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Nguyen VT, Sharp MK, Superchi C, Baron G, Glonti K, Blanco D, Olsen M, Vo Tat TT, Olarte Parra C, Névéol A, Hren D, Ravaud P, Boutron I. Biomedical doctoral students' research practices when facing dilemmas: two vignette-based randomized control trials. Sci Rep 2023; 13:16371. [PMID: 37773192 PMCID: PMC10541422 DOI: 10.1038/s41598-023-42121-1] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2023] [Accepted: 09/05/2023] [Indexed: 10/01/2023] Open
Abstract
Our aim was to describe the research practices of doctoral students facing a dilemma to research integrity and to assess the impact of inappropriate research environments, i.e. exposure to (a) a post-doctoral researcher who committed a Detrimental Research Practice (DRP) in a similar situation and (b) a supervisor who did not oppose the DRP. We conducted two 2-arm, parallel-group randomized controlled trials. We created 10 vignettes describing a realistic dilemma with two alternative courses of action (good practice versus DRP). 630 PhD students were randomized through an online system to a vignette (a) with (n = 151) or without (n = 164) exposure to a post-doctoral researcher; (b) with (n = 155) or without (n = 160) exposure to a supervisor. The primary outcome was a score from - 5 to + 5, where positive scores indicated the choice of DRP and negative scores indicated good practice. Overall, 37% of unexposed participants chose to commit DRP with important variation across vignettes (minimum 10%; maximum 66%). The mean difference [95%CI] was 0.17 [- 0.65 to 0.99;], p = 0.65 when exposed to the post-doctoral researcher, and 0.79 [- 0.38; 1.94], p = 0.16, when exposed to the supervisor. In conclusion, we did not find evidence of an impact of postdoctoral researchers and supervisors on student research practices.Trial registration: NCT04263805, NCT04263506 (registration date 11 February 2020).
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Affiliation(s)
- V T Nguyen
- Centre for Research in Epidemiology and Statistics (CRESS), Université Paris Cité and Université Sorbonne Paris Nord, Inserm, INRAE, 75004, Paris, France
- Department of Health Services Research, Institute of Population Health Sciences, University of Liverpool, Liverpool, UK
| | - M K Sharp
- Centre for Research in Epidemiology and Statistics (CRESS), Université Paris Cité and Université Sorbonne Paris Nord, Inserm, INRAE, 75004, Paris, France
- Department of Psychology, Faculty of Humanities and Social Sciences, University of Split, Split, Croatia
- Royal College of Surgeons in Ireland University of Medicine and Health Sciences, Dublin, Ireland
| | - C Superchi
- Centre for Research in Epidemiology and Statistics (CRESS), Université Paris Cité and Université Sorbonne Paris Nord, Inserm, INRAE, 75004, Paris, France
- Statistics and Operations Research Department, Barcelona-Tech, UPC, Barcelona, Spain
| | - G Baron
- Centre for Research in Epidemiology and Statistics (CRESS), Université Paris Cité and Université Sorbonne Paris Nord, Inserm, INRAE, 75004, Paris, France
- Centre d'Epidémiologie Clinique, AP-HP, Hôpital Hôtel Dieu, 75004, Paris, France
| | - K Glonti
- Centre for Research in Epidemiology and Statistics (CRESS), Université Paris Cité and Université Sorbonne Paris Nord, Inserm, INRAE, 75004, Paris, France
- Department of Psychology, Faculty of Humanities and Social Sciences, University of Split, Split, Croatia
| | - D Blanco
- Centre for Research in Epidemiology and Statistics (CRESS), Université Paris Cité and Université Sorbonne Paris Nord, Inserm, INRAE, 75004, Paris, France
- Department of Physiotherapy, Universitat Internacional de Catalunya, Barcelona, Spain
| | - M Olsen
- Centre for Research in Epidemiology and Statistics (CRESS), Université Paris Cité and Université Sorbonne Paris Nord, Inserm, INRAE, 75004, Paris, France
- Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - T T Vo Tat
- Centre for Research in Epidemiology and Statistics (CRESS), Université Paris Cité and Université Sorbonne Paris Nord, Inserm, INRAE, 75004, Paris, France
- Department of Statistics and Data Science, The Wharton School, University of Pennsylvania, Philadelphia, USA
| | - C Olarte Parra
- Centre for Research in Epidemiology and Statistics (CRESS), Université Paris Cité and Université Sorbonne Paris Nord, Inserm, INRAE, 75004, Paris, France
- Department of Applied Mathematics, Computer Science and Statistics, Ghent University, Ghent, Belgium
| | | | - D Hren
- Department of Psychology, Faculty of Humanities and Social Sciences, University of Split, Split, Croatia
| | - P Ravaud
- Centre for Research in Epidemiology and Statistics (CRESS), Université Paris Cité and Université Sorbonne Paris Nord, Inserm, INRAE, 75004, Paris, France
- Centre d'Epidémiologie Clinique, AP-HP, Hôpital Hôtel Dieu, 75004, Paris, France
| | - I Boutron
- Centre for Research in Epidemiology and Statistics (CRESS), Université Paris Cité and Université Sorbonne Paris Nord, Inserm, INRAE, 75004, Paris, France.
- Centre d'Epidémiologie Clinique, AP-HP, Hôpital Hôtel Dieu, 75004, Paris, France.
