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Créquit P, Vivot A, Grégory J, Milleron B. Availability of results of academic randomized trials involving cooperative groups in oncology in France: A systematic search of clinical trial registries. J Cancer Policy 2022; 33:100347. [PMID: 35779787 DOI: 10.1016/j.jcpo.2022.100347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Revised: 06/17/2022] [Accepted: 06/27/2022] [Indexed: 10/17/2022]
Abstract
BACKGROUND Cooperative groups' involvement is increasing in academic oncological research. We aimed to assess the impact of sponsoring by cooperative groups in France on the availability of results of academic randomized trials in oncology. METHODS We performed a systematic search using ClinicalTrials.gov and the European Clinical Trials Register. We searched for all academic randomized trials in oncology conducted in France between January 1, 2005 and January 1, 2015. The inclusion criteria were: completed or terminated, phase 2 or 3 randomized trials with an academic (non-industry) sponsor. The main outcome was the publication of the results of trial (either as a journal article or as posting results in a registry) across each type of sponsor. RESULTS We included 211 randomized trials, mainly phase 3 (n = 135, 64%) and evaluating pharmacological treatments (n = 149, 71%). French cooperative groups were involved in 69 trials (33%), as part of a collaboration in one third (n = 23) of instances. Seventy-one (34%) trials were run by oncologic hospitals, 50 (23%) by university hospitals, and 21 (10%) by European organizations. Seventy-seven randomized trials (36%) had available results (published n = 73, posted n = 6). Cooperative groups were involved in half of those that have been published (37/73). The cumulative probability of results availability was 57% for cooperative groups, 41% for European organizations, 32% for oncologic hospitals, and 17% for university hospital at 10 years from the beginning of trials (p = 0.0006). In the case of collaboration with cooperative groups, the cumulative probability of results availability achieved 59% for university hospitals and 74% for oncologic hospitals. CONCLUSION The availability of results of randomized trials in oncology remains limited and almost exclusively through publications, but is higher when cooperative groups are involved. POLICY SUMMARY Sponsoring by a cooperative group should become the rule in academic trials to increase availability of trial results.
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Affiliation(s)
- Perrine Créquit
- Direction de la recherche Clinique, Hôpital Foch, Suresnes, France; Université de Paris, CRESS, INSERM, INRA, F-75004 Paris, France.
| | - Alexandre Vivot
- Department of Biostatistics and Medical Information, Saint-Louis Hospital, AP-HP, F-75010 Paris, France
| | - Jules Grégory
- Université de Paris, CRESS, INSERM, INRA, F-75004 Paris, France; Department of Radiology, Beaujon Hospital, Paris Nord Val de Seine Hospitals, APHP, Clichy, France
| | - Bernard Milleron
- Department of Thoracic Oncology, Bichat Hospital, AP-HP, Paris, France
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2
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Puéchal X, Iudici M, Calich AL, Vivot A, Terrier B, Régent A, Cohen P, Jeunne CL, Mouthon L, Ravaud P, Guillevin L. Corrigendum to: Rituximab for induction and maintenance therapy of granulomatosis with polyangiitis: a single-centre cohort study on 114 patients. Rheumatology (Oxford) 2022; 61:3505. [PMID: 35237803 DOI: 10.1093/rheumatology/keac087] [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: 11/14/2022] Open
Affiliation(s)
- Xavier Puéchal
- National Referral Center for Rare Systemic Autoimmune Diseases, Department of Internal Medicine, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris (APHP), Université Paris Descartes.,Institut Cochin, INSERM U1016, CNRS UMR 8104
| | - Michele Iudici
- National Referral Center for Rare Systemic Autoimmune Diseases, Department of Internal Medicine, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris (APHP), Université Paris Descartes
| | - Ana Luisa Calich
- National Referral Center for Rare Systemic Autoimmune Diseases, Department of Internal Medicine, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris (APHP), Université Paris Descartes
| | - Alexandre Vivot
- Clinical Epidemiology Unit, Hôtel-Dieu Hospital, APHP.,UMR 1153 Epidemiology and Statistics Sorbonne Paris Cité Research Center (CRESS), INSERM, Université Paris Descartes, Paris, France
| | - Benjamin Terrier
- National Referral Center for Rare Systemic Autoimmune Diseases, Department of Internal Medicine, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris (APHP), Université Paris Descartes.,Institut Cochin, INSERM U1016, CNRS UMR 8104
| | - Alexis Régent
- National Referral Center for Rare Systemic Autoimmune Diseases, Department of Internal Medicine, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris (APHP), Université Paris Descartes.,Institut Cochin, INSERM U1016, CNRS UMR 8104
| | - Pascal Cohen
- National Referral Center for Rare Systemic Autoimmune Diseases, Department of Internal Medicine, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris (APHP), Université Paris Descartes
| | - Claire Le Jeunne
- National Referral Center for Rare Systemic Autoimmune Diseases, Department of Internal Medicine, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris (APHP), Université Paris Descartes
| | - Luc Mouthon
- National Referral Center for Rare Systemic Autoimmune Diseases, Department of Internal Medicine, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris (APHP), Université Paris Descartes.,Institut Cochin, INSERM U1016, CNRS UMR 8104
| | - Philippe Ravaud
- Clinical Epidemiology Unit, Hôtel-Dieu Hospital, APHP.,UMR 1153 Epidemiology and Statistics Sorbonne Paris Cité Research Center (CRESS), INSERM, Université Paris Descartes, Paris, France
| | - Loïc Guillevin
- National Referral Center for Rare Systemic Autoimmune Diseases, Department of Internal Medicine, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris (APHP), Université Paris Descartes
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Ferreira D, Vivot A, Berthier F. Comment on: Application of a new serratus anterior plane block in modified radical mastectomy under ultrasound guidance: A prospective, randomized controlled trial. J Clin Anesth 2021; 75:110477. [PMID: 34358852 DOI: 10.1016/j.jclinane.2021.110477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Revised: 07/23/2021] [Accepted: 07/27/2021] [Indexed: 11/27/2022]
Affiliation(s)
- D Ferreira
- Anesthesiology and Intensive Care Department, CHU Besançon, F-25000 Besançon, France.
| | - A Vivot
- Service de biostatistique et information médicale, Hôpital Saint Louis, AP-HP, Paris, France
| | - F Berthier
- Anesthesiology and Intensive Care Department, CHU Besançon, F-25000 Besançon, France
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Vivot A, Grégory J, Porcher R. Application of Basic Epidemiologic Principles and Electronic Health Records in a Deep Learning Prediction Model. JAMA Dermatol 2020; 156:472-473. [PMID: 32049304 DOI: 10.1001/jamadermatol.2019.4919] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- Alexandre Vivot
- Université de Paris, Epidemiology and Statistics Research Center (CRESS), Institut National de la Santé et de la Recherche Médicale (INSERM), Institut National de la Recherche Agronomique (INRA), F-75004, Paris, France.,Centre d'Épidémiologie Clinique, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Hôtel-Dieu, F-75004, Paris, France
| | - Jules Grégory
- Université de Paris, Epidemiology and Statistics Research Center (CRESS), Institut National de la Santé et de la Recherche Médicale (INSERM), Institut National de la Recherche Agronomique (INRA), F-75004, Paris, France.,Centre d'Épidémiologie Clinique, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Hôtel-Dieu, F-75004, Paris, France
| | - Raphaël Porcher
- Université de Paris, Epidemiology and Statistics Research Center (CRESS), Institut National de la Santé et de la Recherche Médicale (INSERM), Institut National de la Recherche Agronomique (INRA), F-75004, Paris, France.,Centre d'Épidémiologie Clinique, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Hôtel-Dieu, F-75004, Paris, France
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Oikonomidi T, Vivot A, Tran VT, Riveros C, Robin E, Ravaud P. A Methodologic Systematic Review of Mobile Health Behavior Change Randomized Trials. Am J Prev Med 2019; 57:836-843. [PMID: 31753266 DOI: 10.1016/j.amepre.2019.07.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [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] [Received: 03/11/2019] [Revised: 07/08/2019] [Accepted: 07/09/2019] [Indexed: 12/26/2022]
Abstract
CONTEXT Mobile health helps providers offer accessible, affordable, tailored behavior change interventions. However, research assessing mobile health interventions may feature methodologic shortcomings and poor reporting. This review aims to summarize the characteristics, methods, and intervention reporting of RCTs evaluating mobile health behavior change interventions. EVIDENCE ACQUISITION This was a methodologic systematic review of RCTs assessing mobile health behavior change interventions published in PubMed from January 1, 2014 to January 1, 2018, in journals with the upper half of Impact Factors (Clarivate Analytics). Three reviewers independently extracted sample characteristics. Primary outcomes were classified as patient-important or not using definitions from the literature. Any non-patient-important outcomes were then reclassified by a panel of 3 patients. Intervention reporting was assessed by the mobile health Evidence Reporting and Assessment checklist. Data were analyzed in December 2018. EVIDENCE SYNTHESIS Most of the 231 included RCTs assessed text messaging (51%) or smartphone app (28%) interventions aiming to change nutrition and physical activity (36%) or treatment adherence (25%). Only 8% of RCTs had a patient-important primary outcome, follow-up of ≥6 months, and intent-to-treat analysis. Most primary outcomes were behavioral measures (60%). Follow-up was <3 months in 29% of RCTs. Regarding reporting, 12 of the 16 checklist items were reported in less than half of RCTs (e.g., usability/content testing, 32%; data security, 13%). CONCLUSIONS Reports of RCTs assessing mobile health behavior change interventions lack information that would be useful for providers, including reporting of long-term intervention impact on patient-important primary outcomes and information needed for intervention replicability.
