Validation of an Algorithm to Identify Epidermal Necrolysis on a Medico-Administrative Database. J Invest Dermatol 2024; 144:708-710.e7. [PMID: 37832841 DOI: 10.1016/j.jid.2023.09.274] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Revised: 09/27/2023] [Accepted: 09/28/2023] [Indexed: 10/15/2023]
Affiliation(s)
- Thomas Bettuzzi
- Dermatology Department, Henri Mondor Hospital, Assitance Publique Hôpitaux de Paris (AP-HP), Créteil, France; Epidemiology in Dermatology and Evaluation of Therapeutics (EpiDermE), Paris Est Créteil University (UPEC), Créteil, France; Toxic Bullous Dermatoses and Severe Drug Reactions Reference Center, TOXIBUL, Assistance Publique-Hôpitaux de Paris (AP-HP), Henri Mondor Hospital, Créteil, France.
| | - Léa Hoisnard
- Epidemiology in Dermatology and Evaluation of Therapeutics (EpiDermE), Paris Est Créteil University (UPEC), Créteil, France; University Hospital Federation (FHU) TRUE (InnovaTive theRapy for immUne disordErs), Henri Mondor Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Créteil, France; INSERM, Clinical Investigation Centre 1430, Henri Mondor Hospital, Créteil, France
| | - Quentin Beytout
- Dermatology Department, Henri Mondor Hospital, Assitance Publique Hôpitaux de Paris (AP-HP), Créteil, France; Epidemiology in Dermatology and Evaluation of Therapeutics (EpiDermE), Paris Est Créteil University (UPEC), Créteil, France
| | - Saskia Ingen-Housz-Oro
- Dermatology Department, Henri Mondor Hospital, Assitance Publique Hôpitaux de Paris (AP-HP), Créteil, France; Epidemiology in Dermatology and Evaluation of Therapeutics (EpiDermE), Paris Est Créteil University (UPEC), Créteil, France; Toxic Bullous Dermatoses and Severe Drug Reactions Reference Center, TOXIBUL, Assistance Publique-Hôpitaux de Paris (AP-HP), Henri Mondor Hospital, Créteil, France
| | - Emilie Sbidian
- Dermatology Department, Henri Mondor Hospital, Assitance Publique Hôpitaux de Paris (AP-HP), Créteil, France; Epidemiology in Dermatology and Evaluation of Therapeutics (EpiDermE), Paris Est Créteil University (UPEC), Créteil, France; University Hospital Federation (FHU) TRUE (InnovaTive theRapy for immUne disordErs), Henri Mondor Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Créteil, France; INSERM, Clinical Investigation Centre 1430, Henri Mondor Hospital, Créteil, France
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Ingen-Housz-Oro S, Joly P, Kini-Matondo W, Sbidian E. Prevention of recurrent erythema multiforme with lenalidomide: a case series. Clin Exp Dermatol 2024; 49:166-168. [PMID: 37683088 DOI: 10.1093/ced/llad314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 09/02/2023] [Accepted: 09/21/2023] [Indexed: 09/10/2023]
Abstract
Prevention of recurrences of erythema multiforme is a therapeutic challenge. Thalidomide is effective, but its use is limited by adverse effects, especially peripheral neuropathy. We report seven cases of recurrent severe erythema multiforme treated with lenalidomide. In six cases, the drug was effective without significant adverse effects.
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Affiliation(s)
- Saskia Ingen-Housz-Oro
- Dermatology Department
- Reference Center for Toxic Bullous Diseases and Severe Drug Reactions (TOXIBUL), Créteil, France
- University Paris Est Créteil Val de Marne EpiDermE, Créteil, France
| | - Pascal Joly
- Reference Center for Toxic Bullous Diseases and Severe Drug Reactions (TOXIBUL), Créteil, France
- Dermatology Department, Charles Nicolle University Hospital, Rouen, France
| | | | - Emilie Sbidian
- Dermatology Department
- Reference Center for Toxic Bullous Diseases and Severe Drug Reactions (TOXIBUL), Créteil, France
- University Paris Est Créteil Val de Marne EpiDermE, Créteil, France
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Brenaut E, Godin O, Leboyer M, Tamouza R, Assan F, Pignon B, Sbidian E. Association between Psychotic Disorders and Psoriasis or Psoriatic Arthritis: Cohort Study of French Health Insurance Database. J Invest Dermatol 2024:S0022-202X(24)00024-1. [PMID: 38246581 DOI: 10.1016/j.jid.2024.01.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Revised: 12/30/2023] [Accepted: 01/08/2024] [Indexed: 01/23/2024]
Affiliation(s)
- Emilie Brenaut
- Dermatology Department, University Hospital of Brest, Brest, France; Laboratoire Interactions Epitheliums Neurones, University of Brest, Brest, France; Epidemiology in Dermatology and Evaluation of Therapeutics (EpiDermE) EA7379, Paris Est Créteil University (UPEC), Créteil, France.
| | - Ophélia Godin
- Fondation FondaMental, Créteil, France; Translational NeuroPsychiatry Laboratory, Université Paris Est Créteil (UPEC), INSERM U955, IMRB, Paris, France
| | - Marion Leboyer
- Fondation FondaMental, Créteil, France; Translational NeuroPsychiatry Laboratory, Université Paris Est Créteil (UPEC), INSERM U955, IMRB, Paris, France; Department of Psychiatry, Assistance Publique des Hôpitaux de Paris, Hôpital Henri Mondor, Univ Paris-Est-Créteil (UPEC), DMU IMPACT, FHU ADAPT, Creteil, France
| | - Ryad Tamouza
- Fondation FondaMental, Créteil, France; Translational NeuroPsychiatry Laboratory, Université Paris Est Créteil (UPEC), INSERM U955, IMRB, Paris, France; Department of Psychiatry, Assistance Publique des Hôpitaux de Paris, Hôpital Henri Mondor, Univ Paris-Est-Créteil (UPEC), DMU IMPACT, FHU ADAPT, Creteil, France
| | - Florence Assan
- INSERM UMR 1163, Laboratory of Genetic Skin Diseases, Institut Imagine, Paris, France
| | - Baptiste Pignon
- Translational NeuroPsychiatry Laboratory, Université Paris Est Créteil (UPEC), INSERM U955, IMRB, Paris, France; Department of Psychiatry, Assistance Publique des Hôpitaux de Paris, Hôpital Henri Mondor, Univ Paris-Est-Créteil (UPEC), DMU IMPACT, FHU ADAPT, Creteil, France
| | - Emilie Sbidian
- Epidemiology in Dermatology and Evaluation of Therapeutics (EpiDermE) EA7379, Paris Est Créteil University (UPEC), Créteil, France; Department of Dermatology, Hôpital Henri Mondor, Créteil, France
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Pina Vegas L, Penso L, Sbidian E, Claudepierre P. Influence of sex on the persistence of different classes of targeted therapies for psoriatic arthritis: a cohort study of 14 778 patients from the French health insurance database (SNDS). RMD Open 2023; 9:e003570. [PMID: 38114199 DOI: 10.1136/rmdopen-2023-003570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 10/02/2023] [Indexed: 12/21/2023] Open
Abstract
BACKGROUND Sex differences in phenotype presentation, disease trajectory and treatment response in psoriatic arthritis (PsA) have been reported. Nevertheless, whether classes of targeted therapies differentially affect men and women with PsA remains unclear. OBJECTIVES To assess the effect of sex on the long-term persistence of each class of targeted therapies in PsA. METHODS This nationwide cohort study involved the administrative healthcare database of the French health insurance scheme linked to the hospital discharge database. We included all adults with PsA who were new users of targeted therapies (not in the year before the index date) during 2015-2021 and studied all treatment lines during the study period. Persistence was defined as the time from treatment initiation to discontinuation and was estimated by the Kaplan-Meier method. Comparison of persistence by sex involved multivariate frailty models with conventional synthetic disease-modifying antirheumatic drugs and prednisone as time-dependant variables. RESULTS We included 14 778 patients with PsA who were new users of targeted therapies: 8475 (57%) women (mean age 50±13 years; 15 831 lines), 6303 (43%) men (mean age 51±13 years; 10 488 lines). Overall, 1-year persistence was 52% for women and 62% for men and at 3 years it was 27% and 39%, respectively. After adjustments, persistence was lower for women than men for inhibitors of tumour necrosis factor (TNFi) (adjusted HR (HRa) 1.4, 99% CI 1.3 to 1.5) and interleukin 17 inhibitor (IL17i) (HRa 1.2, 99% CI 1.1 to 1.3) but not IL12/23i (HRa 1.1, 99% CI 0.9 to 1.3), IL23i (HRa 1.1, 99% CI 0.7 to 1.5) or Janus kinase inhibitor (JAKi) (HRa 1.2, 99% CI 0.9 to 1.6). CONCLUSION The treatment persistence was lower for women than men for TNFi and IL17i but not for IL12/23i, IL23i or JAKi.
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Affiliation(s)
- Laura Pina Vegas
- EpiDermE, Université Paris-Est Créteil Val de Marne, Créteil, France
- Service de Rhumatologie, Hopital Henri Mondor, Créteil, France
| | - Laetitia Penso
- EpiDermE, Université Paris-Est Créteil Val de Marne, Créteil, France
| | - Emilie Sbidian
- EpiDermE, Université Paris-Est Créteil Val de Marne, Créteil, France
- Inserm, Centre d'investigation clinique 1430, Hopital Henri Mondor, Créteil, France
| | - Pascal Claudepierre
- EpiDermE, Université Paris-Est Créteil Val de Marne, Créteil, France
- Service de Rhumatologie, Hopital Henri Mondor, Créteil, France
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Diaz E, Bergqvist C, Peiffer B, Fertitta L, Jannic A, Ferkal S, Zehou O, Hemery F, Sbidian E, Wolkenstein P. In-Hospital Clinical Features, Morbidity, and Mortality of Patients with Neurofibromatosis 1 in France: A Nationwide, Population-Based Retrospective Cohort Study. J Invest Dermatol 2023; 143:2408-2415.e7. [PMID: 37257636 DOI: 10.1016/j.jid.2023.04.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 03/29/2023] [Accepted: 04/03/2023] [Indexed: 06/02/2023]
Abstract
Neurofibromatosis 1 (NF1) is a multisystem disease that can affect nearly every organ system. The aim of our study was to describe the in-hospital population with NF1 in France. We conducted a nationwide retrospective cohort study using the French hospital administrative database. A total of 11,425 patients with NF1 (53.4% female, 19,080 person years) were identified from January 2013 to December 2019. A total of 23% had at least one diagnosis of a comorbidity or NF1-associated complication or disease, and it was highest in the age group of 10-15 years. A total of 2,601 (22.8%) had a diagnosis of cancer. There were 366 (3.2%) in-hospital deaths, and we observed a standardized mortality ratio of 4.14 (95% confidence interval = 3.71-4.56), with a higher standardized mortality ratio in women and in the age group of 10-15 years. The standardized incident ratio (SIR) of cancer was 10.3 (95% confidence interval = 9.6-11.1). We observed high SIR values for cancer in childhood, with a decrease toward that of the general population by age 70 years. We observed high SIRs for NF1-associated cancers: CNS SIR of 195.4 (95% confidence interval = 172.2-220.9) and small intestine SIR of 102.9 (95% confidence interval = 71.7-143.2). The study provides a better understanding of the prognosis in people living with NF1.
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Affiliation(s)
- Emmanuelle Diaz
- Department of Dermatology, Henri Mondor Hospital, Créteil, France; Epidemiology in Dermatology and Evaluation of Therapeutics (EpiDermE) - EA 7379, Université Paris Est Créteil (UPEC), Créteil, France.
| | - Christina Bergqvist
- Department of Dermatology, Henri Mondor Hospital, Créteil, France; Reference center of Neurofibromatosis type 1, Henri Mondor Hospital, Créteil, France
| | - Bastien Peiffer
- Department of Dermatology, Henri Mondor Hospital, Créteil, France
| | - Laura Fertitta
- Department of Dermatology, Henri Mondor Hospital, Créteil, France; Reference center of Neurofibromatosis type 1, Henri Mondor Hospital, Créteil, France
| | - Arnaud Jannic
- Department of Dermatology, Henri Mondor Hospital, Créteil, France; Reference center of Neurofibromatosis type 1, Henri Mondor Hospital, Créteil, France
| | - Salah Ferkal
- Department of Dermatology, Henri Mondor Hospital, Créteil, France; Reference center of Neurofibromatosis type 1, Henri Mondor Hospital, Créteil, France; Clinical Investigation Center, Clinical Investigation Center 1430, Henri Mondor Hospital, Créteil, France
| | - Ouidad Zehou
- Department of Dermatology, Henri Mondor Hospital, Créteil, France
| | - François Hemery
- Department of Medical Information, Henri Mondor Hospital, Créteil, France
| | - Emilie Sbidian
- Department of Dermatology, Henri Mondor Hospital, Créteil, France; Epidemiology in Dermatology and Evaluation of Therapeutics (EpiDermE) - EA 7379, Université Paris Est Créteil (UPEC), Créteil, France; Clinical Investigation Center, Clinical Investigation Center 1430, Henri Mondor Hospital, Créteil, France
| | - Pierre Wolkenstein
- Department of Dermatology, Henri Mondor Hospital, Créteil, France; Epidemiology in Dermatology and Evaluation of Therapeutics (EpiDermE) - EA 7379, Université Paris Est Créteil (UPEC), Créteil, France; Reference center of Neurofibromatosis type 1, Henri Mondor Hospital, Créteil, France
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Conte M, Varraso R, Fournier A, Rothwell JA, Baglietto L, Fornili M, Sbidian E, Severi G. A prospective study of the association between living in a rural environment during childhood and risk of psoriasis. Environ Res 2023; 237:117062. [PMID: 37660877 DOI: 10.1016/j.envres.2023.117062] [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] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 08/04/2023] [Accepted: 08/31/2023] [Indexed: 09/05/2023]
Abstract
Psoriasis is one of the most common immune-mediated inflammatory diseases (IMIDs). Living in a rural environment during childhood is associated with a decreased risk of certain IMIDs, like asthma, in adulthood. However, its role in other IMIDs, such as psoriasis is still unclear. To evaluate the relationships between different factors related to the environment during childhood and the risk of psoriasis in adulthood we conducted a study in E3N, a French prospective cohort composed of 98 995 women. During the 1990-2018 follow-up of 72 154 study participants, we identified 1 967 incident cases of psoriasis from self-reports in self-administered structured questionnaires. During the 2004-2018 follow-up of 67 917 study participants, 188 moderate-to-severe cases of psoriasis were identified through self-reports and from data from a drug reimbursement database. We fitted Cox proportional hazards regression models with age as the time scale from which we estimated hazard ratios adjusted for putative confounders (aHRs). We found inverse associations with risk of psoriasis for rural birthplace [aHR: 0.89 (95%CI: 0.79-0.96)] and for having farming parents [aHR: 0.84 (95%CI: 0.72-0.97)]. For moderate-to-severe psoriasis we found a nominally similar inverse association with rural birthplace but not with having farming parents. Our results suggest that an exposure to a rural environment during childhood may be associated with a reduced risk of psoriasis. These findings may help to improve our understanding of the pathogenesis of psoriasis.
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Affiliation(s)
- Marco Conte
- Université Paris-Saclay, UVSQ, Inserm, Gustave Roussy, Exposome and Heredity team, CESP, Villejuif, 94805, France
| | - Raphaëlle Varraso
- Université Paris-Saclay, UVSQ, Inserm, Integrative Respiratory Epidemiology Team, CESP, Villejuif, 94807, France
| | - Agnès Fournier
- Université Paris-Saclay, UVSQ, Inserm, Gustave Roussy, Exposome and Heredity team, CESP, Villejuif, 94805, France
| | - Joseph A Rothwell
- Université Paris-Saclay, UVSQ, Inserm, Gustave Roussy, Exposome and Heredity team, CESP, Villejuif, 94805, France
| | - Laura Baglietto
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, 56126, Italy
| | - Marco Fornili
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, 56126, Italy
| | - Emilie Sbidian
- Hôpital Henri Mondor, Department of Dermatology, Créteil, 94010, France; Université Paris Est Créteil (UPEC), Epidemiology in Dermatology and Evaluation of Therapeutics (Epi-DermE), Créteil, 94010, France
| | - Gianluca Severi
- Université Paris-Saclay, UVSQ, Inserm, Gustave Roussy, Exposome and Heredity team, CESP, Villejuif, 94805, France; Department of Statistics, Computer Science and Applications « G. Parenti », University of Florence, Florence, 50134, Italy.
