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Dupas B, Castro-Farias D, Girmens JF, Eginay A, Couturier A, Villeroy F, Delyfer MN, Creuzot-Garcher C, Giocanti-Auregan A, Béral L, Arndt C, Mesnard C, Vicaut E, Chaumet-Riffaud P, Durand-Zaleski I, Paques M. Photocoagulation or sham laser in addition to conventional anti-VEGF therapy in macular edema associated with TelCaps due to diabetic macular edema or retinal vein occlusion (TalaDME): a study protocol for a multicentric, French, two-group, non-commercial, active-control, observer-masked, non-inferiority, randomized controlled clinical trial. Trials 2024; 25:273. [PMID: 38649937 PMCID: PMC11034085 DOI: 10.1186/s13063-024-07994-1] [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: 06/01/2023] [Accepted: 02/20/2024] [Indexed: 04/25/2024] Open
Abstract
BACKGROUND Macular edema (ME) results from hyperpermeability of retinal vessels, leading to chronic extravasation of plasma components into the retina and hence potentially severe visual acuity loss. Current standard of care consists in using intravitreal injections (IVI), which results in a significant medical and economic burden. During diabetic retinopathy (DR) or retinal vein occlusion (RVO), it has recently been shown that focal vascular anomalies (capillary macro-aneurysms, also termed TelCaps) for telangiectatic capillaries may play a central role in the onset, early recurrence, and/or persistence of ME. Since targeted photocoagulation of TelCaps may improve vision, identification, and photocoagulation of TelCaps, it may represent a way to improve management of ME. OBJECTIVE The Targeted Laser in (Diabetic) Macular Edema (TalaDME) study aims to evaluate whether ICG-guided targeted laser (IGTL), in association with standard of care by IVI, allows reducing the number of injections during the first year of treatment compared with IVI only, while remaining non-inferior for visual acuity. METHODS TalaDME is a French, multicentric, two-arms, randomized, sham laser-controlled, double-masked trial evaluating the effect of photocoagulation of TelCaps combined to IVI in patients with ME associated with TelCaps. Patients with vision loss related to center involved ME secondary to RVO or DR and presenting TelCaps are eligible. Two hundred and seventy eyes of 270 patients are randomized in a 1:1 ratio to standard care, i.e., IVI of anti-VEGF solely (control group) or combined with IGTL therapy (experimental group). Stratification is done on the cause of ME (i.e., RVO versus diabetes). Anti-VEGF IVI are administered to both groups monthly for 3 months (loading dose) and then with a pro re nata regimen with a monthly follow-up for 12 months. The primary endpoint will be the number of IVI and the change in visual acuity from baseline to 12 months. Secondary endpoints will be the changes in central macular thickness, impact on quality of life, cost of treatment, and incremental cost-utility ratio in each groups. KEY SAFETY Rare but severe AE linked to the use of IVI and laser, and previously described, are expected. In the sham group, rescue laser photocoagulation may be administered by the unmasked investigator if deemed necessary at month 3. DISCUSSION The best management of ME associated with TelCaps is debated, and there have been no randomized study designed to answer this question. Given the fact that TelCaps may affect 30 to 60% of patients with chronic ME due to DR or RVO, a large number of patients could benefit from a specific management of TelCaps. TalaDME aims to establish the clinical and medico-economic benefits of additional targeted laser. The results of TalaDME may raise new recommendations for managing ME and impact healthcare costs. TRIAL REGISTRATION EudraCT: 2018-A00800-55/ NCT03751501. Registration date: Nov. 23, 2018.
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Affiliation(s)
- Bénédicte Dupas
- Service d'ophtalmologie, Hôpital Lariboisière, AP-HP Nord, Université Paris Cité, Paris, France.
- FRCRnet/FCRIN Network, Paris, France.
| | - Daniela Castro-Farias
- Hopital Des Quinze-Vingts, Centre d'Investigation Clinique 1423, INSERM, Paris, France
| | - Jean-François Girmens
- Hopital Des Quinze-Vingts, Centre d'Investigation Clinique 1423, INSERM, Paris, France
| | - Ali Eginay
- Service d'ophtalmologie, Hôpital Lariboisière, AP-HP Nord, Université Paris Cité, Paris, France
| | - Aude Couturier
- Service d'ophtalmologie, Hôpital Lariboisière, AP-HP Nord, Université Paris Cité, Paris, France
| | - Frederic Villeroy
- Service d'ophtalmologie, CHU de La Réunion, Hôpital Félix Guyon, Saint-Denis, France
| | - Marie-Noëlle Delyfer
- Service d'ophtalmologie, CHU de Bordeaux - Hôpital Pellegrin, Bordeaux, France
- FRCRnet/FCRIN Network, Bordeaux, France
| | - Catherine Creuzot-Garcher
- Service d'Ophtalmologie, CHU de Dijon - Hopital François Miterrand, Dijon, France
- FRCRnet/FCRIN Network, Dijon, France
| | | | - Laurence Béral
- Service d'Ophtalmologie, CHU de Pointe-À-Pitre, Les Abymes, France
| | - Carl Arndt
- Service d'Ophtalmologie, CHU de Reims, Reims, France
| | - Charles Mesnard
- Service d'Ophtalmologie, CHU de Martinique, Fort-de-France, France
| | - Eric Vicaut
- URC Lariboisière-St Louis, Hôpital Fernand Widal, AP-HP Nord, Université Paris Cité, Paris, France
| | | | | | - Michel Paques
- FRCRnet/FCRIN Network, Paris, France
- Hopital Des Quinze-Vingts, Centre d'Investigation Clinique 1423, INSERM, Paris, France
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Authié CN, Poujade M, Talebi A, Defer A, Zenouda A, Coen C, Mohand-Said S, Chaumet-Riffaud P, Audo I, Sahel JA. Development and Validation of a Novel Mobility Test for Rod-Cone Dystrophies: From Reality to Virtual Reality. Am J Ophthalmol 2024; 258:43-54. [PMID: 37437832 DOI: 10.1016/j.ajo.2023.06.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 06/29/2023] [Accepted: 06/30/2023] [Indexed: 07/14/2023]
Abstract
PURPOSE To validate a novel mobility test (MOST, MObility Standardized Test) and performance outcomes in real (RL) and virtual (VR) environments to be used for interventional clinical studies in order to characterize vision impairment in rod-cone dystrophies, also known as retinitis pigmentosa (RP). DESIGN Prospective, interventional, noninvasive, reliability and validity analysis. METHODS We designed MOST to be used in both VR and RL and conducted 3 experimental studies with 89 participants to (1) validate the difficulty of the mobility courses (15 controls), (2) determine the optimal number of light levels and training trials (14 participants with RP), and (3) validate the reproducibility (test-retest), reliability (VR/RL), sensitivity, and construct/content validity of the test (30 participants with RP and 30 controls). A comprehensive ophthalmologic examination was performed in all subjects. Outcomes of interest included MOST performance score, visual acuity, contrast sensitivity, dark adaptation thresholds, visual field parameters, and correlation between the performance score and visual function. RESULTS The mobility courses exhibited statistically similar difficulty, and 5 trials are sufficient to control for the learning effect. MOST is highly reproducible (test-retest correlations >0.98) and reliable (correlations VR/RL = 0.98). MOST achieved a discrimination between participants with RP and controls (accuracy >95%) and between early and late stages of the disease (82.3% accuracy). The performance score is correlated with visual function parameter (0.57-0.94). CONCLUSION MOST is a validated mobility test, with the controlled learning effect, excellent reproducibility, and high agreement between RL and VR conditions, as well as sensitivity and specificity to measure disease progression and therapeutic benefit in rod-cone dystrophies.
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Affiliation(s)
- Colas Nils Authié
- From the Streetlab (C.N.A., M.P., A.T., A.D., A.Z., C.C.), Paris, France.
| | - Mylène Poujade
- From the Streetlab (C.N.A., M.P., A.T., A.D., A.Z., C.C.), Paris, France
| | - Alireza Talebi
- From the Streetlab (C.N.A., M.P., A.T., A.D., A.Z., C.C.), Paris, France; Institut de la Vision, Sorbonne Universités, INSERM, CNRS (A.T., I.A., J.-A.S.), Paris, France
| | - Alexis Defer
- From the Streetlab (C.N.A., M.P., A.T., A.D., A.Z., C.C.), Paris, France
| | - Ariel Zenouda
- From the Streetlab (C.N.A., M.P., A.T., A.D., A.Z., C.C.), Paris, France
| | - Cécilia Coen
- From the Streetlab (C.N.A., M.P., A.T., A.D., A.Z., C.C.), Paris, France
| | - Saddek Mohand-Said
- Hôpital National de la Vision des Quinze-Vingts, DHU Sight Restore, Centre de Référence Maladies Rares REFERET, INSERM-DHOS CIC 1423 (S.M.-S., P.C.-R., I.A., J.-A.S.), Paris, France
| | - Philippe Chaumet-Riffaud
- Hôpital National de la Vision des Quinze-Vingts, DHU Sight Restore, Centre de Référence Maladies Rares REFERET, INSERM-DHOS CIC 1423 (S.M.-S., P.C.-R., I.A., J.-A.S.), Paris, France
| | - Isabelle Audo
- Institut de la Vision, Sorbonne Universités, INSERM, CNRS (A.T., I.A., J.-A.S.), Paris, France; Hôpital National de la Vision des Quinze-Vingts, DHU Sight Restore, Centre de Référence Maladies Rares REFERET, INSERM-DHOS CIC 1423 (S.M.-S., P.C.-R., I.A., J.-A.S.), Paris, France
| | - José-Alain Sahel
- Institut de la Vision, Sorbonne Universités, INSERM, CNRS (A.T., I.A., J.-A.S.), Paris, France; Hôpital National de la Vision des Quinze-Vingts, DHU Sight Restore, Centre de Référence Maladies Rares REFERET, INSERM-DHOS CIC 1423 (S.M.-S., P.C.-R., I.A., J.-A.S.), Paris, France; Department of Ophthalmology, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA (J.-A.S.)
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Vest A, Keilani C, Chaumet-Riffaud P, Barale PO, Tuil E, Ayello-Scheer S, Koch E, Abada S, Giocanti-Auregan A, Durand-Zaleski I, Delbarre M, Froussart-Maille F, Beaugrand A, Tadayoni R, Sahel JA, Paques M. Incidence and characteristics of rhegmatogenous retinal detachment during coronavirus-19 pandemic: A French study. Eur J Ophthalmol 2022; 32:3644-3649. [PMID: 35172628 PMCID: PMC8859482 DOI: 10.1177/11206721221080810] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [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] [Indexed: 11/20/2022]
Abstract
Purpose To assess the impact of the Covid-19 pandemic and subsequent lockdown on the number and clinical characteristics of patients with retinal detachment (RD) in a French public university eye hospital. Methods Single-center, retrospective non-interventional study. Patients consulting at the emergency room (ER) of Quinze-Vingts Hospital (France) for rhegmatogenous RD before and after instauration of the lockdown were reviewed. We compared the characteristics of patients with RD between the containment period (March17th - April27th,2020) and the period preceding the lockdown (February18th - March16th,2020). We compared the number of RD surgeries performed between the first month of lockdown (March17th - April19th,2020) and the corresponding period of 2019. Number of cases, delay between diagnosis and surgery, visual acuity was measured. Results During the first month of lockdown, 59 RDs were operated on, compared to 107 in the corresponding period in 2019 (-44,8%). Mean time from first symptoms to surgery was significantly higher during the lockdown 12.7 (11.3) days vs 7.6 (7.8) days (p = 0.031) before. During the lockdown, the mean BCVA was lower albeit the difference did not reach statistical significance (1.16 (0.9) during pre-containment vs 1.5 (0.9) during containment; p = 0.09). Reasonsfor delayed consultation were: fear of Covid-19 (31%; p = 0.0001), absence of referral doctor (31%; p = 0.003) and difficulties in getting to public transport (10.3%;p = 0.859). Conclusion Despite maintaining accessto emergency eye care facilitiesin our hospital, the lockdown affected visual health. Should the lockdown be reinstated, we postulate that a better information about eye care access for non-Covid emergencies may attenuate its effect on visual health.