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Affiliation(s)
- Theodora Oikonomidi
- Clinical Epidemiology Unit, Hôtel Dieu Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France; Université de Paris, CRESS, INSERM, INRA, Paris, France
| | - Alexandre Vivot
- Clinical Epidemiology Unit, Hôtel Dieu Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France; Université de Paris, CRESS, INSERM, INRA, Paris, France.
| | - Viet-Thi Tran
- Clinical Epidemiology Unit, Hôtel Dieu Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France; Université de Paris, CRESS, INSERM, INRA, Paris, France
| | - Carolina Riveros
- Clinical Epidemiology Unit, Hôtel Dieu Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | | | - Philippe Ravaud
- Clinical Epidemiology Unit, Hôtel Dieu Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France; Université de Paris, CRESS, INSERM, INRA, Paris, France; Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York
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6
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Li J, Vivot A, Alter L, Durand-Zaleski I. Appraisal of cancer drugs: a comparison of the French health technology assessment with value frameworks of two oncology societies. Expert Rev Pharmacoecon Outcomes Res 2019; 20:405-409. [PMID: 31240965 DOI: 10.1080/14737167.2019.1635458] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
OBJECTIVES Our primary objective was to compare the grading of the value of cancer drugs ('Amélioration du Service Médical Rendu' [ASMR] level) by the French health technology assessment authority ('Haute Autorité de santé' [HAS]) with that by the American Society of Clinical Oncology Value Framework (ASCO-VF) and the European Society for Medical Oncology Magnitude of Clinical Benefit Scale (ESMO-MCBS). Our secondary objective was to study the drivers of the French grading system. METHODS We included new drugs for solid tumors assessed by the HAS between 2010 and 2016 and compared their ASMR level to scores calculated by the 2016-updated ASCO-VF and 2015 ESMO-MCBS. RESULTS We investigated 27 new cancer drugs assessed by the French HAS between 2010 and 2016. Among the 17 drugs eligible for comparison, the correlation between ASMR levels and ASCO and ESMO scores was weak (r = 0.34 and r = 0.27, respectively). The agreement between the HAS and ESMO regarding the level of meaningful additional benefit was moderate (kappa = 0.43). We found no significant association between 12 potential variables and ASMR level of additional benefit of drugs. CONCLUSION Our findings show inconsistencies in cancer drug appraisals among the three appraisers.
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Affiliation(s)
- J Li
- Clinical Epidemiology Unit, Greater Paris University Hospitals (AP-HP) , Paris, France.,Judge Business School, University of Cambridge , Cambridge, UK.,Faculty of Medicine, Paris XII University , Créteil, France
| | - A Vivot
- Clinical Epidemiology Unit, Greater Paris University Hospitals (AP-HP) , Paris, France.,UMR1153 Epidemiology and Statistics Sorbonne Paris Cité Research Center (CRESS), INSERM, University Paris Descartes , Paris, France
| | - L Alter
- Department is Oncology Business Unit, LILLY FRANCE , Neuilly-sur-Seine, France
| | - I Durand-Zaleski
- Faculty of Medicine, Paris XII University , Créteil, France.,URC Eco IdF, Greater Paris University Hospitals (AP-HP) , Paris, France
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Vivot A, Créquit P, Porcher R. Use of Late-Life Expectancy for Assessing the Long-Term Benefit of Immune Checkpoint Inhibitors. J Natl Cancer Inst 2019; 111:519-521. [PMID: 30615127 DOI: 10.1093/jnci/djy211] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Revised: 10/15/2018] [Accepted: 11/12/2018] [Indexed: 11/14/2022] Open
Abstract
To grade the long-term benefit of anticancer agents, the American Society of Clinical Oncology Value Framework (ASCO-VF) awards tail-of-the-curve bonus points by using milestone survival at twice the median control survival. Here, we propose an alternative, late-life expectancy that we defined as the area under the Kaplan-Meier curve from median control survival to the end of follow-up. We analyzed all indications of immune checkpoint inhibitors with survival data and found that 9 indications out of 13 (69.2%) qualified for ASCO-VF tail-of-the-curve bonus points either in progression-free or overall survival. Our proposed score recognized a long-term benefit not captured by the ASCO-VF, for example, for CHECKMATE-66 where twice the median overall survival was not reached. We found that nivolumab was associated with an increase of 65.3% (95% CI = 38.9 to 89.5) in overall survival late-life expectancy, which highlights its important long-term benefit. In conclusion, the ASCO-VF could be improved with the use of late-life expectancy.
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Affiliation(s)
- Alexandre Vivot
- INSERM, UMR1153 Epidemiology and Statistics Sorbonne Paris Cité Research Center (CRESS), METHODS Team, Paris, France
- Paris Descartes University, Paris, France
- Assistance Publique des Hôpitaux de Paris (AP-HP), Hôpital Hôtel Dieu, Centre d'Épidémiologie Clinique, Paris, France
| | - Perrine Créquit
- INSERM, UMR1153 Epidemiology and Statistics Sorbonne Paris Cité Research Center (CRESS), METHODS Team, Paris, France
- Paris Descartes University, Paris, France
- Assistance Publique des Hôpitaux de Paris (AP-HP), Hôpital Hôtel Dieu, Centre d'Épidémiologie Clinique, Paris, France
| | - Raphaël Porcher
- INSERM, UMR1153 Epidemiology and Statistics Sorbonne Paris Cité Research Center (CRESS), METHODS Team, Paris, France
- Paris Descartes University, Paris, France
- Assistance Publique des Hôpitaux de Paris (AP-HP), Hôpital Hôtel Dieu, Centre d'Épidémiologie Clinique, Paris, France
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8
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Vivot A, Créquit P, Porcher R. Utilisation de l’espérance de vie tardive (EDVT) pour mesurer le bénéfice des immunothérapies. Rev Epidemiol Sante Publique 2019. [DOI: 10.1016/j.respe.2019.03.092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Ferreira D, Vivot A, Meyer N. Méthodes bayésiennes dans les essais contrôlés randomisés de phase III : une revue systématique. Rev Epidemiol Sante Publique 2019. [DOI: 10.1016/j.respe.2019.03.011] [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] Open
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10
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Herbemont C, Chekroune S, Bonan S, Cedrin-Durnerin I, Vivot A, Sonigo C, Boujenah J, Grynberg M, Sifer C. Impact of post-warming culture duration on clinical outcomes of vitrified good-quality blastocyst transfers: a prospective randomized study. Fertil Steril 2019; 110:1290-1297. [PMID: 30503128 DOI: 10.1016/j.fertnstert.2018.07.1153] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2018] [Revised: 07/23/2018] [Accepted: 07/30/2018] [Indexed: 10/27/2022]
Abstract
OBJECTIVE To determine whether post-warming culture duration (1 hour vs. 18 hours) influences implantation rates (IRs) of good-quality blastocysts (GQB) in a good-prognosis population. DESIGN Prospective interventional randomized study. SETTING University hospital. PATIENT(S) One hundred sixty-two GQB transfers. INTERVENTION(S) Patients' vitrified blastocysts were randomly allocated to group A, warming on the day before transfer (n = 81), or B, warming on the day of transfer (n = 81). MAIN OUTCOME MEASURE(S) IR, live birth rate, reexpansion degree, and quality after warming and immediately before transfer. RESULT(S) Quality of the warmed and transferred blastocysts was similar (respectively, 39.1% and 32.7% top quality [≥B4AA/AB/BA] in group A vs. 41.7 and 42.2% in group B). In group A, 14 of 102 blastocysts (12.2%) appeared to be unsuitable for transfer, versus only 1 of 103 (0.9%) in group B, thus leading to an additional warming. As expected, reexpansion degree just before transfer was higher in group A (0.90 vs. 0.70). Likewise, the proportion of hatched blastocysts before transfer was higher after a longer culture period (38.6% in group A vs. 12.7% in group B). IRs were similar (38.0% in group A vs. 36% in group B), as were live birth rates (35.8% in group A vs. 34.6% in group B). CONCLUSION(S) IRs were not different, whatever the duration of post-warming culture of GQB. Both warming strategies could be applied to good-prognosis patients to optimize the laboratory workflow without any detrimental effect.