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Demouche S, Bettuzzi T, Sbidian E, Laugier Castellan D, Osmont MN, Ingen-Housz-Oro S, Lebrun-Vignes B. Reality of drug-induced erythema multiforme: A French pharmacovigilance study. Therapie 2023; 78:711-719. [PMID: 37024401 DOI: 10.1016/j.therap.2023.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 02/08/2023] [Accepted: 03/02/2023] [Indexed: 03/11/2023]
Abstract
BACKGROUND Since the 2002 SCAR study, erythema multiforme (EM), a post-infectious disease, has been distinguished from Stevens-Johnson syndrome (SJS), drug-induced. Nevertheless, EM cases are still reported in the French pharmacovigilance database (FPDB). OBJECTIVES To describe EM reported in the FPDB and to compare the quality and the characteristics of the reports. METHODS This retrospective observational study selected all EM cases reported in the FPDB over two periods: period 1 (P1, 2008-2009) and period 2 (P2, 2018-2019). Inclusion criteria were 1) a diagnosis of clinically typical EM and/or validated by a dermatologist; 2) a reported date of onset of the reaction; and 3) a precise chronology of drug exposure. Cases were classified confirmed EM (typical acral target lesions and/or validation by a dermatologist) and possible EM (not-otherwise-specified target lesions, isolated mucosal involvement, doubtful with SJS). We concluded possible drug-induced EM when EM was confirmed, with onset ranging from 5 to 28 days without an alternative cause. RESULTS Among 182 selected reports, 140 (77%) were analyzed. Of these, 67 (48%) presented a more likely alternative diagnosis than EM. Of the 73 reports of EM cases finally included (P1, n=41; P2, n=32), 36 (49%) had a probable non-drug cause and 28 (38%) were associated with only drugs with an onset time ≤4 days and/or ≥29 days. Possible drug-induced EM was retained in 9 cases (6% of evaluable reports). Etiological work-up was more often performed in period 2 than 1 (53.1% vs 29.3%, P=0.04), and the time to onset from 5 to 28 days was more frequent in period 2 (59.2% vs 40%, P=0.04). CONCLUSIONS This study suggests that possible drug-induced EM is rare. Many reports describe "polymorphic" rashes inappropriately concluded as EM or post-infectious EM with unsuitable drug accountability subject to protopathic bias.
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Affiliation(s)
- Sarah Demouche
- Service de dermatologie, hôpital Henri-Mondor, AP-HP, 94000 Créteil, France
| | - Thomas Bettuzzi
- Service de dermatologie, hôpital Henri-Mondor, AP-HP, 94000 Créteil, France; Université Paris-Est Créteil, EpiDermE, 94000 Créteil, France
| | - Emilie Sbidian
- Service de dermatologie, hôpital Henri-Mondor, AP-HP, 94000 Créteil, France; Université Paris-Est Créteil, EpiDermE, 94000 Créteil, France
| | - Delphine Laugier Castellan
- Centre régional de pharmacovigilance Marseille - Provence - Corse, hôpital Sainte-Marguerite, AP-HM, 13005 Marseille, France
| | - Marie-Noelle Osmont
- Centre régional de pharmacovigilance de Rennes, CHRU hôpital Pontchaillou, 35000 Rennes, France
| | - Saskia Ingen-Housz-Oro
- Service de dermatologie, hôpital Henri-Mondor, AP-HP, 94000 Créteil, France; Université Paris-Est Créteil, EpiDermE, 94000 Créteil, France; Reference center for toxic bullous diseases and severe drug reactions TOXIBUL, 94000 Créteil, France.
| | - Bénédicte Lebrun-Vignes
- Université Paris-Est Créteil, EpiDermE, 94000 Créteil, France; Reference center for toxic bullous diseases and severe drug reactions TOXIBUL, 94000 Créteil, France; Centre régional de Pharmacovigilance - hôpital Pitié-Salpêtrière GH, Sorbonne université, AP-HP, 75000 Paris, France
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Marcombes C, Penso L, Weill A, Dray-Spira R, Zureik M, Sbidian E. Persistence of second-line biologics in psoriasis after first-line biologic failure: a nationwide cohort study from the French health insurance database (SNDS). Br J Dermatol 2023; 189:561-568. [PMID: 37479503 DOI: 10.1093/bjd/ljad248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 06/23/2023] [Accepted: 07/15/2023] [Indexed: 07/23/2023]
Abstract
BACKGROUND Many biologics are available for psoriasis and have been compared in real-life studies based on their persistence (i.e. time between initiation and discontinuation). However, after first-line biologic failure, data are lacking on the choice of second-line biologic among the four available classes [tumour necrosis factor inhibitors (TNFi); interleukin (IL)-12/IL-23 inhibitor (IL-12/IL-23i); IL-17 inhibitors (IL-17i); and IL-23 inhibitors (IL-23i)]. OBJECTIVES To compare the long-term persistence of available second-line biologics in psoriasis according to prior exposure. METHODS This nationwide cohort study involved the administrative healthcare database of the French health insurance scheme linked to a hospital discharge database. Participants were adults with psoriasis, defined as having at least two prescriptions of a topical vitamin D derivative within a 2-year period, with initiation of a second-line biologic between 1 January 2015 and 31 December 2021. We included patients who initiated a second-line biologic directly after first-line discontinuation (i.e. without a 'washout' period). The end of follow-up was 30 June 2022. Discontinuation was defined as > 90 days without filling a prescription for the same treatment after the period covered by the previous prescription. Comparison of persistence by biologic class involved using propensity score-weighted Cox models (inverse probability treatment weighting) and adjustment of specific systemic nonbiologics (time-dependent variables). RESULTS We included 8693 patients [mean (SD) age 50 (14) years; 50.5% male]; 2824 (32.5%) started TNFi, 1561 (18.0%) IL-12/IL-23i, 2707 (31.1%) IL-17i and 1601 (18.4%) IL-23i. Overall, 1- and 3-year persistence rates were 60% and 30%, respectively. After weighting and adjustment, persistence was longer with IL-12/IL-23i [weighted hazard ratio (HRw) 0.68, 95% confidence interval (CI) 0.62-0.76)], IL-17i (HRw 0.70, 95% CI 0.64-0.78) and IL-23i (HRw 0.36, 95% CI 0.31-0.42) than TNFi, except after first-line IL-17i treatment, with no difference between IL-12/IL-23i, IL-17i and TNFi second-line persistence. Persistence was longer with IL-23i as a second-line treatment than IL-12/IL-23i (HRw 0.53, 95% CI 0.44-0.63) and IL-17i (HRw 0.51, 95% CI 0.44-0.60), regardless of first-line treatment, with no difference seen between IL-12/IL-23i and IL-17i (HRw 0.97, 95% CI 0.87-1.09). CONCLUSIONS This real-life study suggests the longer persistence of IL-23i than TNFi, IL-17i and IL-12/IL-23i as second-line treatment for psoriasis. Persistence rates for all biologics remained low at 3 years.
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Affiliation(s)
- Clarisse Marcombes
- EpiDermE, Paris Est Créteil University, Créteil, France
- EPI-PHARE Scientific Interest Group in Epidemiology of Health Products from the French National Agency for the Safety of Medicines and Health Products and the French National Health Insurance, Saint Denis, France
| | - Laetitia Penso
- EpiDermE, Paris Est Créteil University, Créteil, France
- EPI-PHARE Scientific Interest Group in Epidemiology of Health Products from the French National Agency for the Safety of Medicines and Health Products and the French National Health Insurance, Saint Denis, France
| | - Alain Weill
- EPI-PHARE Scientific Interest Group in Epidemiology of Health Products from the French National Agency for the Safety of Medicines and Health Products and the French National Health Insurance, Saint Denis, France
| | - Rosemary Dray-Spira
- EPI-PHARE Scientific Interest Group in Epidemiology of Health Products from the French National Agency for the Safety of Medicines and Health Products and the French National Health Insurance, Saint Denis, France
| | - Mahmoud Zureik
- EPI-PHARE Scientific Interest Group in Epidemiology of Health Products from the French National Agency for the Safety of Medicines and Health Products and the French National Health Insurance, Saint Denis, France
| | - Emilie Sbidian
- EpiDermE, Paris Est Créteil University, Créteil, France
- EPI-PHARE Scientific Interest Group in Epidemiology of Health Products from the French National Agency for the Safety of Medicines and Health Products and the French National Health Insurance, Saint Denis, France
- Inserm, Centre d'investigation clinique 1430, Hôpital Henri Mondor, Creteil, France
- Department of Dermatology, AP-HP, Hôpital Henri Mondor, Créteil, France
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15
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Marcombes C, Penso L, Sbidian E. First-Line Persistence of Biologics in Psoriasis from a Cohort Based on French Medico-Administrative Data. J Invest Dermatol 2023; 143:1819-1822.e3. [PMID: 36997111 DOI: 10.1016/j.jid.2023.03.1660] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 03/03/2023] [Accepted: 03/06/2023] [Indexed: 03/30/2023]
Affiliation(s)
| | | | - Emilie Sbidian
- EpiDermE, Paris Est Créteil University, Créteil, France; Institut National de la Santé et de la Recherche Médicale, Centre d'Investigation Clinique 1430, Henri Mondor Hospital, Créteil, France; Dermatology Department, Assistance Publique des Hôpitaux de Paris (AP-HP), Henri Mondor Hospital, Créteil, France
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Phan DB, Jourdain H, González-Quesada A, Zureik M, Rivera-Díaz R, Sahuquillo-Torralba A, Descalzo-Gallego MA, Lunt M, Garcia-Doval I, Sbidian E, Warren RB, Yiu ZZN. Drug survival and safety of biosimilars and originator adalimumab in the treatment of psoriasis: a multinational cohort study. BMJ Open 2023; 13:e075197. [PMID: 37451726 PMCID: PMC10351260 DOI: 10.1136/bmjopen-2023-075197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Accepted: 07/03/2023] [Indexed: 07/18/2023] Open
Abstract
INTRODUCTION Psoriasis is a chronic inflammatory skin disease. Adalimumab is an effective but previously expensive biological treatment for psoriasis. The introduction of biosimilars following the patent expiry of the originator adalimumab Humira has reduced the unit cost of treatment. However, the long-term effectiveness and safety of adalimumab biosimilars for treating psoriasis in real-world settings are uncertain and may be a barrier to widespread usage. METHODS AND ANALYSIS This study aims to compare the drug survival and safety of adalimumab biosimilars to adalimumab originator for the treatment of psoriasis. We will use both routinely collected healthcare databases and dedicated pharmacovigilance registries from the PsoNet initiative, including data from the UK, France and Spain. We will conduct a cohort study using a prevalent new user design. We will match patients on previous adalimumab exposure time to create two equal-sized cohorts of biosimilar and originator users. The coprimary outcomes are drug survival, defined by the time from cohort entry to discontinuation of the drug of interest; and risk of serious adverse events, defined by adverse events leading to hospitalisation or death. Cox proportional hazards models will be fitted to calculate HRs as the effect estimate for the outcomes. ETHICS AND DISSEMINATION The participating registries agree with the Declaration of Helsinki and received approval from local ethics committees. The results of the study will be published in scientific journals and presented at international dermatology conferences by the end of 2023.
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Grants
- Biogen, Boehringer Ingelheim, Bristol Myers Squibb, Celgene
- Amgen, Arena, Astellas
- UCB
- Pfizer
- Novartis
- Leo
- Janssen, Lilly
- Celgene
- GSK, Janssen, Lilly, Leo, Novartis, Pfizer, Sanofi, Sun Pharma, UCB
- The BAD
- British Association of Dermatologists (BAD)
- University of Manchester
- The British Association of Dermatologists
- Amgen
- NIHR Manchester Biomedical Research Centre
- Psoriasis Association
- BAD
- UCB Pharma
- Sandoz
- Amgen, Celgene, Janssen, LEO Pharma, Lilly, Novartis, Samsung
- AbbVie
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Affiliation(s)
- Duc Binh Phan
- Centre for Dermatology Research, Northern Care Alliance NHS Foundation Trust, The University of Manchester, Manchester Academic Health Science Centre, National Institute for Health and Care Research (NIHR) Manchester Biomedical Research Centre, Manchester, UK
| | - Hugo Jourdain
- EPI-PHARE, French National Agency for Medicines and Health Products Safety (ANSM) and French National Health Insurance (CNAM), Saint-Denis, France
| | - Alicia González-Quesada
- Department of Dermatology, Hospital Universitario de Gran Canaria Dr Negrín, Las Palmas de Gran Canaria, Spain
| | - Mahmoud Zureik
- EPI-PHARE, French National Agency for Medicines and Health Products Safety (ANSM) and French National Health Insurance (CNAM), Saint-Denis, France
| | - Raquel Rivera-Díaz
- Department of Dermatology, Hospital Universitario 12 de Octubre, Madrid, Spain
| | | | | | - Mark Lunt
- Versus Arthritis Epidemiology Unit, The University of Manchester, Manchester, UK
| | - Ignacio Garcia-Doval
- , Research Unit, Fundacion Piel Sana AEDV, Madrid, Spain
- Department of Dermatology, Complexo Hospitalario Universitario de Vigo, Vigo, Spain
| | - Emilie Sbidian
- EPI-PHARE, French National Agency for Medicines and Health Products Safety (ANSM) and French National Health Insurance (CNAM), Saint-Denis, France
- EpiDermE Epidemiology in Dermatology and Evaluation of Therapeutics, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris Est Créteil University, Créteil, France
| | - R B Warren
- Centre for Dermatology Research, Northern Care Alliance NHS Foundation Trust, The University of Manchester, Manchester Academic Health Science Centre, National Institute for Health and Care Research (NIHR) Manchester Biomedical Research Centre, Manchester, UK
| | - Zenas Z N Yiu
- Centre for Dermatology Research, Northern Care Alliance NHS Foundation Trust, The University of Manchester, Manchester Academic Health Science Centre, National Institute for Health and Care Research (NIHR) Manchester Biomedical Research Centre, Manchester, UK
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Sbidian E, Chaimani A, Guelimi R, Garcia-Doval I, Hua C, Hughes C, Naldi L, Kinberger M, Afach S, Le Cleach L. Systemic pharmacological treatments for chronic plaque psoriasis: a network meta-analysis. Cochrane Database Syst Rev 2023; 7:CD011535. [PMID: 37436070 PMCID: PMC10337265 DOI: 10.1002/14651858.cd011535.pub6] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/13/2023]
Abstract
BACKGROUND Psoriasis is an immune-mediated disease with either skin or joints manifestations, or both, and it has a major impact on quality of life. Although there is currently no cure for psoriasis, various treatment strategies allow sustained control of disease signs and symptoms. The relative benefit of these treatments remains unclear due to the limited number of trials comparing them directly head-to-head, which is why we chose to conduct a network meta-analysis. OBJECTIVES To compare the benefits and harms of non-biological systemic agents, small molecules, and biologics for people with moderate-to-severe psoriasis using a network meta-analysis, and to provide a ranking of these treatments according to their benefits and harms. SEARCH METHODS For this update of the living systematic review, we updated our searches of the following databases monthly to October 2022: the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, and Embase. SELECTION CRITERIA Randomised controlled trials (RCTs) of systemic treatments in adults over 18 years with moderate-to-severe plaque psoriasis, at any stage of treatment, compared to placebo or another active agent. The primary outcomes were: proportion of participants who achieved clear or almost clear skin, that is, at least Psoriasis Area and Severity Index (PASI) 90; proportion of participants with serious adverse events (SAEs) at induction phase (8 to 24 weeks after randomisation). DATA COLLECTION AND ANALYSIS We conducted duplicate study selection, data extraction, risk of bias assessment, and analyses. We synthesised data using pairwise and network meta-analysis (NMA) to compare treatments and rank them according to effectiveness (PASI 90 score) and acceptability (inverse of SAEs). We assessed the certainty of NMA evidence for the two primary outcomes and all comparisons using CINeMA, as very low, low, moderate, or high. We contacted study authors when data were unclear or missing. We used the surface under the cumulative ranking curve (SUCRA) to infer treatment hierarchy, from 0% (worst for effectiveness or safety) to 100% (best for effectiveness or safety). MAIN RESULTS This update includes an additional 12 studies, taking the total number of included studies to 179, and randomised participants to 62,339, 67.1% men, mainly recruited from hospitals. Average age was 44.6 years, mean PASI score at baseline was 20.4 (range: 9.5 to 39). Most studies were placebo-controlled (56%). We assessed a total of 20 treatments. Most (152) trials were multicentric (two to 231 centres). One-third of the studies (65/179) had high risk of bias, 24 unclear risk, and most (90) low risk. Most studies (138/179) declared funding by a pharmaceutical company, and 24 studies did not report a funding source. Network meta-analysis at class level showed that all interventions (non-biological systemic agents, small molecules, and biological treatments) showed a higher proportion of patients reaching PASI 90 than placebo. Anti-IL17 treatment showed a higher proportion of patients reaching PASI 90 compared to all the interventions. Biologic treatments anti-IL17, anti-IL12/23, anti-IL23, and anti-TNF alpha showed a higher proportion of patients reaching PASI 90 than the non-biological systemic agents. For reaching PASI 90, the most effective drugs when compared to placebo were (SUCRA rank order, all high-certainty evidence): infliximab (risk ratio (RR) 49.16, 95% CI 20.49 to 117.95), bimekizumab (RR 27.86, 95% CI 23.56 to 32.94), ixekizumab (RR 27.35, 95% CI 23.15 to 32.29), risankizumab (RR 26.16, 95% CI 22.03 to 31.07). Clinical effectiveness of these drugs was similar when compared against each other. Bimekizumab and ixekizumab were significantly more likely to reach PASI 90 than secukinumab. Bimekizumab, ixekizumab, and risankizumab were significantly more likely to reach PASI 90 than brodalumab and guselkumab. Infliximab, anti-IL17 drugs (bimekizumab, ixekizumab, secukinumab, and brodalumab), and anti-IL23 drugs except tildrakizumab were significantly more likely to reach PASI 90 than ustekinumab, three anti-TNF alpha agents, and deucravacitinib. Ustekinumab was superior to certolizumab. Adalimumab, tildrakizumab, and ustekinumab were superior to etanercept. No significant difference was shown between apremilast and two non-biological drugs: ciclosporin and methotrexate. We found no significant difference between any of the interventions and the placebo for the risk of SAEs. The risk of SAEs was significantly lower for participants on methotrexate compared with most of the interventions. Nevertheless, the SAE analyses were based on a very low number of events with very low- to moderate-certainty evidence for all the comparisons. The findings therefore have to be viewed with caution. For other efficacy outcomes (PASI 75 and Physician Global Assessment (PGA) 0/1), the results were similar to the results for PASI 90. Information on quality of life was often poorly reported and was absent for several of the interventions. AUTHORS' CONCLUSIONS Our review shows that, compared to placebo, the biologics infliximab, bimekizumab, ixekizumab, and risankizumab were the most effective treatments for achieving PASI 90 in people with moderate-to-severe psoriasis on the basis of high-certainty evidence. This NMA evidence is limited to induction therapy (outcomes measured from 8 to 24 weeks after randomisation), and is not sufficient for evaluating longer-term outcomes in this chronic disease. Moreover, we found low numbers of studies for some of the interventions, and the young age (mean 44.6 years) and high level of disease severity (PASI 20.4 at baseline) may not be typical of patients seen in daily clinical practice. We found no significant difference in the assessed interventions and placebo in terms of SAEs, and the safety evidence for most interventions was very low to moderate quality. More randomised trials directly comparing active agents are needed, and these should include systematic subgroup analyses (sex, age, ethnicity, comorbidities, psoriatic arthritis). To provide long-term information on the safety of treatments included in this review, an evaluation of non-randomised studies is needed. Editorial note: This is a living systematic review. Living systematic reviews offer a new approach to review updating, in which the review is continually updated, incorporating relevant new evidence as it becomes available. Please refer to the Cochrane Database of Systematic Reviews for the current status of this review.
