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Piram M, Darce Bello M, Tellier S, Di Filippo S, Boralevi F, Madhi F, Meinzer U, Cimaz R, Piedvache C, Koné-Paut I. Defining the risk of first intravenous immunoglobulin unresponsiveness in non-Asian patients with Kawasaki disease. Sci Rep 2020; 10:3125. [PMID: 32080307 PMCID: PMC7033244 DOI: 10.1038/s41598-020-59972-7] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Accepted: 01/27/2020] [Indexed: 11/22/2022] Open
Abstract
About 10–20% of patients with Kawasaki disease (KD) are unresponsive to intravenous immunoglobulin (IVIg) and are at increased risk of coronary artery abnormalities (CAAs). Early identification is critical to initiate aggressive therapies, but available scoring systems lack sensitivity in non-Japanese populations. We investigated the accuracy of 3 Japanese scoring systems and studied factors associated with IVIg unresponsiveness in a large multiethnic French population of children with KD to build a new scoring system. Children admitted for KD between 2011–2014 in 65 centers were enrolled. Factors associated with second line-treatment; i.e. unresponsiveness to initial IVIg treatment, were analyzed by multivariate regression analysis. The performance of our score and the Kobayashi, Egami and Sano scores were compared in our population and in ethnic subgroups. Overall, 465 children were reported by 84 physicians; 425 were classified with KD (55% European Caucasian, 12% North African/Middle Eastern, 10% African/Afro-Caribbean, 3% Asian and 11% mixed). Eighty patients (23%) needed second-line treatment. Japanese scores had poor performance in our whole population (sensitivity 14–61%). On multivariate regression analysis, predictors of secondary treatment after initial IVIG were hepatomegaly, ALT level ≥30 IU/L, lymphocyte count <2400/mm3 and time to treatment <5 days. The best sensitivity (77%) and specificity (60%) of this model was with 1 point per variable and cut-off ≥2 points. The sensitivity remained good in our 3 main ethnic subgroups (74–88%). We identified predictors of IVIg resistance and built a new score with good sensitivity and acceptable specificity in a non-Asian population.
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Affiliation(s)
- Maryam Piram
- Université Paris-Saclay, Univ. Paris-Sud, UVSQ, CESP, Inserm, 1018, Le Kremlin Bicêtre, France. .,AP-HP, CHU de Bicêtre, Pediatric Rheumatology, CEREMAIA, Le Kremlin Bicêtre, France.
| | - Martha Darce Bello
- AP-HP, CHU de Bicêtre, Pediatric Rheumatology, CEREMAIA, Le Kremlin Bicêtre, France
| | - Stéphanie Tellier
- CHU de de Toulouse, Paediatric Rheumatology, Nephrology and Internal medicine, Toulouse, France
| | | | | | | | - Ulrich Meinzer
- APHP, CHU Robert Debré, Paediatrics,Paediatric Internal Medicine,Rheumatology and Infectious Diseases, RAISE, Paris, France
| | - Rolando Cimaz
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Celine Piedvache
- APHP, CHU de Bicêtre, Clinical Research Unit, Le Kremlin Bicêtre, France
| | - Isabelle Koné-Paut
- Université Paris-Saclay, Univ. Paris-Sud, UVSQ, CESP, Inserm, 1018, Le Kremlin Bicêtre, France.,AP-HP, CHU de Bicêtre, Pediatric Rheumatology, CEREMAIA, Le Kremlin Bicêtre, France
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Garcia G, Frija-Masson J, Godinas L, Piedvache C, Belguendouz A, Plantier L, Rolland-Debord C, Perez T, Sattler C, Chenivesse C, Agostini H, Humbert M, Lavezeniana P, Taille C. Prévalence et impact du syndrome d’hyperventilation sur le contrôle et la qualité de vie dans l’asthme difficile : une étude prospective. Rev Mal Respir 2019. [DOI: 10.1016/j.rmr.2018.10.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Garcia G, Frija-Masson J, Godinas L, Piedvache C, Belguendouz A, Plantier L, Sarni M, Rolland-Debord C, Laveneziana P, Sattler C, Chenivesse C, Humbert M, Perez T, Taille C. Performance des tests diagnostiques du syndrome d’hyperventilation dans une population de patients asthmatiques difficiles. Rev Mal Respir 2019. [DOI: 10.1016/j.rmr.2018.10.163] [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: 10/27/2022]
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Lebacle C, Bensalah K, Bernhard JC, Albiges L, Laguerre B, Gross-Goupil M, Baumert H, Lang H, Tricard T, Duclos B, Arnoux A, Piedvache C, Patard JJ, Escudier B. Evaluation of axitinib to downstage cT2a renal tumours and allow partial nephrectomy: a phase II study. BJU Int 2018; 123:804-810. [DOI: 10.1111/bju.14581] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Affiliation(s)