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Affiliation(s)
- Charlène Herbemont
- AP-HP, Service de Cytogénétique et Biologie de la Reproduction-CECOS, Hôpital Jean Verdier, Bondy, France; Université, Paris XIII, Bobigny, France
| | - Sarah Chekroune
- AP-HP, Service de Cytogénétique et Biologie de la Reproduction-CECOS, Hôpital Jean Verdier, Bondy, France
| | - Sarah Bonan
- AP-HP, Service de Cytogénétique et Biologie de la Reproduction-CECOS, Hôpital Jean Verdier, Bondy, France
| | - Isabelle Cedrin-Durnerin
- AP-HP, Service de Médecine de la Reproduction et Préservation de la Fertilité, Hôpital Jean Verdier, Bondy, France
| | - Alexandre Vivot
- AP-HP, Centre d'Epidémiologie Clinique, Hôpital Hôtel-Dieu, Paris, France; INSERM, UMR1153, Université Paris Descartes, Paris, France
| | - Charlotte Sonigo
- AP-HP, Service de Médecine de la Reproduction et Préservation de la Fertilité, Hôpital Jean Verdier, Bondy, France; INSERM, U1185, Université Paris-Sud, Le Kremlin-Bicetre, France
| | - Jeremy Boujenah
- AP-HP, Service de Médecine de la Reproduction et Préservation de la Fertilité, Hôpital Jean Verdier, Bondy, France; Service de Gynécologie-Obstétrique, Hôpital Jean Verdier, Bondy, France
| | - Michael Grynberg
- Université, Paris XIII, Bobigny, France; AP-HP, Service de Médecine de la Reproduction et Préservation de la Fertilité, Hôpital Jean Verdier, Bondy, France; INSERM, U1133, Université, Paris-Diderot, Paris, France
| | - Christophe Sifer
- AP-HP, Service de Cytogénétique et Biologie de la Reproduction-CECOS, Hôpital Jean Verdier, Bondy, France; Université, Paris XIII, Bobigny, France.
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Créquit P, Martin-Montoya T, Attiche N, Trinquart L, Vivot A, Ravaud P. Living network meta-analysis was feasible when considering the pace of evidence generation. J Clin Epidemiol 2018; 108:10-16. [PMID: 30552957 DOI: 10.1016/j.jclinepi.2018.12.008] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2018] [Revised: 11/11/2018] [Accepted: 12/07/2018] [Indexed: 01/11/2023]
Abstract
OBJECTIVES The aim of the study was to assess the feasibility of living network meta-analysis (NMA) taking into account the pace of evidence generation across different medical areas. STUDY DESIGN AND SETTING We performed a systematic review to identify published NMAs. For each NMA, we calculated the cumulative number of new trials. To assess the feasibility of living NMA, we considered different update frequencies (4, 6, and 12 months), then evaluated the number of new trials to be included at each update in the NMA and the workload percentage for an update relative to the initial NMA. RESULTS We identified 77 NMAs covering 17 different medical areas; 60 (78%) had fewer than four new trials included per year, on average, and 5 (7%) had more than seven trials. With an update frequency of 4, 6, and 12 months, the median number of new trials to be included in the NMA was 0 (interquartile range, 0-1), 1 (0-2), and 2 (1-4), respectively, with mean of 4%, 5%, and 11% workload per update, respectively. CONCLUSION The workload associated with updating a living NMA represents about one-tenth of the initial workload; therefore, living NMA is manageable.
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Affiliation(s)
- Perrine Créquit
- Centre d'Epidémiologie Clinique, Assistance Publique-Hôpitaux de Paris, Hôpital Hôtel-Dieu, Paris, France; Centre de Recherche Epidémiologie et Statistique Paris Sorbonne Cité, INSERM U1153, Université Paris Descartes, Sorbonne Paris Cité, Paris, France; Cochrane France, Paris, France.
| | - Tania Martin-Montoya
- Centre d'Epidémiologie Clinique, Assistance Publique-Hôpitaux de Paris, Hôpital Hôtel-Dieu, Paris, France; Centre de Recherche Epidémiologie et Statistique Paris Sorbonne Cité, INSERM U1153, Université Paris Descartes, Sorbonne Paris Cité, Paris, France
| | - Nassima Attiche
- Centre d'Epidémiologie Clinique, Assistance Publique-Hôpitaux de Paris, Hôpital Hôtel-Dieu, Paris, France; Centre de Recherche Epidémiologie et Statistique Paris Sorbonne Cité, INSERM U1153, Université Paris Descartes, Sorbonne Paris Cité, Paris, France
| | - Ludovic Trinquart
- Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA
| | - Alexandre Vivot
- Centre d'Epidémiologie Clinique, Assistance Publique-Hôpitaux de Paris, Hôpital Hôtel-Dieu, Paris, France; Centre de Recherche Epidémiologie et Statistique Paris Sorbonne Cité, INSERM U1153, Université Paris Descartes, Sorbonne Paris Cité, Paris, France
| | - Philippe Ravaud
- Centre d'Epidémiologie Clinique, Assistance Publique-Hôpitaux de Paris, Hôpital Hôtel-Dieu, Paris, France; Centre de Recherche Epidémiologie et Statistique Paris Sorbonne Cité, INSERM U1153, Université Paris Descartes, Sorbonne Paris Cité, Paris, France; Cochrane France, Paris, France; Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
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Vivot A, Créquit P, Porcher R. Improving on Tail-of-the-Curve Evaluation With the American Society of Clinical Oncology Value Framework. JAMA Oncol 2018; 4:1437-1438. [PMID: 30128475 DOI: 10.1001/jamaoncol.2018.3289] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Alexandre Vivot
- Assistance Publique des Hôpitaux de Paris (AP-HP), Hôpital Hôtel Dieu, Centre d'Épidémiologie Clinique, Paris, France, INSERM U1153
| | - Perrine Créquit
- Assistance Publique des Hôpitaux de Paris (AP-HP), Hôpital Hôtel Dieu, Centre d'Épidémiologie Clinique, Paris, France, INSERM U1153
| | - Raphaël Porcher
- Assistance Publique des Hôpitaux de Paris (AP-HP), Hôpital Hôtel Dieu, Centre d'Épidémiologie Clinique, Paris, France, INSERM U1153
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Crequit P, Vivot A, Porcher R, Cadranel J. Benefit of immune checkpoint inhibitors (ICIs) for second-line treatment of advanced non-small cell lung cancer (NSCLC) using restricted mean survival time (RMST). Lung Cancer 2018. [DOI: 10.1183/13993003.congress-2018.pa2807] [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: 11/05/2022]
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Vo TT, Vivot A, Porcher R. Impact of Biomarker-based Design Strategies on the Risk of False-Positive Findings in Targeted Therapy Evaluation. Clin Cancer Res 2018; 24:6257-6264. [PMID: 30166443 DOI: 10.1158/1078-0432.ccr-18-0328] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2018] [Revised: 05/24/2018] [Accepted: 08/27/2018] [Indexed: 11/16/2022]
Abstract
PURPOSE When there is more than one potentially predictive biomarker for a new drug, the drug is often evaluated in different subpopulations defined by different biomarkers. We aim to (i) estimate the risk of false-positive findings with this approach and (ii) evaluate the cross-validated adaptive signature design (CVASD) as a potential alternative. EXPERIMENTAL DESIGN By using numerically simulated data, we compare the current approach and the CVASD across different settings and scenarios. We consider three strategies for CVASD. The first two CVASD strategies are different in terms of the partitioning of the overall significance level (between the population test and the subgroup test). In the third CVASD strategy, the order of the two tests is reversed, that is, the population test is realized when the prioritized subgroup test is not statistically significant. RESULTS The current approach results in a high risk of false-positive findings, whereas this risk is close to the nominal level of 5% once applying the CVASD, regardless of the strategy. When the treatment is equally effective to all patients, only the CVASD strategies could specify correctly the absence of a sensitive subgroup. When the treatment is only effective for some sensitive responders, the third CVASD strategy stands out by its ability to correctly identify the predictive biomarker(s). CONCLUSIONS The drug-biomarker coevaluation based on a series of independent enrichment trials can result in a high risk of false-positive findings. CVASD with some appropriate adjustments can be a good alternative to overcome this multiplicity issue.
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Affiliation(s)
- Tat-Thang Vo
- INSERM, UMR1153 Epidemiology and Statistics Sorbonne Paris Cité Research Center (CRESS), METHODS Team, Paris Descartes University, Paris, France.,Department of Applied Mathematics, Computer Science & Statistics, Faculty of Science, Ghent University, Ghent, Belgium
| | - Alexandre Vivot
- INSERM, UMR1153 Epidemiology and Statistics Sorbonne Paris Cité Research Center (CRESS), METHODS Team, Paris Descartes University, Paris, France. .,Assistance Publique des Hôpitaux de Paris (AP-HP), Hôpital Hôtel Dieu, Centre d'Épidémiologie Clinique, Paris, France
| | - Raphaël Porcher
- INSERM, UMR1153 Epidemiology and Statistics Sorbonne Paris Cité Research Center (CRESS), METHODS Team, Paris Descartes University, Paris, France.,Assistance Publique des Hôpitaux de Paris (AP-HP), Hôpital Hôtel Dieu, Centre d'Épidémiologie Clinique, Paris, France
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15
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Créquit P, Mansouri G, Benchoufi M, Vivot A, Ravaud P. Mapping of Crowdsourcing in Health: Systematic Review. J Med Internet Res 2018; 20:e187. [PMID: 29764795 PMCID: PMC5974463 DOI: 10.2196/jmir.9330] [Citation(s) in RCA: 70] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2017] [Revised: 02/10/2018] [Accepted: 03/14/2018] [Indexed: 11/22/2022] Open
Abstract
Background Crowdsourcing involves obtaining ideas, needed services, or content by soliciting Web-based contributions from a crowd. The 4 types of crowdsourced tasks (problem solving, data processing, surveillance or monitoring, and surveying) can be applied in the 3 categories of health (promotion, research, and care). Objective This study aimed to map the different applications of crowdsourcing in health to assess the fields of health that are using crowdsourcing and the crowdsourced tasks used. We also describe the logistics of crowdsourcing and the characteristics of crowd workers. Methods MEDLINE, EMBASE, and ClinicalTrials.gov were searched for available reports from inception to March 30, 2016, with no restriction on language or publication status. Results We identified 202 relevant studies that used crowdsourcing, including 9 randomized controlled trials, of which only one had posted results at ClinicalTrials.gov. Crowdsourcing was used in health promotion (91/202, 45.0%), research (73/202, 36.1%), and care (38/202, 18.8%). The 4 most frequent areas of application were public health (67/202, 33.2%), psychiatry (32/202, 15.8%), surgery (22/202, 10.9%), and oncology (14/202, 6.9%). Half of the reports (99/202, 49.0%) referred to data processing, 34.6% (70/202) referred to surveying, 10.4% (21/202) referred to surveillance or monitoring, and 5.9% (12/202) referred to problem-solving. Labor market platforms (eg, Amazon Mechanical Turk) were used in most studies (190/202, 94%). The crowd workers’ characteristics were poorly reported, and crowdsourcing logistics were missing from two-thirds of the reports. When reported, the median size of the crowd was 424 (first and third quartiles: 167-802); crowd workers’ median age was 34 years (32-36). Crowd workers were mainly recruited nationally, particularly in the United States. For many studies (58.9%, 119/202), previous experience in crowdsourcing was required, and passing a qualification test or training was seldom needed (11.9% of studies; 24/202). For half of the studies, monetary incentives were mentioned, with mainly less than US $1 to perform the task. The time needed to perform the task was mostly less than 10 min (58.9% of studies; 119/202). Data quality validation was used in 54/202 studies (26.7%), mainly by attention check questions or by replicating the task with several crowd workers. Conclusions The use of crowdsourcing, which allows access to a large pool of participants as well as saving time in data collection, lowering costs, and speeding up innovations, is increasing in health promotion, research, and care. However, the description of crowdsourcing logistics and crowd workers’ characteristics is frequently missing in study reports and needs to be precisely reported to better interpret the study findings and replicate them.