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Affiliation(s)
- Agathe Vest
- Department of Ophthalmology IV, 55862Quinze-Vingts National HospitalParis, France.,Faculty of Medicine Hyacinthe Bastaraud, University of the French West Indies and French Guiana, Pointe-à-Pitre, France
| | - Chafik Keilani
- Department of Ophthalmology IV, 55862Quinze-Vingts National HospitalParis, France.,Department of ophthalmology, Percy Military Hospital, Clamart, France.,Pôle ophtalmologique Clemenceau, Rennes, France.,Cabinet d'ophtalmologie La Visitation, Rennes, France
| | - Philippe Chaumet-Riffaud
- Service de Biophysique et Médecine Nucléaire, Hôpital de Bicêtre, AP-HP, Le Kremlin-Bicêtre, France
| | | | - Eric Tuil
- Department of Ophthalmology IV, 55862Quinze-Vingts National HospitalParis, France
| | - Sarah Ayello-Scheer
- Department of Ophthalmology IV, 55862Quinze-Vingts National HospitalParis, France
| | - Edouard Koch
- Department of ophthalmology, Versailles Hospital (André Mignot), Le Chesnay, France
| | - Samir Abada
- Department of ophthalmology, 37107François-Quesnay Hospital, Mantes-la-Jolie, France
| | | | | | - Maxime Delbarre
- Department of ophthalmology, Percy Military Hospital, Clamart, France
| | | | - Amélie Beaugrand
- Department of Biomedical Informatics, 55862Quinze-Vingts National Hospital, Paris, France
| | - Ramin Tadayoni
- Department of ophthalmology, Paris University, Lariboisière Hospital, F-75010, Paris, France.,Department of ophthalmology, Rothschild Foundation, Paris, France
| | - José-Alain Sahel
- Department of Ophthalmology IV, 55862Quinze-Vingts National HospitalParis, France.,INSERM, CNRS, Institut de la Vision, Sorbonne Université, Paris, France
| | - Michel Paques
- Department of Ophthalmology IV, 55862Quinze-Vingts National HospitalParis, France.,INSERM, CNRS, Institut de la Vision, Sorbonne Université, Paris, France
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Lecoq AL, Chaumet-Riffaud P, Blanchard A, Dupeux M, Rothenbuhler A, Lambert B, Durand E, Boros E, Briot K, Silve C, Francou B, Piketty M, Chanson P, Brailly-Tabard S, Linglart A, Kamenický P. Hyperparathyroidism in Patients With X-Linked Hypophosphatemia. J Bone Miner Res 2020; 35:1263-1273. [PMID: 32101626 DOI: 10.1002/jbmr.3992] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Revised: 02/17/2020] [Accepted: 02/22/2020] [Indexed: 12/22/2022]
Abstract
X-linked hypophosphatemia (XLH) is characterized by increased activity of circulating FGF23 resulting in renal phosphate wasting and abnormal bone mineralization. Hyperparathyroidism may develop in XLH patients; however, its prevalence, pathogenesis, and clinical presentation are not documented. This observational study (CNIL 171036 v 0) recruited XLH adult patients in a single tertiary referral center. Each patient was explored in standardized conditions and compared with two healthy volunteers, matched for sex, age, and 25-OH vitamin D concentrations. The primary endpoint was the proportion of patients with hyperparathyroidism. The secondary endpoints were the factors influencing serum parathyroid hormone (PTH) concentrations and the prevalence of hypercalcemic hyperparathyroidism. Sixty-eight patients (51 women, 17 men) were enrolled and matched with 136 healthy volunteers. Patients had higher PTH concentrations compared with healthy controls (53.5 ng/L, interquartile range [IQR] 36.7-72.7 versus 36.0 ng/L, IQR 27.7-44.0, p < .0001). Hyperparathyroidism was observed in 17 patients of 68 (25%). In patients, a positive relationship between PTH and calcium concentrations and a negative relationship between PTH and phosphate concentrations were observed. Seven (10%) patients (3 premenopausal women, 1 postmenopausal woman, and 3 men) were diagnosed with hypercalcemic hyperparathyroidism. All underwent parathyroid surgery, with consecutive normalization of calcium and PTH concentrations. Hyperparathyroidism is a frequent complication in XLH adult patients. Disruption of the physiological regulation of PTH secretion contributes to parathyroid disease. Early-onset hypercalcemic hyperparathyroidism can be effectively and safely cured by surgical resection. © 2020 American Society for Bone and Mineral Research.
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Affiliation(s)
- Anne-Lise Lecoq
- Hôpital de Bicêtre, Service d'Endocrinologie et des Maladies de la Reproduction, Centre de Référence des Maladies Rares du Métabolisme du Calcium et du Phosphate, Filière OSCAR, Assistance Publique-Hôpitaux de Paris (AP-HP), Le Kremlin-Bicêtre, France
| | - Philippe Chaumet-Riffaud
- Hôpital de Bicêtre, Service de Biophysique et Médecine Nucléaire, AP-HP, Le Kremlin-Bicêtre, France
| | - Anne Blanchard
- Hôpital Européen Georges Pompidou, Centre d'Investigations Cliniques 1418, AP-HP, Le Kremlin-Bicêtre, France
| | - Margot Dupeux
- Hôpital de Bicêtre, Service d'Anatomie et Cytologie Pathologiques, AP-HP, Le Kremlin-Bicêtre, France
| | - Anya Rothenbuhler
- Hôpital de Bicêtre, Endocrinologie et Diabétologie de l'Enfant, Centre de Référence des Maladies Rares du Métabolisme du Calcium et du Phosphate, Filière OSCAR, AP-HP, Le Kremlin-Bicêtre, France
| | - Benoit Lambert
- Hôpital de Bicêtre, Service de Chirurgie Viscérale et Digestive, AP-HP, Le Kremlin-Bicêtre, France
| | - Emmanuel Durand
- Hôpital de Bicêtre, Service de Biophysique et Médecine Nucléaire, AP-HP, Le Kremlin-Bicêtre, France
| | - Erika Boros
- Hôpital de Bicêtre, Endocrinologie et Diabétologie de l'Enfant, Centre de Référence des Maladies Rares du Métabolisme du Calcium et du Phosphate, Filière OSCAR, AP-HP, Le Kremlin-Bicêtre, France
| | - Karine Briot
- Hôpital Cochin, Service de Rhumatologie, Centre de Référence des Maladies Rares du Métabolisme du Calcium et du Phosphate Filière OSCAR, AP-HP, Paris, France
| | - Caroline Silve
- Hôpital Cochin, Service de Génétique et Biologie Moléculaires, Centre de Référence des Maladies Rares du Métabolisme du Calcium et du Phosphate, Filière OSCAR, AP-HP, Paris, France
| | - Bruno Francou
- Hôpital de Bicêtre, Laboratoire de Génétique Moléculaire, Pharmacogénétique et Hormonologie, AP-HP, Le Kremlin-Bicêtre, France
| | - Marie Piketty
- Hôpital Necker, Service d'Explorations fonctionnelles Physiologie et Neurophysiologie, AP-HP, Paris, France
| | - Philippe Chanson
- Hôpital de Bicêtre, Service d'Endocrinologie et des Maladies de la Reproduction, Centre de Référence des Maladies Rares du Métabolisme du Calcium et du Phosphate, Filière OSCAR, Assistance Publique-Hôpitaux de Paris (AP-HP), Le Kremlin-Bicêtre, France.,Université Paris-Saclay, Inserm, Physiologie et Physiopathologie Endocriniennes, Le Kremlin-Bicêtre, France
| | - Sylvie Brailly-Tabard
- Hôpital de Bicêtre, Laboratoire de Génétique Moléculaire, Pharmacogénétique et Hormonologie, AP-HP, Le Kremlin-Bicêtre, France
| | - Agnès Linglart
- Hôpital de Bicêtre, Endocrinologie et Diabétologie de l'Enfant, Centre de Référence des Maladies Rares du Métabolisme du Calcium et du Phosphate, Filière OSCAR, AP-HP, Le Kremlin-Bicêtre, France.,Université Paris-Saclay, Inserm, Physiologie et Physiopathologie Endocriniennes, Le Kremlin-Bicêtre, France
| | - Peter Kamenický
- Hôpital de Bicêtre, Service d'Endocrinologie et des Maladies de la Reproduction, Centre de Référence des Maladies Rares du Métabolisme du Calcium et du Phosphate, Filière OSCAR, Assistance Publique-Hôpitaux de Paris (AP-HP), Le Kremlin-Bicêtre, France.,Université Paris-Saclay, Inserm, Physiologie et Physiopathologie Endocriniennes, Le Kremlin-Bicêtre, France
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Vera P, Mihailescu SD, Lequesne J, Modzelewski R, Bohn P, Hapdey S, Pépin LF, Dubray B, Chaumet-Riffaud P, Decazes P, Thureau S. Radiotherapy boost in patients with hypoxic lesions identified by 18F-FMISO PET/CT in non-small-cell lung carcinoma: can we expect a better survival outcome without toxicity? [RTEP5 long-term follow-up]. Eur J Nucl Med Mol Imaging 2019; 46:1448-1456. [PMID: 30868230 DOI: 10.1007/s00259-019-04285-9] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Accepted: 02/06/2019] [Indexed: 12/25/2022]
Abstract
PURPOSE Chemoradiotherapy is the reference curative-intent treatment for nonresectable locally advanced non-small-cell lung carcinoma (NSCLC), with unsatisfactory survival, partially due to radiation resistance in hypoxic tissues. The objective was to update survival and toxicity at 3 years following radiotherapy boost to hypoxic tumours in NSCLC patients treated with curative-intent chemoradiotherapy. METHODS This was an open-label, nonrandomized, multicentre, phase II clinical trial. 18F-Fluoromisonidazole (18F-FMISO) PET/CT was used to determine the hypoxic profile of the patients. 18F-FMISO-positive patients and those without organ-at-risk constraints received a radiotherapy boost (70-84 Gy); the others received standard radiotherapy (66 Gy). Overall survival (OS), progression-free survival (PFS) and safety were assessed. RESULTS A total of 54 patients were evaluated. OS and PFS rates at 3 years were 48.5% and 28.8%, respectively. The median OS in the 18F-FMISO-positive patients was 25.8 months and was not reached in the 18F-FMISO-negative patients (p = 0.01). A difference between the groups was also observed for PFS (12 months vs. 26.2 months, p = 0.048). In 18F-FMISO-positive patients, no difference was observed in OS in relation to dose, probably because of the small sample size (p = 0.30). However, the median OS seemed to be in favour of patients who received the radiotherapy boost (26.5 vs. 15.3 months, p = 0.71). In patients who received the radiotherapy boost, no significant late toxicities were observed. CONCLUSION 18F-FMISO uptake in NSCLC patients is strongly associated with features indicating a poor prognosis. In 18F-FMISO-positive patients, the radiotherapy boost seemed to improve the OS by 11.2 months. A further clinical trial is needed to investigate the efficacy of a radiotherapy boost in patients with hypoxic tumours.
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Affiliation(s)
- Pierre Vera
- Department of Nuclear Medicine, Henri Becquerel Cancer Center and Rouen University Hospital, & QuantIF - LITIS [EA (Equipe d'Accueil) 4108 - FR CNRS 3638], Faculty of Medicine, University of Rouen, Rouen, France.
| | - Sorina-Dana Mihailescu
- Department of Statistics and Clinical Research Unit, Henri Becquerel Cancer Center, Rouen, France
| | - Justine Lequesne
- Department of Statistics and Clinical Research Unit, Henri Becquerel Cancer Center, Rouen, France
| | - Romain Modzelewski
- Department of Nuclear Medicine, Henri Becquerel Cancer Center and Rouen University Hospital, & QuantIF - LITIS [EA (Equipe d'Accueil) 4108 - FR CNRS 3638], Faculty of Medicine, University of Rouen, Rouen, France
| | - Pierre Bohn
- Department of Nuclear Medicine, Henri Becquerel Cancer Center and Rouen University Hospital, & QuantIF - LITIS [EA (Equipe d'Accueil) 4108 - FR CNRS 3638], Faculty of Medicine, University of Rouen, Rouen, France
| | - Sébastien Hapdey
- Department of Nuclear Medicine, Henri Becquerel Cancer Center and Rouen University Hospital, & QuantIF - LITIS [EA (Equipe d'Accueil) 4108 - FR CNRS 3638], Faculty of Medicine, University of Rouen, Rouen, France
| | - Louis-Ferdinand Pépin
- Department of Statistics and Clinical Research Unit, Henri Becquerel Cancer Center, Rouen, France
| | - Bernard Dubray
- Department of Radiation Oncology, Henri Becquerel Cancer Center and Rouen University Hospital, & QuantIF - LITIS [EA (Equipe d'Accueil) 4108], Rouen, France
| | | | - Pierre Decazes
- Department of Nuclear Medicine, Henri Becquerel Cancer Center and Rouen University Hospital, & QuantIF - LITIS [EA (Equipe d'Accueil) 4108 - FR CNRS 3638], Faculty of Medicine, University of Rouen, Rouen, France
| | - Sébastien Thureau
- Department of Nuclear Medicine, Henri Becquerel Cancer Center and Rouen University Hospital, & QuantIF - LITIS [EA (Equipe d'Accueil) 4108 - FR CNRS 3638], Faculty of Medicine, University of Rouen, Rouen, France
- Department of Radiation Oncology, Henri Becquerel Cancer Center and Rouen University Hospital, & QuantIF - LITIS [EA (Equipe d'Accueil) 4108], Rouen, France
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Besson FL, Henry T, Meyer C, Chevance V, Roblot V, Blanchet E, Arnould V, Grimon G, Chekroun M, Mabille L, Parent F, Seferian A, Bulifon S, Montani D, Humbert M, Chaumet-Riffaud P, Lebon V, Durand E. Rapid Contour-based Segmentation for 18F-FDG PET Imaging of Lung Tumors by Using ITK-SNAP: Comparison to Expert-based Segmentation. Radiology 2018; 288:277-284. [DOI: 10.1148/radiol.2018171756] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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7
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Gomez L, Chaumet-Riffaud P, Noel N, Lambotte O, Goujard C, Durand E, Besson FL. Effect of CRP value on 18F-FDG PET vascular positivity in Takayasu arteritis: a systematic review and per-patient based meta-analysis. Eur J Nucl Med Mol Imaging 2017; 45:575-581. [PMID: 28856429 DOI: 10.1007/s00259-017-3798-x] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2017] [Accepted: 08/03/2017] [Indexed: 12/14/2022]
Abstract
PURPOSE The aim of this study was to quantify the association between the CRP value and 18F-FDG PET vascular positivity in Takayasu arteritis (TAK) through a structured dedicated systematic review and meta-analysis. METHODS From January 2000 to December 2016, the PubMed/MEDLINE database was searched for articles specifically dealing with the assessment of vascular inflammation using 18F-FDG PET and CRP biomarkers in TAK. Inclusion criteria for the qualitative analysis were (1) 18F-FDG PET used to assess the disease activity, (2) The use of the ACR criteria for the diagnosis of TAK, (3) No case mixed vasculitis (i.e., no giant cell arteritis), and (4) CRP concentration and clinical disease activity available. For the meta-analysis, PET-positive and PET-negative subgroups with the corresponding CRP concentrations were generated based on per patient data. The standard mean difference, which represents the effect of the CRP concentrations on the 18F-FDG PET vascular uptake, was computed for all studies, and then the results were pooled together. RESULTS Among the 33 initial citations, nine complete articles including 210 patients fulfilled the inclusion criteria. Five studies found a significant correlation between the 18F-FDG PET and CRP concentration, one provided a trend towards association and three did not find any association between the two biomarkers. Six studies found a significant association between 18F-FDG PET and clinical disease activity, one found a trend towards association and the last two studies did not evaluate this correlation. The meta-analysis (121 patients) provided the following results: Standard Mean Deviation = 0.54 [0.15;0.92]; Chi2 = 3.35; I2 = 0%; Test for overall effect: Z = 2.70 (P = 0.007). CONCLUSION The CRP concentration only moderately reflects the 18F-FDG PET vascular positivity in TAK, suggesting dissociated information. Standardized longitudinal prospective studies are necessary to assess the value of 18F-FDG PET as an independent biomarker for subtle vascular wall inflammation detection.
