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Jarrot PA, Mirouse A, Ottaviani S, Cadiou S, Salmon JH, Liozon E, Parreau S, Michaud M, Terrier B, Gavand PE, Trefond L, Lavoiepierre V, Keraen J, Rekassa D, Bouldoires B, Weitten T, Roche D, Poulet A, Charpin C, Grobost V, Hermet M, Pallure M, Wackenheim C, Karkowski L, Grumet P, Rogier T, Belkefi N, Pestre V, Broquet E, Leurs A, Gautier S, Gras V, Gilet P, Holubar J, Sivova N, Schleinitz N, Durand JM, Castel B, Petrier A, Arcani R, Gramont B, Guilpain P, Lepidi H, Weiller PJ, Micallef J, Saadoun D, Kaplanski G. Polymyalgia rheumatica and giant cell arteritis following COVID-19 vaccination: Results from a nationwide survey. Hum Vaccin Immunother 2024; 20:2334084. [PMID: 38563792 PMCID: PMC10989707 DOI: 10.1080/21645515.2024.2334084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Accepted: 03/19/2024] [Indexed: 04/04/2024] Open
Abstract
We conducted a national in-depth analysis including pharmacovigilance reports and clinical study to assess the reporting rate (RR) and to determine the clinical profile of polymyalgia rheumatica (PMR) and giant cell arteritis (GCA) in COVID-19-vaccinated individuals. First, based on the French pharmacovigilance database, we estimated the RR of PMR and GCA cases in individuals aged over 50 who developed their initial symptoms within one month of receiving the BNT162b2 mRNA, mRNA-1273, ChAdOx1 nCoV-19, and Ad26.COV2.S vaccines. We then conducted a nationwide survey to gather clinical profiles, therapeutic management, and follow-up data from individuals registered in the pharmacovigilance study. A total of 70 854 684 COVID-19 vaccine doses were administered to 25 260 485 adults, among which, 179 cases of PMR (RR 7. 1 cases/1 000 000 persons) and 54 cases of GCA (RR 2. 1 cases/1 000 000 persons) have been reported. The nationwide survey allowed the characterization of 60 PMR and 35 GCA cases. Median time to the onset of first symptoms was 10 (range 2-30) and 7 (range 2-25) days for PMR and GCA, respectively. Phenotype, GCA-related ischemic complications and -large vessel vasculitis as well as therapeutic management and follow-up seemed similar according to the number of vaccine shots received and when compared to the literature data of unvaccinated population. Although rare, the short time between immunization and the onset of first symptoms of PMR and GCA suggests a temporal association. Physician should be aware of this potential vaccine-related phenomenon.
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Affiliation(s)
- Pierre-André Jarrot
- Department of Internal Medicine and Clinical Immunology, Hôpital de La Conception, Assistance Publique-Hôpitaux de Marseille (AP-HM), Marseille, France
- Centre for Cardiovascular and Nutrition Research (C2VN), INRA 1260, INSERM UMR_S1263, Aix-Marseille University, Marseille, France
| | - Adrien Mirouse
- Department of Internal Medicine and Clinical Immunology, Centre de Référence des Maladies Auto-Immunes Systémiques Rares, Centre de Référence des Maladies Auto-Inflammatoires et de l’Amylose inflammatoire (CEREMAIA), Sorbonne Universités, Paris, France
- INSERM, UMR_S 959 Lab, Immunology, Immunotherapeutics, Paris, France
- DMU 3ID, AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Paris, France
| | - Sébastien Ottaviani
- Department of Rheumatology, DMU Locomotion, Hôpital Bichat-Claude Bernard, APHP, Université de Paris, Paris, France
| | - Simon Cadiou
- Department of Rheumatology, CHU de Rennes, Université de Rennes 1, Rennes, France
| | - Jean-Hugues Salmon
- Department of Rheumatology, Hôpital de La Maison Blanche, Université de Reims, Reims, France
| | - Eric Liozon
- Department of Internal Medicine, Hôpital Universitaire de Limoges, Limoges, France
| | - Simon Parreau
- Department of Internal Medicine, Hôpital Universitaire de Limoges, Limoges, France
| | - Martin Michaud
- Department of Internal Medicine, Clinique Saint-Exupery, Toulouse, France
| | - Benjamin Terrier
- National Referral Center for Rare Systemic Autoimmune Disease, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris (AP-HP), Centre, Université Paris Cité, Paris, France
| | | | - Ludovic Trefond
- Department of Internal Medicine, Hôpital Gabriel Montpied, Clermont-Ferrand, France
| | - Virginie Lavoiepierre
- Department of Internal Medicine and Clinical Immunology, Hôpital de La Conception, Assistance Publique-Hôpitaux de Marseille (AP-HM), Marseille, France
| | - Jeremy Keraen
- Department of Internal Medicine, Hôpital de Cornouaille, Quimper, France
| | - Daniel Rekassa
- Department of Rehabilitation, Centre Thermal, Greoux Les Bains, France
| | | | - Thierry Weitten
- Department of Internal Medicine, Hôpital des Alpes du Sud, Gap, France
| | - Damien Roche
- Department of Rheumatology, Hôpital Saint-Joseph, Marseille, France
| | - Antoine Poulet
- Department of Internal Medicine, Hôpital Saint-Joseph, Marseille, France
| | - Caroline Charpin
- Department of Rheumatology, Hôpital Saint-Joseph, Marseille, France
| | - Vincent Grobost
- Department of Internal Medicine, Hôpital Estaing, Clermont-Ferrand, France
| | - Marion Hermet
- Department of Internal Medicine, Hôpital de Vichy, Vichy, France
| | - Magali Pallure
- Department of Rheumatology, Hôpital de Cannes Simone Veil, Cannes, France
| | - Chloe Wackenheim
- Department of Internal Medicine, Medipole Hôpital Privé, Villeurbanne, France
| | - Ludovic Karkowski
- Department of Internal Medicine, Hôpital d’Instruction des Armées Sainte-Anne, Toulon, France
| | - Pierre Grumet
- Department of Internal Medicine, Hôpital des Alpes du Sud, Gap, France
| | - Thomas Rogier
- Department of Internal Medicine and Systemic Disease, Hôpital François Mitterand, Dijon, France
| | - Nabil Belkefi
- Department of Internal Medicine, CH de Melun, Melun, France
| | - Vincent Pestre
- Department of Internal Medicine and Infectious Disease, CH d’Avignon, Avignon, France
| | | | - Amélie Leurs
- Department of Internal Medicine and Infectious Disease, CH de Dunkerque, Dunkerque, France
| | - Sophie Gautier
- Department of Pharmacology, centre régional de pharmacovigilance Nord Pas de Calais, CHRU de Lille, Lille, France
| | - Valérie Gras
- Department of Clinical Pharmacology, Centre régional de pharmacovigilance, service de pharmacologie clinique, CHU Amiens-Picardie, Amiens, France
| | - Pierre Gilet
- Regional Center of Pharmacovigilance, CHRU de Nancy, Hôpital Central, Nancy, France
| | - Jan Holubar
- Department of Internal Medicine, CHU de Nîmes, Nîmes, France
| | - Nadia Sivova
- Department of Internal Medicine, CH de Tourcoing, Tourcoing, France
| | - Nicolas Schleinitz
- Department of Internal Medicine, Hôpital de La Timone, Assistance Publique-Hôpitaux de Marseille (AP-HM), Marseille, France
| | - Jean-Marc Durand
- Department of Internal Medicine, Hôpital de La Timone, Assistance Publique-Hôpitaux de Marseille (AP-HM), Marseille, France
| | - Brice Castel
- Department of Internal Medicine, CH de Tarbes, Tarbes, France
| | | | - Robin Arcani
- Department of Internal Medicine and Therapeutics Department, Hôpital de La Timone, Marseille, France
| | - Baptiste Gramont
- Department of Internal Medicine, CHU de Saint-Etienne, Saint-Etienne, France
| | - Philippe Guilpain
- Department of Internal Medicine, CHU Saint-Eloi, Montpellier, France
| | - Hubert Lepidi
- Pathological Laboratory, Hôpital de La Timone, Assistance Publique-Hôpitaux de Marseille (AP-HM), Marseille, France
| | | | - Joelle Micallef
- Department of Clinical Pharmacology and pharmacosurveillance, Regional Pharmacovigilance Center of Marseille, Hôpital de La Timone, Assistance Publique-Hôpitaux de Marseille (AP-HM), Marseille, France
| | - David Saadoun
- Department of Internal Medicine and Clinical Immunology, Centre de Référence des Maladies Auto-Immunes Systémiques Rares, Centre de Référence des Maladies Auto-Inflammatoires et de l’Amylose inflammatoire (CEREMAIA), Sorbonne Universités, Paris, France
- INSERM, UMR_S 959 Lab, Immunology, Immunotherapeutics, Paris, France
- DMU 3ID, AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Paris, France
| | - Gilles Kaplanski
- Department of Internal Medicine and Clinical Immunology, Hôpital de La Conception, Assistance Publique-Hôpitaux de Marseille (AP-HM), Marseille, France
- Centre for Cardiovascular and Nutrition Research (C2VN), INRA 1260, INSERM UMR_S1263, Aix-Marseille University, Marseille, France
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Al Tabosh T, Liu H, Koça D, Al Tarrass M, Tu L, Giraud S, Delagrange L, Beaudoin M, Rivière S, Grobost V, Rondeau-Lutz M, Dupuis O, Ricard N, Tillet E, Machillot P, Salomon A, Picart C, Battail C, Dupuis-Girod S, Guignabert C, Desroches-Castan A, Bailly S. Impact of heterozygous ALK1 mutations on the transcriptomic response to BMP9 and BMP10 in endothelial cells from hereditary hemorrhagic telangiectasia and pulmonary arterial hypertension donors. Angiogenesis 2024; 27:211-227. [PMID: 38294582 PMCID: PMC11021321 DOI: 10.1007/s10456-023-09902-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Accepted: 12/03/2023] [Indexed: 02/01/2024]
Abstract
Heterozygous activin receptor-like kinase 1 (ALK1) mutations are associated with two vascular diseases: hereditary hemorrhagic telangiectasia (HHT) and more rarely pulmonary arterial hypertension (PAH). Here, we aimed to understand the impact of ALK1 mutations on BMP9 and BMP10 transcriptomic responses in endothelial cells. Endothelial colony-forming cells (ECFCs) and microvascular endothelial cells (HMVECs) carrying loss of function ALK1 mutations were isolated from newborn HHT and adult PAH donors, respectively. RNA-sequencing was performed on each type of cells compared to controls following an 18 h stimulation with BMP9 or BMP10. In control ECFCs, BMP9 and BMP10 stimulations induced similar transcriptomic responses with around 800 differentially expressed genes (DEGs). ALK1-mutated ECFCs unexpectedly revealed highly similar transcriptomic profiles to controls, both at the baseline and upon stimulation, and normal activation of Smad1/5 that could not be explained by a compensation in cell-surface ALK1 level. Conversely, PAH HMVECs revealed strong transcriptional dysregulations compared to controls with > 1200 DEGs at the baseline. Consequently, because our study involved two variables, ALK1 genotype and BMP stimulation, we performed two-factor differential expression analysis and identified 44 BMP9-dysregulated genes in mutated HMVECs, but none in ECFCs. Yet, the impaired regulation of at least one hit, namely lunatic fringe (LFNG), was validated by RT-qPCR in three different ALK1-mutated endothelial models. In conclusion, ALK1 heterozygosity only modified the BMP9/BMP10 regulation of few genes, including LFNG involved in NOTCH signaling. Future studies will uncover whether dysregulations in such hits are enough to promote HHT/PAH pathogenesis, making them potential therapeutic targets, or if second hits are necessary.
