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Dalecky M, Dujardin T, Pflimlin A, Baillet A, Romand X. Cardiac conduction disorders in ankylosing spondylitis: A systematic literature review and meta-analyses of controlled studies. Joint Bone Spine 2024; 91:105676. [PMID: 38104656 DOI: 10.1016/j.jbspin.2023.105676] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2023] [Revised: 11/27/2023] [Accepted: 11/30/2023] [Indexed: 12/19/2023]
Affiliation(s)
- Mickaël Dalecky
- Grenoble INP, TIMC-IMAG, CNRS, CHU de Grenoble-Alpes, University Grenoble-Alpes, 38000 Grenoble, France; Department of Rheumatology, CHU de Grenoble-Alpes, University Grenoble-Alpes, 38000 Grenoble, France.
| | - Tiphaine Dujardin
- Department of Rheumatology, CHU de Grenoble-Alpes, University Grenoble-Alpes, 38000 Grenoble, France
| | - Arnaud Pflimlin
- Department of Rheumatology, hôpital Ambroise-Paré, AP-HP, Boulogne-Billancourt, France
| | - Athan Baillet
- Grenoble INP, TIMC-IMAG, CNRS, CHU de Grenoble-Alpes, University Grenoble-Alpes, 38000 Grenoble, France; Department of Rheumatology, CHU de Grenoble-Alpes, University Grenoble-Alpes, 38000 Grenoble, France
| | - Xavier Romand
- Grenoble INP, TIMC-IMAG, CNRS, CHU de Grenoble-Alpes, University Grenoble-Alpes, 38000 Grenoble, France; Department of Rheumatology, CHU de Grenoble-Alpes, University Grenoble-Alpes, 38000 Grenoble, France
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Romand X, Gastaldi R, Pérennou D, Baillet A, Dieterich K. Bone mineral density in adults with arthrogryposis multiplex congenita: a retrospective cohort analysis. Sci Rep 2024; 14:8206. [PMID: 38589451 PMCID: PMC11001861 DOI: 10.1038/s41598-024-58083-x] [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: 06/15/2023] [Accepted: 03/25/2024] [Indexed: 04/10/2024] Open
Abstract
The primary objective of this study was to evaluate the prevalence of low femoral and lumbar spine bone mineral density (BMD) in adults with arthrogryposis multiplex congenita (AMC). We performed a retrospective cohort analysis of adults with AMC who were enrolled in the French Reference Center for AMC and in the Pediatric and Adult Registry for Arthrogryposis (PARART, NCT05673265). Patients who had undergone dual-energy X-ray absorptiometry (DXA) and/or vitamin D testing were included in the analysis. Fifty-one patients (mean age, 32.9 ± 12.6 years) were included; 46 had undergone DXA. Thirty-two (32/51, 62.7%) patients had Amyoplasia, and 19 (19/51, 37.3%) had other types of AMC (18 distal arthrogryposis, 1 Larsen). Six patients (6/42, 14.3%) had a lumbar BMD Z score less than - 2. The mean lumbar spine Z score (- 0.03 ± 1.6) was not significantly lower than the expected BMD Z score in the general population. Nine (9/40, 22.5%) and 10 (10/40, 25.0%) patients had femoral neck and total hip BMD Z scores less than - 2, respectively. The mean femoral neck (- 1.1 ± 1.1) and total hip (- 1.2 ± 1.2) BMD Z scores in patients with AMC were significantly lower than expected in the general population (p < 0.001). Femoral neck BMD correlated with height (rs = 0.39, p = 0.01), age (rs = - 0.315, p = 0.48); total hip BMD correlated with height (rs = 0.331, p = 0.04) and calcium levels (rs = 0.41, p = 0.04). Twenty-five patients (25/51, 49.0%) reported 39 fractures. Thirty-one (31/36, 86.1%) patients had 25-hydroxyvitamin D levels less than 75 nmol/l, and 6 (6/36, 16.7%) had 25-hydroxyvitamin D levels less than 75 nmol/l. Adults with AMC had lower hip BMD than expected for their age, and they more frequently showed vitamin D insufficiency. Screening for low BMD by DXA and adding vitamin D supplementation when vitamin D status is insufficient should be considered in adults with AMC, especially if there is a history of falls or fractures.
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Affiliation(s)
- X Romand
- T-RAIG, TIMC, CNRS, UMR 5525, University of Grenoble Alpes, Grenoble-Alpes University Hospital, 38000, Grenoble, France.
| | - R Gastaldi
- Rheumatology Department, Grenoble-Alpes University Hospital, Grenoble, France
| | - D Pérennou
- Department of PMR, University of Grenoble Alpes, UMR CNRS 5105 LPNC, Grenoble-Alpes University Hospital (South Site), Cs 10217, 38043, Grenoble cedex 9, France
| | - A Baillet
- T-RAIG, TIMC, CNRS, UMR 5525, University of Grenoble Alpes, Grenoble-Alpes University Hospital, 38000, Grenoble, France
| | - K Dieterich
- Medical Genetics, Institute of Advanced Biosciences, University of Grenoble Alpes, Inserm, U1209, CHU Grenoble Alpes, 38000, Grenoble, France.
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Romand X, Paclet MH, Chuong MV, Gaudin P, Pagnoux C, Guillevin L, Terrier B, Baillet A. Serum calprotectin and renal function decline in ANCA-associated vasculitides: a post hoc analysis of MAINRITSAN trial. RMD Open 2023; 9:e003477. [PMID: 37903568 PMCID: PMC10619089 DOI: 10.1136/rmdopen-2023-003477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Accepted: 10/02/2023] [Indexed: 11/01/2023] Open
Abstract
OBJECTIVE Serum calprotectin appears to be an interesting biomarker associated with renal vascular disease activity in antineutrophil cytoplasm antibody (ANCA)-associated vasculitis (AAV). The aim of this study was to assess whether serum calprotectin levels can predict decline in renal function in AAV patients receiving maintenance therapy. METHODS Serum calprotectin levels were assessed at inclusion and month 6 in AAV patients, in complete remission after induction therapy, randomly assigned to rituximab or azathioprine. Renal function decline was defined as a 25% decrease in estimated glomerular filtration rate (eGFR) and a change in the eGFR category, or a decrease of 15 mL/min/1.73 m2. Relapse was defined as a Birmingham Vasculitis Activity Score >0 attributable to active vasculitis. RESULTS Seventy-six AAV were included. Serum calprotectin increased from baseline to month 6 in patients with renal function decline (7940 (-226.0, 28 691) ng/ml vs -4800 (-18 777, 3708) ng/ml; p<0.001). An increase of calprotectin level was associated with a higher risk of subsequent renal function decline even after adjustment (OR 6.50 (95% CI 1.7 to 24.9) p=0.006). A significantly higher risk of relapse was observed in proteinase 3- AAV patients with an increase of serum calprotectin levels (OR 5.6 (95% CI 1.0 to 31.2), p=0.03). CONCLUSION An increase in serum calprotectin by month 6 compared with inclusion during remission-maintenance therapy in AAV was associated with a higher risk of renal function decline in the following 12 months. TRIAL REGISTRATION NUMBER NCT00748644.