- Centre d'Épidémiologie Clinique, Hôpital Hôtel Dieu, 1 place du Parvis Notre-Dame, Cedex 4, 75089, Paris, France.
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Puéchal X, Iudici M, Perrodeau E, Bonnotte B, Lifermann F, Le Gallou T, Karras A, Blanchard-Delaunay C, Quéméneur T, Aouba A, Aumaître O, Cottin V, Hamidou M, Ruivard M, Cohen P, Mouthon L, Guillevin L, Ravaud P, Porcher R, Terrier B. Rituximab versus cyclophosphamide en traitement d’induction de la granulomatose avec polyangéite : essai thérapeutique émulé. Rev Med Interne 2022. [DOI: 10.1016/j.revmed.2022.10.090] [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: 12/12/2022]
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Fertitta L, Bergqvist C, Armand ML, Moryousef S, Ferkal S, Jannic A, Ravaud P, Tran VT, Ezzedine K, Wolkenstein P. Quality of life in neurofibromatosis 1: development and validation of a tool dedicated to cutaneous neurofibromas in adults. J Eur Acad Dermatol Venereol 2022; 36:1359-1366. [PMID: 35412677 DOI: 10.1111/jdv.18140] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Revised: 02/10/2022] [Accepted: 03/14/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND Cutaneous neurofibromas (cNF), present in 95% of individuals with neurofibromatosis 1 (NF1), are considered as one of the greatest medical burden because of physical disfigurement. No specific score evaluates their impact on quality of life (QoL). OBJECTIVE To develop a specific score assessing cNF-related QoL. METHODS Through a multidisciplinary workshop including 10 patients, 3 expert-in-NF1 physicians, 3 health care workers (nurses and psychologist) and 1 methodologist, the French version of the Skindex-16 was modified by adding 3 items. The new cNF-Skindex was validated among patients with NF1 recruited in the ComPaRe online cohort, in France (N=284). Construct validity was assessed by comparing it with the EQ-5D-5L, its visual analog scale and the MYMOP2 and by assessing its association with patients' characteristics. Reliability was assessed by a test-retest. An English version of the tool was developed using a back forward translation. RESULTS A total of 228 individuals with NF1, with cNF answered the 19-item questionnaire. These items fitted into 3 domains: emotions, symptoms, functioning. One was dropped during analysis because >90% responders were not concerned. The cNF-Skindex significantly correlated with the EQ-5D-5L (N=193) and MYMOP2 (N=210) indicating good external validity: rs 0.38 (p<0.001), and 0.58 (p<0.001) respectively. Having >50 cNF was the only independent variable associated with the total score cNF-Skindex (β=15.88, 95%CI 6.96 - 24.81, p=0.001), and with the 3 sub-scores: "functioning" (β=2.65, 95%CI 0.71 - 4.59, p=0.008), "emotions" (β=17.03, 95%CI 4.11 - 29.96, p=0.010) and "symptoms" (β=3.90, 95%CI 1.95 - 5.85, p<0.001). Test-retest reliability (N=133) found an ICC at 0.96 demonstrating good reproducibility. CONCLUSION The cNF-Skindex demonstrated excellent psychometric properties. The global and sub-scores were increased with higher number of cNF arguing for its use in further trials aiming to reduce their number or prevent their development. Cross-cultural validation and evaluation of its responsiveness are the next steps.
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Affiliation(s)
- L Fertitta
- Dept. of Dermatology, National Referral Center for Neurofibromatoses, Henri Mondor Hospital, Assistance Publique - Hôpitaux de Paris (AP-HP), 94010, Créteil, France
| | - C Bergqvist
- Dept. of Dermatology, National Referral Center for Neurofibromatoses, Henri Mondor Hospital, Assistance Publique - Hôpitaux de Paris (AP-HP), 94010, Créteil, France
| | - M L Armand
- Dept. of Dermatology, National Referral Center for Neurofibromatoses, Henri Mondor Hospital, Assistance Publique - Hôpitaux de Paris (AP-HP), 94010, Créteil, France
| | - S Moryousef
- Dept. of Dermatology, National Referral Center for Neurofibromatoses, Henri Mondor Hospital, Assistance Publique - Hôpitaux de Paris (AP-HP), 94010, Créteil, France
| | - S Ferkal
- Dept. of Dermatology, National Referral Center for Neurofibromatoses, Henri Mondor Hospital, Assistance Publique - Hôpitaux de Paris (AP-HP), 94010, Créteil, France.,INSERM, Centre d'Investigation Clinique 1430, National Referral Center for Neurofibromatoses, Henri-Mondor Hospital, Assistance Publique-Hôpitaux Paris (AP-HP), 94010, Créteil, France
| | - A Jannic
- Dept. of Dermatology, National Referral Center for Neurofibromatoses, Henri Mondor Hospital, Assistance Publique - Hôpitaux de Paris (AP-HP), 94010, Créteil, France
| | - P Ravaud
- Center for Clinical Epidemiology, Hôtel-Dieu Hospital (AP-HP), Paris, France.,Université de Paris, CRESS, INSERM, INRA, F-75004, Paris, France