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Affiliation(s)
- Emilie Sbidian
- Department of Dermatology, Hôpital Henri Mondor, Créteil, France
- Clinical Investigation Centre, Hôpital Henri Mondor, Créteil, France
- Epidemiology in Dermatology and Evaluation of Therapeutics (EpiDermE) - EA 7379, Université Paris Est Créteil (UPEC), Créteil, France
| | - Anna Chaimani
- Université de Paris, Centre of Research in Epidemiology and Statistics (CRESS), INSERM, F-75004, Paris, France
- Cochrane France, Paris, France
| | - Robin Guelimi
- Department of Dermatology, Hôpital Henri Mondor, Créteil, France
- Epidemiology in Dermatology and Evaluation of Therapeutics (EpiDermE) - EA 7379, Université Paris Est Créteil (UPEC), Créteil, France
| | - Ignacio Garcia-Doval
- Department of Dermatology, Complexo Hospitalario Universitario de Vigo, Vigo, Spain
| | - Camille Hua
- Department of Dermatology, Hôpital Henri Mondor, Créteil, France
- Epidemiology in Dermatology and Evaluation of Therapeutics (EpiDermE) - EA 7379, Université Paris Est Créteil (UPEC), Créteil, France
| | - Carolyn Hughes
- c/o Cochrane Skin Group, The University of Nottingham, Nottingham, UK
| | - Luigi Naldi
- Centro Studi GISED (Italian Group for Epidemiologic Research in Dermatology) - FROM (Research Foundation of Ospedale Maggiore Bergamo), Padiglione Mazzoleni - Presidio Ospedaliero Matteo Rota, Bergamo, Italy
| | - Maria Kinberger
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Sivem Afach
- Epidemiology in Dermatology and Evaluation of Therapeutics (EpiDermE) - EA 7379, Université Paris Est Créteil (UPEC), Créteil, France
| | - Laurence Le Cleach
- Department of Dermatology, Hôpital Henri Mondor, Créteil, France
- Epidemiology in Dermatology and Evaluation of Therapeutics (EpiDermE) - EA 7379, Université Paris Est Créteil (UPEC), Créteil, France
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18
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Sbidian E. A multistep approach from scoping review to strong evidence: biomarkers in psoriasis. Br J Dermatol 2023; 189:e2. [PMID: 37052471 DOI: 10.1093/bjd/ljac101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 11/09/2022] [Accepted: 11/12/2022] [Indexed: 04/14/2023]
Affiliation(s)
- E Sbidian
- UPEC EpiDermE, Inserm, Centre d'Investigation Clinique 1430, Department of Dermatology, AP-HP Hôpital Henri Mondor, 51 Avenue du Maréchal de Lattre de Tassigny, Créteil, 94000, France
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19
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Moghadam P, Billard K, Lalevée S, Motavasseli D, Sbidian E, De Prost N, Pariat J, Ingen-Housz-Oro S. Heterotopic ossification: An unusual sequela of toxic epidermal necrolysis. J Eur Acad Dermatol Venereol 2023; 37:e352-e354. [PMID: 36308043 DOI: 10.1111/jdv.18697] [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] [Received: 06/19/2022] [Accepted: 10/25/2022] [Indexed: 11/26/2022]
Affiliation(s)
- Parna Moghadam
- Dermatology Department, AP-HP, Henri Mondor Hospital, Créteil, France
| | - Karine Billard
- Dermatology Department, AP-HP, Henri Mondor Hospital, Créteil, France
| | - Sophie Lalevée
- Dermatology Department, AP-HP, Henri Mondor Hospital, Créteil, France.,Reference Center for Toxic Bullous Dermatoses and Severe Drug Reactions TOXIBUL, Créteil, France
| | - Damien Motavasseli
- Physical Medicine and Rehabilitation Department, AP-HP, Henri Mondor Hospital, Créteil, France
| | - Emilie Sbidian
- Dermatology Department, AP-HP, Henri Mondor Hospital, Créteil, France.,Reference Center for Toxic Bullous Dermatoses and Severe Drug Reactions TOXIBUL, Créteil, France.,Univ Paris Est Créteil EpidermE, Créteil, France
| | - Nicolas De Prost
- Reference Center for Toxic Bullous Dermatoses and Severe Drug Reactions TOXIBUL, Créteil, France.,Intensive Care Unit Department, AP-HP, Henri Mondor Hospital, Créteil, France
| | - Jacques Pariat
- Department of Orthopedic Surgery, AP-HP, Henri Mondor Hospital, Créteil, France
| | - Saskia Ingen-Housz-Oro
- Dermatology Department, AP-HP, Henri Mondor Hospital, Créteil, France.,Reference Center for Toxic Bullous Dermatoses and Severe Drug Reactions TOXIBUL, Créteil, France.,Univ Paris Est Créteil EpidermE, Créteil, France
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20
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Jourdain H, Hoisnard L, Sbidian E, Zureik M. Persistance du traitement par anti-TNF alpha, biosimilaire ou princeps : une étude à partir des données du Système national des données de santé. Rev Epidemiol Sante Publique 2023. [DOI: 10.1016/j.respe.2023.101511] [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: 02/26/2023] Open
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21
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Hoisnard L, Pina Vegas L, Dray-Spira R, Weill A, Zureik M, Sbidian E. Risk of major adverse cardiovascular and venous thromboembolism events in patients with rheumatoid arthritis exposed to JAK inhibitors versus adalimumab: a nationwide cohort study. Ann Rheum Dis 2023; 82:182-188. [PMID: 36198438 DOI: 10.1136/ard-2022-222824] [Citation(s) in RCA: 28] [Impact Index Per Article: 28.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Accepted: 08/25/2022] [Indexed: 01/26/2023]
Abstract
OBJECTIVES To assess the risk of major adverse cardiovascular events (MACEs) and venous thromboembolism events (VTEs) among patients initiating a Janus kinase inhibitor (JAKi) (tofacitinib and baricitinib) versus adalimumab in a large real-world population of patients with rheumatoid arthritis. METHODS We conducted a nationwide population-based cohort study of the French national health data system, the exposed group initiating a JAKi and non-exposed group initiating adalimumab. We included all individuals who had their first dispensation of a JAKi or adalimumab between 1 July 2017 and 31 May 2021 and had rheumatoid arthritis. The primary endpoints were the occurrence of a MACE or VTE. Weighted hazard ratio (HRw) values were estimated with the inverse probability of treatment weighting method to account for confounding factors with concomitant administration of methotrexate as a time-varying variable. RESULTS The cohort included 15 835 patients: 8481 and 7354 in the exposed and non-exposed groups (mean age 59.3 and 55.3 years, female 78.3% and 71.2%, respectively). During follow-up, 54 and 35 MACEs and 75 and 32 VTEs occurred in the exposed and non-exposed groups, respectively. Risk of MACEs for the exposed versus non-exposed group was not significant: HRw 1.0 (95% CI 0.7 to 1.5) (p=0.99), nor was risk of VTEs significant: HRw 1.1 (0.7 to 1.6) (p=0.63). Despite a lack of power, results were consistent among patients aged 65 years or older with at least one cardiovascular risk factor. CONCLUSIONS This study provides reassuring data regarding the risks of MACEs and VTEs in patients initiating a JAKi versus adalimumab, including patients at high risk of cardiovascular diseases.
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Affiliation(s)
- Lea Hoisnard
- Fédération Hospitalo-Universitaire TRUE InnovaTive theRapy for immUne disordErs, Assistance Publique - Hôpitaux de Paris (AP-HP), Henri Mondor Hospital, Créteil, Île-de-France, France
- Centre d'Investigation Clinique 1430, INSERM, Créteil, Ile-de-France, France
- EpiDermE Epidemiology in Dermatology and Evaluation of Therapeutics, EA7379, Paris ESt Créteil University UPEC, Créteil, France
| | - Laura Pina Vegas
- Fédération Hospitalo-Universitaire TRUE InnovaTive theRapy for immUne disordErs, Assistance Publique - Hôpitaux de Paris (AP-HP), Henri Mondor Hospital, Créteil, Île-de-France, France
- EpiDermE Epidemiology in Dermatology and Evaluation of Therapeutics, EA7379, Paris ESt Créteil University UPEC, Créteil, France
- Department of Rheumatology, Assistance Publique-Hôpitaux de Paris (AP-HP), Henri Mondor Hospital, Créteil, France
| | - Rosemay Dray-Spira
- EPI-PHARE Scientific Interest Group in Epidemiology of Health Products, French National Agency for Medicines and Health Products Safety, French National Health Insurance, Saint-Denis, France
| | - Alain Weill
- EPI-PHARE Scientific Interest Group in Epidemiology of Health Products, French National Agency for Medicines and Health Products Safety, French National Health Insurance, Saint-Denis, France
| | - Mahmoud Zureik
- EPI-PHARE Scientific Interest Group in Epidemiology of Health Products, French National Agency for Medicines and Health Products Safety, French National Health Insurance, Saint-Denis, France
| | - Emilie Sbidian
- Fédération Hospitalo-Universitaire TRUE InnovaTive theRapy for immUne disordErs, Assistance Publique - Hôpitaux de Paris (AP-HP), Henri Mondor Hospital, Créteil, Île-de-France, France
- Centre d'Investigation Clinique 1430, INSERM, Créteil, Ile-de-France, France
- EpiDermE Epidemiology in Dermatology and Evaluation of Therapeutics, EA7379, Paris ESt Créteil University UPEC, Créteil, France
- EPI-PHARE Scientific Interest Group in Epidemiology of Health Products, French National Agency for Medicines and Health Products Safety, French National Health Insurance, Saint-Denis, France
- Department of Dermatology, Assistance Publique-Hôpitaux de Paris (AP-HP), Henri Mondor Hospital, Créteil, France
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22
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Grolleau C, Le Cleach L, Shourick J, Sbidian E, Afach S. Long-term clinical trials of biologics in plaque psoriasis demonstrate heterogeneous study designs. Br J Dermatol 2023; 188:677-678. [PMID: 36702800 DOI: 10.1093/bjd/ljac142] [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] [Received: 07/11/2022] [Revised: 12/15/2022] [Accepted: 12/17/2022] [Indexed: 01/28/2023]
Affiliation(s)
- Chloé Grolleau
- AP-HP, Hôpitaux universitaires Henri Mondor, Département de Dermatologie, UPEC, Créteil, F-94010, France.,Université Paris-Est Créteil, UPEC, EpiDermE EA 7379, Créteil, F-94010, France
| | - Laurence Le Cleach
- AP-HP, Hôpitaux universitaires Henri Mondor, Département de Dermatologie, UPEC, Créteil, F-94010, France.,Université Paris-Est Créteil, UPEC, EpiDermE EA 7379, Créteil, F-94010, France
| | - Jason Shourick
- AP-HP, Hôpitaux universitaires Henri Mondor, Département de Dermatologie, UPEC, Créteil, F-94010, France.,Université Paris-Est Créteil, UPEC, EpiDermE EA 7379, Créteil, F-94010, France
| | - Emilie Sbidian
- AP-HP, Hôpitaux universitaires Henri Mondor, Département de Dermatologie, UPEC, Créteil, F-94010, France.,Université Paris-Est Créteil, UPEC, EpiDermE EA 7379, Créteil, F-94010, France.,INSERM, Centre d'Investigation Clinique 1430, Créteil, F-94010, France
| | - Sivem Afach
- Université Paris-Est Créteil, UPEC, EpiDermE EA 7379, Créteil, F-94010, France
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23
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Aubert H, Arlegui H, De Rycke Y, Bachelez H, Beylot-Barry M, Dupuy A, Joly P, Jullien D, Mahé E, Paul C, Richard MA, Sbidian E, Viguier M, Chosidow O, Tubach F, Bénéton N. Biologic tapering for patients with psoriasis with low disease activity: data from the French PsoBioTeq Registry. Br J Dermatol 2023; 188:150-152. [PMID: 36689510 DOI: 10.1093/bjd/ljac024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Revised: 09/10/2022] [Accepted: 09/24/2022] [Indexed: 01/22/2023]
Abstract
Dose tapering strategies with biologics in psoriasis may lower the treatment burden over time, while enabling high therapeutic response maintenance in patients benefiting from them. Our results should contribute to developing clinical guidelines to fill the current gap in knowledge on this promising therapeutic approach
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Affiliation(s)
- Helene Aubert
- Dermatology Department, Nantes University Hospital, 1, place Alexis-Ricordeau, Nantes, France
| | - Hugo Arlegui
- Assistance Publique-Hôpitaux de Paris (APHP), INSERM, Hôpital Pitié-Salpêtrière, Centre de Pharmacoépidémiologie (Cephepi), CIC-1901, Paris, France
| | - Yann De Rycke
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, APHP, Hôpital Pitié-Salpêtrière, Département de Santé Publique, Centre de Pharmacoépidémiologie (Cephepi), CIC-1901, Paris, France
| | - Herve Bachelez
- Dermatology Department, Saint-Louis Hospital, APHP, Paris, France
| | | | - Alain Dupuy
- Univ Rennes, CHU Rennes, Service de Dermatologie, Rennes, France
| | - Pascal Joly
- Dermatology Department, Rouen University Hospital, Rouen, France
| | | | - Emmanuel Mahé
- Dermatology Department, Victor-Dupouy Hospital, Argenteuil, France
| | - Carle Paul
- Dermatology Department, Toulouse University and CHU, Toulouse, France
| | | | - Emilie Sbidian
- Dermatology Department, Henri-Mondor University Hospital, APHP, Creteil, France
| | - Manuelle Viguier
- Dermatology Department, Reims University Hospital, Reims, France
| | - Olivier Chosidow
- Dermatology Department, Henri-Mondor University Hospital, APHP, Creteil, France
| | - Florence Tubach
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, APHP, Hôpital Pitié-Salpêtrière, Département de Santé Publique, Centre de Pharmacoépidémiologie (Cephepi), CIC-1901, Paris, France
| | - Nathalie Bénéton
- Dermatology Department, Le Mans Hospital, 194, av Rubillard, 72000 Le Mans, France
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24
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Afach S, Le Cleach L, Sbidian E. Placebo Response in Moderate-to-Severe Psoriasis: Prevalence Meta-Analysis of Randomized Controlled Trials. J Invest Dermatol 2022; 143:1101-1104. [PMID: 36563778 DOI: 10.1016/j.jid.2022.10.024] [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] [Received: 07/09/2022] [Revised: 10/18/2022] [Accepted: 10/20/2022] [Indexed: 12/25/2022]
Affiliation(s)
- Sivem Afach
- Epidemiology in Dermatology and Evaluation of Therapeutics (EpiDermE) EA 7379, University Paris Est Créteil (UPEC), Créteil, France
| | - Laurence Le Cleach
- Epidemiology in Dermatology and Evaluation of Therapeutics (EpiDermE) EA 7379, University Paris Est Créteil (UPEC), Créteil, France; Department of Dermatology, Hôpitaux Universitaires Henri Mondor, Assistance Publique-Hôpitaux de Paris (AP-HP), University Paris Est Créteil (UPEC), Créteil, France
| | - Emilie Sbidian
- Epidemiology in Dermatology and Evaluation of Therapeutics (EpiDermE) EA 7379, University Paris Est Créteil (UPEC), Créteil, France; Department of Dermatology, Hôpitaux Universitaires Henri Mondor, Assistance Publique-Hôpitaux de Paris (AP-HP), University Paris Est Créteil (UPEC), Créteil, France; Clinical Investigation Center 1430, Institut National de la Santé et de la Recherche Médicale (INSERM), Créteil, France.