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Affiliation(s)
- T Al Tabosh
- Biosanté unit U1292, Grenoble Alpes University, INSERM, CEA, 38000, Grenoble, France
| | - H Liu
- Biosanté unit U1292, Grenoble Alpes University, INSERM, CEA, 38000, Grenoble, France
| | - D Koça
- Biosanté unit U1292, Grenoble Alpes University, INSERM, CEA, 38000, Grenoble, France
| | - M Al Tarrass
- Biosanté unit U1292, Grenoble Alpes University, INSERM, CEA, 38000, Grenoble, France
| | - L Tu
- Faculté de Médecine, Pulmonary Hypertension: Pathophysiology and Novel Therapies, Université Paris-Saclay, 94276, Le Kremlin-Bicêtre, France
- INSERM UMR_S 999 «Pulmonary Hypertension: Pathophysiology and Novel Therapies», Hôpital Marie Lannelongue, 92350, Le Plessis-Robinson, France
| | - S Giraud
- Genetics Department, Femme-Mère-Enfants Hospital, Hospices Civils de Lyon, 69677, Bron, France
| | - L Delagrange
- Genetics Department, Femme-Mère-Enfants Hospital, Hospices Civils de Lyon, 69677, Bron, France
- National Reference Center for HHT, 69677, Bron, France
| | - M Beaudoin
- Genetics Department, Femme-Mère-Enfants Hospital, Hospices Civils de Lyon, 69677, Bron, France
- National Reference Center for HHT, 69677, Bron, France
| | - S Rivière
- Internal Medicine Department, CHU of Montpellier, St Eloi Hospital and Center of Clinical Investigation, INSERM, CIC 1411, 34295, Montpellier Cedex 7, France
| | - V Grobost
- Internal Medicine Department, CHU Estaing, 63100, Clermont-Ferrand, France
| | - M Rondeau-Lutz
- Internal Medicine Department, University Hospital of Strasbourg, 67091, Strasbourg Cedex, France
| | - O Dupuis
- Hôpital Lyon SUD, Hospices Civils de Lyon, Université Claude Bernard Lyon 1, 69100, Villeurbanne, France
- Faculty of Medicine, Lyon University, 69921, Lyon, France
| | - N Ricard
- Biosanté unit U1292, Grenoble Alpes University, INSERM, CEA, 38000, Grenoble, France
| | - E Tillet
- Biosanté unit U1292, Grenoble Alpes University, INSERM, CEA, 38000, Grenoble, France
| | - P Machillot
- Biosanté unit U1292, Grenoble Alpes University, INSERM, CEA, 38000, Grenoble, France
| | - A Salomon
- Biosanté unit U1292, Grenoble Alpes University, INSERM, CEA, 38000, Grenoble, France
| | - C Picart
- Biosanté unit U1292, Grenoble Alpes University, INSERM, CEA, 38000, Grenoble, France
| | - C Battail
- Biosanté unit U1292, Grenoble Alpes University, INSERM, CEA, 38000, Grenoble, France
| | - S Dupuis-Girod
- Biosanté unit U1292, Grenoble Alpes University, INSERM, CEA, 38000, Grenoble, France
- Genetics Department, Femme-Mère-Enfants Hospital, Hospices Civils de Lyon, 69677, Bron, France
- National Reference Center for HHT, 69677, Bron, France
| | - C Guignabert
- Faculté de Médecine, Pulmonary Hypertension: Pathophysiology and Novel Therapies, Université Paris-Saclay, 94276, Le Kremlin-Bicêtre, France
- INSERM UMR_S 999 «Pulmonary Hypertension: Pathophysiology and Novel Therapies», Hôpital Marie Lannelongue, 92350, Le Plessis-Robinson, France
| | - A Desroches-Castan
- Biosanté unit U1292, Grenoble Alpes University, INSERM, CEA, 38000, Grenoble, France
| | - S Bailly
- Biosanté unit U1292, Grenoble Alpes University, INSERM, CEA, 38000, Grenoble, France.
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Tauverons-Jalenques U, Grobost V, Magnin B, Moluçon-Chabrot C, Bay JO, Tournilhac O, Guièze R. Successful Treatment of De Novo Acute Myeloid Leukemia-Associated Aortitis by Induction Chemotherapy Alone. Mediterr J Hematol Infect Dis 2024; 16:e2024025. [PMID: 38468839 PMCID: PMC10927218 DOI: 10.4084/mjhid.2024.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Accepted: 02/09/2024] [Indexed: 03/13/2024] Open
Affiliation(s)
- Urbain Tauverons-Jalenques
- Cellular Therapy and Clinical Haematology Department, Clermont-Ferrand University Hospital, Clermont Ferrand, France
| | - Vincent Grobost
- Internal Medicine Department, Clermont-Ferrand University Hospital, Clermont Ferrand, France
| | - Benoît Magnin
- Department of Radiology, Clermont-Ferrand University Hospital, Clermont Ferrand, France
| | - Cécile Moluçon-Chabrot
- Cellular Therapy and Clinical Haematology Department, Clermont-Ferrand University Hospital, Clermont Ferrand, France
| | - Jacques-Olivier Bay
- Cellular Therapy and Clinical Haematology Department, Clermont-Ferrand University Hospital, Clermont Ferrand, France
- EA7453 (CHELTER), Clermont Auvergne University, Clermont-Ferrand, France
| | - Olivier Tournilhac
- Cellular Therapy and Clinical Haematology Department, Clermont-Ferrand University Hospital, Clermont Ferrand, France
- EA7453 (CHELTER), Clermont Auvergne University, Clermont-Ferrand, France
| | - Romain Guièze
- Cellular Therapy and Clinical Haematology Department, Clermont-Ferrand University Hospital, Clermont Ferrand, France
- EA7453 (CHELTER), Clermont Auvergne University, Clermont-Ferrand, France
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Oris C, Lautrette A, Dougé A, Bouraima F, Kahouadji S, Pickering ME, Garrouste C, Gagnière J, Guièze R, D'Ostrevy N, Futier E, Grobost V, Buisson A, Batisse M, Bouillon-Minois JB, Pereira B, Durif J, Sapin V, Bouvier D. Prevalence of FGF23 elevation in patients with hypophosphatemia. Clin Chim Acta 2024; 554:117782. [PMID: 38224930 DOI: 10.1016/j.cca.2024.117782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2023] [Revised: 12/28/2023] [Accepted: 01/10/2024] [Indexed: 01/17/2024]
Abstract
BACKGROUND AND AIMS To investigate the contribution of FGF23 in explaining the cases of hypophosphatemia observed in clinical practice, we aimed to determine for the first time the prevalence of FGF23 elevation in patients with hypophosphatemia and to describe the different mechanisms of FGF23-related hypophosphatemic disorders. MATERIALS AND METHODS We performed a prospective, observational, multicenter, cohort study of 260 patients with hypophosphatemia. Blood measurements (PTH, 1,25-dihydroxyvitamin D, bone alkaline phosphatase, 25-hydroxyvitamin D, and FGF23) were performed on a Liaison XL® (DiaSorin) analyzer. RESULTS Primary elevation of FGF23 (>95.4 pg/mL) was reported in 10.4% (95CI: 7.0-14.7) of patients (n = 27) with hypophosphatemia, suggesting that at least 1 in 10 cases of hypophosphatemia was erroneously attributed to an etiology other than FGF23 elevation. Patients with elevated blood FGF23 were grouped according to the etiology of the FGF23 elevation. Thus, 10 patients had a renal pathology, chronic kidney disease or post-renal transplantation condition. The remaining patients (n = 17) had the following etiologies: malignancies (n = 9), benign pancreatic tumor (n = 1), post-cardiac surgery (n = 4), cirrhosis (n = 2), and chronic obstructive pulmonary disease (n = 1). CONCLUSION In order to improve patient management, it seems essential to better integrate plasma FGF23 measurement into the routine evaluation of hypophosphatemia.
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Affiliation(s)
- Charlotte Oris
- Biochemistry and Molecular Genetics Department, CHU Clermont-Ferrand, 63000 Clermont-Ferrand, France; Clermont Auvergne University, CNRS, INSERM, iGReD, Clermont-Ferrand, France
| | - Alexandre Lautrette
- Department of Intensive Care Medicine, CHU Clermont-Ferrand, 63000 Clermont-Ferrand, France
| | - Aurore Dougé
- Department of Oncology, CHU Clermont-Ferrand, 63000 Clermont-Ferrand, France
| | - Farouk Bouraima
- Biochemistry and Molecular Genetics Department, CHU Clermont-Ferrand, 63000 Clermont-Ferrand, France
| | - Samy Kahouadji
- Biochemistry and Molecular Genetics Department, CHU Clermont-Ferrand, 63000 Clermont-Ferrand, France; Clermont Auvergne University, CNRS, INSERM, iGReD, Clermont-Ferrand, France
| | - Marie-Eva Pickering
- Rheumatology Department, CHU Clermont-Ferrand, 63000 Clermont-Ferrand, France
| | - Cyril Garrouste
- Department of Nephrology, CHU Clermont-Ferrand, 63000 Clermont-Ferrand, France
| | - Johan Gagnière
- Department of Digestive and Hepatobiliary Surgery, CHU Clermont-Ferrand, 63000 Clermont-Ferrand, France
| | - Romain Guièze
- Department of Clinical Hematology, CHU Clermont-Ferrand, 63000 Clermont-Ferrand, France
| | - Nicolas D'Ostrevy
- Department of Cardiac Surgery, CHU Clermont-Ferrand, 63000 Clermont-Ferrand, France
| | - Emmanuel Futier
- Department of Perioperative Medicine, Anesthesia & Critical Care, CHU Clermont-Ferrand, 63000 Clermont-Ferrand, France
| | - Vincent Grobost
- Department of Internal Medicine, CHU Clermont-Ferrand, 63000 Clermont-Ferrand, France
| | - Anthony Buisson
- Department of Hepato-Gastroenterology, CHU Clermont-Ferrand, 63000 Clermont-Ferrand, France
| | - Marie Batisse
- Department of Oncology, Centre Jean Perrin, 63000 Clermont-Ferrand, France
| | | | - Bruno Pereira
- Biostatistics Unit (DRCI) Department, CHU Clermont-Ferrand, 63000 Clermont-Ferrand, France
| | - Julie Durif
- Biochemistry and Molecular Genetics Department, CHU Clermont-Ferrand, 63000 Clermont-Ferrand, France
| | - Vincent Sapin
- Biochemistry and Molecular Genetics Department, CHU Clermont-Ferrand, 63000 Clermont-Ferrand, France; Clermont Auvergne University, CNRS, INSERM, iGReD, Clermont-Ferrand, France
| | - Damien Bouvier
- Biochemistry and Molecular Genetics Department, CHU Clermont-Ferrand, 63000 Clermont-Ferrand, France; Clermont Auvergne University, CNRS, INSERM, iGReD, Clermont-Ferrand, France.
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Dupuis-Girod S, Rivière S, Lavigne C, Fargeton AE, Gilbert-Dussardier B, Grobost V, Leguy-Seguin V, Maillard H, Mohamed S, Decullier E, Roux A, Bernard L, Saurin JC, Saroul N, Faure F, Cartier C, Altwegg R, Laccourreye L, Oberti F, Beaudoin M, Dhelens C, Desvignes C, Azzopardi N, Paintaud G, Hermann R, Chinet T. Efficacy and safety of intravenous bevacizumab on severe bleeding associated with hemorrhagic hereditary telangiectasia: A national, randomized multicenter trial. J Intern Med 2023; 294:761-774. [PMID: 37592715 DOI: 10.1111/joim.13714] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/19/2023]
Abstract
BACKGROUND Bevacizumab-a humanized monoclonal antibody-has been widely used to treat patients with hereditary hemorrhagic telangiectasia (HHT), but no randomized trial has yet been conducted. METHODS This study is a double-blind multicenter randomized phase 2 trial with a 1:1 active-treatment-to-placebo ratio. We included patients over the age of 18 with a confirmed diagnosis and the need for at least four red blood cell (RBC) units transfused in the 3 months before study enrollment. Bevacizumab was administered at a dose of 5 mg/kg every 14 days with a total of six injections. The primary efficacy criterion was a decrease of at least 50% in the cumulative number of RBC units transfused in a 3-month period before and after treatment. RESULTS A total of 24 patients (12 in each group) were included and randomized at 4 different centers. In intention-to-treat analysis, 63.6% of patients (7/11) in the bevacizumab group versus 33.3% of patients (4/12) in the placebo group decreased the number of blood transfusions by at least 50% (p = 0.22). Hemoglobin levels significantly improved at 6 months in the bevacizumab versus placebo group (p = 0.02). The pharmacokinetics study revealed that patients with high exposure to bevacizumab had a significant decrease in RBC transfusions (p = 0.03). Fifty-nine adverse events were observed, 34 in the placebo arm versus 25 in the bevacizumab arm. CONCLUSION Though the present trial was underpowered, patients with HHT receiving bevacizumab required numerically fewer red blood cell transfusions than those receiving placebo, particularly those with high exposure.
