201
|
Placais L, Mekinian A, Bornes M, Poujol-Robert A, Bige N, Adedjouma A, Maury E, Fain O. Adult's onset Still disease occurring during pregnancy: Case report and literature review. Rev Med Interne 2017. [DOI: 10.1016/j.revmed.2017.10.190] [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]
|
202
|
Fraison J, Mahr A, Rivière S, Mura F, Jorgensen C, Lhote F, Dhôte R, Bourgarit-Durand A, Fain O, Mouthon L, Brézin A, Terrier B. Étude du tabagisme sur le phénotype et le pronostic de la maladie de Behçet : une étude multicentrique de 496 cas. Rev Med Interne 2017. [DOI: 10.1016/j.revmed.2017.10.375] [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]
|
203
|
Laurent C, Fain O, Mekinian A, Soussan M. Évaluation du TEP/IRM dans les vascularites des gros vaisseaux : étude monocentrique prospective. Rev Med Interne 2017. [DOI: 10.1016/j.revmed.2017.10.298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
|
204
|
Fraison J, Mahr A, Rivière S, Mura F, Jorgensen C, Lhote F, Dhôte R, Bourgarit-Durand A, Fain O, Mouthon L, Brézin A, Terrier B. Détermination de sous-classes phénotypiques de la maladie de Behçet par la méthode d’analyse « cluster » : une étude multicentrique de 496 cas. Rev Med Interne 2017. [DOI: 10.1016/j.revmed.2017.10.373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
|
205
|
Durtette C, Hachulla E, Resche-Rigon M, Papo T, Zénone T, Lioger B, Deligny C, Lambert M, Landron C, Pouchot J, Kahn JE, Lavigne C, De Wazieres B, Dhote R, Gondran G, Pertuiset E, Quemeneur T, Hamidou M, Sève P, Le Gallou T, Grasland A, Hatron PY, Fain O, Mekinian A. Cogan syndrome: Characteristics, outcome and treatment in a French nationwide retrospective study and literature review. Autoimmun Rev 2017; 16:1219-1223. [DOI: 10.1016/j.autrev.2017.10.005] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2017] [Accepted: 08/14/2017] [Indexed: 10/18/2022]
|
206
|
Mahevas T, Jachiet M, Servy A, Livideanu CB, Cribier B, Frances C, Le Moigne M, Sbidian E, Bouaziz JD, Descamps V, D’incan M, Humbert P, Beylot-Barry M, Passeron T, Arnulf B, Harel S, Sassolas B, de Moreuil C, Hermine O, Dupuy A, Barbarot S, Debardieux S, Carpentier O, Brault F, Schmutz JL, Thomas-Beaulieu D, Zarnitsky C, Limal N, Le-Bras F, Osio A, Battistella M, Tauber M, Mékinian A, Fain O. Caractéristiques clinicobiologiques, facteurs pronostiques et prise en charge thérapeutique du scléromyxœdème : étude rétrospective multicentrique. Ann Dermatol Venereol 2017. [DOI: 10.1016/j.annder.2017.09.157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
|
207
|
Thietart S, Rivière S, Mekinian A, Fain O. [Misleading headache..]. Rev Prat 2017; 67:987-990. [PMID: 30516909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Affiliation(s)
- Sara Thietart
- Service de médecine interne, hôpital Saint-Antoine (AP-HP), université Paris-6 (UPMC), Paris, France
| | - Sébastien Rivière
- Service de médecine interne, hôpital Saint-Antoine (AP-HP), université Paris-6 (UPMC), Paris, France
| | - Arsène Mekinian
- Service de médecine interne, hôpital Saint-Antoine (AP-HP), université Paris-6 (UPMC), Paris, France
| | - Olivier Fain
- Service de médecine interne, hôpital Saint-Antoine(AP-HP), université Paris-6 (UPMC),Paris, France
| |
Collapse
|
208
|
Javaud N, Fain O, Adnet F. Icatibant for ACE-inhibitor angioedema, an opportunity to treat the patients? J Allergy Clin Immunol Pract 2017; 5:1803. [PMID: 29122163 DOI: 10.1016/j.jaip.2017.07.039] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/19/2017] [Accepted: 07/25/2017] [Indexed: 10/18/2022]
Affiliation(s)
- Nicolas Javaud
- AP-HP, Urgences, Samu 93, Hôpital Avicenne, Université Paris 13, Bobigny, France; AP-HP, Urgences, Centre de référence sur les angiœdèmes à kinines (CRéAk), Hôpital Louis Mourier, Université Paris 7, Colombes, France.
| | - Olivier Fain
- AP-HP, Médecine Interne, DHUi2B, Centre de Référence associé sur les angiœdèmes à kinines (CRéAk), Hôpital Saint-Antoine, Université Paris 6, Paris, France
| | - Frédéric Adnet
- AP-HP, Urgences, Samu 93, Hôpital Avicenne, Université Paris 13, Bobigny, France
| |
Collapse
|
209
|
Jachiet V, Mekinian A, Carrat F, Grignano E, Retbi A, Boffa JJ, Ronco P, Rondeau E, Sellam J, Berenbaum F, Chazouillères O, Capron J, Alamowitch S, Chasset F, Frances C, Coppo P, Fain O. Autoimmune manifestations associated with lymphoma: characteristics and outcome in a multicenter retrospective cohort study. Leuk Lymphoma 2017; 59:1399-1405. [DOI: 10.1080/10428194.2017.1379075] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- Vincent Jachiet
- Service de Médecine Interne-(DHU i2B), Hôpital Saint-Antoine, APHP, Université Paris 06, Paris, France
| | - Arsène Mekinian
- Service de Médecine Interne-(DHU i2B), Hôpital Saint-Antoine, APHP, Université Paris 06, Paris, France
| | - Fabrice Carrat
- Sorbonne Universités, UPMC Université Paris 06, INSERM, Institut Pierre Louis d'épidémiologie et de Santé Publique (IPLESP UMRS 1136), Paris, France; Assistance Publique-Hôpitaux de Paris, Hôpital Saint Antoine, Unité de Santé Publique, Paris, France
| | - Eric Grignano
- Service de Médecine Interne-(DHU i2B), Hôpital Saint-Antoine, APHP, Université Paris 06, Paris, France
| | - Aurelia Retbi
- Département d’Information médicale, Hôpital Saint Antoine, APHP, Université Paris 06, Paris, France
| | - Jean-Jacques Boffa
- Service de Néphrologie et Dialyses, Hôpital Tenon, APHP, Université Paris 06, Paris France
| | - Pierre Ronco
- Service de Néphrologie et Dialyses, Hôpital Tenon, APHP, Université Paris 06, Paris France
| | - Eric Rondeau
- Urgences Néphrologiques et Transplantation Rénale, Hôpital Tenon, APHP, Université Paris 06, Paris, France
| | - Jérémie Sellam
- Service de Rhumatologie-(DHU i2B), Hôpital Saint Antoine, APHP, Université Paris 06, Inserm UMRS_938, Paris, France
| | - Francis Berenbaum
- Service de Rhumatologie-(DHU i2B), Hôpital Saint Antoine, APHP, Université Paris 06, Inserm UMRS_938, Paris, France
| | - Olivier Chazouillères
- Service d’Hépatologie, Hôpital Saint Antoine, APHP, Université Paris 06, Paris, France
| | - Jean Capron
- Service de Neurologie, Hôpital Saint Antoine, APHP, Université Paris 06, Paris, France
| | - Sonia Alamowitch
- Service de Neurologie, Hôpital Saint Antoine, APHP, Université Paris 06, Paris, France
| | - Francois Chasset
- Service de Dermatologie, Hôpital Tenon, APHP, Université Paris 06, Paris, France
| | - Camille Frances
- Service de Dermatologie, Hôpital Tenon, APHP, Université Paris 06, Paris, France
| | - Paul Coppo
- Service d'Hématologie, Centre de référence des Microangiopathies Thrombotiques, Hôpital Saint Antoine, APHP, Université Paris 06, Paris, France
| | - Olivier Fain
- Service de Médecine Interne-(DHU i2B), Hôpital Saint-Antoine, APHP, Université Paris 06, Paris, France
| | | |
Collapse
|
210
|
Mekinian A, Mahevas T, Mohty M, Jachiet V, Rivière S, Fain O, Gaugler B. Mucosal-associated Invariant Cells are Deficient in Systemic Sclerosis. Scand J Immunol 2017; 86:216-220. [DOI: 10.1111/sji.12585] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2017] [Accepted: 07/13/2017] [Indexed: 12/30/2022]
Affiliation(s)
- A. Mekinian
- Sorbonne Universités; UPMC Université Paris 06; INSERM; Centre de Recherche Saint-Antoine (CRSA); Paris France
- AP-HP; Hôpital Saint-Antoine; Service de Médecine Interne et de l'Inflammation-(DHU i2B); Université Paris 06; Paris France
| | - T. Mahevas
- AP-HP; Hôpital Saint-Antoine; Service de Médecine Interne et de l'Inflammation-(DHU i2B); Université Paris 06; Paris France
| | - M. Mohty
- Sorbonne Universités; UPMC Université Paris 06; INSERM; Centre de Recherche Saint-Antoine (CRSA); Paris France
- AP-HP; Hôpital Saint-Antoine; Service d'Hématologie; Université Paris 06; Paris France
| | - V. Jachiet
- AP-HP; Hôpital Saint-Antoine; Service de Médecine Interne et de l'Inflammation-(DHU i2B); Université Paris 06; Paris France
| | - S. Rivière
- AP-HP; Hôpital Saint-Antoine; Service de Médecine Interne et de l'Inflammation-(DHU i2B); Université Paris 06; Paris France
| | - O. Fain
- AP-HP; Hôpital Saint-Antoine; Service de Médecine Interne et de l'Inflammation-(DHU i2B); Université Paris 06; Paris France
| | - B. Gaugler
- Sorbonne Universités; UPMC Université Paris 06; INSERM; Centre de Recherche Saint-Antoine (CRSA); Paris France
| |
Collapse
|
211
|
Volle G, Fraison JB, Gobert D, Goulenok T, Dhote R, Fain O, Gonzalez-Chiappe S, Lhote F, Papo T, Thuillier A, Rivière S, Mahr A. Dietary and Nondietary Triggers of Oral Ulcer Recurrences in Behçet's Disease. Arthritis Care Res (Hoboken) 2017; 69:1429-1436. [PMID: 27863145 DOI: 10.1002/acr.23155] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2016] [Revised: 11/01/2016] [Accepted: 11/15/2016] [Indexed: 11/10/2022]
Abstract
OBJECTIVE The nature and impact of food and other external triggers in recurrences of Behçet's disease (BD)-related oral ulcers (OUs) remain unknown. This survey investigated dietary and nondietary triggers of BD-related OU recurrences. METHODS Patients with BD who were followed in 7 French hospital departments completed a self-administered patient questionnaire. General and specific dietary triggering factors were sought in open questions. The questionnaire also included closed questions, notably to evaluate the effect of 6 general triggering situations and 24 selected foods. The results were expressed as number (percentage) of positive responses. RESULTS Among the 101 questionnaires distributed, 81 were usable. Among the 81 patients, 96% fulfilled the International Criteria for Behçet's Disease classification criteria, and 53% qualified their OU recurrences during the previous 12 months as very discomforting or discomforting. For the 6 general situations suggested, 50 patients (62%) declared ≥1 as a "sure" trigger of OU recurrences. In both open and closed questions, the most frequent triggers were fatigue/stress (37-47% of patients) and food (32-35%). Among the 24 suggested foods, nuts (48%), pineapple (42%), peanuts (32%), Emmental cheese (30%), almonds (23%), lemons (22%), and other cheeses (21%) were the most frequently reported. The corresponding open question gave consistent findings but with lower frequencies. CONCLUSION Most patients can identify triggers of recurring BD-related OUs, with fatigue/stress and food representing the most frequent triggers. The management of OU must consider such external factors. The histamine-rich or -liberating properties of the commonly cited OU-triggering foods suggest a hyperreactivity mechanism.
Collapse
Affiliation(s)
- Geoffroy Volle
- Hospital Saint-Louis, University Paris Diderot, Paris, France
| | - Jean-Baptiste Fraison
- Hospital Saint-Louis, University Paris Diderot, Paris, and Hospital Jean Verdier, University Leonard de Vinci, Bondy, France
| | - Delphine Gobert
- Hospital Saint Antoine, University Pierre et Marie Curie, Paris, France
| | | | - Robin Dhote
- Hospital Avicenne, University Leonard de Vinci, Bobigny, France
| | - Olivier Fain
- Hospital Saint Antoine, University Pierre et Marie Curie, Paris, France
| | | | | | - Thomas Papo
- Hospital Bichat, University Paris Diderot, Paris, France
| | | | - Sophie Rivière
- Hospital Saint-Eloi, University Montpellier, Montpellier, France
| | - Alfred Mahr
- Hospital Saint-Louis, University Paris Diderot, and Sorbonne Paris Cité Research Center UMR 1153, Inserm, Paris, France
| |
Collapse
|
212
|
Hommada M, Mekinian A, Brillet PY, Abad S, Larroche C, Dhôte R, Fain O, Soussan M. Aortitis in giant cell arteritis: diagnosis with FDG PET/CT and agreement with CT angiography. Autoimmun Rev 2017; 16:1131-1137. [PMID: 28911987 DOI: 10.1016/j.autrev.2017.09.008] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2017] [Accepted: 08/12/2017] [Indexed: 02/07/2023]
Abstract
OBJECTIVES To assess the detection rate of aortitis in giant cell arteritis (GCA) with fluorodeoxyglucose positron emission tomography/computed tomography (PET) and to compare the findings with CT angiography (CTA). METHODS Fifty-two GCA patients and 27 controls were included. GCA patients had a PET scan at diagnosis (35/52) or during relapse (17/52). Concomitant CTA was performed in 35/52 patients. Aortitis was defined as FDG uptake higher than the liver for PET and wall thickness≥3mm for CTA. Agreement between PET and CTA was evaluated by the kappa coefficient and Spearman correlation coefficient. RESULTS Aortitis was diagnosed using PET in 40% (14/35) of patients at diagnosis and in 0% of controls (0/27). Agreement was perfect between PET and CT at a patient-based level, and very good at a vascular segment-based level (kappa: 0.72 to 1). PET was positive in 35% (6/17) of patients scanned during GCA relapse, showing aortitis (n=4) and/or articular uptake (n=4). Discrepancies between PET and CT were observed only in relapsing GCA (n=3). Correlation between the maximum standardized uptake value and wall thickness was moderate at diagnosis (r: 0.57 to 0.7) and not statistically significant during relapse. CONCLUSIONS The detection rate of aortitis in GCA patients using PET is 40%, approximately in the range of CTA rates, suggesting that the two techniques have similar sensitivity. PET seems valuable in relapsing GCA, allowing the detection of vascular and articular activities.