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25
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Pina Vegas L, Hoisnard L, Bastard L, Sbidian E, Claudepierre P. Long-term persistence of second-line biologics in psoriatic arthritis patients with prior TNF inhibitor exposure: a nationwide cohort study from the French health insurance database (SNDS). RMD Open 2022; 8:rmdopen-2022-002681. [PMID: 36597983 PMCID: PMC9730400 DOI: 10.1136/rmdopen-2022-002681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Accepted: 11/02/2022] [Indexed: 12/12/2022] Open
Abstract
INTRODUCTION Tumour necrosis factor inhibitor (TNFi) agents are most often the first-choice biological treatment for patients with psoriatic arthritis (PsA). When their discontinuation is needed, a switch to another TNFi or to another therapeutic class may be considered. However, data supporting one approach over another are lacking. OBJECTIVE To compare the long-term persistence of classes of biologics in PsA patients with prior TNFi exposure. METHODS This nationwide cohort study involved the administrative healthcare database of the French health insurance scheme linked to the hospital discharge database. We included all adults with PsA starting a second-line biological after discontinuing a TNFi during 2015-2020. Persistence was defined as the time from biological initiation to discontinuation and was estimated by the Kaplan-Meier method. Comparison of persistence by biological class was performed with Poisson regression models with time divided into 6-month intervals. RESULTS We included 2975 patients: 1580 (53%) initiating a second TNFi, 426 (14%) an interleukin 12/23 inhibitor (IL-12/23i) and 969 (33%) an IL-17 inhibitor (IL-17i). Overall, 1-year and 3-year persistence rates were 42% and 17%, respectively. After adjustment, persistence was associated with treatment with an IL-17i (adjusted relative risk (RRa) 0.79, 95% CI 0.71 to 0.87) or IL-12/23i (RRa 0.69, 95% CI 0.61 to 0.79) vs a TNFi, with no significant difference between IL-12/23 and IL-17 inhibitors (RRa 0.88, 95% CI 0.76 to 1.02). CONCLUSIONS Overall, this real-life study shows low persistence for all biologics at 3 years in PsA patients previously exposed to a TNFi. However, persistence was higher with an IL-17i or IL-12/23i than a TNFi.
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Affiliation(s)
- Laura Pina Vegas
- EpiDermE, Université Paris-Est Créteil Val de Marne, Créteil, France,Rhumatologie, Hôpital Henri Mondor, Creteil cedex, France
| | - Léa Hoisnard
- EpiDermE, Université Paris-Est Créteil Val de Marne, Créteil, France,Fédération Hospitalo-Universitaire TRUE InnovaTive theRapy for immUne disordErs, Hôpital Henri Mondor, Créteil, France
| | - Léa Bastard
- EpiDermE, Université Paris-Est Créteil Val de Marne, Créteil, France,Rhumatologie, Hôpital Henri Mondor, Creteil cedex, France
| | - Emilie Sbidian
- EpiDermE, Université Paris-Est Créteil Val de Marne, Créteil, France,Inserm, Centre d’investigation clinique 1430, Hôpital Henri Mondor, Créteil, France,Dermatologie, Hôpital Henri Mondor, Créteil, France
| | - Pascal Claudepierre
- EpiDermE, Université Paris-Est Créteil Val de Marne, Créteil, France,Rhumatologie, Hôpital Henri Mondor, Creteil cedex, France
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26
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Jourdain H, Hoisnard L, Sbidian E, Zureik M. TNF-alpha inhibitors biosimilar use in France: a nationwide population-based study using the French National Health Data System. Sci Rep 2022; 12:19569. [PMID: 36380105 PMCID: PMC9666557 DOI: 10.1038/s41598-022-24050-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Accepted: 11/09/2022] [Indexed: 11/16/2022] Open
Abstract
TNF-alpha inhibitors have revolutionized the therapeutic care in chronic inflammatory diseases. Several biosimilar products were commercialized at their patent expiry, substantially decreasing the cost of treatment. This longitudinal descriptive study aimed at assessing infliximab, etanercept and adalimumab biosimilar penetration rates using data of the French National Health Data System. A total of 207,118 new or prevalent users from the date of first biosimilar commercialization in France (respectively January 2015, May 2016 and October 2018) were included in the study and followed until September 30, 2021. Biosimilars represented respectively 78%, 46% and 53% of the overall initiations, and 94%, 66% and 60% last year's initiations. A total of 46%, 19% and 17% of originator product prevalent users switched for a biosimilar during the follow-up. Biosimilar penetration rate was much higher for infliximab than for its counterparts, due to its hospital delivery modality. Biosimilar initiation and originator-to-biosimilar switch tended to be observed more in rheumatology than in the other specialties. Biosimilar use was mostly consistent across patient socio-demographic characteristics. Biosimilar initiation rate increased rapidly from their market arrival and originator-to-biosimilar switch rate remained moderate, highlighting the need and usefulness of political action and biosimilar use tracking.
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Affiliation(s)
- Hugo Jourdain
- grid.512012.5EPI-PHARE, French National Agency for Medicines and Health Products Safety (ANSM) and French National Health Insurance (CNAM), 143-147 Boulevard Anatole France, 93285 Saint-Denis, France
| | - Léa Hoisnard
- grid.412116.10000 0001 2292 1474Fédération Hospitalo-Universitaire TRUE InnovaTive theRapy for immUne disordErs, Assistance Publique-Hôpitaux de Paris (AP-HP), Henri Mondor Hospital, 94010 Créteil, France ,grid.7429.80000000121866389INSERM, Centre d’Investigation Clinique 1430, 94010 Créteil, France ,grid.410511.00000 0001 2149 7878EpiDermE Epidemiology in Dermatology and Evaluation of Therapeutics, EA7379, Paris Est Créteil University UPEC, F-94010 Créteil, France
| | - Emilie Sbidian
- grid.512012.5EPI-PHARE, French National Agency for Medicines and Health Products Safety (ANSM) and French National Health Insurance (CNAM), 143-147 Boulevard Anatole France, 93285 Saint-Denis, France ,grid.412116.10000 0001 2292 1474Fédération Hospitalo-Universitaire TRUE InnovaTive theRapy for immUne disordErs, Assistance Publique-Hôpitaux de Paris (AP-HP), Henri Mondor Hospital, 94010 Créteil, France ,grid.7429.80000000121866389INSERM, Centre d’Investigation Clinique 1430, 94010 Créteil, France ,grid.410511.00000 0001 2149 7878EpiDermE Epidemiology in Dermatology and Evaluation of Therapeutics, EA7379, Paris Est Créteil University UPEC, F-94010 Créteil, France ,grid.412116.10000 0001 2292 1474Department of Dermatology, Hôpital Henri Mondor, 51 Avenue du Maréchal de Lattre de Tassigny, 94000 Créteil, France
| | - Mahmoud Zureik
- grid.512012.5EPI-PHARE, French National Agency for Medicines and Health Products Safety (ANSM) and French National Health Insurance (CNAM), 143-147 Boulevard Anatole France, 93285 Saint-Denis, France ,grid.463845.80000 0004 0638 6872University Paris-Saclay, UVSQ, University Paris-Sud, Inserm, Anti-Infective Evasion and Pharmacoepidemiology, CESP, Montigny le Bretonneux, France
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27
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Curmin R, Guillo S, De Rycke Y, Bachelez H, Beylot‐Barry M, Beneton N, Chosidow O, Dupuy A, Joly P, Jullien D, Richard M, Viguier M, Sbidian E, Paul C, Mahé E, Tubach F. Switches between biologics in patients with moderate-to-severe psoriasis: results from the French cohort PSOBIOTEQ. J Eur Acad Dermatol Venereol 2022; 36:2101-2112. [PMID: 35793473 PMCID: PMC9796114 DOI: 10.1111/jdv.18409] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [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] [Received: 02/22/2022] [Accepted: 05/18/2022] [Indexed: 01/01/2023]
Abstract
BACKGROUND Biologics are the cornerstone of treatment of patients with moderate-to-severe plaque psoriasis and switches between biologics are frequently needed to maintain clinical improvement over time. OBJECTIVES The main purpose of this study was to describe precisely switches between biologics and how their pattern changed over time with the recent availability of new biologic agents. METHODS We included patients receiving a first biologic agent in the Psobioteq multicenter cohort of adults with moderate-to-severe psoriasis receiving systemic treatment. We described switches between biologics with chronograms, Sankey and Sunburst diagrams, assessed cumulative incidence of first switch by competing risks survival analysis and reasons for switching. We assessed the factors associated with the type of switch (intra-class - i.e. within the same therapeutic class - vs. inter-class) in patients switching from a TNF-alpha inhibitor using multivariate logistic regression. RESULTS A total of 2153 patients was included. The cumulative incidence of switches from first biologic was 34% at 3 years. Adalimumab and ustekinumab were the most prescribed biologic agents as first and second lines of treatment. The main reason for switching was loss of efficacy (72%), followed by adverse events (11%). Patients receiving a TNF-alpha inhibitor before 2016 mostly switched to ustekinumab, whereas those switching in 2016 or after mostly switched to an IL-17 inhibitor. Patients switching from a first-line TNF-alpha inhibitor before 2016 were more likely to switch to another TNF-alpha inhibitor compared with patients switching since 2018. Patients switching from etanercept were more likely to receive another TNF-alpha inhibitor rather than another therapeutic class of bDMARD compared with patients switching from adalimumab. CONCLUSION This study described the switching patterns of biologic treatments and showed how they changed over time, due to the availability of the new biologic agents primarily IL-17 inhibitors.
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Affiliation(s)
- R. Curmin
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé PubliqueParisFrance
| | - S. Guillo
- INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, AP‐HP, Hôpital Pitié Salpêtrière, Département de Santé Publique, Centre de Pharmacoépidémiologie (Cephepi)Sorbonne UniversitéParisFrance
| | - Y. De Rycke
- INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, AP‐HP, Hôpital Pitié Salpêtrière, Département de Santé Publique, Centre de Pharmacoépidémiologie (Cephepi)Sorbonne UniversitéParisFrance
| | - H. Bachelez
- Dermatologie, AP‐HP Hôpital Saint LouisParisFrance,Sorbonne Paris Cité Universitaire Paris DiderotParisFrance,UMR INSERM 1163, Institut ImagineParisFrance
| | - M. Beylot‐Barry
- Dermatologie CHU Bordeaux & INSERM U 1053Bordeaux UniversityBordeauxFrance
| | | | - O. Chosidow
- Dermatologie, AP‐HP, Hôpitaux universitaires Henri Mondor, Département de Dermatologie, UPEC, INSERM, Centre d'Investigation Clinique 1430, EA 7379 EpidermEUniversité Paris‐Est Créteil, UPECCréteilFrance
| | - A. Dupuy
- DermatologieCHU PontchaillouRennesFrance
| | - P. Joly
- DermatologieCHU RouenRouenFrance
| | - D. Jullien
- Dermatologie, Hospices Civils de Lyon, Hôpital E. HerriotUniversité Lyon‐1LyonFrance
| | - M.A. Richard
- Dermatologie, EA 3279: CEReSS ‐ Health Service Research and Quality of Life Center, Timone Hospital, Assistance Publique Hôpitaux de MarseilleAix‐Marseille UniversityMarseilleFrance
| | - M. Viguier
- Dermatologie‐VénéréologieHôpital Robert DebréReimsFrance
| | - E. Sbidian
- Dermatologie, AP‐HP, Hôpitaux universitaires Henri Mondor, Département de Dermatologie, UPEC, INSERM, Centre d'Investigation Clinique 1430, EA 7379 EpidermEUniversité Paris‐Est Créteil, UPECCréteilFrance
| | - C. Paul
- DermatologieCHU and Toulouse UniversityToulouseFrance
| | - E. Mahé
- DermatologieHôpital Victor DupouyArgenteuilFrance
| | - F. Tubach
- INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, AP‐HP, Hôpital Pitié Salpêtrière, Département de Santé Publique, Centre de Pharmacoépidémiologie (Cephepi)Sorbonne UniversitéParisFrance
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Afach S, Le Cleach L, Sbidian E. 32102 Response in the placebo group in randomized controlled trials for moderate-to-severe psoriasis. J Am Acad Dermatol 2022. [DOI: 10.1016/j.jaad.2022.06.446] [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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Bettuzzi T, Drucker A, Staumont-Sallé D, Bihan K, Lebrun-Vignes B, Sbidian E. 34927 Adverse events associated with dupilumab in the WHO pharmacovigilance. J Am Acad Dermatol 2022. [DOI: 10.1016/j.jaad.2022.06.578] [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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Bataille P, Layese R, Claudepierre P, Paris N, Dubiel J, Amiot A, Sbidian E. Paradoxical reactions and biologic agents: a French cohort study of 9,303 patients. Br J Dermatol 2022; 187:676-683. [PMID: 35770735 DOI: 10.1111/bjd.21716] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 05/20/2022] [Accepted: 06/26/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND Paradoxical reactions (PRs) are defined as the occurrence during biologic therapy of a pathological condition that usually responds to these drugs. OBJECTIVE To estimate the incidence of PRs and identify risk factors. METHODS Multicenter study of the database for the Greater Paris University Hospitals including biological-naïve patients receiving anti-tumor necrosis factor-α, anti-interleukin-12/23, anti-interleukin-17 or anti-α4ß7-integrin agents for psoriasis, inflammatory rheumatism or inflammatory bowel disease (IBD). We used natural language processing algorithms to extract data. A cohort and a case-control study nested in the cohort with controls selected by incidence density sampling was used to identify risk factors. RESULTS Most of the 9,303 included patients (median age 43.0; 53.8% women) presented an IBD (3,773 [40.6%]) or a chronic inflammatory rheumatic disease (3,708 [39.9%]), and 8,487 (91.2%) received anti-TNF-α agents. A total of 293 (3.1%) had a PR. The global incidence rate was 7.6 per 1,000 person-years (95%CI 6.7-8.4). Likelihood of PR was associated with IBD (adjusted OR [aOR] 1.9, 95%CI 1.1-3.2, p=0.021) and a combination of two inflammatory diseases (aOR 6.1, 95%CI 3.6-10.6, p<0.001) and was reduced with conventional synthetic disease-modifying anti-rheumatic drugs (csDMARDs) and corticosteroids (aOR 0.6, 95%CI 0.4-0.8, p=0.003; 0.4, 0.2-0.7, p<0.001). CONCLUSION Likelihood of PRs was associated with IBD or a combination of a least two inflammatory diseases. More studies are needed to assess the benefit of systematically adding csDMARDs for such high-risk patients.