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Affiliation(s)
- Sophie Dupuis-Girod
- Service de Génétique et centre de référence de la maladie de Rendu-Osler, Hôpital Femme-Mère-Enfants, Hospices Civils de Lyon, Bron, France
- Inserm, CEA, Laboratory Biology of Cancer and Infection, Université Grenoble Alpes, Grenoble, France
| | - Sophie Rivière
- Service de Médecine Interne A, Centre Hospitalier Universitaire, Montpellier, France
| | - Christian Lavigne
- Service de médecine interne-Immunologie clinique, CHU d'Angers, Angers cedex 09, France
| | - Anne-Emmanuelle Fargeton
- Service de Génétique et centre de référence de la maladie de Rendu-Osler, Hôpital Femme-Mère-Enfants, Hospices Civils de Lyon, Bron, France
| | | | - Vincent Grobost
- Service de Médecine Interne CHU Estaing, Clermont-Ferrand University Hospital, Clermont-Ferrand, France
| | | | - Hélène Maillard
- CHU Lille, Service de Médecine Interne et Immunologie Clinique, Lille, France
| | - Shirine Mohamed
- Département de Médecine interne et Immunologie Clinique, CHRU BRABOIS, Vandoeuvre-lès-Nancy, France
| | - Evelyne Decullier
- Hospices Civils de Lyon, Pôle Santé Publique, Lyon, France
- Faculté de médecine, Université Lyon 1, Lyon, France
| | - Adeline Roux
- Hospices Civils de Lyon, Pôle Santé Publique, Lyon, France
- Faculté de médecine, Université Lyon 1, Lyon, France
| | | | - Jean-Christophe Saurin
- Faculté de médecine, Université Lyon 1, Lyon, France
- Hospices Civils de Lyon, Service d'Hépato-gastroentérologie, Hôpital E. Herriot, Lyon, France
| | - Nicolas Saroul
- CHU Clermont Ferrand, Hôpital Gabriel Montpied, Service d'ORL, Clermont-Ferrand, France
| | - Frédéric Faure
- Hospices Civils de Lyon, Hôpital E. Herriot, Service d'ORL, Lyon, France
| | - Cesar Cartier
- Service d'ORL Centre Hospitalier Universitaire, Montpellier, France
| | - Romain Altwegg
- Service Hépatogastroentérologie CHU St Eloi, Montpellier, France
| | | | - Frédéric Oberti
- Service Hépatogastroentérologie, UPRES EA 3859, Faculté de médecine, CHU Angers and Laboratoire HIFIH, Angers, France
| | - Marjolaine Beaudoin
- Service de Génétique et centre de référence de la maladie de Rendu-Osler, Hôpital Femme-Mère-Enfants, Hospices Civils de Lyon, Bron, France
| | - Carole Dhelens
- Hospices Civils de Lyon, Hôpital Edouard Herriot, Pharmacie à Usage Intérieur, Lyon, France
| | - Céline Desvignes
- CHRU de Tours, Plateforme Recherche, Centre Pilote de suivi Biologique des traitements par Anticorps (CePiBAc), Tours, France
- EA 4245 Transplantation, Immunologie, Inflammation (T2I), Université de Tours, Tours, France
| | | | - Gilles Paintaud
- EA 4245 Transplantation, Immunologie, Inflammation (T2I), Université de Tours, Tours, France
- Service de Pharmacologie Médicale, CHRU de Tours, Tours, France
| | - Ruben Hermann
- Hospices Civils de Lyon, Hôpital Femme-Mère-Enfants, Service d'ORL et centre de référence de la maladie de Rendu-Osler, Bron, France
| | - Thierry Chinet
- Centre Rendu-Osler, Hôpital Ambroise Paré, Assistance Publique-Hôpitaux de Paris, Université de Versailles SQY, Boulogne, France
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6
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Grobost V, Hammi S, Pereira B, Guilhem A, Duffau P, Seguier J, Parrot A, Gautier G, Alric L, Kerjouan M, Le Guillou X, Simon D, Chaussavoine L, Rondeau-Lutz M, Leguy-Seguin V, Delagrange L, Lavigne C, Maillard H, Dupuis-Girod S. Antiplatelet and anticoagulant therapies in hereditary hemorrhagic telangiectasia: A large French cohort study (RETROPLACOTEL). Thromb Res 2023; 229:107-113. [PMID: 37437516 DOI: 10.1016/j.thromres.2023.07.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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: 04/12/2023] [Revised: 06/02/2023] [Accepted: 07/05/2023] [Indexed: 07/14/2023]
Abstract
BACKGROUND It is unclear whether hereditary hemorrhagic telangiectasia (HHT) patients can tolerate antithrombotic therapies (AT) including antiplatelet (AP) and/or anticoagulant (AC) agents. OBJECTIVES Primary endpoint was tolerance to AT in HHT. Secondary endpoints were to identify factors associated with major bleeding events (MBE) and premature discontinuation of AT. METHODS Retrospective multicenter study in French national HHT Registry patients exposed to AT. RESULTS We included 126 patients with 180 courses of AT. Median follow-up was 24 [11-52] months. Mean age was 65.6 ± 13.1 years. The first 3 months of AT exposure had an increased risk of hospitalization for hemorrhage (p < 0.001) and transfusions (p < 0.001). MBE (n = 63) occurred more frequently in the first 3 months of AT exposure (p < 0.001). Premature discontinuation of AT occurred in 61 cases. Rate of premature discontinuation was 29 % under both AP and AT therapy but significantly higher under dual AP therapy (n = 4/7, 57 % p = 0.008). Risk factors for MBE were: age ≥ 60 years (HR 2.34 [1.12;4.87], p = 0.023), prior hospitalization in the 3 months before starting AT for hemorrhage (HR 3.59 [1.93;6.66], p < 0.001) or transfusion (HR 3.15 [1.61;6.18], p = 0.001), previous history of gastro-intestinal bleeding (HR 2.71 [1.57;4.65], p < 0.001) or MBE (HR 4.62 [2.68;7.98], p < 0.001). Frequency of MBE did not differ between groups except for a higher risk in the dual AP group (HR 3.92 [1.37;11.22], p = 0.011). CONCLUSION Tolerance of AC or AP therapy was similar in HHT population but not dual AP therapy. We identified risk factors for MBE occurrence or premature discontinuation under AT.
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Affiliation(s)
- Vincent Grobost
- Service de Médecine Interne, Clermont-Ferrand University Hospital, CHU Estaing, 63000 Clermont-Ferrand, France.
| | - Sami Hammi
- Department of Internal Medicine, Angers University Hospital, 49100 Angers, France
| | - Bruno Pereira
- Biostatistics Unit, Clermont-Ferrand University Hospital, 63000 Clermont-Ferrand, France
| | - Alexandre Guilhem
- Hospices Civils de Lyon, Hôpital Femme-Mère-Enfants, Service de Génétique et centre de référence de la maladie de Rendu-Osler, 69677 Bron, France
| | - Pierre Duffau
- Bordeaux University Hospital, Internal Medicine and Clinical Immunology Department, Université de Bordeaux, CNRS ImmunoConcEpT UMR 5164, 33000 Bordeaux, France
| | - Julie Seguier
- Département de Médecine Interne, Marseille University Hospital, 13000 Marseille, France
| | - Antoine Parrot
- Assistance Publique-Hôpitaux de Paris, Service de Pneumologie et Centre de Compétence de la Maladie de Rendu Osler, Hôpital Tenon, 75020 Paris, France
| | - Giovanni Gautier
- Nantes Université, Nantes University Hospital, Department of Internal and Vascular Medicine, 44000 Nantes, France
| | - Laurent Alric
- Internal Medicine-Digestive Medicine, CHU Rangueil Toulouse 3 University, 31000 Toulouse, France
| | - Mallorie Kerjouan
- Service de Pneumologie, Hôpital Pontchaillou, CHU Rennes, 35000 Rennes, France
| | - Xavier Le Guillou
- Medical Genetics Department, University Hospital of Poitiers, 86000 Poitiers, France
| | - Delphine Simon
- Service de Médecine Interne, CHU Charles Nicolle, 76000 Rouen, France
| | - Laurent Chaussavoine
- Centre Hospitalier Universitaire de Caen Normandie, Service de Médecine Vasculaire, 14000 Caen, France
| | - Murielle Rondeau-Lutz
- Service de Médecine Interne, Nouvel Hôpital Civil, Hôpitaux Universitaires de Strasbourg, 67 091 Strasbourg cedex, France
| | | | - Laura Delagrange
- Hospices Civils de Lyon, Hôpital Femme-Mère-Enfants, Service de Génétique et centre de référence de la maladie de Rendu-Osler, 69677 Bron, France
| | - Christian Lavigne
- Department of Internal Medicine, Angers University Hospital, 49100 Angers, France
| | - Hélène Maillard
- Department of Internal Medicine and Clinical Immunology, Referral Centre for rare systemic autoimmune diseases for North and North-West France (CeRAINO), CHU Lille, 59000, Lille, France
| | - Sophie Dupuis-Girod
- Hospices Civils de Lyon, Hôpital Femme-Mère-Enfants, Service de Génétique et centre de référence de la maladie de Rendu-Osler, 69677 Bron, France
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7
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Stuchfield-Denby E, Mattutzu V, Grobost V, Andre M, Pereira B, Ruivard M. Expression immunohistochimique du DNAJB9 dans la maladie associée aux IgG4. Rev Med Interne 2022. [DOI: 10.1016/j.revmed.2022.10.102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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8
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Puel T, Soavi C, Guilmoteau T, Grobost V, Sabbagh L, Franceschino A, Chiambaretta F, Trouillier S. Rétinopathie exsudative, calcifications cérébrales dans l’enfance puis cytopénies à l’âge adulte : penser au syndrome de COATS plus. Rev Med Interne 2022. [DOI: 10.1016/j.revmed.2022.10.140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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9
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Jachiet V, Ricard L, Hirsch P, Malard F, Pascal L, Beyne-Rauzy O, Peterlin P, Maria ATJ, Vey N, D'Aveni M, Gourin MP, Dimicoli-Salazar S, Banos A, Wickenhauser S, Terriou L, De Renzis B, Durot E, Natarajan-Ame S, Vekhoff A, Voillat L, Park S, Vinit J, Dieval C, Dellal A, Grobost V, Willems L, Rossignol J, Solary E, Kosmider O, Dulphy N, Zhao LP, Adès L, Fenaux P, Fain O, Mohty M, Gaugler B, Mekinian A. Reduced peripheral blood dendritic cell and monocyte subsets in MDS patients with systemic inflammatory or dysimmune diseases. Clin Exp Med 2022:10.1007/s10238-022-00866-5. [PMID: 35953763 DOI: 10.1007/s10238-022-00866-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Accepted: 07/13/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND Systemic inflammatory and autoimmune diseases (SIADs) occur in 10-20% of patients with myelodysplastic syndrome (MDS). Recently identified VEXAS (Vacuoles, E1 enzyme, X-linked, Autoinflammatory, Somatic) syndrome, associated with somatic mutations in UBA1 (Ubiquitin-like modifier-activating enzyme 1), encompasses a range of severe inflammatory conditions along with hematological abnormalities, including MDS. The pathophysiological mechanisms underlying the association between MDS and SIADs remain largely unknown, especially the roles of different myeloid immune cell subsets. The aim of this study was to quantitatively evaluate peripheral blood myeloid immune cells (dendritic cells (DC) and monocytes) by flow cytometry in MDS patients with associated SIAD (n = 14, most often including relapsing polychondritis or neutrophilic dermatoses) and to compare their distribution in MDS patients without SIAD (n = 23) and healthy controls (n = 7). Most MDS and MDS/SIAD patients had low-risk MDS. Eight of 14 (57%) MDS/SIAD patients carried UBA1 somatic mutations, defining VEXAS syndrome.Compared with MDS patients, most DC and monocyte subsets were significantly decreased in MDS/SIAD patients, especially in MDS patients with VEXAS syndrome. Our study provides the first overview of the peripheral blood immune myeloid cell distribution in MDS patients with associated SIADs and raises several hypotheses: possible redistribution to inflammation sites, increased apoptosis, or impaired development in the bone marrow.
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Affiliation(s)
- Vincent Jachiet
- Sorbonne Université, INSERM UMR938, Centre de Recherche Saint-Antoine (CRSA), 75012, Paris, France. .,Service de Médecine Interne et Inflammation-Immunopathology-Biotherapy Department (DMU i3), Sorbonne Université, AP-HP, Hôpital Saint Antoine, Paris, France.