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Affiliation(s)
- Perrine Créquit
- INSERM UMR1153, Methods Team, Epidemiology and Statistics Sorbonne Paris Cité Research Center, Paris Descartes University, Paris, France.,Centre d'Epidémiologie Clinique, Hôpital Hôtel Dieu, Assistance Publique des Hôpitaux de Paris, Paris, France.,Cochrane France, Paris, France
| | - Ghizlène Mansouri
- INSERM UMR1153, Methods Team, Epidemiology and Statistics Sorbonne Paris Cité Research Center, Paris Descartes University, Paris, France
| | - Mehdi Benchoufi
- Centre d'Epidémiologie Clinique, Hôpital Hôtel Dieu, Assistance Publique des Hôpitaux de Paris, Paris, France
| | - Alexandre Vivot
- INSERM UMR1153, Methods Team, Epidemiology and Statistics Sorbonne Paris Cité Research Center, Paris Descartes University, Paris, France.,Centre d'Epidémiologie Clinique, Hôpital Hôtel Dieu, Assistance Publique des Hôpitaux de Paris, Paris, France
| | - Philippe Ravaud
- INSERM UMR1153, Methods Team, Epidemiology and Statistics Sorbonne Paris Cité Research Center, Paris Descartes University, Paris, France.,Centre d'Epidémiologie Clinique, Hôpital Hôtel Dieu, Assistance Publique des Hôpitaux de Paris, Paris, France.,Cochrane France, Paris, France.,Department of Epidemiology, Columbia University, Mailman School of Public Health, New York, NY, United States
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16
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Puéchal X, Iudici M, Calich AL, Vivot A, Terrier B, Régent A, Cohen P, Jeunne CL, Mouthon L, Ravaud P, Guillevin L. Rituximab for induction and maintenance therapy of granulomatosis with polyangiitis: a single-centre cohort study on 114 patients. Rheumatology (Oxford) 2018; 58:401-409. [DOI: 10.1093/rheumatology/key117] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2018] [Revised: 03/28/2018] [Indexed: 11/12/2022] Open
Affiliation(s)
- Xavier Puéchal
- National Referral Center for Rare Systemic Autoimmune Diseases, Department of Internal Medicine, Hôpital Cochin, Assistance Publique–Hôpitaux de Paris (APHP), Université Paris Descartes, Paris, France
- Institut Cochin, INSERM U1016, CNRS UMR, Paris, France
| | - Michele Iudici
- National Referral Center for Rare Systemic Autoimmune Diseases, Department of Internal Medicine, Hôpital Cochin, Assistance Publique–Hôpitaux de Paris (APHP), Université Paris Descartes, Paris, France
| | - Ana Luisa Calich
- National Referral Center for Rare Systemic Autoimmune Diseases, Department of Internal Medicine, Hôpital Cochin, Assistance Publique–Hôpitaux de Paris (APHP), Université Paris Descartes, Paris, France
| | - Alexandre Vivot
- Clinical Epidemiology Unit, Hôtel-Dieu Hospital, APHP, Paris, France
- UMR 1153 Epidemiology and Statistics Sorbonne Paris Cité Research Center (CRESS), INSERM, Université Paris Descartes, Paris, France
| | - Benjamin Terrier
- National Referral Center for Rare Systemic Autoimmune Diseases, Department of Internal Medicine, Hôpital Cochin, Assistance Publique–Hôpitaux de Paris (APHP), Université Paris Descartes, Paris, France
- Institut Cochin, INSERM U1016, CNRS UMR, Paris, France
| | - Alexis Régent
- National Referral Center for Rare Systemic Autoimmune Diseases, Department of Internal Medicine, Hôpital Cochin, Assistance Publique–Hôpitaux de Paris (APHP), Université Paris Descartes, Paris, France
- Institut Cochin, INSERM U1016, CNRS UMR, Paris, France
| | - Pascal Cohen
- National Referral Center for Rare Systemic Autoimmune Diseases, Department of Internal Medicine, Hôpital Cochin, Assistance Publique–Hôpitaux de Paris (APHP), Université Paris Descartes, Paris, France
| | - Claire Le Jeunne
- National Referral Center for Rare Systemic Autoimmune Diseases, Department of Internal Medicine, Hôpital Cochin, Assistance Publique–Hôpitaux de Paris (APHP), Université Paris Descartes, Paris, France
| | - Luc Mouthon
- National Referral Center for Rare Systemic Autoimmune Diseases, Department of Internal Medicine, Hôpital Cochin, Assistance Publique–Hôpitaux de Paris (APHP), Université Paris Descartes, Paris, France
- Institut Cochin, INSERM U1016, CNRS UMR, Paris, France
| | - Philippe Ravaud
- Clinical Epidemiology Unit, Hôtel-Dieu Hospital, APHP, Paris, France
- UMR 1153 Epidemiology and Statistics Sorbonne Paris Cité Research Center (CRESS), INSERM, Université Paris Descartes, Paris, France
| | - Loïc Guillevin
- National Referral Center for Rare Systemic Autoimmune Diseases, Department of Internal Medicine, Hôpital Cochin, Assistance Publique–Hôpitaux de Paris (APHP), Université Paris Descartes, Paris, France
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Zeitoun JD, Ross JS, Atal I, Vivot A, Downing NS, Baron G, Ravaud P. Factors Associated With Postmarketing Research for Approved Indications for Novel Medicines Approved by Both the FDA and EMA Between 2005 and 2010: A Multivariable Analysis. Clin Pharmacol Ther 2018; 104:1000-1007. [DOI: 10.1002/cpt.1038] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2017] [Revised: 01/17/2018] [Accepted: 01/23/2018] [Indexed: 11/05/2022]
Affiliation(s)
- Jean-David Zeitoun
- Centre d'Épidémiologie Clinique, Hôpital Hôtel Dieu, Assistance Publique-Hôpitaux de Paris; Paris France
- Gastroenterology and Nutrition, Hôpital Saint-Antoine, Assistance Publique-Hôpitaux de Paris; Paris France
- Proctology, Groupe Hospitalier Diaconesses-Croix Saint-Simon; Paris France
- INSERM UMR 1153, Centre de Recherche Épidémiologie et Statistique Paris Sorbonne Cité (CRESS), METHODS Team; Paris France
| | - Joseph S. Ross
- Department of Internal Medicine; National Clinician Scholars Program, Yale School of Medicine; New Haven Connecticut USA
- Department of Internal Medicine; Section of General Internal Medicine, Yale School of Medicine; New Haven Connecticut USA
- Department of Health Policy and Management; Yale School of Public Health; New Haven Connecticut USA
- Center for Outcomes Research and Evaluation, Yale-New Haven Health System; New Haven Connecticut USA
| | - Ignacio Atal
- Centre d'Épidémiologie Clinique, Hôpital Hôtel Dieu, Assistance Publique-Hôpitaux de Paris; Paris France
- INSERM UMR 1153, Centre de Recherche Épidémiologie et Statistique Paris Sorbonne Cité (CRESS), METHODS Team; Paris France
| | - Alexandre Vivot
- Centre d'Épidémiologie Clinique, Hôpital Hôtel Dieu, Assistance Publique-Hôpitaux de Paris; Paris France
- INSERM UMR 1153, Centre de Recherche Épidémiologie et Statistique Paris Sorbonne Cité (CRESS), METHODS Team; Paris France
| | - Nicholas S. Downing
- Department of Medicine; Brigham and Women's Hospital and Harvard Medical School; Boston Massachusetts USA
| | - Gabriel Baron
- Centre d'Épidémiologie Clinique, Hôpital Hôtel Dieu, Assistance Publique-Hôpitaux de Paris; Paris France
- Center for Outcomes Research and Evaluation, Yale-New Haven Health System; New Haven Connecticut USA
- Université Paris Descartes, Sorbonne Paris Cité; Paris France
| | - Philippe Ravaud
- Centre d'Épidémiologie Clinique, Hôpital Hôtel Dieu, Assistance Publique-Hôpitaux de Paris; Paris France
- INSERM UMR 1153, Centre de Recherche Épidémiologie et Statistique Paris Sorbonne Cité (CRESS), METHODS Team; Paris France
- Université Paris Descartes, Sorbonne Paris Cité; Paris France
- Department of Epidemiology; Columbia University Mailman School of Public Health; New York New York USA
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Abstract
OBJECTIVES To characterise postmarketing studies for drugs that were newly approved by the US Food and Drug Administration and the European Medicines Agency. DESIGN AND SETTING Cross-sectional analysis of postmarketing studies registered in ClinicalTrials.gov until September 2014 for all novel drugs approved by both regulators between 2005 and 2010. Regulatory documents from both agencies were used. PRIMARY AND SECONDARY OUTCOME MEASURES All identified postmarketing studies were classified according to planned enrolment, funding, status and geographical location, and we determined whether studies studied the originally approved indication. RESULTS Overall, 69 novel drugs approved between 2005 and 2010 were eligible for inclusion. A total of 6679 relevant postmarketing studies were identified; 5972 were interventional (89.4%). The median number of studies per drug was 55 (IQR 33-119) and median number of patients to be enrolled per study was 60 (IQR 28-183). Industry was the primary sponsor of 2713 studies (40.6%) and was a primary or secondary sponsor in 4176 studies (62.5%). In all, 2901 studies (43.4%) were completed, 487 (7.3%) terminated, 1013 (15.2%) active yet not recruiting, 1895 (28.4%) recruiting and 319 (4.8%) not yet recruiting. A total of 80% of studies were conducted in only one country and 84.4% took place in Europe and/or North America; 2441 (36.5%) studied another indication than the originally approved indication. Studies designed in the originally approved indication were found to be more industry-sponsored than others 68.7%vs53.7%; P<0.0001. CONCLUSIONS Postmarketing pharmaceutical research was highly variable and predominantly located in North America and Europe. Postmarketing studies were frequently designed to study indications other than the originally approved one. Although some findings were reassuring, others question the lack of coordination of postmarketing research.