Collapse
Affiliation(s)
- Mona Hommada
- Department of Nuclear Medicine, Hôpital Avicenne, Université Paris 13, Assistance Publique - Hôpitaux de Paris, Bobigny, France
| | - Arsène Mekinian
- Department of Internal Medicine, Inflammation-Immunopathology-Biotherapy Department (DHU i2B), Assistance Publique - Hôpitaux de Paris, Hôpital Saint-Antoine, UPMC University Paris 06, Paris, France
| | - Pierre-Yves Brillet
- Department of Radiology, Hôpital Avicenne, Université Paris 13, Assistance Publique - Hôpitaux de Paris, Bobigny, France
| | - Sébastien Abad
- Department of Internal Medicine, Hôpital Avicenne, Université Paris 13, Assistance Publique - Hôpitaux de Paris, Bobigny, France
| | - Claire Larroche
- Department of Internal Medicine, Hôpital Avicenne, Université Paris 13, Assistance Publique - Hôpitaux de Paris, Bobigny, France
| | - Robin Dhôte
- Department of Internal Medicine, Hôpital Avicenne, Université Paris 13, Assistance Publique - Hôpitaux de Paris, Bobigny, France
| | - Olivier Fain
- Department of Internal Medicine, Inflammation-Immunopathology-Biotherapy Department (DHU i2B), Assistance Publique - Hôpitaux de Paris, Hôpital Saint-Antoine, UPMC University Paris 06, Paris, France
| | - Michael Soussan
- Department of Nuclear Medicine, Hôpital Avicenne, Université Paris 13, Assistance Publique - Hôpitaux de Paris, Bobigny, France.
| |
Collapse
|
213
|
Mekinian A, Dervin G, Lapidus N, Kahn JE, Terriou L, Liozon E, Grignano E, Piette JC, Rauzy OB, Grobost V, Godmer P, Gillard J, Rossignol J, Launay D, Aouba A, Cardon T, Bouillet L, Broner J, Vinit J, Ades L, Carrat F, Salvado C, Toussirot E, Versini M, Costedoat-Chalumeau N, Fraison JB, Guilpain P, Fenaux P, Fain O. Biologics in myelodysplastic syndrome-related systemic inflammatory and autoimmune diseases: French multicenter retrospective study of 29 patients. Autoimmun Rev 2017; 16:903-910. [DOI: 10.1016/j.autrev.2017.07.003] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2017] [Accepted: 05/17/2017] [Indexed: 12/23/2022]
|
214
|
|
215
|
Wesner N, Laoubi K, Rebert S, Adedjouma A, Mekinian A, Fain O. [Adult Kawasaki disease]. Rev Prat 2017; 67:748. [PMID: 30512771] [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] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Affiliation(s)
- Nadège Wesner
- Service de médecine interne, hôpital Saint-Antoine (AP-HP) université Paris-6, 75012 Paris
| | - Khaled Laoubi
- Hôpital privé de la Seine-Saint-Denis, Le Blanc-Mesnil, France
| | - Sarah Rebert
- Service de médecine interne, hôpital Saint-Antoine (AP-HP) université Paris-6, 75012 Paris
| | - Amir Adedjouma
- Service de médecine interne, hôpital Saint-Antoine (AP-HP) université Paris-6, 75012 Paris
| | - Arsene Mekinian
- Service de médecine interne, hôpital Saint-Antoine (AP-HP) université Paris-6, 75012 Paris
| | - Olivier Fain
- Service de médecine interne, hôpital Saint-Antoine (AP-HP) université Paris-6, 75012 Paris
| |
Collapse
|
216
|
Kone-Paut I, Quartier P, Fain O, Grateau G, Pillet P, Le Blay P, Bonnet F, Despert V, Stankovic-Stojanovic K, Willemin L, Quéré S, Reigneau O, Hachulla E. Real-World Experience and Impact of Canakinumab in Cryopyrin-Associated Periodic Syndrome: Results From a French Observational Study. Arthritis Care Res (Hoboken) 2017; 69:903-911. [PMID: 27635935 DOI: 10.1002/acr.23083] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2016] [Revised: 07/04/2016] [Accepted: 09/06/2016] [Indexed: 11/09/2022]
Abstract
OBJECTIVE The ENVOL study was designed to assess the psychosocial impact of disease and therapy in a French cohort of cryopyrin-associated periodic syndromes (CAPS) patients (and caregivers) treated with canakinumab. METHODS The ENVOL study was a multicenter, observational study of CAPS patients given ≥1 canakinumab dose. Data were collected before treatment, at 6 and 12 months afterward, and at the last visit. Patients and caregivers completed questionnaires assessing changes from the 12 months of pretreatment to 12 months prior to interview. Data were analyzed retrospectively. RESULTS The study included 10 physicians and 68 patients (53 adults, 15 children). Sixty-five patients (95.6%) were still receiving canakinumab at the last visit (median 5 years after starting therapy). The mean ± SD score for patient-reported general health increased from 7 ± 2.9 before canakinumab to 2.7 ± 2.7 after treatment (P < 0.001). Physical and emotional symptoms resolved or improved in a substantial proportion of patients, including bodily pain (38 of 46 patients), fever (32 of 39), skin disease (35 of 41), fatigue (31 of 47), self-confidence (29 of 46), and energy (34 of 47). Social activity, relationships, sexuality, and energy measures improved in >40% of respondents. Caregivers spent a median of 3 versus 0.5 hours/week on care in the 12 months of pretreatment versus 12 months prior to interview (P < 0.001). Following treatment, patients required fewer consultations with general practitioners (mean ± SD per patient per year: 5.2 ± 7.4 versus 8.5 ± 7.2 pretreatment), internists/rheumatologists/dermatologists (2.0 ± 2.1 versus 3.7 ± 3.9), and pediatricians (1.8 ± 1.5 versus 4.4 ± 4.2). CONCLUSION Long-term treatment with canakinumab achieves a highly relevant improvement in the physical, emotional, and social lives of patients with CAPS, accompanied by a marked reduction in support required from caregivers and in health care consultations.
Collapse
Affiliation(s)
- I Kone-Paut
- CEREMAI, Hôpital Bicêtre, APHP, University of Paris Sud, Saclay, Le Kremlin Bicêtre, France
| | - P Quartier
- Université Paris-Descartes-Sorbonne Paris, Institut IMAGINE, Hôpital Necker-Enfants Malades, Assistance Publique Hôpitaux de Paris, Paris, France
| | - O Fain
- Hôpital Saint Antoine, Paris, France
| | - G Grateau
- Hôpital Tenon, DHU I2B, Paris, France
| | - P Pillet
- Hôpital Pellegrin, Bordeaux, France
| | - P Le Blay
- Clinique Hôpital Lapeyronie, Montpellier, France
| | - F Bonnet
- Hôpital Saint André, Bordeaux, France
| | | | | | - L Willemin
- Novartis Pharma SAS, Rueil-Malmaison, France
| | - S Quéré
- Novartis Pharma SAS, Rueil-Malmaison, France
| | - O Reigneau
- Novartis Pharma SAS, Rueil-Malmaison, France
| | - E Hachulla
- Hôpital Huriez, CHRU de Lille, FHU IMMINeNT, Université de Lille, France
| |
Collapse
|
217
|
Gérard AL, Cohen-Bittan J, Fenaux P, Leroux G, Verny M, Fain O, Boddaert J, Zerah L. Myelodysplastic Syndrome and Giant Cell Arteritis: A Nonfortuitous Association that Geriatricians Should Know About. J Am Geriatr Soc 2017; 65:2335-2337. [PMID: 28804869 DOI: 10.1111/jgs.15040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Anne-Laure Gérard
- Department of Geriatrics, Unit of Peri-Operative Geriatric Care, Hôpital Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Judith Cohen-Bittan
- Department of Geriatrics, Unit of Peri-Operative Geriatric Care, Hôpital Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Pierre Fenaux
- Department of Senior Hematology, Hôpital Saint Louis, Paris 7 University, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Gaëlle Leroux
- Department of Internal Medicine, Hôpital Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Marc Verny
- Department of Geriatrics, Unit of Peri-Operative Geriatric Care, Hôpital Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris, Paris, France.,University Pierre and Marie Curie Paris 06, University Hospital Department Fight Aging and Stress, UMR 8256, Paris, France
| | - Olivier Fain
- Department of Internal Medicine, Hôpital Saint Antoine, University Pierre and Marie Curie Paris 06, DHU i2B, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Jacques Boddaert
- Department of Geriatrics, Unit of Peri-Operative Geriatric Care, Hôpital Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris, Paris, France.,University Pierre and Marie Curie Paris 06, University Hospital Department Fight Aging and Stress, UMR 8256, Paris, France
| | - Lorene Zerah
- Department of Geriatrics, Unit of Peri-Operative Geriatric Care, Hôpital Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris, Paris, France.,University Pierre and Marie Curie Paris 06, University Hospital Department Fight Aging and Stress, UMR 8256, Paris, France
| |
Collapse
|
218
|
Duchemann B, Annesi-Maesano I, Jacobe de Naurois C, Sanyal S, Brillet PY, Brauner M, Kambouchner M, Huynh S, Naccache JM, Borie R, Piquet J, Mekinian A, Virally J, Uzunhan Y, Cadranel J, Crestani B, Fain O, Lhote F, Dhote R, Saidenberg-Kermanac'h N, Rosental PA, Valeyre D, Nunes H. Prevalence and incidence of interstitial lung diseases in a multi-ethnic county of Greater Paris. Eur Respir J 2017; 50:50/2/1602419. [PMID: 28775045 DOI: 10.1183/13993003.02419-2016] [Citation(s) in RCA: 153] [Impact Index Per Article: 21.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2016] [Accepted: 04/26/2017] [Indexed: 12/13/2022]
Abstract
The objective of the study was to estimate the prevalence and incidence of interstitial lung diseases (ILDs) in Seine-Saint-Denis, a multi-ethnic county of Greater Paris, France.Patients with ILDs were identified between January and December 2012 by using several sources; all potentially involved medical specialists from public and private hospitals, community-based pulmonologists and general practitioners, and the Social Security system. Diagnoses were validated centrally by an expert multidisciplinary discussion.1170 ILD cases were reported (crude overall prevalence: 97.9/105 and incidence: 19.4/105/year). In the 848 reviewed cases, the most prevalent diagnoses were sarcoidosis (42.6%), connective tissue diseases associated ILDs (CTDs-ILDs) (16%), idiopathic pulmonary fibrosis (IPF) (11.6%), and occupational ILDs (5.0%), which corresponded to a crude prevalence of 30.2/105 for sarcoidosis, 12.1/105 for CTDs-ILDs and 8.2/105 for IPF. The prevalence of fibrotic idiopathic interstitial pneumonias, merging IPF, nonspecific interstitial pneumonia and cases registered with code J84.1 was 16.34/105 An adjusted multinomial model demonstrated an increased risk of sarcoidosis in North Africans and Afro-Caribbeans and of CTDs-ILDs in Afro-Caribbeans, compared to that in Europeans.This study, with a comprehensive recruitment and stringent diagnostic criteria, emphasises the importance of secondary ILDs, particularly CTDs-ILDs and the relatively low prevalence of IPF, and confirms that sarcoidosis is a rare disease in France.
Collapse
Affiliation(s)
- Boris Duchemann
- Assistance Publique - Hôpitaux de Paris, Service de Pneumologie, Hôpital Avicenne, Bobigny, France.,Université Paris 13, Sorbonne Paris Cité, EA2363 'hypoxie et poumon', Paris, France
| | - Isabella Annesi-Maesano
- Sorbonne Universités, UPMC Univ Paris 06, INSERM, Pierre Louis Institute of Epidemiology and Public Health (IPLESP UMRS 1136), Epidemiology of Allergic and Respiratory Diseases Department (EPAR), Saint-Antoine Medical School, Paris, France
| | | | - Shreosi Sanyal
- Sorbonne Universités, UPMC Univ Paris 06, INSERM, Pierre Louis Institute of Epidemiology and Public Health (IPLESP UMRS 1136), Epidemiology of Allergic and Respiratory Diseases Department (EPAR), Saint-Antoine Medical School, Paris, France
| | - Pierre-Yves Brillet
- Université Paris 13, Sorbonne Paris Cité, EA2363 'hypoxie et poumon', Paris, France.,Assistance Publique - Hôpitaux de Paris, Service de Radiologie, Hôpital Avicenne, Bobigny, France
| | - Michel Brauner
- Assistance Publique - Hôpitaux de Paris, Service de Radiologie, Hôpital Avicenne, Bobigny, France
| | - Marianne Kambouchner
- Assistance Publique - Hôpitaux de Paris, Service d'Anatomie Pathologique, Hôpital Avicenne, Bobigny, France
| | - Sophie Huynh
- Service de Pneumologie, Hôpital Robert Ballanger, Aulnay sous-bois, France
| | - Jean Marc Naccache
- Assistance Publique - Hôpitaux de Paris, Service de Pneumologie, Hôpital Tenon, Paris, France
| | - Raphael Borie
- Assistance Publique - Hôpitaux de Paris, Service de Pneumologie A, Hôpital Bichat, Paris, France
| | - Jacques Piquet
- Service de Pneumologie, Hôpital de Monfermeil, Montfermeil, France
| | - Arsène Mekinian
- Assistance Publique - Hôpitaux de Paris, Service de Médecine Interne, Hôpital Jean Verdier, Bondy, France
| | - Jerôme Virally
- Service de Pneumologie, Hôpital Robert Ballanger, Aulnay sous-bois, France
| | - Yurdagul Uzunhan
- Assistance Publique - Hôpitaux de Paris, Service de Pneumologie, Hôpital Avicenne, Bobigny, France.,Université Paris 13, Sorbonne Paris Cité, EA2363 'hypoxie et poumon', Paris, France
| | - Jacques Cadranel
- Assistance Publique - Hôpitaux de Paris, Service de Pneumologie, Hôpital Tenon, Paris, France
| | - Bruno Crestani
- Assistance Publique - Hôpitaux de Paris, Service de Pneumologie A, Hôpital Bichat, Paris, France
| | - Olivier Fain
- Assistance Publique - Hôpitaux de Paris, Service de Médecine Interne, Hôpital Jean Verdier, Bondy, France
| | - Francois Lhote
- Service de Médecine Interne, Hôpital de Saint-Denis, Saint-Denis, France
| | - Robin Dhote
- Assistance Publique - Hôpitaux de Paris, Service de Médecine Interne, Hôpital Avicenne, Bobigny, France
| | | | | | - Dominique Valeyre
- Assistance Publique - Hôpitaux de Paris, Service de Pneumologie, Hôpital Avicenne, Bobigny, France.,Université Paris 13, Sorbonne Paris Cité, EA2363 'hypoxie et poumon', Paris, France
| | - Hilario Nunes
- Assistance Publique - Hôpitaux de Paris, Service de Pneumologie, Hôpital Avicenne, Bobigny, France .,Université Paris 13, Sorbonne Paris Cité, EA2363 'hypoxie et poumon', Paris, France
| |
Collapse
|
219
|
Zanichelli A, Longhurst HJ, Maurer M, Bouillet L, Aberer W, Fabien V, Andresen I, Caballero T, Grumach A, Bygum A, Blanchard Delaunay C, Bouillet L, Coppere B, Fain O, Goichot B, Gompel A, Guez S, Jeandel P, Kanny G, Launay D, Maillard H, Martin L, Masseau A, Ollivier Y, Sobel A, Arnolds J, Aygören-Pürsün E, Baş M, Bauer A, Bork K, Martinez I, Maurer M, Papadopoulou-Alataki E, Psarros F, Graif Y, Kivity S, Reshef A, Toubi E, Arcoleo F, Cicardi M, Manconi P, Marone G, Montinaro V, Baeza M, Caballero T, Cabañas R, Guilarte M, Hernandez de Rojas D, Hernando de Larramendi C, Lleonart R, Lobera T, Sáenz de San Pedro B, Bjorkander J, Helbert M, Longhurst H. Misdiagnosis trends in patients with hereditary angioedema from the real-world clinical setting. Ann Allergy Asthma Immunol 2017; 117:394-398. [PMID: 27742086 DOI: 10.1016/j.anai.2016.08.014] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2016] [Revised: 08/05/2016] [Accepted: 08/10/2016] [Indexed: 10/20/2022]
Abstract
BACKGROUND Hereditary angioedema due to C1 inhibitor deficiency (C1-INH-HAE) causes swelling in the skin and upper airways and pain in the abdomen because of mucosal swelling. C1-INH-HAE is frequently misdiagnosed, leading to delays in diagnosis, inadequate treatment, and unnecessary procedures. OBJECTIVE To evaluate the history of misdiagnosis in patients participating in the Icatibant Outcome Survey (IOS). METHODS The IOS is an observational study in which safety and effectiveness of icatibant have been evaluated since 2009. As part of the IOS, patients record any misdiagnoses received before being diagnosed as having C1-INH-HAE. RESULTS In January 2016, a total of 418 of 633 IOS patients with C1-INH-HAE type I or II had provided misdiagnosis data. Of these, 185 of 418 (44.3%) received 1 or more prior misdiagnoses. The most common misdiagnoses were allergic angioedema (103 of 185) and appendicitis (50 of 185). A variety of other misdiagnoses were reported, including a substantial number of gastrointestinal disorders (excluding appendicitis). Misdiagnosis rates were similar between males (41.1%) and females (46.5%) and between C1-INH-HAE type I (43.7%) and type II (51.6%). Patients with family members diagnosed as having C1-INH-HAE were significantly less likely to be misdiagnosed than patients without a family history (140 of 366 [41.7%] vs 38 of 58 [65.5%], respectively; P = .001). Patients with a prior misdiagnosis had longer median delay to C1-INH-HAE diagnosis (13.3 years) than patients without (1.7 years; P < .001). CONCLUSION From this large database, approximately 50% of patients with C1-INH-HAE type I or II have previously had their conditions misdiagnosed, most commonly as allergic angioedema or appendicitis. Misdiagnosis results in marked delays in receiving the correct diagnosis, during which time patients cannot access effective, lifesaving treatment. TRIAL REGISTRATION ClinicalTrials.gov: NCT01034969.