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Affiliation(s)
- Xavier Romand
- CNRS, UMR 5525, T-RAIG, TIMC, CHU Grenoble Alpes, Universite Grenoble Alpes, Grenoble, France
| | - Marie Hélène Paclet
- CNRS, UMR 5525, T-RAIG, TIMC, CHU Grenoble Alpes, Universite Grenoble Alpes, Grenoble, France
| | - Minh Vu Chuong
- CNRS, UMR 5525, T-RAIG, TIMC, CHU Grenoble Alpes, Universite Grenoble Alpes, Grenoble, France
| | - Philippe Gaudin
- CNRS, UMR 5525, T-RAIG, TIMC, CHU Grenoble Alpes, Universite Grenoble Alpes, Grenoble, France
| | | | - Loïc Guillevin
- Université de Paris, Paris, France
- Department of Internal Medicine, National Referral Center for Rare Systemic Autoimmune Diseases, Hopital Cochin APHP-Centre Université Paris (CUP), Paris, France
| | - Benjamin Terrier
- Université de Paris, Paris, France
- Department of Internal Medicine, National Referral Center for Rare Systemic Autoimmune Diseases, Hopital Cochin APHP-Centre Université Paris (CUP), Paris, France
| | - Athan Baillet
- CNRS, UMR 5525, T-RAIG, TIMC, CHU Grenoble Alpes, Universite Grenoble Alpes, Grenoble, France
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Romand X, Clapasson M, Chuong MV, Paclet MH, Fautrel B, Baillet A. Serum calprotectin levels do not predict subsequent relapse in rheumatoid arthritis in remission: a post-hoc analysis of STRASS study. RMD Open 2023; 9:e003198. [PMID: 37364929 PMCID: PMC10410922 DOI: 10.1136/rmdopen-2023-003198] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/08/2023] [Indexed: 06/28/2023] Open
Affiliation(s)
- Xavier Romand
- University Grenoble Alpes, CNRS, UMR 5525, T-RAIG, CHU Grenoble Alpes, TIMC, 38000, Grenoble, Auvergne-Rhône-Alpes, France
| | - Margot Clapasson
- Department of Rheumatology, Centre Hospitalier Universitaire Grenoble Alpes, Grenoble, France
| | - Minh Vu Chuong
- University Grenoble Alpes, CNRS, UMR 5525, T-RAIG, CHU Grenoble Alpes, TIMC, 38000, Grenoble, Auvergne-Rhône-Alpes, France
| | - Marie Hélène Paclet
- University Grenoble Alpes, CNRS, UMR 5525, T-RAIG, CHU Grenoble Alpes, TIMC, 38000, Grenoble, Auvergne-Rhône-Alpes, France
| | - Bruno Fautrel
- Assistance Publique Hôpitaux de Paris, INSERM UMRS 1136, Groupe Hospitalier Universitaire Pitié-Salpêtrière, Sorbonne Universite, Paris, Île-de-France, France
| | - Athan Baillet
- University Grenoble Alpes, CNRS, UMR 5525, T-RAIG, CHU Grenoble Alpes, TIMC, 38000, Grenoble, Auvergne-Rhône-Alpes, France
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Bernardy C, Baillet A, Marnas G, Romand X. Answer to Cadiou et al. "Bone marrow edema of the sacroiliac joint and anatomical variations: Look back the posterior bony excess". Joint Bone Spine 2023;90:105504. Joint Bone Spine 2023; 90:105507. [PMID: 36526230 DOI: 10.1016/j.jbspin.2022.105507] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Accepted: 11/22/2022] [Indexed: 12/15/2022]
Affiliation(s)
- Chloé Bernardy
- Rheumatology department, CHU de Grenoble-Alpes, Grenoble, France; Université de Grenoble Alpes, CNRS, UMR 5525, T-RAIG, TIMC, 38000 Grenoble, France.
| | - Athan Baillet
- Rheumatology department, CHU de Grenoble-Alpes, Grenoble, France; Université de Grenoble Alpes, CNRS, UMR 5525, T-RAIG, TIMC, 38000 Grenoble, France
| | - Guillaume Marnas
- Rheumatology department, CHU de Grenoble-Alpes, Grenoble, France
| | - Xavier Romand
- Rheumatology department, CHU de Grenoble-Alpes, Grenoble, France; Université de Grenoble Alpes, CNRS, UMR 5525, T-RAIG, TIMC, 38000 Grenoble, France
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Romand X, Adeline F, Dalecky M, Pflimlin A, Bellier A, Barone-Rochette G, Wendling D, Gaudin P, Claudepierre P, Dougados M, Baillet A. Systematic assessment of heart valves and cardiac function by echocardiography in axial spondyloarthritis: a systematic review and meta-analysis. Joint Bone Spine 2022; 89:105375. [DOI: 10.1016/j.jbspin.2022.105375] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 02/17/2022] [Accepted: 02/22/2022] [Indexed: 11/30/2022]
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Romand X, Dalecky M, Baillet A, Dougados M. Answer to Avril et al.: “In response to the recent recommendations on the assessment of patients with spondyloarthritis, a translation is needed for health professionals”. Joint Bone Spine 2022;89:105355. Joint Bone Spine 2022; 89:105363. [DOI: 10.1016/j.jbspin.2022.105363] [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: 01/21/2022] [Accepted: 02/02/2022] [Indexed: 11/30/2022]
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Desmottes MC, Sageloli F, Romand X, Baillet A. Alcohol intake prevents structural damage for male but not female patients with rheumatoid arthritis: a meta-analysis. Joint Bone Spine 2021; 88:105233. [PMID: 34098102 DOI: 10.1016/j.jbspin.2021.105233] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Accepted: 05/19/2021] [Indexed: 11/26/2022]
Affiliation(s)
| | - Franck Sageloli
- Centre hospitalier rhumatologique d'Uriage, 38410 Saint-Martin-d'Uriage, France
| | - Xavier Romand
- Rheumatology Department, Grenoble Teaching Hospital, Hôpital Sud, 38130 Échirolles, France; UMR 5525, GREPI TIMC, University Grenoble-Alpes, 38100 Grenoble, France
| | - Athan Baillet
- Rheumatology Department, Grenoble Teaching Hospital, Hôpital Sud, 38130 Échirolles, France; UMR 5525, GREPI TIMC, University Grenoble-Alpes, 38100 Grenoble, France
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Romand X, Liu X, Rahman MA, Bhuyan ZA, Douillard C, Kedia RA, Stone N, Roest D, Chew ZH, Cameron AJ, Rehaume LM, Bozon A, Habib M, Armitage CW, Nguyen MVC, Favier B, Beagley K, Maurin M, Gaudin P, Thomas R, Wells TJ, Baillet A. Mediation of Interleukin-23 and Tumor Necrosis Factor-Driven Reactive Arthritis by Chlamydia-Infected Macrophages in SKG Mice. Arthritis Rheumatol 2021; 73:1200-1210. [PMID: 33452873 DOI: 10.1002/art.41653] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Accepted: 01/07/2021] [Indexed: 12/22/2022]
Abstract
OBJECTIVE ZAP-70W163C BALB/c (SKG) mice develop reactive arthritis (ReA) following infection with Chlamydia muridarum. Since intracellular pathogens enhance their replicative fitness in stressed host cells, we examined how myeloid cells infected with C muridarum drive arthritis. METHODS SKG, Il17a-deficient SKG, and BALB/c female mice were infected with C muridarum or C muridarum luciferase in the genitals. C muridarum dissemination was assessed by in vivo imaging or genomic DNA amplification. Macrophages were depleted using clodronate liposomes. Anti-tumor necrosis factor (anti-TNF) and anti-interleukin-23p19 (anti-IL-23p19) were administered after infection or arthritis onset. Gene expression of Hspa5, Tgtp1, Il23a, Il17a, Il12b, and Tnf was compared in SKG mice and BALB/c mice. RESULTS One week following infection with C muridarum, macrophages and neutrophils were observed to have infiltrated the uteri of mice and were also shown to have carried C muridarum DNA to the spleen. C muridarum load was higher in SKG mice than in BALB/c mice. Macrophage depletion was shown to reduce C muridarum load and prevent development of arthritis. Compared with BALB/c mice, expression of Il23a and Il17a was increased in the uterine and splenic neutrophils of SKG mice. The presence of anti-IL-23p19 during infection or Il17a deficiency suppressed arthritis. Tnf was overexpressed in the joints of SKG mice within 1 week postinfection, and persisted beyond the first week. TNF inhibition during infection or at arthritis onset suppressed the development of arthritis. Levels of endoplasmic reticulum stress were constitutively increased in the joints of SKG mice but were induced, in conjunction with immunity-related GTPase, by C muridarum infection in the uterus. CONCLUSION C muridarum load is higher in SKG mice than in BALB/c mice. Whereas proinflammatory IL-23 produced by neutrophils contributes to the initiation of C muridarum-mediated ReA, macrophage depletion reduces C muridarum dissemination to other tissues, tissue burden, and the development of arthritis. TNF inhibition was also shown to suppress arthritis development. Our data suggest that enhanced bacterial dissemination in macrophages of SKG mice drives the TNF production needed for persistent arthritis.