| | - V T Tran
- Center for Clinical Epidemiology, Hôtel-Dieu Hospital (AP-HP), Paris, France.,Université de Paris, CRESS, INSERM, INRA, F-75004, Paris, France
| | - K Ezzedine
- Dept. of Dermatology, National Referral Center for Neurofibromatoses, Henri Mondor Hospital, Assistance Publique - Hôpitaux de Paris (AP-HP), 94010, Créteil, France.,Université Paris-Est Créteil (UPEC), 94010, Créteil, France
| | - P Wolkenstein
- Dept. of Dermatology, National Referral Center for Neurofibromatoses, Henri Mondor Hospital, Assistance Publique - Hôpitaux de Paris (AP-HP), 94010, Créteil, France.,Université Paris-Est Créteil (UPEC), 94010, Créteil, France.,INSERM U955, 94010, Créteil, France
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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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Diaz E, Ezzedine K, Ferkal S, Jannic A, Zehou O, Tran VT, Ravaud P, Wolkenstein P. ComPaRe NF : résultats à 6 mois des caractéristiques cliniques et de qualité de vie des patients atteints de neurofibromatose. Ann Dermatol Venereol 2020. [DOI: 10.1016/j.annder.2020.09.345] [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: 10/22/2022]
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Condamina M, Tran VT, Penso L, Hotz C, Guillem P, Villani A, Perrot P, Bru MF, Jacquet E, Nassif A, Bachelez H, Wolkenstein P, Beylot-Barry M, Richard MA, Ravaud P, Viguier M, Sbidian E. Caractéristiques cliniques des patients atteints d’hidradénite suppurée participants à la e-cohorte ComPaRe et comparaison avec les données de la littérature. Ann Dermatol Venereol 2020. [DOI: 10.1016/j.annder.2020.09.318] [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]
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Skayem C, Ezzedine K, Ferkal S, Jannic A, Zehou O, Tran VT, Ravaud P, Wolkenstein P. Neurofibromatose de type 1: facteurs associés aux poussées de neurofibromes cutanés à la puberté. Ann Dermatol Venereol 2020. [DOI: 10.1016/j.annder.2020.09.155] [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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Oikonomidi T, Ravaud P, James A, Cosson E, Montori V, Tran VT. What makes digital health intrusive? Qualitative findings from an international study on diabetes. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa165.371] [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: 11/13/2022] Open
Abstract
Abstract
Background
Remote digital monitoring (RDM, i.e., using digital devices to monitor patients' health and behavior) is a novel care model that can improve health outcomes for people with chronic conditions. However, it could be intrusive to patients' lives. We sought to understand which aspects of RDM make it intrusive to patients and why.
Methods
We performed content analysis of qualitative data collected by using open-ended questions in an international, online survey with a convenience sample of adults with type 1 or 2 diabetes (February-July 2019). Participants were first shown scenarios describing possible RDM features (i.e. different RDM tools [for glucose or food monitoring], feedback loops [receiving feedback in consultation, or remotely by a physician, or by artificial intelligence], and data handling options [by the public or private sector]).
Results
We analyzed data from 709 participants from 24 countries (38% men, median age 38, 54% type 1). Participants found RDM burdensome (n = 468). Burden arose from RDM features that caused disruption in daily life (e.g., alerts), features that may invite undesirable attention in public (e.g., visible wearable sensors may invite questions about one's health), or from having to adapt one's life to fit in RDM (e.g., adapt one's mealtime routine around food monitoring). Participants wanted control, particularly over sharing food-monitoring data with health care professionals in real-time to receive feedback (n = 440). They felt RDM could expose a delicate topic to 'surveillance' by authority figures (i.e., their data may 'reveal' poor dietary habits, leading to criticism by physicians). Intrusion could take the form of RDM eroding the patient-physician relationship (n = 34), or fear of data misuse (n = 206), which was associated with private-sector financial interests.
Conclusions
Our findings offer directions for minimally intrusive RDM design and show that digital health may cause concerns about stigma and treatment burden.
Key messages
Remote digital monitoring is intrusive when it increases treatment burden and limits patients’ control over their own health. “Minimally intrusive” digital health design could increase patient acceptability and, ultimately, foster scalability.
