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Shourick J, Seneschal J, Andreu N, Meurant JM, Pane I, Ravaud P, Tran VT, Ezzedine K. Vitiligo Treatment Impact score (VITs): development and validation of a vitiligo burden of treatment questionnaire using the ComPaRe Vitiligo e-cohort. J Eur Acad Dermatol Venereol 2021; 36:279-285. [PMID: 34657353 DOI: 10.1111/jdv.17742] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Accepted: 09/30/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Vitiligo management is challenging and requires long-term adherence of patients who often complain of the burden associated with treatment. OBJECTIVE To develop and validate a patient reported measurement of the burden of treatment in vitiligo. METHODS The study was nested within the ComPaRe Vitiligo e-cohort, an online e-cohort of vitiligo patients in France. Items were derived from a literature review and from the qualitative analysis of a survey using open-ended questions of 204 patients with Vitiligo. Construct validity of the resulting instrument was assessed by comparing the instrument's score to the Dermatology Life Quality Index (DLQI), Vitiligo Impact Patient score (VIPs) and Treatment Burden Questionnaire (TBQ) scores. Reliability was assessed by test-retest with 15 ± 10 days of interval between both assessments. RESULTS In total, 343 adult participants participated in the validation of the Vitiligo Treatment Impact score (VITs). The VITs is a 19-item questionnaire assessing the burden of treatment in patients with vitiligo with results suggesting four domains ('Finding a doctor', 'Phototherapy', 'Topical treatment' and 'Impact on outdoor activities and photoprotection'). The VITs total score was well correlated with the DLQI, VIP and TBQ scores. Agreement between test and retest was good (ICC 0.705, 95% CI 0.491-0.818). CONCLUSIONS We developed a patient reported measurement of the burden of treatment in vitiligo with good psychometric properties.
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Affiliation(s)
- J Shourick
- Service de Dermatologie, AP-HP, Hôpital Henri-Mondor, Créteil, France.,EpiDermE - Epidemiology in Dermatology and Evaluation of Therapeutics, Université Paris-Est Créteil, Creteil, France
| | - J Seneschal
- Service de Dermatologie, Centre de Référence des Maladies Rares de la Peau, Hôpital Saint André, CHU de Bordeaux, Bordeaux, France.,INSERM, BMGIC, U1035, Univ. Bordeaux, Bordeaux, France
| | - N Andreu
- Service de Dermatologie, Centre de Référence des Maladies Rares de la Peau, Hôpital Saint André, CHU de Bordeaux, Bordeaux, France
| | - J-M Meurant
- Association Française du Vitiligo, Paris, France
| | - I Pane
- Centre de Recherche Épidémiologie et StatistiqueS (CRESS - Université de Paris, INSERM UMR1153), Paris, France.,Centre d'épidémiologie clinique - Hôpital Hôtel-Dieu (AP-HP), Paris, France
| | - P Ravaud
- Centre de Recherche Épidémiologie et StatistiqueS (CRESS - Université de Paris, INSERM UMR1153), Paris, France.,Centre d'épidémiologie clinique - Hôpital Hôtel-Dieu (AP-HP), Paris, France
| | - V-T Tran
- Centre de Recherche Épidémiologie et StatistiqueS (CRESS - Université de Paris, INSERM UMR1153), Paris, France.,Centre d'épidémiologie clinique - Hôpital Hôtel-Dieu (AP-HP), Paris, France
| | - K Ezzedine
- Service de Dermatologie, AP-HP, Hôpital Henri-Mondor, Créteil, France.,EpiDermE - Epidemiology in Dermatology and Evaluation of Therapeutics, Université Paris-Est Créteil, Creteil, France
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Gouesbet S, Kvaskoff M, Riveros C, Diard E, Pane I, Gabillet M, Garoche C, Ravaud P, Tran VT. P–327 Patients’ perspectives on how to improve the management of endometriosis in France: The ComPaRe-Endometriosis cohort. Hum Reprod 2021. [DOI: 10.1093/humrep/deab130.326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Study question
How should endometriosis management be improved from the patient’s point of view?
Summary answer
One thousand endometriosis patients proposed 2,587 ideas to improve the management of endometriosis that reflect three main themes: diagnosis, care, and information on the disease.
What is known already
Endometriosis is a gynecologic condition affecting 10% of reproductive-age women. The disease causes severe pelvic pain and has a dramatic impact on women’s quality of life. A mean delay of 7 years was described between onset of symptoms and diagnosis. There is an urgent need to reduce this delay and to rethink endometriosis care in order to adopt a more comprehensive and patient-centered approach, as women are often dissatisfied with the care they receive.