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Affiliation(s)
- Xavier Romand
- Université Grenoble Alpes, GREPI TIMC-IMAG, UMR 5525, Grenoble, France
| | - Xiao Liu
- University of Queensland Diamantina Institute and Princess Alexandra Hospital, Brisbane, Queensland, Australia
| | - M Arifur Rahman
- University of Queensland Diamantina Institute and Princess Alexandra Hospital, Brisbane, Queensland, Australia
| | - Zaied Ahmed Bhuyan
- University of Queensland Diamantina Institute and Princess Alexandra Hospital, Brisbane, Queensland, Australia, and North South University, Dhaka, Bangladesh
| | - Claire Douillard
- Université Grenoble Alpes, GREPI TIMC-IMAG, UMR 5525, Grenoble, France
| | - Reena Arora Kedia
- University of Queensland Diamantina Institute and Princess Alexandra Hospital, Brisbane, Queensland, Australia
| | - Nathan Stone
- University of Queensland Diamantina Institute and Princess Alexandra Hospital, Brisbane, Queensland, Australia
| | - Dominique Roest
- University of Queensland Diamantina Institute and Princess Alexandra Hospital, Brisbane, Queensland, Australia
| | - Zi Huai Chew
- University of Queensland Diamantina Institute and Princess Alexandra Hospital, Brisbane, Queensland, Australia
| | - Amy J Cameron
- University of Queensland Diamantina Institute and Princess Alexandra Hospital, Brisbane, Queensland, Australia
| | - Linda M Rehaume
- University of Queensland Diamantina Institute and Princess Alexandra Hospital, Brisbane, Queensland, Australia
| | - Aurélie Bozon
- Université Grenoble Alpes, GREPI TIMC-IMAG, UMR 5525, Grenoble, France
| | - Mohammed Habib
- Université Grenoble Alpes, GREPI TIMC-IMAG, UMR 5525, Grenoble, France
| | - Charles W Armitage
- Queensland University of Technology, Brisbane, Queensland, Australia, and King's College London, London, UK
| | | | - Bertrand Favier
- Université Grenoble Alpes, GREPI TIMC-IMAG, UMR 5525, Grenoble, France
| | - Kenneth Beagley
- Queensland University of Technology, Brisbane, Queensland, Australia
| | - Max Maurin
- Université Grenoble Alpes, GREPI TIMC-IMAG, UMR 5525, Grenoble, France
| | - Philippe Gaudin
- Université Grenoble Alpes, GREPI TIMC-IMAG, UMR 5525, Grenoble, France
| | - Ranjeny Thomas
- University of Queensland Diamantina Institute and Princess Alexandra Hospital, Brisbane, Queensland, Australia
| | - Timothy J Wells
- University of Queensland Diamantina Institute and Princess Alexandra Hospital, Brisbane, Queensland, Australia
| | - Athan Baillet
- Université Grenoble Alpes, GREPI TIMC-IMAG, UMR 5525, Grenoble, France
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Bernardy C, Baillet A, Gaudin P, Romand X. Comment on the article by Maguire et al. pregnancy in axial spondyloarthropathy: A systematic review & meta-analysis. Semin Arthritis Rheum 2021; 52:151845. [PMID: 34134893 DOI: 10.1016/j.semarthrit.2021.05.005] [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: 04/10/2021] [Accepted: 05/11/2021] [Indexed: 11/16/2022]
Affiliation(s)
- Chloe Bernardy
- Univ. Grenoble Alpes, GREPI TIMC UMR 5525, Grenoble, France; Department of Rheumatology, CHU Grenoble Alpes, Grenoble, France.
| | - Athan Baillet
- Univ. Grenoble Alpes, GREPI TIMC UMR 5525, Grenoble, France; Department of Rheumatology, CHU Grenoble Alpes, Grenoble, France
| | - Philippe Gaudin
- Univ. Grenoble Alpes, GREPI TIMC UMR 5525, Grenoble, France; Department of Rheumatology, CHU Grenoble Alpes, Grenoble, France
| | - Xavier Romand
- Univ. Grenoble Alpes, GREPI TIMC UMR 5525, Grenoble, France; Department of Rheumatology, CHU Grenoble Alpes, Grenoble, France
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Romand X, Dalecky M, Gaudin P, Baillet A. Comment on "Rheumatic presentations of Guillain-Barre syndrome as a diagnostic challenge: A case series" by Demuth et al. Joint Bone Spine 2021;88:105144. Joint Bone Spine 2021; 88:105190. [PMID: 33892198 DOI: 10.1016/j.jbspin.2021.105190] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Accepted: 03/31/2021] [Indexed: 11/20/2022]
Affiliation(s)
- Xavier Romand
- Department of rheumatology, CHU Grenoble Alpes, Échirolles, France; GREPI TIMC, CNRS UMR 5525, université Grenoble Alpes, Grenoble, France.