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Affiliation(s)
- Léa Gomez
- Department of Biophysics and Nuclear Medicine, Bicêtre University Hospital, Assistance Publique-Hôpitaux de Paris, 94275, Le Kremlin-Bicêtre, France
| | - Philippe Chaumet-Riffaud
- Department of Biophysics and Nuclear Medicine, Bicêtre University Hospital, Assistance Publique-Hôpitaux de Paris, 94275, Le Kremlin-Bicêtre, France
| | - Nicolas Noel
- Department of Internal Medicine, Bicêtre University Hospital, Assistance Publique-Hôpitaux de Paris, 94275, Le Kremlin-Bicêtre, France
- Université Paris Sud, Le Kremlin Bicêtre, France
- INSERM UMR 1184, Immunologie des Maladies Virales et Autoimmunes (IMVA), Université Paris Sud, Le Kremlin Bicêtre, France
- CEA, DSV/iMETI, Division of Immuno-Virology IDMIT, Paris, France
| | - Olivier Lambotte
- Department of Internal Medicine, Bicêtre University Hospital, Assistance Publique-Hôpitaux de Paris, 94275, Le Kremlin-Bicêtre, France
- Université Paris Sud, Le Kremlin Bicêtre, France
- INSERM UMR 1184, Immunologie des Maladies Virales et Autoimmunes (IMVA), Université Paris Sud, Le Kremlin Bicêtre, France
- CEA, DSV/iMETI, Division of Immuno-Virology IDMIT, Paris, France
| | - Cécile Goujard
- Department of Internal Medicine, Bicêtre University Hospital, Assistance Publique-Hôpitaux de Paris, 94275, Le Kremlin-Bicêtre, France
- Université Paris Sud, Le Kremlin Bicêtre, France
- CEA, DSV/iMETI, Division of Immuno-Virology IDMIT, Paris, France
- INSERM U1018, CESP, Le Kremlin Bicêtre, France
| | - Emmanuel Durand
- Department of Biophysics and Nuclear Medicine, Bicêtre University Hospital, Assistance Publique-Hôpitaux de Paris, 94275, Le Kremlin-Bicêtre, France
- Université Paris Sud, Le Kremlin Bicêtre, France
- IR4M - UMR8081, Université Paris Sud, Université Paris Saclay, CNRS, 91404, Orsay, France
| | - Florent L Besson
- Department of Biophysics and Nuclear Medicine, Bicêtre University Hospital, Assistance Publique-Hôpitaux de Paris, 94275, Le Kremlin-Bicêtre, France.
- Université Paris Sud, Le Kremlin Bicêtre, France.
- IR4M - UMR8081, Université Paris Sud, Université Paris Saclay, CNRS, 91404, Orsay, France.
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Thuillier P, Bourhis D, Robin P, Keromnes N, Schick U, Le Roux PY, Kerlan V, Chaumet-Riffaud P, Salaün PY, Abgral R. Clinical Validation of a Pixon-Based Reconstruction Method Allowing a Twofold Reduction in Planar Images Time of 111In-Pentetreotide Somatostatin Receptor Scintigraphy. Front Med (Lausanne) 2017; 4:143. [PMID: 28913338 PMCID: PMC5583596 DOI: 10.3389/fmed.2017.00143] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2017] [Accepted: 08/11/2017] [Indexed: 12/24/2022] Open
Abstract
Objective Methods Results Conclusion
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Affiliation(s)
- Philippe Thuillier
- Department of Endocrinology, University Hospital of Brest, Brest, France
| | - David Bourhis
- Department of Nuclear Medicine, University Hospital of Brest, Brest, France
- EA GETBO 3878, IFR 148, University Hospital of Brest, Brest, France
| | - Philippe Robin
- Department of Nuclear Medicine, University Hospital of Brest, Brest, France
- EA GETBO 3878, IFR 148, University Hospital of Brest, Brest, France
| | - Nathalie Keromnes
- Department of Nuclear Medicine, University Hospital of Brest, Brest, France
- EA GETBO 3878, IFR 148, University Hospital of Brest, Brest, France
| | - Ulrike Schick
- Department of Oncology-Radiotherapy, University Hospital of Brest, Brest, France
| | - Pierre-Yves Le Roux
- Department of Nuclear Medicine, University Hospital of Brest, Brest, France
- EA GETBO 3878, IFR 148, University Hospital of Brest, Brest, France
| | - Véronique Kerlan
- Department of Endocrinology, University Hospital of Brest, Brest, France
- EA GETBO 3878, IFR 148, University Hospital of Brest, Brest, France
| | - Philippe Chaumet-Riffaud
- Department of Nuclear Medicine, University Hospital of Paris-Sud Bicêtre, Le Kremlin-Bicêtre, France
| | - Pierre-Yves Salaün
- Department of Nuclear Medicine, University Hospital of Brest, Brest, France
- EA GETBO 3878, IFR 148, University Hospital of Brest, Brest, France
| | - Ronan Abgral
- Department of Nuclear Medicine, University Hospital of Brest, Brest, France
- EA GETBO 3878, IFR 148, University Hospital of Brest, Brest, France
- *Correspondence: Ronan Abgral,
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Vera P, Thureau S, Chaumet-Riffaud P, Modzelewski R, Bohn P, Vermandel M, Hapdey S, Pallardy A, Mahé MA, Lacombe M, Boisselier P, Guillemard S, Olivier P, Beckendorf V, Salem N, Charrier N, Chajon E, Devillers A, Aide N, Danhier S, Denis F, Muratet JP, Martin E, Riedinger AB, Kolesnikov-Gauthier H, Dansin E, Massabeau C, Courbon F, Farcy Jacquet MP, Kotzki PO, Houzard C, Mornex F, Vervueren L, Paumier A, Fernandez P, Salaun M, Dubray B. Phase II Study of a Radiotherapy Total Dose Increase in Hypoxic Lesions Identified by 18F-Misonidazole PET/CT in Patients with Non-Small Cell Lung Carcinoma (RTEP5 Study). J Nucl Med 2017; 58:1045-1053. [PMID: 28254869 DOI: 10.2967/jnumed.116.188367] [Citation(s) in RCA: 53] [Impact Index Per Article: 7.6] [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: 12/08/2016] [Accepted: 02/07/2017] [Indexed: 01/09/2023] Open
Abstract
See an invited perspective on this article on page 1043.This multicenter phase II study investigated a selective radiotherapy dose increase to tumor areas with significant 18F-misonidazole (18F-FMISO) uptake in patients with non-small cell lung carcinoma (NSCLC). Methods: Eligible patients had locally advanced NSCLC and no contraindication to concomitant chemoradiotherapy. The 18F-FMISO uptake on PET/CT was assessed by trained experts. If there was no uptake, 66 Gy were delivered. In 18F-FMISO-positive patients, the contours of the hypoxic area were transferred to the radiation oncologist. It was necessary for the radiotherapy dose to be as high as possible while fulfilling dose-limiting constraints for the spinal cord and lungs. The primary endpoint was tumor response (complete response plus partial response) at 3 mo. The secondary endpoints were toxicity, disease-free survival (DFS), and overall survival at 1 y. The target sample size was set to demonstrate a response rate of 40% or more (bilateral α = 0.05, power 1-β = 0.95). Results: Seventy-nine patients were preincluded, 54 were included, and 34 were 18F-FMISO-positive, 24 of whom received escalated doses of up to 86 Gy. The response rate at 3 mo was 31 of 54 (57%; 95% confidence interval [CI], 43%-71%) using RECIST 1.1 (17/34 responders in the 18F-FMISO-positive group). DFS and overall survival at 1 y were 0.86 (95% CI, 0.77-0.96) and 0.63 (95% CI, 0.49-0.74), respectively. DFS was longer in the 18F-FMISO-negative patients (P = 0.004). The radiotherapy dose was not associated with DFS when adjusting for the 18F-FMISO status. One toxic death (66 Gy) and 1 case of grade 4 pneumonitis (>66 Gy) were reported. Conclusion: Our approach results in a response rate of 40% or more, with acceptable toxicity. 18F-FMISO uptake in NSCLC patients is strongly associated with poor prognosis features that could not be reversed by radiotherapy doses up to 86 Gy.
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Affiliation(s)
- Pierre Vera
- Department of Nuclear Medicine, Henri Becquerel Cancer Center and Rouen University Hospital & QuantIF-LITIS, University of Rouen, Rouen, France
| | - Sébastien Thureau
- Department of Radiation Oncology and Medical Physics, Henri Becquerel Cancer Center and Rouen University Hospital & QuantIF-LITIS, Rouen, France
| | - Philippe Chaumet-Riffaud
- Department of Nuclear Medicine, Hôpitaux universitaires Paris Sud Bicêtre AP-HP and University Paris Sud, Paris, France
| | - Romain Modzelewski
- Department of Nuclear Medicine, Henri Becquerel Cancer Center and Rouen University Hospital & QuantIF-LITIS, University of Rouen, Rouen, France
| | - Pierre Bohn
- Department of Nuclear Medicine, Henri Becquerel Cancer Center and Rouen University Hospital & QuantIF-LITIS, University of Rouen, Rouen, France
| | - Maximilien Vermandel
- University Lille, Inserm, CHU Lille, U1189-ONCO-THAI-Image Assisted Laser Therapy for Oncology, Lille, France
| | - Sébastien Hapdey
- Department of Nuclear Medicine, Henri Becquerel Cancer Center and Rouen University Hospital & QuantIF-LITIS, University of Rouen, Rouen, France
| | - Amandine Pallardy
- Department of Nuclear Medicine, Nantes University Hospital, Nantes, France
| | - Marc-André Mahé
- Department of Radiation Oncology, Institut de Cancérologie de l'Ouest (ICO)-René Gauducheau, Nantes, France
| | - Marie Lacombe
- Department of Nuclear Medicine, Institut de Cancérologie de l'Ouest (ICO), Nantes, France
| | - Pierre Boisselier
- Department of Radiation Oncology, Institut régional du Cancer Montpellier (ICM), Montpellier, France
| | - Sophie Guillemard
- Department of Nuclear Medicine, Institut régional du Cancer Montpellier (ICM), Montpellier, France
| | - Pierre Olivier
- Department of Nuclear Medicine, Brabois University Hospital, Nancy, France
| | - Veronique Beckendorf
- Department of Radiation Oncology, Institut de Cancérologie de Lorraine, Nancy, France
| | - Naji Salem
- Department of Radiation Oncology, Institut Paoli Calmette, Marseille, France
| | - Nathalie Charrier
- Department of Nuclear Medicine, Institut Paoli Calmette, Marseille, France
| | - Enrique Chajon
- Department of Radiation Oncology, Centre regional de lutte contre le cancer de Bretagne Eugène Marquis, Rennes, France
| | - Anne Devillers
- Department of Nuclear Medicine, Centre regional de lutte contre le cancer de Bretagne Eugène Marquis, Rennes, France
| | - Nicolas Aide
- Nicolas Aide, Nuclear Medicine and TEP Centre, Caen University Hospital and Inserm U1086 ANTICIPE, Caen, France
| | - Serge Danhier
- Department of Radiation Oncology, François Baclesse Cancer Center, Caen, France
| | - Fabrice Denis
- Department of Radiation Oncology, Institut Inter-Régional de Cancérologie (ILC), Centre Jean Bernard/Clinique Victor Hugo, Le Mans, France
| | - Jean-Pierre Muratet
- Department of Nuclear Medicine, Institut Inter-Régional de Cancérologie (ILC), Centre Jean Bernard/Clinique Victor Hugo, Le Mans, France
| | - Etienne Martin
- Radiation Oncology, Centre Georges-Francois Leclerc, Dijon, France
| | | | | | - Eric Dansin
- Department of Radiation Oncology, Oscar Lambret Center, Lille cedex, France
| | - Carole Massabeau
- Département de Radiothérapie. Institut Universitaire du Cancer, Toulouse cedex 9, France
| | - Fredéric Courbon
- Department of Nuclear Medicine, Institut Claudius Regaud, IUCT, Toulouse cedex 9, France
| | - Marie-Pierre Farcy Jacquet
- Department of Radiation Oncology, CHU de Nîmes, Institut de cancérologie du Gard, Rue Henri Pujol, Nîmes, France
| | - Pierre-Olivier Kotzki
- Department of Nuclear Medicine, Institut régional du Cancer Montpellier (ICM), Montpellier, France.,Department of Nuclear Medicine, CHU de Nîmes, Institut de cancérologie du Gard, Nîmes, France
| | - Claire Houzard
- Department of Nuclear Medicine, Hospices Civils de Lyon, Lyon, France
| | - Francoise Mornex
- Department of Radiation Oncology, Hospices Civils de Lyon, Lyon, France
| | | | - Amaury Paumier
- Department of Radiation Oncology, Institut de Cancérologie de l'Ouest, site Paul Papin, France
| | - Philippe Fernandez
- Department of Nuclear Medicine, Hôpital Pellegrin, CHU de Bordeaux, France; and
| | - Mathieu Salaun
- Normandy University, UNIROUEN, QuantIF-LITIS EA 4108, Rouen University Hospital, Department of Pulmonology-Thoracic Oncology-Respiratory Intensive Care, Rouen, France
| | - Bernard Dubray
- Department of Radiation Oncology and Medical Physics, Henri Becquerel Cancer Center and Rouen University Hospital & QuantIF-LITIS, Rouen, France
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Thureau S, Chaumet-Riffaud P, Modzelwski R, Hapdey S, Mahé M, Boisselier P, Beckendorf V, Salem N, Lerouge D, Dubray B, Vera P. Étude de phase II sur l’efficacité et la tolérance d’une augmentation de dose de radiothérapie des lésions hypoxiques définies par TEP-scanographie au fluoromisonidazole chez les patients suivis par un cancer bronchique non à petites cellules. Cancer Radiother 2016. [DOI: 10.1016/j.canrad.2016.08.115] [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: 10/21/2022]
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11
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Azoulay L, Chaumet-Riffaud P, Jaron S, Roux C, Sancho S, Berdugo N, Audo I, Sahel JA, Mohand-Saïd S. Threshold levels of visual field and acuity loss related to significant decreases in the quality of life and emotional states of patients with retinitis pigmentosa. Ophthalmic Res 2015; 54:78-84. [PMID: 26228470 DOI: 10.1159/000435886] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2015] [Accepted: 06/11/2015] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Retinitis pigmentosa (RP) is an inherited retinal disorder, characterized by photoreceptor degeneration inducing progressive vision loss. This study evaluates its impact on quality of life (QOL) and emotional states of patients affected by RP. METHODS A cross-sectional study was conducted on 60 RP patients diagnosed with rod-cone dystrophy and on 20 control subjects. The RP population has been divided into 3 groups according to visual field (VF) and visual acuity (VA) impairments. Concurrently, scores of self-reported QOL (25-item National Eye Institute Visual Functioning Questionnaire) and of the Hospital Anxiety and Depression Scale for anxiety/depression assessments were collected. RESULTS For the QOL composite score, we noticed consistent differences between all VF and VA affected groups and their control group. We also found significant differences between both the most affected VF group (VF1: ØVF <20°) and VA group (VA1: VA <0.3) compared to other VF and VA groups. For anxiety/depression scores, consistent differences have been found between the control group and VF1 and VA1, respectively. CONCLUSIONS This work determines that, for RP patients, a significant QOL and emotional state deterioration correlates with a residual VF diameter below 20° and a VA lower than 0.3. It introduces, for the first time, thresholds to be used in visual restoration or visual preservation therapies to improve QOL of RP patients.