| | - Laure Ricard
- Sorbonne Université, INSERM UMR938, Centre de Recherche Saint-Antoine (CRSA), 75012, Paris, France.,Service d'Hématologie Clinique et de Thérapie Cellulaire, Sorbonne Université, AP-HP, Hôpital Saint Antoine, Paris, France
| | - Pierre Hirsch
- Service d'Hématologie Biologique, Sorbonne Université, AP-HP, Hôpital Saint Antoine, Paris, France
| | - Florent Malard
- Sorbonne Université, INSERM UMR938, Centre de Recherche Saint-Antoine (CRSA), 75012, Paris, France.,Service d'Hématologie Clinique et de Thérapie Cellulaire, Sorbonne Université, AP-HP, Hôpital Saint Antoine, Paris, France
| | - Laurent Pascal
- Service d'Oncologie et d'Hématologie, Hôpital Saint Vincent de Paul, Université Catholique de Lille, Lille, France
| | - Odile Beyne-Rauzy
- Service de Médecine Interne, CHU de Toulouse, Institut Universitaire du Cancer Toulouse Oncopole, Toulouse, France
| | - Pierre Peterlin
- Service d'Hématologie Clinique, CHU de Nantes, Nantes, France
| | - Alexandre Thibault Jacques Maria
- Service de Médecine Interne, maladies multi-organiques de l'adulte, Hôpital Saint-Éloi, CHU de Montpellier, Université de Montpellier, Montpellier, France
| | - Norbert Vey
- Institut Paoli-Calmettes, CRCM, Aix-Marseille Univ, Inserm, CNRS, Marseille, France
| | - Maud D'Aveni
- Service d'Hématologie et de Médecine Interne, Hôpital Brabois, CHRU Nancy, Nancy, France
| | - Marie-Pierre Gourin
- Service d'Hématologie Clinique et de Thérapie Cellulaire, Hôpital Dupuytren, CHU de Limoges, Limoges, France
| | | | - Anne Banos
- Service d'Hématologie Clinique, Centre Hospitalier Côte Basque, Bayonne, France
| | - Stefan Wickenhauser
- Service d'Hématologie Clinique, Hôpital Universitaire Carémeau, Institut de Cancérologie du Gard, Nîmes, France
| | - Louis Terriou
- Service de Médecine Interne et Immunologie Clinique, CHU Lille, 59000, Lille, France
| | - Benoit De Renzis
- Service d'Hématologie Clinique, Hôpital Estaing, CHU de Clermont-Ferrand, Clermont-Ferrand, France
| | - Eric Durot
- Service d'Hématologie Clinique, Hôpital Robert Debré, CHU de Reims, Reims, France
| | - Shanti Natarajan-Ame
- Service d'Hématologie, Institut de Cancérologie Strasbourg Europe (ICANS), 17 rue Albert Calmette, Strasbourg, France
| | - Anne Vekhoff
- Service d'Hématologie Clinique et de Thérapie Cellulaire, Sorbonne Université, AP-HP, Hôpital Saint Antoine, Paris, France
| | - Laurent Voillat
- Service d'Hématologie et Oncologie, CH William Morey, Chalon sur Saône, France
| | - Sophie Park
- Service d'Hématologie, Université Grenoble Alpes Et CHU Grenoble Alpes, Grenoble, France
| | - Julien Vinit
- Service de Médecine Interne, CH William Morey, Chalon sur Saône, France
| | - Céline Dieval
- Service de Médecine Interne et Hématologie, GHLA, CH de Rochefort, Rochefort, France
| | - Azeddine Dellal
- Service de Rhumatologie, Hôpital Montfermeil, Montfermeil, France
| | - Vincent Grobost
- Service de Médecine Interne, CHU Estaing, Clermont-Ferrand, France
| | - Lise Willems
- Service d'Hématologie, AP-HP, Hôpital Cochin, Paris, France
| | - Julien Rossignol
- Service d'Hématologie Adultes, AP-HP, Hôpital Necker-Enfants Malades, 75015, Paris, France
| | - Eric Solary
- Département d'Hématologie, Institut Gustave Roussy, Villejuif, France
| | - Olivier Kosmider
- Service d'Hématologie Biologique, Université de Paris, AP-HP, Hôpital Cochin, 75014, Paris, France
| | - Nicolas Dulphy
- Institut de Recherche Saint Louis, Hôpital Saint Louis, Université de Paris, INSERM U1160, Paris, France
| | - Lin Pierre Zhao
- Département d'Hématologie, Université de Paris, AP-HP, Hôpital Saint Louis, 75010, Paris, France
| | - Lionel Adès
- Département d'Hématologie, Université de Paris, AP-HP, Hôpital Saint Louis, 75010, Paris, France
| | - Pierre Fenaux
- Département d'Hématologie, Université de Paris, AP-HP, Hôpital Saint Louis, 75010, Paris, France
| | - Olivier Fain
- Service de Médecine Interne et Inflammation-Immunopathology-Biotherapy Department (DMU i3), Sorbonne Université, AP-HP, Hôpital Saint Antoine, Paris, France
| | - Mohamad Mohty
- Sorbonne Université, INSERM UMR938, Centre de Recherche Saint-Antoine (CRSA), 75012, Paris, France.,Service d'Hématologie Clinique et de Thérapie Cellulaire, Sorbonne Université, AP-HP, Hôpital Saint Antoine, Paris, France
| | - Béatrice Gaugler
- Sorbonne Université, INSERM UMR938, Centre de Recherche Saint-Antoine (CRSA), 75012, Paris, France.,Service d'Hématologie Clinique et de Thérapie Cellulaire, Sorbonne Université, AP-HP, Hôpital Saint Antoine, Paris, France
| | - Arsène Mekinian
- Sorbonne Université, INSERM UMR938, Centre de Recherche Saint-Antoine (CRSA), 75012, Paris, France.,Service de Médecine Interne et Inflammation-Immunopathology-Biotherapy Department (DMU i3), Sorbonne Université, AP-HP, Hôpital Saint Antoine, Paris, France
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10
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Le TTT, Martinent G, Dupuis-Girod S, Parrot A, Contis A, Riviere S, Chinet T, Grobost V, Espitia O, Dussardier-Gilbert B, Alric L, Armengol G, Maillard H, Leguy-Seguin V, Leroy S, Rondeau-Lutz M, Lavigne C, Mohamed S, Chaussavoine L, Magro P, Seguier J, Kerjouan M, Fourdrinoy S. Development and validation of a quality of life measurement scale specific to hereditary hemorrhagic telangiectasia: the QoL-HHT. Orphanet J Rare Dis 2022; 17:281. [PMID: 35854330 PMCID: PMC9295423 DOI: 10.1186/s13023-022-02426-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Accepted: 06/30/2022] [Indexed: 12/01/2022] Open
Abstract
Background Hereditary hemorrhagic telangiectasia (HHT) disease is a rare genetic disorder with symptoms and complications that can significantly affect patients’ daily lives. To date, no scale has been validated to assess the specific symptoms of this disease on the quality of life (QOL) of HHT patients. This makes it difficult for clinicians to accurately measure the quality of life of patients with HHT. The present study aims to develop and validate a QOL measurement tool specific to HHT disease: the QOL questionnaire in HHT (QoL-HHT). Methods A quantitative, non-interventional, multi-center study involving HHT patients in twenty French HHT expert centers was conducted. A calibration sample of 415 HHT patients and a validation sample of 228 HHT patients voluntarily participated in the study. Data were analyzed using exploratory factor analysis (EFA), confirmatory factor analysis (CFA), Exploratory Structural Equation Modeling (ESEM) analyses, reliability analyses, and correlational analyses. Results The EFA, CFA and ESEM results allowed us to provide evidence of the factorial structure of a questionnaire composed of 24 items measuring 6 domains of QOL: Physical limitations, social relationships, concern about bleeding, relationship with the medical profession, experience of symptoms, and concern about the evolution of the disease. Cronbach’s alpha coefficients (> 0.70) demonstrated reliable internal consistency of all the QoL-HHT scores (dimensions). The results of the test–retest provided further evidence of the reliability of the QOL-HHT scores over time. Correlational analyses provided evidence for the convergent validity of the QoL-HHT scores. Conclusions We developed a simple and quick self-assessment tool to measure quality of life specific to HHT disease. This study demonstrated reliability and validity of our QoL-HHT scores. It is a very promising tool to evaluate the impact of HHT disease on all aspects of the quality of life of HHT patients in order to offer them individualized medico-psycho-social support. Trial registration: ClinicalTrials, NCT03695874. Registered 04 October 2018, https://www.clinicaltrials.gov/ct2/show/NCT03695874 Supplementary Information The online version contains supplementary material available at 10.1186/s13023-022-02426-2.
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Affiliation(s)
- Thi Thao Truc Le
- Laboratoire de Psychologie sur les Dynamiques Relationnelles et Processus Identitaires (EA 7458), Université de Bourgogne-Franche-Comté, 3 Allée des Stades Universitaires, 21000, Dijon, France
| | - Guillaume Martinent
- Laboratoire sur les Vulnérabilités et l'Innovation dans le Sport (EA 7428), Université de Lyon, Université Claude Bernard Lyon 1, 27-29 bd du 11 Novembre 1918, 69622, Villeurbanne, France
| | - Sophie Dupuis-Girod
- Service de génétique clinique, Centre de Référence pour la Maladie de Rendu-Osler, Hospices Civils de Lyon, HFME Bâtiment A1, 59 bd Pinel, 69677, Bron Cedex, France
| | - Antoine Parrot
- Service de pneumologie, Hôpital Tenon, Assistance Publique-Hôpitaux de Paris, 4 rue de Chine, 75790, Paris Cedex 20, France
| | - Anne Contis
- Service de médecine interne, Hôpital Saint André, 1 rue Jean Burguet, 33000, Bordeaux, France
| | - Sophie Riviere
- Service de médecine interne, CHU de Montpellier Hôpital St Eloi, Avenue A. Fliche, 34295, Montpellier Cedex 5, France
| | - Thierry Chinet
- Consultation Maladie de Rendu-Osler, CHU Ambroise Paré, 9 av Charles de Gaulle, 92104, Boulogne Billancourt, France
| | - Vincent Grobost
- Service de médecine interne, CHU Estaing, 1 rue Lucie et Raymond Aubrac, 63100, Clermont-Ferrand, France
| | - Olivier Espitia
- Service de médecine interne - médecine vasculaire, CHU de Nantes, 1 place Alexis Ricordeau, 44093, Nantes, France
| | | | - Laurent Alric
- Service de médecine interne, CHU Rangueil, 1 av du Pr Jean Poulhès, 31059, Toulouse Cedex 9, France
| | - Guillaume Armengol
- Service de médecine interne, CHU de Rouen Ch. Nicolle, , 1 rue de Germont, 76031, Rouen Cedex, France
| | - Hélène Maillard
- Service de médecine interne, Hôpital Huriez, 1 rue Michel Polonovski, 59037, LILLE Cedex, France
| | - Vanessa Leguy-Seguin
- Service de médecine interne, Hôpital Le Bocage, 2 Bd Maréchal de Lattre de Tassigny, BP 77908, 21079, Dijon Cedex, France
| | - Sylvie Leroy
- Service de pneumologie, CHU de Nice, 30 av de la Voie Romaine, 06002, Nice Cedex, France
| | - Murielle Rondeau-Lutz
- Service de médecine interne, CHU de Strasbourg Nouvel Hôpital Civil, 1 place de l'Hôpital, 67000, Strasbourg, France
| | - Christian Lavigne
- Service de médecine interne, CHU d'Angers, 4 rue Larrey, 49933, Angers Cedex 09, France
| | - Shirine Mohamed
- Service de médecine interne, CHU de Nancy, Hôpital Brabois, Rue du Morvan, 54511, Vandoeuvre Les Nancy, France
| | - Laurent Chaussavoine
- Service de médecine vasculaire, CHU de Caen, Avenue de la Côte de Nacre, 14000, Caen, France
| | - Pascal Magro
- Service de pneumologie, CHRU de Tours Hôpital Bretonneau, 2 bd Tonnellé, 37044, Tours Cedex 9, France
| | - Julie Seguier
- Service de médecine interne, Hôpital de La Timone, 264 rue Saint Pierre, 13385, Marseille Cedex 05, France
| | - Mallorie Kerjouan
- Service de pneumologie, CHU de Rennes Hôpital Pontchaillou, 2 rue Henri Le Guilloux, 35033, Rennes Cedex 09, France
| | - Sylvie Fourdrinoy
- Service de génétique clinique, Centre de Référence pour la Maladie de Rendu-Osler, Hospices Civils de Lyon, HFME Bâtiment A1, 59 bd Pinel, 69677, Bron Cedex, France.
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11
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Khitri MY, Guedon AF, Georgin-Lavialle S, Terrier B, Saadoun D, Seguier J, le Besnerais M, De Moreuil C, Denis G, Gerfaud-Valentin M, Allain JS, Maria A, Bouillet L, Grobost V, Galland J, Kosmider O, Dumont A, Devaux M, Subran B, Schmidt J, Marianetti-Guingel P, Audia S, Palat S, Roux-Sauvat M, Jachiet V, Hirsch P, Fain O, Mekinian A. Comparison between idiopathic and VEXAS-relapsing polychondritis: analysis of a French case series of 95 patients. RMD Open 2022; 8:rmdopen-2022-002255. [PMID: 35868738 PMCID: PMC9315905 DOI: 10.1136/rmdopen-2022-002255] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Accepted: 04/25/2022] [Indexed: 12/02/2022] Open
Abstract
Objective A new adult-onset autoinflammatory syndrome has been described, named VEXAS (Vacuoles, E1 Enzyme, X-linked, Autoinflammatory, Somatic). We aimed to compare the clinical characteristics, the laboratory features and the outcomes between idiopathic-relapsing polychondritis (I-RP) and VEXAS-relapsing polychondritis (VEXAS-RP). Methods Patients from French retrospective multicentre cohort of RP were separated into two groups: a VEXAS-RP and an I-RP. Results Compared with patients with I-RP (n=40), patients with VEXAS-RP (n=55) were men (96% vs 30%, p<0.001) and were older at diagnosis (66 vs 44 years, p<0.001). They had a greater prevalence of fever (60% vs 10%, p<0.001), of skin lesions (82% vs 20%, p<0.001), of ocular involvement (57% vs 28%, p=0.01), of pulmonary infiltrates (46% vs 0%, p<0.001), of heart involvement (11% vs 0%, p=0.0336) and with higher median C-reactive protein levels (64 mg/L vs 10 mg/L, p<0.001). Seventy-five per cent of the patients with VEXAS-RP had myelodysplastic syndrome (MDS) versus none in I-RP group. The glucocorticoids use, and the number of steroid sparing agents were similar in both groups, but patients with VEXAS-RP had more frequent refractory disease (remission obtained in 27% vs 90%, p<0001). VEXAS-RP was associated with higher risk of death: six patients (11%) died in the VEXAS-RP group after a median follow-up of 37 months and none in the I-RP group after a median follow-up of 92 months (p<0.05). Conclusion We report the largest cohort of VEXAS-RP, characterised by high prevalence of male sex, fever, skin lesion, ocular involvement, pulmonary infiltration, heart involvement, older age and MDS association.