Study design, size, duration
This study was carried out in a random sample of endometriosis patients participating in ComPaRe (Community of Patients for Research), a prospective e-cohort of adult chronic disease patients who will be followed-up for 10 years. Participants complete monthly online questionnaires about their life with their disease(s). Recruitment began in January 2017 and is still ongoing, with currently 44,000 participants, including 10,000 endometriosis patients in the ComPaRe-Endometriosis sub-cohort.
Participants/materials, setting, methods
We selected a random sample of 1,000 participants in ComPaRe-Endometriosis, forming 3 equal groups of age (<25, 25–45, >45 years old) and education (<12, 12–14, >14 years). We conducted a qualitative study to gather their ideas for improving the management of their disease. Participants were asked: “If you had a magic wand, what would you change in your health care?”. One interviewer and two patients independently extracted ideas from the open-ended responses using thematic analysis.
Main results and the role of chance
Patients proposed a total of 2,587 ideas to improve the management of endometriosis, which we classified in three main themes: diagnosis, care, and information on the disease. To improve diagnosis, women proposed 724 ideas classified into 11 areas of improvement, including training of health professionals, taking symptoms seriously, improving the diagnosis process, and recognition of the disease by clinicians. To improve care, patients gave 1,677 ideas classified into 71 areas of improvement. For example, they asked for a better pain management, more listening from caregivers, the reimbursement of care or medical treatments, help in accessing clinicians that are expert in endometriosis, and reduced waiting times for medical appointments and exams. Finally, to improve information on the disease, participants suggested 186 ideas classified into 5 areas of improvement, covering more explanation about the disease, public recognition of endometriosis and general awareness, and more research and more explanation of research results.
Limitations, reasons for caution
The results were reviewed by three people in order to reduce the margin of interpretation in the analysis of this open-ended question, but some subjectivity remains. Generalizability may be difficult because the results are linked to the specificities of the French model of care.
Wider implications of the findings: Through the many ideas proposed by patients, we identified a total of 87 areas for improvement in endometriosis diagnosis, care, and information. These results reflect patients’ expectations in terms of management of their disease and will be useful to design a better global care for endometriosis from the patients’ perspective.
Trial registration number
Not applicable
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Affiliation(s)
- S Gouesbet
- Inserm U1018- Exposome and Heredity Team, Centre for Research in Epidemiology and Population Health CESP, Paris 15e Arrondissement, France
| | - M Kvaskoff
- Inserm U1018- Exposome and Heredity Team, Centre for Research in Epidemiology and Population Health CESP, Paris 15e Arrondissement, France
| | - C Riveros
- Assistance Publique-Hôpitaux de Paris AP-HP, Center for Clinical Epidemiology- Hôtel-Dieu Hospital, Paris, France
| | - E Diard
- Assistance Publique-Hôpitaux de Paris AP-HP, Center for Clinical Epidemiology- Hôtel-Dieu Hospital, Paris, France
| | - I Pane
- Assistance Publique-Hôpitaux de Paris AP-HP, Center for Clinical Epidemiology- Hôtel-Dieu Hospital, Paris, France
| | - M Gabillet
- ENDOmind France, Patient organization, Paris, France
| | - C Garoche
- The ComPaRe cohort, Volunteer patient, Gujan-Mestras, France
| | - P Ravaud
- Assistance Publique-Hôpitaux de Paris AP-HP, Center for Clinical Epidemiology- Hôtel-Dieu Hospital, Paris, France
| | - V T Tran
- Assistance Publique-Hôpitaux de Paris AP-HP, Center for Clinical Epidemiology- Hôtel-Dieu Hospital, Paris, France
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Salmon JH, Cacoub P, Combe B, Sibilia J, Pallot-Prades B, Fain O, Cantagrel A, Dougados M, Andres E, Meyer O, Carli P, Pertuiset E, Pane I, Maurier F, Ravaud P, Mariette X, Gottenberg JE. Late-onset neutropenia after treatment with rituximab for rheumatoid arthritis and other autoimmune diseases: data from the AutoImmunity and Rituximab registry. RMD Open 2015; 1:e000034. [PMID: 26509060 PMCID: PMC4612695 DOI: 10.1136/rmdopen-2014-000034] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2014] [Revised: 04/23/2015] [Accepted: 04/28/2015] [Indexed: 01/12/2023] Open
