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Cacciatore C, Belnou P, Thietart S, Desthieux C, Versini M, Abisror N, Ottaviani S, Cormier G, Deroux A, Dellal A, Belhomme N, Kermanac'H NS, Khafagy P, Michaud M, Lanot S, Carrat F, Fain O, Mékinian A. Acute and Chronic Sarcoid Arthropathies: Characteristics and Treatments From a Retrospective Nationwide French Study. Front Med (Lausanne) 2020; 7:565420. [PMID: 33363181 PMCID: PMC7758528 DOI: 10.3389/fmed.2020.565420] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Accepted: 10/16/2020] [Indexed: 12/26/2022] Open
Abstract
Introduction: We aimed to analyze patients with acute and chronic joint involvements in sarcoidosis. Methods: This is a retrospective multicenter analysis of patients with proven sarcoidosis, as defined by clinical, radiological, and histological criteria, with at least one clinical and/or ultrasonographic synovitis. Results: Thirty-nine patients with sarcoid arthropathy were included, and among them 19 had acute sarcoidosis (Lofgren's syndrome). Joint involvement and DAS44-CRP were not significantly different in acute and chronic sarcoid arthropathies. Acute forms were more frequent than chronic sarcoid arthropathy in Caucasians, without any difference of sex or age between these 2 forms. Joint involvement was frequently more symmetrical in acute than chronic forms (100 vs. 70%; p < 0.05), with a more frequent involvement in wrists and ankles in acute forms, whereas the tender and swollen joint counts and the DAS44-CRP were similar between the 2 groups. Skin lesions were significantly more frequent in patients with acute forms [17 (89%) vs. 5 (25%); p < 0.05] and were erythema nodosum in all patients with Löfgren's syndrome and sarcoid skin lesions in those with chronic sarcoidosis. Among 20 patients with chronic sarcoidosis, treatment was used in 17 (85%) cases, and consisted in NSAIDs alone (n = 5; 25%), steroids alone (n = 5; 25%), hydroxychloroquine (n = 2; 20%), methotrexate (n = 3; 15%), and TNF inhibitors (n = 2; 10%). A complete/partial joint response was noted in 14 (70%) cases with a DAS44-CRP reduction of 2.07 [1.85–2.44] (from 3.13 [2.76–3.42] to 1.06 [0.9–1.17]; p < 0.05). Conclusion: Sarcoid arthropathies have different clinical phenotypes in acute and chronic forms and various treatment regimens such as hydroxychloroquine and methotrexate could be used in chronic forms.
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Affiliation(s)
- Carlotta Cacciatore
- Sorbonne Université, Service de médecine interne, Hôpital Saint-Antoine, DHU I2B: Inflammation, Immunopathologie, Biothérapie, APHP, Paris, France
| | - Pierre Belnou
- Sorbonne Université, Service de santé publique, Hôpital Saint-Antoine, APHP, Paris, France
| | - Sara Thietart
- Sorbonne Université, Service de médecine interne, Hôpital Saint-Antoine, DHU I2B: Inflammation, Immunopathologie, Biothérapie, APHP, Paris, France
| | - Carole Desthieux
- Sorbonne Université, Service de médecine interne, Hôpital Saint-Antoine, DHU I2B: Inflammation, Immunopathologie, Biothérapie, APHP, Paris, France
| | - Mathilde Versini
- Service de Médecine interne, Centre Hospitalier Universitaire de Nice, Nice, France
| | - Noemie Abisror
- Sorbonne Université, Service de médecine interne, Hôpital Saint-Antoine, DHU I2B: Inflammation, Immunopathologie, Biothérapie, APHP, Paris, France
| | | | | | - Alban Deroux
- Service de médecine interne, CHU Grenoble, La Tronche, France
| | - Azeddine Dellal