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Affiliation(s)
| | - Alexis F Guedon
- Pierre Louis Epidemiology and Public Health Research Institute, Paris, Île-de-France, France
| | | | | | - David Saadoun
- Hopital Universitaire Pitie Salpetriere, Paris, Île-de-France, France
| | - Julie Seguier
- Hospital Timone, Marseille, Provence-Alpes-Côte d'Azu, France
| | | | | | - Guillaume Denis
- Centre Hospitalier de Rochefort, Rochefort, Nouvelle-Aquitaine, France
| | | | | | | | - Laurence Bouillet
- Internal Medicine, Centre Hospitalier Universitaire Grenoble, Michallon Hospital, Grenoble, France
| | | | - Joris Galland
- Hospital Centre Fleyriat de Bourg-en-Bresse, Bourg-en-Bresse, Rhône-Alpes, France
| | - Olivier Kosmider
- Service d'Hématologie Biologique, DMU BioPhyGen, APHP, Paris, Île-de-France, France
| | | | - Mathilde Devaux
- Intermunicipal Hospital Centre Poissy-Saint-Germain-en-Laye Poissy Site, Poissy, Île-de-France, France
| | - Benjamin Subran
- Hôpital de la Croix Saint-Simon, Paris, Île-de-France, France
| | - Jean Schmidt
- Internal Medicine, Amiens University Hospital, Amiens, France
| | | | | | | | - Marielle Roux-Sauvat
- Service de médecine interne, Pierre Oudot Hospital of Bourgoin-Jallieu, Bourgoin-Jallieu, Rhône-Alpes, France
| | - Vincent Jachiet
- Hopital Saint-Antoine Service de Medecine Interne, Paris, Île-de-France, France
| | - Pierre Hirsch
- service d'hématologie biologique, Hôpital Saint-Antoine, Paris, Île-de-France, France
| | - Olivier Fain
- Hopital Saint-Antoine Service de Medecine Interne, Paris, Île-de-France, France
| | - Arsène Mekinian
- Service de Médecine Interne, DHUi2B, Hôpital Saint-Antoine, Paris, Île-de-France, France
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Poli A, Schmitt C, Moulouel B, Mirmiran A, Talbi N, Rivière S, Cerutti D, Bouchoule I, Faivre A, Grobost V, Douillard C, Duchêne F, Fiorentino V, Dupré T, Manceau H, Peoc'h K, Puy H, Lefebvre T, Gouya L. Givosiran in acute intermittent porphyria: A personalized medicine approach. Mol Genet Metab 2022; 135:206-214. [PMID: 35058124 DOI: 10.1016/j.ymgme.2022.01.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Revised: 11/30/2021] [Accepted: 01/07/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND In patients with acute intermittent porphyria (AIP), induction of delta aminolevulinic acid synthase 1 (ALAS1) leads to haem precursor accumulation that may cause recurring acute attacks. In a recent phase III trial, givosiran significantly reduced the attack rate in severe AIP patients. Frequent adverse events were injection-site reaction, fatigue, nausea, chronic kidney disease and increased alanine aminotransferase. OBJECTIVES To describe the efficacy and safety of givosiran based on a personalized medical approach. METHODS We conducted a retrospective patient file study in 25 severe AIP patients treated with givosiran in France. We collected data on clinical and biochemical efficacy along with reports of adverse events. RESULTS Givosiran drastically reduced the attack rate in our cohort, as 96% were attack-free at the time of the study. The sustained efficacy of givosiran in most patients allowed us to personalize dosing frequency. In 42%, givosiran was only given when haem precursor levels were increasing. Our data suggest that givosiran is most effective when given early in the disease course. We confirmed a high prevalence of adverse events. One patient discontinued treatment due to acute pancreatitis. All patients had hyperhomocysteinemia, and all patients with initial homocysteine levels available showed an increase under treatment. In this context, one patient was diagnosed with pulmonary embolism. CONCLUSION The sustained effect of givosiran allowed a decrease in dosing frequency without compromising treatment efficacy. The high prevalence of adverse events emphasizes the importance of restricting the treatment to severe AIP and administering the minimum effective dose for each patient.
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Affiliation(s)
- Antoine Poli
- Université de Paris, INSERM U1149, Centre de Recherche sur l’Inflammation, F-75018 Paris, France
- AP-HP, Centre Français des Porphyries, Hôpital Louis Mourier, Colombes, France
- Laboratory of Excellence Gr-Ex, Paris
| | - Caroline Schmitt
- Université de Paris, INSERM U1149, Centre de Recherche sur l’Inflammation, F-75018 Paris, France
- AP-HP, Centre Français des Porphyries, Hôpital Louis Mourier, Colombes, France
- Laboratory of Excellence Gr-Ex, Paris
| | - Boualem Moulouel
- AP-HP, Centre Français des Porphyries, Hôpital Louis Mourier, Colombes, France
| | - Arienne Mirmiran
- AP-HP, Centre Français des Porphyries, Hôpital Louis Mourier, Colombes, France
| | - Neila Talbi
- AP-HP, Centre Français des Porphyries, Hôpital Louis Mourier, Colombes, France
| | - Sophie Rivière
- CHU Montpellier, Médecine interne, Hôpital St Eloi, Montpellier, France
| | - Diane Cerutti
- CH Toulon, Médecine polyvalente, La Seyne-sur-Mer, France
| | - Isabelle Bouchoule
- CHI Elbeuf Louviers Val de Reuil, Néphrologie, Saint-Aubin-lès-Elbeuf, France
| | | | | | - Claire Douillard
- CHRU Lille, Endocrinologie-diabétologie-métabolisme-nutrition, hôpital Huriez, Lille, France
| | - Francis Duchêne
- Hôpital Nord Franche-Comté, Médecine interne, Trévenans, France
| | - Valeria Fiorentino
- Université de Paris, INSERM U1149, Centre de Recherche sur l’Inflammation, F-75018 Paris, France
| | - Thierry Dupré
- Université de Paris, INSERM U1149, Centre de Recherche sur l’Inflammation, F-75018 Paris, France
| | - Hana Manceau
- Université de Paris, INSERM U1149, Centre de Recherche sur l’Inflammation, F-75018 Paris, France
- AP-HP, Biochimie, Hôpital Beaujon, Clichy, France
| | - Katell Peoc'h
- Université de Paris, INSERM U1149, Centre de Recherche sur l’Inflammation, F-75018 Paris, France
- AP-HP, Biochimie, Hôpital Beaujon, Clichy, France
| | - Hervé Puy
- Université de Paris, INSERM U1149, Centre de Recherche sur l’Inflammation, F-75018 Paris, France
- AP-HP, Centre Français des Porphyries, Hôpital Louis Mourier, Colombes, France
- Laboratory of Excellence Gr-Ex, Paris
| | - Thibaud Lefebvre
- Université de Paris, INSERM U1149, Centre de Recherche sur l’Inflammation, F-75018 Paris, France
- AP-HP, Centre Français des Porphyries, Hôpital Louis Mourier, Colombes, France
| | - Laurent Gouya
- Université de Paris, INSERM U1149, Centre de Recherche sur l’Inflammation, F-75018 Paris, France
- AP-HP, Centre Français des Porphyries, Hôpital Louis Mourier, Colombes, France
- Laboratory of Excellence Gr-Ex, Paris
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Clément M, Ruivard M, Rieu V, Denis L, Grobost V, Le Guenno G. Tolérance de l’association méthotrexate et sulfaméthoxazole-triméthoprime faible dose en médecine interne : à propos de 30 patients. Rev Med Interne 2021. [DOI: 10.1016/j.revmed.2021.10.294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Khitri M, Georgin-Lavialle S, Terrier B, Saadoun D, Piette J, Seguier J, Le Bernerais M, De Moreuil C, Fain O, Denis G, Gerfaud-Valentin M, Grobost V, Alexandre M, Laurence B, Galland J, Dumont A, Devaux M, Hirsch P, Jachiet V, Mekinian A. Comparaison entre Polychondrite atrophiante idiopathique et polychondrite atrophiante associée au VEXAS syndrome : analyse d’une série française de 89 patients. Rev Med Interne 2021. [DOI: 10.1016/j.revmed.2021.10.251] [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: 11/27/2022]
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Glatre A, Mahévas T, Jaccard C, Moulis G, Chasset F, Senet P, Pillebout E, Puéchal X, Durel C, Audemard-Verger A, Grobost V, Jachiet M, Terrier B. Traitement des vascularites à IgA cutanées réfractaires ou récidivantes chez l’adulte. Rev Med Interne 2021. [DOI: 10.1016/j.revmed.2021.10.302] [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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Stievenart J, Le Guenno G, Ruivard M, Rieu V, André M, Grobost V. Cardiac sarcoidosis: systematic review of literature on corticosteroid and immunosuppressive therapies. Eur Respir J 2021; 59:13993003.00449-2021. [PMID: 34531273 PMCID: PMC9068974 DOI: 10.1183/13993003.00449-2021] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [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: 02/12/2021] [Accepted: 08/26/2021] [Indexed: 11/26/2022]
Abstract
Background Cardiac sarcoidosis (CS) is a life-threatening condition in which clear recommendations are lacking. We aimed to systematically review the literature on cardiac sarcoidosis treated by corticosteroids and/or immunosuppressive agents in order to update the management of CS. Methods Using PubMed, Embase and Cochrane Library databases, we found original articles on corticosteroid and standard immunosuppressive therapies for CS that provided at least a fair Scottish Intercollegiate Guidelines Network (SIGN) overall assessment of quality and we analysed the relapse rate, major cardiac adverse events (MACEs) and adverse events. We based our methods on the PRISMA statement and checklist. Results We retrieved 21 studies. Mean quality provided by SIGN assessment was 6.8 out of 14 (range 5–9). Corticosteroids appeared to have a positive impact on left ventricular function, atrioventricular block and ventricular arrhythmias. For corticosteroids alone, nine studies (45%, n=351) provided data on relapses, representing an incidence of 34% (n=119). Three studies (14%, n=73) provided data on MACEs (n=33), representing 45% of MACEs in patients treated by corticosteroid alone. Nine studies provided data on adjunctive immunosuppressive therapy, of which four studies (n=78) provided data on CS relapse, representing an incidence of 33% (n=26). Limitations consisted of no randomised control trial retrieved and unclear data on MACEs in patients treated by combined immunosuppressive agents and corticosteroids. Conclusion Corticosteroids should be started early after diagnosis but the exact scheme is still unclear. Studies concerning adjunctive conventional immunosuppressive therapies are lacking and benefits of adjunctive immunosuppressive therapies are unclear. Homogenous data on CS long-term outcomes under corticosteroids, immunosuppressive therapies and other adjunctive therapies are lacking. Corticosteroids are the mainstay treatment for cardiac sarcoidosis. Conventional immunosuppressive agents might be of interest at diagnosis. Cohort studies are clearly heterogeneous. Large cohort and prospective studies using “strong” end-points are lacking.https://bit.ly/3t9Rv8O
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Affiliation(s)
- Julien Stievenart
- Internal Medicine Department, Clermont-Ferrand University Hospital, 58 Avenue Montalembert, Clermont-Ferrand, France
| | - Guillaume Le Guenno
- Internal Medicine Department, Clermont-Ferrand University Hospital, 1 Rue Lucie et Raymond Aubrac, Clermont-Ferrand, France
| | - Marc Ruivard
- Internal Medicine Department, Clermont-Ferrand University Hospital, 1 Rue Lucie et Raymond Aubrac, Clermont-Ferrand, France
| | - Virginie Rieu
- Internal Medicine Department, Clermont-Ferrand University Hospital, 1 Rue Lucie et Raymond Aubrac, Clermont-Ferrand, France
| | - Marc André
- Internal Medicine Department, Clermont-Ferrand University Hospital, 58 Avenue Montalembert, Clermont-Ferrand, France.,Université Clermont Auvergne, Clermont-Ferrand University Hospital, 58 Avenue Montalembert, Inserm U1071, INRA USC2018, M2iSH, Clermont-Ferrand, France
| | - Vincent Grobost
- Internal Medicine Department, Clermont-Ferrand University Hospital, 1 Rue Lucie et Raymond Aubrac, Clermont-Ferrand, France
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Stievenart J, Le Guenno G, Ruivard M, Rieu V, André M, Grobost V. Case Report: TNFα Antagonists Are an Effective Therapy in Cardiac Sarcoidosis. Front Cardiovasc Med 2021; 8:676407. [PMID: 34179141 PMCID: PMC8226185 DOI: 10.3389/fcvm.2021.676407] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Accepted: 04/27/2021] [Indexed: 12/19/2022] Open
Abstract
Introduction: Cardiac sarcoidosis (CS) is a life-threatening disease in which clear recommendations are lacking. We report a case series of CS successfully treated by tumor necrosis factor (TNF)α antagonists. Methods: We conducted a single-center retrospective study of our patients with CS treated by TNFα antagonists. Results: Four cases (4/84, 4.7%) were found in our database. Mean age was 40 years (range 34–53 years), and all were Caucasian men. Mean follow-up was 54.75 months (range 25–115 months). All patients received corticosteroid therapy (CT) and immunosuppressive therapy (IT). TNFα antagonists (infliximab or adalimumab) were started after the first or second CS relapse under CT and IT. One patient experienced relapse under TNFα antagonists (isolated decreased left ventricular ejection) and responded to a shorter interval of TNFα antagonist infusion. CT was discontinued in three patients treated with TNFα antagonists without relapse or major cardiac events during follow-up. No serious adverse event occurred in our case series, possibly due to dose sparing and frequent arrest of CT. Conclusion: TNFα antagonists were effective in refractory and/or relapsing CS treated by corticosteroids and/or immunosuppressive agents, without serious adverse events, and should be considered earlier in CS treatment scheme.