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Affiliation(s)
- Line Azoulay
- Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, DHU ViewMaintain, INSERM-DHOS CIC 1423, Paris, France
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Claudon M, Durand E, Grenier N, Prigent A, Balvay D, Chaumet-Riffaud P, Chaumoitre K, Cuenod CA, Filipovic M, Galloy MA, Lemaitre L, Mandry D, Micard E, Pasquier C, Sebag GH, Soudant M, Vuissoz PA, Guillemin F. Chronic Urinary Obstruction: Evaluation of Dynamic Contrast-enhanced MR Urography for Measurement of Split Renal Function. Radiology 2014; 273:801-12. [DOI: 10.1148/radiol.14131819] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Abstract
Although renovascular disease remains defined as a stenosis of the main renal artery or its proximal branches (renal artery stenosis [RAS]), its clinical overview has changed dramatically over the last 15-20 years and its management is more controversial than ever before. The clinical problems, not only diagnosis and treatment but also the relative contribution of different pathophysiological mechanisms involved in the progression of kidney disease, have shifted dramatically. This presentation aims to emphasize the paradigm change revisiting the (recent) past focused on renovascular hypertension (RVH) to the current context of preservation or recovery of threatened renal function in patients with progressive atherosclerotic renovascular disease until its last stage of irreversible "ischemic nephropathy." In the past, the foreground was occupied by RVH, a very rare disease, where the activation of the renin-angiotensin-aldosterone system (RAAS) was supposed to play the major, if not only, role in RVH issues. The retrospective RVH diagnosis was established either on the improvement or, more rarely, on the cure of hypertension after revascularization by, most often, a percutaneous transluminal renal angioplasty with or without a stent placement. At this time, captoptril radionuclide renography was an efficient diagnostic tool, because it was a functional (angiotensin-converting enzyme inhibition), noninvasive test aiming to evidence both the RAAS activation and the lateralization (or asymmetry) of renin secretion by the kidney affected by a "hemodynamically significant" RAS. At present, even if captoptril radionuclide renography could be looked upon as the most efficient (and cost effective in selected high-risk patients) noninvasive, functional test to predict the improvement of hypertension after RAS correction, its clinical usefulness is questioned as the randomized, prospective trials failed to demonstrate any significant benefits (either on blood pressure control or on renal function protection) of the revascularization over current antihypertensive therapy. Today many patients with RVH remain undetected for years because they are treated successfully and at low expense with these new blockers of RAAS. In addition to its well-known role in hemodynamics, angiotensin II promotes activations of profibrogenic and inflammatory factors and cells and stimulates reactive oxygen species generation. The "atherosclerotic milieu" itself plays a role in the loss of renal microvessels and defective angiogenesis. After an "adaptative" phase, ischemia eventually develops and induces hypoxia, the substratum of ischemic nephropathy. Because blood oxygen level-dependent MRI may provide an index of oxygen content in vivo, it may be useful to predict renal function outcome after percutaneous transluminal renal angioplasty. New PET tracers, dedicated to assess RAAS receptors, inflammatory cell infiltrates, angiogenesis, and apoptose, would be tested in this context of atherosclerotic renovascular disease.
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Affiliation(s)
- Alain Prigent
- Service de Biophysique et Médecine Nucléaire, AP-HP Hôpitaux Universitaires Paris-Sud Bicêtre, Paris, France.
| | - Philippe Chaumet-Riffaud
- Service de Biophysique et Médecine Nucléaire, AP-HP Hôpitaux Universitaires Paris-Sud Bicêtre, Paris, France; IR4M UMR8081 CNRS, Université Paris-Sud, Orsay, France
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14
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Thureau S, Chaumet-Riffaud P, Modzelewski R, Fernandez P, Tessonnier L, Vervueren L, Cachin F, Berriolo-Riedinger A, Olivier P, Kolesnikov-Gauthier H, Blagosklonov O, Bridji B, Devillers A, Collombier L, Courbon F, Gremillet E, Houzard C, Caignon JM, Roux J, Aide N, Brenot-Rossi I, Doyeux K, Dubray B, Vera P. Interobserver agreement of qualitative analysis and tumor delineation of 18F-fluoromisonidazole and 3'-deoxy-3'-18F-fluorothymidine PET images in lung cancer. J Nucl Med 2013; 54:1543-50. [PMID: 23918733 DOI: 10.2967/jnumed.112.118083] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
UNLABELLED As the preparation phase of a multicenter clinical trial using (18)F-fluoro-2-deoxy-d-glucose ((18)F-FDG), (18)F-fluoromisonidazole ((18)F-FMISO), and 3'-deoxy-3'-(18)F-fluorothymidine ((18)F-FLT) in non-small cell lung cancer (NSCLC) patients, we investigated whether 18 nuclear medicine centers would score tracer uptake intensity similarly and define hypoxic and proliferative volumes for 1 patient and we compared different segmentation methods. METHODS Ten (18)F-FDG, ten (18)F-FMISO, and ten (18)F-FLT PET/CT examinations were performed before and during curative-intent radiotherapy in 5 patients with NSCLC. The gold standards for uptake intensity and volume delineation were defined by experts. The between-center agreement (18 nuclear medicine departments connected with a dedicated network, SFMN-net [French Society of Nuclear Medicine]) in the scoring of uptake intensity (5-level scale, then divided into 2 levels: 0, normal; 1, abnormal) was quantified by κ-coefficients (κ). The volumes defined by different physicians were compared by overlap and κ. The uptake areas were delineated with 22 different methods of segmentation, based on fixed or adaptive thresholds of standardized uptake value (SUV). RESULTS For uptake intensity, the κ values between centers were, respectively, 0.59 for (18)F-FDG, 0.43 for (18)F-FMISO, and 0.44 for (18)F-FLT using the 5-level scale; the values were 0.81 for (18)F-FDG and 0.77 for both (18)F-FMISO and (18)F-FLT using the 2-level scale. The mean overlap and mean κ between observers were 0.13 and 0.19, respectively, for (18)F-FMISO and 0.2 and 0.3, respectively, for (18)F-FLT. The segmentation methods yielded significantly different volumes for (18)F-FMISO and (18)F-FLT (P < 0.001). In comparison with physicians, the best method found was 1.5 × maximum SUV (SUVmax) of the aorta for (18)F-FMISO and 1.3 × SUVmax of the muscle for (18)F-FLT. The methods using the SUV of 1.4 and the method using 1.5 × the SUVmax of the aorta could be used for (18)F-FMISO and (18)F-FLT. Moreover, for (18)F-FLT, 2 other methods (adaptive threshold based on 1.5 or 1.6 × muscle SUVmax) could be used. CONCLUSION The reproducibility of the visual analyses of (18)F-FMISO and (18)F-FLT PET/CT images was demonstrated using a 2-level scale across 18 centers, but the interobserver agreement was low for the (18)F-FMISO and (18)F-FLT volume measurements. Our data support the use of a fixed threshold (1.4) or an adaptive threshold using the aorta background to delineate the volume of increased (18)F-FMISO or (18)F-FLT uptake. With respect to the low tumor-on-background ratio of these tracers, we suggest the use of a fixed threshold (1.4).
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Affiliation(s)
- Sébastien Thureau
- Nuclear Medicine and Radiotherapy, Henri Becquerel Cancer Center and Rouen University Hospital, and QuantIF-LITIS (EA [Equipe d'Accueil] 4108), Faculty of Medicine, University of Rouen, Rouen, France
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Archambaud F, Bouilleret V, Hertz-Pannier L, Chaumet-Riffaud P, Rodrigo S, Dulac O, Chassoux F, Chiron C. Optimizing statistical parametric mapping analysis of 18F-FDG PET in children. EJNMMI Res 2013; 3:2. [PMID: 23289862 PMCID: PMC3558387 DOI: 10.1186/2191-219x-3-2] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2012] [Accepted: 12/27/2012] [Indexed: 01/18/2023] Open
Abstract
UNLABELLED BACKGROUND Statistical parametric mapping (SPM) procedure is an objective tool to analyze 18F-fluoro-2-deoxy-d-glucose-positron-emission tomography (FDG-PET) images and a useful complement to visual analysis. However, SPM requires a comparison to control data set that cannot be obtained in healthy children for ethical reasons. Using adults as controls showed some limitations. The purpose of the present study was to generate and validate a group of pseudo-normal children as a control group for FDG-PET studies in pediatrics. METHODS FDG-PET images of 47 children (mean ± SD age 10.2 ± 3.1 years) with refractory symptomatic (MRI-positive, n = 20) and cryptogenic (MRI-negative, n = 27) focal epilepsy planned for surgery were analyzed using visual and SPM analysis. Performances of SPM analysis were compared using two different control groups: (1) an adult control group consisting of healthy young adults (n = 25, 30.5 ± 5.8 years, adult PET template) and (2) a pediatric pseudo-control group consisting of patients (n = 24, 10.6 ± 3.1 years, children PET template) with refractory focal epilepsy but with negative MRI and with PET considered normal not only on visual analysis but also on SPM. RESULTS Among the 47 children, visual analysis succeeded detecting at least one hypometabolic area in 87% of the cases (interobserver kappa = 0.81). Regarding SPM analysis, the best compromise between sensitivity and specificity was obtained with a threshold of p less than 0.001 as an extent of more than 40 voxels. There was a significant concordance to detect hypometabolic areas between both SPM analyses [kappa (K) = 0.59; p < 0.005] and between both SPM and visual analyses (K = 0.45; p < 0.005), in symptomatic (K = 0.74; p < 0.005) as in cryptogenic patients (K = 0.26; p < 0.01). The pediatric pseudo-control group dramatically improved specificity (97% vs. 89%; p < 0.0001) by increasing the positive predictive value (86% vs. 65%). Sensitivity remained acceptable although it was not better (79% vs. 87%, p = 0.039). The main impact was to reduce by 41% the number of hypometabolic cortical artifacts detected by SPM, especially in the younger epileptic patients, which is a key point in clinical practice. CONCLUSIONS This age-matched pseudo-control group is a way to optimize SPM analysis of FDG-PET in children with epilepsy. It might also be considered for other brain pathologies in pediatrics in the future.
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Affiliation(s)
- Frederique Archambaud
- Inserm, U663, Service de Neurologie et Métabolisme, Hôpital Necker, 149 rue de Sèvres, Paris, 75015, France.