- Cedric Lebacle
- Department of Urology; Bicetre University Hospital; Assistance Publique-Hôpitaux de Paris, APHP; University Paris-Saclay; Le Kremlin-Bicetre France
| | - Karim Bensalah
- Department of Urology; Pontchaillou University Hospital; Rennes France
| | - Jean-Christophe Bernhard
- Department of Urology; Bordeaux University Hospital; Pellegrin Hospital; Bordeaux France
- French Research Network on Kidney Cancer UroCCR; Bordeaux France
| | - Laurence Albiges
- Department of Medicine; Gustave Roussy; University Paris-Saclay; Villejuif France
| | | | - Marine Gross-Goupil
- Department of Medical Oncology; Bordeaux University Hospital; Saint-Andre Hospital; Bordeaux France
| | - Herve Baumert
- Department of Urology; Saint-Joseph Hospital; Paris France
| | - Herve Lang
- Department of Urology; Nouvel Hopital Civil; Strasbourg University Hospital; Strasbourg France
| | - Thibault Tricard
- Department of Urology; Nouvel Hopital Civil; Strasbourg University Hospital; Strasbourg France
| | - Brigitte Duclos
- Department of Oncology; Hautepierre Hospital; Strasbourg University Hospital; Strasbourg France
| | - Armelle Arnoux
- Paris-Sud Clinical Research Unit; Department of Statistics; Bicetre University Hospital; Assistance Publique-Hôpitaux de Paris; Le Kremlin-Bicêtre France
| | - Celine Piedvache
- Paris-Sud Clinical Research Unit; Department of Statistics; Bicetre University Hospital; Assistance Publique-Hôpitaux de Paris; Le Kremlin-Bicêtre France
| | | | - Bernard Escudier
- Department of Medicine; Gustave Roussy; University Paris-Saclay; Villejuif France
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Escourrou P, Berthomier C, Balekji Z, Brandewinder M, Berthomier P, Piedvache C, Agostini H, Puisaix N, Roisman G. 0492 Polygraphy+ With One EEG Channel Improves Osas Severity Classification. Sleep 2018. [DOI: 10.1093/sleep/zsy061.491] [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
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Bucher S, Panjo H, Al-Salameh A, Bauduceau B, Benattar-Zibi L, Bertin P, Berrut G, Corruble E, Danchin N, Derumeaux G, Doucet J, Falissard B, Forette F, Hanon O, Ourabah R, Pasquier F, Piedvache C, Pinget M, Becquemont L, Ringa V. Relationship between achieved personalized glycaemic targets and monitoring of clinical events in elderly diabetic patients. Diabetes Metab 2017; 43:59-68. [PMID: 27316980 DOI: 10.1016/j.diabet.2016.05.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/29/2015] [Revised: 04/29/2016] [Accepted: 05/14/2016] [Indexed: 06/06/2023]
Abstract
AIM Recent guidelines for the management of type 2 diabetes (T2DM) in the elderly recommend adjusting the therapeutic target (HbA1c) according to the patient's health. Our study aimed to explore the association between achieving the recommended personalized HbA1c target and the occurrence of major clinical events under real-life conditions. METHODS The T2DM S.AGES cohort was a prospective multicentre study into which 213 general practitioners recruited 983 non-institutionalized T2DM patients aged>65 years. The recommended personalized HbA1c targets were<7%, <8% and <9% for healthy, ill and very ill patients, respectively. Major clinical events (death from any cause, major vascular events and/or hospitalization) were recorded during the 3-year follow-up. Mixed-effects logistic regression models were used for the analyses. RESULTS Of the 747 patients analyzed at baseline, 551 (76.8%) were at their recommended personalized HbA1c target. During follow-up, 391 patients (52.3%) experienced a major clinical event. Of the patients who did not achieve their personalized HbA1c target (compared with those who did), the risk (OR) of a major clinical event was 0.95 (95% CI: 0.69-1.31; P=0.76). The risk of death, major vascular event and hospitalization were 0.88 (95% CI: 0.40-1.94; P=0.75), 1.14 (95% CI: 0.7-1.83; P=0.59) and 0.84 (95% CI: 0.60-1.18; P=0.32), respectively. CONCLUSION Over a 3-year follow-up period, our results showed no difference in risk of a major clinical event among patients, regardless of whether or not they achieved their personalized recommended HbA1c target. These results need to be confirmed before implementing a more permissive strategy for treating T2DM in elderly patients.