Collapse
Affiliation(s)
- Andrea Zanichelli
- Department of Biomedical and Clinical Sciences Luigi Sacco, University of Milan, ASST Fatebenefratelli Sacco, Milan, Italy.
| | - Hilary J Longhurst
- Department of Immunology, Barts Health NHS Trust, London, United Kingdom
| | - Marcus Maurer
- Department of Dermatology and Allergy, Allergie-Centrum-Charité, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Laurence Bouillet
- National Reference Centre for Angioedema, Internal Medicine Department, Grenoble University Hospital, Grenoble, France
| | - Werner Aberer
- Department of Dermatology and Venereology, Medical University of Graz, Graz, Austria
| | | | | | - Teresa Caballero
- Allergy Department, Hospital La Paz Institute for Health Research, Biomedical Research Network on Rare Diseases (CIBERER, U754), Madrid, Spain
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
220
|
Heidelberger V, Ingen-Housz-Oro S, Marquet A, Mahevas M, Bessis D, Bouillet L, Caux F, Chapelon-Abric C, Debarbieux S, Delaporte E, Duval-Modeste AB, Fain O, Joly P, Marchand-Adam S, Monfort JB, Noël N, Passeron T, Ruivard M, Sarrot-Reynauld F, Verrot D, Bouvry D, Fardet L, Chosidow O, Sève P, Valeyre D. Efficacy and Tolerance of Anti-Tumor Necrosis Factor α Agents in Cutaneous Sarcoidosis: A French Study of 46 Cases. JAMA Dermatol 2017; 153:681-685. [PMID: 28564695 DOI: 10.1001/jamadermatol.2017.1162] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Importance Evidence for the long-term efficacy and safety of anti-tumor necrosis factor α agents (anti-TNF) in treating cutaneous sarcoidosis is lacking. Objective To determine the efficacy and safety of anti-TNF in treating cutaneous sarcoidosis in a large observational study. Design, Setting, and Participants STAT (Sarcoidosis Treated with Anti-TNF) is a French retrospective and prospective multicenter observational database that receives data from teaching hospitals and referral centers, as well as several pneumology, dermatology, and internal medicine departments. Included patients had histologically proven sarcoidosis and received anti-TNF between January 2004 and January 2016. We extracted data for patients with skin involvement at anti-TNF initiation. Main Outcomes and Measures Response to treatment was evaluated for skin and visceral involvement using the ePOST (extra-pulmonary Physician Organ Severity Tool) severity score (from 0 [not affected] to 6 [very severe involvement]). Epidemiological and cutaneous features at baseline, efficacy, steroid-sparing, safety, and relapses were recorded. The overall cutaneous response rate (OCRR) was defined as complete (final cutaneous ePOST score of 0 or 1) or partial response (ePOST drop ≥2 points from baseline but >1 at last follow-up). Results Among 140 patients in the STAT database, 46 had skin involvement. The most frequent lesions were lupus pernio (n = 21 [46%]) and nodules (n = 20 [43%]). The median cutaneous severity score was 5 and/or 6 at baseline. Twenty-one patients were treated for skin involvement and 25 patients for visceral involvement. Reasons for initiating anti-TNF were failure or adverse effects of previous therapy in 42 patients (93%). Most patients received infliximab (n = 40 [87%]), with systemic steroids in 28 cases (61%) and immunosuppressants in 32 cases (69.5%). The median (range) follow-up was 45 (3-103) months. Of the 46 patients with sarcoidosis and skin involvement who were treated with anti-TNF were included, median (range) age was 50 (14-78) years, and 33 patients (72%) were women. The OCRR was 24% after 3 months, 46% after 6 months, and 79% after 12 months. Steroid sparing was significant. Treatment was discontinued because of adverse events in 11 patients (24%), and 21 infectious events occurred in 14 patients (30%). Infections were more frequent in patients treated for visceral involvement than in those treated for skin involvement (n = 12 of 25 [48%] vs n = 2 of 21 [9.5%], respectively; P = .02). The relapse rate was 44% 18 months after discontinuation of treatment. Relapses during treatment occurred in 35% of cases, mostly during anti-TNF or concomitant treatment tapering. Conclusions and Relevance Anti-TNF agents are effective but suspensive in cutaneous sarcoidosis. The risk of infectious events must be considered.
Collapse
Affiliation(s)
| | - Saskia Ingen-Housz-Oro
- Department of Dermatology, AP-HP Hôpital Henri Mondor, Créteil, France2Department of Dermatology, EA 7379 - EpiDermE, Université Paris Est, Créteil, France
| | - Alicia Marquet
- Department of Internal Medicine, Hôpital de la Croix-Rousse, Lyon, France
| | - Matthieu Mahevas
- Department of Internal Medicine, APHP Hôpital Henri Mondor, Créteil, France
| | - Didier Bessis
- Department of Dermatology, Hôpital Saint-Eloi, Montpellier, France
| | - Laurence Bouillet
- Department of Internal Medicine, Centre hospitalier universitaire de Grenoble-Alpes, Grenoble, France
| | - Frédéric Caux
- Department of Dermatology, APHP Hôpital Avicenne, Bobigny, France
| | | | | | | | | | - Olivier Fain
- Department of Internal Medicine, APHP Hôpital Saint-Antoine, Paris, France
| | - Pascal Joly
- Department of Dermatology, Hôpital Charles Nicolle, Rouen, France
| | | | | | - Nicolas Noël
- Department of Internal Medicine, APHP Hôpital Bicêtre Le Kremlin-Bicêtre, France
| | | | - Marc Ruivard
- Department of Internal Medicine, Hôpital Estaing, Clermont-Ferrand, France
| | - Françoise Sarrot-Reynauld
- Department of Internal Medicine, Centre hospitalier universitaire de Grenoble-Alpes, Grenoble, France
| | - Denis Verrot
- Department of Internal Medicine, Hôpital Saint-Joseph, Marseille, France
| | - Diane Bouvry
- Department of Pneumology, APHP Hôpital Avicenne, Bobigny, France
| | - Laurence Fardet
- Department of Dermatology, AP-HP Hôpital Henri Mondor, Créteil, France2Department of Dermatology, EA 7379 - EpiDermE, Université Paris Est, Créteil, France20Department of Dermatology, Université Paris Est UPEC, Créteil, France
| | - Olivier Chosidow
- Department of Dermatology, AP-HP Hôpital Henri Mondor, Créteil, France2Department of Dermatology, EA 7379 - EpiDermE, Université Paris Est, Créteil, France20Department of Dermatology, Université Paris Est UPEC, Créteil, France
| | - Pascal Sève
- Department of Internal Medicine, Hôpital de la Croix-Rousse, Lyon, France
| | | |
Collapse
|
221
|
Plaçais L, Mekinian A, Bornes M, Poujol-Robert A, Bigé N, Maury E, Fain O. Adult onset Still's disease occurring during pregnancy: Case-report and literature review. Semin Arthritis Rheum 2017; 47:575-577. [PMID: 28781105 DOI: 10.1016/j.semarthrit.2017.07.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2017] [Accepted: 07/07/2017] [Indexed: 10/19/2022]
Abstract
INTRODUCTION Adult onset Still's disease is a rare affection classified among non-hereditary autoinflammatory diseases. We here report a case of AOSD revealed during pregnancy with a life-threatening presentation along with a review of 19 cases from literature. CASE A 38-years old woman was treated in our department for diffuse systemic sclerosis and associated Sjögren syndrome. She was pregnant and presented with acute fever and arthralgias. Laboratory data revealed mild liver cytolysis but a large screening for infectious and auto-immune diseases was negative and hepato-biliar imaging was normal. Ferritin levels were at 41 000 ng/mL with glycosylated ferritin less than 5%. The diagnosis of AOSD was stated and because of persistent fever and polyarthralgias, after exclusion of active infection, steroids were started (prednisone 1 mg/kg) associated with colchicine, which allowed clinical remission and C-reactive protein significant decrease. CONCLUSION Pregnancy-revealed AOSD appears to be a specifical subset of the disease with a systemic course, flares on first and second trimester, obstetrical complications such as prematurity and IUGR sometimes leading to life-threatening situations requiring parenteral corticotherapy and intravenous immunoglobulins.
Collapse
Affiliation(s)
- Léo Plaçais
- Service de Médecine Interne and Inflammation-Immunopathology-Biotherapy Department (DHU i2B), AP-HP, Hôpital Saint-Antoine, Sorbonne Universités, UPMC University Paris 06, F-75012, Paris, France
| | - Arsène Mekinian
- Service de Médecine Interne and Inflammation-Immunopathology-Biotherapy Department (DHU i2B), AP-HP, Hôpital Saint-Antoine, Sorbonne Universités, UPMC University Paris 06, F-75012, Paris, France.
| | - Marie Bornes
- AP-HP, Hôpital Tenon, Service de Gynécologie et d'Obstétrique, UPMC University Paris 06, Paris, France
| | - Armelle Poujol-Robert
- AP-HP, Hôpital Saint-Antoine, Service de Hépatologie, UPMC University Paris 06, Paris, France
| | - Naiké Bigé
- AP-HP, Hôpital Saint-Antoine, Service de Réanimation Médicale, UPMC University Paris 06, Paris, France
| | - Eric Maury
- AP-HP, Hôpital Saint-Antoine, Service de Réanimation Médicale, UPMC University Paris 06, Paris, France
| | - Olivier Fain
- Service de Médecine Interne and Inflammation-Immunopathology-Biotherapy Department (DHU i2B), AP-HP, Hôpital Saint-Antoine, Sorbonne Universités, UPMC University Paris 06, F-75012, Paris, France
| |
Collapse
|
222
|
Le Burel S, Champiat S, Mateus C, Marabelle A, Michot JM, Robert C, Belkhir R, Soria JC, Laghouati S, Voisin AL, Fain O, Mékinian A, Coutte L, Szwebel TA, Dunogeant L, Lioger B, Luxembourger C, Mariette X, Lambotte O. Prevalence of immune-related systemic adverse events in patients treated with anti-Programmed cell Death 1/anti-Programmed cell Death-Ligand 1 agents: A single-centre pharmacovigilance database analysis. Eur J Cancer 2017. [PMID: 28646772 DOI: 10.1016/j.ejca.2017.05.032] [Citation(s) in RCA: 123] [Impact Index Per Article: 17.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
AIM The growing use of immune checkpoint inhibitors (ICIs) is associated with the occurrence of immune-related adverse events (irAEs). Few data are published on systemic, immunohaematological and rheumatic irAEs. In a pharmacovigilance database analysis, we screened for these irAEs and calculated their prevalence. PATIENTS AND METHODS Participants were recruited via Registre des Effets Indésirables Sévères des Anticorps Monoclonaux Immunomodulateurs en Cancérologie (REISAMIC)1 a French registry of grade ≥2 irAEs occurring in ICI-treated patients. The pathologies of interest were systemic autoimmune and inflammatory diseases, rheumatic diseases and immune cytopenia. RESULTS Out of 908 patients treated with anti-Programmed cell Death 1 (PD1)/anti-Programmed cell Death-Ligand 1 (PD-L1) agents (together with an anti-cytotoxic T-lymphocyte antigen-4 (CTLA-4) agent in 40 cases) between December 2012 and December 2016 at a single centre, 21 patients experienced systemic irAEs. The types and the prevalence of irAEs were as follows: immune thrombocytopenia (0.2%), Sjögren syndrome (0.3%), rheumatoid arthritis (0.2%), polymyalgia rheumatica (0.2%), psoriatic arthritis (0.2%), seronegative polyarthritis (0.7%) and sarcoidosis (0.2%). Patients with Sjögren syndrome or seronegative polyarthritis were more likely to have received combination therapy with ipilimumab (2.5% for both). We described these 21 cases, together with nine additional cases from five other centres. Most irAE were moderately severe (grade 2, 63%). The median time to onset was 57°days (interquartile range (IQR) 24-117). The ICI was withdrawn in 12 cases, 25 patients (83%) received corticosteroids, and five patients (17%) received immunosuppressant/immunomodulatory agents. The irAEs resolved fully or partially in 28 cases (93%). CONCLUSION Although systemic, immunohaematological and rheumatic diseases are rarely associated with ICI use, the prevalence is higher when two ICIs are combined. Corticosteroids are often effective and may enable the continued administration of ICIs. Studies designed to identify at-risk patients are warranted.
Collapse
Affiliation(s)
- Sébastien Le Burel
- Assistance Publique - Hôpitaux de Paris, Hôpital Bicêtre, Service de Médecine Interne et Immunologie Clinique, F-94275 Le Kremlin-Bicêtre, France
| | - Stéphane Champiat
- Département D'Innovation Thérapeutique et des Essais Précoces (DITEP), Gustave Roussy, Université Paris Saclay, F-94805 Villejuif, France; INSERM U981, F-94805 Villejuif, France
| | - Christine Mateus
- Département de Dermatologie, Institut Gustave Roussy, F-94805 Villejuif, France
| | - Aurélien Marabelle
- Département D'Innovation Thérapeutique et des Essais Précoces (DITEP), Gustave Roussy, Université Paris Saclay, F-94805 Villejuif, France; INSERM U981, F-94805 Villejuif, France
| | - Jean-Marie Michot
- Département D'Innovation Thérapeutique et des Essais Précoces (DITEP), Gustave Roussy, Université Paris Saclay, F-94805 Villejuif, France
| | - Caroline Robert
- Département de Dermatologie, Institut Gustave Roussy, F-94805 Villejuif, France
| | - Rakiba Belkhir
- Assistance Publique - Hôpitaux de Paris, Hôpital Bicêtre, Service de Rhumatologie, F-94275 Le Kremlin-Bicêtre, France
| | - Jean-Charles Soria
- Département D'Innovation Thérapeutique et des Essais Précoces (DITEP), Gustave Roussy, Université Paris Saclay, F-94805 Villejuif, France; INSERM U981, F-94805 Villejuif, France
| | - Salim Laghouati
- Unité Fonctionnelle de Pharmacovigilance, Institut Gustave Roussy, F-94805 Villejuif, France
| | - Anne-Laure Voisin
- Unité Fonctionnelle de Pharmacovigilance, Institut Gustave Roussy, F-94805 Villejuif, France
| | - Olivier Fain
- Assistance Publique - Hôpitaux de Paris, Hôpital Saint-Antoine, Service de Médecine Interne, DHU I2B, Université Paris 6, F-75012 Paris, France
| | - Arsène Mékinian
- Assistance Publique - Hôpitaux de Paris, Hôpital Saint-Antoine, Service de Médecine Interne, DHU I2B, Université Paris 6, F-75012 Paris, France
| | - Laetitia Coutte
- Assistance Publique - Hôpitaux de Paris, Hôpital Cochin, Service de Médecine Interne, F-75014 Paris, France
| | - Tali-Anne Szwebel
- Assistance Publique - Hôpitaux de Paris, Hôpital Cochin, Service de Médecine Interne, F-75014 Paris, France
| | - Laetitia Dunogeant
- Center Hospitalier Du Pays D'Aix, Service de Rhumatologie et Médecine Interne, F-13616 Aix en Provence, France
| | - Bertrand Lioger
- CHRU de Tours, Hôpital Bretonneau, Service de Médecine Interne, F-37044 Tours, France
| | - Cécile Luxembourger
- CHU de Toulouse, Hôpital Pierre-Paul Ricquet, Center de Rhumatologie, F-31059 Toulouse, France
| | - Xavier Mariette
- Assistance Publique - Hôpitaux de Paris, Hôpital Bicêtre, Service de Rhumatologie, F-94275 Le Kremlin-Bicêtre, France; INSERM, U1184, Immunology of Viral Infections and Autoimmune Diseases, F-94276 Le Kremlin-Bicêtre, France; Université Paris Sud, UMR 1184, F-94276 Le Kremlin-Bicêtre, France
| | - Olivier Lambotte
- Assistance Publique - Hôpitaux de Paris, Hôpital Bicêtre, Service de Médecine Interne et Immunologie Clinique, F-94275 Le Kremlin-Bicêtre, France; INSERM, U1184, Immunology of Viral Infections and Autoimmune Diseases, F-94276 Le Kremlin-Bicêtre, France; Université Paris Sud, UMR 1184, F-94276 Le Kremlin-Bicêtre, France; CEA, DSV/iMETI, IDMIT, F-92265 Fontenay-aux-Roses, France.
| |
Collapse
|
223
|
Vallet H, Seve P, Biard L, Baptiste Fraison J, Bielefeld P, Perard L, Bienvenu B, Abad S, Rigolet A, Deroux A, Sene D, Perlat A, Marie I, Feurer E, Hachulla E, Fain O, Clavel G, Riviere S, Bouche PA, Gueudry J, Pugnet G, Le Hoang P, Resche Rigon M, Cacoub P, Bodaghi B, Saadoun D. Infliximab Versus Adalimumab in the Treatment of Refractory Inflammatory Uveitis: A Multicenter Study From the French Uveitis Network. Arthritis Rheumatol 2017; 68:1522-30. [PMID: 27015607 DOI: 10.1002/art.39667] [Citation(s) in RCA: 104] [Impact Index Per Article: 14.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2015] [Accepted: 02/25/2016] [Indexed: 01/09/2023]
Abstract
OBJECTIVE To analyze the factors associated with response to anti-tumor necrosis factor (anti-TNF) treatment and compare the efficacy and safety of infliximab (IFX) and adalimumab (ADA) in patients with refractory noninfectious uveitis. METHODS This was a multicenter observational study of 160 patients (39% men and 61% women; median age 31 years [interquartile range 21-42]) with uveitis that had been refractory to other therapies, who were treated with anti-TNF (IFX 5 mg/kg at weeks 0, 2, 6, and then every 5-6 weeks [n = 98] or ADA 40 mg every 2 weeks [n = 62]). Factors associated with complete response were assessed by multivariate analysis. Efficacy and safety of IFX versus ADA were compared using a propensity score approach with baseline characteristics taken into account. Subdistribution hazard ratios (SHRs) and 95% confidence intervals (95% CIs) were calculated. RESULTS The main etiologies of uveitis included Behçet's disease (BD) (36%), juvenile idiopathic arthritis (22%), spondyloarthropathy (10%), and sarcoidosis (6%). The overall response rate at 6 and 12 months was 87% (26% with complete response) and 93% (28% with complete response), respectively. The median time to complete response was 2 months. In multivariate analysis, BD and occurrence of >5 uveitis flares before anti-TNF initiation were associated with complete response to anti-TNF (SHR 2.52 [95% CI 1.35-4.71], P = 0.004 and SHR 1.97 [95% CI 1.02-3.84], P = 0.045, respectively). Side effects were reported in 28% of patients, including serious adverse events in 13%. IFX and ADA did not differ significantly in terms of occurrence of complete response (SHR 0.65 [95% CI 0.25-1.71], P = 0.39), serious side effects (SHR 0.22 [95% CI 0.04-1.25], P = 0.089), or event-free survival (SHR 0.55 [95% CI 0.28-1.08], P = 0.083). CONCLUSION Anti-TNF treatment is highly effective in refractory inflammatory uveitis. BD is associated with increased odds of response. IFX and ADA appear to be equivalent in terms of efficacy.