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Paques M, Koch E, Girerd X, Rossant F, Rosenbaum D, Benesty J, Sahel J, Chaumet-Riffaud P. P2.01 HIGH RESOLUTION IMAGING OF SMALL ARTERIES IN THE HUMAN RETINA DURING HYPERTENSIVE RETINOPATHY. Artery Res 2013. [DOI: 10.1016/j.artres.2013.10.063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
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Thureau S, Chaumet-Riffaud P, Fernandez P, Bridji B, Houzard C, Tessonnier L, Cachin F, Modzelewski R, Vera P, Dubray B. PD-0293 REPRODUCIBILITY AND VOLUME SEGMENTATION METHODS ON F-MISO AND FLT PET-CT IMAGES IN PATIENTS WITH LUNG CANCER. Radiother Oncol 2012. [DOI: 10.1016/s0167-8140(12)70632-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Tick S, Rossant F, Ghorbel I, Gaudric A, Sahel JA, Chaumet-Riffaud P, Paques M. Foveal Shape and Structure in a Normal Population. ACTA ACUST UNITED AC 2011; 52:5105-10. [PMID: 21803966 DOI: 10.1167/iovs.10-7005] [Citation(s) in RCA: 151] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Affiliation(s)
- Sarah Tick
- From the Clinical Investigation Center 503, Centre Hospitalier National des Quinze-Vingts, INSERM and Université Pierre et Marie Curie-Paris 6, Paris, France
| | | | | | - Alain Gaudric
- the Lariboisière Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France; and
| | - José-Alain Sahel
- From the Clinical Investigation Center 503, Centre Hospitalier National des Quinze-Vingts, INSERM and Université Pierre et Marie Curie-Paris 6, Paris, France
| | - Philippe Chaumet-Riffaud
- From the Clinical Investigation Center 503, Centre Hospitalier National des Quinze-Vingts, INSERM and Université Pierre et Marie Curie-Paris 6, Paris, France; the 5Centre Hospitalier de Bicêtre, Assistance Publique-Hôpitaux de Paris, Université Paris Sud
| | - Michel Paques
- From the Clinical Investigation Center 503, Centre Hospitalier National des Quinze-Vingts, INSERM and Université Pierre et Marie Curie-Paris 6, Paris, France
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Abstract
The objective of this work is to compare the characteristics of various techniques for functional renal imaging, with a focus on nuclear medicine and magnetic resonance imaging. Even with low spatial resolution and rather poor signal-to-noise ratio, classical nuclear medicine has the advantage of linearity and good sensitivity. It remains the gold standard technique for renal relative functional assessment. Technetium-99m ((99m)Tc)-labeled diethylenetriamine penta-acetate remains the reference glomerular tracer. Tubular tracers have been improved: (123)I- or (131)I-hippuran, (99m)Tc-MAG3 and, recently, (99m)Tc-nitrilotriacetic acid. However, advancement in molecular imaging has not produced a groundbreaking tracer. Renal magnetic resonance imaging with classical gadolinated tracers probably has potential in this domain but has a lack of linearity and, therefore, its value still needs evaluation. Moreover, the advent of nephrogenic systemic fibrosis has delayed its expansion. Other developments, such as diffusion or blood oxygen level-dependent imaging, may have a role in the future. The other modalities have a limited role in clinical practice for functional renal imaging.
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Affiliation(s)
- Emmanuel Durand
- Biophysics and Nuclear Medicine, University Paris Sud, 78 Rue du Général Leclerc, Le Kremlin-Bicêtre Cedex, France.
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Schwartz L, Guais A, Chaumet-Riffaud P, Grévillot G, Sasco AJ, Molina TJ, Mohammad A. Carbon dioxide is largely responsible for the acute inflammatory effects of tobacco smoke. Inhal Toxicol 2011; 22:543-51. [PMID: 20387988 DOI: 10.3109/08958370903555909] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Tobacco smoking is responsible for a vast array of diseases, particularly chronic bronchitis and lung cancer. It is still unclear which constituent(s) of the smoke is responsible for its toxicity. The authors decided to focus on carbon dioxide, since its level of concentration in mainstream cigarette smoke is about 200 times higher than in the atmosphere. The authors previously demonstrated that inhalation of carbon dioxide concentrations above 5% has a deleterious effect on lungs. In this study, the authors assessed the inflammatory potential of carbon dioxide contained in cigarette smoke. Mice were exposed to cigarette smoke containing a high or reduced CO(2) level by filtration through a potassium hydroxyde solution. The inflammatory response was evaluated by histological analysis, protein phosphatase 2 A (PP2A) and nuclear factor (NF)-kappaB activation, and proinflammatory cytokine secretion measurements. The data show that the toxicity of cigarette smoke may be largely due to its high level of CO(2). Pulmonary injuries consequent to tobacco smoke inhalation observed by histology were greatly diminished when CO(2) was removed. Cigarette smoke exposure causes an inflammatory response characterized by PP2A and NF-kappaB activation followed by proinflammatory cytokine secretion. This inflammatory response was reduced when the cigarette smoke was filtered through a potassium hydroxide column, and reestablished when CO(2) was injected downstream from the filtration column.Given that there is an extensive literature linking a chronic inflammatory response to the major smoking-related diseases, these data suggest that carbon dioxide may play a key role in the causation of these diseases by tobacco smoking.
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Affiliation(s)
- Laurent Schwartz
- Service de Radiothérapie, AP-HP Hôpital Pitié-Salpétrière, boulevard de l'Hôpital, Paris, France.
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Chaumet-Riffaud P, Martinez-Duncker I, Marty AL, Richard C, Prigent A, Moati F, Sarda-Mantel L, Scherman D, Bessodes M, Mignet N. Synthesis and Application of Lactosylated, 99mTc Chelating Albumin for Measurement of Liver Function. Bioconjug Chem 2010; 21:589-96. [DOI: 10.1021/bc900275f] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Philippe Chaumet-Riffaud
- Université Paris-Sud 11, EA4046, Kremlin-Bicêtre, F-94275, AP-HP, CHU de Bicêtre, Le Kremlin-Bicêtre, F-94275, Unité de Pharmacologie Chimique et Génétique, U640 INSERM, UMR8151 CNRS, Université Paris Descartes, Paris, France, F-75006, Université Paris 7, U733 INSERM, CRB3, Faculté Xavier Bichat, Paris, France, AP-HP, Hôpital Bichat, Paris, F-75018, and Faculty of Science, Morelos State Autonomous University, Cuernavaca, Mexico
| | - Ivan Martinez-Duncker
- Université Paris-Sud 11, EA4046, Kremlin-Bicêtre, F-94275, AP-HP, CHU de Bicêtre, Le Kremlin-Bicêtre, F-94275, Unité de Pharmacologie Chimique et Génétique, U640 INSERM, UMR8151 CNRS, Université Paris Descartes, Paris, France, F-75006, Université Paris 7, U733 INSERM, CRB3, Faculté Xavier Bichat, Paris, France, AP-HP, Hôpital Bichat, Paris, F-75018, and Faculty of Science, Morelos State Autonomous University, Cuernavaca, Mexico
| | - Anne-Laure Marty
- Université Paris-Sud 11, EA4046, Kremlin-Bicêtre, F-94275, AP-HP, CHU de Bicêtre, Le Kremlin-Bicêtre, F-94275, Unité de Pharmacologie Chimique et Génétique, U640 INSERM, UMR8151 CNRS, Université Paris Descartes, Paris, France, F-75006, Université Paris 7, U733 INSERM, CRB3, Faculté Xavier Bichat, Paris, France, AP-HP, Hôpital Bichat, Paris, F-75018, and Faculty of Science, Morelos State Autonomous University, Cuernavaca, Mexico
| | - Cyrille Richard
- Université Paris-Sud 11, EA4046, Kremlin-Bicêtre, F-94275, AP-HP, CHU de Bicêtre, Le Kremlin-Bicêtre, F-94275, Unité de Pharmacologie Chimique et Génétique, U640 INSERM, UMR8151 CNRS, Université Paris Descartes, Paris, France, F-75006, Université Paris 7, U733 INSERM, CRB3, Faculté Xavier Bichat, Paris, France, AP-HP, Hôpital Bichat, Paris, F-75018, and Faculty of Science, Morelos State Autonomous University, Cuernavaca, Mexico
| | - Alain Prigent
- Université Paris-Sud 11, EA4046, Kremlin-Bicêtre, F-94275, AP-HP, CHU de Bicêtre, Le Kremlin-Bicêtre, F-94275, Unité de Pharmacologie Chimique et Génétique, U640 INSERM, UMR8151 CNRS, Université Paris Descartes, Paris, France, F-75006, Université Paris 7, U733 INSERM, CRB3, Faculté Xavier Bichat, Paris, France, AP-HP, Hôpital Bichat, Paris, F-75018, and Faculty of Science, Morelos State Autonomous University, Cuernavaca, Mexico
| | - Frederic Moati
- Université Paris-Sud 11, EA4046, Kremlin-Bicêtre, F-94275, AP-HP, CHU de Bicêtre, Le Kremlin-Bicêtre, F-94275, Unité de Pharmacologie Chimique et Génétique, U640 INSERM, UMR8151 CNRS, Université Paris Descartes, Paris, France, F-75006, Université Paris 7, U733 INSERM, CRB3, Faculté Xavier Bichat, Paris, France, AP-HP, Hôpital Bichat, Paris, F-75018, and Faculty of Science, Morelos State Autonomous University, Cuernavaca, Mexico
| | - Laure Sarda-Mantel
- Université Paris-Sud 11, EA4046, Kremlin-Bicêtre, F-94275, AP-HP, CHU de Bicêtre, Le Kremlin-Bicêtre, F-94275, Unité de Pharmacologie Chimique et Génétique, U640 INSERM, UMR8151 CNRS, Université Paris Descartes, Paris, France, F-75006, Université Paris 7, U733 INSERM, CRB3, Faculté Xavier Bichat, Paris, France, AP-HP, Hôpital Bichat, Paris, F-75018, and Faculty of Science, Morelos State Autonomous University, Cuernavaca, Mexico
| | - Daniel Scherman
- Université Paris-Sud 11, EA4046, Kremlin-Bicêtre, F-94275, AP-HP, CHU de Bicêtre, Le Kremlin-Bicêtre, F-94275, Unité de Pharmacologie Chimique et Génétique, U640 INSERM, UMR8151 CNRS, Université Paris Descartes, Paris, France, F-75006, Université Paris 7, U733 INSERM, CRB3, Faculté Xavier Bichat, Paris, France, AP-HP, Hôpital Bichat, Paris, F-75018, and Faculty of Science, Morelos State Autonomous University, Cuernavaca, Mexico
| | - Michel Bessodes
- Université Paris-Sud 11, EA4046, Kremlin-Bicêtre, F-94275, AP-HP, CHU de Bicêtre, Le Kremlin-Bicêtre, F-94275, Unité de Pharmacologie Chimique et Génétique, U640 INSERM, UMR8151 CNRS, Université Paris Descartes, Paris, France, F-75006, Université Paris 7, U733 INSERM, CRB3, Faculté Xavier Bichat, Paris, France, AP-HP, Hôpital Bichat, Paris, F-75018, and Faculty of Science, Morelos State Autonomous University, Cuernavaca, Mexico
| | - Nathalie Mignet
- Université Paris-Sud 11, EA4046, Kremlin-Bicêtre, F-94275, AP-HP, CHU de Bicêtre, Le Kremlin-Bicêtre, F-94275, Unité de Pharmacologie Chimique et Génétique, U640 INSERM, UMR8151 CNRS, Université Paris Descartes, Paris, France, F-75006, Université Paris 7, U733 INSERM, CRB3, Faculté Xavier Bichat, Paris, France, AP-HP, Hôpital Bichat, Paris, F-75018, and Faculty of Science, Morelos State Autonomous University, Cuernavaca, Mexico
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Richard C, Chaumet-Riffaud P, Belland A, Parat A, Contino-Pepin C, Bessodes M, Scherman D, Pucci B, Mignet N. Amphiphilic perfluoroalkyl carbohydrates as new tools for liver imaging. Int J Pharm 2009; 379:301-8. [DOI: 10.1016/j.ijpharm.2009.05.045] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2009] [Revised: 04/09/2009] [Accepted: 05/18/2009] [Indexed: 10/20/2022]
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Abolhassani M, Guais A, Chaumet-Riffaud P, Sasco AJ, Schwartz L. Carbon dioxide inhalation causes pulmonary inflammation. Am J Physiol Lung Cell Mol Physiol 2009; 296:L657-65. [PMID: 19136578 DOI: 10.1152/ajplung.90460.2008] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The aim of this study was to assess whether one of the most common poisons of cellular respiration, i.e., carbon dioxide, is proinflammatory. CO(2) is naturally present in the atmosphere at the level of 0.038% and involved in numerous cellular biochemical reactions. We analyzed in vitro the inflammation response induced by exposure to CO(2) for 48 h (0-20% with a constant O(2) concentration of 21%). In vivo mice were submitted to increasing concentrations of CO(2) (0, 5, 10, and 15% with a constant O(2) concentration of 21%) for 1 h. The exposure to concentrations above 5% of CO(2) resulted in the increased transcription (RNase protection assay) and secretion (ELISA) of proinflammatory cytokines [macrophage inflammatory protein-1alpha (MIP-1alpha), MIP-1beta, MIP-2, IL-8, IL-6, monocyte chemoattractant protein-1, and regulated upon activation, normal T cell expressed, and, presumably, secreted (RANTES)] by epithelial cell lines HT-29 or A549 and primary pulmonary cells retrieved from the exposed mice. Lung inflammation was also demonstrated in vivo by mucin 5AC-enhanced production and airway hyperreactivity induction. This response was mostly mediated by the nuclear translocation of p65 NF-kappaB, itself a consequence of protein phosphatase 2A (PP2A) activation. Short inhibiting RNAs (siRNAs) targeted toward PP2Ac reversed the effect of carbon dioxide, i.e., disrupted the NF-kappaB activation and the proinflammatory cytokine secretion. In conclusion, this study strongly suggests that exposure to carbon dioxide may be more toxic than previously thought. This may be relevant for carcinogenic effects of combustion products.