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Affiliation(s)
- Julien Stievenart
- Internal Medicine Department, Clermont-Ferrand University Hospital, Clermont-Ferrand, France
| | - Guillaume Le Guenno
- Internal Medicine Department, Clermont-Ferrand University Hospital, Clermont-Ferrand, France
| | - Marc Ruivard
- Internal Medicine Department, Clermont-Ferrand University Hospital, Clermont-Ferrand, France
| | - Virginie Rieu
- Internal Medicine Department, Clermont-Ferrand University Hospital, Clermont-Ferrand, France
| | - Marc André
- Internal Medicine Department, Clermont-Ferrand University Hospital, Clermont-Ferrand, France.,Université Clermont Auvergne, Clermont-Ferrand University Hospital, Inserm U1071, INRA USC2018, M2iSH, Clermont-Ferrand, France
| | - Vincent Grobost
- Internal Medicine Department, Clermont-Ferrand University Hospital, Clermont-Ferrand, France
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Péan de Ponfilly-Sotier M, Jachiet V, Benhamou Y, Lahuna C, De Renzis B, Kottler D, Voillat L, Dimicoli-Salazar S, Banos A, Chauveheid MP, Alexandra JF, Grignano E, Liferman F, Laborde M, Broner J, Michel M, Lambotte O, Laribi K, Venon MD, Dussol B, Martis N, Thepot S, Park S, Couret D, Roux-Sauvat M, Terriou L, Hachulla E, Bally C, Galland J, Allain JS, Parcelier A, Peterlin P, Cohen-Bittan J, Regent A, Ackermann F, Le Guen J, Algrin C, Charles P, Daguindau E, Puechal X, Dunogue B, Blanchard-Delaunay C, Beyne-Rauzy O, Grobost V, Schmidt J, Le Gallou T, Dubos-Lascu G, Sonet A, Denis G, Roy-Peaud F, Fenaux P, Adès L, Fain O, Mekinian A. Venous thromboembolism during systemic inflammatory and autoimmune diseases associated with myelodysplastic syndromes, chronic myelomonocytic leukaemia and myelodysplastic/myeloproliferative neoplasms: a French multicentre retrospective case-control study. Clin Exp Rheumatol 2021; 40:1336-1342. [DOI: 10.55563/clinexprheumatol/nbn38d] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Accepted: 07/19/2021] [Indexed: 11/13/2022]
Affiliation(s)
- Marie Péan de Ponfilly-Sotier
- Sorbonne Université, AP-HP, Hôpital Saint-Antoine, Service de Médecine Interne and Inflammation-Immunopathology-Biotherapy Department (DMU 3iD), Paris, France
| | - Vincent Jachiet
- Sorbonne Université, AP-HP, Hôpital Saint-Antoine, Service de Médecine Interne and Inflammation-Immunopathology-Biotherapy Department (DMU 3iD), Paris, France
| | - Ygal Benhamou
- Normandie Université, UNIROUEN, Service de Médecine Interne, INSERM U1096, Rouen, France
| | - Constance Lahuna
- Sorbonne Université, AP-HP, Hôpital Saint-Antoine, Service de Médecine Interne and Inflammation-Immunopathology-Biotherapy Department (DMU 3iD), Paris, France
| | - Benoit De Renzis
- CHU de Clermont-Ferrand, Service d’Hématologie, Clermont-Ferrand, France
| | - Diane Kottler
- CHU Bichat APHP, Service de Dermatologie, Paris, France
| | - Laurent Voillat
- CH Chalon sur Saône, service d’Hématologie-Oncologie, Chalon sur Saône, France
| | | | - Anne Banos
- CH de la Côte Basque, Service d’Hématologie, Bayonne, France
| | | | | | | | | | | | | | - Marc Michel
- CHU Henri Mondor APHP, Service de Médecine Interne, Créteil, France
| | - Olivier Lambotte
- Paris Saclay Université, CHU Kremlin-Bicêtre, Service de Médecine Interne, Le Kremlin Bicêtre, France
| | - Kamel Laribi
- CH Le Mans, Service d’Hématologie, Le Mans, France
| | | | - Bertrand Dussol
- CHU Hôpital de la Conception APHM, Service de Néphrologie, Marseille, France
| | - Nihal Martis
- CHU de Nice Côte d’Azur, Service de Médecine Interne, Nice, France
| | | | - Sophie Park
- CHU Grenoble, Service d’Hématologie, Grenoble, France
| | - David Couret
- CH de Cornouailles Quimper Concarneau, Service de Médecine Interne-Maladies Infectieuses, Maladies du Sang, Quimper, France
| | - Marielle Roux-Sauvat
- CH Pierre-Oudot Groupe Hospitalier Nord Dauphiné, Service de Médecine Interne, Bourgoin-Jallieu, France
| | - Louis Terriou
- Université de Lille, Hôpital Claude Huriez, Service de Médecine Interne et Immunologie Clinique, Lille, France
| | - Eric Hachulla
- Université de Lille, Hôpital Claude Huriez, Service de Médecine Interne et Immunologie Clinique, Lille, France
| | - Cécile Bally
- CHU Necker-Enfants Malades APHP, Service d’Hématologie Adultes, Paris, France
| | - Joris Galland
- CH Bourg-En-Bresse, Service Médecine Interne, Bourg-En-Bresse, France
| | - Jean-Sébastien Allain
- CHU Rennes, Service de Médecine Interne et Immunologie Clinique, Inserm, CIC 1414, Rennes, France
| | - Anne Parcelier
- CHU de Nantes, Service d’Hématologie Clinique, Nantes, France
| | - Pierre Peterlin
- CHU de Nantes, Service d’Hématologie Clinique, Nantes, France
| | | | | | | | - Julien Le Guen
- CHU Hôpital Européen Georges Pompidou APHP, Service de Gériatrie, Paris, France
| | - Caroline Algrin
- Institut de Cancérologie Daniel Hollard Groupe Hospitalier Mutualiste de Grenoble, Service d’Oncologie, Grenoble, France
| | - Pierre Charles
- Institut Mutualiste Montsouris, Service de Médecine Interne, Paris, France
| | | | | | | | | | - Odile Beyne-Rauzy
- Institut Universitaire du Cancer de Toulouse, Service de Médecine Interne et Immunopathologie Clinique, Toulouse, France
| | - Vincent Grobost
- CHU Estaing de Clermont-Ferrand, Service de Médecine Interne, Clermond-Ferrand, France
| | - Jean Schmidt
- CHU Amiens Nord, Service de Médecine Interne, Amiens, France
| | - Thomas Le Gallou
- CHU Rennes, Service de Médecine Interne et Immunologie Clinique, Inserm, CIC 1414, Rennes, France
| | | | - Anne Sonet
- CHU UCL Namur-Site Godinne, Service d’Hématologie, Yvoir, Belgium
| | - Guillaume Denis
- CH de la Rochelle, Service de Médecine Interne et Hématologie, La Rochelle, France
| | - Frédérique Roy-Peaud
- CHU de Poitiers, Service de Médecine Interne-Maladies infectieuses et Tropicales, Poitiers, France
| | - Pierre Fenaux
- CHU Saint-Louis APHP, Service d’Hématologie Clinique, Université Paris VII, Paris, France
| | - Lionel Adès
- CHU Saint-Louis APHP, Service d’Hématologie Clinique, Université Paris VII, Paris, France
| | - Olivier Fain
- Sorbonne Université, AP-HP, Hôpital Saint-Antoine, Service de Médecine Interne and Inflammation-Immunopathology-Biotherapy Department (DMU 3iD), Paris, France
| | - Arsène Mekinian
- Sorbonne Université, AP-HP, Hôpital Saint-Antoine, Service de Médecine Interne and Inflammation-Immunopathology-Biotherapy Department (DMU 3iD), Paris, France.
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Lobbes H, Dervout C, Toussirot E, Felten R, Sibilia J, Wendling D, Gombert B, Ruivard M, Grobost V, Saraux A, Cornec D, Verhoeven F, Soubrier M. Utilisation du rituximab dans la leucémie à grands lymphocytes à grains associée à la polyarthrite rhumatoïde: étude rétrospective multicentrique. Rev Med Interne 2020. [DOI: 10.1016/j.revmed.2020.10.116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Trefond L, Rieu V, Grobost V, Resseguier AS, Lemaire A, Le Guenno G, Ruivard M. Des paupières lourdes. Rev Med Interne 2020; 41:569-570. [DOI: 10.1016/j.revmed.2020.04.013] [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] [Received: 12/28/2019] [Revised: 02/10/2020] [Accepted: 04/05/2020] [Indexed: 10/23/2022]
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Devers É, Courouge-Dorcier D, Arpajou G, Chevenet C, Chevaleyre A, Grobost V, D'incan M. Ischaemic skin lesions with multi-organ failure due to cocaine intake. Eur J Dermatol 2020; 30:ejd.2020.3703. [PMID: 32229431 DOI: 10.1684/ejd.2020.3703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Affiliation(s)
- Élodie Devers
- Department of Dermatology, CHU Clermont-Ferrand, Clermont-Ferrand
| | | | - Gauthier Arpajou
- Department of Reanimation, University Clermont-Auvergne, CHU Clermont-Ferrand, Clermont-Ferrand
| | - Carole Chevenet
- Department of Anatomopathology, University Clermont-Auvergne, CHU Clermont-Ferrand, Clermont-Ferrand
| | | | - Vincent Grobost
- Department of Internal medicine, University Clermont-Auvergne, CHU Clermont-Ferrand, Clermont-Ferrand
| | - Michel D'incan
- Department of Dermatology, University Clermont-Auvergne, CHU Clermont-Ferrand, Clermont-Ferrand, France
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Buvry C, Cassagnes L, Tekath M, Artigues M, Pereira B, Rieu V, Le Guenno G, Tournadre A, Ruivard M, Grobost V. Anti-Ro52 antibodies are a risk factor for interstitial lung disease in primary Sjögren syndrome. Respir Med 2020; 163:105895. [DOI: 10.1016/j.rmed.2020.105895] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2019] [Revised: 12/16/2019] [Accepted: 02/05/2020] [Indexed: 01/22/2023]
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Delaval L, Daumas A, Samson M, Ebbo M, De Boysson H, Liozon E, Dupuy H, Puyade M, Blockmans D, Benhamou Y, Sacré K, Berezne A, Devilliers H, Pugnet G, Maurier F, Zénone T, de Moreuil C, Lifermann F, Arnaud L, Espitia O, Deroux A, Grobost V, Lazaro E, Agard C, Balageas A, Bouiller K, Durel CA, Humbert S, Rieu V, Roriz M, Souchaud-Debouverie O, Vinzio S, Nguyen Y, Régent A, Guillevin L, Terrier B. Large-vessel vasculitis diagnosed between 50 and 60 years: Case-control study based on 183 cases and 183 controls aged over 60 years. Autoimmun Rev 2019; 18:714-720. [PMID: 31059846 DOI: 10.1016/j.autrev.2019.05.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [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: 02/11/2019] [Accepted: 02/16/2019] [Indexed: 12/18/2022]
Abstract
BACKGROUND Age at onset of large-vessel vasculitis (LVV) is commonly used to distinguish giant cell arteritis (GCA) and Takayasu arteritis (TA). However, LVV between age 50 and 60 years may be difficult to classify. METHODS We conducted a retrospective study including LVV aged between 50 and 60 years at onset (LVV50-60, cases) and compared them to LVV aged over 60 years (LVV>60, controls). LVV was defined histologically and/or morphologically. Controls fulfilled ACR 1990 criteria for GCA or presented isolated aortitis. RESULTS We included 183 LVV50-60 and 183 gender-matched LVV>60. LVV50-60 had more frequent peripheral limb manifestations (23 vs. 5%), and less frequent cephalic (73 vs. 90%) and ocular signs (17 vs. 27%) than LVV>60. Compared to LVV>60, CT angiography and PET/CT scan were more frequently abnormal in LVV50-60 (74 vs. 38%, and 90 vs. 72%, respectively), with aorta being more frequently involved (78 vs. 47%). By multivariate analysis, absence of cephalic symptoms, presence of peripheral limb ischemia and aorta involvement, and increased CRP level were significantly associated with LVV50-60 presentation compared to LVV>60. At last follow-up, compared to LVV>60, LVV50-60 received significantly more lines of treatment (2 vs. 1), more frequent biologics (12 vs. 3%), had more surgery (10 vs. 0%), and had higher prednisone dose (8.8 vs. 6.5 mg/d) at last follow-up, CONCLUSION: LVV onset between 50 and 60 years identifies a subset of patients with more frequent aorta and peripheral vascular involvement and more refractory disease compared to patients with LVV onset after 60.