Collapse
Affiliation(s)
- Hélène Vallet
- Hôpital Pitié-Salpêtrière, AP-HP, Centre National de Référence Maladies Systémiques et Autoimmunes Rares, and Université Paris VI, Paris, France
| | | | - Lucie Biard
- Hôpital Saint Louis and Le Centre de Recherche INSERM, Paris Sorbonne Cité, UMR 1153, Paris, France
| | | | | | | | | | | | - Aude Rigolet
- Hôpital Pitié-Salpêtrière, AP-HP, Centre National de Référence Maladies Systémiques et Autoimmunes Rares, and Université Paris VI, Paris, France
| | - Alban Deroux
- CHU de Grenoble-Hôpital Michallon, Grenoble, France
| | | | | | | | | | - Eric Hachulla
- Eric Hachulla, MD, PhD: Centre Hospitalier Régional Universitaire de Lille, Lille, France
| | | | | | | | - Pierre-Alban Bouche
- Hôpital Saint Louis and Le Centre de Recherche INSERM, Paris Sorbonne Cité, UMR 1153, Paris, France
| | | | - Gregory Pugnet
- CHU de Toulouse-Hôpital Purpan, INSERM UMR 1027, Toulouse, France
| | | | - Matthieu Resche Rigon
- Hôpital Saint Louis and Le Centre de Recherche INSERM, Paris Sorbonne Cité, UMR 1153, Paris, France
| | - Patrice Cacoub
- Hôpital Pitié-Salpêtrière, AP-HP, Centre National de Référence Maladies Systémiques et Autoimmunes Rares, and Université Paris VI, Paris, France
| | | | - David Saadoun
- Hôpital Pitié-Salpêtrière, AP-HP, Centre National de Référence Maladies Systémiques et Autoimmunes Rares, and Université Paris VI, Paris, France
| | | |
Collapse
|
224
|
Slama B, Fain O, Maisonneuve H, Jourdan E, Viallard JF, Ouaja R, Alfa-Cissé O, Godeau B. Erratum: Efficacy and safety of ClairYg®, a ready-to-use intravenous immunoglobulin, in adult patients with primary immune thrombocytopenia. Am J Blood Res 2017; 7:29. [PMID: 28690918 PMCID: PMC5498821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Received: 05/30/2017] [Accepted: 05/31/2017] [Indexed: 06/07/2023]
Abstract
[This corrects the article on p. 1 in vol. 7, PMID: 28203488.].
Collapse
Affiliation(s)
- Borhane Slama
- Department of Haematology, Henri Duffaut HospitalFrance
| | - Olivier Fain
- Department of Internal Medicine, Jean Verdier HospitalFrance
| | | | | | | | - Rabye Ouaja
- Global Scientific Affairs Unit, LFB BiomedicamentsFrance
| | | | - Bertrand Godeau
- Department of Internal Medicine, University Hospital Henri MondorFrance
| | | |
Collapse
|
225
|
Belkhir R, Burel SL, Dunogeant L, Marabelle A, Hollebecque A, Besse B, Leary A, Voisin AL, Pontoizeau C, Coutte L, Pertuiset E, Mouterde G, Fain O, Lambotte O, Mariette X. Rheumatoid arthritis and polymyalgia rheumatica occurring after immune checkpoint inhibitor treatment. Ann Rheum Dis 2017; 76:1747-1750. [PMID: 28600350 DOI: 10.1136/annrheumdis-2017-211216] [Citation(s) in RCA: 166] [Impact Index Per Article: 23.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2017] [Revised: 05/08/2017] [Accepted: 05/10/2017] [Indexed: 11/03/2022]
Abstract
OBJECTIVES Immune checkpoint inhibitors (ICIs) targeting cytotoxic T-lymphocyte-associated protein 4 and programmed cell death protein 1 (PD-1) have demonstrated improved survival for multiple cancers. However, these new drug classes have led to increased immune-related adverse events (IrAE). Rheumatic IrAEs have not been well described in clinical trials. We report here cases of rheumatoid arthritis (RA) and polymyalgia rheumatica (PMR) occurring after ICI treatment. METHODS This was a retrospective study of patients receiving an ICI in whom symptoms of arthritis or arthralgia developed and revealed a diagnosis of RA or PMR. RESULTS In 10 patients who received ICI therapy (all anti-PD-1 or anti-PDL1 antibodies), RA or PMR developed at a median of 1 month (1 to 9) after exposure. No patient had pre-existing rheumatic or autoimmune disease. RA developed in six patients; all six were positive for anti-cyclic citrullinated peptide (anti-CCP) antibodies and four for rheumatoid factor. Anti-CCP antibodies were detected in two out of three patients tested before immunotherapy. Disease-modifying antirheumatic drugs were needed for three patients; the three others received corticosteroids or non-steroid anti-inflammatory drugs. PMR was diagnosed in four patients, all responded to corticosteroids. Despite these IrAEs, immunotherapy was pursued for all but one patient until cancer progression. CONCLUSIONS This is the first description of RA occurring after ICI therapy for cancer. PMR can also occur after ICI, particularly after anti-PD-1 therapy. All cases responded to corticosteroids or with immunosuppressive therapy. Collaboration between rheumatologists and oncologists is crucial and could lead to better recognition and care of these patients.
Collapse
Affiliation(s)
- Rakiba Belkhir
- Rheumatology, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpitaux Universitaires Paris-Sud, Le Kremlin-Bicêtre, France
| | - Sébastien Le Burel
- AP-HP, Hôpital Bicêtre, Service de Médecine Interne et Immunologie clinique, Le Kremlin-Bicêtre, France
| | - Laetitia Dunogeant
- Service de rhumatologie et médecine interne, Centre Hospitalier du Pays d'Aix, Aix-en-Provence, France
| | - Aurélien Marabelle
- Département d'Innovation Thérapeutique et Essais Précoces (DITEP), Gustave Roussy Cancer Campus, France
| | - Antoine Hollebecque
- Département d'Innovation Thérapeutique et Essais Précoces (DITEP), Gustave Roussy Cancer Campus, France
| | - Benjamin Besse
- Gustave Roussy Cancer Campus, Villejuif; Univ. Paris-Sud, Université Paris-Saclay, Villejuif, France
| | - Alexandra Leary
- Gustave Roussy Cancer Campus, Villejuif; Univ. Paris-Sud, Université Paris-Saclay, Villejuif, France
| | - Anne-Laure Voisin
- Institut Gustave Roussy, Unité Fonctionnelle de Pharmacovigilance, Villejuif, France
| | - Clémence Pontoizeau
- Service de médecine nucléaire, Centre Hospitalier de Saint Brieuc, 22000 Saint Brieuc, France
| | - Laetitia Coutte
- AP-HP, université Paris-Descartes, hôpital Cochin, centre de référence maladies auto-immunes et systémiques rares, service de médecine interne, Paris, France
| | | | - Gaël Mouterde
- Rheumatology Department, Lapeyronie Hospital and &EA 2415, Montpellier, France
| | - Olivier Fain
- AP-HP, Service de Médecine Interne, Hôpital Saint-Antoine, Université Paris, France
| | - Olivier Lambotte
- AP-HP, Hôpital Bicêtre, Service de Médecine Interne et Immunologie clinique, Le Kremlin-Bicêtre, France.,CEA, DSV/iMETI, Division d'Immunovirologie, IDMIT, Fontenay-aux-Roses, France
| | - Xavier Mariette
- Rheumatology, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpitaux Universitaires Paris-Sud, Le Kremlin-Bicêtre, France.,Université Paris Sud, INSERM, Center for Immunology of Viral Infections and Autoimmune Diseases, Le Kremlin-Bicêtre, France
| |
Collapse
|
226
|
Grignano E, Mekinian A, Jachiet V, Coppo P, Fain O. Manifestations auto-immunes et inflammatoires des hémopathies lymphoïdes. Rev Med Interne 2017; 38:374-382. [DOI: 10.1016/j.revmed.2016.10.396] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2016] [Revised: 10/03/2016] [Accepted: 10/27/2016] [Indexed: 10/20/2022]
|
227
|
Schmaier AH, Cicardi M, Reshef A, Moldovan D, Mócsai A, López-Trascasa M, Lera AL, Brown NJ, Germenis AE, Filippelli-Silva R, Duarte DA, Martin RP, Veronez CL, Bouvier M, Bader M, Costa-Neto CM, Pesquero JB, Charest-Morin X, Marceau F, Rivard GÉ, Bonnefoy A, Wagner É, Debreczeni ML, Németh Z, Kajdácsi E, Schwaner E, Cervenak L, Oroszlán G, Szilágyi A, Dani R, Závodszky P, Gál P, Dobó J, Hébert J, Vincent M, Boursiquot JN, Chapdeleine H, Desjardins M, Laramée B, Gagnon R, Payette N, Lepeshkina O, Charignon D, Ghannam A, Ponard D, Drouet C, Joseph K, Tholanikunnel BG, Sexton DJ, Kaplan AP, Loffredo S, Bova M, Ferrara AL, Petraroli A, Suffritti C, Veszeli N, Zanichelli A, Farkas H, Marone G, Luyasu S, Favier B, Martin L, Kőhalmi KV, Temesszentandrási G, Várnai K, Varga L, Zuraw BL, Feussner A, Tortorici MA, Pawaskar D, Li HH, Anderson J, Bernstein JA, Zhang Y, Pragst I, Aygören-Pürsün E, Jacobson K, Christensen J, Van Leerberghe A, Wang Y, Schranz J, Martinez-Saguer I, Soteres D, Steiner U, Panovska VG, Rae W, Aberer W, Huissoon A, Bygum A, Magerl M, Graff J, Longhurst H, Lleonart R, Fang L, Cornpropst M, Clemons D, Mathis A, Collis P, Dobo S, Sheridan WP, Maurer M, Riedl MA, Craig T, Banerji A, Shennak M, Yang W, Baptista J, Busse P, Kalfus I, McDonald A, Qian S, Roberts A, Panousis C, Green T, Gille A, Zamanakou M, Loules G, Csuka D, Psarros F, Parsopoulou F, Speletas M, Firinu D, De Pasquale TMA, Zoli A, Radice A, Pizzimenti S, Manoussakis E, Konstantinou GN, Bafunno V, Montinaro V, Cancian M, Margaglione M, Bork K, Wulff K, Witzke G, Hardt J, Bouillet L, Caballero T, Grumach AS, Pommie C, Andresen I, Ettingshausen CE, Gutowski Z, Andritschke K, Linde R, Andrási N, Szilágyi T, Leibovich-Nassi I, Symons C, Dempster J, Boccon-Gibod I, Pagnier A, Lehmann A, Kreiberg KB, Nieto SA, Martins R, Martins R, Menendez A, Valle SOR, Olivares M, Hernandez-Landeros ME, Nievas E, Fili N, Barrera OM, Bailleau R, Gallardo-Olivos AM, Grau M, Rodriguez-Galindo J, Carabantes MJO, Zapata-Venegas E, Alfonso MM, Rosario-Grauert M, Ratti M, Vaszquez D, Josviack D, Landivar-Salinas LF, Calderón-Llosa OME, Campilay-Sarmiento R, Raby P, Fabiani J, Lumry WR, Feuersenger H, Watson DJ, Machnig T, Lamacchia D, Hernanz A, Alvez A, Lluncor M, Pedrosa M, Cabañas R, Prior N, Nordenfelt P, Nilsson M, Lindfors A, Wahlgren CF, Björkander J, Hakl R, Kuklínek P, Krčmová I, Hanzlíková J, Vachová M, Zachová R, Sobotková M, Strenková J, Litzman J, Palasopoulou M, Tsinti G, Gianni P, Kompoti M, Garrido S, Dyga W, Bogdali A, Obtułowicz A, Tomasz M, Czarnobilska E, Obtulowicz K, Książek T, Koncz A, Gulyás D, Staevska M, Jesenak M, Hrubiskova K, Bellizzi L, Relan A, Wu MA, Castelli A, Colombo R, Podda G, Del Medico M, Catena E, Casella F, Perego F, Afifi NA, Tobaldini E, Montano N, Sánchez-Jareño M, Stobiecki M, Obtułowicz K, Guryanova I, Polyakova E, Lebedz V, Salivonchik A, Aleshkevich S, Belevtsev M, Nordmann-Kleiner M, Trainotti S, Hahn J, Greve J, Zabrodska L, Alonso MLO, Tórtora RP, França AT, Ribeiro MG, Fu L, Kanani A, Lacuesta G, Waserman S, Betschel S, Espinosa MI, Contreras FA, Hrubisko M, Vavrova L, Banovcin P, Ayazi M, Fazlollahi MR, Saghafi S, Mohammadian S, Deshiry SN, Bidad K, Shoormasti RS, Mohammadzadeh I, Bemanian MH, Mahdaviani SA, Pourpak Z, Valerieva A, Vasileva M, Velikova T, Petkova E, Dimitrov V, Di Maulo R, Somech R, Golander H, Sifuentes EJ, Mansard C, Gompel A, Floccard B, Blanchard-Delaunay C, Launay D, Fain O, Sobel A, Gayet S, Amarger S, Armengol G, Ollivier Y, Zélinsky-Gurung A, Jeandel PY, Kanny G, Coppéré B, Dubrel M, Pelletier F, Du Thanh A, Trouiller S, Laurent J, De Moreuil C, Pajot CA, Belot A, Rodríguez A, Roa D, Prieto A, Baeza ML, Krusheva B, Almeida SKA, Constantino-Silva RN, Melo N, Simoes JA, Palma SMU, da Silva J, de Azevedo BF, Mansour E, González-Quevedo T, Marcos C, Lobera T, de San Pedro BS, Avilla E, Badiou J, Binkley K, Borici-Mazi R, Howlett L, Keith PK, Rowe A, Waite P, Billebeau A, Boccon-Gibbod I, Lis K, Laitman Y, Friedman E, Gokmen NM, Gulbahar O, Onay H, Koc ZP, Sin AZ. Abstracts from the 10th C1-inhibitor deficiency workshop. Allergy Asthma Clin Immunol 2017. [PMCID: PMC5496025 DOI: 10.1186/s13223-017-0198-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
|
228
|
Mekinian A, Alijotas-Reig J, Carrat F, Costedoat-Chalumeau N, Ruffatti A, Lazzaroni MG, Tabacco S, Maina A, Masseau A, Morel N, Esteve-Valverde EE, Ferrer-Oliveras R, Andreoli L, De Carolis S, Josselin-Mahr L, Abisror N, Nicaise-Roland P, Tincani A, Fain O. Refractory obstetrical antiphospholipid syndrome: Features, treatment and outcome in a European multicenter retrospective study. Autoimmun Rev 2017; 16:730-734. [PMID: 28478081 DOI: 10.1016/j.autrev.2017.05.006] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2017] [Accepted: 04/11/2017] [Indexed: 12/12/2022]
Abstract
AIM To describe the consecutive pregnancy outcome and treatment in refractory obstetrical antiphospholipid syndrome (APS). METHODS Retrospective multicenter open-labelled study from December 2015 to June 2016. We analyzed the outcome of pregnancies in patients with obstetrical APS (Sydney criteria) and previous adverse obstetrical event despite low-dose aspirin and low-molecular weight heparin LMWH (LMWH) conventional treatment who experienced at least one subsequent pregnancy. RESULTS Forty nine patients with median age 27years (23-32) were included from 8 European centers. Obstetrical APS was present in 71%, while 26% had obstetrical and thrombotic APS. Lupus anticoagulant was present in 76% and triple antiphospholipid antibody (APL) positivity in 45% of patients. Pregnancy loss was noted in 71% with a median age of gestation of 11 (8-21) weeks. The presence of APS non-criteria features (35% vs 17% in pregnancies without adverse obstetrical event; p=0.09), previous intrauterine death (65% vs 38%; p=0.06), of LA (90% vs 65%; p=0.05) were more frequent in pregnancies with adverse pregnancy outcome, whereas isolated recurrent miscarriage profile was more frequent in pregnancies without any adverse pregnancy outcome (15% vs 41%; p=0.04). In univariate analysis considering all pregnancies (index and subsequent ones), an history of previous intrauterine death was associated with pregnancy loss (odds-ratio 2.51 (95% CI 1.274.96); p=0.008), whereas previous history of prematurity related to APS (odds-ratio 0.13 95%CI 0.04 0.41, P=0.006), steroids use during the pregnancy (odds-ratio 0.30 95% CI 0.11-0.82, p=0.019) and anticardiolipids isolated profile (odds-ratio 0.51 95% CI 0.26-1.03, p=0.0588) were associated with favorable outcome. In multivariate analysis, only previous history of prematurity, steroids use and anticardiolipids isolated profiles were associated with live-birth pregnancy. CONCLUSION The main features of refractory obstetrical APS were the high rates of LA and triple APL positivity. Steroids could be effective in this APS profile, but prospective studies are necessary.