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Affiliation(s)
- Jean-David Zeitoun
- Centre d’Épidémiologie Clinique, Hôpital Hôtel Dieu, Assistance Publique-Hôpitaux de Paris, Paris, France
- Department of Gastroenterology and Nutrition, Saint-Antoine Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
- Department of Proctology, Groupe Hospitalier Diaconesses-Croix Saint-Simon, Paris, France
| | - Joseph S Ross
- Department of Internal Medicine, Robert Wood Johnson Foundation Clinical Scholars Program, Yale School of Medicine, New Haven, Connecticut, USA
- Department of Internal Medicine, Section of General Internal Medicine, Yale School of Medicine, New Haven, Connecticut, USA
- Department of Health Policy and Management, Yale School of Public Health, New Haven, Connecticut, USA
- Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, New Haven, Connecticut, USA
| | - Ignacio Atal
- Centre d’Épidémiologie Clinique, Hôpital Hôtel Dieu, Assistance Publique-Hôpitaux de Paris, Paris, France
- INSERM UMR 1153, Centre de Recherche Épidémiologie et Statistique Paris Sorbonne Cité (CRESS), METHODS Team, Paris, France
| | - Alexandre Vivot
- Centre d’Épidémiologie Clinique, Hôpital Hôtel Dieu, Assistance Publique-Hôpitaux de Paris, Paris, France
- INSERM UMR 1153, Centre de Recherche Épidémiologie et Statistique Paris Sorbonne Cité (CRESS), METHODS Team, Paris, France
| | - Nicholas S Downing
- Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Gabriel Baron
- Centre d’Épidémiologie Clinique, Hôpital Hôtel Dieu, Assistance Publique-Hôpitaux de Paris, Paris, France
- INSERM UMR 1153, Centre de Recherche Épidémiologie et Statistique Paris Sorbonne Cité (CRESS), METHODS Team, Paris, France
- Université Paris Descartes, Sorbonne Paris Cité, Paris, France
| | - Philippe Ravaud
- Centre d’Épidémiologie Clinique, Hôpital Hôtel Dieu, Assistance Publique-Hôpitaux de Paris, Paris, France
- INSERM UMR 1153, Centre de Recherche Épidémiologie et Statistique Paris Sorbonne Cité (CRESS), METHODS Team, Paris, France
- Université Paris Descartes, Sorbonne Paris Cité, Paris, France
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, USA
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Puéchal X, Iudici M, Calich A, Vivot A, Terrier B, Regent A, Cohen P, Le Jeunne C, Mouthon L, Ravaud P, Guillevin L. Le rituximab comme traitement d’induction et d’entretien de la granulomatose avec polyangéite (Wegener). Étude de cohorte monocentrique de 114 patients. Rev Med Interne 2017. [DOI: 10.1016/j.revmed.2017.10.296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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20
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Herbemont C, Sarandi S, Boujenah J, Cedrin-Durnerin I, Sermondade N, Vivot A, Poncelet C, Grynberg M, Sifer C. Should we consider day-2 and day-3 embryo morphology before day-5 transfer when blastocysts reach a similar good quality? Reprod Biomed Online 2017; 35:521-528. [DOI: 10.1016/j.rbmo.2017.07.014] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2016] [Revised: 07/06/2017] [Accepted: 07/25/2017] [Indexed: 10/19/2022]
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21
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Zeitoun JD, Baron G, Vivot A, Atal I, Downing NS, Ross JS, Ravaud P. Post-marketing research and its outcome for novel anticancer agents approved by both the FDA and EMA between 2005 and 2010: A cross-sectional study. Int J Cancer 2017; 142:414-423. [PMID: 28929484 DOI: 10.1002/ijc.31061] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [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: 05/18/2017] [Revised: 08/06/2017] [Accepted: 08/16/2017] [Indexed: 12/14/2022]
Abstract
Post-marketing research in oncology has rarely been described. We aimed to characterize post-marketing trials for a consistent set of anticancer agents over a long period. We performed a cross-sectional analysis of post-marketing trials registered at ClinicalTrials.gov through September 2014 for novel anticancer agents approved by both the US Food and Drug Administration and the European Medicines Agency between 2005 and 2010. All relevant post-marketing trials were classified according to indication, primary outcome, starting date, sponsors, and planned enrollment. Supplemental indications were retrieved from regulatory documents and publication rate was assessed by two different methods. Ten novel anticancer agents were eligible: five were indicated for hematologic malignancies and the remaining five for solid cancers (three for kidney cancer). We identified 2,345 post-marketing trials; 1,362 (58.1%) targeted an indication other than the originally approved one. We observed extreme variations among drugs in both number of post-marketing trials (range 8-530) and overall population to be enrolled per trial (1-8,381). Post-marketing trials assessed almost all types of cancers, the three most frequently studied cancers being leukemia, kidney cancer and myeloma. In all, 6.6% of post-marketing trials had a clinical endpoint as a primary outcome, and 35.9% and 54.1% had a safety or surrogate endpoint, respectively, as a primary outcome. Nine drugs obtained approval for supplemental indications. The publication rate at 10 years was 12.3 to 26.1% depending on the analysis method. In conclusion, we found that post-marketing research in oncology is highly heterogeneous and the publication rate of launched trials is low.