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Affiliation(s)
| | - Richard Layese
- Univ Paris Est Creteil, INSERM, IMRB, CEpiA Team, F-94010 Creteil, France.,AP-HP, Hôpital Henri Mondor, Unité de Recherche Clinique (URC Mondor), Creteil, F-94010, France
| | - Pascal Claudepierre
- AP-HP, Hopital Henri-Mondor, Department of Rheumatology, F-94010 Creteil, France
| | - Nicolas Paris
- WIND Department APHP Greater Paris University Hospital
| | - Julien Dubiel
- WIND Department APHP Greater Paris University Hospital
| | - Aurélien Amiot
- AP-HP, Hopital Henri-Mondor, Department of Gastroenterology, F-94010 Creteil, France
| | - Emilie Sbidian
- Univ Paris Est Creteil, EpiDermE, F-94010 Creteil, France.,AP-HP, Hopital Henri-Mondor, Department of Dermatology, F-94010 Creteil, France
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Pina Vegas L, Claudepierre P, Sbidian E. Comment on: RISK OF MAJOR ADVERSE CARDIOVASCULAR EVENTS IN PATIENTS INITIATING BIOLOGICS/APREMILAST FOR PSORIATIC ARTHRITIS: A NATIONWIDE COHORT STUDY: Reply. Rheumatology (Oxford) 2022; 61:e321-e322. [PMID: 35686890 DOI: 10.1093/rheumatology/keac331] [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] [Received: 05/24/2022] [Accepted: 05/27/2022] [Indexed: 11/13/2022] Open
Affiliation(s)
- Laura Pina Vegas
- EpiDermE, Université Paris Est Créteil, Créteil, F-94010, France.,Service de Rhumatologie, AP-HP, Hôpital Henri Mondor, Créteil, F-94010, France
| | - Pascal Claudepierre
- EpiDermE, Université Paris Est Créteil, Créteil, F-94010, France.,Service de Rhumatologie, AP-HP, Hôpital Henri Mondor, Créteil, F-94010, France
| | - Emilie Sbidian
- EpiDermE, Université Paris Est Créteil, Créteil, F-94010, France.,Inserm, Centre d'investigation clinique 1430, Hôpital Henri Mondor, Creteil, F-94010, France.,Service de Dermatologie, AP-HP, Hôpital Henri Mondor, Créteil, F-94010, France
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Mahé E, Tubach F, Jullien D, Tran D, Paul C, Beylot-Barry M, Dupuy A, Viguier M, Richard MA, Sbidian E, Beneton N, Joly P, Chosidow O, Bachelez H. Impact of Childhood Onset Psoriasis on Addictive Behaviours, Socioeconomic and Educational Data in Adulthood. Acta Derm Venereol 2022; 102:adv00733. [DOI: 10.2340/actadv.v102.2484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Paediatric psoriasis has been associated with school absenteeism, limitation of physical activities, psychiatric disorders and, in the longer term, with sexual dysfunction and addictions. This raises the hypothesis that childhood onset psoriasis may affect patients’ educational development, and further social and professional outcomes. This study evaluated the relationship between childhood onset psoriasis and patients’ educational and socioeconomic characteristics, and the development of addictions in adulthood. This cross-sectional ancillary study captured patients’ characteristics at baseline in the French PSOBIOTEQ registry. Data in adulthood included: educational (baccalaureate) and socioeconomic (working activity) groups, smoking status (self-reporting of being a current smoker vs past smoker or non-smoker), alcohol consumption (defined as at least 1 glass of alcoholic beverage per day), and living conditions (alone/family/social institutions; child at home). A total of 1,960 patients were included, of whom 26.2% had childhood onset psoriasis. In multivariate analyses, childhood onset psoriasis was associated with smoker status (p = 0.02). No association was observed with educational level, working activity, living conditions, or alcohol consumption. This study provides reassuring data overall with regard to the impact of childhood onset psoriasis on major social outcomes. Evidence for some association with addictive behaviours paves the way for larger prospective studies assessing in depth the social and educational impact of this disease.
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Pina Vegas L, Penso L, Sbidian E, Claudepierre P. POS0075 LONG-TERM PERSISTENCE OF FIRST-LINE BIOLOGICS FOR PSORIATIC ARTHRITIS AND PSORIASIS: A COHORT STUDY OF 23,423 PATIENTS FROM THE FRENCH HEALTH INSURANCE DATABASE (SNDS). Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BackgroundTreatment options for psoriasis (PsO) and psoriatic arthritis (PsA) have evolved significantly since the era of biologics. Clinical trials (mainly placebo-controlled for 12 to 16 weeks) are inadequate to assess the relative long-term efficacy of biologics and are often insufficient regarding safety.ObjectivesTo assess the long-term persistence of different biologic classes to treat PsA and PsO.MethodsThis nationwide cohort study involved the administrative healthcare database of the French health insurance scheme linked to the hospital discharge database. We included, in two sub-cohorts, all adults with PsA and those with PsO, who were new users of biologics (not in the year before the index date) during 2015-2019. We excluded patients hospitalised for PsO in the PsA cohort and for PsA in the PsO cohort in the year before the index date. Persistence was defined as the time from biologic initiation to discontinuation and was estimated by the Kaplan-Meier method. Comparison of persistence by biologic class involved using propensity score-weighted Cox models (IPTW) and adjustment on specific systemic non-biologics (time-dependant variables).ResultsWe included 6,531 patients with PsA (mean age 49±13 years, 45% male): 4,974 (76%) starting a TNFi, 803 (12%) an IL12/23i and 754 (12%) an IL17i. We included 16,892 patients with PsO (mean age 53±17 years, 50% male): 10,199 (60%) starting a TNF inhibitor (TNFi), 3,982 (24%) an IL12/23i, and 2,711 (16%) an IL17i. Overall 3-year persistence rates were 36% and 41% for PsA and PsO (Figure 1). After IPTW and adjustment, IL17i was associated with higher persistence than TNFi for PsA (weighted hazard ratio [HRw] 0.70, 95% confidence interval [95%CI] 0.58-0.85) and PsO (HRw 0.78, 95%CI 0.73-0.83) and than IL12/23i for PsA (HRw 0.69, 95%CI 0.55-0.87). We found no difference between IL17i and IL12/23i for PsO. IL12/23i had better persistence than TNFi for PsO (HRw 0.76, 95%CI 0.72-0.80), with no difference observed for PsA.Figure 1.Kaplan Meier estimates of biologic treatment persistence in psoriasis and psoriatic arthritis cohorts TNFi: tumor necrosis factor inhibitor; ILi: interleukin inhibitor.ConclusionThis real-life study suggests a higher persistence of IL17i than TNFi for PsA and PsO. IL17i also has better persistence than IL12/23i for PsA, with no difference for PsO. However, the persistence rates of all biologics remained globally low at 3 years.Disclosure of InterestsLaura Pina Vegas: None declared, Laetitia Penso: None declared, Emilie Sbidian: None declared, Pascal Claudepierre Speakers bureau: P. Claudepierre has been an investigator for Roche Chugai, Sanofi Aventis, Celgene, Pfizer, MSD, Novartis and BMS., Consultant of: P. Claudepierre has received consulting fees from Abbvie, Amgen, Pfizer, Roche-Chugai, BMS, MSD, UCB, Novartis, Janssen, Lilly, Galapagos, Celgene (less than $10,000 each)
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Guelimi R, Metelli S, Sbidian E, van Zuuren EJ, Flohr C, Leonardi-Bee J, Le Cleach L. Network meta-analysis: methodological points for readers, authors and reviewers. Br J Dermatol 2022; 186:917-918. [PMID: 35657177 DOI: 10.1111/bjd.21013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Accepted: 11/26/2021] [Indexed: 11/28/2022]
Affiliation(s)
- Robin Guelimi
- Université Paris Est Créteil (UPEC), Epidemiology in Dermatology and Evaluation of Therapeutics (EpiDermE) - EA 7379, Créteil, France
| | - Sylvia Metelli
- Université de Paris, Research Center of Epidemiology and Statistics (CRESS-U1153), INSERM, Paris, France
| | - Emilie Sbidian
- Université Paris Est Créteil (UPEC), Epidemiology in Dermatology and Evaluation of Therapeutics (EpiDermE) - EA 7379, Créteil, France.,Hôpital Henri Mondor, Department of Dermatology, 51 Avenue du Maréchal de Lattre de Tassigny, Créteil, 94000, France
| | - Esther J van Zuuren
- Department of Dermatology, Leiden, University Medical Centre, Leiden, the Netherlands
| | - Carsten Flohr
- Unit for Population-Based Dermatology Research, St John's Institute of Dermatology, Guy's and St Thomas' NHS Foundation Trust and King's College London, London, UK
| | - Jo Leonardi-Bee
- Centre for Evidence Based Healthcare, School of Medicine, Clinical Sciences Building Phase 2, University of Nottingham, Nottingham, UK
| | - Laurence Le Cleach
- Université Paris Est Créteil (UPEC), Epidemiology in Dermatology and Evaluation of Therapeutics (EpiDermE) - EA 7379, Créteil, France.,Hôpital Henri Mondor, Department of Dermatology, 51 Avenue du Maréchal de Lattre de Tassigny, Créteil, 94000, France
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Sbidian E, Chaimani A, Garcia-Doval I, Doney L, Dressler C, Hua C, Hughes C, Naldi L, Afach S, Le Cleach L. Systemic pharmacological treatments for chronic plaque psoriasis: a network meta-analysis. Cochrane Database Syst Rev 2022; 5:CD011535. [PMID: 35603936 PMCID: PMC9125768 DOI: 10.1002/14651858.cd011535.pub5] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
BACKGROUND Psoriasis is an immune-mediated disease with either skin or joints manifestations, or both, and it has a major impact on quality of life. Although there is currently no cure for psoriasis, various treatment strategies allow sustained control of disease signs and symptoms. The relative benefit of these treatments remains unclear due to the limited number of trials comparing them directly head-to-head, which is why we chose to conduct a network meta-analysis. OBJECTIVES To compare the efficacy and safety of non-biological systemic agents, small molecules, and biologics for people with moderate-to-severe psoriasis using a network meta-analysis, and to provide a ranking of these treatments according to their efficacy and safety. SEARCH METHODS For this update of the living systematic review, we updated our searches of the following databases monthly to October 2021: the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, and Embase. SELECTION CRITERIA Randomised controlled trials (RCTs) of systemic treatments in adults over 18 years with moderate-to-severe plaque psoriasis, at any stage of treatment, compared to placebo or another active agent. The primary outcomes were: proportion of participants who achieved clear or almost clear skin, that is, at least Psoriasis Area and Severity Index (PASI) 90; proportion of participants with serious adverse events (SAEs) at induction phase (8 to 24 weeks after randomisation). DATA COLLECTION AND ANALYSIS We conducted duplicate study selection, data extraction, risk of bias assessment and analyses. We synthesised data using pairwise and network meta-analysis (NMA) to compare treatments and rank them according to effectiveness (PASI 90 score) and acceptability (inverse of SAEs). We assessed the certainty of NMA evidence for the two primary outcomes and all comparisons using CINeMA, as very low, low, moderate, or high. We contacted study authors when data were unclear or missing. We used the surface under the cumulative ranking curve (SUCRA) to infer treatment hierarchy, from 0% (worst for effectiveness or safety) to 100% (best for effectiveness or safety). MAIN RESULTS This update includes an additional 19 studies, taking the total number of included studies to 167, and randomised participants to 58,912, 67.2% men, mainly recruited from hospitals. Average age was 44.5 years, mean PASI score at baseline was 20.4 (range: 9.5 to 39). Most studies were placebo-controlled (57%). We assessed a total of 20 treatments. Most (140) trials were multicentric (two to 231 centres). One-third of the studies (57/167) had high risk of bias; 23 unclear risk, and most (87) low risk. Most studies (127/167) declared funding by a pharmaceutical company, and 24 studies did not report a funding source. Network meta-analysis at class level showed that all interventions (non-biological systemic agents, small molecules, and biological treatments) showed a higher proportion of patients reaching PASI 90 than placebo. Anti-IL17 treatment showed a higher proportion of patients reaching PASI 90 compared to all the interventions, except anti-IL23. Biologic treatments anti-IL17, anti-IL12/23, anti-IL23 and anti-TNF alpha showed a higher proportion of patients reaching PASI 90 than the non-biological systemic agents. For reaching PASI 90, the most effective drugs when compared to placebo were (SUCRA rank order, all high-certainty evidence): infliximab (risk ratio (RR) 50.19, 95% CI 20.92 to 120.45), bimekizumab (RR 30.27, 95% CI 25.45 to 36.01), ixekizumab (RR 30.19, 95% CI 25.38 to 35.93), risankizumab (RR 28.75, 95% CI 24.03 to 34.39). Clinical effectiveness of these drugs was similar when compared against each other. Bimekizumab, ixekizumab and risankizumab showed a higher proportion of patients reaching PASI 90 than other anti-IL17 drugs (secukinumab and brodalumab) and guselkumab. Infliximab, anti-IL17 drugs (bimekizumab, ixekizumab, secukinumab and brodalumab) and anti-IL23 drugs (risankizumab and guselkumab) except tildrakizumab showed a higher proportion of patients reaching PASI 90 than ustekinumab and three anti-TNF alpha agents (adalimumab, certolizumab and etanercept). Ustekinumab was superior to certolizumab; adalimumab and ustekinumab were superior to etanercept. No significant difference was shown between apremilast and two non-biological drugs: ciclosporin and methotrexate. We found no significant difference between any of the interventions and the placebo for the risk of SAEs. The risk of SAEs was significantly lower for participants on methotrexate compared with most of the interventions. Nevertheless, the SAE analyses were based on a very low number of events with low- to moderate-certainty for all the comparisons (except methotrexate versus placebo, which was high-certainty). The findings therefore have to be viewed with caution. For other efficacy outcomes (PASI 75 and Physician Global Assessment (PGA) 0/1), the results were similar to the results for PASI 90. Information on quality of life was often poorly reported and was absent for several of the interventions. AUTHORS' CONCLUSIONS Our review shows that, compared to placebo, the biologics infliximab, bimekizumab, ixekizumab, and risankizumab were the most effective treatments for achieving PASI 90 in people with moderate-to-severe psoriasis on the basis of high-certainty evidence. This NMA evidence is limited to induction therapy (outcomes measured from 8 to 24 weeks after randomisation), and is not sufficient for evaluating longer-term outcomes in this chronic disease. Moreover, we found low numbers of studies for some of the interventions, and the young age (mean 44.5 years) and high level of disease severity (PASI 20.4 at baseline) may not be typical of patients seen in daily clinical practice. We found no significant difference in the assessed interventions and placebo in terms of SAEs, and the safety evidence for most interventions was low to moderate quality. More randomised trials directly comparing active agents are needed, and these should include systematic subgroup analyses (sex, age, ethnicity, comorbidities, psoriatic arthritis). To provide long-term information on the safety of treatments included in this review, an evaluation of non-randomised studies and postmarketing reports from regulatory agencies is needed. Editorial note: This is a living systematic review. Living systematic reviews offer a new approach to review updating, in which the review is continually updated, incorporating relevant new evidence as it becomes available. Please refer to the Cochrane Database of Systematic Reviews for the current status of this review.
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Affiliation(s)
- Emilie Sbidian
- Department of Dermatology, Hôpital Henri Mondor, Créteil, France
- Clinical Investigation Centre, Hôpital Henri Mondor, Créteil, France
- Epidemiology in Dermatology and Evaluation of Therapeutics (EpiDermE) - EA 7379, Université Paris Est Créteil (UPEC), Créteil, France
| | - Anna Chaimani
- Université de Paris, Centre of Research in Epidemiology and Statistics (CRESS), INSERM, F-75004, Paris, France
- Cochrane France, Paris, France
| | - Ignacio Garcia-Doval
- Department of Dermatology, Complexo Hospitalario Universitario de Vigo, Vigo, Spain
| | - Liz Doney
- Cochrane Skin, Centre of Evidence Based Dermatology, University of Nottingham, Nottingham, UK
| | - Corinna Dressler
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Camille Hua
- Department of Dermatology, Hôpital Henri Mondor, Créteil, France
- Epidemiology in Dermatology and Evaluation of Therapeutics (EpiDermE) - EA 7379, Université Paris Est Créteil (UPEC), Créteil, France
| | - Carolyn Hughes
- c/o Cochrane Skin Group, The University of Nottingham, Nottingham, UK
| | - Luigi Naldi
- Centro Studi GISED (Italian Group for Epidemiologic Research in Dermatology) - FROM (Research Foundation of Ospedale Maggiore Bergamo), Padiglione Mazzoleni - Presidio Ospedaliero Matteo Rota, Bergamo, Italy
| | - Sivem Afach
- Epidemiology in Dermatology and Evaluation of Therapeutics (EpiDermE) - EA 7379, Université Paris Est Créteil (UPEC), Créteil, France
| | - Laurence Le Cleach
- Department of Dermatology, Hôpital Henri Mondor, Créteil, France
- Epidemiology in Dermatology and Evaluation of Therapeutics (EpiDermE) - EA 7379, Université Paris Est Créteil (UPEC), Créteil, France
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Morel A, Hoisnard L, Dudreuilh C, Moktefi A, Kheav D, Pimentel A, Sakhi H, Mokrani D, Attias P, El Sakhawi K, Champy CM, Remy P, Sbidian E, Grimbert P, Matignon M. Three-Year Outcomes in Kidney Transplant Recipients Switched From Calcineurin Inhibitor-Based Regimens to Belatacept as a Rescue Therapy. Transpl Int 2022; 35:10228. [PMID: 35497889 PMCID: PMC9043102 DOI: 10.3389/ti.2022.10228] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2021] [Accepted: 03/18/2022] [Indexed: 01/05/2023]
Abstract
Background: The long-term benefits of conversion from calcineurin inhibitors (CNIs) to belatacept in kidney transplant recipients (KTr) are poorly documented. Methods: A single-center retrospective work to study first-time CNI to belatacept conversion as a rescue therapy [eGFR <30 ml/min/1.73 m2, chronic histological lesions, or CNI-induced thrombotic microangiopathy (TMA)]. Patient and kidney allograft survivals, eGFR, severe adverse events, donor-specific antibodies (DSA), and histological data were recorded over 36 months after conversion. Results: We included N = 115 KTr. The leading cause for switching was chronic histological lesions with non-optimal eGFR (56.5%). Three years after conversion, patient, and death-censored kidney allograft survivals were 88% and 92%, respectively, eGFR increased significantly from 31.5 ± 17.5 to 36.7 ± 15.7 ml/min/1.73 m2 (p < 0.01), the rejection rate was 10.4%, OI incidence was 5.2 (2.9–7.6) per 100 person-years. Older age was associated with death, eGFR was not associated with death nor allograft loss. No patient developed dnDSA at M36 after conversion. CNI-induced TMA disappeared in all cases without eculizumab use. Microvascular inflammation and chronic lesions remained stable. Conclusion: Post-KT conversion from CNIs to belatacept, as rescue therapy, is safe and beneficial irrespective of the switch timing and could represent a good compromise facing organ shortage. Age and eGFR at conversion should be considered in the decision whether to switch.
