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Lévesque H, Viallard JF, Houivet E, Bonnotte B, Voisin S, Le Cam-Duchez V, Maillot F, Lambert M, Liozon E, Hervier B, Fain O, Guillet B, Schmidt J, Luca LE, Ebbo M, Ferreira-Maldent N, Babuty A, Sailler L, Duffau P, Barbay V, Audia S, Benichou J, Graveleau J, Benhamou Y. Cyclophosphamide vs rituximab for eradicating inhibitors in acquired hemophilia A: A randomized trial in 108 patients. Thromb Res 2024; 237:79-87. [PMID: 38555718 DOI: 10.1016/j.thromres.2024.03.012] [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: 11/07/2023] [Revised: 02/19/2024] [Accepted: 03/07/2024] [Indexed: 04/02/2024]
Abstract
BACKGROUND Acquired hemophilia A (AHA) is a rare autoimmune disorder due to autoantibodies against Factor VIII, with a high mortality risk. Treatments aim to control bleeding and eradicate antibodies by immunosuppression. International recommendations rely on registers and international expert panels. METHODS CREHA, an open-label randomized trial, compared the efficacy and safety of cyclophosphamide and rituximab in association with steroids in patients with newly diagnosed AHA. Participants were treated with 1 mg/kg prednisone daily and randomly assigned to receive either 1.5-2 mg/kg/day cyclophosphamide orally for 6 weeks, or 375 mg/m2 rituximab once weekly for 4 weeks. The primary endpoint was complete remission over 18 months. Secondary endpoints included time to achieve complete remission, relapse occurrence, mortality, infections and bleeding, and severe adverse events. RESULTS Recruitment was interrupted because of new treatment recommendations after 108 patients included (58 cyclophosphamide, 50 rituximab). After 18 months, 39 cyclophosphamide patients (67.2 %) and 31 rituximab patients (62.0 %) were in complete remission (OR 1.26; 95 % CI, 0.57 to 2.78). In the poor prognosis group (FVIII < 1 IU/dL, inhibitor titer > 20 BU mL-1), significantly more remissions were observed with cyclophosphamide (22 patients, 78.6 %) than with rituximab (12 patients, 48.0 %; p = 0.02). Relapse rates, deaths, severe infections, and bleeding were similar in the 2 groups. In patients with severe infection, cumulative doses of steroids were significantly higher than in patients without infection (p = 0.03). CONCLUSION Cyclophosphamide and rituximab showed similar efficacy and safety. As first line, cyclophosphamide seems preferable, especially in poor prognosis patients, as administered orally and less expensive. FUNDING French Ministry of Health. CLINICALTRIALS gov number: NCT01808911.
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Affiliation(s)
- H Lévesque
- Normandie Univ, UNIROUEN, U 1096, CHU Rouen, Department of Internal Medicine, F-76000 Rouen, France.
| | - J F Viallard
- Service de Médecine Interne et Maladies Infectieuses Hôpital Haut-Lévêque, CHU Bordeaux, 5 avenue de Magellan, 33604 Pessac, France
| | - E Houivet
- Department of Biostatistics, CHU Rouen, F-76031 Rouen, France
| | - B Bonnotte
- Service de médecine interne et immunologie clinique, CHU Dijon-Bourgogne, Université de Dijon, F-21079 Dijon, France
| | - S Voisin
- Department of Internal Medicine, CHU Toulouse, F-31059 Toulouse. France
| | - V Le Cam-Duchez
- Normandie Univ, UNIROUEN, Hématologie biologique, F-76031 Rouen, France
| | - F Maillot
- Département de Médecine Interne et immunologie clinique, CHRU Tours, Université de Tours, F-37044 Tours, France
| | - M Lambert
- CHU Lille, Département de Médecine Interne et d'Immunologie Clinique, Centre National de Référence Maladies Systémiques et Auto-immunes Rares Nord et Nord-Ouest de France (CeRAINO), European Reerence Network on Rare Connective Tissue and Musculoskeletal Diseases Network (ReCONNECT), F-59000 Lille, France
| | - E Liozon
- Department of Internal Medicine, Dupuytren Hospital, F-87000 Limoges, France
| | - B Hervier
- Service de Médecine Interne, Hôpital Saint-Louis, APHP, 75010 Paris & INSERM UMR-S 976, Human Immunology, Pathophysiology, Immunotherapy, Saint-Louis Research Institute, F-75000 Paris, France
| | - O Fain
- Sorbonne Université, APHP, Service de Médecine Interne-DMU i3, Hôpital Saint-Antoine, Paris F-75000, France
| | - B Guillet
- Univ Rennes, CHU Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail) - UMR-S 1085, F-35000 Rennes, France
| | - J Schmidt
- Department of Internal Medicine, Amiens University Hospital, F-80000 Amiens, France
| | - L E Luca
- Department of Internal Medicine, Poitiers University Hospital, F-86000 Poitiers, France
| | - M Ebbo
- Service de Médecine Interne, Hôpital La Timone, CHU Marseille, Aix-Marseille Université, F-13000 Marseille, France
| | - N Ferreira-Maldent
- Département de Médecine Interne et immunologie clinique, CHRU Tours, Université de Tours, F-37044 Tours, France
| | - A Babuty
- Service d'Hématologie Biologique, CRC-MHC, CHU de Nantes, Nantes Cedex 1, France
| | - L Sailler
- Department of Internal Medicine, CHU Toulouse, F-31059 Toulouse. France
| | - P Duffau
- Service de Médecine Interne-Immunologie Clinique Hôpital Saint-André, CHU Bordeaux, 1 rue Jean Burguet, 33075 Bordeaux, France
| | - V Barbay
- Normandie Univ, UNIROUEN, Hématologie biologique, F-76031 Rouen, France
| | - S Audia
- Service de médecine interne et immunologie clinique, CHU Dijon-Bourgogne, Université de Dijon, F-21079 Dijon, France
| | - J Benichou
- Department of Biostatistics, CHU Rouen and CESP UMR 1018, University of Rouen and University Paris-Saclay, F-76031 Rouen, France
| | - J Graveleau
- Nantes Université, CHU Nantes, Service de Médecine Interne, Nantes, France
| | - Y Benhamou
- Normandie Univ, UNIROUEN, U 1096, CHU Rouen, Department of Internal Medicine, F-76000 Rouen, France
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Mahé I, Mayeur D, Couturaud F, Scotté F, Benhamou Y, Benmaziane A, Bertoletti L, Laporte S, Girard P, Mismetti P, Sanchez O. [Translation into French and republication of: "Anticoagulant treatment of cancer-associated thromboembolism"]. Rev Med Interne 2024; 45:210-225. [PMID: 38677976 DOI: 10.1016/j.revmed.2024.04.004] [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: 11/17/2023] [Accepted: 11/17/2023] [Indexed: 04/29/2024]
Abstract
Venous thromboembolism (VTE) is a frequent and potentially fatal complication in patients with cancer. During the initial period after the thromboembolic event, a patient receiving anticoagulant treatment is exposed both to a risk of VTE recurrence and also to an elevated bleeding risk conferred by the treatment. For this reason, the choice of anticoagulant is critical. The choice should take into account patient-related factors (such as functional status, age, body mass index, platelet count and renal function), VTE-related factors (such as severity or site), cancer-related factors (such as activity and progression) and treatment related factors (such as drug-drug interactions), which all potentially influence bleeding risk, and patient preference. These should be evaluated carefully for each patient during a multidisciplinary team meeting. For most patients, apixaban or a low molecular-weight heparin is the most appropriate initial choice for anticoagulant treatment. Such treatment should be offered to all patients with active cancer for at least 6months. The patient and treatment should be re-evaluated regularly, and anticoagulant treatment changed when necessary. Continued anticoagulant treatment beyond 6months is justified if the cancer remains active or if the patient experienced recurrence of VTE in the first 6months. In other cases, the interest of continued anticoagulant treatment may be considered on an individual patient basis in collaboration with oncologists.
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Affiliation(s)
- I Mahé
- Service de médecine interne, hôpital Louis-Mourier, AP-HP, 92700 Colombes, France; Inserm UMR S1140, Innovations thérapeutiques en hémostase, université Paris Cité, Paris, France; F-CRIN INNOVTE network, Saint-Étienne, France.
| | - D Mayeur
- Département d'oncologie médicale, centre Georges-François-Leclerc, Dijon, France
| | - F Couturaud
- F-CRIN INNOVTE network, Saint-Étienne, France; Département de médecine interne, médecine vasculaire et pneumologie, Inserm U1304-Getbo, université de Brest, CHU de Brest, Brest, France
| | - F Scotté
- Département interdisciplinaire d'organisation des parcours patients (DIOPP), institut Gustave-Roussy, Villejuif, France
| | - Y Benhamou
- F-CRIN INNOVTE network, Saint-Étienne, France; UniRouen, U1096, service de médecine interne, CHU Charles-Nicolle, Normandie université, Rouen, France
| | - A Benmaziane
- Département d'oncologie et de soins de supports, hôpital Foch, Suresnes, France
| | - L Bertoletti
- F-CRIN INNOVTE network, Saint-Étienne, France; Service de médecine vasculaire et thérapeutique, Inserm, UMR1059, équipe dysfonction vasculaire et hémostase, université Jean-Monnet, Inserm CIC-1408, CHU de Saint-Étienne, Saint-Étienne, France
| | - S Laporte
- F-CRIN INNOVTE network, Saint-Étienne, France; Sainbiose Inserm U1059, unité de Recherche clinique, innovation et pharmacologie, hôpital Nord, CHU de Saint-Étienne, université Jean-Monnet, Saint-Étienne, France
| | - P Girard
- F-CRIN INNOVTE network, Saint-Étienne, France; Institut du thorax Curie-Montsouris, Institut mutualiste Montsouris, Paris, France
| | - P Mismetti
- F-CRIN INNOVTE network, Saint-Étienne, France; Service de médecine vasculaire et thérapeutique, hôpital Nord, CHU de Saint-Étienne, Saint-Étienne, France
| | - O Sanchez
- Inserm UMR S1140, Innovations thérapeutiques en hémostase, université Paris Cité, Paris, France; F-CRIN INNOVTE network, Saint-Étienne, France; Service de pneumologie et de soins intensifs, hôpital européen Georges-Pompidou, AP-HP, Paris, France
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Amoura Z, Bader-Meunier B, Bal Dit Sollier C, Belot A, Benhamou Y, Bezanahary H, Cohen F, Costedoat-Chalumeau N, Darnige L, Drouet L, Elefant E, Harroche A, Lambert M, Martin T, Martin-Toutain I, Mathian A, Mekinian A, Pineton De Chambrun M, de Pontual L, Wahl D, Yelnik C, Zuily S. French National Diagnostic and Care Protocol for antiphospholipid syndrome in adults and children. Rev Med Interne 2023; 44:495-520. [PMID: 37735010 DOI: 10.1016/j.revmed.2023.08.004] [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: 08/21/2023] [Accepted: 08/29/2023] [Indexed: 09/23/2023]
Abstract
Antiphospholipid syndrome (APS) is a chronic autoimmune disease involving vascular thrombosis and/or obstetric morbidity and persistent antibodies to phospholipids or certain phospholipid-associated proteins. It is a rare condition in adults and even rarer in children. The diagnosis of APS can be facilitated by the use of classification criteria based on a combination of clinical and biological features. APS may be rapidly progressive with multiple, often synchronous thromboses, resulting in life-threatening multiple organ failure. This form is known as "catastrophic antiphospholipid syndrome" (CAPS). It may be primary or associated with systemic lupus erythematosus (associated APS) and in very rare cases with other systemic autoimmune diseases. General practitioners and paediatricians may encounter APS in patients with one or more vascular thromboses. Because APS is so rare and difficult to diagnosis (risk of overdiagnosis) any suspected case should be confirmed rapidly and sometimes urgently by an APS specialist. First-line treatment of thrombotic events in APS includes heparin followed by long-term anticoagulation with a VKA, usually warfarin. Except in the specific case of stroke, anticoagulants should be started as early as possible. Any temporary discontinuation of anticoagulants is associated with a high risk of thrombosis in APS. A reference/competence centre specialised in autoimmune diseases must be urgently consulted for the therapeutic management of CAPS.