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Affiliation(s)
- S Bucher
- CESP, Inserm, University Paris-Sud, UVSQ, University Paris-Saclay, 94275 Kremlin-Bicêtre, France; General Practice Department, Paris-Sud Faculty of Medicine, University of Paris-Sud, 63, rue Gabriel-Peri, 94275 Le Kremlin-Bicêtre, France.
| | - H Panjo
- CESP, Inserm, University Paris-Sud, UVSQ, University Paris-Saclay, 94275 Kremlin-Bicêtre, France
| | - A Al-Salameh
- Pharmacology Department, Faculty of Medicine Paris-Sud, University Paris Sud, UMR 1184, CEA, DSV/iMETI, Division of Immuno-virology, IDMIT, Inserm Center for immunology of viral infections and autoimmune diseases, Assistance publique-Hôpitaux de Paris, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
| | - B Bauduceau
- Endocrinology department, Begin hospital, Saint-Mandé, France
| | | | - P Bertin
- Rheumatology Department, Limoges University Hospital, Limoges, France
| | - G Berrut
- Clinical Gerontology, Nantes University Hospital, Nantes, France
| | - E Corruble
- Inserm U 1178, Paris-Sud Faculty of Medicine, University of Paris-Sud, Psychiatry Department, Bicêtre University Hospital, Assistance publique-Hôpitaux de Paris, Le Kremlin- Bicêtre, France
| | - N Danchin
- HEGP, Coronary Diseases, Paris, France
| | - G Derumeaux
- Cardiovascular Functional Exploration, Louis-Pradel Hospital, Hospices Civils de Lyon, Bron, France
| | - J Doucet
- Internal medicine, Geriatry and therapeutics, Saint-Julien university Hospital, Rouen University, Rouen, France
| | - B Falissard
- CESP, Inserm, University Paris-Sud, UVSQ, University Paris-Saclay, 94800 Villejuif, France
| | - F Forette
- University of Paris Descartes, National Foundation of Gerontology, Paris, France
| | - O Hanon
- University of Paris Descartes, EA 4468, Assistance publique-Hôpitaux de Paris, Broca Hospital, Geriatrics Department, Paris, France
| | - R Ourabah
- General Practice Department, Paris-Sud Faculty of Medicine, University of Paris-Sud, 63, rue Gabriel-Peri, 94275 Le Kremlin-Bicêtre, France
| | - F Pasquier
- University of Lille Nord de France, UDSL, EA 1046, CHU de Lille, Lille, France
| | - C Piedvache
- Pharmacology Department, Faculty of Medicine Paris-Sud, University Paris Sud, UMR 1184, CEA, DSV/iMETI, Division of Immuno-virology, IDMIT, Inserm Center for immunology of viral infections and autoimmune diseases, Assistance publique-Hôpitaux de Paris, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
| | - M Pinget
- Endocrinology, Diabetes and Nutrition-Related Diseases (NUDE Unit), Strasbourg University Hospital and the European Centre for the Study of Diabetes (CeeD), University of Strasbourg, Strasbourg, France
| | - L Becquemont
- Pharmacology Department, Faculty of Medicine Paris-Sud, University Paris Sud, UMR 1184, CEA, DSV/iMETI, Division of Immuno-virology, IDMIT, Inserm Center for immunology of viral infections and autoimmune diseases, Assistance publique-Hôpitaux de Paris, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
| | - V Ringa
- CESP, Inserm, University Paris-Sud, UVSQ, University Paris-Saclay, 94275 Kremlin-Bicêtre, France
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Bucher S, Panjo H, Al-Salameh A, Bauduceau B, Benattar-Zibi L, Bertin P, Berrut G, Corruble E, Danchin N, Derumeaux G, Doucet J, Falissard B, Forette F, Hanon O, Ourabah R, Pasquier F, Piedvache C, Pinget M, Becquemont L, Ringa V. Atteinte de la cible thérapeutique personnalisée et la survenue d’événements cliniques chez des patients âgés diabétiques. Rev Epidemiol Sante Publique 2016. [DOI: 10.1016/j.respe.2016.10.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Becquemont L, Bauduceau B, Benattar-Zibi L, Al-Salameh A, Berrut G, Bertin P, Bucher S, Corruble E, Danchin N, Derumeaux G, Doucet J, Falissard B, Forette F, Hanon O, Pasquier F, Pinget M, Ourabah R, Piedvache C. Cardiovascular Drugs and Metformin Drug Dosage According to Renal Function in Non-Institutionalized Elderly Patients. Basic Clin Pharmacol Toxicol 2015; 118:468-73. [DOI: 10.1111/bcpt.12526] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2015] [Accepted: 10/30/2015] [Indexed: 11/28/2022]
Affiliation(s)
- Laurent Becquemont
- Pharmacology Department; Faculty of Medicine Paris-Sud; University Paris-Sud; UMR 1184; CEA, DSV/iMETI; Division of Immuno-Virology; IDMIT, INSERM Center for Immunology of Viral Infections and Autoimmune Diseases; Assistance Publique-Hôpitaux de Paris, Hopital Bicêtre; Le Kremlin Bicêtre France