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Affiliation(s)
- T Oikonomidi
- UMR 1153, Université de Paris, CRESS, INSERM, INRA, Paris, France
- Clinical Epidemiology Unit, Hôtel-Dieu Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - P Ravaud
- UMR 1153, Université de Paris, CRESS, INSERM, INRA, Paris, France
- Clinical Epidemiology Unit, Hôtel-Dieu Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, France
| | - A James
- UMR 1153, Université de Paris, CRESS, INSERM, INRA, Paris, France
- Clinical Epidemiology Unit, Hôtel-Dieu Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - E Cosson
- U 1125, Sorbonne Paris Nord, INRA/CNAM, Bobigny, France
- Department of Endocrinology, Sorbonne Paris Nord, Sorbonne Paris Cité, AP-HP, Avicenne Hospital, CRNH-IdF, CINFO, Bobigny, France
| | - V Montori
- Knowledge and Evaluation Research Unit, Mayo Clinic, Rochester, USA
- Department of Health and Human Services, Center for Evidence and Practice Improvement of the Agency for Healthcare Research and Quality, Rockville, USA
| | - V T Tran
- UMR 1153, Université de Paris, CRESS, INSERM, INRA, Paris, France
- Clinical Epidemiology Unit, Hôtel-Dieu Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
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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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Lafarge A, Pagnoux C, Puéchal X, Samson M, Hamidou M, Karras A, Quéméneur T, Groh M, Mouthon L, Ravaud P, Guillevin L, Terrier B. Complications onco-hématologiques au cours des vascularites nécrosantes : analyse poolée de 5 essais thérapeutiques prospectifs. Rev Med Interne 2017. [DOI: 10.1016/j.revmed.2017.03.114] [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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Lafarge A, Pagnoux C, Puéchal X, Samson M, Hamidou M, Karras A, Quéméneur T, Groh M, Mouthon L, Ravaud P, Guillevin L, Terrier B. Complications infectieuses au cours des vascularites nécrosantes : analyse poolée de 5 essais thérapeutiques prospectifs. Rev Med Interne 2017. [DOI: 10.1016/j.revmed.2017.03.112] [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: 10/19/2022]
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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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Perlmutter A, Tran VT, Dechartres A, Ravaud P. Statistical controversies in clinical research: comparison of primary outcomes in protocols, public clinical-trial registries and publications: the example of oncology trials. Ann Oncol 2017; 28:688-695. [DOI: 10.1093/annonc/mdw682] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2016] [Accepted: 12/12/2016] [Indexed: 01/03/2023] Open
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Crequit P, Cadranel J, Trinquart L, Ravaud P. Les traitements de 2e ligne du cancer bronchique non à petites cellules (CBNPC) avancé EGFR sauvage ou de statut inconnu : revue systémique et méta-analyse en réseau. Rev Mal Respir 2017. [DOI: 10.1016/j.rmr.2016.10.477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Crequit P, Trinquart L, Cadranel J, Ravaud P. La méta-analyse en réseau cumulative et dynamique : un nouvel outil méthodologique pour adapter les traitements du CBNPC au quotidien ? Rev Mal Respir 2017. [DOI: 10.1016/j.rmr.2016.10.474] [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]
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Martinez V, Beloeil H, Marret E, Fletcher D, Ravaud P, Trinquart L. Non-opioid analgesics in adults after major surgery: systematic review with network meta-analysis of randomized trials. Br J Anaesth 2017; 118:22-31. [DOI: 10.1093/bja/aew391] [Citation(s) in RCA: 124] [Impact Index Per Article: 17.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
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Terrier B, Pagnoux C, Perrodeau E, Karras A, Khouatra C, Aumaître O, Maurier F, Decaux O, Desmurs H, Quéméneur T, Ravaud P, Guillevin L. Rituximab versus azathioprine pour le maintien de la rémission au cours des vascularites associées aux ANCA (essai Mainritsan) : suivi à 60 mois. Rev Med Interne 2016. [DOI: 10.1016/j.revmed.2016.10.094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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van Middelkoop M, Arden NK, Atchia I, Birrell F, Chao J, Rezende MU, Lambert RGW, Ravaud P, Bijlsma JW, Doherty M, Dziedzic KS, Lohmander LS, McAlindon TE, Zhang W, Bierma-Zeinstra SMA. The OA Trial Bank: meta-analysis of individual patient data from knee and hip osteoarthritis trials show that patients with severe pain exhibit greater benefit from intra-articular glucocorticoids. Osteoarthritis Cartilage 2016; 24:1143-52. [PMID: 26836288 DOI: 10.1016/j.joca.2016.01.983] [Citation(s) in RCA: 71] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2015] [Revised: 11/26/2015] [Accepted: 01/22/2016] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To evaluate the efficacy of intra-articular (IA) glucocorticoids for knee or hip osteoarthritis (OA) in specific subgroups of patients with severe pain and inflammatory signs using individual patient data (IPD) from existing trials. DESIGN Randomized trials evaluating one or more IA glucocorticoid preparation in patients with knee or hip OA, published from 1995 up to June 2012 were selected from the literature. IPD obtained from original trials included patient and disease characteristics and outcomes measured. The primary outcome was pain severity at short-term follow-up (up to 4 weeks). The subgroup factors assessed included severe pain (≥70 points, 0-100 scale) and signs of inflammation (dichotomized in present or not) at baseline. Multilevel regression analyses were applied to estimate the magnitude of the effects in the subgroups with the individuals nested within each study. RESULTS Seven out of 43 published randomized clinical trials (n = 620) were included. Patients with severe baseline pain had a significantly larger reduction in short-term pain, but not in mid- and long-term pain, compared to those with less severe pain at baseline (Mean Difference 13.91; 95% Confidence Interval 1.50-26.31) when receiving IA glucocorticoid injection compared to placebo. No statistical significant interaction effects were found between inflammatory signs and IA glucocorticoid injections compared to placebo and to tidal irrigation at all follow-up points. CONCLUSIONS This IPD meta-analysis demonstrates that patients with severe knee pain at baseline derive more benefit from IA glucocorticoid injection at short-term follow-up than those with less severe pain at baseline.