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Affiliation(s)
- Z Amoura
- Department of Internal Medicine, Institut E3M, CIMI-Paris, Faculty of medicine, National Reference Centre of Systemic Lupus, antiphospholipid syndrome, and other autoimmune diseases, Sorbonne University, AP-HP, Pitié Salpêtrière, boulevard de l'Hôpital, 75013 Paris, France.
| | - B Bader-Meunier
- Laboratory of Immunogenetics of Paediatric Autoimmune Diseases, Institute Imagine, University Paris Cité, Paris, France
| | - C Bal Dit Sollier
- Thrombosis and atherosclerosis research unit, vessels and blood institute (IVS), anticoagulation clinic (CREATIF), Lariboisière hospital, AP-HP, 75010 Paris, France
| | - A Belot
- Department of Pediatric Nephrology, Rheumatology, Dermatology, Reference Centre for Rheumatic, AutoImmune and Systemic diseases in children (RAISE), hôpital femme mère enfant, CHU de Lyon, Bron, France
| | - Y Benhamou
- National Reference Centre of MicroAngiopathies Thrombotic, Paris, France; Department of Internal Medicine, University Hospital of Rouen, Normandie University, Rouen, France
| | - H Bezanahary
- Department of Internal Medicine and Clinical Immunology, centre hospitalier universitaire de Limoges, Limoges, France
| | - F Cohen
- Department of Internal Medicine, Institut E3M, CIMI-Paris, Faculty of medicine, National Reference Centre of Systemic Lupus, antiphospholipid syndrome, and other autoimmune diseases, Sorbonne University, AP-HP, Pitié Salpêtrière, boulevard de l'Hôpital, 75013 Paris, France
| | - N Costedoat-Chalumeau
- Department of Internal Medicine, Referral Centre for Rare Autoimmune and Systemic Diseases of Île-de-France, AP-HP, Cochin Hospital, Paris, France; Centre for Epidemiology and Statistics, Institut national de la santé et de la recherche médicale, French National Institute for Agricultural Research, University Paris Cité, Paris, France
| | - L Darnige
- Biological Hematology Department, Assistance publique-Hôpitaux de Paris, hôpital européen Georges-Pompidou, Inserm, UMR-S1140, Innovative Therapies in Haemostasis, Paris, France
| | - L Drouet
- Thrombosis and atherosclerosis research unit, vessels and blood institute (IVS), anticoagulation clinic (CREATIF), Lariboisière hospital, AP-HP, 75010 Paris, France
| | - E Elefant
- Reference Center for Teratogenic Agents, hôpital Armand-Trousseau centre de référence sur les agents tératogènes, Île-de-France, Paris, France
| | - A Harroche
- Department of Hematology, Haemophilia Treatment Centre, University Hospital Necker Enfants Malades, Paris, France
| | - M Lambert
- Department of Internal Medicine and Clinical immunology, Reference Centre of Autoimmune Systemic Rare Diseases Of North And North-West of France (CeRAINO), U1167 RID-AGE, Lille University, Inserm, University hospital of Lille, 59000 Lille, France
| | - T Martin
- Department of Internal Medicine and Clinical Immunology, Strasbourg University Hospital, Strasbourg, France
| | - I Martin-Toutain
- Resource and Competence Centre for Haemorrhagic Diseases, Hospital Center of Versailles André-Mignot, Le Chesnay, France
| | - A Mathian
- Department of Internal Medicine, Institut E3M, CIMI-Paris, Faculty of medicine, National Reference Centre of Systemic Lupus, antiphospholipid syndrome, and other autoimmune diseases, Sorbonne University, AP-HP, Pitié Salpêtrière, boulevard de l'Hôpital, 75013 Paris, France
| | - A Mekinian
- Department of Internal Medicine and Inflammation-Immunopathology-Biotherapy (DMU i3), Saint-Antoine Hospital, Sorbonne University, AP-HP, 75012 Paris, France
| | - M Pineton De Chambrun
- Department of Internal Medicine, Institut E3M, CIMI-Paris, Faculty of medicine, National Reference Centre of Systemic Lupus, antiphospholipid syndrome, and other autoimmune diseases, Sorbonne University, AP-HP, Pitié Salpêtrière, boulevard de l'Hôpital, 75013 Paris, France
| | - L de Pontual
- Department of Paediatrics, Jean-Verdier Hospital, AP-HP, HUPSSD, 93140 Bondy, France
| | - D Wahl
- Vascular Medicine Division and Regional Competence Centre for Rare Vascular and Systemic Autoimmune Diseases, CHRU de Nancy, Nancy, France
| | - C Yelnik
- Department of Internal Medicine and Clinical immunology, Reference Centre of Autoimmune Systemic Rare Diseases Of North And North-West of France (CeRAINO), U1167 RID-AGE, Lille University, Inserm, University hospital of Lille, 59000 Lille, France
| | - S Zuily
- Vascular Medicine Division and Regional Competence Centre for Rare Vascular and Systemic Autoimmune Diseases, CHRU de Nancy, Nancy, France
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Dutertre M, Pugnet G, De Moreuil C, Bonnotte B, Benhamou Y, Chauveau D, Diot E, Duffau P, Limal N, Néel A, Urbansky G, Jourde-Chiche N, Fauchais A, Dossier A, Schleinitz N, Jilet L, Guillevin L, Abdoul H, Puéchal X, Terrier B. Efficacité à long terme des schémas d’induction de la rémission au cours de la granulomatose éosinophilique avec polyangéite : résultats de l’essai REOVAS. Rev Med Interne 2022. [DOI: 10.1016/j.revmed.2022.10.085] [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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Stammler R, Nguyen Y, Yelnik C, Le Guern V, Lambert M, Paule R, Mouthon L, Dupré A, Ackermann F, Dufrost V, Godeau B, Leroux G, Benhamou Y, Lazaro E, Daugas E, Bezanahary H, Mekinian A, Piette J, Morel N, Costedoat-Chalumeau N. Facteurs précipitants la survenue d’un syndrome catastrophique des antiphospholipides : étude du rôle du traitement anticoagulant. Rev Med Interne 2022. [DOI: 10.1016/j.revmed.2022.10.070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Marcellin F, Brégigeon-Ronot S, Ramier C, Protopopescu C, Gilbert C, Di Beo V, Duvivier C, Bureau-Stoltmann M, Rosenthal E, Wittkop L, Salmon-Céron D, Carrieri P, Sogni P, Barré T, Salmon D, Wittkop L, Sogni P, Esterle L, Trimoulet P, Izopet J, Serfaty L, Paradis V, Spire B, Carrieri P, Valantin M, Pialoux G, Chas J, Zaegel-Faucher O, Barange K, Naqvi A, Rosenthal E, Bicart-See A, Bouchaud O, Gervais A, Lascoux-Combe C, Goujard C, Lacombe K, Duvivier C, Neau D, Morlat P, Bani-Sadr F, Meyer L, Boufassa F, Autran B, Roque A, Solas C, Fontaine H, Costagliola D, Piroth L, Simon A, Zucman D, Boué F, Miailhes P, Billaud E, Aumaître H, Rey D, Peytavin G, Petrov-Sanchez V, Levier A, Salmon D, Usubillaga R, Sogni P, Terris B, Tremeaux P, Katlama C, Valantin M, Stitou H, Simon A, Cacoub P, Nafissa S, Benhamou Y, Charlotte F, Fourati S, Poizot-Martin I, Zaegel O, Laroche H, Tamalet C, Pialoux G, Chas J, Callard P, Bendjaballah F, Amiel C, Le Pendeven C, Marchou B, Alric L, Barange K, Metivier S, Selves J, Larroquette F, Rosenthal E, Naqvi A, Rio V, Haudebourg J, Saint-Paul M, De Monte A, Giordanengo V, Partouche C, Bouchaud O, Martin A, Ziol M, Baazia Y, Iwaka-Bande V, Gerber A, Uzan M, Bicart-See A, Garipuy D, Ferro-Collados M, Selves J, Nicot F, Gervais A, Yazdanpanah Y, Adle-Biassette H, Alexandre G, Peytavin G, Lascoux-Combe C, Molina J, Bertheau P, Chaix M, Delaugerre C, Maylin S, Lacombe K, Bottero J, Krause J, Girard P, Wendum D, Cervera P, Adam J, Viala C, Vittecocq D, Goujard C, Quertainmont Y, Teicher E, Pallier C, Lortholary O, Duvivier C, Rouzaud C, Lourenco J, Touam F, Louisin C, Avettand-Fenoel V, Gardiennet E, Mélard A, Neau D, Ochoa A, Blanchard E, Castet-Lafarie S, Cazanave C, Malvy D, Dupon M, Dutronc H, Dauchy F, Lacaze-Buzy L, Desclaux A, Bioulac-Sage P, Trimoulet P, Reigadas S, Morlat P, Lacoste D, Bonnet F, Bernard N, Hessamfar M, Paccalin J, Martell C, Pertusa M, Vandenhende M, Mercié P, Malvy D, Pistone T, Receveur M, Méchain M, Duffau P, Rivoisy C, Faure I, Caldato S, Bioulac-Sage P, Trimoulet P, Reigadas S, Bellecave P, Tumiotto C, Pellegrin J, Viallard J, Lazzaro E, Greib C, Bioulac-Sage P, Trimoulet P, Reigadas S, Zucman D, Majerholc C, Brollo M, Farfour E, Boué F, Polo Devoto J, Kansau I, Chambrin V, Pignon C, Berroukeche L, Fior R, Martinez V, Abgrall S, Favier M, Deback C, Lévy Y, Dominguez S, Lelièvre J, Lascaux A, Melica G, Billaud E, Raffi F, Allavena C, Reliquet V, Boutoille D, Biron C, Lefebvre M, Hall N, Bouchez S, Rodallec A, Le Guen L, Hemon C, Miailhes P, Peyramond D, Chidiac C, Ader F, Biron F, Boibieux A, Cotte L, Ferry T, Perpoint T, Koffi J, Zoulim F, Bailly F, Lack P, Maynard M, Radenne S, Amiri M, Valour F, Koffi J, Zoulim F, Bailly F, Lack P, Maynard M, Radenne S, Augustin-Normand C, Scholtes C, Le-Thi T, Piroth L, Chavanet P, Duong Van Huyen M, Buisson M, Waldner-Combernoux A, Mahy S, Salmon Rousseau A, Martins C, Aumaître H, Galim S, Bani-Sadr F, Lambert D, Nguyen Y, Berger J, Hentzien M, Brodard V, Rey D, Partisani M, Batard M, Cheneau C, Priester M, Bernard-Henry C, de Mautort E, Fischer P, Gantner et S Fafi-Kremer P, Roustant F, Platterier P, Kmiec I, Traore L, Lepuil S, Parlier S, Sicart-Payssan V, Bedel E, Anriamiandrisoa S, Pomes C, Touam F, Louisin C, Mole M, Bolliot C, Catalan P, Mebarki M, Adda-Lievin A, Thilbaut P, Ousidhoum Y, Makhoukhi F, Braik O, Bayoud R, Gatey C, Pietri M, Le Baut V, Ben Rayana R, Bornarel D, Chesnel C, Beniken D, Pauchard M, Akel S, Caldato S, Lions C, Ivanova A, Ritleg AS, Debreux C, Chalal L, J.Zelie, Hue H, Soria A, Cavellec M, Breau S, Joulie A, Fisher P, Gohier S, Croisier-Bertin D, Ogoudjobi S, Brochier C, Thoirain-Galvan V, Le Cam M, Carrieri P, Chalouni M, Conte V, Dequae-Merchadou L, Desvallées M, Esterle L, Gilbert C, Gillet S, Guillochon Q, Khan C, Knight R, Marcellin F, Michel L, Mora M, Protopopescu C, Roux P, Spire B, Barré T, Ramier C, Sow A, Lions C, Di Beo V, Bureau M, Wittkop L. Depressive symptoms after hepatitis C cure and socio-behavioral correlates in aging people living with HIV (ANRS CO13 HEPAVIH). JHEP Rep 2022; 5:100614. [DOI: 10.1016/j.jhepr.2022.100614] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 10/06/2022] [Accepted: 10/07/2022] [Indexed: 11/06/2022] Open
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Mirouse A, Deltour S, Leclerc D, Pouchelon C, Comarmond C, Kahn J, Benhamou Y, Mirault T, Mekinian A, Lambert M, Cacoub P, Biard L, Saadoun D. Accidents cérébraux ischémiques au cours de la maladie de Takayasu. Rev Med Interne 2022. [DOI: 10.1016/j.revmed.2022.03.322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Lévesque H, Guillet B, Benhamou Y. [Acquired hemophilia and pregnancy: A necessarily multidisciplinary approach]. Rev Med Interne 2022; 43:494-497. [PMID: 35637030 DOI: 10.1016/j.revmed.2022.04.012] [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: 02/15/2022] [Revised: 03/22/2022] [Accepted: 04/02/2022] [Indexed: 11/19/2022]
Abstract
The occurrence of acquired hemophilia during pregnancy or postpartum is rare (2 to 10 % in series). It is generally suspected in the presence of haemorrhagic manifestations (especially subcutataneous or mucosal bleeding) associated with an isolated prolongation of the activated partial thromboplastin time (APTT). The diagnosis is confirmed by the association of a low level of factor VIII (FVIII) and the presence of an anti-FVIII inhibitor. Postpartum management is similar to that of other acquired haemophilias: correction of a severe haemorrhagic syndrome by "bypassing" agents, eradication of the inhibitor by corticosteroids alone or in combination with another immunosuppressive agent depending on the residual level of FVIII and the titer of the inhibitor. Management of the forms occurring during pregnancy is based on rare experiences or expert opinions. The management of childbirth is particularly delicate in terms of haemorrhage, especially if the anti-FVIII inhibitor is still present, and must be prepared in a multidisciplinary manner. Finally, as with any acquired hemophilia, a relapse is possible, especially in the year following remission. During a subsequent pregnancy, the risk of recurrence is possible but should not be a contraindication to a new pregnancy.