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Schwartz L, Abolhassani M, Pooya M, Steyaert JM, Wertz X, Israël M, Guais A, Chaumet-Riffaud P. Hyperosmotic stress contributes to mouse colonic inflammation through the methylation of protein phosphatase 2A. Am J Physiol Gastrointest Liver Physiol 2008; 295:G934-41. [PMID: 18755808 DOI: 10.1152/ajpgi.90296.2008] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
There are several reports suggesting hyperosmotic contents in the feces of patients suffering from inflammatory bowel disease (IBD). Previous works have documented that hyperosmolarity can cause inflammation attributable to methylation of the catalytic subunit of protein phosphatase 2A (PP2A) and subsequent NF-kappaB activation resulting in cytokine secretion. In this study, we demonstrate that dextran sulfate sodium (DSS) induces colitis due to hyperosmolarity and subsequent PP2A activation. Mice were randomized and fed with increased concentrations of DSS (0 mOsm, 175 mOsm, 300 mOsm, and 627 mOsm) for a duration of 3 wk or with hyperosmotic concentrations of DSS (627 mOsm) or mannitol (450 mOsm) for a duration of 12 wk. Long-term oral administration of hyposmotic DSS or mannitol had no demonstrable effect. Hyperosmotic DSS or mannitol produced a significant increase in colonic inflammation, as well as an increase in the weight of sacral lymph nodes and in serum amyloid A protein levels. Similar results were obtained through the ingestion of comparable osmolarities of mannitol. Hyperosmolarity induces the methylation of PP2A, nuclear p65 NF-kappaB activation. and cytokine secretion. The rectal instillation of okadaic acid, a well-known PP2A inhibitor, reverses the IBD. Short inhibiting RNAs (siRNAs) targeted toward PP2Ac reverse the effect of hyperosmotic DSS. The present study strongly suggests that DSS-induced chronic colitis is a consequence of the methylation of PP2Ac induced by hyperosmolarity.
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Affiliation(s)
- Laurent Schwartz
- Service de Radiothérapie Hôpital Pitié-Salpétrière, bd. de l'Hôpital, 75013 Paris, France.
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Abolhassani M, Wertz X, Pooya M, Chaumet-Riffaud P, Guais A, Schwartz L. Hyperosmolarity causes inflammation through the methylation of protein phosphatase 2A. Inflamm Res 2008; 57:419-29. [DOI: 10.1007/s00011-007-7213-0] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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Mortazavi N, Chaumet-Riffaud P, Chauffet-Riffaud P, Archambaud F, Prigent A. Biliary leak in a child after liver transplant and value of delayed images. Clin Nucl Med 2007; 33:44-5. [PMID: 18097259 DOI: 10.1097/rlu.0b013e31815c5115] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
A 2-year-old child underwent liver transplant and was referred for postsurgical abdominal pain. Hepatobiliary scintigraphy with Tc-99m iminodiacetic acid (IDA) was performed and with the help of 24-hour delayed images, the diagnosis of biliary leak at the site of anastomosis was made possible. This case report confirms the value of delayed images to facilitate the diagnosis in unequivocal situations and reminds us of the usefulness of this noninvasive method, especially in pediatrics.
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Affiliation(s)
- Nina Mortazavi
- Service de Biophysique et Médecine Nucléaire, AP-HP, Bicêtre & Univ Paris-Sud, Le Kremelin Bicêtre Cedex, France.
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Kas A, Payoux P, Habert MO, Malek Z, Cointepas Y, El Fakhri G, Chaumet-Riffaud P, Itti E, Remy P. Validation of a Standardized Normalization Template for Statistical Parametric Mapping Analysis of 123I-FP-CIT Images. J Nucl Med 2007; 48:1459-67. [PMID: 17704252 DOI: 10.2967/jnumed.106.038646] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
UNLABELLED (123)I-FP-CIT ((123)I-N-omega-fluoropropyl-2beta-carbomethoxy-3beta-(4-iodophenyl)nortropane) is a SPECT dopamine transporter (DAT) tracer that probes dopaminergic cell loss in Parkinson's disease (PD). Quantification of (123)I-FP-CIT images is performed at equilibrium using a ratio (BR) of specific (striatal) to nonspecific (occipital) uptake with values obtained from regions of interest drawn manually over these structures. Statistical parametric mapping (SPM) is a fully automated voxel-based statistical approach that has great potential in the context of DAT imaging. However, the accuracy of the spatial normalization provided by SPM has not been validated for (123)I-FP-CIT images. Our first aim was to create an (123)I-FP-CIT template that does not require the acquisition of patient-specific MRI and to validate the spatial normalization procedure. Next, we hypothesized that this customized template could be used by different SPECT centers without affecting the outcomes of imaging analyses. METHODS The spatial normalization to the customized template created with SPM (template A1) was validated using (123)I-FP-CIT images obtained from 6 subjects with essential tremor (ET) with normal DAT status and 6 PD patients. Variability in BR values due to the normalization was evaluated using striatal volume of interest (VOI). To determine whether different SPECT centers could use a unique (123)I-FP-CIT template, we generated 3 other (123)I-FP-CIT templates using different subjects and image-processing schemes. The interchangeability of these templates was assessed using (a) putamen BR values analyzed with the intraclass correlation coefficient (ICC) and the Bland-Altman graphical analysis, and (b) SPM analysis comparing the results of group comparisons-that is, ET versus PD, obtained after normalization to each of the 4 templates. RESULTS There was no significant difference between pre- and post-normalization striatal BR values in our study. The mean variability calculated with putamen VOI values after normalization to each template was <10%, with the lowest ICC of 98%. Intergroup analyses performed with VOI and SPM approaches provided similar results independently of the template used. CONCLUSION SPM normalization was accurate even in subjects with low striatal (123)I-FP-CIT uptake, making it a promising approach for automatic analysis of (123)I-FP-CIT images using a single customized template at different centers.
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Affiliation(s)
- Aurélie Kas
- URA Centre National de la Recherche Scientifique, Commissariat à l'Energie Atomique 2210, Service Hospitalier Frédéric Joliot, 4 place du Général Leclerc, 91401 Orsay, France.
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Durand E, Chaumet-Riffaud P, Prigent A. Is it possible to predict renal function in small animals using a multi-pinhole SPECT system? Eur J Nucl Med Mol Imaging 2007; 34:606. [PMID: 17221183 DOI: 10.1007/s00259-006-0336-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Durand E, Chaumet-Riffaud P, Archambaud F, Moati F, Prigent A. Mesure de la fonction rénale par les méthodes radio-isotopiques. ACTA ACUST UNITED AC 2006. [DOI: 10.1016/s1762-0945(06)75699-6] [Citation(s) in RCA: 2] [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: 12/12/2022]
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Vray M, Girault D, Hoog-Labouret N, Porcher R, Thalabard JC, Auriche C, Bernard J, Boichut D, Bouhassira M, Boutouyrie P, Chaumet-Riffaud P, Chiron C, Costa Y, de Crémiers F, Etienne S, Fender P, Giorgi R, Girard F, Girault D, Grosskopf C, Gueyffier F, Labouret NH, Juillet Y, Lechat P, Leroy S, Parmentier L, Ropers J, Salanave B, Simon T, Van Ganse E, Vray M. Methodology for Small Clinical Trials. Therapie 2004. [DOI: 10.2515/therapie:2004055] [Citation(s) in RCA: 5] [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: 11/20/2022]
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Poynard T, Marcellin P, Bissery A, Myers RP, Moussalli J, Degos F, Dhumeaux D, Riachi G, Bronowicki JP, Brissot P, Buffet C, Serfaty L, Naveau S, Sogni P, Beaugrand M, Gayno S, Larrey D, Samuel D, Eugene C, Pol S, Bedossa P, Daurat V, Chaumet-Riffaud P. Reinforced interferon alpha-2b and ribavirin is more effective than standard combination therapy in the retreatment of chronic hepatitis C previously nonresponsive to interferon: a randomized trial. J Viral Hepat 2003; 10:197-204. [PMID: 12753338 DOI: 10.1046/j.1365-2893.2003.00427.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
Interferon-alpha (IFN) monotherapy results in sustained virological clearance in a minority of patients with chronic hepatitis C. The aim of this study was to assess the effect of a reinforced regimen combining ribavirin and high-dose IFN for 48 weeks compared with a nonreinforced regimen combining a standard IFN regimen and ribavirin for 24 weeks in nonresponders with chronic hepatitis C. A total of 231 patients with chronic hepatitis C and previous nonresponse to IFN monotherapy were randomized. The reinforced group (n = 114) received IFN-2b 6 million units (MU) thrice weekly (TIW) and ribavirin for 48 weeks, and the nonreinforced group (n = 117) received IFN-2b 3 MU TIW and ribavirin for 24 weeks. The main outcome measure was a sustained virological response, defined as negative serum hepatitis C virus (HCV)-RNA 24 weeks following the end of treatment. This endpoint was determined in 98 patients of the reinforced group and 105 patients of the nonreinforced group. At the end of follow-up, a sustained virological response was observed in 29 of the 98 patients (29.6%) in the reinforced group vs 16 of the 105 patients (15.2%) in the nonreinforced group (P = 0.014). In multivariate analysis, factors associated with a sustained virological response were treated with a reinforced regimen [odds ratio (OR) 2.9; P = 0.06] and genotype 2 or 3 (OR 8.8; P < 0.0002). A total of 160 patients had paired biopsies before and after treatment. Histological activity improvement was observed in 32 of 80 patients (40%) and fibrosis worsening in 26 of 80 patients (33%) in the reinforced group vs 13 of 80 (16%) and 19 of 80 (24%) in the nonreinforced group (P = 0.30 and 0.20, respectively). Hence in nonresponders, a high-dose 48-week regimen of IFN and ribavirin combination was more effective than a regimen with interferon at lower dose and ribavirin for 24 weeks only.
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Affiliation(s)
- T Poynard
- Service d'Hepatogastroentérologie, Groupe Hospitalier Pitié-Salpêtrière, Université Paris 6, 47-83 Boulevard de l'Hôpital, CNRS ESA 8067, 75651 Paris Cedex 13, France.
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Annane D, Sébille V, Charpentier C, Bollaert PE, François B, Korach JM, Capellier G, Cohen Y, Azoulay E, Troché G, Chaumet-Riffaud P, Chaumet-Riffaut P, Bellissant E. Effect of treatment with low doses of hydrocortisone and fludrocortisone on mortality in patients with septic shock. JAMA 2002; 288:862-71. [PMID: 12186604 DOI: 10.1001/jama.288.7.862] [Citation(s) in RCA: 1919] [Impact Index Per Article: 87.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
CONTEXT Septic shock may be associated with relative adrenal insufficiency. Thus, a replacement therapy of low doses of corticosteroids has been proposed to treat septic shock. OBJECTIVE To assess whether low doses of corticosteroids improve 28-day survival in patients with septic shock and relative adrenal insufficiency. DESIGN AND SETTING Placebo-controlled, randomized, double-blind, parallel-group trial performed in 19 intensive care units in France from October 9, 1995, to February 23, 1999. PATIENTS Three hundred adult patients who fulfilled usual criteria for septic shock were enrolled after undergoing a short corticotropin test. INTERVENTION Patients were randomly assigned to receive either hydrocortisone (50-mg intravenous bolus every 6 hours) and fludrocortisone (50- micro g tablet once daily) (n = 151) or matching placebos (n = 149) for 7 days. MAIN OUTCOME MEASURE Twenty-eight-day survival distribution in patients with relative adrenal insufficiency (nonresponders to the corticotropin test). RESULTS One patient from the corticosteroid group was excluded from analyses because of consent withdrawal. There were 229 nonresponders to the corticotropin test (placebo, 115; corticosteroids, 114) and 70 responders to the corticotropin test (placebo, 34; corticosteroids, 36). In nonresponders, there were 73 deaths (63%) in the placebo group and 60 deaths (53%) in the corticosteroid group (hazard ratio, 0.67; 95% confidence interval, 0.47-0.95; P =.02). Vasopressor therapy was withdrawn within 28 days in 46 patients (40%) in the placebo group and in 65 patients (57%) in the corticosteroid group (hazard ratio, 1.91; 95% confidence interval, 1.29-2.84; P =.001). There was no significant difference between groups in responders. Adverse events rates were similar in the 2 groups. CONCLUSION In our trial, a 7-day treatment with low doses of hydrocortisone and fludrocortisone significantly reduced the risk of death in patients with septic shock and relative adrenal insufficiency without increasing adverse events.
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Affiliation(s)
- Djillali Annane
- Service de Réanimation Médicale, Hôpital Raymond Poincaré, 104 Blvd Raymond Poincaré, 92380 Garches, France.