- Service de rhumatologie, Hôpital Montfermeil, Montfermeil, France
| | - Nicolas Belhomme
- Service de médecine interne et immunologie clinique, CHU Rennes, Rennes, France
| | - Nathalie Saidenberg Kermanac'H
- Service de rhumatologie, Groupe hospitalier Avicenne-Jean Verdier-René Muret, APHP, Bobigny, France.,Sorbonne Paris Cité, Université Paris 13, INSERM U1125, Bobigny, France
| | | | - Martin Michaud
- Service de médecine interne, Hôpital Joseph Ducuing, Toulouse, France
| | - Sylvain Lanot
- Service de rhumatologie, C.H intercommunal Alençon-Mamers, Alençon, France
| | - Fabrice Carrat
- Sorbonne Université, Service de santé publique, Hôpital Saint-Antoine, APHP, Paris, France.,Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Paris, France
| | - Olivier Fain
- Sorbonne Université, Service de médecine interne, Hôpital Saint-Antoine, DHU I2B: Inflammation, Immunopathologie, Biothérapie, APHP, Paris, France
| | - Arsène Mékinian
- Sorbonne Université, Service de médecine interne, Hôpital Saint-Antoine, DHU I2B: Inflammation, Immunopathologie, Biothérapie, APHP, Paris, France
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Hirabayashi Y, Munakata Y, Miyata M, Urata Y, Saito K, Okuno H, Yoshida M, Kodera T, Watanabe R, Miyamoto S, Ishii T, Nakazawa S, Takemori H, Ando T, Kanno T, Komagamine M, Kato I, Takahashi Y, Komatsuda A, Endo K, Murai C, Takakubo Y, Miura T, Sato Y, Ichikawa K, Konta T, Chiba N, Muryoi T, Kobayashi H, Fujii H, Sekiguchi Y, Hatakeyama A, Ogura K, Sakuraba H, Asano T, Kanazawa H, Suzuki E, Takasaki S, Asakura K, Sugisaki K, Suzuki Y, Takagi M, Nakayama T, Watanabe H, Miura K, Mori Y. Clinical and structural remission rates increased annually and radiographic progression was continuously inhibited during a 3-year administration of tocilizumab in patients with rheumatoid arthritis: A multi-center, prospective cohort study by the Michinoku Tocilizumab Study Group. Mod Rheumatol 2016; 26:828-835. [DOI: 10.3109/14397595.2016.1160991] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
| | | | - Masayuki Miyata
- Department of Internal Medicine, Fukushima Red Cross Hospital, Fukushima, Japan,
| | - Yukitomo Urata
- Department of Rheumatology, Tsugaru General Hospital, Gosyogawara, Japan,
| | - Koichi Saito
- Suminoya Rheumatism & Orthopedics Clinic, Iwaki, Japan,
| | - Hiroshi Okuno
- Department of Orthopaedic Surgery, Tohoku University Graduate School of Medicine, Sendai, Japan,
| | - Masaaki Yoshida
- Yoshida Orthopaedic Surgery and Rheumatology Clinic, Morioka, Japan,
| | - Takao Kodera
- Center for Arthritis and Rheumatic Diseases, Tohoku Pharmaceutical University Hospital, Sendai, Japan,
| | - Ryu Watanabe
- Department of Hematology and Rheumatology, Tohoku University Graduate School of Medicine, Sendai, Japan,
| | - Seiya Miyamoto
- Department of Orthopaedic Surgery, Nakadori General Hospital, Akita, Japan,
| | - Tomonori Ishii
- Department of Hematology and Rheumatology, Tohoku University Graduate School of Medicine, Sendai, Japan,
| | | | - Hiromitsu Takemori
- Department of Rheumatology, Aomori Prefectural Central Hospital, Aomori, Japan,
| | - Takanobu Ando
- School of Medicine Department of Orthopaedic Surgery, Iwate Medical University, Morioka, Japan,
| | - Takashi Kanno
- Department of Rheumatology, Ohta Nishinouchi Hospital, Koriyama, Japan,
| | | | - Ichiro Kato
- Department of Arthritis and Rheumatic Diseases, Tohoku Rosai Hospital, Sendai, Japan,
| | | | - Atsushi Komatsuda
- Department of Hematology, Nephrology, and Rheumatology, Akita University Hospital, Akita, Japan,