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Affiliation(s)
- H Lévesque
- Service de médecine interne, Normandie université, UNIROUEN, Interne, 76031 Rouen, France.
| | - B Guillet
- Centre de traitement des maladies hémorragiques, CHU de Rennes, Rennes, France; Inserm, EHESP, IRSET (institut de recherche en santé, environnement et travail) - UMR_S 1085, Université Rennes, CHU de Rennes, 35000 Rennes, France
| | - Y Benhamou
- Service de médecine interne, Normandie université, UNIROUEN, Interne, 76031 Rouen, France
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Barré T, Mercié P, Lions C, Miailhes P, Zucman D, Aumaître H, Esterle L, Sogni P, Carrieri P, Salmon-Céron D, Marcellin F, Salmon D, Wittkop L, Sogni P, Esterle L, Trimoulet P, Izopet J, Serfaty L, Paradis V, Spire B, Carrieri P, Valantin MA, Pialoux G, Chas J, Poizot-Martin I, Barange K, Naqvi A, Rosenthal E, Bicart-See A, Bouchaud O, Gervais A, Lascoux-Combe C, Goujard C, Lacombe K, Duvivier C, Neau D, Morlat P, Bani-Sadr F, Meyer L, Boufassa F, Autran B, Roque AM, Solas C, Fontaine H, Costagliola D, Piroth L, Simon A, Zucman D, Boué F, Miailhes P, Billaud E, Aumaître H, Rey D, Peytavin G, Petrov-Sanchez V, Levier A, Usubillaga R, Terris B, Tremeaux P, Katlama C, Valantin MA, Stitou H, Cacoub P, Nafissa S, Benhamou Y, Charlotte F, Fourati S, Zaegel O, Laroche H, Tamalet C, Callard P, Bendjaballah F, Le Pendeven C, Marchou B, Alric L, Metivier S, Selves J, Larroquette F, Rio V, Haudebourg J, Saint-Paul MC, De Monte A, Giordanengo V, Partouche C, Martin A, Ziol M, Baazia Y, Iwaka-Bande V, Gerber A, Uzan M, Garipuy D, Ferro-Collados MJ, Nicot F, Yazdanpanah Y, Adle-Biassette H, Alexandre G, Molina JM, Bertheau P, Chaix ML, Delaugerre C, Maylin S, Bottero J, Krause J, Girard PM, Wendum D, Cervera P, Adam J, Viala C, Vittecocq D, Quertainmont Y, Teicher E, Pallier C, Lortholary O, Rouzaud C, Lourenco J, Touam F, Louisin C, Avettand-Fenoel V, Gardiennet E, Mélard A, Ochoa A, Blanchard E, Castet-Lafarie S, Cazanave C, Malvy D, Dupon M, Dutronc H, Dauchy F, Lacaze-Buzy L, Desclaux A, Bioulac-Sage P, Reigadas S, Lacoste D, Bonnet F, Bernard N, Hessamfar M, J, Paccalin F, Martell C, Pertusa MC, Vandenhende M, Mercié P, Pistone T, Receveur MC, Méchain M, Duffau P, Rivoisy C, Faure I, Caldato S, Bellecave P, Tumiotto C, Pellegrin JL, Viallard JF, Lazzaro E, Greib C, Majerholc C, Brollo M, Farfour E, Devoto JP, Kansau I, Chambrin V, Pignon C, Berroukeche L, Fior R, Martinez V, Abgrall S, Favier M, Deback C, Lévy Y, Dominguez S, Lelièvre JD, Lascaux AS, Melica G, Raffi F, Allavena C, Reliquet V, Boutoille D, Biron C, Lefebvre M, Hall N, Bouchez S, Rodallec A, Le Guen L, Hemon C, Peyramond D, Chidiac C, Ader F, Biron F, Boibieux A, Cotte L, Ferry T, Perpoint T, Koffi J, Zoulim F, Bailly F, Lack P, Maynard M, Radenne S, Amiri M, Valour F, Augustin-Normand C, Scholtes C, Le-Thi TT, Van Huyen PCMD, Buisson M, Waldner-Combernoux A, Mahy S, Rousseau AS, Martins C, Galim S, Lambert D, Nguyen Y, Berger JL, Hentzien M, Brodard V, Partisani M, Batard ML, Cheneau C, Priester M, Bernard-Henry C, de Mautort E, Fischer P, Gantner P, Fafi-Kremer S, Roustant F, Platterier P, Kmiec I, Traore L, Lepuil S, Parlier S, Sicart-Payssan V, Bedel E, Anriamiandrisoa S, Pomes C, Mole M, Bolliot C, Catalan P, Mebarki M, Adda-Lievin A, Thilbaut P, Ousidhoum Y, Makhoukhi FZ, Braik O, Bayoud R, Gatey C, Pietri MP, Le Baut V, Rayana RB, Bornarel D, Chesnel C, Beniken D, Pauchard M, Akel S, Lions C, Ivanova A, Ritleg AS, Debreux C, Chalal L, Zelie J, Hue H, Soria A, Cavellec M, Breau S, Joulie A, Fisher P, Gohier S, Croisier-Bertin D, Ogoudjobi S, Brochier C, Thoirain-Galvan V, Le Cam M, Chalouni M, Conte V, Dequae-Merchadou L, Desvallees M, Gilbert C, Gillet S, Knight R, Lemboub T, Marcellin F, Michel L, Mora M, Protopopescu C, Roux P, Tezkratt S, Barré T, Rojas TR, Baudoin M, Di Beo MSV, Nishimwe M. HCV cure: an appropriate moment to reduce cannabis use in people living with HIV? (ANRS CO13 HEPAVIH data). AIDS Res Ther 2022; 19:15. [PMID: 35292069 PMCID: PMC8922772 DOI: 10.1186/s12981-022-00440-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Accepted: 03/06/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Thanks to direct-acting antivirals, hepatitis C virus (HCV) infection can be cured, with similar rates in HCV-infected and HIV-HCV co-infected patients. HCV cure is likely to foster behavioral changes in psychoactive substance use, which is highly prevalent in people living with HIV (PLWH). Cannabis is one substance that is very commonly used by PLWH, sometimes for therapeutic purposes. We aimed to identify correlates of cannabis use reduction following HCV cure in HIV-HCV co-infected cannabis users and to characterize persons who reduced their use. METHODS We used data collected on HCV-cured cannabis users in a cross-sectional survey nested in the ANRS CO13 HEPAVIH cohort of HIV-HCV co-infected patients, to perform logistic regression, with post-HCV cure cannabis reduction as the outcome, and socio-behavioral characteristics as potential correlates. We also characterized the study sample by comparing post-cure substance use behaviors between those who reduced their cannabis use and those who did not. RESULTS Among 140 HIV-infected cannabis users, 50 and 5 had reduced and increased their use, respectively, while 85 had not changed their use since HCV cure. Cannabis use reduction was significantly associated with tobacco use reduction, a decrease in fatigue level, paying more attention to one's dietary habits since HCV cure, and pre-HCV cure alcohol abstinence (p = 0.063 for alcohol use reduction). CONCLUSIONS Among PLWH using cannabis, post-HCV cure cannabis reduction was associated with tobacco use reduction, improved well-being, and adoption of healthy behaviors. The management of addictive behaviors should therefore be encouraged during HCV treatment.
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Leclercq M, Vannier M, Benhamou Y, Liard A, Gilard V, Auquit-Auckbur I, Levesque H, Sibert L, Schneider P. Identification des facteurs associés à la réussite aux examens cliniques objectifs et structurés dans la faculté de médecine de Rouen. Rev Med Interne 2022; 43:278-285. [DOI: 10.1016/j.revmed.2022.02.007] [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: 11/01/2021] [Revised: 02/18/2022] [Accepted: 02/23/2022] [Indexed: 11/29/2022]
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Deghmani I, Miranda S, Guerrot D, Nouhaud F, Benhamou Y, Levesque H, Armengol G. Fibrose rétropéritonéale: analyse descriptive retrospective d’une cohorte de 56 patients. Rev Med Interne 2021. [DOI: 10.1016/j.revmed.2021.10.317] [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: 11/17/2022]
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Nassarmadji K, Miranda S, Billoir P, Benhamou Y. Prévalence et facteurs associés à la récidive thrombotique dans le syndrome des antiphospholipides. Rev Med Interne 2021. [DOI: 10.1016/j.revmed.2021.10.260] [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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De gail S, Levesque H, Jardin F, Manuel E, Tamion F, Benhamou Y, Grall M. Caractéristiques et profil évolutif des lymphohistiocytoses hémophagogytaires : étude rétrospective monocentrique au CHU de Rouen entre 2010 et 2020. Rev Med Interne 2021. [DOI: 10.1016/j.revmed.2021.10.238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Fares Y, Sinzogan-Eyoum YC, Billoir P, Bogaert A, Armengol G, Alexandre K, Lammens J, Grall M, Levesque H, Benhamou Y, Miranda S. Systematic screening for a proximal DVT in COVID-19 hospitalized patients: Results of a comparative study. J Med Vasc 2021; 46:163-170. [PMID: 34238510 PMCID: PMC8118667 DOI: 10.1016/j.jdmv.2021.05.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Accepted: 05/06/2021] [Indexed: 02/07/2023]
Abstract
INTRODUCTION The COVID-19 pandemic is associated with a high incidence of venous thromboembolism questioning the utility of a systematic screening for deep venous thrombosis (DVT) in hospitalised patients. METHODS In this prospective bicentric controlled study, 4-point ultrasound using a pocket device was used to screen for DVT, in patients with SARS-CoV-2 infection and controls admitted for acute medical illness not related to COVID-19 hospitalised in general ward, in order to assess the utility of a routine screening and to estimate the prevalence of VTE among those patients. RESULTS Between April and May 2020, 135 patients were screened, 69 in the COVID+ group and 66 in the control one. There was no significant difference in the rate of proximal DVT between the two groups (2.2% vs. 1.5%; P=0.52), despite the high rate of PE diagnosed among COVID-19 infected patients (10.1% vs. 1.5%, P=0.063). No isolated DVT was detected, 37.5% of PE was associated with DVT. Mortality (7.2% vs. 1.5%) was not different (P=0.21) between COVID-19 patients and controls. CONCLUSION The systematic screening for proximal DVT was not found to be relevant among COVID-19 patients hospitalized in general ward despite the increase of VTE among this population. Further studies are needed to confirm the hypothesis of a local pulmonary thrombosis which may lead to new therapeutic targets.
