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Larid G, Baudens G, Tiemdjo-Djimaffo G, Coquerelle P, Goeb V, Guyot MH, Marguerie L, Maury F, Veillard E, Houvenagel E, Salmon JH, Flipo RM, Gervais E. Retention rate of subcutaneous TNF inhibitors in axial spondyloarthritis in a multicentre study from the RIC-FRANCE network. Sci Rep 2024; 14:1374. [PMID: 38228719 PMCID: PMC10791989 DOI: 10.1038/s41598-024-52016-4] [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: 07/08/2022] [Accepted: 01/12/2024] [Indexed: 01/18/2024] Open
Abstract
The objectives of our study were to assess retention rate, safety, and predictive factors for retention of subcutaneous (SC) TNF inhibitors (TNFi) (adalimumab (ADA), etanercept (ETN), golimumab (GOL), and certolizumab pegol (CZP)) in axial spondyloarthritis (axSpA) depending on the line of treatment in real-life conditions. A multicentre retrospective observational study was conducted including 552 patients fulfilling the ASAS criteria for axSpA followed in the RIC-France register who began SC-TNFi between 01/01/13 and 08/31/2018 for a total of 824 prescriptions. Taking all lines of treatment into account, GOL had a significantly higher retention rate compared with ADA, ETN, and CZP with a mean retention length of 59 months. As first-line bDMARDs, GOL had a significantly higher retention rate compared with ADA and ETN. ETN had the best retention rate when prescribed as at least 3rd bDMARD. Taking all lines of treatment into account, female sex, peripheral disease, BASDAI at initiation, and line of treatment were predictive factors for treatment cessation. Primary inefficiency was the most frequent reason for treatment cessation. In conclusion, GOL showed the highest retention rate in axSpA. Male sex, absence of peripheral disease, and early line of prescription were associated with better SC-TNFi retention in axSpA.
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Affiliation(s)
- Guillaume Larid
- LITEC, Université de Poitiers, CHU Poitiers, 86000, Poitiers, France.
| | | | | | | | - Vincent Goeb
- University Hospital of Amiens-Picardie, Amiens, France
| | | | | | | | | | | | | | | | - Elisabeth Gervais
- LITEC, Université de Poitiers, CHU Poitiers, 86000, Poitiers, France
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El Haddad R, Meneton P, Melchior M, Wiernik E, Zins M, Airagnes G. Changes in alcohol consumption according to the duration of unemployment: prospective findings from the French CONSTANCES cohort. BMJ Open 2023; 13:e077255. [PMID: 37984957 PMCID: PMC10660887 DOI: 10.1136/bmjopen-2023-077255] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Accepted: 10/19/2023] [Indexed: 11/22/2023] Open
Abstract
OBJECTIVES To prospectively examine the association between the duration of unemployment among job seekers and changes in alcohol use in a year. DESIGN A prospective study. SETTING French population-based CONSTANCES cohort. PARTICIPANTS We selected 84 943 participants from the CONSTANCES cohort included between 2012 and 2019 who, at baseline and 1-year follow-up, were either employed or job-seeking. OUTCOME MEASURES Multinomial logistic regression models computed the odds of reporting continuous no alcohol use, at-risk alcohol use, increased or decreased alcohol use compared with being continuously at low risk and according to employment status. The duration of unemployment was self-reported at baseline; thus, the employment status at 1-year follow-up was categorised as follows: (1) employed, (2) return to employment since less than a year, (3) unemployed for less than 1 year, (4) unemployed for 1 to 3 years and (5) unemployed for 3 years or more. Analyses were adjusted for age, gender, education, household monthly income, marital status, self-rated health, smoking status and depressive state. RESULTS Compared with being continuously at low risk (ie, ≤10 drinks per week), the unemployment categories were associated in a dose-dependent manner with an increased likelihood of reporting continuous no alcohol use (OR: 1.74-2.50), being continuously at-risk (OR: 1.21-1.83), experiencing an increase in alcohol use (OR: 1.21-1.51) and a decrease in alcohol use (OR: 1.17-1.84). CONCLUSION Although our results suggested an association between the duration of unemployment and a decrease in alcohol use, they also revealed associations between at-risk and increased alcohol use. Thus, screening for alcohol use among unemployed job seekers must be reinforced, especially among those with long-term unemployment.