| | | | | | - Abdallah Al-Salameh
- Pharmacology Department; Faculty of Medicine Paris-Sud; University Paris-Sud; UMR 1184; CEA, DSV/iMETI; Division of Immuno-Virology; IDMIT, INSERM Center for Immunology of Viral Infections and Autoimmune Diseases; Assistance Publique-Hôpitaux de Paris, Hopital Bicêtre; Le Kremlin Bicêtre France
| | | | - Philippe Bertin
- Rheumatology Department; Limoges University Hospital; Limoges France
| | - Sophie Bucher
- General Practice Department; Faculty of Medicine Paris-Sud; University Paris-Sud; Le Kremlin-Bicêtre France
| | - Emmanuelle Corruble
- Department of Psychiatry; Faculty of Medicine Paris-Sud; INSERM U 669; University Paris-Sud; Bicêtre University Hospital; Assistance Publique-Hôpitaux de Paris; Le Kremlin Bicêtre France
| | | | - Geneviève Derumeaux
- Cardiovascular Functional Exploration; Louis Pradel Hospital, Hospices Civils de Lyon; Bron France
| | - Jean Doucet
- Internal Medicine, Geriatrics and Therapeutics; Saint Julien University Hospital; Rouen University; Rouen France
| | - Bruno Falissard
- Biostatistics Department; Faculty of Medicine Paris-Sud; INSERM U 669; University Paris-Sud; Assistance Publique-Hôpitaux de Paris, Hôpital Paul Brousse; Le Kremlin-Bicêtre France
| | - Francoise Forette
- National Foundation of Gerontology; University Paris Descartes; Paris France
| | - Olivier Hanon
- Geriatrics Department; University Paris Descartes; Assistance Publique-Hôpitaux de Paris, Hôpital Broca; Paris France
| | | | - Michel Pinget
- Endocrinology, Diabetes and Diseases of Nutrition (Pôle NUDE); University Hospital of Strasbourg and the European Centre for the Study of Diabetes (CeeD); University of Strasbourg; Strasbourg France
| | - Rissane Ourabah
- General Practice Department; Faculty of Medicine Paris-Sud; University Paris-Sud; Le Kremlin-Bicêtre France
| | - Celine Piedvache
- Pharmacology Department; Faculty of Medicine Paris-Sud; University Paris-Sud; UMR 1184; CEA, DSV/iMETI; Division of Immuno-Virology; IDMIT, INSERM Center for Immunology of Viral Infections and Autoimmune Diseases; Assistance Publique-Hôpitaux de Paris, Hopital Bicêtre; Le Kremlin Bicêtre France
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Koné-Paut I, Shahram F, Darce-Bello M, Cantarini L, Cimaz R, Gattorno M, Anton J, Hofer M, Chkirate B, Bouayed K, Tugal-Tutkun I, Kuemmerle-Deschner J, Agostini H, Federici S, Arnoux A, Piedvache C, Ozen S. Consensus classification criteria for paediatric Behçet's disease from a prospective observational cohort: PEDBD. Ann Rheum Dis 2015; 75:958-64. [PMID: 26698843 DOI: 10.1136/annrheumdis-2015-208491] [Citation(s) in RCA: 115] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2015] [Accepted: 11/24/2015] [Indexed: 01/27/2023]
Abstract
BACKGROUND We aimed to describe the main features of Behçet's disease (BD) in children in the largest prospective cohort to date and to propose a classification. METHODS An international expert consensus group was formed to define a data set of minimal symptoms for the inclusion of patients. Patients were entered prospectively during 66 months. Experts classified patients on a consensus basis. The concordance of two international classifications was analysed in confirmed patients with BD. Comparisons of subgroups of patients helped define consensus criteria. BD-associated clinical manifestations were also investigated in three control diseases extracted from an independent data set (Eurofever). FINDINGS In total, 42 centres from 12 countries included 230 patients; data for 219 (M/F ratio=1) could be analysed. The experts classified 156 patients (71.2%) as having confirmed BD. Males more often than females showed cutaneous, ocular and vascular symptoms and females more often genital aphthosis. Age at disease onset and skin and vascular involvement were lower for European than non-European children. Oral aphthosis was the presenting sign for 81% (179/219) of patients. The mean delay to the second symptom was 2.9±2.2 years. International classifications were not concordant with the expert classification. Our paediatric classification contains six categories, a minimum of three signs (each in a distinct category) defining paediatric BD. Three clinical signs discriminated our cohort from the Eurofever cohorts. INTERPRETATION We present a comprehensive description of a large cohort of patients from both European and non-European countries and propose the first classification of paediatric BD for future therapeutic trials.