Abstract
Objectives To evaluate the prevalence of late-onset neutropenia and its complications in patients treated with rituximab (RTX) for rheumatoid arthritis (RA) and other autoimmune diseases (AIDs) in a prospective registry. Methods The AutoImmunity and Rituximab registry is an independent 7-year prospective registry promoted by the French Society of Rheumatology. For each episode of neutropenia, data were validated by the clinician in charge of the patient. Results Among 2624 patients treated with RTX for refractory AIDs, and at least 1 follow-up visit (a total follow-up of 4179 patient-years in RA and 987 patient-years in AIDs), late-onset neutropenia was observed in 40 patients (25 RA (1.3% of patients with RA, 0.6/100 patient-years), and AIDs in 15 (2.3% of patients with AIDs, 1.5/100 patient-years)). 6 patients (15%) had neutrophils <500/mm3, 8 (20%) had neutrophils between 500 and 1000/mm3, and 26 (65%) had neutrophils between 1000 and 1500/mm3. Neutropenia occurred after a median period of 4.5 (3–6.5) months after the last RTX infusion in patients with RA, and 5 (3–6.5) months in patients with AIDs. 5 patients (12.5%), 4 of them with neutrophils lower than 500/mm3, developed a non-opportunistic serious infection and required antibiotics and granulocyte colony-stimulating factor injections, with a favourable outcome. After resolution of their RTX-related neutropenia, 19 patients (47.5%) were re-treated, and neutropenia reoccurred in 3 of them. Conclusions Late-onset neutropenia might occur after RTX and may result in serious infections. Thus, monitoring of white cell count should be performed after RTX. However, in this large registry of patients with AIDs, the frequency of RTX-induced neutropenia was much lower than that previously reported in patients treated for blood malignancies or AIDs.
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Affiliation(s)
- J H Salmon
- Rheumatology Department, CHU Reims, Reims, France
| | - P Cacoub
- Departement Hospitalo-Universitaire I2B, UPMC Univ Paris 06, CNRS, UMR 7211, INSERM, UMR_S 959, Department of Internal Medicine, Groupe Hospitalier Pitié-Salpêtrière (AP-HP), Paris, France
| | - B Combe
- Rheumatology Department, Lapeyronie University Hospital, Montpellier I, University, UMR5535, Montpellier, France
| | - J Sibilia
- Rheumatology department, National Center for Rare Systemic Autoimmune Diseases, Hôpitaux Universitaires de Strasbourg, INSERM UMRS_1109, Université de Strasbourg, Strasbourg, France
| | - B Pallot-Prades
- Rheumatology Department, CHU Saint-Etienne, Saint-Etienne, France
| | - O Fain
- Department of Internal Medicine, Hôpital Jean Verdier, Bondy, France
| | - A Cantagrel
- Rheumatology Center, Purpan Hospital, Paul Sabatier University, Toulouse, France
| | - M Dougados
- Medicine Faculty, Paris-Descartes University, Paris, UPRES-EA 4058, Cochin Hospital, Rheumatology B, Paris, France
| | - E Andres
- Department of Internal Medicine, University Hospital of Strasbourg, Strasbourg, France
| | - O Meyer
- Rheumatology Department, GroupeHospitalier Bichat-Claude Bernard (AP-HP), Paris, France
| | - P Carli
- Department of Internal Medicine, Hôpital D'Instruction des Armeés Sainte-541 Anne, Toulon, France
| | - E Pertuiset
- Rheumatology Department, CH René Dubos, Pontoise, France
| | - I Pane
- Centre de Recherche en Epidémiologie et Statistiques, INSERM U1153, Centre d'Épidémiologie Clinique, Hôpital Hôtel-Dieu, Assistance Publique-Hôpitaux de Paris (AP-HP), Descartes University, Paris, France
| | - F Maurier
- Department of Internal Medicine, CHR Metz, Metz, France
| | - P Ravaud
- Centre de Recherche en Epidémiologie et Statistiques, INSERM U1153, Centre d'Épidémiologie Clinique, Hôpital Hôtel-Dieu, Assistance Publique-Hôpitaux de Paris (AP-HP), Descartes University, Paris, France
| | - X Mariette
- Rheumatology Department, Hôpitaux Universitaires Paris-Sud, AP-HP, INSERM U1184, IMVA: Center of Immunology of Viral Infections and Autoimmune Diseases, Paris, France
| | - J E Gottenberg
- Rheumatology Department, National Center for Rare Systemic Autoimmune Diseases, Hôpitaux Universitaires de Strasbourg, CNRS, Institut de Biologie Moléculaire et Cellulaire, Immunopathologie et Chimie Thérapeutique/Laboratory of Excellence Medalis, Université de Strasbourg, Strasbourg, France