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Affiliation(s)
- Y Fares
- Department of internal medicine, Rouen university hospital, 76000 Rouen, France
| | - Y C Sinzogan-Eyoum
- Department of internal medicine, Rouen university hospital, 76000 Rouen, France
| | - P Billoir
- Department of vascular haemostasis, Rouen university hospital, Normandie university, 76000 Rouen, France
| | - A Bogaert
- Department of internal medicine, Rouen university hospital, 76000 Rouen, France
| | - G Armengol
- UNIROUEN, Inserm U1096 EnVI, department of internal medicine, Rouen university hospital, Normandie university, 76000 Rouen, France
| | - K Alexandre
- Department of infectious diseases, Rouen university hospital, 76000 Rouen, France
| | - J Lammens
- Department of internal medicine, Rouen university hospital, 76000 Rouen, France
| | - M Grall
- Department of internal medicine, Rouen university hospital, 76000 Rouen, France; Department of medical intensive care unit, Rouen university hospital, 76000 Rouen, France
| | - H Levesque
- UNIROUEN, Inserm U1096 EnVI, department of internal medicine, Rouen university hospital, Normandie university, 76000 Rouen, France
| | - Y Benhamou
- UNIROUEN, Inserm U1096 EnVI, department of internal medicine, Rouen university hospital, Normandie university, 76000 Rouen, France
| | - S Miranda
- UNIROUEN, Inserm U1096 EnVI, department of internal medicine, Rouen university hospital, Normandie university, 76000 Rouen, France.
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Simon D, Veyradier A, Coppo P, Joly B, Malot S, Grange S, Benhamou Y. Profil évolutif du Purpura thrombotique thrombocytopénique acquis sans auto-anticorps : expérience du Centre de Référence Français des Microangiopathies Thrombotiques. Rev Med Interne 2021. [DOI: 10.1016/j.revmed.2021.03.264] [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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Moschetti L, Dal Pozzolo L, Le Guern V, Morel N, Yelnik CM, Lambert M, Hachulla E, Benhamou Y, Franceschini F, Andreoli L, Costedoat-Chalumeau N, Tincani A. POS0724 GENDER DIFFERENCES IN THROMBOTIC PRIMARY ANTIPHOSPHOLIPID SYNDROME IN A LARGE COHORT OF PATIENTS FROM FOUR EUROPEAN CENTERS. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.1228] [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: 11/03/2022]
Abstract
Background:Autoimmune diseases occur more frequently in females and their course and severity can be affected by gender. Antiphospholipid syndrome (APS) is a systemic autoimmune disorder in which antiphospholipid antibodies (aPL) exert a pathogenic role resulting in vascular thrombosis and/or pregnancy morbidities. Data about gender differences in thrombotic APS (t-APS) are still scarce1,2.Objectives:To evaluate the differences in frequency, disease expression and severity between females and males affected by primary t-APS.Methods:Retrospective study enrolling subjects with a formal diagnosis of primary APS (Miyakis 2006) with vascular thrombosis at onset. Women who presented with obstetric events as first aPL-related manifestation were excluded. All the patients were followed from 1967 to 2019 in four European centers: three French centers and one Italian center.Results:The study included 433 patients (68% females, 32% males). Median age at t-APS onset [31 (24-46) vs 41 (29-53) years, p<0.001] and at diagnosis [34 (27-50) vs 46 (34-57) years, p<0.001] was significantly lower in females.The most common presenting manifestations were venous thrombosis (60%) followed by arterial events (37%) and catastrophic APS (3%). Venous events were more frequent in women as compared to men (64% vs 51% p:0.012 OR:1.7 [1.1-2.5]). Sites of venous thrombosis included: limbs (35%), pulmonary (17%), cerebral (3%), portal and inferior cava (2%) and retinal (1%) veins, without gender differences. The arterial events were more frequent among men (43% vs 34% p:0.053). Strokes (27%) and myocardial infarctions (4%) were the most frequent manifestations, followed by thrombosis of limbs (2%), retina (2%) and abdominal organs (1%). Noteworthy, only men presented with visceral ischemia.During the follow-up, new thrombosis occurred in 41% of patients (179/433). 33% out of them had at least two episodes and these occurred especially among males (22% vs 10% p:0.001 OR:2.5 [1.3-4.8]). New events were mostly of the same type, but ⅓ of patients presented a switch from venous to arterial side and viceversa, with no gender differences.Complete aPL profile was available in 357 subjects: 33% had single aPL positivity, 24% double positivity and 43% triple positivity, with no differences between women and men. About 80% of the patients had a concomitant risk factor (RF) for thrombosis. Established cardiovascular RFs were more represented among men as shown in table 1. In women, estrogenic exposure was the main RFs, present in almost 40% of them.Table 1.MALESn= 137FEMALESn= 296POR [IC 95%]Traditional cardiovascular RFs, n (%)Smoke66 (48)81 (27)<0.0012.5 [1.6-3.8]Arterial hypertension59 (43)75 (25)<0.0012.2 [1.5-3.4]Dyslipidemia52 (38)72 (24)0.0041.9 [1.2-2.9]Diabetes16 (12)15 (5)0.0142.5 [1.8-5.1]Obesity13 (10)38 (13)nsOther thrombophilic factors, n (%)Estrogenic stimuli*0116 (39)-Trauma / surgery / immobilization21 (15)32 (11)nsCongenital thrombophilia9/94 (10)33/204 (16)nsData were compared using contingency tables, p value was calculated with Chi-Squared or Fisher exact test. *= hormonal therapy, pregnancy, post-partumConclusion:This gender-oriented analysis of patients with primary t-APS showed that women had the first vascular event at a younger age and mostly on the venous side, while men presented mainly with arterial events, later in life and suffered from more recurrent events. No differences were observed in the distribution of the aPL profile. The different frequency of arterial and venous events in the two groups could be attributed mainly to the presence of additional RFs rather than to biological gender-specific issues. However, it should be underlined that some RFs, such as the use of estrogens or classic cardiovascular RFs, are exclusive or more represented in one gender rather than the other, making it difficult to assess the link of causality between gender and manifestations of t-APS.References:[1]JF de Carvalho. Rheumatol Int. 2011.[2]LJ Jara. Lupus. 2005.Disclosure of Interests:None declared
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Sanchez O, Benhamou Y, Bertoletti L, Constans J, Couturaud F, Delluc A, Elias A, Fischer AM, Frappé P, Gendron N, Girard P, Godier A, Gut-Gobert C, Laporte S, Mahé I, Mauge L, Meneveau N, Meyer G, Mismetti P, Parent F, Pernod G, Quéré I, Revel MP, Roy PM, Salaün PY, Smadja DM, Sevestre MA. [Recommendations for best practice in the management of venous thromboembolic disease in adults. Long version]. Rev Mal Respir 2021; 38 Suppl 1:e1-e6. [PMID: 31280989 DOI: 10.1016/j.rmr.2019.05.038] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- O Sanchez
- Université de Paris, Service de pneumologie et soins intensifs, AH-HP, hôpital Européen Georges-Pompidou, 75015 Paris, France; F-CRIN INNOVTE, 42055 Saint-Étienne cedex 2, France.
| | - Y Benhamou
- Service de médecine interne, Normandie université UNI Rouen U1096, CHU Charles-Nicolle, 76000 Rouen, France
| | - L Bertoletti
- F-CRIN INNOVTE, 42055 Saint-Étienne cedex 2, France; Inserm UMR1059, Inserm, CIC-1408, équipe dysfonction vasculaire et hémostase, service de médecine vasculaire et thérapeutique, CHU de Saint-Étienne, université Jean-Monnet, 42000 Saint-Étienne, France
| | - J Constans
- Service de médecine vasculaire, hôpital Saint-André, université de Bordeaux, 33000 Bordeaux, France
| | - F Couturaud
- F-CRIN INNOVTE, 42055 Saint-Étienne cedex 2, France; Département de médecine interne et pneumologie, EA3878-GETBO, CIC Inserm1412, université de Bretagne occidentale, centre hospitalo-universitaire de Brest, 29200 Brest, France
| | - A Delluc
- F-CRIN INNOVTE, 42055 Saint-Étienne cedex 2, France; EA 3878 GETBO, université de Bretagne occidentale, 29200 Brest, France
| | - A Elias
- F-CRIN INNOVTE, 42055 Saint-Étienne cedex 2, France; Département de médecine vasculaire, hôpital Sainte-Musse, 83100 Toulon, France
| | - A-M Fischer
- F-CRIN INNOVTE, 42055 Saint-Étienne cedex 2, France; Service d'hématologie biologique hôpital européen Georges-Pompidou, université Paris Descartes, Sorbonne Paris Cité, Assistance publique-Hôpitaux de Paris, 75015 Paris, France
| | - P Frappé
- Inserm UMR 1059 Sainbiose DVH, Inserm CIC-EC 1408, département de médecine générale, université de Saint-Étienne, 42000 Saint-Étienne, France
| | - N Gendron
- Inserm UMR 1148, laboratoire d'hématologie, hôpital Bichat-Claude-Bernard, université Paris Diderot, Sorbonne Paris Cité, AP-HP, 75018 Paris, France
| | - P Girard
- Institut du Thorax-Curie-Montsouris, l'institut Mutualiste Montsouris, 75014 Paris, France
| | - A Godier
- Inserm UMR-S 1140, service d'anesthésie réanimation, hôpital européen Georges-Pompidou, AP-HP, 75015 Paris, France
| | - C Gut-Gobert
- F-CRIN INNOVTE, 42055 Saint-Étienne cedex 2, France; Département de médecine interne et pneumologie, EA3878-GETBO, CIC Inserm1412, université de Bretagne occidentale, centre hospitalo-universitaire de Brest, 29200 Brest, France
| | - S Laporte
- F-CRIN INNOVTE, 42055 Saint-Étienne cedex 2, France; Inserm, unité de recherche clinique, SAINBOIS U1059 équipe DVH, hôpital Nord, université Jean-Monnet, université de Lyon, innovation, pharmacologie, CHU Saint-Étienne, 42000 Saint-Étienne, France
| | - I Mahé
- F-CRIN INNOVTE, 42055 Saint-Étienne cedex 2, France; Service de médecine interne, hôpital Louis-Mourier, université Paris 7, Assistance publique-Hôpitaux de Paris, 92700 Colombes, France; Inserm UMR S1140, 75006 Paris, France
| | - L Mauge
- UMR-S 970, Paris-Cardiovascular Research Center (PARCC), service d'hématologie biologique, hôpital européen Georges-Pompidou, université Paris Descartes, Sorbonne Paris Cité, Assistance publique-Hôpitaux de Paris, 75015 Paris, France
| | - N Meneveau
- F-CRIN INNOVTE, 42055 Saint-Étienne cedex 2, France; Service de cardiologie, EA3920, université de Bourgogne-Franche Comté, CHU Jean-Minjoz, boulevard Fleming, 25030 Besançon cedex, France
| | - G Meyer
- F-CRIN INNOVTE, 42055 Saint-Étienne cedex 2, France; Université de Paris, Service de pneumologie et soins intensifs, AH-HP, Hôpital Européen Georges Pompidou, 75015 Paris, France; Inserm UMRS 970, 75015 Paris, France; Inserm CIC 1418, 75015 Paris, France
| | - P Mismetti
- F-CRIN INNOVTE, 42055 Saint-Étienne cedex 2, France; Inserm, SAINBOIS U1059 équipe DVH, unité de recherche clinique, innovation, pharmacologie, service de médecine vasculaire et thérapeutique, hôpital Nord, université Jean-Monnet, université de Lyon, CHU Saint-Étienne, 42000 Saint-Étienne, France
| | - F Parent
- Service de pneumologie, centre de référence de l'hypertension pulmonaire, hôpital Bicêtre, faculté de médecine, université Paris-Sud, université Paris-Saclay, AP-HP, 94270 Le Kremlin-Bicêtre, France; Inserm UMR-S 999, hôpital Marie-Lannelongue, 92350 Le Plessis-Robinson, France
| | - G Pernod
- F-CRIN INNOVTE, 42055 Saint-Étienne cedex 2, France; Service universitaire de médecine vasculaire, CNRS, TIMC-IMAG UMR-5525, Thèmas, CHU Grenoble, université Grenoble Alpes, 38700 La Tronche, France
| | - I Quéré
- F-CRIN INNOVTE, 42055 Saint-Étienne cedex 2, France; Département de médecine vasculaire, centre de référence des maladies vasculaires rares, EA2992, université de Montpellier, hôpital Saint-Éloi, CHU de Montpellier, 34295 Montpellier cedex 5, France
| | - M-P Revel
- Service de radiologie A, hôpital Cochin, université Paris Descartes, Sorbonne Paris Cité, Assistance publique-Hôpitaux de Paris, 75014 Paris, France
| | - P-M Roy
- F-CRIN INNOVTE, 42055 Saint-Étienne cedex 2, France; Département de médecine d'urgence et service de médecine vasculaire, CHU d'Angers, 49000 Angers, France; Institut Mitovasc, UMR 1083, UFR santé, université d'Angers, 49000 Angers, France
| | - P-Y Salaün
- Inserm EA3878 (GETBO), service de médecine nucléaire, université de Bretagne occidentale, CHRU de Brest, 29200 Brest, France
| | - D M Smadja
- F-CRIN INNOVTE, 42055 Saint-Étienne cedex 2, France; Unversité de Paris, Service d'hématologie, AH-HP, Hôpital Européen Georges-Pompidou, 75015 Paris, France; Laboratoire de recherche biochirurgicale, fondation Carpentier, Innovations Thérapeutiques en Hémostase, INSERM UMRS 1140, 75006 Paris, France
| | - M-A Sevestre
- F-CRIN INNOVTE, 42055 Saint-Étienne cedex 2, France; Service de médecine vasculaire, EA 7516 Chimère, CHU d'Amiens, 80080 Amiens, France
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Benhamou Y, Delluc A, Mauge L, Fischer AM, Sanchez O. [Which aetiological investigations to undertake during the progress of PE/DVT?]. Rev Mal Respir 2021; 38 Suppl 1:e90-e98. [PMID: 33744073 DOI: 10.1016/j.rmr.2019.05.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
- Y Benhamou
- Service de médecine interne, CHU Charles-Nicolle, Normandie université UNI Rouen U1096, 76000 Rouen, France
| | - A Delluc
- F-CRIN INNOVTE, 42055 St-Étienne cedex 2, France; EA 3878 GETBO, université de Bretagne occidentale, 29200 Brest, France
| | - L Mauge
- UMR-S 970, PARCC (Paris-Cardiovascular Research Center), service d'hématologie biologique, hôpital européen Georges-Pompidou, Assistance publique Hôpitaux de Paris, université Paris Descartes, Sorbonne Paris cité, 75015 Paris, France
| | - A-M Fischer
- F-CRIN INNOVTE, 42055 St-Étienne cedex 2, France; Service d'hématologie biologique hôpital européen Georges-Pompidou, Assistance publique des hôpitaux de Paris, université Paris Descartes, Sorbonne Paris cité, 75015 Paris, France
| | - O Sanchez
- F-CRIN INNOVTE, 42055 St-Étienne cedex 2, France; Inserm UMRS 1140, service de pneumologie et de soins intensifs, hôpital européen Georges-Pompidou, Assistance publique des Hôpitaux de Paris, université Paris Descartes, Sorbonne Paris cité, 75015 Paris, France.