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Affiliation(s)
- Rita El Haddad
- Population-based Epidemiological Cohorts Unit, UMS011, INSERM, Villejuif, France
| | - Pierre Meneton
- INSERM U1142 LIMICS, UMRS 1142, Sorbonne Universities, UPMC University of Paris 06, University of Paris 13, Paris, France
| | - Maria Melchior
- Institut Pierre Louis d'Épidémiologie et de Santé Publique IPLESP, INSERM UMR_S 1136, Sorbonne Université, Paris, France
| | - Emmanuel Wiernik
- Population-based Epidemiological Cohorts Unit, UMS011, INSERM, Villejuif, France
| | - Marie Zins
- Population-based Epidemiological Cohorts Unit, UMS011, INSERM, Villejuif, France
| | - Guillaume Airagnes
- Centre Ambulatoire d'Addictologie, AP-HP, Centre-Université Paris Cité, Paris, France
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Lespessailles E, Mahé E, Reguiai Z, Begon E, Maccari F, Beneton N, Chaby G, Rosenberg C, Dernis E, Roux F, Henry-Desailly I, Charles B, Ferdynus C, Marty M, Esteve E. Psychometric validation of a patient-reported outcome questionnaire (Qualipsosex) assessing the impact of psoriasis and psoriatic arthritis on patient perception of sexuality. Medicine (Baltimore) 2021; 100:e24168. [PMID: 33429800 PMCID: PMC7793412 DOI: 10.1097/md.0000000000024168] [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] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Revised: 10/30/2020] [Accepted: 12/10/2020] [Indexed: 01/05/2023] Open
Abstract
ABSTRACT Psoriasis (Pso) and psoriatic arthritis (PsA) frequently have a negative impact on patients' sexual health. We have developed a specific questionnaire assessing the impact of Pso and PsA on patient perception of sexuality: the QualipsoSex Questionnaire (QSQ). The aim of the present study was to further validate this questionnaire by checking its psychometric properties including validity, reliability, and responsiveness.A cross sectional observational study with a longitudinal component for responsiveness and test-retest reliability was performed in 12 centers in France including 7 dermatologists and 5 rheumatologists. Psychometric properties were examined according to the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) check-list.At baseline, 114 patients had Pso and 35 patients had PsA including 17 peripheral arthritis, 4 axial disease, 13 patients with both axial disease and peripheral arthritis and one patient with an undifferentiated phenotype. The mean Pso Area and Severity Index score was 12.5. Genital organs were involved in 44.7% of Pso cases. Internal consistency, construct validity, and reliability were good with Cronbach's α coefficient, measure of sampling adequacy and intraclass correlation coefficient respectively at 0.87, 0.84, and 0.93. The QSQ also demonstrated acceptable sensitivity to change.The QSQ has demonstrated good psychometric properties fulfilling the validation process relative to the recommendations of the COSMIN check list. The QSQ is simple to score and may hopefully be valuable in clinical practice and in clinical trials.
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Affiliation(s)
- Eric Lespessailles
- Department of Rheumatology, Regional Hospital of Orleans
- University of Orleans, EA 4708, I3MTO Laboratory
| | - Emmanuel Mahé
- Department of Dermatology, Hôpital Victor Dupouy, Argenteuil
| | - Ziad Reguiai
- Department of Dermatology, Polyclinique Courlancy-Bezannes, Reims
| | - Edouard Begon
- Department of Dermatology, Hôpital René Dubos, Pontoise
| | | | | | - Guillaume Chaby
- Department of Dermatology, Hôpital Nord, University of Amiens-Picardie, Amiens
| | | | | | - Fabienne Roux
- Department of Rheumatology, Saint Joseph Hospital, Paris
| | | | | | - Cyril Ferdynus
- CHU La Réunion, Unité de Soutien Méthodologique, F-97400, Saint-Denis, La Réunion
- INSERM, CIC 1410, F-97410, Saint Pierre, La Réunion
| | - Marc Marty
- Department of Rheumatology, Henri Mondor Hospital, Creteil
| | - Eric Esteve
- University of Orleans, EA 4708, I3MTO Laboratory
- Department of Dermatology, Regional Hospital of Orleans, Orleans, France
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Peffault De Latour R, Chevallier P, Blaise D, Alami S, Lévy-Bachelot L, Allavoine T, Tadmouri A, Blomkvist J, Duhamel A, Srour M, Beauvais D, Yakoub-Agha I. Clinical and economic impact of treated CMV infection in adult CMV-seropositive patients after allogeneic hematopoietic cell transplantation. J Med Virol 2020; 92:3665-3673. [PMID: 32297984 DOI: 10.1002/jmv.25895] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2019] [Accepted: 03/31/2020] [Indexed: 11/10/2022]
Abstract
OBJECTIVE Recipients of allogeneic hematopoietic stem cell transplantation (allo-HCT) with positive cytomegalovirus (CMV) serology are at increased risk of morbidity and mortality. The primary objective of this study was to assess the association between treated CMV infection and overall mortality within 1 year after allo-HCT in adult CMV-seropositive Recipients (R+). Secondary objectives included overall 5-year mortality after allo-HCT, risk factors for treated CMV infection, associations between treated CMV infection and allo-HCT complications and medical costs. METHODS A multicenter retrospective cohort study was conducted in adult CMV-seropositive recipients (R+) who underwent to allo-HCT between 1st January 2010 and 31st December 2014. RESULTS Five hundred seventy two CMV-seropositive patients (mean age, 50.2 years) undergoing allo-HCT between 2010 and 2014 were included; 55.9% of donors were CMV seropositive. CMV infection treated with antiviral therapy was reported in 227 patients (39.7%) after transplantation. One-year overall mortality was significantly increased in patients with treated CMV infections (hazard ratio, 1.86; 95% CI, 1.16-3.00; P = .011). Mean medical costs during the first post-HCT year were higher in patients with CMV infection (€46 853 vs €31 318; P < .0001). CONCLUSION In this large cohort of CMV-seropositive patients undergoing allo-HCT, treated CMV infection was significantly associated with an increased 1-year risk of overall mortality, with increased length of stay and with hospitalization cost. The burden of CMV disease in allo-HCT could be reduced in the future by appropriate prophylactic strategies.