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Affiliation(s)
- Jean-David Zeitoun
- Centre d'Épidémiologie Clinique, Hôpital Hôtel Dieu, Assistance Publique-Hôpitaux de Paris, Paris, France.,Gastroenterology and Nutrition, Hôpital Saint-Antoine, Assistance Publiques-Hôpitaux de Paris, Paris, France.,Proctology, Groupe Hospitalier Diaconesses-Croix Saint-Simon, Paris, France.,INSERM UMR 1153, Centre de Recherche Épidémiologie et Statistique Paris Sorbonne Cité (CRESS), METHODS Team, Paris, France
| | - Gabriel Baron
- Centre d'Épidémiologie Clinique, Hôpital Hôtel Dieu, Assistance Publique-Hôpitaux de Paris, Paris, France.,INSERM UMR 1153, Centre de Recherche Épidémiologie et Statistique Paris Sorbonne Cité (CRESS), METHODS Team, Paris, France.,Université Paris Descartes, Sorbonne Paris Cité, Paris, France
| | - Alexandre Vivot
- Centre d'Épidémiologie Clinique, Hôpital Hôtel Dieu, Assistance Publique-Hôpitaux de Paris, Paris, France.,INSERM UMR 1153, Centre de Recherche Épidémiologie et Statistique Paris Sorbonne Cité (CRESS), METHODS Team, Paris, France
| | - Ignacio Atal
- Centre d'Épidémiologie Clinique, Hôpital Hôtel Dieu, Assistance Publique-Hôpitaux de Paris, Paris, France.,INSERM UMR 1153, Centre de Recherche Épidémiologie et Statistique Paris Sorbonne Cité (CRESS), METHODS Team, Paris, France
| | - Nicholas S Downing
- Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA
| | - Joseph S Ross
- Department of Internal Medicine, Robert Wood Johnson Foundation Clinical Scholars Program, Yale School of Medicine, New Haven, Connecticut, USA.,Department of Internal Medicine, Section of General Internal Medicine, Yale School of Medicine, New Haven, CT.,Department of Health Policy and Management, Yale School of Public Health, New Haven, CT.,Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, New Haven, CT
| | - Philippe Ravaud
- Centre d'Épidémiologie Clinique, Hôpital Hôtel Dieu, Assistance Publique-Hôpitaux de Paris, Paris, France.,INSERM UMR 1153, Centre de Recherche Épidémiologie et Statistique Paris Sorbonne Cité (CRESS), METHODS Team, Paris, France.,Université Paris Descartes, Sorbonne Paris Cité, Paris, France.,Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY
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22
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Vivot A, Boutron I, Béraud-Chaulet G, Zeitoun JD, Ravaud P, Porcher R. Evidence for Treatment-by-Biomarker interaction for FDA-approved Oncology Drugs with Required Pharmacogenomic Biomarker Testing. Sci Rep 2017; 7:6882. [PMID: 28761069 PMCID: PMC5537292 DOI: 10.1038/s41598-017-07358-7] [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] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2016] [Accepted: 06/22/2017] [Indexed: 01/21/2023] Open
Abstract
For oncology drugs that were approved by the US Food and Drug Administration (FDA) and required pharmacogenomic biomarker testing, we describe 1) the use of enrichment (biomarker-positive patients) and a randomized controlled design by pre-approval trials and 2) the treatment-by-biomarker interaction. From the 137 drugs included in the FDA table, we selected the 22 oncology drugs with required genetic testing in their labels. These drugs corresponded to 35 approvals supported by 80 clinical studies included in the FDA medical officer reviews of efficacy. For two thirds of approvals (24/35, 69%), all clinical studies were restricted to biomarker-positive patients (enriched). Among the 11 remaining approvals with at least one non-enriched trial, for five approvals, the non-enriched studies were non-randomized. The treatment-by-biomarker interaction was statistically significant for three approvals and missing for two. Among the six approvals with a non-enriched randomized controlled trial, three featured a statistically significant treatment-by-biomarker interaction (p < 0.10), for an enhanced treatment effect in the biomarker-positive subgroup. For two thirds of FDA approvals of anticancer agents, the requirement for predictive biomarker testing was based on clinical development restricted to biomarker-positive patients. We found only few cases with clinical evidence that biomarker-negative patients would not benefit from treatment.
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Affiliation(s)
- Alexandre Vivot
- Clinical Epidemiology Unit, Hôtel-Dieu Hospital, Greater Paris University Hospital (AP-HP), Paris, France.
- Epidemiology and Statistics Sorbonne Paris Cité Research Center (CRESS), INSERM, Paris Descartes University, Paris, UMR1153, France.
| | - Isabelle Boutron
- Clinical Epidemiology Unit, Hôtel-Dieu Hospital, Greater Paris University Hospital (AP-HP), Paris, France
- Epidemiology and Statistics Sorbonne Paris Cité Research Center (CRESS), INSERM, Paris Descartes University, Paris, UMR1153, France
- School of Medicine, Paris Descartes University, Sorbonne Paris Cité, Paris, France
| | - Geoffroy Béraud-Chaulet
- Clinical Epidemiology Unit, Hôtel-Dieu Hospital, Greater Paris University Hospital (AP-HP), Paris, France
- Epidemiology and Statistics Sorbonne Paris Cité Research Center (CRESS), INSERM, Paris Descartes University, Paris, UMR1153, France
| | - Jean-David Zeitoun
- Epidemiology and Statistics Sorbonne Paris Cité Research Center (CRESS), INSERM, Paris Descartes University, Paris, UMR1153, France
- Gastroenterology and Nutrition Department, Saint-Antoine Hospital, Greater Paris University Hospital (AP-HP), Paris, France
- Proctology Department, Croix Saint-Simon Hospital, Paris, France
| | - Philippe Ravaud
- Clinical Epidemiology Unit, Hôtel-Dieu Hospital, Greater Paris University Hospital (AP-HP), Paris, France
- Epidemiology and Statistics Sorbonne Paris Cité Research Center (CRESS), INSERM, Paris Descartes University, Paris, UMR1153, France
- School of Medicine, Paris Descartes University, Sorbonne Paris Cité, Paris, France
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Raphaël Porcher
- Clinical Epidemiology Unit, Hôtel-Dieu Hospital, Greater Paris University Hospital (AP-HP), Paris, France
- Epidemiology and Statistics Sorbonne Paris Cité Research Center (CRESS), INSERM, Paris Descartes University, Paris, UMR1153, France
- School of Medicine, Paris Descartes University, Sorbonne Paris Cité, Paris, France
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Vivot A, Jacot J, Zeitoun JD, Ravaud P, Crequit P, Porcher R. Clinical benefit, price and approval characteristics of FDA-approved new drugs for treating advanced solid cancer, 2000–2015. Ann Oncol 2017; 28:1111-1116. [DOI: 10.1093/annonc/mdx053] [Citation(s) in RCA: 83] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Vivot A, Power MC, Glymour MM, Mayeda ER, Benitez A, Spiro A, Manly JJ, Proust-Lima C, Dufouil C, Gross AL. Jump, Hop, or Skip: Modeling Practice Effects in Studies of Determinants of Cognitive Change in Older Adults. Am J Epidemiol 2016; 183:302-14. [PMID: 26825924 DOI: 10.1093/aje/kwv212] [Citation(s) in RCA: 70] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2014] [Accepted: 08/10/2015] [Indexed: 12/31/2022] Open
Abstract
Improvements in cognitive test scores upon repeated assessment due to practice effects (PEs) are well documented, but there is no empirical evidence on whether alternative specifications of PEs result in different estimated associations between exposure and rate of cognitive change. If alternative PE specifications produce different estimates of association between an exposure and rate of cognitive change, this would be a challenge for nearly all longitudinal research on determinants of cognitive aging. Using data from 3 cohort studies-the Three-City Study-Dijon (Dijon, France, 1999-2010), the Normative Aging Study (Greater Boston, Massachusetts, 1993-2007), and the Washington Heights-Inwood Community Aging Project (New York, New York, 1999-2012)-for 2 exposures (diabetes and depression) and 3 cognitive outcomes, we compared results from longitudinal models using alternative PE specifications: no PEs; use of an indicator for the first cognitive visit; number of prior testing occasions; and square root of the number of prior testing occasions. Alternative specifications led to large differences in the estimated rates of cognitive change but minimal differences in estimated associations of exposure with cognitive level or change. Based on model fit, using an indicator for the first visit was often (but not always) the preferred model. PE specification can lead to substantial differences in estimated rates of cognitive change, but in these diverse examples and study samples it did not substantively affect estimated associations of risk factors with change.
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Vivot A, Li J, Zeitoun JD, Mourah S, Crequit P, Ravaud P, Porcher R. Pharmacogenomic biomarkers as inclusion criteria in clinical trials of oncology-targeted drugs: a mapping of ClinicalTrials.gov. Genet Med 2015; 18:796-805. [PMID: 26681315 DOI: 10.1038/gim.2015.165] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2015] [Accepted: 10/05/2015] [Indexed: 11/09/2022] Open
Abstract
PURPOSE The aim of this study was to describe pharmacogenomics-based inclusion criteria (enrichment) and the main characteristics of clinical trials involving oncology-targeted therapies. METHODS Clinical trials of oncology-targeted therapies approved after 2005 with pharmacogenomic testing required or recommended in their label were retrieved from a mapping of the ClinicalTrials.gov database. RESULTS We examined information for 12 drugs and 858 trials. Overall, 434 trials (51%) were enriched on the biomarker first mentioned in the label and 145 (17%) were enriched on another biomarker, whereas 270 trials (31%) included all patients. The median proportion of trials corresponding to both the drug's indication and drug's target was 35%. Of the 361 trials that tested drugs in another disease than the first one in the label, 219 (61%) were without enrichment and 87 (24%) were actually enriched but on another biomarker than the first one in the label. CONCLUSION Several drugs have been tested in trials enriched on many different biomarkers. Nonetheless, most targeted therapies have been developed only using biomarker-positive patients; therefore, exclusion of biomarker-negative patients from treatment relies on only preclinical data and on biological understanding of the disease and target.Genet Med 18 8, 796-805.