Collapse
Affiliation(s)
- Arsène Mekinian
- AP-HP, Hôpital Saint-Antoine, service de médecine interne and Inflammation-Immunopathology-Biotherapy Department (DHU i2B), Sorbonne Universités, UPMC University Paris 06, F-75012 Paris, France.
| | - Jaume Alijotas-Reig
- Systemic Autoimmune Disease Unit, Department of Internal Medicine I, Vall d'Hebrón University Hospital, Department of Medicine, Universitat Autonoma de Barcelona, Barcelona, Spain
| | - Fabrice Carrat
- AP-HP, Hôpital Saint-Antoine, service de Biostatistiques, Sorbonne Universités, UPMC Univ Paris 06, F-75012 Paris, France
| | - Nathalie Costedoat-Chalumeau
- Université René Descartes Paris V, Centre de référence maladies auto-immunes et systémiques rares, Service de médecine interne Pôle médecine, Hôpital Cochin, AP-HP, 27 rue du Faubourg Saint Jacques, 75679 Paris cedex 14, France; INSERM U 1153, Center for Epidemiology and Statistics Sorbonne Paris Cité (CRESS), Paris, France
| | - Amelia Ruffatti
- Rheumatology Unit, Department of Medicine, University of Padua, Padua, Italy
| | - Maria Grazia Lazzaroni
- Rheumatology and Clinical Immunology, Department of Clinical and Experimental Sciences, University and Spedali Civili of Brescia, Brescia, Italy
| | - Sara Tabacco
- Department of Gynaecology, Obstetrics and Urology, "Sapienza" University of Rome, Rome, Italy
| | - Aldo Maina
- Department of Internal Medicine, Ospedale Sant'Anna, Torino, Italy
| | - Agathe Masseau
- Hôpital Hôtel Dieu, service de médecine interne, Université de Nantes, Nantes, France
| | - Nathalie Morel
- AP-HP, Cochin Hospital, Internal Medicine Department, Paris, France; Université Paris 7, Paris, France
| | - Enrique Esteve Esteve-Valverde
- Systemic Autoimmune Disease Unit, Department of Internal Medicine I, Vall d'Hebrón University Hospital, Department of Medicine, Universitat Autonoma de Barcelona, Barcelona, Spain
| | - Raquel Ferrer-Oliveras
- Systemic Autoimmune Disease Unit, Department of Internal Medicine I, Vall d'Hebrón University Hospital, Department of Medicine, Universitat Autonoma de Barcelona, Barcelona, Spain
| | - Laura Andreoli
- Rheumatology and Clinical Immunology, Department of Clinical and Experimental Sciences, University and Spedali Civili of Brescia, Brescia, Italy
| | - Sara De Carolis
- Department of Obstetrics and Gynaecology, Catholic University of Sacred Heart, Rome, Italy
| | - Laurence Josselin-Mahr
- AP-HP, Hôpital Saint-Antoine, service de médecine interne and Inflammation-Immunopathology-Biotherapy Department (DHU i2B), Sorbonne Universités, UPMC University Paris 06, F-75012 Paris, France
| | - Noémie Abisror
- AP-HP, Hôpital Saint-Antoine, service de médecine interne and Inflammation-Immunopathology-Biotherapy Department (DHU i2B), Sorbonne Universités, UPMC University Paris 06, F-75012 Paris, France
| | - Pascale Nicaise-Roland
- AP-HP, Unité Fonctionnelles d'Immunologie "Auto-immunité et Hypersensibilités", Hôpital Bichat-Claude Bernard, Paris, France
| | - Angela Tincani
- Rheumatology and Clinical Immunology, Department of Clinical and Experimental Sciences, University and Spedali Civili of Brescia, Brescia, Italy
| | - Olivier Fain
- AP-HP, Hôpital Saint-Antoine, service de médecine interne and Inflammation-Immunopathology-Biotherapy Department (DHU i2B), Sorbonne Universités, UPMC University Paris 06, F-75012 Paris, France
| | | |
Collapse
|
229
|
Deroux A, Boccon-Gibod I, Fain O, Pralong P, Ollivier Y, Pagnier A, Djenouhat K, Du-Thanh A, Gompel A, Faisant C, Launay D, Bouillet L. Hereditary angioedema with normal C1 inhibitor and factor XII mutation: a series of 57 patients from the French National Center of Reference for Angioedema. Clin Exp Immunol 2017; 185:332-7. [PMID: 27271546 DOI: 10.1111/cei.12820] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2016] [Revised: 05/27/2016] [Accepted: 05/31/2016] [Indexed: 11/29/2022] Open
Abstract
Hereditary angioedema (HAE) is a rare disease associated with either a quantitative or qualitative deficiency in C1-inhibitor (C1-INH) or normal C1-INH. HAE with normal C1-INH is associated in 20% of cases with mutations in the gene for factor XII (FXII) or FXII-HAE. A recent review described 41 families, including 14 German and 15 Spanish families. We have constructed a register of French patients and their characteristics. A national survey was launched through the French National Center of Reference for Angioedema (CREAK) to study the clinical, biological and therapeutic characteristics of patients with HAE linked to a mutation of FXII gene. Fifty-seven patients were identified from 24 different families. In most cases they were young women (mean age at diagnosis: 31 years, mean age at first symptom: 21 years, female/male ratio: 76%). Twenty-one per cent of the patients experienced angioedema attacks only during pregnancy or when on oestrogen contraception. Sixty-three per cent had attacks at all times, but they were more severe during these same periods. Male carriers of the mutation were more frequently asymptomatic than females (P = 0·003). C1-INH concentrate and icatibant were both effective for treating attacks. The prophylactic use of tranexamic acid led to a 64% decrease in the number of attacks. This is one of the largest series reported of HAE patients with FXII mutation. The therapeutic management appeared to be identical to that of HAE with C1-INH deficiency.
Collapse
Affiliation(s)
- A Deroux
- Internal Medicine Department, Centre Hospitalier Des Alpes, Grenoble, France
| | - I Boccon-Gibod
- Internal Medicine Department, Centre Hospitalier Des Alpes, Grenoble, France
| | - O Fain
- Internal Medicine Department, Hôpital Saint Antoine, Université Paris, France
| | - P Pralong
- Dermatology Department, Allergology and Photobiology, CHU De Grenoble, Grenoble, France
| | - Y Ollivier
- Internal Medicine Department, Caen, France
| | - A Pagnier
- Internal Medicine Department, Centre Hospitalier Des Alpes, Grenoble, France
| | - K Djenouhat
- Service De Biologie Médicale, EPH De Rouïba, Alger, Algéria
| | - A Du-Thanh
- Dermatology Department, Hôpital Saint-Eloi, Centre Hospitalier Universitaire De Montpellier, Montpellier, France
| | - A Gompel
- Gynecology Department, CHU Paris-Centre, Hopital, Cochin, Paris, France
| | - C Faisant
- Internal Medicine Department, Centre Hospitalier Des Alpes, Grenoble, France
| | - D Launay
- Université Lille, Lille Inflammation Research International Center, Lille, France.,Département De Médecine Interne Et Immunologie Clinique, Lille, Lille, France
| | - L Bouillet
- Internal Medicine Department, Centre Hospitalier Des Alpes, Grenoble, France
| |
Collapse
|
230
|
Grimaldi-Bensouda L, Rossignol M, Koné-Paut I, Krivitzky A, Lebrun-Frenay C, Clet J, Brassat D, Papeix C, Nicolino M, Benhamou PY, Fain O, Costedoat-Chalumeau N, Courcoux MF, Viallard JF, Godeau B, Papo T, Vermersch P, Bourgault-Villada I, Breart G, Abenhaim L, Abbas F, Abdelmoumni A, Hilliquin P, Requeda E, Adoue D, Brassat D, Agard C, Masseau A, Aladjidi N, Clet J, Fernandes H, Lemasson G, Perel Y, Raymond I, Richer O, Vital A, Allain-Launay E, Bru M, Nicolino M, Thomas C, Altman JJ, Amsallem D, Aras N, Boukari L, Dubrel M, Fain O, Letellier E, Lucidarme N, Mekinian A, Morin AS, Stirnemann J, Atlan C, Audry D, Augustin J, Bakir R, Bartolucci P, Chevalier X, Godeau B, Guillaud C, Khellaf M, Limal N, Lousteau V, Mahevas M, Méliksetyan G, Michel M, Roumier M, Bayart S, Bonnet F, Decaux O, Bekherraz A, Brihaye B, Dachez R, Daugas E, Hayem G, Meyer O, Papo T, Pasqualoni E, Sacre K, Travert F, Bellon H, Beltrand J, Lefrere F, Simon A, Benhamou PY, Benveniste O, Bolgert F, Costedoat-Chalumeau N, De Paz R, Demeret S, Fautrel B, Jacqueminet S, Louapre C, Maillart E, Morel N, Papeix C, Rigabert J, Bensaid P, Berger C, Berquin P, Le Moing AG, Berroir S, Besson G, Boutte C, Casez O, Bonnotte B, Audia S, Bossu-Estour C, Bourgarit A, Dupuy A, Keshmandt H, Bourre B, Brac A, Perrin A, Pondarré C, Villar-Fimbel S, Bruckert I, Cosson A, Magy-Bertrand N, Tisserand G, Camu W, Carlander B, Morales RJ, Cances C, Pasquet M, Castilla Lievre MA, Chabroux S, Charif M, Chatelus E, Sibilia J, Chevrant-Breton J, Clavel S, Bille-Turc F, Cohen J, Courcoux MF, Leverger G, Machet L, Cuisset JM, Cony-Makhoul P, Darsy P, Favre S, Giraud P, Leitenschenck L, Monteiro I, Morati C, DeSeze J, Dinulescu M, Dhaoui T, Dommange-Romero F, Drevard E, Dupuis C, Dumuis ML, Durand JM, Farad S, Lecomte P, Pierre P, Fouyssac F, Gaudin P, Gautier A, Gellen-Dautremer J, Jarrin I, Richette P, Georget E, Gras P, Moreau T, Giraud E, Hacini M, Mayer A, Guillaumat C, Guillaume S, Guitton C, Kone-Paut I, Marsaud C, Rossi L, Guyot MH, Hassler P, Heimfert C, Heinzlef O, Hillion B, Hocquelet C, Husson H, Ichai P, Jeziorski E, Deslandre CJ, Le Guern V, Kamenov K, Kerlan V, Lemoine P, Misery L, Pan-Petesch B, Krivitzky A, Labauge P, Rodier M, Lacade C, Razafimahefa B, Lachgar K, Larmarau MP, Leblanc T, Lebrun-Frenay C, Lefèbvre P, Lejoyeux P, Leske C, Ly K, Magy L, Mansuy S, Marechaud R, Martin Negrier ML, Sole G, Maupetit J, Mazingue F, Mochon S, Moktar B, Morcamp D, Morlet-Barla N, Nicolas G, Pautot V, Pellier I, Verret JL, Outteryck O, Vermersch P, Pallot-Prades B, Paquet JM, Puechal X, Sortais A, Pelletier J, Rico A, Pez D, Stankoff B, Quittet P, Rémy C, Roba E, Rosario H, Roudaut N, Sonnet E, Ruel M, Sebban S, Schaepelynck P, Simonin MJ, Vial C, Viallard JF, Ladedan I, Zenone T. Risk of autoimmune diseases and human papilloma virus (HPV) vaccines: Six years of case-referent surveillance. J Autoimmun 2017; 79:84-90. [DOI: 10.1016/j.jaut.2017.01.005] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2016] [Revised: 12/08/2016] [Accepted: 01/26/2017] [Indexed: 10/20/2022]
|
231
|
Mekinian A, Cohen J, Kayem G, Carbillon L, Nicaise-Roland P, Gaugler B, Darai E, Bornes M, Fain O. Fausses couches précoces récurrentes inexpliquées : quelle est la place de l’immunomodulation ? Rev Med Interne 2017; 38:264-268. [DOI: 10.1016/j.revmed.2016.08.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2016] [Revised: 06/04/2016] [Accepted: 08/02/2016] [Indexed: 02/07/2023]
|
232
|
Hefez L, Gatfossé M, Mekinian A, Fain O. [Sweet syndrome]. Rev Prat 2017; 67:399. [PMID: 30525337] [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] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Affiliation(s)
- Louise Hefez
- Service de médecine interne, Hôpital Saint-Antoine Paris 6
| | - Marc Gatfossé
- Service de médecine interne, Hôpital Saint-Antoine Paris 6
| | | | - Olivier Fain
- Service de médecine interne, Hôpital Saint-Antoine Paris 6
| |
Collapse
|
233
|
Sanges S, Rivière S, Mekinian A, Martin T, Le Quellec A, Chatelus E, Lescoat A, Jego P, Cazalets C, Quéméneur T, Le Gouellec N, Senet P, Francès C, Deroux A, Imbert B, Fain O, Boukari L, Sené T, Deligny C, Mathian A, Agard C, Pugnet G, Speca S, Dubucquoi S, Hatron PY, Hachulla É, Launay D. Intravenous immunoglobulins in systemic sclerosis: Data from a French nationwide cohort of 46 patients and review of the literature. Autoimmun Rev 2017; 16:377-384. [PMID: 28232167 DOI: 10.1016/j.autrev.2017.02.008] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2016] [Accepted: 12/26/2016] [Indexed: 12/25/2022]
Abstract
BACKGROUND As intravenous immunoglobulins (IVIG) exhibit immunomodulatory and antifibrotic properties, they may be a relevant treatment for systemic sclerosis (SSc). The objectives of this work were thus to report on the efficacy and safety of IVIG in a population of SSc patients and to review the available literature. METHODS 46 patients from 19 French centers were retrospectively recruited. They were included if they had a diagnosis of SSc and received at least 1 IVIG infusion at a dosage >1g/kg/cycle. Relevant data collected at IVIG discontinuation were compared to those collected at IVIG initiation. A comprehensive literature review was performed. RESULTS We observed a significant improvement of muscle pain (74% vs. 20%, p<0.0001), muscle weakness (45% vs. 21%, p=0.01), joint pain (44% vs. 19%, p=0.02), CK levels (1069±1552UI vs. 288±449UI, p<0.0001) and CRP levels (13.1±17.6mg/L vs. 9.2±16.6mg/L, p=0.001). We also noted a trend for an improvement of gastro-esophageal reflux disease (68% vs. 53%, p=0.06) and bowel symptoms (42% vs. 27%, p=0.06). Skin and cardiorespiratory involvements remained stable. Finally, corticosteroid daily dose was significantly lower by the end of treatment (13.0±11.6mg/day vs. 8.9±10.4mg/day, p=0.01). Only two severe adverse events were reported (one case of deep vein thrombosis and one case of diffuse edematous syndrome). CONCLUSION Our work suggests that IVIG are a safe therapeutic option that may be effective in improving musculoskeletal involvement, systemic inflammation, digestive tract symptoms and could be corticosteroid sparing.