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Affiliation(s)
| | | | - Didier Blaise
- Institut Paoli Calmettes, Department of Hematology, Centre de Recherche en Cancérologie de Marseille (CRCM), Marseille, France
| | | | | | | | | | | | - Alain Duhamel
- Université de Lille, CHU Lille, EA 2694 - Santé publique: épidémiologie et qualité des soins, Lille, France
| | - Micha Srour
- Hematology Department, Claude Huriez Hospital, Lille, France
| | - David Beauvais
- Hematology Department, Claude Huriez Hospital, Lille, France
- Lille University Hospital, Lille, France
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Michiels Y, Bugnon O, Chicoye A, Dejager S, Moisan C, Allaert FA, Hunault C, Romengas L, Méchin H, Vergès B. Impact of a Community Pharmacist-Delivered Information Program on the Follow-up of Type-2 Diabetic Patients: A Cluster Randomized Controlled Study. Adv Ther 2019; 36:1291-1303. [PMID: 31049873 PMCID: PMC6824455 DOI: 10.1007/s12325-019-00957-y] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Indexed: 11/26/2022]
Abstract
Introduction Low-quality communication between patients and care providers and limited patient knowledge of the disease and the therapy are important factors associated with poor glycemic control in patients with type 2 diabetes. We conducted a multicenter study to determine whether structured and tailored information delivered by pharmacists to type 2 diabetic patients could improve patient treatment adherence, hemoglobin A1c (HbA1c) levels and knowledge about diabetes. Methods One hundred seventy-four pharmacies were randomized to deliver an educational program on diet, drug treatment, disease and complications during three 30-min interviews over a 6-month period, or to provide no intervention, to type 2 diabetic patients treated with oral antidiabetic agents. Medication adherence was assessed by measuring the medication possession ratio and diabetes control by collecting HbA1c values. Levels of patient treatment self-management and disease knowledge were assessed using self-questionnaires. Results Three hundred seventy-seven patients were analyzed. The medication possession ratio, already very high at baseline in the intervention (94.8%) and control (92.3%) groups, did not vary significantly after 6 months with no difference between the two groups. Significant decreases in HbA1c were observed in both groups at 6 months (p < 0.001) and 12 months (p < 0.01), with significantly greater changes from baseline in the intervention group than in the control group at 6 months (− 0.5% vs. − 0.2%, p = 0.0047) and 12 months (− 0.6% vs. − 0.2%, p = 0.0057). Patients in the intervention group showed greater improvement in their ability to self-manage treatment (+ 4.86 vs. + 1.58, p = 0.0014) and in the extent of their knowledge about diabetes (+ 0.6 vs. + 0.2, p < 0.01) at 6 months versus baseline compared with the control group. Conclusion Tailored information provided by the pharmacist to patients with type 2 diabetes did not significantly improve the already high adherence rates, but was associated with a significant decrease in HbA1c and an improvement of patient knowledge about diabetes. Trial Registration ISRCTN33776525. Funding MSD France. Electronic Supplementary Material The online version of this article (10.1007/s12325-019-00957-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Yves Michiels
- Community Pharmacy, School of Pharmaceutical Sciences, University of Geneva, University of Lausanne, Lausanne, Switzerland
- Community Pharmacy, Center for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland
| | - Olivier Bugnon
- Community Pharmacy, School of Pharmaceutical Sciences, University of Geneva, University of Lausanne, Lausanne, Switzerland
- Community Pharmacy, Center for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland
| | - Annie Chicoye
- Institut d'Études Politiques de Paris, Paris, France
| | | | | | | | | | | | | | - Bruno Vergès
- Department of Endocrinology, Diabetology and Metabolic Diseases, CHU Dijon, Dijon, France.