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Affiliation(s)
- Alexandre Vivot
- Assistance Publique des Hôpitaux de Paris (AP-HP), Hôpital Hôtel Dieu, Centre d'Épidémiologie Clinique, Paris, France.,INSERM, UMR1153 Epidemiology and Biostatistics Sorbonne Paris Cité Research Center (CRESS), METHODS Team, Paris Descartes University, Paris, France
| | - Jacques Li
- Assistance Publique des Hôpitaux de Paris (AP-HP), Hôpital Hôtel Dieu, Centre d'Épidémiologie Clinique, Paris, France.,INSERM, UMR1153 Epidemiology and Biostatistics Sorbonne Paris Cité Research Center (CRESS), METHODS Team, Paris Descartes University, Paris, France
| | - Jean-David Zeitoun
- Assistance Publique des Hôpitaux de Paris (AP-HP), Hôpital Hôtel Dieu, Centre d'Épidémiologie Clinique, Paris, France.,INSERM, UMR1153 Epidemiology and Biostatistics Sorbonne Paris Cité Research Center (CRESS), METHODS Team, Paris Descartes University, Paris, France
| | - Samia Mourah
- Department of Pharmacology-Genetics, Assistance Publique des Hôpitaux de Paris (AP-HP), Saint-Louis Hospital, Paris, France.,INSERM UMRS 976, Paris, France
| | - Perrine Crequit
- Assistance Publique des Hôpitaux de Paris (AP-HP), Hôpital Hôtel Dieu, Centre d'Épidémiologie Clinique, Paris, France.,INSERM, UMR1153 Epidemiology and Biostatistics Sorbonne Paris Cité Research Center (CRESS), METHODS Team, Paris Descartes University, Paris, France
| | - Philippe Ravaud
- Assistance Publique des Hôpitaux de Paris (AP-HP), Hôpital Hôtel Dieu, Centre d'Épidémiologie Clinique, Paris, France.,INSERM, UMR1153 Epidemiology and Biostatistics Sorbonne Paris Cité Research Center (CRESS), METHODS Team, Paris Descartes University, Paris, France.,Faculté de Médecine, Université Paris Descartes, Paris, France.,Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York, USA
| | - Raphaël Porcher
- Assistance Publique des Hôpitaux de Paris (AP-HP), Hôpital Hôtel Dieu, Centre d'Épidémiologie Clinique, Paris, France.,INSERM, UMR1153 Epidemiology and Biostatistics Sorbonne Paris Cité Research Center (CRESS), METHODS Team, Paris Descartes University, Paris, France.,Faculté de Médecine, Université Paris Descartes, Paris, France
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Sibon I, Tourdias T, Felix S, Asselineau J, Bracoud L, Vivot A, Rouanet F, Renou P, Orgogozo J, Dousset V. Magnetisation transfer parameters and stroke outcome. J Clin Neurosci 2015; 22:1012-7. [DOI: 10.1016/j.jocn.2014.11.035] [Citation(s) in RCA: 8] [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: 02/23/2014] [Revised: 11/19/2014] [Accepted: 11/26/2014] [Indexed: 10/23/2022]
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Vivot A, Boutron I, Ravaud P, Porcher R. Niveau de recommandation pour l’utilisation des biomarqueurs pharmacogénomiques dans les notices des médicaments approuvés par l’« US Food and Drug Administration ». Rev Epidemiol Sante Publique 2015. [DOI: 10.1016/j.respe.2015.03.070] [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: 11/25/2022] Open
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Danet-Lamasou M, Asselineau J, Perez P, Vivot A, Nunes ML, Loiseau H, San-Galli F, Cherifi-Gatta B, Corcuff JB, Tabarin A. Accuracy of repeated measurements of late-night salivary cortisol to screen for early-stage recurrence of Cushing's disease following pituitary surgery. Clin Endocrinol (Oxf) 2015; 82:260-6. [PMID: 24975391 DOI: 10.1111/cen.12534] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2014] [Revised: 03/23/2014] [Accepted: 06/18/2014] [Indexed: 12/21/2022]
Abstract
OBJECTIVE The performance of late-night salivary cortisol (LNSC) to accurately screen for postoperative recurrence of Cushing's disease (CD) at an early stage is unknown. The aim of this study was to compare the accuracy of multiple sampling strategies to suggest the optimal number of LNSC samples needed for diagnosing post-surgical recurrences of CD at an early stage. DESIGN Retrospective analysis in a single centre. PATIENTS AND MEASUREMENTS Thirty-six patients in surgical remission of CD had successive measurements of LNSC, defined as 'sequences', using a locally modified RIA assay as part of long-term follow-up (69·2 ± 10·6 months). Patients underwent an extensive biochemical evaluation within 3 months before or after a sequence of saliva sampling and were classified as being in remission or in early-stage recurrence. The accuracy of three diagnostic strategies combining two, three or four LNSC results from a sequence was estimated using areas under the ROC curves (AUC), sensitivity, specificity and predictive values. RESULTS Forty-four sequences of LNSC measurements were available. Fifty-two percent of sequences were performed during early-stage recurrence. The intrasequence variability of LNSC was higher during recurrence than during remission (medians of SDs: 2·1 vs 0·5 nm; P < 0·0001). AUCs from ROC curves ranged from 0·93 to 0·96 depending on the strategy. For 90% sensitivities, the best specificities (92·9% and 90·9%) were achieved by strategies taking into account three or four measurements summarized either by their mean or their maximum value. CONCLUSIONS Increase in LNSC concentration is an early abnormality during post-surgical recurrence of CD. However, due to a major within-patient variability of LNSC from 1 day to another, a screening strategy using three or four samples collected on successive days may be recommended to detect early-stage recurrence of CD with a high accuracy.
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Affiliation(s)
- Marie Danet-Lamasou
- Departement d'Endocrinologie et Maladies Metaboliques, CHU de Bordeaux, Hopital du Haut Leveque, Pessac, France
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Vivot A, Boutron I, Ravaud P, Porcher R. Guidance for pharmacogenomic biomarker testing in labels of FDA-approved drugs. Genet Med 2014; 17:733-8. [PMID: 25521333 DOI: 10.1038/gim.2014.181] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2014] [Accepted: 11/11/2014] [Indexed: 12/26/2022] Open
Abstract
PURPOSE The aim of this study was to compare guidance for genetic testing in US Food and Drug Administration (FDA)-approved drug labels in oncology to those of drugs for other therapeutic areas. METHODS We reviewed labels of all the FDA-approved drugs with labels containing pharmacogenomic information. We assessed whether genetic testing was required or recommended before prescription and, if not, the reason for pharmacogenomic labeling. RESULTS We included 140 drugs corresponding to 158 drug-biomarker pairs. Overall, 46 (29%) of 158 pairs stated a requirement or recommendation for genetic biomarker testing in the label. This proportion was higher in oncology than in other areas (62 vs. 12%; P < 0.001). For the 112 drug-biomarker pairs (including 20 in oncology) without recommendation or requirement for genetic testing, the main reasons for pharmacogenomic labeling were change in pharmacologic end points (32%) and higher risk of toxicity (30%). For 11 (10%) pairs (including 1 in oncology), a genetic biomarker was mentioned only to inform that it was not relevant. In oncology, the main reasons for pharmacogenomic labeling were higher risk of toxicity (55%) and definition of the mechanism of action (25%). CONCLUSION Inclusion of biomarkers in drug labels does not always correspond to required or recommended genetic testing, especially outside oncology.Genet Med 17 9, 733-738.
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Affiliation(s)
- Alexandre Vivot
- Centre d'Épidémiologie Clinique, Hôpital Hôtel Dieu, Assistance Publique des Hôpitaux de Paris, Paris, France.,METHODS Team, Unit 1153, INSERM, Paris, France
| | - Isabelle Boutron
- Centre d'Épidémiologie Clinique, Hôpital Hôtel Dieu, Assistance Publique des Hôpitaux de Paris, Paris, France.,METHODS Team, Unit 1153, INSERM, Paris, France.,Faculté de Médecine, University of Paris Descartes, Sorbonne Paris Cité, Paris, France
| | - Philippe Ravaud
- Centre d'Épidémiologie Clinique, Hôpital Hôtel Dieu, Assistance Publique des Hôpitaux de Paris, Paris, France.,METHODS Team, Unit 1153, INSERM, Paris, France.,Faculté de Médecine, University of Paris Descartes, Sorbonne Paris Cité, Paris, France.,Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York, USA
| | - Raphaël Porcher
- Centre d'Épidémiologie Clinique, Hôpital Hôtel Dieu, Assistance Publique des Hôpitaux de Paris, Paris, France.,METHODS Team, Unit 1153, INSERM, Paris, France.,Faculté de Médecine, University of Paris Descartes, Sorbonne Paris Cité, Paris, France
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Jullié ML, Carlotti M, Vivot A, Beylot-Barry M, Ortonne N, Frouin E, Carlotti A, de Muret A, Balme B, Franck F, Merlio JP, Vergier B. CD20 antigen may be expressed by reactive or lymphomatous cells of transformed mycosis fungoides: diagnostic and prognostic impact. Am J Surg Pathol 2013; 37:1845-54. [PMID: 24145652 DOI: 10.1097/pas.0000000000000091] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Mycosis fungoides (MF), the most common primitive cutaneous T-cell lymphoma, can undergo transformation in about 10% of cases. Transformed mycosis fungoides (T-MF) is often associated with the appearance of a CD20 component. The aim of this study was to analyze whether such cells are reactive or lymphomatous and to evaluate their prognostic impact. Among 311 T-MFs from the French Cutaneous Lymphoma Study Group registry, we studied 148 cases. CD20 was expressed in 88 cases (59%). The proportion of CD20 cells among T-MF lesions was <10% for 54 cases (38%), 10% to 49% for 71 cases (81%), and >50% for 17 cases (19%). We focused the study on 23 cases that contained >50% CD20 cells. To evaluate the nature of the CD20 component, we used immunohistochemistry (2 anti-CD20 antibodies, L26 and 7D1 clones, and 2 other anti-B-cell antigen antibodies, CD22 and PAX5) and a double-stain immunofluorescence technique (anti-CD20 and anti-CD3 antibodies). The clonality of B cells was studied by polymerase chain reaction. Three profiles were observed. In 15 of the 23 cases, the CD20 cells were reactive. In 6 cases, CD20 protein was aberrantly expressed in T-MF lesions. Lastly, there were 2 composite lymphomas (T-MF infiltrate with a B-cell follicular lymphoma). In view of this series, we propose a simple algorithm to help pathologists evaluate the nature of the CD20 component associated with T-MF. Although statistically not significant, there was a trend toward a worse prognosis in the presence of >50% CD20 cells and of a nodular perifollicular pattern of this component.