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Salmon JH, Gottenberg JE, Ravaud P, Cantagrel A, Combe B, Flipo RM, Schaeverbeke T, Houvenagel E, Gaudin P, Loeuille D, Rist S, Dougados M, Sibilia J, Le Loët X, Meyer O, Solau-Gervais E, Marcelli C, Bardin T, Pane I, Baron G, Perrodeau E, Mariette X. Predictive risk factors of serious infections in patients with rheumatoid arthritis treated with abatacept in common practice: results from the Orencia and Rheumatoid Arthritis (ORA) registry. Ann Rheum Dis 2015; 75:1108-13. [PMID: 26048170 DOI: 10.1136/annrheumdis-2015-207362] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2015] [Accepted: 05/14/2015] [Indexed: 11/04/2022]
Abstract
OBJECTIVES Little data are available regarding the rate and predicting factors of serious infections in patients with rheumatoid arthritis (RA) treated with abatacept (ABA) in daily practice. We therefore addressed this issue using real-life data from the Orencia and Rheumatoid Arthritis (ORA) registry. METHODS ORA is an independent 5-year prospective registry promoted by the French Society of Rheumatology that includes patients with RA treated with ABA. At baseline, 3 months, 6 months and every 6 months or at disease relapse, during 5 years, standardised information is prospectively collected by trained clinical nurses. A serious infection was defined as an infection occurring during treatment with ABA or during the 3 months following withdrawal of ABA without any initiation of a new biologic and requiring hospitalisation and/or intravenous antibiotics and/or resulting in death. RESULTS Baseline characteristics and comorbidities: among the 976 patients included with a follow-up of at least 3 months (total follow-up of 1903 patient-years), 78 serious infections occurred in 69 patients (4.1/100 patient-years). Predicting factors of serious infections: on univariate analysis, an older age, history of previous serious or recurrent infections, diabetes and a lower number of previous anti-tumour necrosis factor were associated with a higher risk of serious infections. On multivariate analysis, only age (HR per 10-year increase 1.44, 95% CI 1.17 to 1.76, p=0.001) and history of previous serious or recurrent infections (HR 1.94, 95% CI 1.18 to 3.20, p=0.009) were significantly associated with a higher risk of serious infections. CONCLUSIONS In common practice, patients treated with ABA had more comorbidities than in clinical trials and serious infections were slightly more frequently observed. In the ORA registry, predictive risk factors of serious infections include age and history of serious infections.
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Affiliation(s)
- J H Salmon
- Rheumatology Department, CHU Reims, Reims, France
| | - J E Gottenberg
- Rheumatology Department, National Center for Rare Systemic Autoimmune Diseases, Hôpitaux Universitaires de Strasbourg, CNRS, Institut de Biologie Moléculaire et Cellulaire, Immunopathologie et Chimie Thérapeutique/Laboratory of Excellence Medalis, Université de Strasbourg, Strasbourg, France
| | - P Ravaud
- Centre de Recherche en Epidémiologie et Statistiques, INSERM U1153, Centre d'Épidémiologie Clinique, Hôpital Hôtel-Dieu, Assistance Publique-Hôpitaux de Paris (AP-HP), Descartes University, Paris, France
| | - A Cantagrel
- Rheumatology Center, Purpan Hospital, Paul Sabatier University, Toulouse, France
| | - B Combe
- Rheumatology Department, Lapeyronie University Hospital, Montpellier I University, Montpellier, France
| | - R M Flipo
- Rheumatology Department, CHRU de Lille, Université de Lille-2, Lille, France
| | | | - E Houvenagel
- Rheumatology Department, CHU Lomme, Lomme, France
| | - P Gaudin
- Rheumatology Department, CHU Grenoble, Grenoble, France
| | - D Loeuille
- Rheumatology Department, CHU Nancy, Nancy, France
| | - S Rist
- Rheumatology Department, CHR Orléans, Orléans, France
| | - M Dougados
- Medicine Faculty, Paris-Descartes University, Paris, UPRES-EA 4058, Cochin Hospital, Rheumatology B, Paris, France
| | - J Sibilia
- Rheumatology department, National Center for Rare Systemic Autoimmune Diseases, Hôpitaux Universitaires de Strasbourg, INSERM UMRS_1109, Université de Strasbourg, Strasbourg, France
| | - X Le Loët
- Rheumatology Department, Rouen University Hospital & Inserm U905, Rouen, France
| | - O Meyer
- Rheumatology Department, Groupe Hospitalier Bichat-Claude Bernard (AP-HP), Paris, France
| | | | - C Marcelli
- Rheumatology Department, CHU Caen, Caen, France
| | - T Bardin
- Rheumatology Department, Hôpital Lariboisière, Paris, France
| | - I Pane
- Centre de Recherche en Epidémiologie et Statistiques, INSERM U1153, Centre d'Épidémiologie Clinique, Hôpital Hôtel-Dieu, Assistance Publique-Hôpitaux de Paris (AP-HP), Descartes University, Paris, France