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Prevel R, Roubaud-Baudron C, Tellier E, Le Besnerais M, Kaplanski G, Veyradier A, Benhamou Y, Coppo P. [Endothelial dysfunction in thrombotic thrombocytopenic purpura: therapeutic perspectives]. Rev Med Interne 2021; 42:202-209. [PMID: 33455838 DOI: 10.1016/j.revmed.2020.12.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 11/19/2020] [Accepted: 12/26/2020] [Indexed: 01/05/2023]
Abstract
Immune Thrombotic Thrombocytopenic Purpura (iTTP) is a rare but severe disease with a mortality rate of almost 100 % in the absence of adequate treatment. iTTP is caused by a severe deficiency in ADAMTS13 activity due to the production of inhibitory antibodies. Age has been shown to be a major prognostic factor. iTTP patients in the elderly (60yo and over) have more frequent organ involvement, especially heart and kidney failures compared with younger patients. They also have non-specific neurologic symptoms leading to a delayed diagnosis. Factors influencing this impaired survival among older patients remain unknown so far. Alteration of the functional capacity of involved organs could be part of the explanation as could be the consequences of vascular aging. In fact, severe ADAMTS13 deficiency is necessary but likely not sufficient for iTTP physiopathology. A second hit leading to endothelial activation is thought to play a central role in iTTP. Interestingly, the mechanisms involved in endothelial activation may share common features with those involved in vascular aging, potentially leading to endothelial dysfunction. It could thus be interesting to better investigate the causes of mid- and long-term mortality among older iTTP patients to confirm whether inflammation and endothelial activation really impact vascular aging and long-term mortality in those patients, in addition to their presumed role at iTTP acute phase. If so, further insights into the mechanisms involved could lead to new therapeutic targets.
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Affiliation(s)
- R Prevel
- CHU Bordeaux, Pôle de Gérontologie Clinique, 33000 Bordeaux, France; CHU Bordeaux, FHU Acronim 33000 Bordeaux, France; University Bordeaux, INSERM 1045 CRCTB 33000 Bordeaux, France
| | - C Roubaud-Baudron
- CHU Bordeaux, Pôle de Gérontologie Clinique, 33000 Bordeaux, France; University Bordeaux, INSERM UMR 1053 Bariton 33000 Bordeaux, France
| | - E Tellier
- Vascular Research Center of Marseille, Inserm, UMRS_1076, Aix-Marseille Université, Marseille, France
| | - M Le Besnerais
- Service de Médecine Interne, CHU Charles Nicolle, Rouen, France; INSERM U1096, UFR médecine pharmacie Rouen, Rouen, France
| | - G Kaplanski
- Vascular Research Center of Marseille, Inserm, UMRS_1076, Aix-Marseille Université, Marseille, France; Aix-Marseille université, 13284, Service de médecine interne, hôpital de la Conception, AP-HM, 147, boulevard Baille, 13385 Marseille cedex 05, France; Centre de Référence des Microangiopathies Thrombotiques (CNR-MAT, www.cnr-mat.fr), Paris, France
| | - A Veyradier
- Centre de Référence des Microangiopathies Thrombotiques (CNR-MAT, www.cnr-mat.fr), Paris, France; Hématologie biologique, Hôpital Lariboisière, AP-HP, Université Paris Diderot, Paris, France
| | - Y Benhamou
- Service de Médecine Interne, CHU Charles Nicolle, Rouen, France; INSERM U1096, UFR médecine pharmacie Rouen, Rouen, France; Centre de Référence des Microangiopathies Thrombotiques (CNR-MAT, www.cnr-mat.fr), Paris, France
| | - P Coppo
- Centre de Référence des Microangiopathies Thrombotiques (CNR-MAT, www.cnr-mat.fr), Paris, France; Service d'Hématologie, Centre de Référence des Microangiopathies Thrombotiques (CNR-MAT, www.cnr-mat.fr), AP-HP.6, Paris, France.
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Levesque H, Benhamou Y. Rituximab versus cyclophosphamide au cours de l’hémophilie acquise. Résultats à 6 mois d’une étude prospective randomisée (étude CREHA). Rev Med Interne 2020. [DOI: 10.1016/j.revmed.2020.10.120] [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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Benhamou Y, Azoulay E, Galicier L, Poullin P, Hamidou M, Deligny C, Veyradier A, Coppo P. Le traitement du purpura thrombotique thrombocytopénique auto-immun par caplacizumab prévient la survenue d’évolutions défavorables jusqu’à l’amélioration de l’activité ADAMTS13. Rev Med Interne 2020. [DOI: 10.1016/j.revmed.2020.10.089] [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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Benhamou Y, Sauvètre G, Grangé S, Veyradier A, Coppo P. La maladie thrombo-embolique veineuse au cours du purpura thrombotique thrombocytopénique autoimmun est associée à un traitement prolongé par échanges plasmatiques. Rev Med Interne 2020; 41:809-813. [DOI: 10.1016/j.revmed.2020.06.014] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Revised: 05/29/2020] [Accepted: 06/19/2020] [Indexed: 11/29/2022]
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Delforge J, Sovaila S, Alix L, Didon A, Steichen O, Ranque B, Froissart A, Amadou K, Hanslik T, Cador B, Bergmann JF, Mekininan A, Goujard C, Gayet S, Cathebras P, Fantin B, Raigniac D, Weber JC, Rosenthal E, Hery L, Andres E, Benhamou Y, Bourgarit A. [Characteristics of patients admitted from emergency units in 18 internal medicine departments and organisation of these departments: A cross sectional study from SNFMI (SiFMI study group) in 2015]. Rev Med Interne 2020; 42:79-85. [PMID: 33160706 DOI: 10.1016/j.revmed.2020.09.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [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: 05/23/2019] [Revised: 08/04/2020] [Accepted: 09/13/2020] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Patients admitted from emergency units represent a large portion of the population in internal medicine departments. The aim of this study is to identify characteristics of patients and organization of these departments. METHODS Between June 29th and July 26th 2015, voluntary internal medicine departments from the SiFMI group prospectively filled anonymized internet forms to collect data of each patients admitted in their ward from emergency units, during seven consecutive days. RESULTS Three hundred and sixty-five patients from emergency departments were admitted in 18 internal medicine inpatients departments, totalling 1100 beds and 33,530 annual stays, 56% of them for emergency units inpatients. Mean age was 68 years, 54% were women, mean Charlson score was 2.6 and 44% of the patients took at least three drugs. Main causes of hospitalization were infectious (29%) and neurological (17%) diseases. Mean length of stay was 9.2 days. The medical team was composed by a median value of 4,5 [2,75-6,25] senior full-time equivalents, 86% were internists. Each department except one received residents, two third of them were from general medicine. CONCLUSION This study highlights a high organizational variability among internal medicine departments and patients, and sets internal medicine as a specialty with a great capacity to achieve an integrative/comprehensive management of patients and to offer a comprehensive basis for physicians in training.
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Affiliation(s)
- J Delforge
- Service de médecine interne et immunologie clinique, CHU de Rennes, 2 rue Henri-Le-Guilloux, 35000 Rennes, France
| | - S Sovaila
- Service de médecine interne et immunologie clinique, CHU de Rennes, 2 rue Henri-Le-Guilloux, 35000 Rennes, France
| | - L Alix
- Service de médecine interne et immunologie clinique, CHU de Rennes, 2 rue Henri-Le-Guilloux, 35000 Rennes, France.