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Affiliation(s)
- M van Middelkoop
- Erasmus MC Medical University Center Rotterdam, Department of General Practice, The Netherlands.
| | - N K Arden
- Oxford NIHR Musculoskeletal Biomedical Research Unit, University of Oxford, OX3 7LD, UK; Arthritis Research UK Centre of Excellence for Sports, Exercise and Osteoarthritis, University of Oxford, OX3 7LD, UK; MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton SO16 6YD, UK.
| | - I Atchia
- Northumbria Healthcare NHS Foundation Trust, University of Newcastle, UK.
| | - F Birrell
- Northumbria Healthcare NHS Foundation Trust, University of Newcastle, UK.
| | - J Chao
- UCSD School of Medicine, La Jolla, CA, USA.
| | - M U Rezende
- Instituto de Ortopedia e Traumatologia, Faculdade de Medicina, HCFMUSP, Sao Paulo, Brazil.
| | - R G W Lambert
- Department of Radiology & Diagnostic Imaging, University of Alberta, Edmonton, Canada.
| | - P Ravaud
- Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité, Paris, France.
| | - J W Bijlsma
- University Medical Center Utrecht, Department of Rheumatology & Clinical Immunology, Utrecht, The Netherlands.
| | - M Doherty
- Division of Rheumatology, Orthopaedics and Dermatology, University of Nottingham, Nottingham, UK.
| | - K S Dziedzic
- Arthritis Research UK Primary Care Centre, Primary Care Sciences, Keele University, UK.
| | - L S Lohmander
- Lund University, Department of Orthopaedics, Clinical Sciences Lund, Sweden; Institute of Sports Science and Clinical Biomechanics, Department of Orthopaedics and Traumatology, University of Southern Denmark, Denmark.
| | - T E McAlindon
- Tufts University, Department of Medicine, Boston, USA.
| | - W Zhang
- Division of Rheumatology, Orthopaedics and Dermatology, University of Nottingham, Nottingham, UK.
| | - S M A Bierma-Zeinstra
- Erasmus MC Medical University Center Rotterdam, Department of General Practice, The Netherlands.
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Puéchal X, Pagnoux C, Baron G, Quémeneur T, Néel A, Agard C, Lifermann F, Liozon E, Ruivard M, Godmer P, Limal N, Mékinian A, Papo T, Ruppert AM, Bourgarit-Durand A, Bienvenu B, Geffray L, Terrier B, Groh M, Le Jeunne C, Mouthon L, Ravaud P, Guillevin L. LB0002 Does Adding Azathioprine To Glucocorticoid Induction Increase The Remission Rate and Prevent Relapses in Patients with Systemic Necrotizing Vasculitides without Poor-Prognosis Factors? A Multicenter, Double-Blind Randomized Controlled Trial. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.6204] [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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Chatelus E, Sordet C, Ravaud P, Sibilia J, Gottenberg JE. SAT0059 Criteria for Choice by Clincians of The Therapeutic Strategy in Patients with Insufficient Response To A First Anti-TNF: Data from The Randomized “Roc” Criteria. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.6141] [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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Sordet C, Chatelus E, Ravaud P, Sibilia J, Gottenberg JE. THU0597 Comparaison of Self Assessment of Disease Activity To Das28 in Rheumatoid Arthritis: Data from The Randomized “Roc” Trial. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.6072] [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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Morel J, Constantin A, Dernis E, Rist S, Flipo R, Schaeverbeke T, Vittecoq O, Soubrier M, Saraux A, Combe B, Dougados M, Pinta A, Baron G, Gottenberg JE, Mariette X, Ravaud P, Sibilia J. FRI0219 Risk Factors of Severe Infections in Patients with Rheumatoid Arthritis Treated with Tocilizumab in The French Registry Regate (Registry –Roactemra). Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.3249] [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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Rousseau A, Rozenberg P, Perrodeau E, Deneux-Tharaux C, Ravaud P. Variations in Postpartum Hemorrhage Management among Midwives: A National Vignette-Based Study. PLoS One 2016; 11:e0152863. [PMID: 27043439 PMCID: PMC4820253 DOI: 10.1371/journal.pone.0152863] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [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: 06/05/2015] [Accepted: 03/21/2016] [Indexed: 11/18/2022] Open
Abstract
Objective To assess variations in adherence to guidelines for management of postpartum hemorrhage (PPH) among midwives. Methods A multicentre vignette-based study was e-mailed to a random sample of midwives from 145 maternity units in France. They were asked to describe how they would manage the PPH described in 2 case-vignettes. These previously validated case-vignettes described 2 different scenarios for severe PPH. Vignette 1 described a typical immediate, severe PPH and vignette 2 a less typical case of severe but gradual PPH. They were constructed in 3 successive steps and included multiple-choice questions proposing several types of clinical practice options at each step. An expert consensus defined 14 criteria for assessing adherence to guidelines issued by the French College of Obstetricians and Gynecologists in 2004 in the midwives’ responses. We analyzed the number of errors among the 14 criteria to quantify the level of adherence. Results We obtained 450 complete responses from midwives from 87 maternity units. The rate of complete adherence (no error for any of the 14 criteria) was low: 25.1% in vignette 1 and 4.2% in vignette 2. The error rate was higher for pharmacological management, especially oxytocin use, than for non-pharmacological management and communication-monitoring-investigation. Adherence to guidelines varied substantially between and within maternity units, as well as between the vignettes for the same midwives. Conclusion Reponses to case-vignettes demonstrated substantial variations in PPH management and especially individual variations in adherence to guidelines. Midwives should participate in continuous and individualized training.