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Affiliation(s)
- Isabelle Koné-Paut
- Department of Paediatric Rheumatology, CEREMAI, Bicêtre University Hospital, APHP, Paris SUD, Le Kremlin Bicêtre, France
| | - Fahrad Shahram
- Rheumatology Research Center, Shariati Hospital, Tehran, Iran
| | - Martha Darce-Bello
- Department of Paediatric Rheumatology, CEREMAI, Bicêtre University Hospital, APHP, Paris SUD, Le Kremlin Bicêtre, France
| | | | - Rolando Cimaz
- Department of Paediatric Rheumatology, A. Meyer Children, Florence, Italy
| | - Marco Gattorno
- UO Pediatria II, G. Gaslini Scientific Institute, Genoa, Italy
| | - Jordi Anton
- Paediatric Rheumatology Unit, Sant Joan de Déu University Hospital, Esplugues de Llobregat, Spain
| | - Michael Hofer
- Department of Paediatric Rheumatology, Vaudois University Hospital, Lausanne, Switzerland
| | - Bouchra Chkirate
- Internal Medicine and Immunology Clinic, Hassan II University Hospital, Fes, Morocco
| | - Kenza Bouayed
- Department of Paediatrics, IBN Rochd University Hospital, Casablanca, Morocco
| | - Ilknur Tugal-Tutkun
- Department of Ophthalmology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Jasmin Kuemmerle-Deschner
- Division of Pediatric Rheumatology, Department of Pediatrics, University Hospital Tübingen, Tübingen, Germany
| | - Hélène Agostini
- Clinical Research Unit, Bicêtre University Hospital, APHP, Paris SUD, Le Kremlin Bicêtre, France
| | - Sylvia Federici
- UO Pediatria II, G. Gaslini Scientific Institute, Genoa, Italy
| | - Armelle Arnoux
- Clinical Research Unit, Bicêtre University Hospital, APHP, Paris SUD, Le Kremlin Bicêtre, France
| | - Celine Piedvache
- Clinical Research Unit, Bicêtre University Hospital, APHP, Paris SUD, Le Kremlin Bicêtre, France
| | - Seza Ozen
- Department of Paediatrics, Hacettepe University, Ankara, Turkey
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Lazkani A, Delespierre T, Bauduceau B, Benattar-Zibi L, Bertin P, Berrut G, Corruble E, Danchin N, Derumeaux G, Doucet J, Falissard B, Forette F, Hanon O, Pasquier F, Pinget M, Ourabah R, Piedvache C, Becquemont L. Predicting falls in elderly patients with chronic pain and other chronic conditions. Aging Clin Exp Res 2015; 27:653-61. [PMID: 25637513 DOI: 10.1007/s40520-015-0319-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2014] [Accepted: 01/19/2015] [Indexed: 11/29/2022]
Abstract
BACKGROUND The aim was to identify fall predictors in elderly suffering from chronic pain (CP) and to test their applicability among patients with other chronic conditions. METHODS 1,379 non-institutionalized patients aged 65 years and older who were suffering from CP (S.AGE CP sub-cohort) were monitored every 6 months for 1 year. Socio-demographic, clinical and pain data and medication use were assessed at baseline for the association with falls in the following year. Falls were assessed retrospectively at each study visit. Logistic regression analyses were performed to identify fall predictors. The derived model was applied to two additional S.AGE sub-cohorts: atrial fibrillation (AF) (n = 1,072) and type-2 diabetes mellitus (T2DM) (n = 983). RESULTS Four factors predicted falls in the CP sub-cohort: fall history (OR: 4.03, 95 % CI 2.79-5.82), dependency in daily activities (OR: 1.81, 95 % CI 1.27-2.59), age ≥75 (OR: 1.53, 95 % CI 1.04-2.25) and living alone (OR: 1.73, 95 % CI 1.24-2.41) (Area Under the Curve: AUC = 0.71, 95 % CI 0.67-0.75). These factors were relevant in AF (AUC = 0.71, 95 % CI 0.66-0.75) and T2DM (AUC = 0.67, 95 % CI 0.59-0.73) sub-cohorts. Fall predicted probability in CP, AF and T2DM sub-cohorts increased from 7, 7 and 6 % in patients with no risk factors to 59, 66 and 45 % respectively, in those with the four predictors. Fall history was the strongest predictor in the three sub-cohorts. CONCLUSION Fall history, dependency in daily activities, age ≥75 and living alone are independent fall predictors in CP, AF and T2DM patients.