Collapse
Affiliation(s)
- Sébastien Sanges
- Univ. Lille, INSERM U995 - LIRIC - Lille Inflammation Research International Center, F-59000 Lille, France; INSERM, U995, F-59000 Lille, France; CHU Lille, Département de Médecine Interne et Immunologie Clinique, F-59000 Lille, France; Centre National de Référence Maladies Systémiques et Auto-immunes Rares (Sclérodermie Systémique), F-59000 Lille, France; Health Care Provider of the European Reference Network on Rare Connective Tissue and Musculoskeletal Diseases Network (ReCONNET)
| | - Sébastien Rivière
- AP-HP, Hôpital Saint Antoine, Service de Médecine Interne, Paris, France; UPMC Université Paris 06, Faculté de Médecine Pierre et Marie Curie, Paris, France
| | - Arsène Mekinian
- AP-HP, Hôpital Saint Antoine, Service de Médecine Interne, Paris, France; UPMC Université Paris 06, Faculté de Médecine Pierre et Marie Curie, Paris, France
| | - Thierry Martin
- Service d'Immunologie Clinique, Hôpitaux universitaires de Strasbourg, UPR CNRS 3572, Strasbourg, France
| | - Alain Le Quellec
- Service de Médecine Interne et Maladies Multi-Organiques de l'Adulte, Hôpital Saint-Éloi, Centre Hospitalier Régional Universitaire de Montpellier, Montpellier, France
| | - Emmanuel Chatelus
- Hôpitaux Universitaires de Strasbourg, CHU Hautepierre, Service de Rhumatologie, Centre de Référence des Maladies Auto-Immunes Systémiques Rares, Université de Strasbourg, Fédération de Médecine Translationnelle de Strasbourg, INSERM UMR 1109, Strasbourg, France
| | - Alain Lescoat
- Service de Médecine Interne, Centre Hospitalo-Universitaire de Rennes, Université de Rennes 1, Rennes, France
| | - Patrick Jego
- Service de Médecine Interne, Centre Hospitalo-Universitaire de Rennes, Université de Rennes 1, Rennes, France
| | - Claire Cazalets
- Service de Médecine Interne, Centre Hospitalo-Universitaire de Rennes, Université de Rennes 1, Rennes, France
| | - Thomas Quéméneur
- Service de Médecine Interne, Néphrologie et Médecine Vasculaire, Centre Hospitalier de Valenciennes, Valenciennes, France
| | - Noémie Le Gouellec
- Service de Médecine Interne, Néphrologie et Médecine Vasculaire, Centre Hospitalier de Valenciennes, Valenciennes, France
| | - Patricia Senet
- Service de Dermatologie, Hôpital Tenon, AP-HP, UPMC, Paris, France
| | - Camille Francès
- Service de Dermatologie, Hôpital Tenon, AP-HP, UPMC, Paris, France
| | - Alban Deroux
- Service de Médecine Interne, Université Grenoble Alpes, Centre Hospitalier Universitaire (CHU) de Grenoble, Grenoble, France
| | - Bernard Imbert
- Service de Médecine Interne, Université Grenoble Alpes, Centre Hospitalier Universitaire (CHU) de Grenoble, Grenoble, France
| | - Olivier Fain
- AP-HP, Hôpital Saint Antoine, Service de Médecine Interne, Paris, France; UPMC Université Paris 06, Faculté de Médecine Pierre et Marie Curie, Paris, France
| | - Latifatou Boukari
- Service de Médecine Interne, Hôpital Jean-Verdier, AP-HP, Université Paris-13, Bondy, France
| | - Thomas Sené
- Service de Médecine Interne et Rhumatologie, GH Diaconesses Croix Saint Simon, Paris, France
| | - Christophe Deligny
- Service de Médecine Interne et Rhumatologie 3C/5D, Centre Hospitalier Universitaire Pierre Zobda-Quitman, Fort-de-France, Martinique
| | - Alexis Mathian
- Service de Médecine Interne 2, Centre de Référence National pour le Lupus et le Syndrome des Antiphospholipides, institut E3M, Groupe Hospitalier Pitié-Salpêtrière, AP-HP, Paris, France; Sorbonne universités, UPMC université Paris 06, 75013 Paris, France
| | - Christian Agard
- Service de Médecine interne, Hôtel-Dieu, CHU de Nantes, Université de Nantes, Nantes, France
| | - Grégory Pugnet
- CHU, Université de Toulouse, Faculté de Médecine, Service de Médecine Interne, Toulouse, France; INSERM, UMR 1027, Toulouse, France
| | - Silvia Speca
- Univ. Lille, INSERM U995 - LIRIC - Lille Inflammation Research International Center, F-59000 Lille, France; INSERM, U995, F-59000 Lille, France
| | - Sylvain Dubucquoi
- Univ. Lille, INSERM U995 - LIRIC - Lille Inflammation Research International Center, F-59000 Lille, France; INSERM, U995, F-59000 Lille, France
| | - Pierre-Yves Hatron
- Univ. Lille, INSERM U995 - LIRIC - Lille Inflammation Research International Center, F-59000 Lille, France; CHU Lille, Département de Médecine Interne et Immunologie Clinique, F-59000 Lille, France; Centre National de Référence Maladies Systémiques et Auto-immunes Rares (Sclérodermie Systémique), F-59000 Lille, France; Health Care Provider of the European Reference Network on Rare Connective Tissue and Musculoskeletal Diseases Network (ReCONNET)
| | - Éric Hachulla
- Univ. Lille, INSERM U995 - LIRIC - Lille Inflammation Research International Center, F-59000 Lille, France; INSERM, U995, F-59000 Lille, France; CHU Lille, Département de Médecine Interne et Immunologie Clinique, F-59000 Lille, France; Centre National de Référence Maladies Systémiques et Auto-immunes Rares (Sclérodermie Systémique), F-59000 Lille, France; Health Care Provider of the European Reference Network on Rare Connective Tissue and Musculoskeletal Diseases Network (ReCONNET)
| | - David Launay
- Univ. Lille, INSERM U995 - LIRIC - Lille Inflammation Research International Center, F-59000 Lille, France; INSERM, U995, F-59000 Lille, France; CHU Lille, Département de Médecine Interne et Immunologie Clinique, F-59000 Lille, France; Centre National de Référence Maladies Systémiques et Auto-immunes Rares (Sclérodermie Systémique), F-59000 Lille, France; Health Care Provider of the European Reference Network on Rare Connective Tissue and Musculoskeletal Diseases Network (ReCONNET).
| |
Collapse
|
234
|
Longhurst HJ, Zanichelli A, Caballero T, Bouillet L, Aberer W, Maurer M, Fain O, Fabien V, Andresen I. Comparing acquired angioedema with hereditary angioedema (types I/II): findings from the Icatibant Outcome Survey. Clin Exp Immunol 2017; 188:148-153. [PMID: 27936514 PMCID: PMC5343339 DOI: 10.1111/cei.12910] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [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] [Accepted: 11/11/2016] [Indexed: 11/26/2022] Open
Abstract
Icatibant is used to treat acute hereditary angioedema with C1 inhibitor deficiency types I/II (C1-INH-HAE types I/II) and has shown promise in angioedema due to acquired C1 inhibitor deficiency (C1-INH-AAE). Data from the Icatibant Outcome Survey (IOS) were analysed to evaluate the effectiveness of icatibant in the treatment of patients with C1-INH-AAE and compare disease characteristics with those with C1-INH-HAE types I/II. Key medical history (including prior occurrence of attacks) was recorded upon IOS enrolment. Thereafter, data were recorded retrospectively at approximately 6-month intervals during patient follow-up visits. In the icatibant-treated population, 16 patients with C1-INH-AAE had 287 attacks and 415 patients with C1-INH-HAE types I/II had 2245 attacks. Patients with C1-INH-AAE versus C1-INH-HAE types I/II were more often male (69 versus 42%; P = 0·035) and had a significantly later mean (95% confidence interval) age of symptom onset [57·9 (51·33-64·53) versus 14·0 (12·70-15·26) years]. Time from symptom onset to diagnosis was significantly shorter in patients with C1-INH-AAE versus C1-INH-HAE types I/II (mean 12·3 months versus 118·1 months; P = 0·006). Patients with C1-INH-AAE showed a trend for higher occurrence of attacks involving the face (35 versus 21% of attacks; P = 0·064). Overall, angioedema attacks were more severe in patients with C1-INH-HAE types I/II versus C1-INH-AAE (61 versus 40% of attacks were classified as severe to very severe; P < 0·001). Median total attack duration was 5·0 h and 9·0 h for patients with C1-INH-AAE versus C1-INH-HAE types I/II, respectively.
Collapse
Affiliation(s)
- H J Longhurst
- Department of Immunology, Barts Health NHS Trust, London, UK
| | - A Zanichelli
- Department of Biomedical and Clinical Sciences Luigi Sacco, University of Milan, Luigi Sacco Hospital Milan, Milan, Italy
| | - T Caballero
- Department of Allergy, Hospital La Paz Institute for Health Research (IdiPaz), Biomedical Research Network on Rare Diseases (CIBERER, U754), Madrid, Spain
| | - L Bouillet
- National Reference Centre for Angioedema, Internal Medicine Department, Grenoble University Hospital, Grenoble, France
| | - W Aberer
- Department of Dermatology and Venerology, Medical University of Graz, Graz, Austria
| | - M Maurer
- Department of Dermatology and Allergy, Allergie-Centrum-Charité, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - O Fain
- Department of Internal Medicine, DHU i2B, Saint Antoine Hospital, University Paris 6, Paris, France
| | - V Fabien
- Shire, Zug, Switzerland at the time of data analysis. Now with Vifor Pharma, Glattbrugg, Switzerland
| | | | | |
Collapse
|
235
|
Slama B, Fain O, Maisonneuve H, Jourdan E, Viallard JF, Ouaja R, Alfa-Cissé O, Godeau B. Efficacy and safety of ClairYg ®, a ready-to-use intravenous immunoglobulin, in adult patients with primary immune thrombocytopenia. Am J Blood Res 2017; 7:1-9. [PMID: 28203488 PMCID: PMC5306448] [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] [Subscribe] [Scholar Register] [Received: 09/21/2016] [Accepted: 12/19/2016] [Indexed: 06/06/2023]
Abstract
PURPOSE The present study was designed to assess the efficacy and safety of IGNG that is a new liquid, saccharose and maltose-free highly purified ready-to-use 5% intravenous immunoglobulin (IVIg), in primary immune thrombocytopenic patients with severe thrombocytopenia. METHODS Nineteen adults with a platelet count ≤ 25 × 109/L received a single dose of IGNG (1 g/kg) on Day 1, with a second identical dose on Day 3 if needed. Patients were followed for 30 days. Primary endpoint was the response rate, defined as the proportion of patients with a platelet count ≥ 50 × 109/L within 96 hours after the first IGNG dose. RESULTS All but one of the 17 evaluable patients for efficacy responded with an overall response rate of 94.1% (95% CI 71.3%-99.9%). Response was observed after only one infusion (1 g/kg boby weight) in 11 patients (59%) and the others required a second dose. Mean time to response was 2.2 days. Maximum platelet count was reached within 1 week after the first dose and lasted for approximately 2 weeks. Patients requiring a second dose had lower platelet counts at baseline than patients requiring a single dose. In the 19 evaluable patients for safety, IGNG demonstrated good safety, good hepatic and renal tolerance, and did not induce hemolysis. This trial was registered at the French Medical Agency (AFSSAPS) as #DI n°060735.
Collapse
Affiliation(s)
- Borhane Slama
- Department of Haematology, Henri Duffaut HospitalFrance
| | - Olivier Fain
- Department of Internal Medicine, Jean Verdier HospitalFrance
| | | | | | | | - Rabye Ouaja
- Global Scientific Affairs Unit, LFB BiomedicamentsFrance
| | | | - Bertrand Godeau
- Department of Internal Medicine, University Hospital Henri MondorFrance
| | | |
Collapse
|
236
|
Mekinian A, Kayem G, Cohen J, Carbillon L, Abisror N, Josselin-Mahr L, Bornes M, Fain O. [Obstetrical APS: Is there a place for additional treatment to aspirin-heparin combination?]. Gynecol Obstet Fertil Senol 2017; 45:37-42. [PMID: 28238314 DOI: 10.1016/j.gofs.2016.12.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/06/2016] [Accepted: 11/14/2016] [Indexed: 06/06/2023]
Abstract
Obstetrical APS is defined by thrombosis and/or obstetrical morbidity associated with persistent antiphospholipid antibodies. The aspirin and low molecular weighted heparin combination dramatically improved obstetrical outcome in APS patients. Several factors could be associated with obstetrical prognosis, as previous history of thrombosis, associated SLE, the presence of lupus anticoagulant and triple positivity of antiphospholipid antibodies. Obstetrical APS with isolated recurrent miscarriages is mostly associated with isolated anticardiolipids antibodies and have better obstetrical outcome. The pregnancy loss despite aspirin and heparin combination define the refractory obstetrical APS, and the prevalence could be estimated to 20-39%. Several other treatments have been used in small and open labeled studies, as steroids, intravenous immunoglobulins, plasma exchanges and hydroxychloroquine to improve the obstetrical outcome. Some other drugs as eculizumab and statins could also have physiopathological rational, but studies are necessary to define the place of these various drugs.
Collapse
Affiliation(s)
- A Mekinian
- AP-HP, hôpital Saint-Antoine, service de médecine interne et l'inflammation-(DHU i2B), université Paris 06, 184, rue Faubourg-Saint-Antoine, 75012 Paris, France.