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Affiliation(s)
- A. Rousseau
- Department of Obstetrics and Gynecology, Poissy-Saint Germain Hospital, Poissy, France
- INSERM U1153, METHODS (Méthodes en évaluation thérapeutique des maladies chroniques) Research Unit, Paris Descartes-Sorbonne Paris Cité University, Paris, France
- * E-mail:
| | - P. Rozenberg
- Department of Obstetrics and Gynecology, Poissy-Saint Germain Hospital, Poissy, France
- Research unit EA 7285, Versailles-St Quentin University, Saint Quentin en Yvelines, France
| | - E. Perrodeau
- INSERM U1153, METHODS (Méthodes en évaluation thérapeutique des maladies chroniques) Research Unit, Paris Descartes-Sorbonne Paris Cité University, Paris, France
- Assistance Publique-Hôpitaux de Paris, Centre d’Epidémiologie Clinique, Hôpital Hôtel-Dieu, Paris, France
| | - C. Deneux-Tharaux
- INSERM U1153, EPOPé (Epidémiologie Obstétricale, Périnatale et Pédiatrique) Research Unit, Paris Descartes-Sorbonne Paris Cité University, Paris, France
| | - P. Ravaud
- INSERM U1153, METHODS (Méthodes en évaluation thérapeutique des maladies chroniques) Research Unit, Paris Descartes-Sorbonne Paris Cité University, Paris, France
- Assistance Publique-Hôpitaux de Paris, Centre d’Epidémiologie Clinique, Hôpital Hôtel-Dieu, Paris, France
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Crequit P, Trinquart L, Yavchitz A, Cadranel J, Ravaud P. Manque d’exhaustivité dans les revues systématiques des traitements de 2e ligne des cancers bronchiques non à petites cellules métastatiques. Rev Mal Respir 2016. [DOI: 10.1016/j.rmr.2015.10.683] [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: 11/17/2022]
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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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De Vita S, Quartuccio L, Seror R, Salvin S, Ravaud P, Fabris M, Nocturne G, Gandolfo S, Isola M, Mariette X. THU0392 Efficacy and Safety of Belimumab Given for 12 Months in Primary sjögren's Syndrome: The Beliss Open-Label Phase II Study. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.3101] [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: 11/03/2022]
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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, Moussalieh F, Seror R, Ravaud P, Benessiano J, Dieude P, Dernis E, Devauchelle-Pensec V, Dubost J, Fauchais A, Goeb V, Hachulla E, Morel J, Hatron P, Larroche C, Le Guern V, Morel J, Perdriger A, Puéchal X, Rist S, Saraux A, Sene D, Sibilia J, Vittecoq O, Ravaud P, Elbayed K, Mariette X, Namer I. AB0173 Metabolomics in Primary SjÖgren's Syndrome: Data from the Assess Cohort. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.3978] [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 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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Nourisson C, Gottenberg JE, Mariette X, Mulliez A, Bardin T, Cantagrel A, Combe B, Dougados M, Flipo RM, Gaudin P, Vittecoq O, Schaeverbeke T, Sibilia J, Soubrier M, Ravaud P, Tournadre A. AB0444 Impact of Gender on the Response and the Tolerance to Treatment with Abatacept in RA Patients: Results from the “Orencia and Rheumatoid Arthritis” Registry. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.5782] [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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Lévesque K, Morel N, Maltret A, Baron G, Hamidou M, Orquevaux P, Piette JC, Barriere F, Lebidois J, Fermont L, Fain O, Theulin A, Sassolas F, Pezard P, Amoura Z, Guettrot-Imbert G, Lemercier D, Georgin-Lavialle S, Deligny C, Hachulla E, Mouthon L, Ravaud P, Villain E, Bonnet D, Costedoat-Chalumeau N. OP0090 Determinants of Survival of Fetuses with Autoimmune Congenital Heart Block and Factors Associated with Neonatal and Late-Onset Dilated Cardiomyopathy: 214 Cases from the French Registry of Neonatal Lupus. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.2641] [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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Seror R, Nocturne G, Lazure T, Hendel-Chavez H, Desmoulins F, Belkhir R, Ravaud P, Benbijja M, Taoufik Y, Mariette X. THU0395 Low Numbers of Blood and Salivary Natural Killer Cells are Associated with a Better Response to Belimumab in Primary Sjogren's Syndrome: Results of the Beliss Study. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.5261] [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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Seror R, Baron G, Vitali C, Bowman S, Gottenberg JE, Tzioufas A, Theander E, Bootsma H, Doerner T, Ramos-Casals M, Mariette X, Ravaud P. FRI0421 Development of Clinessdai Score (Clinical Eular Sjögren's Syndrome Disease Activity Index) Without Biological Domain: A Tool For Biological Studies. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.5236] [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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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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Gottenberg J, Seror R, Benessiano J, Devauchelle-Pensec V, Dieude P, Dubost J, Fauchais A, Goeb V, Hachulla E, Hatron P, Larroche C, Le Guern V, Micelli-Richard C, Morel J, Perdriger A, Puéchal X, Rist S, Saraux A, Sene D, Sibilia J, Vittecoq O, Nocturne G, Ravaud P, Mariette X. SAT0379 Is Fatigue Immune-Mediated in Primary SjÖgren's Syndrome? Data from the Prospective Assess Cohort. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.3949] [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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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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Boyer P, Villain B, Pelissier A, Loriaut P, Dallaudière B, Massin P, Ravaud P, Ravaud P. Current state of anterior cruciate ligament registers. Orthop Traumatol Surg Res 2014; 100:879-83. [PMID: 25442050 DOI: 10.1016/j.otsr.2014.07.020] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2013] [Revised: 07/22/2014] [Accepted: 07/30/2014] [Indexed: 02/02/2023]
Abstract
PURPOSE The purpose of this work was to report the main characteristics and results of all active anterior cruciate ligament (ACL) reconstruction registers along with the differences between them. METHODS We systematically searched on Google and Medline via PubMed to identify ACL registers. National or regional registers were included if they were active and took into account ACL reconstructions. The main results and characteristics, namely the number of inclusions, exhaustivity, data collection methods and results dissemination methods were determined. The collected information was then submitted to each register for validation. RESULTS Four registers (3 national, 1 regional) were identified that routinely included every ACL reconstruction procedure. Register data were collected either through dedicated websites or on paper forms. All the registers used the same two outcome measures, namely the revision rate and a subjective patient score (KOOS score). Register results were made available through scientific publications or annual reports. The main differences between registers were in the graft choice and presence of associated meniscus and cartilage injuries. CONCLUSIONS Although there are only a few ACL reconstruction-specific registers, their scientific contribution is undeniable thanks to the quality of the collected data and the organization and collaboration between registers. Their impact on health care and science should grow in the future.