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Lechat P, Lardoux H, Mallet A, Sanchez P, Derumeaux G, Lecompte T, Maillard L, Mas JL, Mentre F, Pousset F, Lacomblez L, Pisica G, Solbes-Latourette S, Raynaud P, Chaumet-Riffaud P. Anticoagulant (fluindione)-aspirin combination in patients with high-risk atrial fibrillation. A randomized trial (Fluindione, Fibrillation Auriculaire, Aspirin et Contraste Spontané; FFAACS). Cerebrovasc Dis 2002; 12:245-52. [PMID: 11641591 DOI: 10.1159/000047711] [Citation(s) in RCA: 66] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND A combination of low-dose aspirin with anticoagulants may provide better protection against thromboembolic events compared to anticoagulants alone in high-risk patients with atrial fibrillation. OBJECTIVE Evaluation of the preventive efficacy against nonfatal thromboembolic events and vascular deaths of the combination of the oral anticoagulant fluindione and aspirin (100 mg) in patients with high-risk atrial fibrillation. METHODS A multicenter, placebo-controlled, double-blind, randomized trial was conducted at 49 investigating centers in France. Atrial fibrillation patients with a previous thromboembolic event or older than 65 years and with either a history of hypertension, a recent episode of heart failure or decreased left ventricular function were included in the study. Patients were treated with fluindione plus placebo (i.e. anticoagulant alone) or fluindione plus aspirin (i.e. combination therapy), with an international normalized ratio target of between 2 and 2.6. The combined primary endpoint was stroke (ischemic or hemorrhagic), myocardial infarction, systemic arterial emboli or vascular death. The secondary endpoint was the incidence of hemorrhagic complications. RESULTS The 157 participants (average age 74 years; 52% women; 42% with paroxysmal atrial fibrillation) were followed for an average of 0.84 years. Three nonfatal thromboembolic events were observed (1 in the anticoagulation group, 2 in the combination group) and 6 patients died (3 in the anticoagulation group, 3 in the combination group), none of them from a thromboembolic complication. However, 3 deaths were secondary to severe hemorrhagic complications (1 in the anticoagulation group, 2 in the combination group). Nonfatal hemorrhagic complications occurred more often in the combination group (n = 10, 13.1%) compared to the anticoagulation group (n = 1, 1.2%) (p = 0.003). CONCLUSION The combination of aspirin with anticoagulant is associated with increased bleeding in elderly atrial fibrillation patients. The effect on thromboembolism and the overall balance of benefit to risk could not be accurately assessed in this study due to the limited number of ischemic events.
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Affiliation(s)
- P Lechat
- Pharmacology Department, Pitié-Salpêtrière Hospital, Paris, France.
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Rozenberg P, Chevret S, Goffinet F, Durand-Zaleski I, Ville Y, Vayssiere C, Roberto A, Lahna Z, Nisand I, Fisch C, Chaumet-Riffaud P, Chastang C. Induction of labour with a viable infant: a randomised clinical trial comparing intravaginal misoprostol and intravaginal dinoprostone. BJOG 2001; 108:1255-62. [PMID: 11843388 DOI: 10.1111/j.1471-0528.2001.00270.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To compare the efficacy and safety of vaginal misoprostol (50 microg) with vaginal dinoprostone. DESIGN Double-blind randomised trial. SETTING Obstetrics Department, Poissy Hospital, France. PARTICIPANTS 370 patients with medical indications for induction of labour. OUTCOME MEASURES Vaginal deliveries within 24 hours, as well as time to vaginal deliveries, caesarean rates, costs, and fetal, neonatal and maternal condition. RESULTS Compared with vaginal dinoprostone, vaginal misoprostol resulted in greater efficacy in several areas: vaginal delivery within 24 hours; time to vaginal delivery; and vaginal delivery within 12 hours. There was a non-significant increase in the caesarean section rate for fetal distress in the misoprostol group, but fewer caesarean sections for failed induction. Fetal tolerance was similar in the two groups, although significantly more neonates had a cord pH <7.20 and (non-significantly) none had meconium stained amniotic fluid in the misoprostol group. The incidence of poor neonatal outcome was similar in both groups. Subgroup analysis by indication for induction showed that the higher rates of arterial cord pH <7.20 and of meconium-stained amniotic fluid with misoprostol persisted only in possible fetal compromise. Poor neonatal outcome was less frequent in the misoprostol group in cases of induction for non-fetal indications. CONCLUSIONS Vaginal misoprostol resulted in successful and earlier induction of labour more often than dinoprostone, but the safety of misoprostol raises some concern in potentially compromised infants. Misoprostol should be preferred to dinoprostone in cases of induction for non-fetal indications.
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Affiliation(s)
- P Rozenberg
- Department of Gynaecology and Obstetrics, Poissy Hospital, University Paris V, France
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Rozenberg P, Chevret S, Goffinet F, Durand-Zaleski I, Ville Y, Vayssière C, Roberto A, Lahna Z, Nisand I, Fisch C, Chaumet-Riffaud P, Chastang C. Induction of labour with a viable infant: a randomised clinical trial comparing intravaginal misoprostol and intravaginal dinoprostone. ACTA ACUST UNITED AC 2001. [DOI: 10.1016/s0306-5456(01)00270-4] [Citation(s) in RCA: 6] [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: 10/17/2022]
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Lechat P, Lardoux H, Mallet A, Sanchez P, Derumeaux G, Lecompte T, Maillard L, Mas JL, Mentré F, Pousset F, Lacomblez L, Pisica G, Solbes-Latourette S, Raynaud P, Chaumet-Riffaud P. [Study of combined anticoagulant (fluindione)-aspirin therapy in patients with atrial fibrillation at high risk for thromboembolic complications. A randomized trial (FFAACS)]. Therapie 2000; 55:681-9. [PMID: 11234463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
Abstract
BACKGROUND A combination of low-dose aspirin (A) and anticoagulation (AC) may provide better protection against thromboembolic events compared with AC alone in high-risk patients with atrial fibrillation (AF). METHODS We performed a multicentric placebo-controlled double blind-trial to test the preventive efficacy against thromboembolic events of the addition of aspirin (A) (100 mg) or placebo (P) to anticoagulant treatment in patients with high-risk atrial fibrillation. A total of 157 patients were included, with atrial fibrillation and previous thromboembolic event or older than 65 years with either a history of hypertension, a recent episode of heart failure or a left ventricular dysfunction. All patients received fluindione (F) and P or F and A, with an INR target between 2 and 2.6. The primary endpoint was a combined endpoint of stroke (ischaemic or haemorrhagic), myocardial infarction, systemic arterial emboli or vascular death. RESULTS The study had to be stopped prematurely owing to a too low recruitment rate. During follow-up (0.84 years) 3 non-fatal thromboembolic events were recorded (1P, 2A) and 6 patients died (3P, 3A), none of them from a thromboembolic complication. However, 3 deaths were secondary to severe haemorrhagic complications (1P, 2A). Non-fatal haemorrhagic complications occurred more often in group A (n = 10, 13.1 pour cent) compared with group P (n = 1, 1.2 pour cent), p = 0.003. CONCLUSION The FFAACS study was not able to show any therapeutic benefit from the addition of aspirin to anticoagulant in patients with high-risk AF. Such a combination increased the incidence rate of bleeding complications, which therefore greatly reduces its potential overall benefit.
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Affiliation(s)
- P Lechat
- Service de Pharmacologie, Hôpital Pitié Salpêtrière, 47 Bd de l'Hôpital 75013 Paris, France
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Pons G, Marchand MC, d'Athis P, Sauvage E, Foucard C, Chaumet-Riffaud P, Sautegeau A, Navarro J, Lenoir G. French multicenter randomized double-blind placebo-controlled trial on nebulized amiloride in cystic fibrosis patients. The Amiloride-AFLM Collaborative Study Group. Pediatr Pulmonol 2000; 30:25-31. [PMID: 10862159 DOI: 10.1002/1099-0496(200007)30:1<25::aid-ppul5>3.0.co;2-c] [Citation(s) in RCA: 63] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The effect of amiloride, a sodium channel blocker, has been evaluated in a multicenter randomized double-blind placebo-controlled trial in cystic fibrosis patients more than 5-years-old (n = 137) whose forced vital capacity (FVC), forced expiratory volume in 1 sec (FEV(1)), and forced mid-expiratory flow (FEF(25-75)) were not below 50%, 50%, and 30% of reference values, respectively. Patients were randomly allocated to two parallel groups. Sixty-four patients were chronically colonized with Pseudomonas aeruginosa; they received either amiloride or placebo as a nebulized solution three times daily for 6 months. Routine treatments were continued. Patients chronically colonized with Pseudomonas received nebulized colimycine twice a day for a month during the third and sixth months of treatment. Bronchopulmonary exacerbations were treated in the usual way. The effects of the amiloride treatment were assessed at the end of the 6-month treatment period. The effects on FVC and secondarily on FEV(1), FEF(25-75), the number of days on antibiotic therapy, the Shwachman score, a nutritional index (weight/height(2)), the change in sputum bacterial flora, and nocturnal cough were assessed. For the patients not chronically colonized with Pseudomonas, the effect of the treatment was also evaluated by counting chronic colonizations with pathogens appearing during the trial period. The present study failed to demonstrate any significant benefit of amiloride over placebo on FVC, FEV(1), and the other secondary endpoints in the studied population. Neither the chronically colonized, nor the noncolonized patients benefited. The confidence intervals of the differences between treatment groups indicated small differences that were most likely of no clinical significance. Complementary analyses taking into account the gender, the type of mutation, the subpopulations whose FVC and FEV(1) were below 80% of normal values at the beginning of the study, and also patients less than 10 years old, did not show any statistically or clinically significant improvements following amiloride therapy.
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Affiliation(s)
- G Pons
- Pharmacologie Périnatale et Pédiatrique, Hôpital Saint-Vincent de Paul, Paris, France.
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Naveau S, Balian A, Degos F, Daurat V, Chevret S, Gayno S, Bastie A, Riachi G, Bartolomei-Portal I, Barange K, Moussalli J, Bailly F, Chaumet-Riffaud P, Emilie D. Prognostic value of the soluble interleukin-2 receptor in chronic hepatitis C treated with interferon-alfa. Multicenter GER-CYT 04 Group. J Hepatol 1999; 31:612-7. [PMID: 10551383 DOI: 10.1016/s0168-8278(99)80339-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
Abstract
BACKGROUND/AIMS High serum levels of the soluble interleukin 2 receptor (sIL-2R) have been reported in patients with chronic hepatitis C. The aims of this study were to determine the evolution of sIL-2R considered as an indicator of activation of T cells in patients with hepatitis C virus (HCV) treated with IFN-alpha and to correlate sIL-2R serum levels with parameters reflecting ongoing liver disease and with outcome of interferon treatment. METHODS In a case-control study, we studied patients enrolled in a multicenter randomized clinical trial which had demonstrated the benefit of a reinforced regimen of interferon alpha. Each of the 26 sustained virological responders (SVR) was paired for treatment regimen with two non-responders (NR). RESULTS Prior to treatment, higher levels of sIL-2R were found in the sera of 78 patients compared with healthy controls (3791+/-210 pg/ml versus 956+/-88 pg/ml (p<0.001)). In the 78 patients after 4 weeks of treatment, the levels of sIL-2R were higher than pretreatment levels (4308+/-206 pg/ml (p<0.01)). In the NR, levels of sIL-2R increased significantly after 4 weeks of treatment compared with pretreatment levels (p<0.01), and levels of sIL-2R at week 72 were not significantly different from those at pretreatment. Conversely, in the SVR, levels of sIL-2R at week 4 did not significantly increase compared to pretreatment values, and thereafter gradually decreased. At week 72, levels of sIL-2R were significantly lower than before treatment (p<0.001). The difference between levels of sIL-2R at week 4 and before initiation of treatment (delta s IL-2R) was smaller in the SVR than in the NR (142+/-219 pg/ml versus 704+/-107 pg/ml (p<0.02). The disappearance of HCV RNA from the serum at week 4 showed a sensitivity of 92% (95% confidence interval 86-98) and a specificity of 60% (95% confidence interval 49-71), delta sIL-2R had a sensitivity of 42% (95% confidence interval 31-53) and a specificity of 81% (95% confidence interval 79-90) for the prediction of a sustained virological response 6 months after stopping treatment. The disappearance of HCV RNA from serum at week 4 and delta sIL-2R were independent and early predictive factors for a sustained virological response 6 months after stopping treatment. CONCLUSIONS At week 4, delta sIL-2R may be a more specific parameter than the disappearance of HCV RNA for assessing total, and hence more sustained, elimination of HCV infection 6 months after stopping treatment.
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Affiliation(s)
- S Naveau
- Service d'Hépatogastroentérologie, Hôpital Antoine Béclère, Clamart, France
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Janin A, Dupont M, Chaumet-Riffaud P. [Cryopreserved tissue fo cell bank for diagnosis and research: statutory aspects]. Ann Pathol 1999; 18:19-21. [PMID: 9884752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Affiliation(s)
- A Janin
- Service d'Anatomie Pathologique, Hôpital Saint-Louis
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Tennezé L, Daurat V, Tibi A, Chaumet-Riffaud P, Funck-Brentano C. A study of the relative bioavailability of cysteamine hydrochloride, cysteamine bitartrate and phosphocysteamine in healthy adult male volunteers. Br J Clin Pharmacol 1999; 47:49-52. [PMID: 10073739 PMCID: PMC2014194 DOI: 10.1046/j.1365-2125.1999.00844.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
AIMS Cysteamine, the only drug available for the treatment of cystinosis in paediatric patients, is available as the hydrochloride, the bitartrate and as sodium phosphocysteamine salts. It has been suggested that cysteamine bitartrate and phosphocysteamine are better tolerated and may have a better bioavailability than cysteamine hydrochloride. This has, however, never been demonstrated. METHODS We compared the pharmacokinetics and tolerance of these three formulations of cysteamine in 18 healthy adult male volunteers in a double-blind, latin-square, three-period, single oral dose cross-over relative bioavailability study. RESULTS No statistical difference was found between relative bioavailabilities, AUC (0, infinity) (geometric mean and s.d. in micromol l(-1) h: 169+/-51, 158+/-46, 173+/-49 with cysteamine hydrochloride, phosphocysteamine and cysteamine bitartrate respectively), Cmax (geometric mean and s.d. in micromol l(-1); 66+/-25.5, 59+/-12, 63+/-20) and tmax (median and range in h: 0.88 (0.25-2), 1.25 (0.25-2), 0.88 (0.25-2)) with each of the three forms of cysteamine tested. Bioequivalence statistics (90% confidence intervals) showed non equivalence of Cmax of cysteamine base as the only non equivalence of pharmacokinetics between the three formulations: 90% CI for Cmax relative ratios to cysteamine hydrochloride were [75.6-105.81 for phosphocysteamine and [74.2-124.2] for cysteamine bitartrate. The only significant adverse event was vomiting whose frequency was inversely correlated with body weight (Spearman's r=-0.76, P<0.001). The nature of the salt tested did not influence vomiting. CONCLUSIONS While none of the three forms of cysteamine tested has a clear advantage over the others in terms of pharmacokinetics and tolerance profile, this should now however be addressed in patients treated for cystinosis during repeat administrations.