| | - Mickael Dalecky
- Department of rheumatology, CHU Grenoble Alpes, Échirolles, France; GREPI TIMC, CNRS UMR 5525, université Grenoble Alpes, Grenoble, France
| | - Philippe Gaudin
- Department of rheumatology, CHU Grenoble Alpes, Échirolles, France; GREPI TIMC, CNRS UMR 5525, université Grenoble Alpes, Grenoble, France
| | - Athan Baillet
- Department of rheumatology, CHU Grenoble Alpes, Échirolles, France; GREPI TIMC, CNRS UMR 5525, université Grenoble Alpes, Grenoble, France
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Rakotozafiarison A, Puyraimond-Zemmour D, Romand X, Lavielle M, Moltó A, Flipo RM, Richez C, Saraux A, Dougados M, Gossec L. The adherence questionnaires in chronic inflammatory rheumatic diseases and their psychometric properties: A systematic literature review. Joint Bone Spine 2021; 88:105160. [PMID: 33578034 DOI: 10.1016/j.jbspin.2021.105160] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Accepted: 01/27/2021] [Indexed: 11/28/2022]
Affiliation(s)
- Antsa Rakotozafiarison
- Service de Rhumatologie, Hôpital de la Pitié Salpetrière, 48-83, boulevard de l'Hôpital, 75013 Paris, France.
| | - Déborah Puyraimond-Zemmour
- Service de Rhumatologie, Hôpital de la Pitié Salpetrière, 48-83, boulevard de l'Hôpital, 75013 Paris, France; Sorbonne Université, INSERM, Institut Pierre-Louis d'Épidémiologie et de Santé Publique, 47-83, boulevard de l'Hôpital, 75013 Paris, France
| | - Xavier Romand
- Univ. Grenoble-Alpes, GREPI TIMC-IMAG, UMR 5525, 38000 Grenoble, France; Service de Rhumatologie, CHU Grenoble-Alpes, 38000 Grenoble, France
| | | | - Anna Moltó
- Service de Rhumatologie, Cochin Hospital, AP-HP, 75014 Paris, France; Université de Paris, Inserm, Unit 1183 (CRESS), 75014 Paris, France
| | | | - Christophe Richez
- Service de Rhumatologie, Hôpital Pellegrin, 33000 Bordeaux, France; Université de Bordeaux, CNRS 5164, 33000 Bordeaux, France
| | - Alain Saraux
- Service de Rhumatologie, CHU de la Cavale-Blanche, boulevard Tanguy-Prigent, 29200 Brest, France; INSERM 1227, Université de Bretagne Occidentale, 29200 Brest, France
| | - Maxime Dougados
- Service de Rhumatologie, Cochin Hospital, AP-HP, 75014 Paris, France; Université de Paris, Inserm, Unit 1183 (CRESS), 75014 Paris, France
| | - Laure Gossec
- Service de Rhumatologie, Hôpital de la Pitié Salpetrière, 48-83, boulevard de l'Hôpital, 75013 Paris, France; Sorbonne Université, INSERM, Institut Pierre-Louis d'Épidémiologie et de Santé Publique, 47-83, boulevard de l'Hôpital, 75013 Paris, France
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Hillion J, Bellier A, Romand X, Fautrel B, Mariette X, Sagéloli F, Baillet A, Gaudin P. Alcohol is not the missing link between Porphyromonas gingivalis-related periodontitis and radiological progression in early rheumatoid arthritis. Ann Rheum Dis 2020; 79:e107. [DOI: 10.1136/annrheumdis-2019-215603] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2019] [Accepted: 05/15/2019] [Indexed: 11/03/2022]
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Bellier A, Romand X, Baillet A. Response to: ‘Response to: ‘Alcohol is not the missing link between Porphyromonas gingivalis related periodontitis and radiologic progression in early Rheumatoid arthritis’ by Hillion et al’ by Marotte and Paul. Ann Rheum Dis 2020; 79:e109. [DOI: 10.1136/annrheumdis-2019-215962] [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: 06/29/2019] [Revised: 07/09/2019] [Accepted: 07/09/2019] [Indexed: 11/04/2022]
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Baillet A, Romand X, Pfimlin A, Dalecky M, Dougados M. SAT0364 DATA TO BE COLLECTED FOR AN OPTIMAL MANAGEMENT OF AXIAL SPONDYLOARTHRITIS IN DAILY PRACTICE: PROPOSAL FROM AN EVIDENCE BASED AND CONSENSUAL APPROACHES. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.3588] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:Standardization of clinical practice has been proven to be effective in management of chronic diseases. This is particularly true at the time where the concept of treat to target is becoming more and more important in the field of axial spondyloarthritis (ax-SpA).Objectives:To propose a list of variables to be collected at the time of the diagnosis and over the follow-up of patients with axial spondyloarthritis (ax-SpA) for an optimal management in daily practice.Methods:The process comprised (1) the evaluation of the interest of 51 variables proposed for the assessment of axSpA via a systematic literature research, (2) a consensus process involving 78 hospital-based or office-based rheumatologists, considering the collection of the variable in a 4 grade scale from ”potentially useful” to “mandatory”, (3) a consensus on optimal timeline for periodic assessment of the selected variables on a 5 grade scale from “at each visit” to “never to be re-collected”.Results:The systematic literature research retrieved a total of 14,133 abstracts, of which 213 were included in the final qualitative synthesis. Concerning the data to be collected at the time of the diagnosis and during follow-up, we proposed to differentiate the results based on a) the way of collection of the variables (e.g. questionnaires by the patient, interview by the physician, physical examination, investigations) b) the usefulness these variables in daily practice based on the opinion of the rheumatologists ” c) the optimal timeline between 2 evaluations of the variable based on the opinion of the rheumatologists. In the initial systematic review, symptoms of heart failure history of inflammatory bowel disease, psoriasis or uveitis, patient global visual analogic scale, spine radiographs, modified Schöber test, coxo-femoral rotations, swollen joint count, urine strip test, BASDAI and ASDAS global scores were considered very useful and nocturnal back pain/morning stiffness, sacro-iliac joints radiographs and CRP were considered mandatory (Figure 1). Timeline between 2 evaluations of variables to collect in the periodic review are summarized inFigure 2.Figure 1.Core sets of items to collect and report in the systematic review in axial spondyloarthritis management in daily practice ASDAS=Ankylosing Spondylitis Disease Activity Score, BASDAI=Bath Ankylosing Spondylitis Disease Activity Index, BASFI=Bath Ankylosing Spondylitis Functionnal Index, BASMI=Bath Ankylosing Spondylitis Metrology Index, CRP=C Reactive Protein, CT=computerized tomography, FIRST=Fibromyalgia Rapid Screening Tool, HLA=Human Leukocyte Antigen, MRI=Magnetic resonance imaging, PET=positron emission tomography.Figure 2.Periodic review timeline of variables to collectASDAS=Ankylosing Spondylitis Disease Activity Score, BASDAI=Bath Ankylosing Spondylitis Disease Activity Index, Spondylitis Metrology Index, CRP=C Reactive Protein, IBD = inflammatory bowel diseases, PRO = Patient Reported OutcomesConclusion:Using an evidence-based and an expert consensus approaches, this initiative defined a core set of variables to be collected and reported at the time of the diagnosis and during follow-up of patients with ax-SpA in daily practice.Acknowledgments:this study has been conducted in two parts: the first one (evidence-based) was conducted thanks to a support from Abbvie France. AbbVie did not review the content or have influence on this manuscript. The second part of this initiative (consensus) has been conducted thanks to a support from the scientific non-profit organization: Association de Recherche Clinique en RhumatologieDisclosure of Interests:Athan Baillet Consultant of: Athan BAILLET has received honorarium fees from Abbvie for his participation as the coordinator of the systematic literature review, Xavier Romand Consultant of: Xavier ROMAND has received honorarium fees from Abbvie, Arnaud Pfimlin Consultant of: Arnaud PFIMLIN has received honorarium fees from Abbvie, Mickael Dalecky Consultant of: Mickael DALECKY has received honorarium fees from Abbvie, Maxime Dougados Grant/research support from: AbbVie, Eli Lilly, Merck, Novartis, Pfizer and UCB Pharma, Consultant of: AbbVie, Eli Lilly, Merck, Novartis, Pfizer and UCB Pharma, Speakers bureau: AbbVie, Eli Lilly, Merck, Novartis, Pfizer and UCB Pharma