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Affiliation(s)
- Laure Delaval
- National Referral Center for Rare Autoimmune and Systemic Diseases, Hopital Cochin, AP-HP, Université Paris Descartes, Paris, France
| | - Aurélie Daumas
- Department of Internal Medecine, La Timone University Hospital, Marseille, France
| | - Maxime Samson
- Department of Internal Medicine and Clinical Immunology, Dijon University Hospital, Dijon, France
| | - Mikael Ebbo
- Department of Internal Medecine, La Timone University Hospital, Marseille, France
| | - Hubert De Boysson
- Department of Internal Medecine, Caen University Hospital, University of Caen-Basse Normandie, France
| | - Eric Liozon
- Department of Internal Medecine, Limoges University Hospital, France
| | - Henry Dupuy
- Department of Internal Medicine, Haut-Lévêque Hospital, Pessac, France
| | - Mathieu Puyade
- Department of Internal Medicine, University Hospital of Poitiers, Poitiers, France
| | - Daniel Blockmans
- Clinical department of general internal medicine department, University Hospitals Leuven, Belgium
| | - Ygal Benhamou
- Department of Internal Medecine, 1 rue de Germont, Rouen, France
| | - Karim Sacré
- Department of Internal Medecine, Bichat Hospital, Paris, France
| | - Alice Berezne
- Department of Internal Medecine, CHR Annecy-Genevois, Annecy, France
| | - Hervé Devilliers
- Department of Internal Medicine and Systemic Diseases, CHU Dijon Bourgogne, Inserm CIC 1432, Clinical Epidemiology Unit, Dijon, France
| | - Grégory Pugnet
- Department of Internal Medecine, CHU de Toulouse, UMR 1027 Inserm-Université de Toulouse, France
| | - François Maurier
- Department of Internal Medicine, Hôpital Belle Isle, Metz, France
| | - Thierry Zénone
- Internal Medicine Department, Valence Hospital, Valence, France
| | - Claire de Moreuil
- Department of Internal Medecine and pneumology, CHU Brest, La Cavale Blanche Hospital, Brest Cedex, France
| | | | - Laurent Arnaud
- Department of Rheumatology, CHU Strasbourg, INSERM UMR-S1109, RESO, Strasbourg University, F-67000 Strasbourg, France
| | - Olivier Espitia
- Department of Internal Medicine, Nantes University Hospital, Nantes, France
| | - Alban Deroux
- Grenoble University Hospital, Division of Internal Medicine, Grenoble F-38043, France
| | - Vincent Grobost
- Internal Medicine Department, University Hospital, Clermont-Ferrand, France
| | - Estibaliz Lazaro
- Department of Internal Medicine, Haut-Lévêque Hospital, Pessac, France
| | - Christian Agard
- Department of Internal Medicine, Nantes University Hospital, Nantes, France
| | | | - Kevin Bouiller
- Department of internal medicine, CHU Jean Minjoz, Besancon, France
| | | | | | - Virginie Rieu
- Internal Medicine Department, University Hospital, Clermont-Ferrand, France
| | - Mélanie Roriz
- Department of Internal Medicine, Hôpital Lariboisière, Paris, France
| | | | - Stéphane Vinzio
- Department of Internal Medicine Groupe Hospitalier Mutualiste of Grenoble, Grenoble, France
| | - Yann Nguyen
- National Referral Center for Rare Autoimmune and Systemic Diseases, Hopital Cochin, AP-HP, Université Paris Descartes, Paris, France
| | - Alexis Régent
- National Referral Center for Rare Autoimmune and Systemic Diseases, Hopital Cochin, AP-HP, Université Paris Descartes, Paris, France
| | - Loïc Guillevin
- National Referral Center for Rare Autoimmune and Systemic Diseases, Hopital Cochin, AP-HP, Université Paris Descartes, Paris, France
| | - Benjamin Terrier
- National Referral Center for Rare Autoimmune and Systemic Diseases, Hopital Cochin, AP-HP, Université Paris Descartes, Paris, France.
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Deshayes S, Liozon E, Chanson N, Sacré K, Moulinet T, Blanchard-Delaunay C, Espitia O, Groh M, Versini M, Le Gallou T, Kahn JE, Grobost V, Humbert S, Samson M, Mourot Cottet R, Mazodier K, Dartevel A, Campagne J, Dumont A, Bienvenu B, Lambert M, Daumas A, Saadoun D, Aouba A, de Boysson H. Concomitant association of giant cell arteritis and malignancy: a multicenter retrospective case-control study. Clin Rheumatol 2019; 38:1243-1249. [PMID: 30617596 DOI: 10.1007/s10067-018-04407-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [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: 11/14/2018] [Accepted: 12/18/2018] [Indexed: 12/31/2022]
Abstract
INTRODUCTION Some studies suggest that there is an increased risk of malignancies in giant cell arteritis (GCA). We aimed to describe the clinical characteristics and outcomes of GCA patients with concomitant malignancy and compare them to a GCA control group. METHOD Patients with a diagnosis of GCA and malignancy and with a maximal delay of 12 months between both diagnoses were retrospectively included in this study and compared to a control group of age-matched (3:1) patients from a multicenter cohort of GCA patients. RESULTS Forty-nine observations were collected (median age 76 years). Malignancies comprised 33 (67%) solid neoplasms and 16 (33%) clonal hematologic disorders. No over-representation of a particular type of malignancy was observed. Diagnosis of GCA and malignancy was synchronous in 7 (14%) patients, while malignancy succeeded GCA in 29 (59%) patients. Malignancy was fortuitously diagnosed based on abnormalities observed in laboratory tests in 26 patients, based on imaging in 14 patients, and based on symptoms or clinical examination in the nine remaining patients. Two patients had a concomitant relapse of both conditions. When compared to the control group, patients with concomitant GCA and malignancy were more frequently male (p < 0.001), with an altered general state (p < 0.001), and polymyalgia rheumatica (p < 0.01). CONCLUSIONS This study does not indicate an over-representation of any particular type of malignancy in GCA patients. Initial follow-up dictated by vasculitis may have led to an early identification of malignancy. Nevertheless, GCA male patients with an altered general state and polymyalgia rheumatica might more frequently show concomitant malignancies.
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Affiliation(s)
- S Deshayes
- Department of Internal Medicine and Clinical Immunology, Normandie Univ, UNICAEN, CHU de Caen Normandie, Avenue de la Côte de Nacre, 14000, Caen, France
| | - E Liozon
- Department of Internal Medicine, CHU Limoges, Limoges, France
| | - N Chanson
- Department of Internal Medicine, Hôpital Bichat, Paris, France
| | - K Sacré
- Department of Internal Medicine, Hôpital Bichat, Paris, France
| | - T Moulinet
- Department of Internal Medicine, Hôpitaux Privés de Metz, Metz, France
| | - C Blanchard-Delaunay
- Department of Internal Medicine, Centre Hospitalier Georges Renon, Niort, France
| | - O Espitia
- Department of Internal Medicine, CHU Nantes, Nantes, France
| | - M Groh
- Department of Internal Medicine, National Referral Center for Hypereosinophilic Syndromes (CEREO), Hôpital Foch, Suresnes, France
| | - M Versini
- Institut Arnault Tzanck, Saint Laurent du Var, France
| | - T Le Gallou
- Department of Internal Medicine, CHU Rennes, Rennes, France
| | - J-E Kahn
- Department of Internal Medicine, Hôpital Ambroise Paré, Boulogne Billancourt, France
| | - V Grobost
- Department of Internal Medicine, CHU Estaing, Clermont-Ferrand, France
| | - S Humbert
- Department of Internal Medicine, CHU de Besançon, Besançon, France
| | - M Samson
- Department of Internal Medicine and Clinical Immunology, CHU Dijon, Dijon, France
| | - R Mourot Cottet
- Department of Internal Medicine, Hôpital Civil, Strasbourg, France
| | - K Mazodier
- Department of Internal Medicine, Hôpital de la Conception, Marseille, France
| | - A Dartevel
- Department of Internal Medicine, CHU Grenoble, Grenoble, France
| | - J Campagne
- Department of Infectious and Systemic Diseases, Hôpital d'Instruction des Armées, Metz, France
| | - A Dumont
- Department of Internal Medicine and Clinical Immunology, Normandie Univ, UNICAEN, CHU de Caen Normandie, Avenue de la Côte de Nacre, 14000, Caen, France
| | - B Bienvenu
- Department of Internal Medicine, Hôpital Saint Joseph, Marseille, France
| | - M Lambert
- Department of Internal Medicine, CHU de Lille, Lille, France
| | - A Daumas
- Department of Geriatric and Internal Medicine, CHU de Marseille, Marseille, France
| | - D Saadoun
- Department of Internal Medicine, Hôpital Pitié Salpétrière, Paris, France
| | - A Aouba
- Department of Internal Medicine and Clinical Immunology, Normandie Univ, UNICAEN, CHU de Caen Normandie, Avenue de la Côte de Nacre, 14000, Caen, France
| | - H de Boysson
- Department of Internal Medicine and Clinical Immunology, Normandie Univ, UNICAEN, CHU de Caen Normandie, Avenue de la Côte de Nacre, 14000, Caen, France.
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Texier C, Accoceberry M, Grobost V, Chadeyras JB, Gallot D. [Osler-Weber-Rendu disease diagnosed during pregnancy because of an important hemothorax]. Gynecol Obstet Fertil Senol 2018; 46:668-670. [PMID: 30170865 DOI: 10.1016/j.gofs.2018.07.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2017] [Indexed: 06/08/2023]
Affiliation(s)
- C Texier
- Pôle femme et enfant, CHU Estaing Clermont-Ferrand, 1, place Lucie-et-Raymond-Aubrac, 63003 Clermont-Ferrand cedex 1, France
| | - M Accoceberry
- Pôle femme et enfant, CHU Estaing Clermont-Ferrand, 1, place Lucie-et-Raymond-Aubrac, 63003 Clermont-Ferrand cedex 1, France
| | - V Grobost
- Pôle spécialités médicales et chirurgicales, CHU Estaing Clermont-Ferrand, référent régional de la maladie de Rendu-Osler, 1, place Lucie-et-Raymond-Aubrac, 63003 Clermont-Ferrand cedex 1, France
| | - J-B Chadeyras
- Centre Jean-Perrin, 58, rue Montalembert, 63011 Clermont-Ferrand, France
| | - D Gallot
- Pôle femme et enfant, CHU Estaing Clermont-Ferrand, 1, place Lucie-et-Raymond-Aubrac, 63003 Clermont-Ferrand cedex 1, France; Équipe « Translationnal approach to epithelial injury and repair », université Clermont Auvergne, CNRS, Inserm, GReD, 63000 Clermont-Ferrand, France.
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Lobbes H, Grobost V, Lemal R, Rieu V, Le Guenno G, Ruivard M. Efficacy of bortezomib in non-IgM type I cryoglobulinaemic vasculitis: a single-centre retrospective case series. Eur J Haematol 2018; 101:635-642. [PMID: 30058297 DOI: 10.1111/ejh.13154] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2018] [Revised: 07/17/2018] [Accepted: 07/20/2018] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Treatment of non-IgM type I cryoglobulinaemic vasculitis (CV) is challenging. Corticosteroids are first-line therapy, but relapses are frequent leading to therapeutic escalation. Bortezomib is a proteasome inhibitor with rapid effect on monoclonal component. However, its use in non-IgM type I CV has been barely reported. OBJECTIVE To assess the efficacy of bortezomib in non-IgM type I CV. METHOD Single-centre case series of four patients with non-IgM type I CV treated with bortezomib monotherapy. RESULTS Two men and two women, 60-84 years old, received bortezomib monotherapy. Monoclonal component was IgG-λ (n = 2), IgA-λ and IgG-κ. Clinical features were necrotic rash (n = 3), synovitis (n = 3) and sensitive neuropathy (n = 2). CV was refractory to corticosteroids (n = 4), cyclophosphamide (n = 3) and rituximab (n = 2). Three patients experienced dramatic clinical improvement with undetectable cryoglobulin after three cycles (bortezomib 1.3 mg/m2 weekly). Each patient relapsed 4-18 months after treatment discontinuation. Bortezomib was unsuccessful after four cycles in one patient. Bortezomib toxicity included one pneumonia and 1 case of worsening neuropathic pain. CONCLUSION Bortezomib in monotherapy should be considered as a valuable option in refractory non-IgM type I CV because of its swift efficacy and acceptable tolerance profile.
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Affiliation(s)
- Hervé Lobbes
- Internal Medicine Department, University Hospital, Clermont-Ferrand, France
| | - Vincent Grobost
- Internal Medicine Department, University Hospital, Clermont-Ferrand, France
| | - Richard Lemal
- Haematology Department, University Hospital, Clermont-Ferrand, France
| | - Virginie Rieu
- Internal Medicine Department, University Hospital, Clermont-Ferrand, France
| | | | - Marc Ruivard
- Internal Medicine Department, University Hospital, Clermont-Ferrand, France
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Buvry C, Cassagnes L, Tekath M, Artigues M, Pereira B, Le Guenno G, Rieu V, Tournadre A, Ruivard M, Grobost V. Les anticorps anti-SSA 52kd sont un facteur de risque de pneumopathie interstitielle dans la maladie de Gougerot-Sjogrën. Rev Med Interne 2018. [DOI: 10.1016/j.revmed.2018.03.317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Lobbes H, Grobost V, Lemal R, Rieu V, Le Guenno G, Ruivard M. Bortézomib en monothérapie dans le traitement des vascularites cryoglobulinémiques de type 1. Rev Med Interne 2018. [DOI: 10.1016/j.revmed.2018.03.282] [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: 10/14/2022]
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Mekinian A, Dervin G, Lapidus N, Kahn JE, Terriou L, Liozon E, Grignano E, Piette JC, Rauzy OB, Grobost V, Godmer P, Gillard J, Rossignol J, Launay D, Aouba A, Cardon T, Bouillet L, Broner J, Vinit J, Ades L, Carrat F, Salvado C, Toussirot E, Versini M, Costedoat-Chalumeau N, Fraison JB, Guilpain P, Fenaux P, Fain O. Biologics in myelodysplastic syndrome-related systemic inflammatory and autoimmune diseases: French multicenter retrospective study of 29 patients. Autoimmun Rev 2017; 16:903-910. [DOI: 10.1016/j.autrev.2017.07.003] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2017] [Accepted: 05/17/2017] [Indexed: 12/23/2022]
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Resseguier AS, Pereira B, Rieu V, Le Guenno G, Grobost V, Ruivard M. Direct oral anticoagulants: an alternative treatment for thrombotic antiphospholipid syndrome? Lupus 2017; 26:1297-1303. [DOI: 10.1177/0961203317701841] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background Direct oral anticoagulants (DOACs) demonstrate a lower risk–benefit ratio than vitamin K antagonists (VKAs) for secondary thromboprophylaxis of thrombotic events. But there are no data on the efficacy of DOACs for the prevention of thrombotic recurrence in patients with antiphospholipid syndrome (APS). In this study, we evaluated the efficacy of DOACs to prevent recurrences of thrombotic events in patients with APS. Methods This was a single-center pilot, using a multi-step Fleming design. If seven or fewer patients presented treatment failure with rivaroxaban, the study could conclude efficacy. Results A total of 23 patients were included. APS involved the veins only ( n = 19), arteries only ( n = 2) or both ( n = 1) and 1 patient exhibited catastrophic antiphospholipid syndrome (CAPS). Overall, two patients were positive for lupus anticoagulant, anti-beta-2 glycoprotein I antibodies and anticardiolipid antibodies (triple positivity). The mean duration of follow up was 35.6 (range, 29–40) months. A total of six treatment failures were reported: one patient, with triple positivity, developed bilateral distal pulmonary embolism (PE) after 20 months of treatment with rivaroxaban, two patients refused to take rivaroxaban, the treatment was stopped in three other patients: two with adverse effects and one with chronic iron-deficiency anemia. Conclusions Rivaroxaban may represent an alternative for secondary thromboprophylaxis for thrombo-embolism in patients with APS, in particular, those with poor international normalized ratio (INR) control and those who are not at the highest risk of recurrent thrombosis, such as those with triple positivity.