| | - A Didon
- Service de médecine interne et immunologie clinique, CHU de Rennes, 2 rue Henri-Le-Guilloux, 35000 Rennes, France
| | - O Steichen
- Service de médecine interne et immunologie clinique, CHU de Rennes, 2 rue Henri-Le-Guilloux, 35000 Rennes, France
| | - B Ranque
- Service de médecine interne et immunologie clinique, CHU de Rennes, 2 rue Henri-Le-Guilloux, 35000 Rennes, France
| | - A Froissart
- Service de médecine interne et immunologie clinique, CHU de Rennes, 2 rue Henri-Le-Guilloux, 35000 Rennes, France
| | - K Amadou
- Service de médecine interne et immunologie clinique, CHU de Rennes, 2 rue Henri-Le-Guilloux, 35000 Rennes, France
| | - T Hanslik
- Service de médecine interne et immunologie clinique, CHU de Rennes, 2 rue Henri-Le-Guilloux, 35000 Rennes, France
| | - B Cador
- Service de médecine interne et immunologie clinique, CHU de Rennes, 2 rue Henri-Le-Guilloux, 35000 Rennes, France
| | - J F Bergmann
- Service de médecine interne et immunologie clinique, CHU de Rennes, 2 rue Henri-Le-Guilloux, 35000 Rennes, France
| | - A Mekininan
- Service de médecine interne et immunologie clinique, CHU de Rennes, 2 rue Henri-Le-Guilloux, 35000 Rennes, France
| | - C Goujard
- Service de médecine interne et immunologie clinique, CHU de Rennes, 2 rue Henri-Le-Guilloux, 35000 Rennes, France
| | - S Gayet
- Service de médecine interne et immunologie clinique, CHU de Rennes, 2 rue Henri-Le-Guilloux, 35000 Rennes, France
| | - P Cathebras
- Service de médecine interne et immunologie clinique, CHU de Rennes, 2 rue Henri-Le-Guilloux, 35000 Rennes, France
| | - B Fantin
- Service de médecine interne et immunologie clinique, CHU de Rennes, 2 rue Henri-Le-Guilloux, 35000 Rennes, France
| | - D Raigniac
- Service de médecine interne et immunologie clinique, CHU de Rennes, 2 rue Henri-Le-Guilloux, 35000 Rennes, France
| | - J C Weber
- Service de médecine interne et immunologie clinique, CHU de Rennes, 2 rue Henri-Le-Guilloux, 35000 Rennes, France
| | - E Rosenthal
- Service de médecine interne et immunologie clinique, CHU de Rennes, 2 rue Henri-Le-Guilloux, 35000 Rennes, France
| | - L Hery
- Service de médecine interne et immunologie clinique, CHU de Rennes, 2 rue Henri-Le-Guilloux, 35000 Rennes, France
| | - E Andres
- Service de médecine interne et immunologie clinique, CHU de Rennes, 2 rue Henri-Le-Guilloux, 35000 Rennes, France
| | - Y Benhamou
- Service de médecine interne et immunologie clinique, CHU de Rennes, 2 rue Henri-Le-Guilloux, 35000 Rennes, France
| | - A Bourgarit
- Service de médecine interne et immunologie clinique, CHU de Rennes, 2 rue Henri-Le-Guilloux, 35000 Rennes, France
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- Service de médecine interne et immunologie clinique, CHU de Rennes, 2 rue Henri-Le-Guilloux, 35000 Rennes, France
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Marcellin F, Di Beo V, Aumaitre H, Mora M, Wittkop L, Duvivier C, Protopopescu C, Lacombe K, Esterle L, Berenger C, Gilbert C, Bouchaud O, Poizot-Martin I, Sogni P, Salmon-Ceron D, Carrieri P, Wittkop L, Sogni P, Esterle L, Trimoulet P, Izopet J, Serfaty L, Paradis V, Spire B, Carrieri P, Valantin M, Pialoux G, Chas J, Poizot-Martin I, Barange K, Naqvi A, Rosenthal E, Bicart-See A, Bouchaud O, Gervais A, Lascoux-Combe C, Goujard C, Lacombe K, Duvivier C, Neau D, Morlat P, Bani-Sadr F, Meyer L, Boufassa F, Autran B, Roque A, Solas C, Fontaine H, Costagliola D, Piroth L, Simon A, Zucman D, Boué F, Miailhes P, Billaud E, Aumaître H, Rey D, Peytavin G, Petrov-Sanchez V, Lebrasseur-Longuet D, Salmon D, Usubillaga R, Sogni P, Terris B, Tremeaux P, Katlama C, Valantin M, Stitou H, Simon A, Cacoub P, Nafissa S, Benhamou Y, Charlotte F, Fourati S, Poizot-Martin I, Zaegel O, Laroche H, Tamalet C, Pialoux G, Chas J, Callard P, Bendjaballah F, Amiel C, Le Pendeven C, Marchou B, Alric L, Barange K, Metivier S, Selves J, Larroquette F, Rosenthal E, Naqvi A, Rio V, Haudebourg J, Saint-Paul M, De Monte A, Giordanengo V, Partouche C, Bouchaud O, Martin A, Ziol M, Baazia Y, Iwaka-Bande V, Gerber A, Uzan M, Bicart-See A, Garipuy D, Ferro-Collados M, Selves J, Nicot F, Gervais A, Yazdanpanah Y, Adle-Biassette H, Alexandre G, Peytavin G, Lascoux-Combe C, Molina J, Bertheau P, Chaix M, Delaugerre C, Maylin S, Lacombe K, Bottero J, Krause J, Girard P, Wendum D, Cervera P, Adam J, Viala C, Vittecocq D, Goujard C, Quertainmont Y, Teicher E, Pallier C, Lortholary O, Duvivier C, Rouzaud C, Lourenco J, Touam F, Louisin C, Avettand-Fenoel V, Gardiennet E, Mélard A, Neau D, Ochoa A, Blanchard E, Castet-Lafarie S, Cazanave C, Malvy D, Dupon M, Dutronc H, Dauchy F, Lacaze-Buzy L, Desclaux A, Bioulac-Sage P, Trimoulet P, Reigadas S, Morlat P, Lacoste D, Bonnet F, Bernard N, Hessamfar, J M, Paccalin F, Martell C, Pertusa M, Vandenhende M, Mercié P, Malvy D, Pistone T, Receveur M, Méchain M, Duau P, Rivoisy C, Faure I, Caldato S, Bioulac-Sage P, Trimoulet P, Reigadas S, Bellecave P, Tumiotto C, Pellegrin J, Viallard J, Lazzaro E, Greib C, Bioulac-Sage P, Trimoulet P, Reigadas S, Zucman D, Majerholc C, Brollo M, Farfour E, Boué F, Polo Devoto J, Kansau I, Chambrin V, Pignon C, Berroukeche L, Fior R, Martinez V, Abgrall S, Favier M, Deback C, Lévy Y, Dominguez S, Lelièvre J, Lascaux A, Melica G, Billaud E, Raffi F, Allavena C, Reliquet V, Boutoille D, Biron C, Lefebvre M, Hall N, Bouchez S, Rodallec A, Le Guen L, Hemon C, Miailhes P, Peyramond D, Chidiac C, Ader F, Biron F, Boibieux A, Cotte L, Ferry T, Perpoint T, Koffi J, Zoulim F, Bailly F, Lack P, Maynard M, Radenne S, Amiri M, Valour F, Koffi J, Zoulim F, Bailly F, Lack P, Maynard M, Radenne S, Augustin-Normand C, Scholtes C, Le-Thi T, Piroth L, Chavanet P, Duong Van Huyen M, Buisson M, Waldner-Combernoux A, Mahy S, Binois R, Simonet-Lann A, Croisier-Bertin D, Salmon Rousseau A, Martins C, Aumaître H, Galim S, Bani-Sadr F, Lambert D, Nguyen Y, Berger J, Hentzien M, Brodard V, Rey D, Partisani M, Batard M, Cheneau C, Priester M, Bernard-Henry C, de Mautort E, Gantner et S Fafi-Kremer P, Roustant F, Platterier P, Kmiec I, Traore L, Lepuil S, Parlier S, Sicart-Payssan V, Bedel E, Anriamiandrisoa S, Pomes C, Touam F, Louisin C, Mole M, Bolliot C, Catalan P, Mebarki M, Adda-Lievin A, Thilbaut P, Ousidhoum Y, Makhoukhi F, Braik O, Bayoud R, Gatey C, Pietri M, Le Baut V, Ben Rayana R, Bornarel D, Chesnel C, Beniken D, Pauchard M, Akel S, Caldato S, Lions C, Ivanova A, Ritleg AS, Debreux C, Chalal L, Zelie J, Hue H, Soria A, Cavellec M, Breau S, Joulie A, Fisher P, Gohier S, Croisier-Bertin D, Ogoudjobi S, Brochier C, Thoirain-Galvan V, Le Cam M, Carrieri P, Chalouni M, Conte V, Dequae-Merchadou L, Desvallees M, Esterle L, Gilbert C, Gillet S, Knight R, Lemboub T, Marcellin F, Michel L, Mora M, Protopopescu C, Roux P, Spire B, Tezkratt S, Barré T, Baudoin M, Santos M, Di Beo V, Nishimwe M, Wittkop L. Patient-reported symptoms during direct-acting antiviral treatment: A real-life study in HIV-HCV coinfected patients (ANRS CO13 HEPAVIH). J Hepatol 2020; 72:588-591. [PMID: 31924411 DOI: 10.1016/j.jhep.2019.10.019] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Revised: 10/17/2019] [Accepted: 10/25/2019] [Indexed: 01/26/2023]
Affiliation(s)
- Fabienne Marcellin
- Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Économiques & Sociales de la Santé & Traitement de l'Information Médicale, Marseille, France; ORS PACA, Observatoire régional de la santé Provence-Alpes-Côte d'Azur, Marseille, France.
| | - Vincent Di Beo
- Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Économiques & Sociales de la Santé & Traitement de l'Information Médicale, Marseille, France; ORS PACA, Observatoire régional de la santé Provence-Alpes-Côte d'Azur, Marseille, France
| | - Hugues Aumaitre
- Infectious and Tropical Disease Unit, Perpignan Hospital Center, Perpignan, France
| | - Marion Mora
- Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Économiques & Sociales de la Santé & Traitement de l'Information Médicale, Marseille, France; ORS PACA, Observatoire régional de la santé Provence-Alpes-Côte d'Azur, Marseille, France
| | - Linda Wittkop
- Univ. Bordeaux, ISPED, Inserm, Bordeaux Population Health Research Center, Team MORPH3EUS, UMR 1219, CIC-EC 1401, F-33000 Bordeaux, France; CHU de Bordeaux, Pole de santé publique, F-33000 Bordeaux, France
| | - Claudine Duvivier
- AP-HP-Necker Hospital, Infectious Diseases Department, Necker-Pasteur Infectiology Center, IHU Imagine, Université de Paris, INSERM, U1016, Institut Cochin, CNRS, UMR8104, Paris, France; Institut Pasteur, Medical Center of Institut Pasteur, Necker-Pasteur Infectiology Center, Paris, France
| | - Camelia Protopopescu
- Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Économiques & Sociales de la Santé & Traitement de l'Information Médicale, Marseille, France; ORS PACA, Observatoire régional de la santé Provence-Alpes-Côte d'Azur, Marseille, France
| | - Karine Lacombe
- Infectious and Tropical Disease Unit, Paris Public Hospitals, Saint-Antoine Hospital, Paris, France; UMR S1136, Pierre Louis Epidemiology and Public Health Institute, Pierre and Marie Curie University, Paris, France
| | - Laure Esterle
- Univ. Bordeaux, ISPED, Inserm, Bordeaux Population Health Research Center, Team MORPH3EUS, UMR 1219, CIC-EC 1401, F-33000 Bordeaux, France
| | - Cyril Berenger
- Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Économiques & Sociales de la Santé & Traitement de l'Information Médicale, Marseille, France; ORS PACA, Observatoire régional de la santé Provence-Alpes-Côte d'Azur, Marseille, France
| | - Camille Gilbert
- Univ. Bordeaux, ISPED, Inserm, Bordeaux Population Health Research Center, Team MORPH3EUS, UMR 1219, CIC-EC 1401, F-33000 Bordeaux, France
| | - Olivier Bouchaud
- Infectious and Tropical Disease Unit, Paris Publics Hospitals, Avicenne Hospital, Bobigny, France; Paris 13 Nord University, Bobigny, France
| | - Isabelle Poizot-Martin
- Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Économiques & Sociales de la Santé & Traitement de l'Information Médicale, Marseille, France; APHM Sainte-Marguerite, Clinical Immunohematology Unit, Aix Marseille University, Marseille, France
| | - Philippe Sogni
- Université Paris Descartes, Paris, France; INSERM U-1223, Institut Pasteur, Paris, France; Service d'Hépatologie, hôpital Cochin, Assistance Publique - Hôpitaux de Paris, France
| | - Dominique Salmon-Ceron
- Université Paris Descartes, Paris, France; Service Maladies infectieuses et tropicales, AP-HP, Hôpital Cochin, Paris, France
| | - Patrizia Carrieri
- Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Économiques & Sociales de la Santé & Traitement de l'Information Médicale, Marseille, France; ORS PACA, Observatoire régional de la santé Provence-Alpes-Côte d'Azur, Marseille, France
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Membrey B, Miranda S, Lévesque H, Cailleux N, Benhamou Y, Armengol G. Artérite gigantocellulaire : apport de l’écho-doppler. Rev Med Interne 2020; 41:106-110. [DOI: 10.1016/j.revmed.2019.10.337] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Revised: 10/04/2019] [Accepted: 10/21/2019] [Indexed: 01/22/2023]
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Miranda S, Billoir P, Le Besnerais M, Joannides R, Richard V, Lévesque H, Armengol G, Bellien J, Benhamou Y. New insights into antiphospholipid-related endothelial dysfunction by assessment of vascular glycocalyx layer: results from a preliminary cross-sectional study. Lupus 2020; 29:157-164. [DOI: 10.1177/0961203319897958] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Introduction Antiphospholipid syndrome (APS) is associated with greater atherothrombotic risk and endothelial dysfunction, suggesting that endothelial glycocalyx is impaired in this disease. Objectives The aim was to investigate the endothelial glycocalyx and the relationship between glycocalyx markers, endothelial dysfunction parameters and atherosclerotic markers in APS. Methods A total of 15 primary arterial APS patients and healthy controls were included in the study. Glycocalyx was assessed in both groups by sublingual sidestream dark field imaging and syndecan-1 plasma level. Endothelial function was evaluated by brachial artery flow-mediated dilatation (FMD) and early atherosclerosis by carotid intima media thickness (IMT). Thrombotic profile was also performed by measuring the plasma level of the tissue factor (TF). Results APS patients had significantly increased syndecan-1 plasma level 38.6 ± 5.0 pg/ml vs. 19.1 ± 3.5 pg/ml; p < 0.01 and a reduced glycocalyx thickness 0.26 ± 0.03 µm vs. 0.75 ± 0.07 µm; p < 0.01 compared with control. FMD was impaired in APS patients compared with control, 5.68% ± 0.42 vs. 8.29 ± 0.30, p < 0.01, respectively. IMT was significantly increased in APS patients compared with control, 0.52 ± 0.13 mm vs. 0.40 ± 0.06 mm, p < 0.01, respectively. Soluble TF, thiobarbituric acid-reactive substances levels were increased in the sera from APS patients compared with control. Conclusions This preliminary study supports, for the first time, that in APS patients endothelial glycocalyx is impaired, which could lead to thrombosis, endothelial dysfunction and early atherosclerosis.