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Romand X, Courtier A, Nguyen MVC, Paclet MH, Gaudin P, Guillevin L, Terrier B, Baillet A. OP0031 AN INCREASE IN SERUM CALPROTECTIN LEVEL IN ANCA-ASSOCIATED VASCULITIDES PATIENTS DURING MAINTENANCE THERAPY IS ASSOCIATED WITH MORE RELAPSE AND ACCELERATED RENAL FUNCTION DECLINE. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.4083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:Calprotectin (S100A8/A9), a protein secreted by activated neutrophils and monocytes in inflammatory conditions, is upregulated in active ANCA-associated vasculitides. Serum calprotectin level variation during induction therapy is associated with disease relapse in PR3-ANCA-associated vasculitides (1). However, the place of this biomarker during maintenance therapy is unknown.Objectives:To demonstrate whether variation in serum calprotectin level during maintenance therapy could be used as a biomarker predicting subsequent relapse in ANCA-associated vasculitides.Methods:Patients with ANCA-associated vasculitides in complete remission (BVAS=0) after induction therapy with cyclophosphamide and included in the MAINRITSAN trial (2) were analyzed. Patients were randomized to receive rituximab or azathioprine as maintenance therapy. Relapse was defined as the re-occurrence or new onset of disease attributable to active vasculitis. Accelerated decline renal function (estimated Glomerular Filtration Rate (eGFR) assessed using the MDRD equation) was defined in concordance with NICE 2015 guideline (3) as “a decrease in eGFR of 25% or more and a change in GFR category or a sustained decrease in eGFR of 15 ml/min/1.73m2over 12 months”. Calprotectin was assessed in the serum at inclusion and 6 months by ELISA (IDK® Calprotectin ELISA kit, Immunodiagnostik). We defined an increase in serum levels of calprotectin as a positive variation of calprotectin level at M6 compared to baseline.Results:Of all, 96 patients (female 45.8%, mean age 55.3±13.5, 69.8% PR3+, 62.5% ANCA positive at inclusion) had at least a calprotectin dosage (86 at baseline, 86 at M6 and 76 patients at this 2 time-point). Calprotectin level at baseline or 6 months was not significantly different between relapsing patients and those without relapse after 18 months of follow-up, whereas the calprotectin variation at M6 compared to baseline was higher in relapsing patients (n=10) (mean (SD) 17991 (±28972) ng/ml) than in patients not experiencing any relapse (n=66) (9419 (±50002) ng/mL; p=0.03). An increase in serum calprotectin level at 6 months was significantly associated with an increased risk of relapse in PR3-ANCA patients (OR=5.6 (95%CI, 1.0-31.3; p=0,049) but not in the whole study group (OR=3.3 (95%CI, 0.8-14.1; p=0.1), and identified patients with accelerated renal function decline (all cohort: OR=10.6 (95%CI, 2.9-39.6; p=0.002; PR3+ patients: OR=5.909 (95%CI, 2.9-39.6; p=0.01)), whereas calprotectin level did not correlate with glomerular filtration rate (r = -0.07, p=0.35).Conclusion:An increase in serum calprotectin during the first 6 months of maintenance therapy in ANCA-associated vasculitides is a useful biomarker predicting vasculitis relapse and accelerated renal function deterioration in the following 12 months.Increase calprotectin serum at 6 months identify relapser and accelerated decline renal function at 1 year.Kaplan-Meier survival curves of ANCA-associated vasculitis patients with an increase in serum calprotectin at 6 months (solid line) or not (dotted line) remaining total relapse-free or accelerated decline renal function-free. Gehan-Beslow-Wilcoxon test.References:[1]Pepper RJ et al. Arthritis Rheumatol. 2017;69(1):185-93.[2]Guillevin L et al. N Engl J Med. 2014;371(19):1771-80.[3]NIH. Chronic kidney disease 2014.Acknowledgments:Supported by a grant from the Programme Hospitalier de Recherche Clinique, French Ministry of Health (2008-002846-51).Disclosure of Interests:Xavier Romand Consultant of: Xavier ROMAND has received honorarium fees from Abbvie, Anais Courtier: None declared, Minh Vu Chuong Nguyen: None declared, Marie-Hélène Paclet: None declared, Philippe Gaudin Speakers bureau: Lilly, Loïc Guillevin: None declared, Benjamin Terrier: None declared, Athan Baillet Consultant of: Athan BAILLET has received honorarium fees from Abbvie for his participation as the coordinator of the systematic literature review
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Adeline F, Romand X, Dalecky M, Pfimlin A, Wendling D, Gaudin P, Claudepierre P, Dougados M, Baillet A. AB0665 VALVULOPATHY, SYSTOLIC AND DIASTOLIC DYSFUNCTION IN AXIAL SPONDYLOARTHRITIS: A SYSTEMATIC REVIEW AND META-ANALYSIS. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.5223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:Axial Spondyloarthritis (ax-SpA) displays an increased cardiovascular disease (CVD) risk compared with the general population. Although ischemic cardiac manifestations are well known, prevalence of non-ischemic manifestations such as myocardial dysfunction and valvulopathy is less clear.Objectives:To compare prevalence of myocardial dysfunction and valvulopathy by ultrasound in ax-SpA patients and versus healthy controls.Methods:Two investigators independently searched for studies indexed in PUBMED, Cochrane Library and EMBASE databases and published before January 17th 2020. The search was focused on ultrasound evaluation of myocardial function and valvulopathy, with two-dimensional, Doppler, tissue Doppler, and speckle tracking echocardiography. We included for meta-analysis all controlled studies including ax-SpA without previous cardiovascular disease. Data were pooled using appropriate random or fixed effects model.Results:Literature search retrieved of 186 abstracts. A total of 31 papers were included in the systematic review and 27 papers were analyzed in the meta-analysis (1,494 ax-SpA patients and 1,091 healthy controls). Studies displayed cross-sectional design and included ax-SpA without prevalent cardiovascular disease.Ax-SpA was defined according to the modified New York criteria (24 studies) followed or the ASAS criteria (2 studies). HLA B27+ positivity ranged from 51 to 100%, mean age ranged from 26.7 to 55.7 years, disease duration ranged from 3.2 to 23.3 years and mean BASDAI ranged from 1.24 to 5.6.Patients with ax-SpA displayed a lower diastolic function with a lower E/A ratio, a higher deceleration time, a higher isovolumetric relaxation time and a lower systolic function with a lower ejection fraction (figure 1). Left-ventricular end diastolic and systolic diameters were higher in ax-SpA patients with respectively mean difference 0.55 mm [CI95%; 0.19, 0.91] and 0.79 mm [CI95%; 0.40, 1.17]. We did not find any difference for left and posterior ventricular thickness, left atrial dimension, and left ventricular mass index.Figure 1.Systolic and diastolic dysfunction is slightly