| | - Kojiro Endo
- Department of Rheumatology and Department of Orthopaedic Surgery, Hoshi General Hospital, Koriyama, Japan,
| | | | - Yuya Takakubo
- Department of Orthopaedic Surgery, Yamagata University Faculty of Medicine, Yamagata, Japan,
| | - Takao Miura
- Department of Orthopaedic Surgery, Hirosaki Memorial Hospital, Hirosaki, Japan,
| | | | - Kazunobu Ichikawa
- Department of Cardiology, Pulmonology, and Nephrology, Yamagata University Faculty of Medicine, Yamagata, Japan,
| | - Tsuneo Konta
- Department of Cardiology, Pulmonology, and Nephrology, Yamagata University Faculty of Medicine, Yamagata, Japan,
| | - Noriyuki Chiba
- Department of Internal Medicine, Morioka National Hospital, Morioka, Japan,
| | | | - Hiroko Kobayashi
- Department of Gastroenterology and Rheumatology, Fukushima Medical University Hospital, Fukushima, Japan,
| | - Hiroshi Fujii
- Department of Hematology and Rheumatology, Tohoku University Graduate School of Medicine, Sendai, Japan,
| | | | - Akira Hatakeyama
- Department of Arthritis and Rheumatic Diseases, Tohoku Rosai Hospital, Sendai, Japan,
| | - Ken Ogura
- Department of Orthopaedic Surgery, Yonezawa City Hospital, Yonezawa, Japan,
| | - Hirotake Sakuraba
- Department of Gastroenterology and Hematology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan,
| | - Tomoyuki Asano
- Department of Gastroenterology and Rheumatology, Fukushima Medical University Hospital, Fukushima, Japan,
| | - Hiroshi Kanazawa
- Department of Rheumatology, Aomori Prefectural Central Hospital, Aomori, Japan,
| | - Eiji Suzuki
- Department of Rheumatology, Ohta Nishinouchi Hospital, Koriyama, Japan,
| | - Satoshi Takasaki
- Department of Cardiology, Pulmonology, and Nephrology, Yamagata University Faculty of Medicine, Yamagata, Japan,
| | - Kenichi Asakura
- Department of Internal Medicine, Yuri Kumiai General Hospital, Yurihonjo, Japan,
| | - Kota Sugisaki
- Department of Internal Medicine, Mito Red Cross Hospital, Mito, Japan,
| | | | - Michiaki Takagi
- Department of Orthopaedic Surgery, Yamagata University Faculty of Medicine, Yamagata, Japan,
| | - Takahiro Nakayama
- Department of Internal Medicine, Nihonkai General Hospital, Sakata, Japan, and
| | - Hiroshi Watanabe
- Department of Gastroenterology and Rheumatology, Fukushima Medical University Hospital, Fukushima, Japan,
| | - Keiki Miura
- Department of Orthopaedic Surgery, Tome Citizen Hospital, Miyagi, Japan
| | - Yu Mori
- Department of Orthopaedic Surgery, Tohoku University Graduate School of Medicine, Sendai, Japan,
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Comparative Effectiveness of Tocilizumab and TNF Inhibitors in Rheumatoid Arthritis Patients: Data from the Rheumatic Diseases Portuguese Register, Reuma.pt. BIOMED RESEARCH INTERNATIONAL 2015; 2015:279890. [PMID: 26000286 PMCID: PMC4427085 DOI: 10.1155/2015/279890] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/05/2014] [Accepted: 02/11/2015] [Indexed: 01/10/2023]
Abstract