| | - G Kayem
- AP-HP, hôpital Trousseau, service d'obstétrique, université de Paris 06, 75012 Paris, France
| | - J Cohen
- AP-HP, hôpital Tenon, service d'obstétrique et de procréation médicalement assistée, université Paris 06, UMRS-938, 75020 Paris, France
| | - L Carbillon
- AP-HP, hôpital Jean-Verdier, service d'obstétrique, université Paris 13, 93300 Bondy, France
| | - N Abisror
- AP-HP, hôpital Saint-Antoine, service de médecine interne et l'inflammation-(DHU i2B), université Paris 06, 184, rue Faubourg-Saint-Antoine, 75012 Paris, France
| | - L Josselin-Mahr
- AP-HP, hôpital Saint-Antoine, service de médecine interne et l'inflammation-(DHU i2B), université Paris 06, 184, rue Faubourg-Saint-Antoine, 75012 Paris, France
| | - M Bornes
- AP-HP, hôpital Bichat, auto-immunité et hypersensibilité, université Paris 7, Paris, France
| | - O Fain
- AP-HP, hôpital Saint-Antoine, service de médecine interne et l'inflammation-(DHU i2B), université Paris 06, 184, rue Faubourg-Saint-Antoine, 75012 Paris, France
| |
Collapse
|
237
|
Kleinmann J, Tubach F, Le Guern V, Mathian A, Richez C, Saadoun D, Sacré K, Sellam J, Seror R, Amoura Z, Andres E, Audia S, Bader-Meunier B, Blaison G, Bonnotte B, Cacoub P, Caillard S, Chiche L, Chosidow O, Costedoat-Chalumeau N, Daien C, Daugas E, Derdèche N, Doria A, Fain O, Fakhouri F, Farge D, Gabay C, Guillo S, Hachulla E, Hajjaj-Hassouni N, Hamidou M, Houssiau F, Jourde-Chiche N, Kone-Paut I, Ladjouz-Rezig A, Lambotte O, Lipsker D, Mariette X, Martin Silva N, Martin T, Maurier F, Meckenstock R, Mekinian A, Meyer O, Mohamed S, Morel J, Moulin B, Mulleman D, Papo T, Poindron V, Puéchal X, Punzi L, Quartier P, Sailler L, Smail A, Soubrier M, Sparsa A, Tazi Mezalek Z, Zakraoui L, Zuily S, Sibilia J, Gottenberg J. Recommandations francophones, internationales et multidisciplinaires d’experts pour l’utilisation de biomédicaments dans le lupus érythémateux systémique : le groupe de travail du CRI-IMIDIATE. Rev Med Interne 2016. [DOI: 10.1016/j.revmed.2016.10.039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
238
|
Dervin G, Mekinian A, Kahn J, Terriou L, Liozon E, Grignano E, Piette J, Beyne-Rauzy O, Geraldine F, Godmer P, Fenaux P, Fain O, Rossignol J, Launay D, Aouba A, Gillard J, Cardon T, Bouillet L, Broner T, Vinit J, Ades L, Salvado C, Toussirot E, Guilpain P, Groh M, Lapidus N, Carrat F. Efficacité des biothérapies dans les manifestations auto-immunes et systémiques des syndromes myélodysplasiques : étude multicentrique rétrospective de 29 patients. Rev Med Interne 2016. [DOI: 10.1016/j.revmed.2016.10.134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
239
|
Soussan M, Hommada M, Abad S, Larroche C, Dhôte R, Fain O, Mekinian A. Comparaison du TEP au FDG et de l’angioscanner aortique pour la détection d’aortite au cours de l’artérite à cellules géantes. Rev Med Interne 2016. [DOI: 10.1016/j.revmed.2016.10.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
240
|
Melboucy‐Belkhir S, Khellaf M, Augier A, Boubaya M, Levy V, Le Guenno G, Terriou L, Lioger B, Ebbo M, Morin A, Chauveheid M, Michel M, Belkhir F, About F, Rose C, Moulis G, Mekinian A, Stirnemann J, Papo T, Cheze S, Rosenthal E, Viallard J, Schleinitz N, Galicier L, Adoue D, Lambotte O, Hamidou M, Godeau B, Fain O. Risk factors associated with intracranial hemorrhage in adults with immune thrombocytopenia: A study of 27 cases. Am J Hematol 2016; 91:E499-E501. [PMID: 27528011 DOI: 10.1002/ajh.24529] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2016] [Revised: 07/26/2016] [Accepted: 08/03/2016] [Indexed: 01/19/2023]
Affiliation(s)
- Sara Melboucy‐Belkhir
- Department of Internal MedicineCentre hospitalier de Saint‐QuentinSaint‐Quentin France
| | - Mehdi Khellaf
- Department of EmergencyHenri Mondor Hospital, AP‐HP, Université Paris‐Est CréteilCréteilFrance
| | - Alexandre Augier
- Department of RadiologyAvicenne Hospital, AP‐HP, Université Paris XIIIBobignyFrance
| | - Marouane Boubaya
- Department of Clinical ResearchAvicenne Hospital, AP‐HP, Université Paris XIIIBobignyFrance
| | - Vincent Levy
- Department of Clinical ResearchAvicenne Hospital, AP‐HP, Université Paris XIIIBobignyFrance
| | - Guillaume Le Guenno
- Department of Internal MedicineEstaing University HospitalClermont FerrandFrance
| | - Louis Terriou
- Department of HematologyClaude Huriez University HospitalLilleFrance
| | - Bertrand Lioger
- Department of Internal MedicineBretonneau University HospitalToursFrance
| | - Mikaël Ebbo
- Department of Internal MedicineLa Conception Hospital, Assistance Publique Hôpitaux de Marseille, Université Aix‐MarseilleMarseilleFrance
| | - Anne‐Sophie Morin
- Jean Verdier Hospital, AP‐HP, Bondy, Université Paris XIIIBondy France
| | | | - Marc Michel
- Department of Internal MedicineHenri Mondor Hospital, AP‐HP, Université Paris‐Est CréteilCréteilFrance
| | - Farid Belkhir
- Department of Onco‐radiotherapyCentre hospitalier de Saint‐QuentinSaint‐QuentinFrance
| | - Frédégonde About
- Department of Statistics and Public HealthHenri Mondor Hospital, AP‐HP, Université Paris‐Est CréteilCréteilFrance
| | - Christian Rose
- Department of HematologySaint‐Vincent de Paul HospitalLilleFrance
| | - Guillaume Moulis
- Department of Internal MedicinePurpan University HospitalToulouseFrance
| | - Arsene Mekinian
- Department of Internal MedicineSaint Antoine Hospital, DHUi2B, University ParisVIIParis France
| | - Jérôme Stirnemann
- Department of Internal MedicineGeneva University HospitalGeneva Switzerland
| | - Thomas Papo
- Department of Internal MedicineBichat Hospital, AP‐HP, Université Paris VIIParisFrance
| | - Stéphane Cheze
- Department of HematologyClémenceau University HospitalCaenFrance
| | - Eric Rosenthal
- Department of Internal MedicineL'Archet 1 University HospitalNiceFrance
| | | | - Nicolas Schleinitz
- Department of Internal MedicineLa Conception Hospital, Assistance Publique Hôpitaux de Marseille, Université Aix‐MarseilleMarseilleFrance
| | - Lionel Galicier
- Department of Clinical ImmunologySaint Louis University HospitalParisFrance
| | - Daniel Adoue
- Department of Internal MedicinePurpan University HospitalToulouseFrance
| | - Olivier Lambotte
- Department of Internal MedicineBicêtre Hospital, AP‐HP, Université Paris SudLe Kremlin‐BicêtreFrance
| | - Mohamed Hamidou
- Department of Internal MedicineHôtel Dieu University HospitalNantesFrance
| | - Bertrand Godeau
- Department of Internal MedicineHenri Mondor Hospital, AP‐HP, Université Paris‐Est CréteilCréteilFrance
| | - Olivier Fain
- Department of Internal MedicineSaint Antoine Hospital, DHUi2B, University ParisVIIParis France
| |
Collapse
|
241
|
Jachiet V, Mekinian A, Carrat F, Grignano E, Retbi A, Coppo P, Fain O. Manifestations auto-immunes et inflammatoires associées aux lymphomes : caractéristiques et pronostic d’une série rétrospective de 108 patients. Rev Med Interne 2016. [DOI: 10.1016/j.revmed.2016.10.103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
242
|
Mahévas T, Gobert D, Gatfossé M, Mekinian A, Fain O. [Insulin edema in hepatic glycogenosis]. Rev Med Interne 2016; 38:201-203. [PMID: 27745935 DOI: 10.1016/j.revmed.2016.05.001] [Citation(s) in RCA: 4] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2015] [Revised: 03/06/2016] [Accepted: 05/02/2016] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Hepatic glycogenosis is a rare syndrome, which includes poorly controlled diabetes mellitus, hepatomegaly, delayed puberty, and growth delay. Insulin edema is sometimes associated. CASE REPORT An 18-year-old woman presented with diffuse edema, hepatomegaly, amenorrhea, uncontrolled diabetes, and elevated transaminases and cholestasis. Hepatic ultrasonography and abdominal computed tomographic scan confirmed the hepatomegaly. The liver biopsy showed a massive glycogenosis and the diagnosis of hepatic glycogenosis was confirmed. Too large doses of insulin were responsible of diffuse edema. Diabetes equilibration and diminution of insulin intakes allow correction of this disorder. CONCLUSION Excess of insulin can lead to excessive hepatic glycogen storage by activation of glycogenosis enzymes. Biological manifestations consist on elevated liver enzymes and hyperlactatemia. There is a link between administration of high dose of insulin and edema. Hepatic glycogenosis should be suspected when diabetes is uncontrolled and be considered as a differential diagnosis of steatosis. It may be associated and revealed by insulin edema directly related to excessive insulin intakes.
Collapse
Affiliation(s)
- T Mahévas
- Service de médecine interne, DHU i2B, hôpital Saint-Antoine, université Paris 6, 184, rue du Faubourg-Saint-Antoine, 75012 Paris, France.
| | - D Gobert
- Service de médecine interne, DHU i2B, hôpital Saint-Antoine, université Paris 6, 184, rue du Faubourg-Saint-Antoine, 75012 Paris, France
| | - M Gatfossé
- Service de médecine interne, DHU i2B, hôpital Saint-Antoine, université Paris 6, 184, rue du Faubourg-Saint-Antoine, 75012 Paris, France
| | - A Mekinian
- Service de médecine interne, DHU i2B, hôpital Saint-Antoine, université Paris 6, 184, rue du Faubourg-Saint-Antoine, 75012 Paris, France
| | - O Fain
- Service de médecine interne, DHU i2B, hôpital Saint-Antoine, université Paris 6, 184, rue du Faubourg-Saint-Antoine, 75012 Paris, France
| |
Collapse
|
243
|
Bohelay G, Robert S, Bouges-Michel C, Gerin M, Levy A, Fain O, Caux F. Subcutaneous phaeohyphomycosis caused byExophiala spiniferain a European patient with lymphoma: a rare occurrence case report and literature review. Mycoses 2016; 59:691-696. [DOI: 10.1111/myc.12515] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2015] [Revised: 03/27/2016] [Accepted: 04/19/2016] [Indexed: 11/28/2022]
Affiliation(s)
- G. Bohelay
- Department of Dermatology; Avicenne Hospital; Assistance Publique des Hôpitaux de Paris (AP-HP); Bobigny France
| | - S. Robert
- Department of General Practice; University Paris Diderot; Sorbonne Paris Cité; Paris France
| | - C. Bouges-Michel
- Laboratory of Mycology; Avicenne Hospital; Assistance Publique des Hôpitaux de Paris (AP-HP); Bobigny France
| | - M. Gerin
- Department of Internal Medicine; Jean Verdier Hospital; Assistance Publique des Hôpitaux de Paris (AP-HP); Bondy France
| | - A. Levy
- Department of Pathology; Avicenne Hospital; Assistance Publique des Hôpitaux de Paris (AP-HP); Bobigny France
| | - O. Fain
- Department of Internal Medicine; Saint-Antoine Hospital; AP-HP; DHU i2B; University Paris 6; Paris France
| | - F. Caux
- Department of Dermatology; Avicenne Hospital; Assistance Publique des Hôpitaux de Paris (AP-HP); Bobigny France
| |
Collapse
|
244
|
Mekinian A, Bourrienne MC, Carbillon L, Benbara A, Noémie A, Chollet-Martin S, Tigaizin A, Montestruc F, Fain O, Nicaise-Roland P. Non-conventional antiphospholipid antibodies in patients with clinical obstetrical APS: Prevalence and treatment efficacy in pregnancies. Semin Arthritis Rheum 2016; 46:232-237. [DOI: 10.1016/j.semarthrit.2016.05.006] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2015] [Revised: 04/16/2016] [Accepted: 05/20/2016] [Indexed: 11/29/2022]
|
245
|
Sené T, Lidove O, Sebbah J, Darondel JM, Picard H, Aaron L, Fain O, Zenone T, Joly D, Charron P, Ziza JM. Cardiac device implantation in Fabry disease: A retrospective monocentric study. Medicine (Baltimore) 2016; 95:e4996. [PMID: 27749559 PMCID: PMC5059061 DOI: 10.1097/md.0000000000004996] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
The incidence and predictive factors of arrhythmias and/or conduction abnormalities (ACAs) requiring cardiac device (CD) implantation are poorly characterized in Fabry disease (FD). The aim of our retrospective study was to determine the prevalence, incidence, and factors associated with ACA requiring CD implantation in a monocentric cohort of patients with confirmed FD who were followed up in a department of internal medicine and reference center for FD.Forty-nine patients (20M, 29F) were included. Nine patients (4M, 5F; 18%) had at least one episode of ACA leading to device therapy. Six patients (4M/2F) required a pacemaker (PM) for sinus node dysfunction (n = 4) or atrioventricular disease (n = 2). One female patient required an internal cardioverter-defibrillator (ICD) to prevent sudden cardiac death because of nonsustained ventricular tachycardia (nSVT). One female patient required PM-ICD for sinus node dysfunction and nSVT. One patient underwent CD implantation before the diagnosis of FD. The annual rate of CD implantation was estimated at 1.90 per 100 person years. On univariate analysis at the end of the follow-up period, the factors associated with ACAs requiring CD implantation were as follows: delayed diagnosis of FD, delayed initiation of enzyme replacement therapy, age at the last follow-up visit, and severe multiorgan phenotype (hypertrophic cardiomyopathy, chronic kidney disease, and/or sensorineural hearing loss). On multivariate analysis, age at diagnosis of FD and age at the last follow-up visit were independently associated with an increased risk of ACAs requiring CD (P < 0.05).Considering the high frequency of ACAs requiring CD implantation and the risk of sudden death in patients with FD, regular monitoring is mandatory, especially in patients with a late diagnosis of FD and/or with a severe phenotype. Regular Holter ECGs, therapeutic education of patients, and deliverance of an emergency card including a phenotype summary are crucial in the care of FD patients.Available guidelines for device therapy and the efficacy of enzyme replacement therapy for arrhythmias or conduction abnormalities are discussed.
Collapse
Affiliation(s)
- Thomas Sené
- Department of Internal Medicine and Rheumatology, Reference Center for Lysosomal Storage Disorders (CRML, site Avron), Groupe Hospitalier Diaconesses Croix-Saint-Simon
| | - Olivier Lidove
- Department of Internal Medicine and Rheumatology, Reference Center for Lysosomal Storage Disorders (CRML, site Avron), Groupe Hospitalier Diaconesses Croix-Saint-Simon
- Inserm UMRS 974, Université Pierre & Marie Curie
- Correspondence: Olivier Lidove, Service de Médecine Interne-Rhumatologie, Hôpital de la Croix Saint-Simon, 125, rue d’Avron, 75020 Paris, France (e-mail: )
| | - Joel Sebbah
- Department of Cardiology, Institut Mutualiste Montsouris
| | | | - Hervé Picard
- Department of Clinical Research, Fondation Ophtalmologique Rothschild, Paris
| | - Laurent Aaron
- Department of Internal Medicine, Centre Hospitalier Jacques Coeur, Bourges
| | - Olivier Fain
- Department of Internal Medicine, Hôpital Saint-Antoine, AP-HP, Université Pierre & Marie Curie, Paris
| | - Thierry Zenone
- Department of Internal Medicine, Centre Hospitalier de Valence, Valence
| | - Dominique Joly
- Department of Nephrology, Hôpital Necker, AP-HP, Université René Descartes, Paris
| | - Philippe Charron
- Referral Center For Cardiac Hereditary Diseases, Hôpital Pitié-Salpêtrière, AP-HP, Université Versailles-Saint-Quentin, Saint-Quentin-en-Yvelines, France
| | - Jean-Marc Ziza
- Department of Internal Medicine and Rheumatology, Reference Center for Lysosomal Storage Disorders (CRML, site Avron), Groupe Hospitalier Diaconesses Croix-Saint-Simon
| |
Collapse
|
246
|
Gottenberg JE, Brocq O, Perdriger A, Lassoued S, Berthelot JM, Wendling D, Euller-Ziegler L, Soubrier M, Richez C, Fautrel B, Constantin AL, Mariette X, Morel J, Gilson M, Cormier G, Salmon JH, Rist S, Lioté F, Marotte H, Bonnet C, Marcelli C, Sellam J, Meyer O, Solau-Gervais E, Guis S, Ziza JM, Zarnitsky C, Chary-Valckenaere I, Vittecoq O, Saraux A, Pers YM, Gayraud M, Bolla G, Claudepierre P, Ardizzone M, Dernis E, Breban MA, Fain O, Balblanc JC, Aberkane O, Vazel M, Back C, Candon S, Chatenoud L, Perrodeau E, Sibilia J, Ravaud P. Non-TNF-Targeted Biologic vs a Second Anti-TNF Drug to Treat Rheumatoid Arthritis in Patients With Insufficient Response to a First Anti-TNF Drug: A Randomized Clinical Trial. JAMA 2016; 316:1172-1180. [PMID: 27654603 DOI: 10.1001/jama.2016.13512] [Citation(s) in RCA: 139] [Impact Index Per Article: 17.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
IMPORTANCE One-third of patients with rheumatoid arthritis show inadequate response to tumor necrosis factor α (TNF-α) inhibitors; little guidance on choosing the next treatment exists. OBJECTIVE To compare the efficacy of a non-TNF-targeted biologic (non-TNF) vs a second anti-TNF drug for patients with insufficient response to a TNF inhibitor. DESIGN, SETTING, AND PARTICIPANTS A total of 300 patients (conducted between 2009-2012) with rheumatoid arthritis, with persistent disease activity (disease activity score in 28 joints-erythrocyte sedimentation rate [DAS28-ESR] ≥ 3.2 [range, 0-9.3]) and an insufficient response to anti-TNF therapy were included in a 52-week multicenter, pragmatic, open-label randomized clinical trial. The final follow-up date was in August 2013. INTERVENTIONS Patients were randomly assigned (1:1) to receive a non-TNF-targeted biologic agent or an anti-TNF that differed from their previous treatment. The choice of the biologic prescribed within each randomized group was left to the treating clinician. MAIN OUTCOMES AND MEASURES The primary outcome was the proportion of patients with good or moderate response according to the European League Against Rheumatism (EULAR) scale at week 24. Secondary outcomes included the EULAR response at weeks 12 and 52; at weeks 12, 24, and 52; DAS28ESR, low disease activity (DAS28 ≤3.2), remission (DAS28 ≤2.6); serious adverse events; and serious infections. RESULTS Of the 300 randomized patients (243 [83.2%] women; mean [SD] age, 57.1 [12.2] years; baseline DAS28-ESR, 5.1 [1.1]), 269 (89.7%) completed the study. At week 24, 101 of 146 patients (69%) in the non-TNF group and 76 (52%) in the second anti-TNF group achieved a good or moderate EULAR response (OR, 2.06; 95% CI, 1.27-3.37; P = .004, with imputation of missing data; absolute difference, 17.2%; 95% CI, 6.2% to 28.2%). The DAS28-ESR was lower in the non-TNF group than in the second anti-TNF group (mean difference adjusted for baseline differences, -0.43; 95% CI, -0.72 to -0.14; P = .004). At weeks 24 and 52, more patients in the non-TNF group vs the second anti-TNF group showed low disease activity (45% vs 28% at week 24; OR, 2.09; 95% CI, 1.27 to 3.43; P = .004 and 41% vs 23% at week 52; OR, 2.26; 95% CI, 1.33 to 3.86; P = .003). CONCLUSIONS AND RELEVANCE Among patients with rheumatoid arthritis previously treated with anti-TNF drugs but with inadequate primary response, a non-TNF biologic agent was more effective in achieving a good or moderate disease activity response at 24 weeks than was the second anti-TNF medication. TRIAL REGISTRATION clinicaltrials.gov Identifier: NCT01000441.