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Affiliation(s)
- Aida Lazkani
- Pharmacology Department, Paris-Sud Faculty of Medicine, AP-HP, Bicêtre Hospital, Paris-Sud University, 63, rue Gabriel Péri, 94276, Le Kremlin-Bicêtre, France.
| | - Tiba Delespierre
- Pharmacology Department, Paris-Sud Faculty of Medicine, AP-HP, Bicêtre Hospital, Paris-Sud University, 63, rue Gabriel Péri, 94276, Le Kremlin-Bicêtre, France
| | | | | | - Philippe Bertin
- Rheumatology Department, Limoges University Hospital, Limoges, France
| | - Gilles Berrut
- Clinical Gerontology, Nantes University Hospital, Nantes, France
| | - Emmanuelle Corruble
- Paris-Sud Faculty of Medicine, Psychiatry Department, Bicêtre University Hospital, AP-HP, INSERM U 669, Paris-Sud University, Le Kremlin-Bicêtre, France
| | | | - Geneviève Derumeaux
- Cardiovascular Functional Exploration, Louis Pradel Hospital, Hospices Civils de Lyon, Bron, France
| | - Jean Doucet
- Internal Medicine, Geriatrics and Therapeutics, Saint Julien University Hospital, Rouen University, Rouen, France
| | - Bruno Falissard
- Paris-Sud Faculty of Medicine, Biostatistics Department, AP-HP, Paul Brousse Hospital, INSERM U 669, Paris-Sud University, Le Kremlin-Bicêtre, France
| | - Francoise Forette
- National Gerontology Foundation, Paris Descartes University, Paris, France
| | - Olivier Hanon
- AP-HP, Broca Hospital, Geriatrics Department, Paris Descartes University, EA 4468, Paris, France
| | - Florence Pasquier
- Lille University Hospital, Lille Nord de France University, UDSL, EA 1046, Lille, France
| | - Michel Pinget
- Endocrinology, Diabetes and Nutrition-Related Diseases (NUDE Unit), Strasbourg University Hospital, and the European Centre for the Study of Diabetes (CeeD), Strasbourg University, Strasbourg, France
| | - Rissane Ourabah
- General Practice Department, Paris-Sud Faculty of Medicine, Paris-Sud University, Le Kremlin-Bicêtre, France
| | - Celine Piedvache
- Pharmacology Department, Paris-Sud Faculty of Medicine, AP-HP, Bicêtre Hospital, Paris-Sud University, 63, rue Gabriel Péri, 94276, Le Kremlin-Bicêtre, France
| | - Laurent Becquemont
- Pharmacology Department, Paris-Sud Faculty of Medicine, AP-HP, Bicêtre Hospital, Paris-Sud University, 63, rue Gabriel Péri, 94276, Le Kremlin-Bicêtre, France
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Bucher S, Bauduceau B, Benattar-Zibi L, Bertin P, Berrut G, Corruble E, Danchin N, Delespierre T, Derumeaux G, Doucet J, Falissard B, Forette F, Hanon O, Ourabah R, Pasquier F, Piedvache C, Pinget M, Ringa V, Becquemont L. Primary care management of non-institutionalized elderly diabetic patients: The S.AGES cohort - Baseline data. Prim Care Diabetes 2015; 9:267-274. [PMID: 25086913 DOI: 10.1016/j.pcd.2014.07.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2014] [Revised: 07/04/2014] [Accepted: 07/10/2014] [Indexed: 11/17/2022]
Abstract
AIM S.AGES is a multicenter prospective cohort study of non-institutionalized patients aged 65 and over with atrial fibrillation, type 2 diabetes or chronic pain. Its objective is to describe the medical management in primary care. This article presents the baseline characteristics of subjects in the diabetes subcohort and compares the results to those from cohorts of older diabetic patients. METHODS From April 2009 to June 2011, 983 patients were included in the diabetes subcohort by 213 primary care providers. Demographic data, geriatric parameters and the history, characteristics and treatment of the diabetes were recorded at baseline. RESULTS The mean age was 76.7 ± 5.9 years. Most patients were living independently, with no cognitive impairment and in relatively good health. The duration of diabetes was 11.3 ± 8.7 years with average HbA1c of 6.9 ± 1.0%. 20% of patients had macrovascular disease, 33% renal failure, 14.6% ocular complication and 7.1% neuropathy. The first-line antidiabetic treatment was metformin (61.2%) and 18% of patients had used insulin. Treatment intensified with the worsening of diabetic symptoms. When compared to those from French and North American cohorts, the results showed increased complications and use of insulin with age, disease duration and severity. CONCLUSION Due to the method of recruitment, S.AGES patients were generally healthy with well-controlled diabetes. However, the results were consistent with those from other cohorts. Three-year follow-up is expected to study the management of diabetic patients aged 65 and over in primary care.