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Affiliation(s)
- L Tennezé
- Clinical Investigation Centre and Clinical Pharmacology Unit, Saint-Antoine University Hospital, Paris, France
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Degos F, Daurat V, Chevret S, Gayno S, Bastie A, Riachi G, Bartolomei-Portal I, Barange K, Moussalli J, Naveau S, Bailly F, Chaumet-Riffaud P, Chastang C. Reinforced regimen of interferon alfa-2a reduces the incidence of cirrhosis in patients with chronic hepatitis C: a multicentre randomised trial. Multicentre GER-CYT-04 Group. J Hepatol 1998; 29:224-32. [PMID: 9722203 DOI: 10.1016/s0168-8278(98)80007-x] [Citation(s) in RCA: 23] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
BACKGROUND/AIMS Our aim was to assess and compare the long-term effect of interferon at standard (6 months) and reinforced dose and duration regimens in chronic hepatitis C. METHODS A multicentre institutional trial included 244 previously untreated patients with chronic hepatitis C, without cirrhosis, who were randomly allocated to either standard (3 MU thrice a week for 24 weeks; n=120) or reinforced (6 MU daily for 12 days, 6 MU thrice a week for 22 weeks, 3 MU thrice a week for 24 weeks; n=124) regimens. The main endpoint was sustained ALT response at 72 weeks (18 months); secondary end-points were virological (branched DNA and PCR) and histological responses (incidence of cirrhosis) at month 18. RESULTS Sustained ALT response was observed in five patients (4%, 95% confidence interval 0-8%) in the standard group and in 21 patients (18%, 95% confidence interval 11-25%), from the reinforced group (p=0.002), in agreement with virological response in 21 (81%) patients. Cirrhosis at month 18 was observed in ten (10%) patients in the standard group and one (1%) in the reinforced group (p=0.004). CONCLUSIONS The standard regimen of interferon, in chronic hepatitis C, confers a minimal sustained response rate at 18 months and may not prevent the occurrence of cirrhosis. Reinforced regimens allow sustained response to be reached in a limited number of patients and reduce the risk of cirrhosis during 18 months of follow-up.
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Affiliation(s)
- F Degos
- Service d'Hépatogastroentérologie, Hôpital Beaujon, Clichy, France
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Warnet A, Harris AG, Renard E, Martin D, James-Deidier A, Chaumet-Riffaud P. A prospective multicenter trial of octreotide in 24 patients with visual defects caused by nonfunctioning and gonadotropin-secreting pituitary adenomas. French Multicenter Octreotide Study Group. Neurosurgery 1997; 41:786-95; discussion 796-7. [PMID: 9316039 DOI: 10.1097/00006123-199710000-00005] [Citation(s) in RCA: 48] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
OBJECTIVE The somatostatin analog octreotide has been demonstrated to improve optic tract compression caused by pituitary macroadenomas within hours of its administration and/or reduce tumor size in some patients. We report the results of a prospective multicenter study of the effects of octreotide on visual function and tumor size in patients with nonfunctioning pituitary adenomas or gonadotropin-secreting adenomas. METHODS Twenty-four patients with visual defects caused by histologically confirmed macroadenomas were administered octreotide via continuous subcutaneous infusion, as follows: 100 micrograms the 1st day and, if necessary, 200 micrograms the 2nd and then 100 or 200 micrograms three times daily if visual function improved. Vision was assessed after 4 days, 1 month, and 2 months, including tumor size evaluation. Visual improvement was defined by a net gain of at least 2/10 in acuity and/or of more than 20% of the surface of one isopter (a reduction in tumor volume of > or = 20% of the initial measurement); opposite changes were defined as deterioration. RESULTS Visual improvement was noted in 13 of 24 patients, 10 of 23 patients and 9 of 22 patients, and was not noted in 11 of 24 patients, 14 of 23 patients, and 13 of 22 patients after 4 days, 1 month, and 2 months, respectively. After 2 months, three adenomas had shrunk, three had not changed in size, and one had increased; visual function improved in the seven patients with these adenomas. Octreotide was discontinued in 13 patients for lack of efficacy. CONCLUSION The incidence of visual improvement and tumor shrinkage noted in this study was higher than previously reported. Our data suggest that early onset of visual improvement might help in deciding which patients profit from octreotide. However, concomitant gain in visual acuity with deterioration in visual fields or visual improvement with an increase (moderate) in tumor size can occur.
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Affiliation(s)
- A Warnet
- Department of Internal Medicine, Hôpital Lariboisière, Université Paris VII, France
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Spriet A, Chaumet-Riffaud P. [Essential elements of quality assurance of clinical trials in hospital environment]. Therapie 1996; 51:434-8. [PMID: 8953826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
This round table discussion was devoted to describing the present status of clinical trials in the hospital setting, analysing common difficulties in conducting quality clinical research, and proposing realistic solutions to solve or attenuate those difficulties. This analysis was performed on five critical topics: personnel, laboratory tests and investigations, drug supplies, source documents and investigator's procedures.
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Affiliation(s)
- A Spriet
- GERMED, Hôpital Saint-Louis, Paris, France
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Chaumet-Riffaud P. [Evaluation of new drugs]. Soins Psychiatr 1994:21-3. [PMID: 7809701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
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Chaumet-Riffaud P, Wolmark Y, Péré JJ, Goulley F. [Therapeutic trials in Alzheimer disease. Selection--recruitment and stratification]. Therapie 1993; 48:201-5. [PMID: 8140558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Therapeutic trials conducted in Alzheimer's disease have benefited from the standardization of diagnostic criteria based on internationally recognized scales (DSM III-R, NINCDS-ADRDA) which ensure more valid inclusions. Well specified exclusion criteria are also of the utmost importance, in particular depression, vascular dementia and concomitant psychotropic drugs. Cognitive and/or functional scales allow an appreciation of the severity of the disease. Due to the heterogeneity of Alzheimer's disease stratification methods on identified prognostic factors i.e. aphasia, extrapyramidal symptoms should be performed. Selection of responders during an enrichment phase has still to be discussed. Multicentric studies become imperative because of the large number of patients required and the difficulties in selecting the adequate patients. These raise the issues of investigators' experience, coordination and between center variability.
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Affiliation(s)
- P Chaumet-Riffaud
- Laboratoires Sandoz, Département Recherche Clinique, Rueil-Malmaison
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Abstract
The risk of hip fracture is higher among persons living in long-term care than among persons living at home. The aim of this study was to explain the difference in risk between the two types of residence by identifying differences in the respective risk factor profiles. Information from the Mediterranean osteoporosis (MEDOS) study questionnaire was used for statistical analyses of 107 non-demented female cases and 225 neighbourhood controls matched for age, sex, and residential area. The statistical analyses incorporated adjustments of the risk estimates by unconditional multivariate logistic regression. Urban background, activity, and morbidity were found to differ between the two types of residence. The detected differences in risk factor profiles were, however, not considered to be sufficient as an explanation for the difference in risk of fracture.
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Affiliation(s)
- L Miravet
- Centre Viggo Petersen, Paris, France
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Massiou H, Chaumet-Riffaud P, Bourdeix I. Nicardipine in the prevention of spasm-induced neurological deficits after subarachnoid hemorrhage: a dose-ranging study. Surg Neurol 1992; 38:7-11. [PMID: 1615378 DOI: 10.1016/0090-3019(92)90205-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
The tolerability of four doses of intravenous nicardipine (0.03, 0.08, 0.11, and 0.15 mg/kg/h) was assessed in this randomized multicenter, parallel-group study. Fifty-two patients with Hunt and Hess grade I-III aneurysmal subarachnoid hemorrhage were treated with intravenous nicardipine beginning within 4 days of bleeding, for a mean duration of 12.6 days; this treatment was followed by administration of oral nicardipine 90-120 mg until day 30. Hypotension was the main side effect, and it occurred only in the two groups that received the highest doses. However, it was possible to continue nicardipine in all cases at lower doses or even without modification, and hypotension was never responsible for any deleterious clinical effect.
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Affiliation(s)
- H Massiou
- Service de Neurologie, Hôpital St. Antoine, Paris
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48
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Allain H, Le Coz F, Goulley F, Brunet-Bourgin F, Loria Y, Bentue-Ferrer D, Decombe R, Reymann JM, Chaumet-Riffaud P, Gandon JM. Comparison of three regimens of Parlodel-SRO in levodopa-treated parkinsonians: a randomized double-blind crossover study. Int J Clin Pharmacol Ther Toxicol 1991; 29:314-22. [PMID: 1743806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Parlodel-SRO is a newly developed slow-release formulation of bromocriptine, which prevents initial plasma peak--a known source of adverse events--and extends the half-life of the compound, an interesting feature for the management of motor symptoms in Parkinsonians. This study was designed to determine the best daily administration schedule for 30 mg Parlodel-SRO in 18 parkinsonians previously treated with levodopa and standard Bromocriptine (Br). The 30 mg dose was replaced from one day to the next, in a randomized, double-blind latin square design trial. Three consecutive 7-day courses were implemented, during which a total daily dose of 30 mg P-SRO was administered in one dose, two intakes (b.i.d.) and three intakes, (t.i.d.) respectively. The b.i.d. schedule produced the best improvement in UPDRS scores, especially as to postural stability, walking, bradykinesia; it also provided greater pharmacological stability throughout the assessment day. Adverse event analysis was not in favor of a single daily dose. It appeared that P-SRO administered in two 15 mg intakes (morning and evening) produces the best benefit-risk ratio in Parkinsonians who were already being treated with levodopa.
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Affiliation(s)
- H Allain
- Department of Neurology and Neuropharmacology, University Hospital, Rennes, France
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Pinquier JL, Urien S, Chaumet-Riffaud P, Tillement JP. Differences in the serum binding determinants of isradipine and darodipine--consequences for serum protein binding in various diseases. Br J Clin Pharmacol 1989; 28:587-92. [PMID: 2531607 PMCID: PMC1380020 DOI: 10.1111/j.1365-2125.1989.tb03546.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
1. Serum protein binding of isradipine and darodipine, and serum concentrations of alpha 1-acid glycoprotein (AAG), albumin (HSA) and non-esterified fatty acids (NEFA) were measured in three groups of patients, I: healthy subjects (n = 20); II: patients with inflammatory disorders (n = 15) and III: patients with hepatic insufficiency (n = 17). 2. AAG was increased significantly in group II patients (P less than 0.001) and decreased in group III patients (P less than 0.001); HSA was decreased significantly in group II and group III patients (P less than 0.001). 3. The free percentage of isradipine was decreased significantly in group II patients (P less than 0.05) and increased in group III patients (P less than 0.05) and multivariate analysis showed that these variations were inversely related to changes in AAG concentration. 4. The free percentage of darodipine was increased significantly in group II and III patients (P less than 0.05) due to a decrease in HSA concentration, as shown by multivariate analysis. 5. The changes in free serum percentages of isradipine and darodipine were inversely related to concomitant changes in the concentration of the serum protein for which they showed the highest affinity, AAG for isradipine and HSA for darodipine, respectively. 6. The unexplained variability in the binding data was greater when AAG was the major determinant of binding (isradipine).
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Affiliation(s)
- J L Pinquier
- Département de Pharmacologie, Faculté de Médecine de Paris XII, France
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50
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Tillement JP, Urien S, Chaumet-Riffaud P, Riant P, Bree F, Morin D, Albengres E, Barre J. Blood binding and tissue uptake of drugs. Recent advances and perspectives. Fundam Clin Pharmacol 1988; 2:223-38. [PMID: 3042568 DOI: 10.1111/j.1472-8206.1988.tb00634.x] [Citation(s) in RCA: 38] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
The free drug hypothesis, which states that only the unbound moiety of drug in blood is available for tissue diffusion, is discussed according to recent investigations. In some experimental conditions, it must be assumed that part of the protein-bound drug in plasma is extracted during a single passage through the organ studied. The mechanisms underlying these observations are not unequivocal and remain hypothetical. In the liver, high-affinity binding sites for serum albumin have been demonstrated, and they would explain the high extraction by liver of endogenous and exogenous compounds. However, these experiments measure the unidirectional transfer of a drug from the vascular to the extravascular space in non-steady-state conditions. Hence, in steady-state conditions, the free drug hypothesis cannot be ruled out because it is supported by numerous pharmacokinetic studies.
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Affiliation(s)
- J P Tillement
- Laboratoire Hospitalo-Universitaire de Pharmacologie, Faculté de Médecine, Université Paris XII, Créteil, France
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