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Maunoury F, Clément A, Nwankwo C, Levy-Bachelot L, Abergel A, Di Martino V, Thervet E, Durand-Zaleski I. Cost-effectiveness analysis of elbasvir-grazoprevir regimen for treating hepatitis C virus genotype 1 infection in stage 4-5 chronic kidney disease patients in France. PLoS One 2018; 13:e0194329. [PMID: 29543897 PMCID: PMC5854359 DOI: 10.1371/journal.pone.0194329] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2017] [Accepted: 02/20/2018] [Indexed: 01/20/2023] Open
Abstract
Objective To assess the cost-effectiveness of the elbasvir/grazoprevir (EBR/GZR) regimen in patients with genotype 1 chronic hepatitis C virus (HCV) infection with severe and end-stage renal disease compared to no treatment. Design This study uses a health economic model to estimate the cost-effectiveness of treating previously untreated and treatment experienced chronic hepatitis C patients who have severe and end stage renal disease with the elbasvir-grazoprevir regimen versus no treatment in the French context. The lifetime homogeneous markovian model comprises of forty combined health states including hepatitis C virus and chronic kidney disease. The model parameters were from a multicentre randomized controlled trial, ANRS CO22 HEPATHER French cohort and literature. 1000 Monte Carlo simulations of patient health states for each treatment strategy are used for probabilistic sensitivity analysis and 95% confidence intervals calculations. The results were expressed in cost per quality-adjusted life year (QALY) gained. Patients The mean age of patients in the HEPATHER French cohort was 59.6 years and 56% of them were men. 22.3% of patients had a F0 fibrosis stage (no fibrosis), 24.1% a F1 stage (portal fibrosis without septa), 7.1% a F2 stage (portal fibrosis with few septa), 21.4% a F3 stage (numerous septa without fibrosis) and 25% a F4 fibrosis stage (compensated cirrhosis). Among these HCV genotype 1 patients, 30% had severe renal impairment stage 4, 33% had a severe renal insufficiency stage 5 and 37% had terminal severe renal impairment stage 5 treated by dialysis. Intervention Fixed-dose combination of direct-acting antiviral agents elbasvir and grazoprevir compared to no-treatment. Results EBR/GZR increased the number of life years (6.3 years) compared to no treatment (5.1 years) on a lifetime horizon. The total number of QALYs was higher for the new treatment because of better utility on health conditions (6.2 versus 3.7 QALYs). The incremental cost-utility ratio (ICUR) was of €15,212 per QALY gained for the base case analysis. Conclusions This cost-utility model is an innovative approach that simultaneously looks at the disease evolution of chronic hepatitis C and chronic kidney disease. EBR/GZR without interferon and ribavirin, produced the greatest benefit in terms of life expectancy and quality-adjusted life years (QALY) in treatment-naïve or experienced patients with chronic hepatitis C genotype 1 and stage 4–5 chronic kidney disease including dialysis patients. Based on shape of the acceptability curve, EBR/GZR can be considered cost-effective at a willingness to pay of €20,000 /QALY for patients with renal insufficiency with severe and end-stage renal disease compared to no treatment.
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MESH Headings
- Amides
- Antiviral Agents/economics
- Antiviral Agents/therapeutic use
- Benzofurans/economics
- Benzofurans/therapeutic use
- Carbamates
- Cost-Benefit Analysis/methods
- Cyclopropanes
- Drug Therapy, Combination/economics
- Drug Therapy, Combination/methods
- Female
- France
- Genotype
- Hepacivirus/genetics
- Hepacivirus/isolation & purification
- Hepatitis C, Chronic/complications
- Hepatitis C, Chronic/drug therapy
- Hepatitis C, Chronic/economics
- Hepatitis C, Chronic/virology
- Humans
- Imidazoles/economics
- Imidazoles/therapeutic use
- Kidney Failure, Chronic/complications
- Kidney Failure, Chronic/economics
- Kidney Failure, Chronic/therapy
- Kidney Failure, Chronic/virology
- Liver Cirrhosis/complications
- Liver Cirrhosis/drug therapy
- Liver Cirrhosis/economics
- Liver Cirrhosis/virology
- Male
- Middle Aged
- Models, Economic
- Quality-Adjusted Life Years
- Quinoxalines/economics
- Quinoxalines/therapeutic use
- RNA, Viral/genetics
- RNA, Viral/isolation & purification
- Randomized Controlled Trials as Topic
- Renal Dialysis
- Sulfonamides
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Affiliation(s)
| | | | - Chizoba Nwankwo
- Merck & Co., Inc., Kenilworth, New Jersey, United States of America
| | | | - Armand Abergel
- Hepato-gastro enterology Service, CHU Estaing, Clermont-Ferrand, France
| | - Vincent Di Martino
- Hepatology Department, Franche-Comté University and Besançon University hospital, Besançon, France
| | - Eric Thervet
- HYPPARC Department, Nephrology Service, Paris Descartes University, Paris, France
- Georges Pompidou European Hospital (ET), Paris, France
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