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Affiliation(s)
- Antoine Morel
- Nephrology and Renal Transplantation Department, AP-HP (Assistance Publique-Hôpitaux de Paris), Hôpitaux Universitaires Henri Mondor, Créteil, France
| | - Léa Hoisnard
- AP-HP (Assistance Publique-Hôpitaux de Paris), Hôpitaux Universitaires Henri Mondor, Centre d'Investigation Clinique and Fédération Hospitalo-Universitaire TRUE (InnovaTive theRapy for immUne disordErs), Créteil, France.,Université Paris Est Créteil (UPEC), EpiDermE (Epidemiology in Dermatology and Evaluation of therapeutics), Créteil, France
| | - Caroline Dudreuilh
- Nephrology and Renal Transplantation Department, AP-HP (Assistance Publique-Hôpitaux de Paris), Hôpitaux Universitaires Henri Mondor, Créteil, France
| | - Anissa Moktefi
- Groupe Hospitalier Henri-Mondor/Albert-Chenevier, Pathology Department, AP-HP (Assistance Publique-Hôpitaux de Paris), Créteil, France.,Institut National de la Santé et de la Recherche Médicale (INSERM) U955, Institut Mondor de Recherche Biomédicale (IMRB), Université Paris-Est Créteil, Créteil, France
| | - David Kheav
- AP-HP (Assistance Publique-Hôpitaux de Paris), Laboratoire Régional d'histocompatibilité, Hôpital Saint Louis, Vellefaux, Paris
| | - Ana Pimentel
- Nephrology and Renal Transplantation Department, AP-HP (Assistance Publique-Hôpitaux de Paris), Hôpitaux Universitaires Henri Mondor, Créteil, France
| | - Hamza Sakhi
- Nephrology and Renal Transplantation Department, AP-HP (Assistance Publique-Hôpitaux de Paris), Hôpitaux Universitaires Henri Mondor, Créteil, France
| | - David Mokrani
- Nephrology and Renal Transplantation Department, AP-HP (Assistance Publique-Hôpitaux de Paris), Hôpitaux Universitaires Henri Mondor, Créteil, France
| | - Philippe Attias
- Nephrology and Renal Transplantation Department, AP-HP (Assistance Publique-Hôpitaux de Paris), Hôpitaux Universitaires Henri Mondor, Créteil, France
| | - Karim El Sakhawi
- Nephrology and Renal Transplantation Department, AP-HP (Assistance Publique-Hôpitaux de Paris), Hôpitaux Universitaires Henri Mondor, Créteil, France
| | - Cécile Maud Champy
- Groupe Hospitalier Henri-Mondor/Albert Chenevier, Urology department, AP-HP (Assistance Publique-Hôpitaux de Paris), Hôpitaux Universitaires Henri Mondor, Créteil, France
| | - Philippe Remy
- Nephrology and Renal Transplantation Department, AP-HP (Assistance Publique-Hôpitaux de Paris), Hôpitaux Universitaires Henri Mondor, Créteil, France.,Institut National de la Santé et de la Recherche Médicale (INSERM) U955, Institut Mondor de Recherche Biomédicale (IMRB), Université Paris-Est Créteil, Créteil, France
| | - Emilie Sbidian
- AP-HP (Assistance Publique-Hôpitaux de Paris), Hôpitaux Universitaires Henri Mondor, Centre d'Investigation Clinique and Fédération Hospitalo-Universitaire TRUE (InnovaTive theRapy for immUne disordErs), Créteil, France.,Université Paris Est Créteil (UPEC), EpiDermE (Epidemiology in Dermatology and Evaluation of therapeutics), Créteil, France.,Department of Dermatology, AP-HP (Assistance Publique-Hôpitaux de Paris), Hôpitaux Universitaires Henri Mondor, Créteil, France.,INSERM, Centre d'Investigation Clinique 1430, Créteil, France
| | - Philippe Grimbert
- Nephrology and Renal Transplantation Department, AP-HP (Assistance Publique-Hôpitaux de Paris), Hôpitaux Universitaires Henri Mondor, Créteil, France.,AP-HP (Assistance Publique-Hôpitaux de Paris), Hôpitaux Universitaires Henri Mondor, Centre d'Investigation Clinique and Fédération Hospitalo-Universitaire TRUE (InnovaTive theRapy for immUne disordErs), Créteil, France.,Institut National de la Santé et de la Recherche Médicale (INSERM) U955, Institut Mondor de Recherche Biomédicale (IMRB), Université Paris-Est Créteil, Créteil, France.,AP-HP (Assistance Publique-Hôpitaux de Paris), Hôpitaux Universitaires Henri Mondor, CIC biotherapy, Créteil, France
| | - Marie Matignon
- Nephrology and Renal Transplantation Department, AP-HP (Assistance Publique-Hôpitaux de Paris), Hôpitaux Universitaires Henri Mondor, Créteil, France.,Institut National de la Santé et de la Recherche Médicale (INSERM) U955, Institut Mondor de Recherche Biomédicale (IMRB), Université Paris-Est Créteil, Créteil, France
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Hoisnard L, Lebrun-Vignes B, Maury S, Mahevas M, El Karoui K, Roy L, Zarour A, Michel M, Cohen JL, Amiot A, Claudepierre P, Wolkenstein P, Grimbert P, Sbidian E. Adverse events associated with JAK inhibitors in 126,815 reports from the WHO pharmacovigilance database. Sci Rep 2022; 12:7140. [PMID: 35504889 PMCID: PMC9065106 DOI: 10.1038/s41598-022-10777-w] [Citation(s) in RCA: 42] [Impact Index Per Article: 21.0] [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: 11/30/2021] [Accepted: 03/23/2022] [Indexed: 01/13/2023] Open
Abstract
Increasing number of Janus kinase (JAK) inhibitors have been approved for chronic haematopoietic neoplasms and inflammatory/autoimmune diseases. We aimed to assess safety of the first three approved JAK inhibitors: ruxolitinib, tofacitinib and baricitinib. In this retrospective observational study, pharmacovigilance data were extracted from the World Health Organization database. Adverse events are classified according to Medical Dictionary for Regulatory Activities hierarchy. Until February 28, 2021, all Individual Case Safety Reports [ICSRs] with the suspected drug ruxolitinib, tofacitinib or baricitinib were included. Disproportionality analysis was performed and the information component (IC) was estimated. Adverse events were considered a significant signal if the lower end of the 95% credibility interval of the IC (IC025) was positive. We identified 126,815 ICSRs involving JAK inhibitors. Ruxolitinib, tofacitinib and baricitinib were associated with infectious adverse events (IC025 1.7, especially with viral [herpes and influenza], fungal, and mycobacterial infectious disorders); musculoskeletal and connective tissue disorders (IC025 1.1); embolism and thrombosis (IC025 0.4); and neoplasms (IC025 0.8, especially malignant skin neoplasms). Tofacitinib was associated with gastrointestinal perforation events (IC025 1.5). We did not find a significant increase in the reporting of major cardiovascular events. We identified significant association between adverse events and ruxolitinib, tofacinitib and baricitinib in international pharmacovigilance database.
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Affiliation(s)
- Léa Hoisnard
- Fédération Hospitalo-Universitaire TRUE InnovaTive theRapy for immUne disordErs, Assistance Publique-Hôpitaux de Paris (AP-HP), Henri Mondor Hospital, 94010, Créteil, France.
- INSERM, Centre d'Investigation Clinique 1430, 94010, Créteil, France.
- EpiDermE Epidemiology in Dermatology and Evaluation of Therapeutics, EA7379, Paris Est Créteil University UPEC, 94010, Créteil, France.
| | - Bénédicte Lebrun-Vignes
- Department of Pharmacology, Pharmacovigilance Unit, Assistance Publique-Hôpitaux de Paris (AP-HP), Pitié-Salpêtrière Hospital, Paris, France
| | - Sébastien Maury
- Fédération Hospitalo-Universitaire TRUE InnovaTive theRapy for immUne disordErs, Assistance Publique-Hôpitaux de Paris (AP-HP), Henri Mondor Hospital, 94010, Créteil, France
- Hematology Department, Assistance Publique-Hôpitaux de Paris (AP-HP), Henri Mondor Hospital & Faculté de Santé, UPEC (Université Paris Est Créteil), 94010, Créteil, France
| | - Matthieu Mahevas
- Fédération Hospitalo-Universitaire TRUE InnovaTive theRapy for immUne disordErs, Assistance Publique-Hôpitaux de Paris (AP-HP), Henri Mondor Hospital, 94010, Créteil, France
- Department of Internal Medicine, Assistance Publique-Hôpitaux de Paris (AP-HP), Henri Mondor Hospital, 94010, Créteil, France
| | - Khalil El Karoui
- Fédération Hospitalo-Universitaire TRUE InnovaTive theRapy for immUne disordErs, Assistance Publique-Hôpitaux de Paris (AP-HP), Henri Mondor Hospital, 94010, Créteil, France
- Department of Nephrology and Renal Transplantation, Assistance Publique-Hôpitaux de Paris (AP-HP), Henri Mondor Hospital, 94010, Créteil, France
- UPEC (Université Paris Est Créteil), UMR-S955, 94010, Créteil, France
- INSERM (Institut National de la Santé et de la Recherche Médicale) U955, Institut Mondor de Recherche Biomédicale (IMRB), 94010, Créteil, France
| | - Lydia Roy
- Hematology Department, Assistance Publique-Hôpitaux de Paris (AP-HP), Henri Mondor Hospital & Faculté de Santé, UPEC (Université Paris Est Créteil), 94010, Créteil, France
| | - Anissa Zarour
- Fédération Hospitalo-Universitaire TRUE InnovaTive theRapy for immUne disordErs, Assistance Publique-Hôpitaux de Paris (AP-HP), Henri Mondor Hospital, 94010, Créteil, France
| | - Marc Michel
- Fédération Hospitalo-Universitaire TRUE InnovaTive theRapy for immUne disordErs, Assistance Publique-Hôpitaux de Paris (AP-HP), Henri Mondor Hospital, 94010, Créteil, France
- Department of Internal Medicine, Assistance Publique-Hôpitaux de Paris (AP-HP), Henri Mondor Hospital, 94010, Créteil, France
| | - José L Cohen
- Fédération Hospitalo-Universitaire TRUE InnovaTive theRapy for immUne disordErs, Assistance Publique-Hôpitaux de Paris (AP-HP), Henri Mondor Hospital, 94010, Créteil, France
- UPEC (Université Paris Est Créteil), UMR-S955, 94010, Créteil, France
- INSERM (Institut National de la Santé et de la Recherche Médicale) U955, Institut Mondor de Recherche Biomédicale (IMRB), 94010, Créteil, France
- INSERM, Centre d'Investigation Clinique Biothérapie 1430, 94010, Créteil, France
| | - Aurélien Amiot
- Fédération Hospitalo-Universitaire TRUE InnovaTive theRapy for immUne disordErs, Assistance Publique-Hôpitaux de Paris (AP-HP), Henri Mondor Hospital, 94010, Créteil, France
- Department of Gastroenterology, Henri Mondor Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), EA7375 and Université Paris Est, Creteil, France
| | - Pascal Claudepierre
- Fédération Hospitalo-Universitaire TRUE InnovaTive theRapy for immUne disordErs, Assistance Publique-Hôpitaux de Paris (AP-HP), Henri Mondor Hospital, 94010, Créteil, France
- EpiDermE Epidemiology in Dermatology and Evaluation of Therapeutics, EA7379, Paris Est Créteil University UPEC, 94010, Créteil, France
- Department of Rheumatology, Henri Mondor Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), 94000, Créteil, France
| | - Pierre Wolkenstein
- Fédération Hospitalo-Universitaire TRUE InnovaTive theRapy for immUne disordErs, Assistance Publique-Hôpitaux de Paris (AP-HP), Henri Mondor Hospital, 94010, Créteil, France
- EpiDermE Epidemiology in Dermatology and Evaluation of Therapeutics, EA7379, Paris Est Créteil University UPEC, 94010, Créteil, France
- Department of Dermatology, Assistance Publique-Hôpitaux de Paris (AP-HP), Henri Mondor Hospital, 94010, Créteil, France
| | - Philippe Grimbert
- Fédération Hospitalo-Universitaire TRUE InnovaTive theRapy for immUne disordErs, Assistance Publique-Hôpitaux de Paris (AP-HP), Henri Mondor Hospital, 94010, Créteil, France
- Department of Nephrology and Renal Transplantation, Assistance Publique-Hôpitaux de Paris (AP-HP), Henri Mondor Hospital, 94010, Créteil, France
- INSERM (Institut National de la Santé et de la Recherche Médicale) U955, Institut Mondor de Recherche Biomédicale (IMRB), 94010, Créteil, France
| | - Emilie Sbidian
- Fédération Hospitalo-Universitaire TRUE InnovaTive theRapy for immUne disordErs, Assistance Publique-Hôpitaux de Paris (AP-HP), Henri Mondor Hospital, 94010, Créteil, France
- INSERM, Centre d'Investigation Clinique 1430, 94010, Créteil, France
- EpiDermE Epidemiology in Dermatology and Evaluation of Therapeutics, EA7379, Paris Est Créteil University UPEC, 94010, Créteil, France
- Department of Dermatology, Assistance Publique-Hôpitaux de Paris (AP-HP), Henri Mondor Hospital, 94010, Créteil, France
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Pina Vegas L, Penso L, Claudepierre P, Sbidian E. Long-term Persistence of First-line Biologics for Patients With Psoriasis and Psoriatic Arthritis in the French Health Insurance Database. JAMA Dermatol 2022; 158:513-522. [PMID: 35319735 PMCID: PMC8943623 DOI: 10.1001/jamadermatol.2022.0364] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Accepted: 02/01/2022] [Indexed: 12/12/2022]
Abstract
Importance Treatment options for psoriasis (PsO) and psoriatic arthritis (PsA) have evolved significantly throughout the era of biologics. Clinical trials are inadequate to assess the relative long-term efficacy of biologics and are often insufficient regarding safety. Objectives To assess the long-term persistence of different biologic classes to treat PsO and PsA. Design, Setting, and Participants This nationwide cohort study involved the administrative health care database of the French health insurance scheme linked to the hospital discharge database. All adults with PsO and PsA who were new users of biologics (not in the year before the index date) from January 1, 2015, to May 31, 2019, were included and followed up through December 31, 2019. Patients hospitalized for PsA in the PsO cohort and for PsO in the PsA cohort in the year before the index date were excluded. Data were analyzed from June 1 to October 31, 2021. Main Outcomes and Measures Persistence was defined as the time from biologic therapy initiation to discontinuation and was estimated using the Kaplan-Meier method. Comparison of persistence by biologic class involved using propensity score-weighted Cox proportional hazards regression models and adjustment on specific systemic nonbiologics (time-dependent variables). Results A total of 16 892 patients with PsO were included in the analysis (mean [SD] age, 48.5 [13.8] years; 9152 men [54.2%] men). Of these, 10 199 patients (60.4%) started therapy with a tumor necrosis factor (TNF) inhibitor; 3982 (23.6%), with an interleukin 12 and interleukin 23 (IL-12/23) inhibitor; and 2711 (16.0%), with an interleukin 17 (IL-17) inhibitor. An additional 6531 patients with PsA (mean [SD] age, 49.1 [12.8] years; 3565 [54.6%] women) were included; of these, 4974 (76.2%) started therapy with a TNF inhibitor; 803 (12.3%), with an IL-12/23 inhibitor; and 754 (11.5%), with an IL-17 inhibitor. Overall 3-year persistence rates were 40.9% and 36.2% for PsO and PsA, respectively. After inverse probability of treatment weighting and adjustment, the IL-17 inhibitor was associated with higher persistence compared with the TNF inhibitor for PsO (weighted hazard ratio [HR], 0.78 [95% CI, 0.73-0.83]) and PsA (weighted HR, 0.70 [95% CI, 0.58-0.85]) and compared with the IL-12/23 inhibitor for PsA (weighted HR, 0.69 [95% CI, 0.55-0.87]). No difference between the IL-17 inhibitor and IL-12/23 inhibitor for PsO was noted. The IL-12/23 inhibitor was associated with higher persistence than the TNF inhibitor for PsO (weighted HR, 0.76 [95% CI, 0.72-0.80]), with no difference observed for PsA. Conclusions and Relevance The findings of this cohort study suggest that IL-17 inhibitors are associated with higher treatment persistence than the TNF inhibitor for PsO and PsA. Interleukin 17 inhibitors were also associated with higher persistence than the IL-12/23 inhibitor for PsA, with no difference for PsO. However, the persistence rates of all biologics remained globally low at 3 years.