altered in ax-SpA patients compared to healthy individuals Diastolic dysfunction was assessed by (A) E/A ratio (m/s), (B) deceleration time (ms), (C) Isovolumetric relaxation time (ms) and (D) systolic function was assessed by ejection fraction (%).A total of 15 articles reported prevalence of valvulopathy in ax-SpA. Prevalence of mitral regurgitation and aortic regurgitation were similar in ax-SpA patients and healthy individuals: OR=1.13 [CI95% 0.76, 1.68] and OR=1.18 [CI95% 0.68, 2.04].Conclusion:Prevalence of valvulopathy was similar in ax-SpA and healthy individuals. Diastolic and systolic function seems to be slightly altered in ax-SpA compared to healthy controls. However, this difference is unlikely clinically relevant. Usefulness of systematic echography remains to be determined in future longitudinal studies.Disclosure of Interests:Fanny Adeline: None declared, Xavier Romand Consultant of: Xavier ROMAND has received honorarium fees from Abbvie, Mickael Dalecky Consultant of: Mickael DALECKY has received honorarium fees from Abbvie, Arnaud Pfimlin Consultant of: Arnaud PFIMLIN has received honorarium fees from Abbvie, Daniel Wendling: None declared, Philippe Gaudin Speakers bureau: Lilly, Pascal Claudepierre Speakers bureau: Janssen, Novartis, Lilly, Maxime Dougados Grant/research support from: AbbVie, Eli Lilly, Merck, Novartis, Pfizer and UCB Pharma, Consultant of: AbbVie, Eli Lilly, Merck, Novartis, Pfizer and UCB Pharma, Speakers bureau: AbbVie, Eli Lilly, Merck, Novartis, Pfizer and UCB Pharma, Athan Baillet Consultant of: Athan BAILLET has received honorarium fees from Abbvie for his participation as the coordinator of the systematic literature review
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Trabelsi M, Romand X, Gilson M, Vaillant M, Guerne PA, Hayem G, Bertolini E, Baillet A, Gaudin P. Rheumatoid Meningitis a Rare Extra-Articular Manifestation of Rheumatoid Arthritis: Report of 6 Cases and Literature Review. J Clin Med 2020; 9:jcm9061625. [PMID: 32471260 PMCID: PMC7356493 DOI: 10.3390/jcm9061625] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2020] [Revised: 05/15/2020] [Accepted: 05/22/2020] [Indexed: 12/13/2022] Open
Abstract
Objectives. Central neurological manifestations of rheumatoid arthritis (RA) like rheumatoid meningitis (RM) are rare, little known and have a high rate of morbi-mortality. METHODS. We described six cases of RM that were directly related to RA activity after exhaustive assessment. RESULTS. They were mainly women, aged of 50 to 69. All were positive for anti-cyclic citrullinated peptide antibodies and half for rheumatoid factors. RA activity, duration, and treatments were heterogeneous including oral steroids, conventional synthetic disease modifying anti-rheumatic drugs (DMARDs) and biologic DMARDs. Symptoms were various, with acute or progressive beginning; main were: generalized or focal seizure (4/6), fever (3/6), headaches (3/6), and frontal syndrome (2/6). Imaging lesions were four leptomeningitis, one pachymeningitis, and one association of both. MRI usually showed hypersignal in various territories in T2-FLAIR (fluid attenuated inversion recovery) mode, and enhancement in T1-weighted mode after gadolinium injection. All patients had lumbar puncture that found sterile cerebrospinal fluid, no neoplasic cell, elevated cell count in 5/6 cases and elevated proteins concentration in 3/6 cases. Cerebral biopsy was possible for three patients, and definitively confirmed the diagnosis of aseptic lepto- or pachymenintis, excluding vasculitis and lymphoma. Different treatments were used like intravenous high dose steroids, immunoglobulins or biologic DMARDs, with variable clinical and imaging outcome: one death, one complete recovery, and four recoveries with sequelae. Conclusions. Clinical symptoms, imaging, lumbar puncture, and serological studies are often nonspecific, only histologic examination can confirm the diagnosis of RM. Any central neurological manifestation in RA patients, even in quiescent and ancient RA, should warn the physician.
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Affiliation(s)
- Mélanie Trabelsi
- Rheumatology Department, CHU Grenoble Alpes, Hôpital Sud, 38130 Echirolles, France; (X.R.); (M.G.); (A.B.); (P.G.)
- Correspondence:
| | - Xavier Romand
- Rheumatology Department, CHU Grenoble Alpes, Hôpital Sud, 38130 Echirolles, France; (X.R.); (M.G.); (A.B.); (P.G.)
- GREPI TIMC, CNRS UMR 5525, Université Grenoble Alpes, 38000 Grenoble, France
| | - Mélanie Gilson
- Rheumatology Department, CHU Grenoble Alpes, Hôpital Sud, 38130 Echirolles, France; (X.R.); (M.G.); (A.B.); (P.G.)
| | - Mathieu Vaillant
- Neurology Department, CHU Grenoble Alpes, Hôpital Nord, 38000 Grenoble, France;
| | | | - Gilles Hayem
- Rheumatology Department, Groupe Hospitalier Paris Saint Joseph, 75014 Paris, France;
| | - Ewa Bertolini
- Rheumatology Department, CH Annecy, 74370 Annecy, France;
| | - Athan Baillet
- Rheumatology Department, CHU Grenoble Alpes, Hôpital Sud, 38130 Echirolles, France; (X.R.); (M.G.); (A.B.); (P.G.)
- GREPI TIMC, CNRS UMR 5525, Université Grenoble Alpes, 38000 Grenoble, France
| | - Philippe Gaudin
- Rheumatology Department, CHU Grenoble Alpes, Hôpital Sud, 38130 Echirolles, France; (X.R.); (M.G.); (A.B.); (P.G.)
- GREPI TIMC, CNRS UMR 5525, Université Grenoble Alpes, 38000 Grenoble, France
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Baillet A, Romand X, Pflimlin A, Dalecky M, Claudepierrec P, Flipo RM, Ruyssen-Witrand A, Gaudin P, Gossec L, Molto A, Lukas C, Pouplin S, Soubrier M, Wendling D, Fayet F, Hudry C, Senbel E, Schwartz M, Hacquard-Bouder C, Dougados M. Data to be collected for an optimal management of axial spondyloarthritis in daily practice: Proposal from evidence-based and consensual approaches. Joint Bone Spine 2020; 87:405-411. [PMID: 32428691 DOI: 10.1016/j.jbspin.2020.04.019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Accepted: 04/30/2020] [Indexed: 01/17/2023]
Abstract
OBJECTIVE To propose a list of variables to be collected right after the diagnosis has been made and during the follow-up of patients with axial spondyloarthritis (ax-SpA) for an optimal management in daily practice. METHODS The process comprised (1) the evaluation of the interest of 51 variables proposed for the assessment of ax-SpA by means of a systematic literature research; (2) a consensus process involving 78 hospital-based or office-based rheumatologists, considering the collection of each variable in a 4 grade scale from "not very useful/useless" to "mandatory"; (3) a consensus on the minimum interval of time for periodic assessment of the selected variables on a 5 grade scale from "at each visit" to "never to be re-collected". RESULTS The systematic literature research retrieved a total of 14,133 abstracts, of which 213 were included in the final qualitative synthesis. Data to be collected at the initial systematic review comprised 5 patient's self-administered questionnaires, 3 variables of the physician's interview, 2 variables of the physical examination, 2 variables of the specific ax-SpA imaging and 2 other investigations. Two variables were recommended to be systematically collected at each visit, 1 variable twice a year, 6 variables yearly and 1 variable every 2 years. CONCLUSIONS Using an evidence-based and an expert consensus approaches, this initiative defined a core set of variables to be collected and reported right after the diagnosis and during follow-up of patients with ax-SpA in daily practice.