Objectives. To compare the effectiveness of TNF inhibitors (TNFi) and tocilizumab in rheumatoid arthritis (RA) treatment, according to different response criteria. Methods. We included RA patients registered in the Rheumatic Diseases Portuguese Register treated with TNFi or tocilizumab for at least 6 months, between January 2008 and July 2013. We assessed remission/low disease activity (LDA) at 6 months according to DAS28, CDAI, and SDAI, as well as Boolean ACR/EULAR remission and EULAR response rate, adjusting for measured confounders. Results. Tocilizumab-treated patients (n = 95) presented higher baseline disease activity and were less frequently naïve to biologics compared to TNFi users (n = 429). Multivariate logistic regression analysis including the propensity score for receiving tocilizumab showed that patients treated with tocilizumab were more likely to achieve remission or LDA according to DAS28 (OR = 11.0/6.2, 95% CI 5.6–21.6/3.2–12.0), CDAI (OR = 2.8/2.6, 95% CI 1.2–6.5/1.3–5.5), or SDAI (OR = 3.6/2.5, 95% CI 1.5–8.7/1.1–5.5), as well as a good EULAR response (OR = 6.4, 95% CI 3.4–12.0). However, both groups did not differ in Boolean remission (OR = 1.9, 95% CI 0.8–4.8) or good/moderate EULAR response (OR = 1.8, 95% CI 0.8–4.5). Conclusions. Compared with TNFi, tocilizumab was associated with greater likelihood of achieving DAS28, CDAI, and SDAI remission/LDA and EULAR good response. Boolean remission and EULAR good/moderate response did not differ significantly between groups.
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Balogh E, Madruga Dias J, Orr C, Mullan R, Harty L, FitzGerald O, Gallagher P, Molloy M, O'Flynn E, Kelly A, Minnock P, O'Neill M, Moore L, Murray M, Fearon U, Veale DJ. Comparison of remission criteria in a tumour necrosis factor inhibitor treated rheumatoid arthritis longitudinal cohort: patient global health is a confounder. Arthritis Res Ther 2013; 15:R221. [PMID: 24365061 PMCID: PMC3978469 DOI: 10.1186/ar4421] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2013] [Accepted: 12/10/2013] [Indexed: 02/06/2023] Open
Abstract
INTRODUCTION Our objectives were to assess the frequency and sustainability of American College of Rheumatology (ACR)/European League against Rheumatism (EULAR) and Disease Activity Score (DAS)28(4v)-C-reactive protein (CRP) remission 12 months after the initiation of tumour necrosis factor inhibitor (TNFi) therapy in a rheumatoid arthritis (RA) cohort. METHODS Data were collected of 273 biologic naive RA patients at baseline, then 3, 6 and 12 months post-TNFi therapy. Remission status was calculated using DAS28(4v)-CRP <2.6 and ACR/EULAR Boolean criteria. Response was scored using EULAR criteria. RESULTS Mean (range) patient age was 59.9 (7.2-85.4) years with disease duration of 13.4 (1.0-52.0) years. Responder status maintained from 3-12 months (86%, 82.4%), laboratory/clinical parameters (erythrocyte sedimentation rate (ESR), CRP, patient global health (PGH), DAS28(4v)-CRP) also showed sustained improvement (P < 0.05). DAS28 remission was reached by 102 subjects at 1 year, 27 patients were in Boolean remission, but 75 missed it from the DAS28 remission group. Patients in remission were younger (P = 0.041) with lower baseline tender joint count (TJC)28 and PGH than those not in remission (P = 0.001, P = 0.047). DAS28 remission patients were older (P = 0.026) with higher 12 months PGH and subsequently higher DAS28 than Boolean remission patients (P < 0.0001). Patients not achieving Boolean remission due to missing one subcriteria most frequently missed PGH ≤1 criteria (79.8%). CONCLUSIONS Only 10% of this TNFi treated cohort achieved remission according to the new ACR/EULAR criteria, which requires lower disease activity. More stringent criteria may ensure further resolution of disease activity and better longterm radiographic outcome, which supports earlier intervention with biologic therapy in RA.
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