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Affiliation(s)
- Marie-Laure Jullié
- *Department of Pathology, the Tumor Bank and Tumor Biology Laboratory, the departments of Statistics and Dermatology, University Hospital of Bordeaux †Departments of Pathology and Dermatology, University Hospital of Paris-Est Créteil ‡Departments of Pathology and Dermatology, University Hospital of Montpellier §Departments of Pathology and Dermatology, University Hospital of Paris, APHP ∥Departments of Pathology and Dermatology, University Hospital of Tours ¶Departments of Pathology and Dermatology, University Hospital of Lyon #Departments of Pathology and Dermatology, University Hospital of Clermont-Ferrand, France
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Morlat P, Vivot A, Vandenhende MA, Dauchy FA, Asselineau J, Déti E, Gerard Y, Lazaro E, Duffau P, Neau D, Bonnet F, Chêne G. Role of traditional risk factors and antiretroviral drugs in the incidence of chronic kidney disease, ANRS CO3 Aquitaine cohort, France, 2004-2012. PLoS One 2013; 8:e66223. [PMID: 23776637 PMCID: PMC3680439 DOI: 10.1371/journal.pone.0066223] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2012] [Accepted: 05/01/2013] [Indexed: 11/29/2022] Open
Abstract
Objective To examine the role of antiretroviral drugs (ART), HIV-related and traditional risk factors on the incidence of chronic kidney disease (CKD) in HIV-infected patients. Design Prospective hospital-based cohort of HIV-infected patients from 2004 to 2012. Methods CKD was defined using MDRD equation as an estimated glomerular filtration rate (eGFR) less than 60 ml/mn/1.73 m2 at 2 consecutive measurements ≥3 months apart. Poisson regression models were used to study determinants of CKD either measured at baseline or updated. ART exposure was classified as ever or never. We additionally tested the role of tenofovir (TDF), whether or not prescribed concomitantly with a Protease Inhibitor (PI), taking into account the cumulative exposure to the drug. Results 4,350 patients (74% men) with baseline eGFR>60 ml/mn/1.73 m2 were followed for a median of 5.8 years. At the end of follow-up, 96% had received ART, one third of them (35%) jointly received TDF and a PI. Average incidence rate of CKD was 0.95% person-years of follow-up. Incidence of CKD was higher among women (IRR = 2.2), older patients (>60 y vs <45 y: IRR = 2.5 and 45–60 y: IRR = 1.7), those with diabetes (IRR = 1.9), high blood pressure (IRR = 1.5), hyperlipidemia (IRR = 1.5), AIDS stage (IRR = 1.4), low baseline eGFR (IRR = 15.8 for 60<eGFR<70 ml/mn/1.73 m2 vs >90 and IRR = 7.1 for 70<eGFR<80 ml/mn/1.73 m2), current CD4+<200 cells/mm3 vs >500/mm3 (IRR = 2.5), and exposure to TDF (IRR = 2.0). Exposure to TDF was even strongly associated with CKD when co-administered with PIs (IRR = 3.1 vs 1.3 when not, p<0,001). A higher risk of CKD was found when tenofovir exposure was >12 months [IRR = 3.0 with joint PIs vs 1.3 without (p<0.001)]. A vast majority of those developing CKD (76.6%) had a baseline eGFR between 60 and 80 ml/mn/1.73 m2. Conclusion In patients with eGFR between 60 and 80 mL/min/1.73 m2, a thorough control of CKD risk factors is warranted. The use of TDF, especially when co-administered with PIs, should be mentioned as a relative contraindication in presence of at least one of these risk factors.
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Affiliation(s)
- Philippe Morlat
- Univ. Bordeaux, ISPED, Centre INSERM U897-Epidemiologie-Biostatistique, Bordeaux, France.
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Garnache-Ottou F, Biichlé S, Petitjean R, Aupet S, Naegelen C, Vivot A, König F, Lartod N, MarpauX N, Morel P, Bardiaux L, Saas P. Quantification des microparticules érythrocytaires et plaquettaires dans les concentrés globulaires : impact de la méthode de production et de la conservation. Transfus Clin Biol 2013. [DOI: 10.1016/j.tracli.2013.04.024] [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: 10/26/2022]
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Genevieve M, Vivot A, Gonzalez C, Raffaitin C, Barberger-Gateau P, Gin H, Rigalleau V. Skin autofluorescence is associated with past glycaemic control and complications in type 1 diabetes mellitus. Diabetes Metab 2013; 39:349-54. [PMID: 23643347 DOI: 10.1016/j.diabet.2013.03.003] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [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: 09/21/2012] [Revised: 03/01/2013] [Accepted: 03/12/2013] [Indexed: 11/20/2022]
Abstract
As skin autofluorescence (AF) can assess subcutaneous accumulation of fluorescent advanced glycation end-products (AGEs), this study aimed to investigate whether it was linked to glycaemic control and complications in patients with type 1 diabetes mellitus (T1DM). Using the AGE Reader™, AF was measured in T1DM patients referred to Haut-Levêque Hospital (Bordeaux, France); data on their HbA1c levels measured every 6months as far back as the last 5years were also collected. The association of AF with the patients' past glucose control, based on their latest HbA1c values, and the means of the last five and 10 HbA1c values, and with diabetic complications was also examined by linear regression analysis. The sample included 300 patients: 58% were male; the mean age was 49 (SD 17) years and the mean diabetes duration was 21 (SD 13) years. The median skin AF measurement was 2.0 [25th-75th percentiles: 1.7-2.4] arbitrary units (AU), and this was associated with age (β=0.15 per 10years, P<0.001) and diabetes duration (β=0.17 per 10years, P<0.001). After adjusting for age and estimated glomerular filtration rate (eGFR), the skin AF measurement was also related to the means of the last five and 10 HbA1c values (β=0.10 per 1% of HbA1c, P=0.005, and β=0.13 per 1% of HbA1c, P=0.001, respectively). In addition, the skin AF was associated with retinopathy (P<0.001), albuminuria (P<0.001) and decreased eGFR (P<0.001). In conclusion, the skin AF is related to the long-term glucose control and diabetic complications.
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Affiliation(s)
- M Genevieve
- Nutrition-Diabétologie, Bordeaux hospital, 33600 Pessac, France; Université Bordeaux Segalen, 33000 Bordeaux, France
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Ghorayeb I, Bénard A, Vivot A, Tison F, Burbaud P. A phase II, open-label, non-comparative study of Botulinum toxin in Restless Legs Syndrome. Sleep Med 2012; 13:1313-6. [PMID: 23063302 DOI: 10.1016/j.sleep.2012.08.019] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2012] [Revised: 08/18/2012] [Accepted: 08/20/2012] [Indexed: 11/18/2022]
Abstract
OBJECTIVE To assess the efficacy of intradermally injected botulinum neurotoxin type A (BoNT/A) in patients with Restless Legs Syndrome (RLS). METHODS We conducted an optimal two-stage, phase II exploratory, open label, non-comparative clinical trial. The primary outcome measure was the efficacy of BoNT/A defined by the proportion of patients (responders) with ⩾50% improvement of their RLS severity score at week 2 following injections compared to baseline score at inclusion. Twenty-seven patients were to be included in the first stage of the trial, which was to be stopped if less than nine responders were documented. Selected patients had a minimum score of 21 on the International RLS Rating Scale. They all received a series of 20 intradermal injections of 0.05 ml of BoNT/A in symptomatic areas in their lower limbs. Change of RLS severity was evaluated over a 6 months period. RESULTS Of the 27 selected patients, only six achieved the primary endpoint at week 2. In these six patients, the median duration (Inter-Quartile Range) of the IRLSRS score improvement of at least 50% was 46 days (42-126). CONCLUSIONS Considering the proportion of responders as the primary endpoint of this trial, BoNT/A showed no efficacy in alleviating RLS sensory symptoms.
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Affiliation(s)
- Imad Ghorayeb
- Service des Explorations Fonctionnelles du Système Nerveux, Hôpital Pellegrin, Place Amélie Raba-Léon, Bordeaux cedex, France.
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Ghorayeb I, Bénard A, Vivot A, Burbaud P. Évaluation de l’efficacité de la toxine botulique dans le traitement du syndrome des jambes sans repos (SJSR) : étude SOXIS. Rev Neurol (Paris) 2012. [DOI: 10.1016/j.neurol.2012.01.308] [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: 10/28/2022]
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Ghorayeb I, Bénard A, Vivot A, Burbaud P. Évaluation de l’efficacité de la toxine botulique dans le traitement du syndrome des jambes sans repos (SJSR) : étude SOXIS. Neurophysiol Clin 2012. [DOI: 10.1016/j.neucli.2012.02.048] [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: 11/29/2022] Open
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Vivot A, Colombani F, Trouette H, Colonna M, Fournier E, Leux C, Coureau G, Salamon R, Savès M, Nicolescu-Catargi B. R128 – Oral Surincidence des carcinomes thyroïdiens en Gironde : comparaison de la taille des tumeurs entre différents registres de cancer français. Bull Cancer 2010. [DOI: 10.1016/s0007-4551(15)31048-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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