Collapse
Affiliation(s)
- Jacques-Eric Gottenberg
- Department of Rheumatology, National Reference Center for Systemic Autoimmune Diseases, Strasbourg University Hospital, Université de Strasbourg, Strasbourg, France
| | - Olivier Brocq
- Department of Rheumatology, Centre Hospitalier Princesse Grâce, Monaco
| | - Aleth Perdriger
- Department of Rheumatology, Rennes University Hospital, Rennes, France
| | - Slim Lassoued
- Department of Rheumatology, Centre Hospitalier de Cahors, Cahors, France
| | | | - Daniel Wendling
- Department of Rheumatology, Besançon University Hospital, Besançon, France
| | | | - Martin Soubrier
- Department of Rheumatology, Clermont-Ferrand University Hospital, Clermont-Ferrand, France
| | - Christophe Richez
- Department of Rheumatology, Bordeaux University Hospital, Bordeaux, France
| | - Bruno Fautrel
- Department of Rheumatology, Hôpital La Pitié Salpétrière, Paris, France
| | | | - Xavier Mariette
- Department of Rheumatology, Hôpital Kremlin Bicêtre, Kremlin Bicêtre, France
| | - Jacques Morel
- Department of Rheumatology, Montpellier University Hospital, Montpellier, France
| | - Melanie Gilson
- Department of Rheumatology, Grenoble University Hospital, Grenoble, France
| | - Gregoire Cormier
- Department of Rheumatology, Centre Hospitalier de La Roche Sur Yon, La Roche Sur Yon, France
| | | | - Stephanie Rist
- Department of Rheumatology, Centre Hospitalier d'Orléans, Orléans, France
| | - Frederic Lioté
- Department of Rheumatology, Hôpital Lariboisière, Paris, France
| | - Hubert Marotte
- Department of Rheumatology, Saint-Etienne University Hospital, Saint-Etienne, France
| | - Christine Bonnet
- Department of Rheumatology, Limoges University Hospital, Limoges, France
| | | | - Jeremie Sellam
- Department of Rheumatology, Hôpital Saint-Antoine, Paris, France
| | - Olivier Meyer
- Department of Rheumatology, Hôpital Bichat, Paris, France
| | | | - Sandrine Guis
- Department of Rheumatology, Marseille University Hospital, Marseille, France
| | - Jean-Marc Ziza
- Department of Rheumatology, Hôpital La Croix Saint Simon, Paris, France
| | - Charles Zarnitsky
- Department of Rheumatology, Centre Hospitalier du Havre, Le Havre, France
| | | | - Olivier Vittecoq
- Department of Rheumatology, Rouen University Hospital, Rouen, France
| | - Alain Saraux
- Department of Rheumatology, Brest University Hospital, Brest, France
| | - Yves-Marie Pers
- Department of Rheumatology, Montpellier University Hospital, Montpellier, France
| | - Martine Gayraud
- Department of Internal Medicine, Institut Montsouris, Paris, France
| | - Gilles Bolla
- Department of Rheumatology, Centre Hospitalier de Cannes, Cannes, France
| | | | - Marc Ardizzone
- Department of Rheumatology, Centre Hospitalier de Mulhouse, Mulhouse, France
| | - Emmanuelle Dernis
- Department of Rheumatology, Centre Hospitalier du Mans, Le Mans, France
| | - Maxime A Breban
- Department of Rheumatology, Hôpital Ambroise Paré, Paris, France
| | - Olivier Fain
- Department of Internal Medicine, Hôpital Saint-Antoine, Paris, France
| | | | - Ouafaa Aberkane
- Department of Direction de la recherche clinique et de l'innovation, Strasbourg University Hospital, Strasbourg, France
| | - Marion Vazel
- Department of Direction de la recherche clinique et de l'innovation, Strasbourg University Hospital, Strasbourg, France
| | - Christelle Back
- Department of Direction de la recherche clinique et de l'innovation, Strasbourg University Hospital, Strasbourg, France
| | - Sophie Candon
- Department of Immunology, Hôpital Necker, Paris, France
| | | | - Elodie Perrodeau
- Department of Epidemiology and Biostatistics, Hotel Dieu, Paris, France
| | - Jean Sibilia
- Department of Rheumatology, National Reference Center for Systemic Autoimmune Diseases, Strasbourg University Hospital, Université de Strasbourg, Strasbourg, France
| | - Philippe Ravaud
- Department of Epidemiology and Biostatistics, Hotel Dieu, Paris, France
| |
Collapse
|
247
|
Mekinian A, Fain O. [Not Available]. Rev Prat 2016; 66:e305-e309. [PMID: 30512315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Affiliation(s)
- Arsène Mekinian
- Service de médecine interne, hôpital Saint-Antoine, AP-HP, université Paris-VI, 75012 Paris, France
| | - Olivier Fain
- Service de médecine interne, hôpital Saint-Antoine, AP-HP, université Paris-VI, 75012 Paris, France
| |
Collapse
|
248
|
Gobert D, Paule R, Ponard D, Levy P, Frémeaux-Bacchi V, Bouillet L, Boccon-Gibod I, Drouet C, Gayet S, Launay D, Martin L, Mekinian A, Leblond V, Fain O. A nationwide study of acquired C1-inhibitor deficiency in France: Characteristics and treatment responses in 92 patients. Medicine (Baltimore) 2016; 95:e4363. [PMID: 27537564 PMCID: PMC5370791 DOI: 10.1097/md.0000000000004363] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Acquired angioedema (AAE) due to C1-inhibitor (C1INH) deficiency is rare. Treatment options for acute attacks are variable and used off-label. Successful treatment of the associated lymphoma with rituximab seems to prevent acute attacks in subjects with AAE. The aim of this study was to describe AAE manifestations, its associated diseases, and patients' responses to treatments in a representative cohort.A retrospective nationwide study was conducted in France. The inclusion criteria were recurrent angioedema attacks and an acquired decrease in functional C1INH <50% of the reference value.A total of 92 cases were included, with a median age at onset of 62 years. Facial edema and abdominal pain were the most frequent symptoms. Fifteen patients were hospitalized in the intensive care unit because of laryngeal edema, and 1 patient died. Anti-C1INH antibodies were present in 43 patients. The associated diseases were primarily non-Hodgkin lymphoma (n = 44, with 24 splenic marginal zone lymphomas) and monoclonal gammopathy of undetermined significance (n = 24). Three patients had myeloma, 1 had amyloid light-chain (of immunoglobulin) (AL) amyloidosis, 1 patient had a bronchial adenocarcinoma, and 19 patients had no associated disease. Icatibant relieved the symptoms in all treated patients (n = 26), and plasma-derived C1INH concentrate in 19 of 21 treated patients. Six patients experienced thromboembolic events under tranexamic acid prophylaxis. Rituximab prevented angioedema in 27 of 34 patients as a monotherapy or in association with chemotherapy. Splenectomy controlled AAE in 7 patients treated for splenic marginal zone lymphoma. After a median follow-up of 4.2 years, angioedema was on remission in 52 patients.AAE cases are primarily associated with indolent lymphoma-especially splenic marginal zone lymphoma-and monoclonal gammopathy of undetermined significance but not with autoimmune diseases or other conditions. Icatibant and plasma-derived C1INH concentrate control attacks; splenectomy and immunochemotherapy prevent angioedema in lymphoma setting.
Collapse
Affiliation(s)
- Delphine Gobert
- Internal Medicine Department, Saint Antoine Hospital, Assistance Publique-Hôpitaux de Paris, DHU i2B, Paris 6 University, Paris
- Correspondence: Delphine Gobert, Internal Medicine Department, Hôpital Saint Antoine, 184 Rue Du Faubourg Saint Antoine, 75571 Paris Cedex 12, France (e-mail: )
| | - Romain Paule
- Hematology Department, Pitié Salpétrière Hospital, Assistance Publique-Hôpitaux de Paris, Paris 6 University, Paris
| | - Denise Ponard
- Immunology Laboratory, University Hospital, Grenoble
- Centre de Référence et d’Etude des Angioedèmes à Kinine (CREAK) , Grenoble
| | - Pierre Levy
- Public Health Department, Tenon Hospital, Assistance Publique-Hôpitaux de Paris, Paris 6 University
| | - Véronique Frémeaux-Bacchi
- Immunology Laboratory, Georges Pompidou European Hospital, Assistance Publique-Hôpitaux de Paris, Paris 5 University, Paris
| | - Laurence Bouillet
- Centre de Référence et d’Etude des Angioedèmes à Kinine (CREAK) , Grenoble
- Joint Unit 1036 CNRS-CEA-INSERM, University Grenoble Alpes
- Internal Medicine Department, University Hospital, Grenoble
| | - Isabelle Boccon-Gibod
- Centre de Référence et d’Etude des Angioedèmes à Kinine (CREAK) , Grenoble
- Joint Unit 1036 CNRS-CEA-INSERM, University Grenoble Alpes
- Internal Medicine Department, University Hospital, Grenoble
| | - Christian Drouet
- Centre de Référence et d’Etude des Angioedèmes à Kinine (CREAK) , Grenoble
- Université Joseph Fourier Grenoble, GREPI/AGIM CNRS FRE 3405, Grenoble
| | - Stéphane Gayet
- Centre de Référence et d’Etude des Angioedèmes à Kinine (CREAK) , Grenoble
- Internal Medicine Department, La Conception Hospital, AP-HM, Marseille
| | - David Launay
- Centre de Référence et d’Etude des Angioedèmes à Kinine (CREAK) , Grenoble
- Internal Medicine and Clinical Immunology Department, Lille University Hospital
- LIRIC, INSERM UMR 995, EA2686, Lille
| | - Ludovic Martin
- Centre de Référence et d’Etude des Angioedèmes à Kinine (CREAK) , Grenoble
- Dermatology Department, L’UNAM Université, University Hospital, Angers, France
| | - Arsène Mekinian
- Internal Medicine Department, Saint Antoine Hospital, Assistance Publique-Hôpitaux de Paris, DHU i2B, Paris 6 University, Paris
| | - Véronique Leblond
- Hematology Department, Pitié Salpétrière Hospital, Assistance Publique-Hôpitaux de Paris, Paris 6 University, Paris
| | - Olivier Fain
- Internal Medicine Department, Saint Antoine Hospital, Assistance Publique-Hôpitaux de Paris, DHU i2B, Paris 6 University, Paris
- Centre de Référence et d’Etude des Angioedèmes à Kinine (CREAK) , Grenoble
| |
Collapse
|
249
|
Grignano E, Mekinian A, Braun T, Liozon E, Hamidou M, Decaux O, Puéchal X, Kahn JE, Schoindre Y, Rossignol J, Lortholary O, Lioger B, Hermine O, Park S, Ades L, Montestruc F, Ricard L, Gardin C, Fenaux P, Fain O. Autoimmune and inflammatory diseases associated with chronic myelomonocytic leukemia: A series of 26 cases and literature review. Leuk Res 2016; 47:136-41. [DOI: 10.1016/j.leukres.2016.05.013] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2016] [Revised: 05/13/2016] [Accepted: 05/19/2016] [Indexed: 12/26/2022]
|
250
|
Ghrenassia E, Mekinian A, Chapelon-Albric C, Levy P, Cosnes J, Sève P, Lefèvre G, Dhôte R, Launay D, Prendki V, Morell-Dubois S, Sadoun D, Mehdaoui A, Soussan M, Bourrier A, Ricard L, Benamouzig R, Valeyre D, Fain O. Digestive-tract sarcoidosis: French nationwide case-control study of 25 cases. Medicine (Baltimore) 2016; 95:e4279. [PMID: 27442665 PMCID: PMC5265782 DOI: 10.1097/md.0000000000004279] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2016] [Revised: 06/19/2016] [Accepted: 06/22/2016] [Indexed: 12/21/2022] Open
Abstract
Digestive tract sarcoidosis (DTS) is rare and case-series are lacking. In this retrospective case-control study, we aimed to compare the characteristics, outcome, and treatment of patients with DTS, nondigestive tract sarcoidosis (NDTS), and Crohn disease.We included cases of confirmed sarcoidosis, symptomatic digestive tract involvement, and noncaseating granuloma in any digestive tract. Each case was compared with 2 controls with sarcoidoisis without digestive tract involvement and 4 with Crohn disease.We compared 25 cases of DTS to 50 controls with NDTS and 100 controls with Crohn disease. The major digestive clinical features were abdominal pain (56%), weight loss (52%), nausea/vomiting (48%), diarrhea (32%), and digestive bleeding (28%). On endoscopy of DTS, macroscopic lesions were observed in the esophagus (9%), stomach (78%), duodenum (9%), colon, (25%) and rectum (19%). As compared with NDTS, DTS was associated with weight loss (odds ratio [OR] 5.8; 95% confidence interval [CI] 1.44-23.3) and the absence of thoracic adenopathy (OR 5.0; 95% CI 1.03-25). As compared with Crohn disease, DTS was associated with Afro-Caribbean origin (OR 27; 95% CI 3.6-204) and the absence of ileum or colon macroscopic lesions (OR 62.5; 95% CI 10.3-500). On the last follow-up, patients with DTS showed no need for surgery (versus 31% for patients with Crohn disease; P = 0.0013), and clinical digestive remission was frequent (76% vs. 35% for patients with Crohn disease; P = 0.0002).The differential diagnosis with Crohn disease could be an issue with DTS. Nevertheless, the 2 diseases often have different clinical presentation and outcome.
Collapse
Affiliation(s)
- Etienne Ghrenassia
- AP-HP, Hôpital Saint-Antoine, Sorbonne Universités, UPMC Université Paris 06, service de médecine interne and Inflammation-Immunopathology-Biotherapy Department (DHU i2B)
| | - Arsene Mekinian
- AP-HP, Hôpital Saint-Antoine, Sorbonne Universités, UPMC Université Paris 06, service de médecine interne and Inflammation-Immunopathology-Biotherapy Department (DHU i2B)
| | - Catherine Chapelon-Albric
- APHP, Hôpital Pitié-Salpétrière, Sorbonne Universités, UPMC Université Paris 06, service de médecine interne
| | - Pierre Levy
- APHP, Hôpital Tenon, Sorbonne Universités, UPMC Université Paris 06, Public health department
| | - Jacques Cosnes
- APHP, Hôpital Saint-Antoine, Sorbonne Universités, UPMC Université Paris 06, service de gastro-entérologie, Paris
| | - Pascal Sève
- Hôpital de la Croix-Rousse, Hospices Civils de Lyon, department of internal medicine, F-Lyon. University Claude Bernard Lyon 1, F-69100, Villeurbanne
| | | | - Robin Dhôte
- APHP, Hôpital Avicenne, service de médecine interne, université Paris 13, Bobigny, France
| | - David Launay
- Hôpital Claude Huriez, service de médecine interne, Lille, France
| | - Virginie Prendki
- Department of internal medicine, Division of internal medicine and rehabilitation, rehabilitation and geriatrics, Geneva University Hospitals and University of Geneva, Geneva, Switzerland
| | | | - Danielle Sadoun
- APHP, Hôpital Avicenne, Université Paris 13, service de pneumologie, Bobigny
| | | | - Michael Soussan
- APHP, Hôpital Avicenne, Université Paris 13, service de médecine nucléaire
| | - Anne Bourrier
- APHP, Hôpital Saint-Antoine, Sorbonne Universités, UPMC Université Paris 06, service de gastro-entérologie, Paris
| | - Laure Ricard
- AP-HP, Hôpital Saint-Antoine, Sorbonne Universités, UPMC Université Paris 06, service de médecine interne and Inflammation-Immunopathology-Biotherapy Department (DHU i2B)
| | - Robert Benamouzig
- APHP, Hôpital Avicenne, Université Paris 13, service de gastro-entérologie, Bobigny, France
| | - Dominique Valeyre
- APHP, Hôpital Avicenne, Université Paris 13, service de pneumologie, Bobigny
| | - Olivier Fain
- AP-HP, Hôpital Saint-Antoine, Sorbonne Universités, UPMC Université Paris 06, service de médecine interne and Inflammation-Immunopathology-Biotherapy Department (DHU i2B)
| |
Collapse
|