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Affiliation(s)
- Sophie Bucher
- General Practice Department, Paris-Sud Faculty of Medicine, University of Paris-Sud, Le Kremlin-Bicêtre, France; INSERM, CESP Centre for Research in Epidemiology and Population Health, U1018, Gender, Sexual and Reproductive Health Team, University of Paris-Sud, Le Kremlin-Bicêtre, France.
| | | | | | - Philippe Bertin
- Rheumatology Department, Limoges University Hospital, Limoges, France
| | - Gilles Berrut
- Clinical Gerontology, Nantes University Hospital, France
| | - Emmanuelle Corruble
- INSERM U 669, Paris-Sud Faculty of Medicine, University of Paris-Sud, Psychiatry Department, Bicêtre University Hospital, Assistance Publique-Hôpitaux de Paris, Le Kremlin-Bicêtre, France
| | | | - Tiba Delespierre
- Pharmacology Department, Paris-Sud Faculty of Medicine, University of Paris-Sud, Assistance Publique-Hôpitaux de Paris, Bicêtre Hospital, Le Kremlin-Bicêtre, France
| | - Geneviève Derumeaux
- Cardiovascular Functional Exploration, Louis Pradel Hospital, Hospices Civils de Lyon, Bron, France
| | - Jean Doucet
- Internal Medicine, Geriatry and Therapeutics, Saint Julien University Hospital, Rouen University, Rouen, France
| | - Bruno Falissard
- INSERM U 669, Paris-Sud Faculty of Medicine, University of Paris-Sud, Biostatistics Department, Assistance Publique-Hôpitaux de Paris, Paul Brousse Hospital, Le Kremlin-Bicêtre, France
| | - Francoise Forette
- University of Paris Descartes, National Foundation of Gerontology, Paris, France
| | - Olivier Hanon
- University of Paris Descartes, EA 4468, AP-HP, Broca Hospital, Geriatrics Department, Paris, France
| | - Rissane Ourabah
- General Practice Department, Paris-Sud Faculty of Medicine, University of Paris-Sud, Le Kremlin-Bicêtre, France
| | - Florence Pasquier
- University of Lille Nord de France, UDSL, EA 1046, CHU, Lille, France
| | - Celine Piedvache
- Pharmacology Department, Paris-Sud Faculty of Medicine, University of Paris-Sud, Assistance Publique-Hôpitaux de Paris, Bicêtre Hospital, Le Kremlin-Bicêtre, France
| | - Michel Pinget
- Endocrinology, Diabetes and Nutrition-Related Diseases (NUDE Unit), Strasbourg University Hospital and the European Centre for the Study of Diabetes (CeeD), University of Strasbourg, Strasbourg, France
| | - Virginie Ringa
- INSERM, CESP Centre for Research in Epidemiology and Population Health, U1018, Gender, Sexual and Reproductive Health Team, University of Paris-Sud, Le Kremlin-Bicêtre, France
| | - Laurent Becquemont
- Pharmacology Department, Paris-Sud Faculty of Medicine, University of Paris-Sud, Assistance Publique-Hôpitaux de Paris, Bicêtre Hospital, Le Kremlin-Bicêtre, France
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Becquemont L, Bauduceau B, Benattar-Zibi L, Berrut G, Bertin P, Bucher S, Corruble E, Danchin N, al-Salameh A, Derumeaux G, Doucet J, Falissard B, Forette F, Hanon O, Pasquier F, Pinget M, Ourabah R, Piedvache C. Association between Cardiovascular Drugs and Chronic Kidney Disease in Non-Institutionalized Elderly Patients. Basic Clin Pharmacol Toxicol 2015; 117:137-43. [DOI: 10.1111/bcpt.12376] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2014] [Accepted: 01/05/2015] [Indexed: 12/20/2022]
Affiliation(s)
- Laurent Becquemont
- Pharmacology Department; Faculty of Medicine Paris-Sud; APHP; Bicêtre university Hospital; University Paris-Sud; Le Kremlin Bicêtre France
| | | | | | - Gilles Berrut
- Clinical Gerontology; Nantes university hospital; Nantes France
| | - Philippe Bertin
- Rheumatology Department; Limoges University Hospital; Limoges France
| | - Sophie Bucher
- General Practice Department; Faculty of Medicine Paris-Sud; University Paris-Sud; Le Kremlin-Bicêtre France
| | - Emmanuelle Corruble
- INSERM U 669; Faculty of Medicine Paris-Sud; Department of Psychiatry; Bicêtre University Hospital; APHP; University Paris-Sud; Le Kremlin Bicêtre France
| | | | - Abdallah al-Salameh
- Pharmacology Department; Faculty of Medicine Paris-Sud; APHP; Bicêtre university Hospital; University Paris-Sud; Le Kremlin Bicêtre France