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Affiliation(s)
- A S Resseguier
- Department of Internal Medicine, CHU Clermont-Ferrand, Clermont-Ferrand, France
| | - B Pereira
- EA 4681 PEPRADE, University Clermont Auvergne, Clermont-Ferrand, France
| | - V Rieu
- Biostatistics Unit, Délégation Recherche Clinique & Innovation, University Hospital Clermont-Ferrand, France
| | - G Le Guenno
- Biostatistics Unit, Délégation Recherche Clinique & Innovation, University Hospital Clermont-Ferrand, France
| | - V Grobost
- Biostatistics Unit, Délégation Recherche Clinique & Innovation, University Hospital Clermont-Ferrand, France
| | - M Ruivard
- Department of Internal Medicine, CHU Clermont-Ferrand, Clermont-Ferrand, France
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Deshayes S, Chanson N, Sacré K, Blanchard-Delaunay C, Espitia O, Le Gallou T, Groh M, Kahn J, Grobost V, Humbert S, De Boysson H, Bienvenu B. Association concomitante d’une artérite à cellules géantes et d’une pathologie maligne : une étude rétrospective multicentrique. Rev Med Interne 2016. [DOI: 10.1016/j.revmed.2016.10.056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Ballester C, Grobost V, Roblot P, Pourrat O, Pierre F, Laurichesse-Delmas H, Gallot D, Aubard Y, Bezanahary H, Fauchais AL. Pregnancy and primary Sjögren’s syndrome: management and outcomes in a multicentre retrospective study of 54 pregnancies. Scand J Rheumatol 2016; 46:56-63. [DOI: 10.3109/03009742.2016.1158312] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Affiliation(s)
- C Ballester
- Department of Obstetrics, Limoges University Hospital, Limoges, France
| | - V Grobost
- Department of Internal Medicine, Clermont-Ferrand University Hospital, Clermont-Ferrand, France
| | - P Roblot
- Department of Internal Medicine, Poitiers University Hospital, Poitiers, France
| | - O Pourrat
- Department of Internal Medicine, Poitiers University Hospital, Poitiers, France
| | - F Pierre
- Department of Obstetrics, Poitiers University Hospital, Poitiers, France
| | - H Laurichesse-Delmas
- Department of Obstetrics, Clermont-Ferrand University Hospital, Clermont-Ferrand, France
| | - D Gallot
- Department of Obstetrics, Clermont-Ferrand University Hospital, Clermont-Ferrand, France
| | - Y Aubard
- Department of Obstetrics, Limoges University Hospital, Limoges, France
| | - H Bezanahary
- Department of Internal Medicine, Limoges University Hospital, Limoges, France
| | - A-L Fauchais
- Department of Internal Medicine, Limoges University Hospital, Limoges, France
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Louvet C, Maqdasy S, Tekath M, Grobost V, Rieu V, Ruivard M, Le Guenno G. Infundibuloneurohypophysitis Associated With Sjögren Syndrome Successfully Treated With Mycophenolate Mofetil: A Case Report. Medicine (Baltimore) 2016; 95:e3132. [PMID: 27043673 PMCID: PMC4998534 DOI: 10.1097/md.0000000000003132] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Hypophysitis is an inflammatory disorder of the pituitary gland and corticosteroids are usually recommended as the first-line treatment. Hypophysitis related to primary Sjögren syndrome (pSS) is uncommon. We describe the unusual case of a patient with infundibuloneurohypophysitis associated with pSS successfully treated with mycophenolate mofetil (MMF).We describe a case of a 60-year-old man with a medical history of pSS presented with central diabetes insipidus and panhypopituitarism. Magnetic resonance imaging (MRI) revealed a thickening of the pituitary stalk and intense enhancement of the posterior pituitary, pituitary stalk, and hypothalamus. We diagnosed infundibuloneurohypophysitis associated with pSS. Hormonal replacement was started immediately and MMF was introduced without corticosteroids. After 9 months of treatment, MRI of the pituitary revealed a complete regression of the nodular thickening of the pituitary stalk, with normal enhancement and appearance of the pituitary. The pituitary axes had completely recovered, whereas the diabetes insipidus was partially restored. Our findings suggest that MMF is an effective alternative to corticosteroids for the treatment of lymphocytic hypophysitis associated with an autoimmune disease. Furthermore, this report could contribute to extend the spectrum of the neurological and endocrinological manifestations of pSS.
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Affiliation(s)
- Camille Louvet
- From the Department of Internal Medicine (CL, VG, VR, MR, GLG) and Department of Radiology (MT), Centre Hospitalier Universitaire Estaing; and Department of Endocrinology and Diabetology (SM), Centre Hospitalier Universitaire Gabriel Montpied, Clermont-Ferrand, France
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Lemaire A, Rieu V, Grobost V, Le Guenno G, Ruivard M. Un purpura thrombotique thrombocytopénique associé à une maladie de Castleman. Rev Med Interne 2015. [DOI: 10.1016/j.revmed.2015.03.164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Resseguier A, Rieu V, Le Guenno G, Grobost V, Philippe P, Ruivard M. Les anticoagulants oraux directs : une alternative thérapeutique dans le syndrome des antiphospholipides ? Rev Med Interne 2015. [DOI: 10.1016/j.revmed.2015.03.305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Lemaire A, Rieu V, Grobost V, Souweine B, Le Guenno G, Ruivard M. Déficit neurologique focal brutal : penser à une microangiopathie thrombotique. Rev Med Interne 2015. [DOI: 10.1016/j.revmed.2015.03.171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Grobost V, Khouatra C, Lazor R, Cordier JF, Cottin V. Effectiveness of cladribine therapy in patients with pulmonary Langerhans cell histiocytosis. Orphanet J Rare Dis 2014; 9:191. [PMID: 25433492 PMCID: PMC4268858 DOI: 10.1186/s13023-014-0191-8] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [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: 09/02/2014] [Accepted: 11/11/2014] [Indexed: 12/27/2022] Open
Abstract
Background Pulmonary Langerhans cell histiocytosis (PLCH) is a rare disorder characterised by granulomatous proliferation of CD1a-positive histiocytes forming granulomas within lung parenchyma, in strong association with tobacco smoking, and which may result in chronic respiratory failure. Smoking cessation is considered to be critical in management, but has variable effects on outcome. No drug therapy has been validated. Cladribine (chlorodeoxyadenosine, 2-CDA) down-regulates histiocyte proliferation and has been successful in curbing multi-system Langerhans cell histiocytosis and isolated PLCH. Methods and patients We retrospectively studied 5 patients (aged 37–55 years, 3 females) with PLCH who received 3 to 4 courses of cladribine therapy as a single agent (0.1 mg/kg per day for 5 consecutive days at monthly intervals). One patient was treated twice because of relapse at 1 year. Progressive pulmonary disease with obstructive ventilatory pattern despite smoking cessation and/or corticosteroid therapy were indications for treatment. Patients were administered oral trimethoprim/sulfamethoxazole and valaciclovir to prevent opportunistic infections. They gave written consent to receive off-label cladribine in the absence of validated treatment. Results Functional class dyspnea improved with cladribine therapy in 4 out of 5 cases, and forced expiratory volume in 1 second (FEV1) increased in all cases by a mean of 387 ml (100–920 ml), contrasting with a steady decline prior to treatment. Chest high-resolution computed tomography (HRCT) features improved with cladribine therapy in 4 patients. Hemodynamic improvement was observed in 1 patient with pre-capillary pulmonary hypertension. The results suggested a greater treatment effect in subjects with nodular lung lesions and/or thick-walled cysts on chest HRCT, with diffuse hypermetabolism of lung lesions on positron emission tomography (PET)-scan, and with progressive disease despite smoking cessation. Infectious pneumonia developed in 1 patient, with later grade 4 neutrocytopenia but without infection. Discussion Data interpretation was limited by the retrospective, uncontrolled study design and small sample size. Conclusion Cladribine as a single agent may be effective therapy in patients with progressive PLCH.
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Affiliation(s)
- Vincent Grobost
- National Reference Centre for Rare Pulmonary Diseases, Department of Respiratory Medicine, Louis Pradel Hospital; Claude Bernard Lyon 1 University, Lyon, UMR 754, France.
| | - Chahera Khouatra
- National Reference Centre for Rare Pulmonary Diseases, Department of Respiratory Medicine, Louis Pradel Hospital; Claude Bernard Lyon 1 University, Lyon, UMR 754, France.
| | - Romain Lazor
- National Reference Centre for Rare Pulmonary Diseases, Department of Respiratory Medicine, Louis Pradel Hospital; Claude Bernard Lyon 1 University, Lyon, UMR 754, France. .,Department of Medicine, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland.
| | - Jean-François Cordier
- National Reference Centre for Rare Pulmonary Diseases, Department of Respiratory Medicine, Louis Pradel Hospital; Claude Bernard Lyon 1 University, Lyon, UMR 754, France.
| | - Vincent Cottin
- National Reference Centre for Rare Pulmonary Diseases, Department of Respiratory Medicine, Louis Pradel Hospital; Claude Bernard Lyon 1 University, Lyon, UMR 754, France. .,Hospices Civils de Lyon, Hôpital Louis Pradel, Centre national de référence des maladies pulmonaires rares, Centre de compétences de l'hypertension pulmonaire, Service de pneumologie, Université de Lyon, Université Claude Bernard Lyon 1, INRA, Lyon, UMR754, France.
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Grobost V, Rigal E, Pavier Y, Vidal M, Mrozek N, Beytout J, Laurichesse H, Lesens O. Suppressive therapy using azithromycin in 2 rare cases of recurrent staphylococcal infections. Diagn Microbiol Infect Dis 2014; 79:90-2. [PMID: 24629578 DOI: 10.1016/j.diagmicrobio.2014.01.013] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2013] [Revised: 01/08/2014] [Accepted: 01/12/2014] [Indexed: 10/25/2022]
Abstract
Recurrent staphylococcal skin and soft tissue infections may recur despite decontamination and multiple courses of antibiotic therapy and may dramatically impair the patient's quality of life. We report successful use of long-term azithromycin prophylaxis in a recurrent laryngitis and a scalp folliculitis due to methicillin-susceptible Staphylococcus aureus.
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Affiliation(s)
- Vincent Grobost
- Department of Infectious Diseases, Clermont-Ferrand University Hospital, France: CHU Gabriel Montpied, 58 Av. Montalembert 63003 Clermont-Ferrand, France.
| | - Emilie Rigal
- Department of Dermatology, CHU Estaing, 1 Place Lucie et Raymond Aubrac 63100 Clermont-Ferrand, France
| | - Yoann Pavier
- Department of Otorhinolaryngology, Clermont-Ferrand University Hospital, France: CHU Gabriel Montpied, 58 Av. Montalembert 63003 Clermont-Ferrand, France
| | - Magali Vidal
- Department of Infectious Diseases, Clermont-Ferrand University Hospital, France: CHU Gabriel Montpied, 58 Av. Montalembert 63003 Clermont-Ferrand, France
| | - Natacha Mrozek
- Department of Infectious Diseases, Clermont-Ferrand University Hospital, France: CHU Gabriel Montpied, 58 Av. Montalembert 63003 Clermont-Ferrand, France
| | - Jean Beytout
- Department of Infectious Diseases, Clermont-Ferrand University Hospital, France: CHU Gabriel Montpied, 58 Av. Montalembert 63003 Clermont-Ferrand, France
| | - Henri Laurichesse
- Department of Infectious Diseases, Clermont-Ferrand University Hospital, France: CHU Gabriel Montpied, 58 Av. Montalembert 63003 Clermont-Ferrand, France
| | - Olivier Lesens
- Department of Infectious Diseases, Clermont-Ferrand University Hospital, France: CHU Gabriel Montpied, 58 Av. Montalembert 63003 Clermont-Ferrand, France
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Grobost V, Rieu V, Le Guenno G, Makarawiez C, Le Quang C, Philippe P, Ruivard M. Thromboses portes et mésentériques. Étude rétrospective de 33 cas. Rev Med Interne 2012. [DOI: 10.1016/j.revmed.2012.03.061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Resseguier A, Grobost V, Samou F, Delèvaux I, Guettrot-Imbert G, Tournilhac O, Trouillier S, Aumaitre O. Une dermatomyosite révélant un syndrome myélodysplasique 5q-. Rev Med Interne 2011. [DOI: 10.1016/j.revmed.2011.10.224] [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: 10/15/2022]
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