| | - G Baron
- Centre de Recherche en Epidémiologie et Statistiques, INSERM U1153, Centre d'Épidémiologie Clinique, Hôpital Hôtel-Dieu, Assistance Publique-Hôpitaux de Paris (AP-HP), Descartes University, Paris, France
| | - E Perrodeau
- Centre de Recherche en Epidémiologie et Statistiques, INSERM U1153, Centre d'Épidémiologie Clinique, Hôpital Hôtel-Dieu, Assistance Publique-Hôpitaux de Paris (AP-HP), Descartes University, Paris, France
| | - X Mariette
- Rheumatology Department, Hôpitaux Universitaires Paris-Sud, AP-HP, INSERM U1184, IMVA: Center of Immunology of Viral Infections and Autoimmune Diseases, Paris, France
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Salliot C, Beaudoin C, Chauffier K, Gilson M, Séror R, Sordet C, Sparsa L, Pane I, Ravaud P, Gottenberg J. FRI0070 Prevalence and Evolution of Monoclonal Gammapathy of Undetermined Significance in Patients with Rheumatoid Arthritis Patients Treated with Abatacept: Data from the ORA Registry. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.3993] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Gottenberg J, Morel J, Ravaud P, Bardin T, Cacoub P, Cantagrel A, Combe B, Constantin A, Dougados M, Flipo R, Godeau B, Hachulla E, Le Loet X, Schaeverbeke T, Sibilia J, Pane I, Baron G, Mariette X. FRI0154 Incidence of Cancers in Patients with Rheumatoid Arthritis and a History of Cancer Treated with Rituximab or Abatacept. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.3822] [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: 11/03/2022]
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Gottenberg JE, Morel J, Ravaud P, Bardin T, Cacoub P, Cantagrel A, Combe B, Constantin A, Dougados M, Flipo R, Godeau B, Hachulla E, Le Loet X, Schaeverbeke T, Sibilia J, Pane I, Baron G, Mariette X. OP0035 Tolerance of Rituximab, Abatacept and Tocilizumab in Common Practice: Analysis of the 3 Registries of the French Society of Rheumatology (Air, Ora and Regate). Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.3807] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Sagez F, Ravaud P, Afif N, Benmansour A, Constantin A, Dernis E, Dougados M, Flipo R, Jamard B, Legrand J, Morel J, Redeker S, Richez C, Scotto C, Solau-Gervais E, Pane I, Mariette X, Gottenberg J. AB0460 Remission After Discontinuation of Abatacept for Good Response: Results from the ORA Registry. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.3704] [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: 11/03/2022]
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Godot S, Gottenberg JE, Paternotte S, Pane I, Combe B, Sibilia J, Flipo RM, Schaeverbeke T, Ravaud P, Toussirot E, Berenbaum F, Mariette X, Wendling D, Sellam J. Safety of surgery after rituximab therapy in 133 patients with rheumatoid arthritis: data from the autoimmunity and rituximab registry. Arthritis Care Res (Hoboken) 2014; 65:1874-9. [PMID: 23754822 DOI: 10.1002/acr.22056] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2012] [Revised: 03/12/2013] [Accepted: 05/23/2013] [Indexed: 12/20/2022]
Abstract
OBJECTIVE We used data from the AutoImmunity and Rituximab (AIR) registry to investigate the safety of surgery for patients with rheumatoid arthritis receiving rituximab (RTX) in routine care. METHODS Data for patients included in the AIR registry and undergoing surgery during the year following an infusion of RTX were reviewed to describe the frequency of postsurgical complications, compare patients with and without complications, and identify factors associated with complications. RESULTS We examined data for 133 patients with a known date of surgery and at least 1 followup visit, corresponding to 140 procedures, including 94 orthopedic surgeries (67%) and 23 abdominal surgeries (16.5%). The median delay between surgery and the last RTX infusion was 6.4 months (interquartile range 4.3– 8.7 months), without any difference between patients with and without complications. Nine patients (6.7%) experienced 12 complications (8.5%), including 8 surgical site infections (5.7%) and 1 death due to septic shock. Postoperative complications occurred after 4.3% of abdominal surgeries (1 of 23) and 7.4% of orthopedic surgeries (7 of 95). On univariate analysis, spine surgery was associated with postoperative complications (P = 0.048). CONCLUSION In common practice, the risk of complications may be more important in case of spine surgery, but does not seem to be linked to the time between the last RTX infusion and surgery.