| | - Geneviève Derumeaux
- Cardiovascular Functional Exploration; Louis Pradel Hospital; HCL; Bron France
| | - Jean Doucet
- Internal Medicine, Geriatrics and Therapeutics; Saint Julien University Hospital; Rouen University; Rouen France
| | - Bruno Falissard
- INSERM U 669; Faculty of Medicine Paris-Sud; Biostatistics Department; APHP; Hôpital Paul Brousse; University Paris-Sud; Le Kremlin-Bicêtre France
| | - Francoise Forette
- National Foundation of Gerontology; University Paris Descartes; Paris France
| | - Olivier Hanon
- Geriatrics Department; EA 4468, AP-HP; Broca university hospital; University Paris Descartes; Paris France
| | - Florence Pasquier
- UDSL; EA 1046, CHU; University of Lille Nord de France; Lille France
| | - Michel Pinget
- Endocrinology, Diabetes and Diseases of Nutrition; University Hospital of Strasbourg; European Centre for the Study of Diabetes (CeeD); University of Strasbourg; Strasbourg France
| | - Rissane Ourabah
- General Practice Department; Faculty of Medicine Paris-Sud; University Paris-Sud; Le Kremlin-Bicêtre France
| | - Celine Piedvache
- Pharmacology Department; Faculty of Medicine Paris-Sud; APHP; Bicêtre university Hospital; University Paris-Sud; Le Kremlin Bicêtre France
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Lazkani A, Delespierre T, Benattar-Zibi L, Bertin P, Corruble E, Derumeaux G, Falissard B, Forette F, Hanon O, Piedvache C, Becquemont L. Do male and female general practitioners differently prescribe chronic pain drugs to older patients? Pain Med 2014; 16:696-705. [PMID: 25521663 DOI: 10.1111/pme.12659] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The aim of this study was to identify the relationship between general practitioner (GP) gender and prescribing practice of chronic pain drugs in older adults. DESIGN Cross-sectional observational study. SETTING GPs in private practice throughout France. SUBJECTS Two hundred and sixty GPs (80.8% male and 19.2% female) enrolled 1,379 (28.4% male and 71.6% female) noninstitutionalized patients over 65 years of age, suffering from chronic pain. METHODS A comparison of prescribing habits between male and female GPs was performed on baseline data with univariate analyses followed by multivariate analyses after taking several confounding factors into account. RESULTS No significant differences were found when comparing male and female GPs' prescriptions of World Health Organization step 1, step 2, and step 3 analgesics. Male GPs were more likely than female GPs to prescribe antineuropathic pain drugs (11.3% of patients with male GPs versus 4.8% of patients with female GPs, P = 0.004) and less likely to prescribe symptomatic slow-acting drugs for osteoarthritis (SySADOA) (10.2% of male GPs' patients versus 18.8% of female GPs' patients, P = 0.0003). After adjusting for several confounding factors, male GPs were still more likely to prescribe antineuropathic pain drugs (OR 2.43, 95% CI 1.15-5.14, P = 0.02) and less likely to prescribe symptomatic slow-acting drugs (OR 0.64, 95% CI 0.42-0.97, P = 0.03). CONCLUSION Male and female GPs prescribe analgesics in a similar manner. However, male GPs prescribe more antineuropathic pain drugs, but fewer SySADOA.
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Affiliation(s)
- Aida Lazkani
- Pharmacology Department, Faculty of Medicine Paris-Sud, University Paris-Sud; Assistance Publique-Hôpitaux de Paris, Hôpital Bicêtre, Le Kremlin Bicêtre, France
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Becquemont L, Delespierre T, Bauduceau B, Benattar-Zibi L, Berrut G, Corruble E, Danchin N, Derumeaux G, Doucet J, Falissard B, Forette F, Hanon O, Pasquier F, Pinget M, Ourabah R, Bucher S, Lazkani A, Piedvache C, Bertin P. Consequences of dextropropoxyphene market withdrawal in elderly patients with chronic pain. Eur J Clin Pharmacol 2014; 70:1237-42. [DOI: 10.1007/s00228-014-1722-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2014] [Accepted: 07/21/2014] [Indexed: 11/29/2022]
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