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Affiliation(s)
- S Miranda
- Department of Internal Medicine, Rouen University Hospital, Rouen, France
- Normandie Univ, UNIROUEN, INSERM U1096, FHU REMOD-VHF, Rouen, France
| | - P Billoir
- Normandie Univ, UNIROUEN, INSERM U1096, FHU REMOD-VHF, Rouen, France
- Department of Vascular Haemostasis, Rouen University Hospital, Rouen, France
| | - M Le Besnerais
- Department of Internal Medicine, Rouen University Hospital, Rouen, France
- Normandie Univ, UNIROUEN, INSERM U1096, FHU REMOD-VHF, Rouen, France
| | - R Joannides
- Normandie Univ, UNIROUEN, INSERM U1096, FHU REMOD-VHF, Rouen, France
- Department of Pharmacology, Rouen University Hospital, Rouen, France
- Centre d'Investigation Clinique (CIC)-INSERM 1404, Rouen University Hospital, Rouen, France
| | - V Richard
- Normandie Univ, UNIROUEN, INSERM U1096, FHU REMOD-VHF, Rouen, France
| | - H Lévesque
- Department of Internal Medicine, Rouen University Hospital, Rouen, France
- Normandie Univ, UNIROUEN, INSERM U1096, FHU REMOD-VHF, Rouen, France
| | - G Armengol
- Department of Internal Medicine, Rouen University Hospital, Rouen, France
- Normandie Univ, UNIROUEN, INSERM U1096, FHU REMOD-VHF, Rouen, France
| | - J Bellien
- Normandie Univ, UNIROUEN, INSERM U1096, FHU REMOD-VHF, Rouen, France
- Department of Pharmacology, Rouen University Hospital, Rouen, France
- Centre d'Investigation Clinique (CIC)-INSERM 1404, Rouen University Hospital, Rouen, France
| | - Y Benhamou
- Department of Internal Medicine, Rouen University Hospital, Rouen, France
- Normandie Univ, UNIROUEN, INSERM U1096, FHU REMOD-VHF, Rouen, France
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Roupie A, Fain O, Mekinian A, Terrier B, Regent A, de Boysson H, Carrat F, Seguier J, Terriou L, Versini M, Queyrel V, Groh M, Benhamou Y, Maurier F, Decaux O, Le Clech L, d’Aveni M, Rossignol J, Gal J. Vascularites associées aux syndromes myélodysplasiques : étude de cas multicentrique française. Rev Med Interne 2019. [DOI: 10.1016/j.revmed.2019.10.074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Abisror N, Mariozo L, Esteve Valderde E, De Moreuil C, Billoir P, Pleguezuelo Garrote D, Carbillon L, Kayem G, Bornes M, Johanet C, Nicaise P, Urbanski G, Zigon P, Bezananary H, Mayer Pickel K, Benhamou Y, Fain O, Alijotas-Reig J, Mekinian A. SAPL séronégatif obstétrical : caractéristiques et prise en charge à partir d’une étude européenne. Rev Med Interne 2019. [DOI: 10.1016/j.revmed.2019.10.095] [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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Leclercq M, Langlois V, Girszyn N, Benhamou Y, Gueudry J. Biothérapies versus immunosuppresseurs conventionnels au cours des uvéites non-infectieuses non-antérieures : étude comparative rétrospective. Rev Med Interne 2019. [DOI: 10.1016/j.revmed.2019.10.016] [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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Benhamou Y, Delluc A, Sanchez O. [What is the management of sub-segmental pulmonary embolism?]. Rev Mal Respir 2019; 38 Suppl 1:e161-e163. [PMID: 31703828 DOI: 10.1016/j.rmr.2019.05.013] [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: 11/28/2022]
Affiliation(s)
- Y Benhamou
- UNI Rouen U1096, service de médecine interne, Normandie université, CHU Charles-Nicolle, 76000 Rouen, France
| | - A Delluc
- F-CRIN INNOVTE, 42055 Saint-Étienne cedex 2, France; EA 3878 GETBO, université de Bretagne occidentale, 29200 Brest, France
| | - O Sanchez
- F-CRIN INNOVTE, 42055 Saint-Étienne cedex 2, France; Inserm UMRS 1140, service de pneumologie et de soins intensifs, hôpital européen Georges-Pompidou, université Paris Descartes, Sorbonne Paris Cité, Assistance publique-Hôpitaux de Paris, 75015 Paris, France.
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Simon D, Cailleux-Talbot N, Armengol G, Benhamou Y, Lévesque H, Monnot A, Miranda S. [A neck mass]. Rev Med Interne 2019; 41:348-349. [PMID: 31662231 DOI: 10.1016/j.revmed.2019.09.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Revised: 09/19/2019] [Accepted: 09/26/2019] [Indexed: 11/18/2022]
Affiliation(s)
- D Simon
- UNIROUEN, service de médecine interne, Normandie université, 76000 Rouen, France.
| | - N Cailleux-Talbot
- UNIROUEN, service de médecine interne, Normandie université, 76000 Rouen, France
| | - G Armengol
- UNIROUEN, service de médecine interne, Normandie université, 76000 Rouen, France
| | - Y Benhamou
- UNIROUEN, service de médecine interne, Normandie université, 76000 Rouen, France; UNIROUEN, U1096, service de médecine interne, Normandie université, 76000 Rouen, France
| | - H Lévesque
- UNIROUEN, service de médecine interne, Normandie université, 76000 Rouen, France; UNIROUEN, U1096, service de médecine interne, Normandie université, 76000 Rouen, France
| | - A Monnot
- UNIROUEN, service de chirurgie vasculaire, Normandie université, 76000 Rouen, France
| | - S Miranda
- UNIROUEN, service de médecine interne, Normandie université, 76000 Rouen, France; UNIROUEN, U1096, service de médecine interne, Normandie université, 76000 Rouen, France
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Lévesque H, Grall M, Bréant N, Idrissi Kassimy I, Arbid TD, Boujedaini R, Clamageran C, Joly LM, Tanguy L, Marpeau L, Benhamou Y, Gricourt C. [Pre-hospitalization unit: A simple organization and a place for internists to improve the non-scheduled hospitalization stream from emergencies]. Rev Med Interne 2019; 40:707-713. [PMID: 31409518 DOI: 10.1016/j.revmed.2019.07.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [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: 04/02/2019] [Revised: 07/29/2019] [Accepted: 07/29/2019] [Indexed: 11/28/2022]
Abstract
INTRODUCTION The adult emergency department at Rouen University hospital (CHU) welcomes over 100.000 patients per year. In order to streamline unscheduled hospital admissions from the emergency room (ER), a 20-bed pre-hospitalization unit and a centralized bed management system (bed manager, bed manager software, dedicated beds) have been put into place. PATIENTS AND METHODS Emergency admissions have increased by (+3.5% between 2017 and 2018) with 20% direct hospitalization from the ER to other conventional units (2/3 in medicine, 1/3 in surgery). In 2018, 3450 patients, of which 54% aged over 75 years have been admitted in the pre-hospitalization unit with an average length of stay of 1.3±1.4 days: 35.4% stayed less than 24hours and 34.8% more than 48hours of which 5.2% stated more than 4 days, 132 patients (3.8%) died, 805 patients (23.3%) were discharged at home, 220 (6.4%) transferred to another facility, and 2287 (66.3%) were secondarily hospitalized in another hospital unit: more than 9 times out of 10 in a medicine unit (internal medicine 30%, geriatrics 27.9%, respiratory medicine 12.2%). This unscheduled emergency hospitalization allowed a daily hospitalization of 50 short stay inpatients beds. It has to be noted that the number of available inpatient beds clearly decreases during the week-ends. The main pathologies were respiratory infections (14.2%), heart diseases (9.7%), metabolic disorders (3.9%), and urinary tract infections (13.6%). CONCLUSION This pre-hospitalization unit associated with a centralized bed management system has clearly improved the unscheduled hospital admissions, in particular concerning the emergency medical sector. The lack of inpatient beds at the week-end and the management of epidemic periods still remain a challenge that has to be taken up.
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Affiliation(s)
- H Lévesque
- Service de médecine interne, Normandie université, UniRouen, U1096, 76000 Rouen, France.
| | - M Grall
- Service de médecine interne, Normandie université, UniRouen, U1096, 76000 Rouen, France
| | - N Bréant
- Cadre gestionnaire du pôle médecine, CHU Rouen, 76000 Rouen, France
| | - I Idrissi Kassimy
- Unité d'attente d'hospitalisation, CHU Rouen, 76000 Rouen, France; Cadre gestionnaire du pôle médecine, CHU Rouen, 76000 Rouen, France; Service d'accueil et des urgences, 76000 Rouen, France
| | - T D Arbid
- Unité d'attente d'hospitalisation, CHU Rouen, 76000 Rouen, France; Cadre gestionnaire du pôle médecine, CHU Rouen, 76000 Rouen, France; Service d'accueil et des urgences, 76000 Rouen, France
| | - R Boujedaini
- Unité d'attente d'hospitalisation, CHU Rouen, 76000 Rouen, France; Cadre gestionnaire du pôle médecine, CHU Rouen, 76000 Rouen, France; Service d'accueil et des urgences, 76000 Rouen, France
| | - C Clamageran
- Unité d'attente d'hospitalisation, CHU Rouen, 76000 Rouen, France; Cadre gestionnaire du pôle médecine, CHU Rouen, 76000 Rouen, France; Service d'accueil et des urgences, 76000 Rouen, France
| | - L M Joly
- Service d'accueil et des urgences, 76000 Rouen, France
| | - L Tanguy
- Département d'informatique médicale, Normandie université, UniRouen, 76000 Rouen, France
| | - L Marpeau
- Service de gynécologie-obstétrique, Commission Médicale d'Établissement, CHU Rouen, 76000 Rouen, France
| | - Y Benhamou
- Service de médecine interne, Normandie université, UniRouen, U1096, 76000 Rouen, France
| | - C Gricourt
- Unité d'attente d'hospitalisation, CHU Rouen, 76000 Rouen, France; Cadre gestionnaire du pôle médecine, CHU Rouen, 76000 Rouen, France; Service d'accueil et des urgences, 76000 Rouen, France
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Avenel M, Miranda S, Benhamou Y, Michelin P, Boyer J, Lévesque H, Armengol G. Canal carpien aigu : penser à la thrombose de l’artère persistante du nerf médian ! Rev Med Interne 2019; 40:453-456. [DOI: 10.1016/j.revmed.2019.04.002] [Citation(s) in RCA: 4] [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: 03/11/2019] [Revised: 03/23/2019] [Accepted: 04/10/2019] [Indexed: 11/27/2022]
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Stammler R, Morel N, Lambert M, Godeau B, Yelnik C, Dufrost V, Benhamou Y, Le Guern V, Amoura Z, Leroux G, Piette J, Costedoat-Chalumeau N. Syndrome catastrophique des antiphospholipides : une étude rétrospective descriptive multicentrique. Rev Med Interne 2019. [DOI: 10.1016/j.revmed.2019.03.055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Roupie A, De Boysson H, Carrat F, Seguier J, Terriou L, Maurier F, Versini M, Groh M, Benhamou Y, Fain O, Mekinian A. Artérite à cellules géantes associées aux syndromes myélodysplasiques : étude cas contrôle multicentrique française. Rev Med Interne 2019. [DOI: 10.1016/j.revmed.2019.03.071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Billoir P, Miranda S, Abboud J, Armengol G, Levesque H, Benhamou Y, Le Cam Duchez V. [Which place of antiphosphatidylethanolamine antibodies research in seronegative antiphospholipid syndrome suspicion?]. Rev Med Interne 2019; 40:351-354. [PMID: 30905593 DOI: 10.1016/j.revmed.2018.11.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [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: 08/03/2018] [Revised: 11/19/2018] [Accepted: 11/25/2018] [Indexed: 10/27/2022]
Abstract
PURPOSE Antiphospholipid syndrome (APS) is a clinico-biological syndrome, which associates vascular injury and persisting antiphospholipid antibodies (aPL). Patients with clinical symptoms of APS but without aPL are defined as "seronegative APS" (SNAPS). The aim of this study was to evaluate antiphosphatidylethanolamine antibody (aPE) investigation in patients with SNAPS suspicion. METHODS This retrospective study was conducted in patients with SNAPS suspicion. A homemade enzyme-linked immunosorbent assay (ELISA) was used to search for aPE. The results of this homemade method were compared with those from a global screening ELISA. RESULTS Two hundred twenty-eight patients with SNAPS suspicion were included. Among them, 58.3% had a thrombotic event. The homemade ELISA found positive persisting aPE in 23 patients (10%): 15 with a thrombotic event, 6 with obstetrical morbidity and 2 with a combined event. The global screening ELISA was positive in only 11 of these 23 patients (47.8%). CONCLUSION These results suggest the implication of aPE in SNAPS.