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Affiliation(s)
- Athan Baillet
- University Grenoble Alpes, GREPI TIMC, CNRS UMR 5525, Grenoble, France.
| | - Xavier Romand
- University Grenoble Alpes, GREPI TIMC, CNRS UMR 5525, Grenoble, France
| | - Arnaud Pflimlin
- Rheumatology, R Salengro Hospital, University of Lille, Lille, France
| | - Mickael Dalecky
- University Grenoble Alpes, GREPI TIMC, CNRS UMR 5525, Grenoble, France
| | - Pascal Claudepierrec
- Departement de Rhumatologie, Henri Mondor Hospital, AP-HP, Université Paris Est Créteil, EA 7379 - EpidermE, 94010, Créteil, France
| | - René-Marc Flipo
- Rheumatology, R Salengro Hospital, University of Lille, Lille, France
| | - Adeline Ruyssen-Witrand
- Rheumatology, UMR 1027 Inserm, Paul Sabatier University and Purpan Hospital, Toulouse, France. Sorbonne Universités, UPMC Univ, Paris, France
| | - Philippe Gaudin
- University Grenoble Alpes, GREPI TIMC, CNRS UMR 5525, Grenoble, France
| | - Laure Gossec
- Sorbonne Université, inserm, Institut Pierre-Louis d'épidémiologie et de santé Publique, Paris, France; Pitié Salpêtrière hospital, AP-HP, Rheumatology department, Paris, France
| | - Anna Molto
- Paris Descartes University, Department of Rheumatology - Hôpital Cochin. Assistance publique-Hôpitaux de Paris. inserm (U1153): Clinical epidemiology and biostatistics, Université de Paris, Paris, France
| | - Cédric Lukas
- Department of Rheumatology, CHU Montpellier and UMR5535 CNRS, Montpellier, France
| | | | - Martin Soubrier
- Department of Rheumatology, Gabriel Montpied University Hospital, Clermont-Ferrand, France
| | - Daniel Wendling
- Department of Rheumatology, CHRU Besançon, and EA 4266, Université de Franche-Comté, Besançon, France
| | - Françoise Fayet
- Department of Rheumatology, Gabriel Montpied University Hospital, Clermont-Ferrand, France
| | - Christophe Hudry
- Department of Rheumatology - Hôpital Cochin, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Eric Senbel
- AP-HM, Rheumatology Department, Sainte Marguerite Hospital, Marseille, France
| | - Marjorie Schwartz
- Departement de Rhumatologie, Henri Mondor Hospital, AP-HP, Université Paris Est Créteil, EA 7379 - EpidermE, 94010, Créteil, France
| | | | - Maxime Dougados
- Paris Descartes University, Department of Rheumatology - Hôpital Cochin. Assistance publique-Hôpitaux de Paris. inserm (U1153): Clinical epidemiology and biostatistics, Université de Paris, Paris, France
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Hubac J, Tribouillard H, Gastaldi R, Romand X, Gaudin P, Allenet B, Baillet A. Implementation of comorbidities' systematic screening program in daily practice in France. Joint Bone Spine 2020; 87:663-665. [PMID: 32387583 DOI: 10.1016/j.jbspin.2020.04.011] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Accepted: 04/27/2020] [Indexed: 11/17/2022]
Affiliation(s)
- Jason Hubac
- Department of Rheumatology, Grenoble Alpes University Hospital, 38130 Grenoble, France.
| | | | - Romain Gastaldi
- Department of Rheumatology, Grenoble Alpes University Hospital, 38130 Grenoble, France
| | - Xavier Romand
- Department of Rheumatology, Grenoble Alpes University Hospital, 38130 Grenoble, France; TIMC-IMAG UMR CNRS 5525, Grenoble Alpes University, Grenoble, France
| | - Philippe Gaudin
- Department of Rheumatology, Grenoble Alpes University Hospital, 38130 Grenoble, France; TIMC-IMAG UMR CNRS 5525, Grenoble Alpes University, Grenoble, France
| | - Benoit Allenet
- Pharmacy Department, Grenoble Alpes University Hospital, Grenoble, France; GREPI EA7408, Grenoble Alpes University, La Tronche, France
| | - Athan Baillet
- Department of Rheumatology, Grenoble Alpes University Hospital, 38130 Grenoble, France; TIMC-IMAG UMR CNRS 5525, Grenoble Alpes University, Grenoble, France
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Baillet A, Trocmé C, Romand X, Nguyen CMV, Courtier A, Toussaint B, Gaudin P, Epaulard O. Calprotectin discriminates septic arthritis from pseudogout and rheumatoid arthritis. Rheumatology (Oxford) 2020; 58:1644-1648. [PMID: 30919904 DOI: 10.1093/rheumatology/kez098] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [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: 11/08/2018] [Revised: 02/14/2019] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVE We aimed to determine whether calprotectin and α-defensins could discriminate septic from other inflammatory arthritides. METHODS Synovial fluids with a predominance of neutrophils from patients with septic arthritis, pseudogout and RA were prospectively collected. Neutrophil-related proteins calprotectin and human neutrophil α-defensins levels were assessed in synovial fluids. Demographic parameters and biomarkers with P-value ⩽0.05 for differentiating septic from non-septic arthritis were included in a multivariable model. Multivariable logistic regression with stepwise selection was performed to build the final combined model. RESULTS A total of 74 patients were included: septic arthritis (n = 26), pseudogout (n = 28) and RA (n = 20). Patients with septic arthritis were more likely to be male and young, and to display higher synovial neutrophil count. Calprotectin was significantly increased in patients with septic arthritis. The multivariable model included calprotectin, synovial fluid neutrophil count and gender. Calprotectin was the only biomarker that discriminated septic arthritis from non-septic inflammatory arthritides, with 76% sensitivity, 94% specificity and a positive likelihood ratio = 12.2 at the threshold for calprotectin of 150 mg/l. CONCLUSION Synovial fluid calprotectin is a relevant biomarker to discriminate septic arthritis from other inflammatory arthritides. This biomarker should be tested in an independent cohort.