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Affiliation(s)
- Laura Pina Vegas
- EpiDermE, Université Paris Est Créteil, Créteil, France
- Service de Rhumatologie, Assistance Publique–Hôpitaux de Paris (AP-HP), Hôpital Henri Mondor, Créteil, France
| | - Laetitia Penso
- EpiDermE, Université Paris Est Créteil, Créteil, France
- EPI-PHARE Scientific Interest Group in Epidemiology of Health Products, French National Agency for the Safety of Medicines and Health Products and French National Health Insurance, St Denis
| | - Pascal Claudepierre
- EpiDermE, Université Paris Est Créteil, Créteil, France
- Service de Rhumatologie, Assistance Publique–Hôpitaux de Paris (AP-HP), Hôpital Henri Mondor, Créteil, France
| | - Emilie Sbidian
- EpiDermE, Université Paris Est Créteil, Créteil, France
- Institut National de la Santé et de la Recherche Médicale, Centre d’Investigation Clinique 1430, Hôpital Henri Mondor, Créteil, France
- Service de Dermatologie, AP-HP, Hôpital Henri Mondor, Créteil, France
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Curmin R, Guillo S, De Rycke Y, Bachelez H, Beylot-Barry M, Beneton N, Olivier C, Dupuy A, Joly P, Jullien D, Richard M, Viguier M, Sbidian E, Paul C, Mahé E, Tubach F. Switchs de biothérapies chez les patients atteints de psoriasis modéré à sévère dans la cohorte française PSOBIOTEQ. Rev Epidemiol Sante Publique 2022. [DOI: 10.1016/j.respe.2022.03.019] [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] Open
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Assan F, Husson B, Hegazy S, Seneschal J, Aubin F, Mahé E, Jullien D, Sbidian E, D'Incan M, Conrad C, Brenaut E, Girard C, Richard MA, Bachelez H, Viguier M. Palmoplantar pustulosis and acrodermatitis continua of Hallopeau: demographical and clinical comparative study in a large multicentre cohort. J Eur Acad Dermatol Venereol 2022; 36:1578-1583. [PMID: 35366356 PMCID: PMC9546063 DOI: 10.1111/jdv.18127] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Accepted: 03/23/2022] [Indexed: 12/04/2022]
Abstract
Background Acral pustular disease within the pustular psoriasis/psoriasis‐like spectrum mainly includes palmoplantar pustulosis (PPP) and acrodermatitis continua of Hallopeau (ACH). Scarce data argue for a distinction between these two entities, but no study has compared the clinical and epidemiologic characteristics of ACH and PPP. Objectives We aimed to perform a comparative description of the epidemiological and clinical characteristics of PPP and ACH in a multicentre retrospective cohort. Methods In this multicentre national retrospective cohort study, we compared the epidemiological characteristics, comorbidities and psoriasis characteristics of patients with PPP and ACH. Results A total of 234 patients were included: 203 (87%) with PPP, 18 (8%) with ACH and 13 (6%) with both, according to 2017 ERASPEN criteria. As compared with ACH, PPP was associated with female sex, smoking activity and higher median BMI (P = 0.01, P = 0.02 and P = 0.05 respectively). A family background of psoriasis was more frequent in PPP than ACH. Age of onset of palmoplantar disease was similar between PPP and ACH patients, median age 44 and 48 years respectively. Peripheral joint inflammatory involvement was the only rheumatic disease associated with ACH. The association with another psoriasis type was similar in PPP and ACH (57.6% and 61.1% respectively). Conclusion Our study confirms in a large PPP cohort the predominance of females and a high prevalence of smoking and elevated body mass index but also shows an association of these features in PPP as compared with ACH. In addition, it highlights peripheral arthritis as the only arthritis endotype associated with ACH. Increased knowledge of the immunogenetic backgrounds underlying these two entities is warranted to better stratify pustular psoriasis or psoriasis‐like entities for precision medicine.
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Affiliation(s)
- F Assan
- Dermatology Department, Hôpital Robert-Debré, Reims, France
| | - B Husson
- Dermatology Department, Hôpital Robert-Debré, Reims, France
| | - S Hegazy
- Dermatology Department, Hôpital Larrey, Toulouse, France
| | - J Seneschal
- Dermatology Department, National Reference Center for Rare Skin Diseases, Hôpital Saint-André, Bordeaux, France
| | - F Aubin
- Dermatology Department and Inserm 1098, Centre Hospitalo-Universitaire (CHU), Besançon, France
| | - E Mahé
- Dermatology Department, Centre Hospitalier (CH), Argenteuil, France
| | - D Jullien
- Clinical Immunology Department, CH Lyon-Sud, Lyon, France
| | - E Sbidian
- Dermatology Department, Hôpital Henri-Mondor, Créteil, France
| | - M D'Incan
- Dermatology Department, CHU Estaing, Clermont-Ferrand, France
| | - C Conrad
- Dermatology Department, Lausanne University Hospital, CHUV, Lausanne, Switzerland
| | - E Brenaut
- Dermatology Department, CHU, Brest, France
| | - C Girard
- Dermatology Department, CHU Lapeyronie, Montpellier, France
| | - M A Richard
- Dermatology Department, CEReSS-EA 3279, Research Center in Health Services and Quality of Life Aix Marseille University, University Hospital Timone, Assistance Publique Hôpitaux de Marseille, Marseille, France
| | - H Bachelez
- Université de Paris, Paris, France.,Dermatology Department, Assistance Publique-Hôpitaux de Paris, Hôpital Saint-Louis, Paris, France.,Laboratory of Genetics of Skin Diseases, INSERM UMR1163, Institut Imagine, Necker Hospital, Paris, France
| | - M Viguier
- Dermatology Department, Hôpital Robert-Debré, Reims, France
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Pina Vegas L, Claudepierre P, Sbidian E. Comment on: risk of major adverse cardiovascular events in patients initiating biologics/apremilast for psoriatic arthritis: a nationwide cohort study: Reply. Rheumatology (Oxford) 2022; 61:e238-e239. [PMID: 35333297 DOI: 10.1093/rheumatology/keac158] [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] [Received: 03/04/2022] [Accepted: 03/09/2022] [Indexed: 11/13/2022] Open
Affiliation(s)
- Laura Pina Vegas
- EpiDermE, Université Paris Est Créteil, Créteil, F-94010, France.,Service de Rhumatologie, AP-HP, Hôpital Henri Mondor, Créteil, F-94010, France
| | - Pascal Claudepierre
- EpiDermE, Université Paris Est Créteil, Créteil, F-94010, France.,Service de Rhumatologie, AP-HP, Hôpital Henri Mondor, Créteil, F-94010, France
| | - Emilie Sbidian
- EpiDermE, Université Paris Est Créteil, Créteil, F-94010, France.,Inserm, Centre d'investigation clinique 1430, Hôpital Henri Mondor, Creteil, F-94010, France.,Service de Dermatologie, AP-HP, Hôpital Henri Mondor, Créteil, F-94010, France
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Amici JM, Bergqvist C, Ly S, Corgibet F, Seï JF, Seneschal J, Sbidian E, Beylot-Barry M. CITY-PSO: Prescribing behaviour of French private-practice dermatologists in psoriasis management: An observational, multicentre, cross-sectional study. Ann Dermatol Venereol 2022; 149:169-175. [PMID: 35181154 DOI: 10.1016/j.annder.2022.01.001] [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: 07/24/2021] [Revised: 10/24/2021] [Accepted: 01/04/2022] [Indexed: 12/01/2022]
Abstract
BACKGROUND Information regarding the prescribing behaviour of French private-practice dermatologists (PPDs) is scarce. OBJECTIVES First, to describe the population of PPDs involved in psoriasis management. Second, to describe the population of adult patients treated for psoriasis and their management. METHODS We published a call for participation targeting PPDs; we first asked respondents to complete a form regarding their prescribing behaviour, and then to include consecutive patients consulting for psoriasis during a one-month study period and to collect patient data. RESULTS The 94 participating PPDs included 1022 patients of mean age 52.9±17.9 years. The average body mass index was 28, and 25% had vascular comorbidities. Two thirds of patients had chronic psoriasis, for which 45% had consulted at least 5 times. Psoriasis was mostly with plaques (70.8%) and 11.4% of patients had psoriatic arthritis. The average body surface area (BSA) affected was 10.1%. Among the 679 patients without initial systemic treatment, 159 were started on systemic treatment. The main agents initiated were phototherapy (n=63), methotrexate (n=40), acitretin (n=30) and apremilast (n=20). In multivariate analysis, a higher BSA [Odds Ratio (OR) 1.10, 95% Confidence Interval (CI): 1.07-1.13; P<10-4] and Dermatology Life Quality Index (DLQI) [OR 1.09, 95% CI: 1.03-1.15; P=0.04] were associated with prescription of systemic therapy at the end of the consultation. CONCLUSION The main limitation of our study was that participating PPDs were strongly involved in psoriasis management, which accounts for the high proportion of moderate-to-severe psoriasis and prescription of systemic treatments. Such committed PPDs and the development of psoriasis networks are key factors for improving the quality of care provided to psoriasis patients.
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Affiliation(s)
- J-M Amici
- Association des Dermato-Vénéréologues du Sud-Ouest (ADVSO, Association of Dermatologists and Venerologists of the French South-West), Maison de la Dermatologie, 8, rue Jules Ferry, 33290 Blanquefort, France; Dermatology department, Bordeaux university hospital, 33000 Bordeaux, France
| | - C Bergqvist
- CIC 1430 Inserm, Dermatology department, Henri-Mondor hospital, Assistance publique-Hôpitaux de Paris (AP-HP), 94000 Créteil, France
| | - S Ly
- Association des Dermato-Vénéréologues du Sud-Ouest (ADVSO, Association of Dermatologists and Venerologists of the French South-West), Maison de la Dermatologie, 8, rue Jules Ferry, 33290 Blanquefort, France; Dermatology department, Bordeaux university hospital, 33000 Bordeaux, France
| | - F Corgibet
- Fédération française de formation continue et d'évaluation en dermatologie et vénéréologie (FFFCEDV, French Federation of Continuing Education and Assessment in Dermatology), Maison de la Dermatologie, 10, cité Malesherbes, 75009 Paris, France
| | - J-F Seï
- Fédération française de formation continue et d'évaluation en dermatologie et vénéréologie (FFFCEDV, French Federation of Continuing Education and Assessment in Dermatology), Maison de la Dermatologie, 10, cité Malesherbes, 75009 Paris, France
| | - J Seneschal
- Dermatology department, Bordeaux university hospital, 33000 Bordeaux, France
| | - E Sbidian
- CIC 1430 Inserm, Dermatology department, Henri-Mondor hospital, Assistance publique-Hôpitaux de Paris (AP-HP), 94000 Créteil, France; EpiDermE, Paris-Est Créteil university, Val-de-Marne, 94000 Créteil, France
| | - M Beylot-Barry
- Dermatology department, Bordeaux university hospital, 33000 Bordeaux, France.
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Bergqvist C, Fertitta L, Ezzedine K, Jannic A, Zehou O, Ferkal S, Combemale P, Barbarot S, Mazereeuw‐Hautier J, Sbidian E, Wolkenstein P, France NF. Identification of three clinical neurofibromatosis 1 subtypes: Latent class analysis of a series of 1,351 patients. J Eur Acad Dermatol Venereol 2022; 36:739-743. [DOI: 10.1111/jdv.17974] [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] [Received: 10/19/2021] [Revised: 12/08/2021] [Accepted: 01/07/2022] [Indexed: 12/01/2022]
Affiliation(s)
- C. Bergqvist
- Department of Dermatology National Referral Center for Neurofibromatoses Henri‐Mondor Hospital Assistance Publique‐Hôpital Paris (AP‐HP) Créteil France
| | - L. Fertitta
- Department of Dermatology National Referral Center for Neurofibromatoses Henri‐Mondor Hospital Assistance Publique‐Hôpital Paris (AP‐HP) Créteil France
| | - K. Ezzedine
- Department of Dermatology National Referral Center for Neurofibromatoses Henri‐Mondor Hospital Assistance Publique‐Hôpital Paris (AP‐HP) Créteil France
- Faculty of Medicine Université Paris‐Est Créteil (UPEC) Créteil France
| | - A. Jannic
- Department of Dermatology National Referral Center for Neurofibromatoses Henri‐Mondor Hospital Assistance Publique‐Hôpital Paris (AP‐HP) Créteil France
| | - O. Zehou
- Department of Dermatology National Referral Center for Neurofibromatoses Henri‐Mondor Hospital Assistance Publique‐Hôpital Paris (AP‐HP) Créteil France
| | - S. Ferkal
- Department of Dermatology National Referral Center for Neurofibromatoses Henri‐Mondor Hospital Assistance Publique‐Hôpital Paris (AP‐HP) Créteil France
- INSERM Centre d’Investigation Clinique 1430 Assistance Publique‐Hôpital Paris (AP‐HP) Henri‐Mondor Hospital Créteil France
| | - P. Combemale
- Department of Dermatology Centre Léon Bérard Lyon France
| | - S. Barbarot
- Dermatology Department Nantes Université University hospital of Nantes UMR INRAE 1280 PhAN Nantes France
| | - J. Mazereeuw‐Hautier
- Department of Dermatology Referral Centre for Rare Skin Diseases Toulouse University Hospital Toulouse France
| | - E. Sbidian
- Department of Dermatology National Referral Center for Neurofibromatoses Henri‐Mondor Hospital Assistance Publique‐Hôpital Paris (AP‐HP) Créteil France
- Faculty of Medicine Université Paris‐Est Créteil (UPEC) Créteil France
| | - P. Wolkenstein
- Department of Dermatology National Referral Center for Neurofibromatoses Henri‐Mondor Hospital Assistance Publique‐Hôpital Paris (AP‐HP) Créteil France
- Faculty of Medicine Université Paris‐Est Créteil (UPEC) Créteil France
- INSERM U955 Neurofibromatosis and Lymphoma oncogenesis Créteil France
| | - NF France
- Department of Dermatology National Referral Center for Neurofibromatoses Henri‐Mondor Hospital Assistance Publique‐Hôpital Paris (AP‐HP) Créteil France
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44
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Bettuzzi T, Ingen-Housz-Oro S, Maison P, de Prost N, Wolkenstein P, Lebrun-Vignes B, Sbidian E. Biases associated with epidermal necrolysis reporting in pharmacovigilance: An exploratory analysis using World Health Organization VigiBase. Pharmacoepidemiol Drug Saf 2021; 31:434-441. [PMID: 34907614 DOI: 10.1002/pds.5399] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Revised: 11/25/2021] [Accepted: 12/08/2021] [Indexed: 11/11/2022]
Abstract
BACKGROUND Possible biases in pharmacovigilance reporting may impact epidermal necrolysis (EN) and drugs associations. OBJECTIVES To assess biases associated with EN-reporting. METHODS Using VigiBase, the World Health Organization-pharmacovigilance database, among drugs associated with EN between 2016 and 2020, we used an unsupervised clustering including reports characteristics, that is, reporter quality, time from drug intake to EN onset, and only one suspected drug in the report. RESULTS Among 152 drugs, three clusters were identified. Cluster 1 (n = 41) exhibited drugs frequently reported within a time from intake to onset longer than 4 days, in 57 ± 13% of reports. It corresponded to well-reported drugs and was composed mainly of antivirals and antiepileptics. Cluster 2 (n = 42) exhibited drugs frequently reported within a time from drug intake to onset shorter than 4 days, in 31 ± 12% of reports. It corresponded to drugs with a high risk of protopathic bias and was composed of nonsteroidal anti-inflammatory drugs (NSAIDs), analgesics, and antibiotics. Cluster 3 (n = 69) exhibited drugs frequently reported with an unavailable time from drug intake to reaction, in 66 ± 11% of reports, and reported by a high frequency of consumers (9 ± 9%). It corresponded to drugs reported with a high risk of classification bias, and was composed of anticancer therapies and cardiovascular drugs. CONCLUSION Protopathic and classification biases impact EN-reporting and should be considered regarding associations with antibiotics, NSAIDs, analgesics, anticancer therapies, and cardiovascular drugs.