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Godot S, Gottenberg J, Paternotte S, Pane I, Combe B, Sibilia J, Flipo RM, Schaeverbeke T, Ravaud P, Toussirot E, Berenbaum F, Mariette X, Wendling D, Sellam J. THU0122 Safety of surgery in patients with rheumatoid arthritis treated by rituximab in routine care: Data from the french air registry:. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2012-eular.2087] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Salmon JH, Ravaud P, Bardin T, Cacoub P, Cantagruel A, Combe B, Dougados M, Flipo RM, Godeau B, Guillevin L, Le Loët X, Hachulla E, Schaeverbeke T, Sibilia J, Pane I, Baron G, Mariette X, Gottenberg JE. FRI0246 Serious infusion-related reactions after rituximab in patients with rheumatoid arthritis: data from the autoimmunity and rituximab registry. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2013-eular.1373] [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: 11/04/2022]
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Gottenberg JE, Ravaud P, Cantagrel A, Combe B, Flipo RM, Schaeverbeke T, Houvenagel E, Gaudin P, Loeuille D, Rist S, Dougados M, Sibilia J, Le Loët X, Marcelli C, Bardin T, Pane I, Baron G, Mariette X. Positivity for anti-cyclic citrullinated peptide is associated with a better response to abatacept: data from the 'Orencia and Rheumatoid Arthritis' registry. Ann Rheum Dis 2012; 71:1815-9. [PMID: 22615458 DOI: 10.1136/annrheumdis-2011-201109] [Citation(s) in RCA: 106] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
OBJECTIVES Very limited data are available regarding the efficacy of abatacept (ABA) in real life. The aims of this study were to determine the efficacy of ABA in rheumatoid arthritis and predicting factors of efficacy in common practice. METHODS The Orencia and Rheumatoid Arthritis" (ORA) prospective registry, promoted by the French Society of Rheumatology, has included 1003 patients with RA. RESULTS 773 patients had already fulfilled the 6-month follow-up visit. Only 21.3% of patients would have fulfilled inclusion criteria used in pivotal controlled trials. The European League Against Rheumatism (EULAR) response, was observed in 330 (59.1%) of the 558 assessed patients (good response: 20.4%, moderate response: 38.7%) and was similar in patients who did and in patients who did not fulfill inclusion criteria of controlled trials. Among EULAR responders, initial 28-joint disease activity score (5.4 (4.7-6.5) in responders vs 4.9 (4.0-6.0) in non responders, p< 0.0001), the proportion of rheumatoid factor (75.6% vs 66.7%, p= 0.03) and the proportion of anti-cyclic citrullinated peptide antibody (anti-CCP)-positivity (75.9% vs 62.2%, p= 0.001) were significantly higher. In multivariate analysis adjusted on initial 28-joint disease activity score and CRP, anti-CCP positivity was associated with EULAR response (OR=1.9;95% CI=1.2 to 2.9, p=0.007), but not rheumatoid factor (OR=1.0;95% CI=0.6 to 1.6, p=0.9). Anti-CCP positivity was also significantly associated with a higher ABA retention rate at 6 months. CONCLUSIONS Real life efficacy of ABA in the ORA registry was similar as that reported in clinical trials. Anti-CCP positivity was associated with a better response to ABA, independently from disease activity.
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Affiliation(s)
- J E Gottenberg
- Rhumatologie, Hôpitaux Universitaires de Strasbourg, Centre de Référence National des Maladies Auto-Immunes Systémique Rares, EA 4438 Physiopathologie des Arthrites, Strasbourg, France.
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