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Affiliation(s)
- Athan Baillet
- University Grenoble-Alpes, GREPI EA74 08.,Sinnovial, SAS
| | - Candice Trocmé
- TheReX/TIMC-IMAG (UMR 5525) Laboratory, UGA.,Laboratoire de Biochimie des Enzymes et des Protéines, Centre Hospitalier Universitaire Grenoble Alpes
| | | | | | | | - Bertrand Toussaint
- TheReX/TIMC-IMAG (UMR 5525) Laboratory, UGA.,Laboratoire de Biochimie des Enzymes et des Protéines, Centre Hospitalier Universitaire Grenoble Alpes
| | | | - Olivier Epaulard
- Infectious Diseases Unit, Centre Hospitalier Universitaire Grenoble Alpes.,Fédération d'Infectiologie Multidisciplinaire de l'Arc Alpin, Université Grenoble Alpes, Grenoble, France
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Lavielle M, Puyraimond-Zemmour D, Romand X, Gossec L, Senbel E, Pouplin S, Beauvais C, Gutermann L, Mezieres M, Dougados M, Molto A. Methods to improve medication adherence in patients with chronic inflammatory rheumatic diseases: a systematic literature review. RMD Open 2018; 4:e000684. [PMID: 30116556 PMCID: PMC6088346 DOI: 10.1136/rmdopen-2018-000684] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2018] [Revised: 05/14/2018] [Accepted: 05/15/2018] [Indexed: 01/24/2023] Open
Abstract
Objective Lack of adherence to treatment is frequent in chronic inflammatory rheumatic diseases and is associated with poorer outcomes. The objective of this study was to describe and evaluate interventions that have been proposed to enhance medication adherence in these conditions. Methods A systematic literature review was performed in Pubmed, Cochrane, Embase and clinicaltrials.gov databases completed by the rheumatology meeting (ACR, EULAR and SFR) abstracts from last 2 years. All studies in English or French evaluating an intervention to improve medication adherence in chronic inflammatory rheumatic diseases (rheumatoid arthritis (RA), spondyloarthritis (SpA), crystal related diseases, connective tissue diseases, vasculitis and Still's disease) were included. Interventions on adherence were collected and classified in five modalities (educational, behavioural, cognitive behavioural, multicomponent interventions or others). Results 1325 abstracts were identified and 22 studies were finally included (18 studies in RA (72%), 4 studies in systemic lupus erythematosus (16%), 2 studies in SpA (8%) and 1 study in gout (4%)). On 13 randomised controlled trials (RCT) (1535 patients), only 5 were positive (774 patients). Educational interventions were the most represented and had the highest level of evidence: 8/13 RCT (62%, 1017 patients) and 4/8 were positive (50%). In these studies, each patient was individually informed or educated by different actors (physicians, pharmacists, nurses and so on). Supports and contents of these educational interventions were heterogenous. Conclusion Despite the importance of medication adherence in chronic inflammatory rheumatic disorders, evidence on interventions to improve medication adherence is scarce.
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Affiliation(s)
- Matthieu Lavielle
- Rheumatology Department, Cochin Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France.,Paris Descartes University, Paris, France
| | | | - Xavier Romand
- Rheumatology Department, Centre Hospitalier Universitaire Grenoble Alpes, Hôpital Sud, Echirolles, France
| | - Laure Gossec
- Sorbonne University, Paris, France.,Rheumatology Department, Pitié Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Eric Senbel
- Rheumatology Department, Sainte Marguerite Hospital, Assistance Publique-Hôpitaux de Marseille, Marseille, France
| | - Sophie Pouplin
- Rheumatology Department, Hôpitaux de Rouen, Rouen, France
| | - Catherine Beauvais
- Rheumatology Department, Saint-Antoine Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Loriane Gutermann
- Pharmacy Department, Cochin Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Maryse Mezieres
- Rheumatology Department, Cochin Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Maxime Dougados
- Rheumatology Department, Cochin Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France.,Paris Descartes University, Paris, France.,Paris Descartes University, INSERM (U1153): Clinical Epidemiology and Biostatistics, PRES Sorbonne Paris-Cité, Paris, France
| | - Anna Molto
- Rheumatology Department, Cochin Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France.,Paris Descartes University, Paris, France.,Paris Descartes University, INSERM (U1153): Clinical Epidemiology and Biostatistics, PRES Sorbonne Paris-Cité, Paris, France
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Chevreau M, Paclet MH, Romand X, Quesada JL, Vittecoq O, Dieudé P, Toussaint B, Gaudin P, Baillet A. Calprotectin is not independent from baseline erosion in predicting radiological progression in early rheumatoid arthritis. Comment on ‘Calprotectin as a marker of inflammation in patients with early rheumatoid arthritis’ by Jonsson et al. Ann Rheum Dis 2018; 77:e84. [DOI: 10.1136/annrheumdis-2017-212816] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2017] [Accepted: 12/15/2017] [Indexed: 11/03/2022]
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Chevreau M, Romand X, Gaudin P, Juvin R, Baillet A. Bisphosphonates for treatment of Complex Regional Pain Syndrome type 1: A systematic literature review and meta-analysis of randomized controlled trials versus placebo. Joint Bone Spine 2017; 84:393-399. [PMID: 28408275 DOI: 10.1016/j.jbspin.2017.03.009] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [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: 01/22/2017] [Accepted: 03/15/2017] [Indexed: 11/19/2022]
Abstract
OBJECTIVES Complex Regional Pain Syndrome Type 1 is a severely disabling pain syndrome with no definite established treatment. We have performed a systematic literature review and meta-analysis of all randomized controlled trials to assess the benefit of bisphosphonates on pain and function in patients with Complex Regional Pain Syndrome Type 1. METHODS A systematic literature search was performed in the Medline, Embase and Cochrane databases. Two authors selected independently blinded randomized trials comparing bisphosphonates to placebo on short-term (J30 to J40) and medium term pain (M2-M3), safety and function in patients with CRPS 1. The methodological quality of the studies was analyzed. Data were aggregated using the method of the inverse of the variance. RESULTS 258 articles were identified. Four trials of moderate to good quality comprising 181 patients (90 in the bisphosphonate group and 91 in the placebo group) were included in this meta-analysis. Short-term pain Visual Analog Scale was significantly lower in the bisphosphonate group versus the placebo group (SMD=-2.6, 95%CI [-1.8, -3.4], P<0.001), as well as the medium term Visual Analog Scale pain (SMD=-2.5, 95%CI [-1.4, -3.6], P<0.001). There were more adverse events in the bisphosphonate group (35.5%) than in the placebo group (16.4%) with a relative risk of 2.1 (95%CI [1.3, 3.5], P=0.004) and a number needed to harm of 4.6, (95%CI [2.4, 168.0]) but no serious side effects. CONCLUSIONS Our results suggest that bisphosphonates reduce pain in patients with Complex Regional Pain Syndrome type 1. Other studies are needed to determine their effectiveness.
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Affiliation(s)
- Maxime Chevreau
- Rheumatology Department, Hôpital Sud, Grenoble Teaching Hospital, 38130 Echirolles, France
| | - Xavier Romand
- Rheumatology Department, Hôpital Sud, Grenoble Teaching Hospital, 38130 Echirolles, France; GREPI - UGA EA 7408, Domaine de la Merci, 38700 La Tronche, France
| | - Philippe Gaudin
- Rheumatology Department, Hôpital Sud, Grenoble Teaching Hospital, 38130 Echirolles, France; GREPI - UGA EA 7408, Domaine de la Merci, 38700 La Tronche, France
| | - Robert Juvin
- Rheumatology Department, Hôpital Sud, Grenoble Teaching Hospital, 38130 Echirolles, France
| | - Athan Baillet
- Rheumatology Department, Hôpital Sud, Grenoble Teaching Hospital, 38130 Echirolles, France; GREPI - UGA EA 7408, Domaine de la Merci, 38700 La Tronche, France.
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