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Affiliation(s)
- Thomas Bettuzzi
- Service de Dermatologie, AP-HP, Hôpital Henri Mondor, Créteil, France.,EpiDermE, Univ Paris Est Créteil, Créteil, France
| | - Saskia Ingen-Housz-Oro
- Service de Dermatologie, AP-HP, Hôpital Henri Mondor, Créteil, France.,EpiDermE, Univ Paris Est Créteil, Créteil, France.,Centre de Référence des Dermatoses Bulleuses Toxiques et Toxidermies Graves TOXIBUL, Hôpital Henri Mondor, Créteil, France
| | - Patrick Maison
- EpiDermE, Univ Paris Est Créteil, Créteil, France.,Direction Générale, ANSM, Saint-Denis, France
| | - Nicolas de Prost
- Centre de Référence des Dermatoses Bulleuses Toxiques et Toxidermies Graves TOXIBUL, Hôpital Henri Mondor, Créteil, France.,Service de Réanimation Médicale, AP-HP, Hôpital Henri Mondor, Créteil, France
| | - Pierre Wolkenstein
- Service de Dermatologie, AP-HP, Hôpital Henri Mondor, Créteil, France.,EpiDermE, Univ Paris Est Créteil, Créteil, France.,Centre de Référence des Dermatoses Bulleuses Toxiques et Toxidermies Graves TOXIBUL, Hôpital Henri Mondor, Créteil, France
| | - Bénédicte Lebrun-Vignes
- EpiDermE, Univ Paris Est Créteil, Créteil, France.,Centre de Référence des Dermatoses Bulleuses Toxiques et Toxidermies Graves TOXIBUL, Hôpital Henri Mondor, Créteil, France.,Centre Régional de Pharmacovigilance, Service de Pharmacologie Clinique, Hôpital Pitié-Salpétrière, AP-HP, Paris, France
| | - Emilie Sbidian
- Service de Dermatologie, AP-HP, Hôpital Henri Mondor, Créteil, France.,EpiDermE, Univ Paris Est Créteil, Créteil, France.,Centre d'Investigation Clinique 1430, INSERM, Créteil, France
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45
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Oniszczuk J, Bettuzzi T, Anjou L, Audard V, Sbidian E, El Karoui K, Moktefi A. De novo IgA vasculitis following adenovirus-based SARS-CoV-2 vaccination. Clin Kidney J 2021; 15:587-589. [PMID: 35211316 PMCID: PMC8862086 DOI: 10.1093/ckj/sfab257] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Indexed: 11/12/2022] Open
Affiliation(s)
- Julie Oniszczuk
- AP-HP, Hôpitaux Universitaires Henri Mondor, Service de Néphrologie et Transplantation, Centre de Référence Maladie Rare « Syndrome Néphrotique Idiopathique », Fédération Hospitalo-Universitaire TRUE, Créteil, France
- UnivParis Est Créteil (UPEC), Institut National de la Santé et de la Recherche Médicale (INSERM) U955, Institut Mondor de Recherche Biomédicale (IMRB), Equipe 21, Créteil, France
| | - Thomas Bettuzzi
- AP-HP, Hôpitaux Universitaires Henri Mondor, Dermatology Department, Fédération Hospitalo-Universitaire TRUE, Créteil, France
| | - Louis Anjou
- AP-HP, Hôpitaux Universitaires Henri Mondor, Service de Néphrologie et Transplantation, Centre de Référence Maladie Rare « Syndrome Néphrotique Idiopathique », Fédération Hospitalo-Universitaire TRUE, Créteil, France
- UnivParis Est Créteil (UPEC), Institut National de la Santé et de la Recherche Médicale (INSERM) U955, Institut Mondor de Recherche Biomédicale (IMRB), Equipe 21, Créteil, France
| | - Vincent Audard
- AP-HP, Hôpitaux Universitaires Henri Mondor, Service de Néphrologie et Transplantation, Centre de Référence Maladie Rare « Syndrome Néphrotique Idiopathique », Fédération Hospitalo-Universitaire TRUE, Créteil, France
- UnivParis Est Créteil (UPEC), Institut National de la Santé et de la Recherche Médicale (INSERM) U955, Institut Mondor de Recherche Biomédicale (IMRB), Equipe 21, Créteil, France
| | - Emilie Sbidian
- AP-HP, Hôpitaux Universitaires Henri Mondor, Dermatology Department, Fédération Hospitalo-Universitaire TRUE, Créteil, France
| | - Khalil El Karoui
- AP-HP, Hôpitaux Universitaires Henri Mondor, Service de Néphrologie et Transplantation, Centre de Référence Maladie Rare « Syndrome Néphrotique Idiopathique », Fédération Hospitalo-Universitaire TRUE, Créteil, France
- UnivParis Est Créteil (UPEC), Institut National de la Santé et de la Recherche Médicale (INSERM) U955, Institut Mondor de Recherche Biomédicale (IMRB), Equipe 21, Créteil, France
| | - Anissa Moktefi
- UnivParis Est Créteil (UPEC), Institut National de la Santé et de la Recherche Médicale (INSERM) U955, Institut Mondor de Recherche Biomédicale (IMRB), Equipe 21, Créteil, France
- AP-HP, Hôpitaux Universitaires Henri Mondor, Département de Pathologie, Créteil, France
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46
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Guelimi R, Afach S, Régnaux JP, Bettuzzi T, Chaby G, Sbidian E, Naudet F, Le Cleach L. Overlapping network meta-analyses on psoriasis systemic treatments: an overview, quantity does not make quality. Br J Dermatol 2021; 187:29-41. [PMID: 34854074 DOI: 10.1111/bjd.20908] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Revised: 11/27/2021] [Accepted: 11/28/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Network Meta-analyses (NMAs) have become successful in addressing gaps in the comparative effectiveness of systemic treatments in moderate-to-severe psoriasis. However, their increasing number carries both a risk of overlap and reproducibility issues that can hamper clinical decision-making. In this overview, we aimed to assess redundancy across these NMAs and to describe their characteristics. METHODS We considered all systematic reviews with NMAs of randomized controlled trials that included adult patients with moderate-to-severe psoriasis and that evaluated the efficacy and/or safety of systemic treatments compared with placebo or with an active comparator. PubMed/MEDLINE, Epistemonikos, PROSPERO and the Evidence Update of the Centre of Evidence-Based Dermatology of the University of Nottingham were searched up to 25 February 2021. Our main outcome was the number per year of redundant NMAs and the extent of their overlap. We also described their features, especially, the confidence in the results of the reviews, the studies' funding and the presence of spin (a description that overstates efficacy and/or understates harm), reporting issues and methodological characteristics. RESULTS In total, 47 redundant NMAs were included. Only 2/47 (4%) included all available treatments. Both efficacy and safety were evaluated in 14/47 (30%) NMAs and both short and long-term evaluations were assessed in 5/47 (11 %). Confidence in the results was critically low for 39/47 (83%) NMAs and only 10/47 (23 %) registered a protocol. 26/47 NMAs (55%) received pharmaceutical funding. CROs were involved in 19/47 (40%) NMAs. Reporting was poor across most of the NMAs' abstracts and spin was present in all of the abstracts. Almost half of the NMA failed to consider important limitations such as heterogeneity (32%) or consistency (66%). DISCUSSION In addition to a duplication of efforts, our overview showed heterogeneous methods and poor confidence in the results in a majority of the included NMAs, further distorted by reporting issues and spin. Clinicians need to interpret NMAs with caution when looking for the most reliable and comprehensive evidence.
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Affiliation(s)
- R Guelimi
- EpiDermE EA 7379, Université Paris Est Créteil, F-94010, Créteil, France
| | - S Afach
- EpiDermE EA 7379, Université Paris Est Créteil, F-94010, Créteil, France
| | - J-P Régnaux
- EpiDermE EA 7379, Université Paris Est Créteil, F-94010, Créteil, France.,Ecole des Hautes Etudes en Santé Publique (EHESP), F-35000, Rennes, France
| | - T Bettuzzi
- EpiDermE EA 7379, Université Paris Est Créteil, F-94010, Créteil, France.,Department of Dermatology, Assistance Publique-Hôpitaux de Paris, Henri Mondor Hospital, F-94010, Créteil, France
| | - G Chaby
- Dermatology Department, Amiens-Picardie University Hospital Center, Amiens, F-80000, France
| | - E Sbidian
- EpiDermE EA 7379, Université Paris Est Créteil, F-94010, Créteil, France.,Department of Dermatology, Assistance Publique-Hôpitaux de Paris, Henri Mondor Hospital, F-94010, Créteil, France
| | - F Naudet
- CHU Rennes, INSERM CIC 1414 (Centre d'Investigation Clinique de Rennes), University Rennes, Rennes, F-35000, France
| | - L Le Cleach
- EpiDermE EA 7379, Université Paris Est Créteil, F-94010, Créteil, France.,Department of Dermatology, Assistance Publique-Hôpitaux de Paris, Henri Mondor Hospital, F-94010, Créteil, France
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47
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Roux C, Sbidian E, Bouaziz JD, Kottler D, Joly P, Descamps V, Prost C, Samimi M, Seneschal J, Dupin N, Girard C, Paul M, Le Cleach L, Ingen-Housz-Oro S. Evaluation of Thalidomide Treatment of Patients With Chronic Erythema Multiforme: A Multicenter Retrospective Cohort Study. JAMA Dermatol 2021; 157:1472-1476. [PMID: 34757396 DOI: 10.1001/jamadermatol.2021.4083] [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] [Indexed: 01/04/2023]
Abstract
Importance Erythema multiforme (EM) may become long term, with a recurrent or persistent course. First-line treatment for chronic EM is valaciclovir. There is no consensus for selection of second-line treatment of chronic EM. Objective The aim of this study was to assess the effectiveness of treatment with thalidomide for patients with chronic EM. Design, Setting, and Participants In this retrospective national multicenter cohort study, among 68 French hospital dermatology departments contacted by e-mail, 10 reported having eligible cases. All adults aged 18 years or older under dermatology care for chronic EM (including recurrent and persistent forms) who had received thalidomide between 2010 and 2018 were included. Analyses were conducted from June 24, 2019, to December 31, 2019. Main Outcomes and Measures The primary outcome was the proportion of patients who did not experience an EM flare within 6 months of initiating thalidomide treatment for recurrent EM or with complete clearance at 6 months for persistent EM (complete remission). Results Overall, 35 patients with chronic EM (median [range] age, 33 [15-65] years; 20 [57%] female) experienced failure of at least 1 previous treatment prior to initiating treatment with thalidomide. After 6 months of continuous thalidomide treatment, 23 (66%) were in complete remission, 5 (14%) had stopped the treatment, and 7 (20%) experienced at least 1 flare. The median (IQR) initial dose followed by remission was 50 (50-100) mg/d. Main adverse effects were asthenia (16 [46%]) and neuropathy (14 [40%]). Twenty-five (71%) of patients stopped thalidomide treatment after a median (IQR) of 12 (8-20) months owing to lack of effect (7/25 [28%]), neuropathy or another adverse effect (14/25 [56%]), or long-term complete remission (4/25 [16%]). Low-dose thalidomide, less than 50 mg every other day was sufficient in 9 of 23 (39%) of responders and was associated with less neuropathy and longer treatment duration. Conclusions and Relevance In this cohort study, second-line therapy with thalidomide was associated with complete remission in two-thirds of the 35 patients with chronic EM. However, adverse events were a common cause of thalidomide withdrawal. In the long term, dose reduction when possible may allow for continuation by improving tolerance.
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Affiliation(s)
- Camille Roux
- Department of Dermatology, Henri Mondor Hospital, AP-HP, Créteil, France
| | - Emilie Sbidian
- Department of Dermatology, Henri Mondor Hospital, AP-HP, Créteil, France.,Université Paris Est Créteil EpiDermE, Créteil, France
| | - Jean-David Bouaziz
- Department of Dermatology, Saint-Louis Hospital, AP-HP, Université de Paris, Paris, France
| | - Diane Kottler
- Department of Dermatology, Bichat Hospital, AP-HP, Université de Paris, Paris, France.,Department of Dermatology, Caen University Hospital, Caen, France
| | - Pascal Joly
- Department of Dermatology, Rouen University Hospital and INSERM 1234, Normandie University, Rouen, France
| | - Vincent Descamps
- Department of Dermatology, Bichat Hospital, AP-HP, Université de Paris, Paris, France.,Department of Dermatology, Caen University Hospital, Caen, France
| | - Catherine Prost
- Department of Dermatology, Avicenne Hospital, AP-HP, Bobigny, France
| | - Mahtab Samimi
- Department of Dermatology, University Hospital of Tours, Tours, France
| | - Julien Seneschal
- Department of Dermatology, National Reference Center for Rare Skin Diseases, Université Bordeaux, Bordeaux, France
| | - Nicolas Dupin
- Department of Dermatology, Cochin Hospital, AP-HP, Paris, France
| | - Céline Girard
- Department of Dermatology, Montpellier University Hospital, Montpellier, France
| | - Muriel Paul
- Université Paris Est Créteil EpiDermE, Créteil, France.,Department of Hospital Pharmacy, Henri Mondor Hospital, AP-HP, Créteil, France
| | - Laurence Le Cleach
- Department of Dermatology, Henri Mondor Hospital, AP-HP, Créteil, France.,Université Paris Est Créteil EpiDermE, Créteil, France
| | - Saskia Ingen-Housz-Oro
- Department of Dermatology, Henri Mondor Hospital, AP-HP, Créteil, France.,Université Paris Est Créteil EpiDermE, Créteil, France.,Reference Center for toxic bullous dermatoses and severe drug reactions TOXIBUL, Créteil, France
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48
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Bettuzzi T, Bachelez H, Beylot-Barry M, Arlégui H, Paul C, Viguier M, Mahé E, Beneton N, Jullien D, Richard MA, Joly P, Tubach F, Dupuy A, Sbidian E, Chosidow O. Evolution of Drug Survival with Biological Agents and Apremilast Between 2012 and 2018 in Psoriasis Patients from the PsoBioTeq Cohort. Acta Derm Venereol 2021; 102:adv00665. [PMID: 34806759 PMCID: PMC9631244 DOI: 10.2340/actadv.v101.566] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Drug survival reflects treatment effectiveness and safety in real life. There is limited data on the variation of drug survival with the availability of systemic treatments with additional biological disease-modifying antirheumatic drugs (bDMARDs) or synthetic disease-modifying antirheumatic drugs (sDMARDs). The aim of this study was to determine whether the increasing number of available systemic treatments for psoriasis affects drug survival over time. Patients were selected from the PsoBioTeq cohort, a French prospective observational cohort enrolling patients with moderate to severe psoriasis. All patients initiating a first bDMARD or sDMARD were included. The primary outcome was comparison of drug survival over time. A multivariate Cox proportional hazard ratio model was computed. A total of 1,866 patients were included; 739 females (39%), median age 47 years. In the multivariate Cox model, no association was found between the calendar year of initiation and drug survival (hazard ratio) overlapping from 0.80 (0.42–1.52) to 1.17 (0.64–2.17), p = 0.633). In conclusion, drug survival in psoriasis is not affected by the year of initiation.
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Affiliation(s)
- Thomas Bettuzzi
- Service de Dermatologie, Assistance Publique-Hôpitaux de Paris, Hôpital Henri-Mondor, Université Paris-Est, Créteil, France.
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Sbidian E, Pina-Vegas L. Head-to-head trials in psoriasis and psoriatic arthritis: how to conclude? Br J Dermatol 2021; 185:1085. [PMID: 34668197 DOI: 10.1111/bjd.20771] [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] [Received: 08/19/2021] [Accepted: 08/20/2021] [Indexed: 11/28/2022]
Affiliation(s)
- E Sbidian
- Département de Dermatologie, AP-HP, Hôpitaux Universitaires Henri Mondor, Créteil, France.,Inserm, Centre d'Investigation Clinique 1430, Créteil, France.,Université Paris Est (UPEC), Research unit EpiDermE, Paris, France
| | - L Pina-Vegas
- Département de Rhumatologie, AP-HP, Hôpitaux Universitaires Henri Mondor, Créteil, France.,Université Paris Est (UPEC), Research unit EpiDermE, Paris, France
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50
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Bettuzzi T, Drucker A, Staumont-Sallé D, Bihan K, Lebrun-Vignes B, Sbidian E. Adverse events associated with dupilumab in the World Health Organization pharmacovigilance database. J Am Acad Dermatol 2021; 86:431-433. [PMID: 34600034 DOI: 10.1016/j.jaad.2021.09.050] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 09/14/2021] [Accepted: 09/19/2021] [Indexed: 11/17/2022]
Affiliation(s)
- Thomas Bettuzzi
- Service de Dermatologie, Assistance Publique-Hôpitaux de Paris, Hôpital Henri Mondor, Créteil, France; EpiDermE, Université Paris Est Créteil, Créteil, France.
| | - Aaron Drucker
- Division of Dermatology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada; Women's College Research Institute and Department of Medicine, Women's College Hospital, Toronto, Ontario, Canada
| | - Delphine Staumont-Sallé
- Service de Dermatologie, Centre Hospitalo-Universitaire de Lille, Université de Lille 2, Lille, France
| | - Kevin Bihan
- Centre Régional de Pharmacovigilance, Service de Pharmacologie clinique, Hôpital Pitié-Salpétrière, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Bénédicte Lebrun-Vignes
- Centre Régional de Pharmacovigilance, Service de Pharmacologie clinique, Hôpital Pitié-Salpétrière, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Emilie Sbidian
- Service de Dermatologie, Assistance Publique-Hôpitaux de Paris, Hôpital Henri Mondor, Créteil, France; EpiDermE, Université Paris Est Créteil, Créteil, France; and Institut National de la Santé et de la Recherche Médicale, Centre d'Investigation Clinique 1430, Créteil, France
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