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Affiliation(s)
- P Boyer
- Service de chirurgie orthopédique et traumatologique, université Paris Diderot, hôpital Bichat Claude-Bernard, Assistance publique-Hôpitaux de Paris, 46, rue Henri-Huchard, 75018 Paris, France; Inserm U738, université Paris Descartes, hôpital Hôtel-Dieu, Assistance publique-Hôpitaux de Paris, 1, place du parvis Notre-Dame, 75004 Paris, France.
| | - B Villain
- Service de chirurgie orthopédique et traumatologique, université Paris Diderot, hôpital Bichat Claude-Bernard, Assistance publique-Hôpitaux de Paris, 46, rue Henri-Huchard, 75018 Paris, France; Inserm U738, université Paris Descartes, hôpital Hôtel-Dieu, Assistance publique-Hôpitaux de Paris, 1, place du parvis Notre-Dame, 75004 Paris, France
| | - A Pelissier
- Service de chirurgie orthopédique et traumatologique, université Paris Diderot, hôpital Bichat Claude-Bernard, Assistance publique-Hôpitaux de Paris, 46, rue Henri-Huchard, 75018 Paris, France
| | - P Loriaut
- Service de chirurgie orthopédique et traumatologique, université Paris Diderot, hôpital Bichat Claude-Bernard, Assistance publique-Hôpitaux de Paris, 46, rue Henri-Huchard, 75018 Paris, France
| | | | - P Massin
- Service de chirurgie orthopédique et traumatologique, université Paris Diderot, hôpital Bichat Claude-Bernard, Assistance publique-Hôpitaux de Paris, 46, rue Henri-Huchard, 75018 Paris, France
| | - P Ravaud
- Inserm U738, université Paris Descartes, hôpital Hôtel-Dieu, Assistance publique-Hôpitaux de Paris, 1, place du parvis Notre-Dame, 75004 Paris, France
| | - P Ravaud
- Inserm U738, université Paris Descartes, hôpital Hôtel-Dieu, Assistance publique-Hôpitaux de Paris, 1, place du parvis Notre-Dame, 75004 Paris, France
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Dechartres A, Riveros C, Perrodeau E, Haneef R, Boutron I, Ravaud P. Intérêt de ClinicalTrials.gov pour évaluer les résultats d’essais contrôlés randomisés. Rev Epidemiol Sante Publique 2014. [DOI: 10.1016/j.respe.2014.06.002] [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: 10/24/2022] Open
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Seror R, Gottenberg J, Bootsma H, Saraux A, Theander E, Ramos-Casals M, Bowman S, Le Guern V, Dörner T, Tzioufas A, Goeb V, Vitali C, Ravaud P, Mariette X. OP0217 Defining Disease Activity Sates and Minimal Clinically Important Improvement (MCII) with the EULAR Primary SjÖGren's Syndrome Disease Activity Index (ESSDAI). Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.4399] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [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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Van Middelkoop M, Arden N, Atchia I, Birrell F, Chao J, Lambert R, Ravaud P, Bijlsma J, Doherty M, Dziedzic K, Lohmander S, McAlindon T, Zhang W, Bierma-Zeinstra S. SAT0429 The OA TRIAL Bank: Meta-Analysis of Individual Patient Data Show That Patients with Severe Pain or with Inflammatory Signs Detected by Ultrasound Especially Benefit from Intra-Articular Glucocorticoids for Knee or Hip Oa. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.2250] [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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Morel J, Duzanski M, Flipo R, Cantagrel A, Combe B, Dougados M, Mariette X, Gottenberg J, Soubrier M, Vittecoq O, Saraux A, Schaeverbeke T, Bardin T, Rist S, Ravaud P, Sibilia J. FRI0323 Prospective Follow-Up of Tocilizumab Treatment in 1503 Patients with Refractory Rheumatoid Arthritis: Tolerance Data at 1 Year from the French Registry Regate (Registry – Roactemra). Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.5093] [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: 11/03/2022]
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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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Pugnet G, Pagnoux C, Karras A, Aumaitre O, Cohen P, Mahr A, Terrier B, Ravaud P, Mouthon L, Guillevin L. Traitement d’entretien des vascularites associées aux ANCA, comparant le rituximab à l’azathioprine (MAINRITSAN) : impact sur la qualité de vie, 24 mois après l’inclusion. Rev Med Interne 2014. [DOI: 10.1016/j.revmed.2014.03.020] [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: 12/01/2022]
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Gottenberg J, Seror R, Miceli-Richard C, Benessiano J, Devauchelle-Pensec V, Dieude P, Dubost JJ, Fauchais AL, Goeb V, Hachulla E, Hatron P, Larroche C, Le Guern V, Morel J, Perdriger A, Puéchal X, Rist S, Saraux A, Séné D, Sibilia J, Vittecoq O, Nocturne G, Ravaud P, Mariette X. OP0218 Elevated Serum BAFF is Associated with an Increased Risk of Developing A New Systemic Complication: Data from the Prospective ASSESS Cohort. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.4266] [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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Couderc M, Gottenberg JE, Mariette X, Pereira B, Bardin T, Cantagrel A, Combe B, Dougados M, Flipo RM, Le Loet X, Shaeverbeke T, Ravaud P, Soubrier M. Influence of gender on response to rituximab in patients with rheumatoid arthritis: results from the Autoimmunity and Rituximab registry. Rheumatology (Oxford) 2014; 53:1788-93. [DOI: 10.1093/rheumatology/keu176] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
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Chevalier X, Ravaud P, Maheu E, Baron G, Rialland A, Vergnaud P, Roux C, Maugars Y, Mulleman D, Lukas C, Wendling D, Lafforgue P, Loeuille D, Foltz V, Richette P. Adalimumab in patients with hand osteoarthritis refractory to analgesics and NSAIDs: a randomised, multicentre, double-blind, placebo-controlled trial. Ann Rheum Dis 2014; 74:1697-705. [PMID: 24817417 DOI: 10.1136/annrheumdis-2014-205348] [Citation(s) in RCA: 110] [Impact Index Per Article: 11.0] [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: 02/04/2014] [Accepted: 04/13/2014] [Indexed: 01/15/2023]
Abstract
AIM To test the efficiency of tumour necrosis factor blockers (adalimumab) in patients with painful refractory (non-responders to analgesics and non-steroidal anti-inflammatory drugs (NSAIDs)) hand osteoarthritis (OA). METHODS We performed a randomised, double-blind, placebo-controlled, parallel group, multicentre study. Patients were randomised to: 1/1 adalimumab 40 mg for two subcutaneous injections at a 15-day interval or placebo and monitored for 6 months. The primary outcome was the percentage of patients with an improvement of more than 50% in global pain (Visual Analogue Scale) between week 0 (W0) and week 6 (W6). Secondary outcomes included the number of painful joints, swollen joints, morning stiffness duration, patient and practitioner global assessments, functional indexes for hand OA, and consumption of analgesics. Analysis on the mean primary outcome measure was done on patients who received at least one injection. RESULTS 99 patients were recruited and 85 patients were randomised. Among them, 37 patients in the placebo group and 41 in the adalimumab group received at least one injection and were evaluated at W6 (n=78) on the main efficacy outcome. Mean age was 62 years, 85% were women, and mean level of pain was 62 mm at W0. At W6, 35.1% in the adalimumab group versus 27.3% in the placebo group had a pain reduction ≥50% (RR 1.12 (95% CI 0.82 to 1.54; p=0.48). There were no statistical differences for all secondary end points. The rate of adverse events was similar in the two groups. CONCLUSIONS Adalimumab was not superior to placebo to alleviate pain in patients with hand OA not responding to analgesics and NSAIDs. TRIALS REGISTRATION NUMBER NCT00597623.
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Affiliation(s)
- X Chevalier
- Department of Rheumatology, Henri Mondor Hospital, Creteil, France
| | - P Ravaud
- INSERM, AP-HP (Assistance Publique des Hôpitaux de Paris), Hôpital Hôtel Dieu, Centre d'Epidémiologie Clinique, Univ. Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, Paris, France
| | - E Maheu
- Department of Rheumatology, Hopital Saint Antoine University Paris VI, Paris, France
| | - G Baron
- INSERM, AP-HP (Assistance Publique des Hôpitaux de Paris), Hôpital Hôtel Dieu, Centre d'Epidémiologie Clinique, Univ. Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, Paris, France
| | - A Rialland
- Unité de Recherche Clinique, Hopital Henri Mondor, UPEC Paris XII
| | | | - C Roux
- Department of Rheumatology, Hopital de l'Archet, University Nice, France
| | - Y Maugars
- Department of Rheumatology, University Nantes, France
| | - D Mulleman
- Department of Rheumatology, Hopital Trousseau, University Tours, France
| | - C Lukas
- Department of Rheumatology, Hopital Lapeyronnie, University Montpellier, France
| | - D Wendling
- Department of Rheumatology, Centre Hospitalier Universitaire de Besançon, Université de Franche-Comté, Besançon, University of Besancon, France
| | - P Lafforgue
- Department of Rheumatology, Hopital de la Conception, University of Marseille, France
| | - D Loeuille
- Department of Rheumatology, Hopital Brabois, University of Nancy, France
| | - V Foltz
- Department of Rheumatology, Hopital La Pitié, University Paris VI, France
| | - P Richette
- Université Paris Diderot, Assistance Publique-Hôpitaux de Paris, Hôpital Lariboisière, Fédération de Rhumatologie, Paris, France
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Granger B, François C, Carcelain G, Ravaud P, Mariette X, Fautrel B. Analyse coût–efficacité de différentes stratégies de diagnostic de la tuberculose latente avant initiation de traitement par anti-TNF alpha. Rev Epidemiol Sante Publique 2014. [DOI: 10.1016/j.respe.2013.12.058] [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] Open
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