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Affiliation(s)
- P Billoir
- Normandie université, UNIROUEN, Inserm U1096, Rouen university hospital, vascular hemostasis unit, 76000 Rouen, France.
| | - S Miranda
- Normandie université, UNIROUEN, Inserm U1096, Rouen university hospital, department of internal medicine, vascular and thrombosis unit, 76000 Rouen, France
| | - J Abboud
- Rouen university hospital, vascular hemostasis unit, 76000 Rouen, France
| | - G Armengol
- Normandie université, UNIROUEN, Inserm U1096, Rouen university hospital, department of internal medicine, vascular and thrombosis unit, 76000 Rouen, France
| | - H Levesque
- Normandie université, UNIROUEN, Inserm U1096, Rouen university hospital, department of internal medicine, vascular and thrombosis unit, 76000 Rouen, France
| | - Y Benhamou
- Normandie université, UNIROUEN, Inserm U1096, Rouen university hospital, department of internal medicine, vascular and thrombosis unit, 76000 Rouen, France
| | - V Le Cam Duchez
- Normandie université, UNIROUEN, Inserm U1096, Rouen university hospital, vascular hemostasis unit, 76000 Rouen, France
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Sanchez O, Benhamou Y, Bertoletti L, Constant J, Couturaud F, Delluc A, Elias A, Fischer AM, Frappé P, Gendron N, Girard P, Godier A, Gut-Gobert C, Laporte S, Mahé I, Mauge L, Meneveau N, Meyer G, Mismetti P, Parent F, Pernod G, Quéré I, Revel MP, Roy PM, Salaün PY, Smadja DM, Sevestre MA. [Recommendations of good practice for the management of thromboembolic venous disease in adults. Short version]. Rev Mal Respir 2019; 36:249-283. [PMID: 30799126 DOI: 10.1016/j.rmr.2019.01.003] [Citation(s) in RCA: 55] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Affiliation(s)
- O Sanchez
- INSERM UMRS 1140, Université Paris Descartes, Sorbonne Paris Cité, Service de Pneumologie et de soins intensifs, hôpital Européen Georges-Pompidou, Assistance publique des Hôpitaux de Paris, 75015 Paris, France; F-CRIN INNOVTE, 42055 St-Étienne cedex 2, France.
| | - Y Benhamou
- Normandie université UNI Rouen U1096, service de médecine interne, CHU Charles Nicolle, 76000 Rouen, France
| | - L Bertoletti
- F-CRIN INNOVTE, 42055 St-Étienne cedex 2, France; INSERM UMR1059, Équipe dysfonction vasculaire et hémostase, service de médecine vasculaire et thérapeutique, CHU de St-Étienne, Université Jean-Monnet, INSERM, CIC-1408, 42000 Saint-Étienne, France
| | - J Constant
- Service de médecine vasculaire, hôpital St-André, université de Bordeaux, 33000 Bordeaux, France
| | - F Couturaud
- F-CRIN INNOVTE, 42055 St-Étienne cedex 2, France; Département de médecine interne et pneumologie, EA3878-GETBO, CIC_INSERM1412, université de Bretagne occidentale, centre hospitalo-universitaire de Brest, 29200 Brest, France
| | - A Delluc
- F-CRIN INNOVTE, 42055 St-Étienne cedex 2, France; EA 3878 GETBO, université de Bretagne occidentale, 29200 Brest, France
| | - A Elias
- F-CRIN INNOVTE, 42055 St-Étienne cedex 2, France; Département de médecine vasculaire, hôpital Sainte-Musse, 83100 Toulon, France
| | - A-M Fischer
- F-CRIN INNOVTE, 42055 St-Étienne cedex 2, France; Université Paris Descartes, Sorbonne Paris Cité, service d'hématologie biologique hôpital Européen Georges-Pompidou, Assistance publique des Hôpitaux de Paris, 75015 Paris, France
| | - P Frappé
- Inserm UMR 1059 Sainbiose DVH, Inserm CIC-EC 1408, département de médecine générale, université de Saint-Étienne, 42000 St-Étienne, France
| | - N Gendron
- INSERM UMR 1148, Université Paris Diderot, Sorbonne Paris Cité, laboratoire d'hématologie, hôpital Bichat-Claude Bernard, AP-HP, 75018 Paris, France
| | - P Girard
- Institut du Thorax-Curie-Montsouris, l'institut Mutualiste Montsouris, 75014 Paris, France
| | - A Godier
- INSERM UMRS 1140, service d'anesthésie réanimation, hôpital Européen Georges-Pompidou, AP-HP, 75015 Paris, France
| | - C Gut-Gobert
- F-CRIN INNOVTE, 42055 St-Étienne cedex 2, France; Département de médecine interne et pneumologie, EA3878-GETBO, CIC_INSERM1412, université de Bretagne occidentale, centre hospitalo-universitaire de Brest, 29200 Brest, France
| | - S Laporte
- F-CRIN INNOVTE, 42055 St-Étienne cedex 2, France; INSERM, unité de Recherche Clinique, SAINBOIS U1059 équipe DVH, université Jean-Monnet, université de Lyon, Innovation, Pharmacologie, CHU Saint-Étienne, hôpital Nord, 42000 Saint-Étienne, France
| | - I Mahé
- F-CRIN INNOVTE, 42055 St-Étienne cedex 2, France; Université Paris 7, Service de Médecine Interne-Hôpital Louis-Mourier, Assistance Publique des Hôpitaux de Paris, 92700 Colombes, France; Inserm UMR_S1140, 75006 Paris, France
| | - L Mauge
- UMR-S 970, PARCC (Paris-Cardiovascular Research Center), Université Paris Descartes, Sorbonne Paris Cité, Service d'Hématologie biologique, Hôpital Européen Georges Pompidou, Assistance Publique Hôpitaux de Paris, 75015 Paris, France
| | - N Meneveau
- F-CRIN INNOVTE, 42055 St-Étienne cedex 2, France; Service de cardiologie, CHU Jean Minjoz Boulevard Fleming ; EA3920, Université de Bourgogne-Franche Comté, 25030 Besançon cedex, France
| | - G Meyer
- F-CRIN INNOVTE, 42055 St-Étienne cedex 2, France; INSERM UMRS 970 ; INSERM CIC 1418, université Paris Descartes, Sorbonne Paris Cité, service de pneumologie et de soins intensifs, hôpital Européen Georges-Pompidou, Assistance publique des Hôpitaux de Paris, 75015 Paris, France
| | - P Mismetti
- F-CRIN INNOVTE, 42055 St-Étienne cedex 2, France; INSERM, SAINBOIS U1059 équipe DVH, université Jean-Monnet, université de Lyon, Unité de Recherche Clinique, Innovation, Pharmacologie, et service de médecine vasculaire et thérapeutique, CHU Saint-Étienne, Hôpital Nord, 42000 Saint-Étienne, France
| | - F Parent
- Université Paris-Sud, faculté de médecine, université Paris-Saclay, service de pneumologie, centre de référence de l'hypertension pulmonaire, hôpital Bicêtre, AP-HP, 94270 Le Kremlin Bicêtre, France; INSERM UMR_S 999, hôpital Marie-Lannelongue, 92350 Le Plessis Robinson, France
| | - G Pernod
- F-CRIN INNOVTE, 42055 St-Étienne cedex 2, France; Service universitaire de médecine vasculaire, CHU Grenoble, université Grenoble Alpes CNRS/TIMC-IMAG UMR 5525/Thèmas, 38700 La Tronche, France
| | - I Quéré
- F-CRIN INNOVTE, 42055 St-Étienne cedex 2, France; Département de médecine vasculaire, centre de référence des maladies vasculaires rares, EA2992, université de Montpellier, CHU Montpellier, hôpital Saint-Éloi, 34295 Montpellier cedex 5, France
| | - M-P Revel
- Université Paris Descartes, Sorbonne Paris Cité, service de radiologie A, hôpital Cochin, Assistance publique des Hôpitaux de Paris, 75014 Paris, France
| | - P-M Roy
- F-CRIN INNOVTE, 42055 St-Étienne cedex 2, France; Département de médecine d'urgence et service de médecine vasculaire, CHU Angers, 49000 Angers, France; Institut Mitovasc, UMR 1083, UFR Santé, université d'Angers, 49000 Angers, France
| | - P-Y Salaün
- INSERM EA3878 (GETBO), service de médecine nucléaire, CHRU de BREST, université de Bretagne occidentale, 29200 Brest, France
| | - D M Smadja
- F-CRIN INNOVTE, 42055 St-Étienne cedex 2, France; INSERM UMR-S1140, université Paris Descartes, Sorbonne Paris Cité, hôpital Européen Georges-Pompidou, service d'hématologie, AP-HP, hôpital Européen Georges-Pompidou, laboratoire de recherche biochirurgicale, Fondation Carpentier, 75015 Paris, France
| | - M-A Sevestre
- F-CRIN INNOVTE, 42055 St-Étienne cedex 2, France; Service de médecine vasculaire, EA 7516 Chimère, CHU Amiens, 80080 Amiens, France
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Damian L, Jardin F, Langlois V, Kerleau J, Benhamou Y, Levesque H, Sauvetre G. Thrombopénie immunologique primaire de l’adulte : facteurs prédictifs d’évolution vers la chronicité. Rev Med Interne 2018. [DOI: 10.1016/j.revmed.2018.10.275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Hellouin De Menibus Demas L, Miranda S, Cailleux N, Armengol G, Levesque H, Benhamou Y, Le Besnerais M. Ischémies digitales : élaboration d’un algorithme diagnostique à partir d’une étude rétrospective de 203 patients. Rev Med Interne 2018. [DOI: 10.1016/j.revmed.2018.03.326] [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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Bodard Q, Guilpain P, Lequerré T, Quatresous I, Eble V, Josse S, Schmidt J, Aouba A, Le Quellec A, Levesque H, Benhamou Y, Langlois V. Maladie de Still de l’adulte avec atteinte cardiaque : étude rétrospective multicentrique de 38 cas. Rev Med Interne 2018. [DOI: 10.1016/j.revmed.2018.03.338] [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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Alexandre K, Ingen-Housz-Oro S, Versini M, Sailler L, Benhamou Y. Pneumocystis jirovecii pneumonia in patients treated with rituximab for systemic diseases: Report of 11 cases and review of the literature. Eur J Intern Med 2018; 50:e23-e24. [PMID: 29198498 DOI: 10.1016/j.ejim.2017.11.014] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2017] [Revised: 11/23/2017] [Accepted: 11/28/2017] [Indexed: 11/27/2022]
Affiliation(s)
- K Alexandre
- Department of Infectious Disease, Rouen University Hospital, Rouen F-76031, France.
| | | | - M Versini
- Department of Internal Medicine, Archet Hospital, Nice, France
| | - L Sailler
- Department of Internal Medicine, Purpan University Hospital, Toulouse, France
| | - Y Benhamou
- Department of Internal Medicine, Rouen University Hospital, Rouen F-76031, France; Inserm, U1096, Rouen, F-76000, France
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Leclercq M, Le Besnerais M, Langlois V, Girszyn N, Benhamou Y, Ngo C, Levesque H, Muraine M, Gueudry J. Tocilizumab for the treatment of birdshot uveitis that failed interferon alpha and anti-tumor necrosis factor-alpha therapy: two cases report and literature review. Clin Rheumatol 2018; 37:849-853. [PMID: 29397459 DOI: 10.1007/s10067-018-4007-4] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Accepted: 01/24/2018] [Indexed: 12/14/2022]
Abstract
Biotherapies appear as potential drugs for the treatment of inflammatory noninfectious uveitis. In this report, we show that tocilizumab, an anti-IL-6 agent, greatly improved two patients with birdshot chorioretinopathy refractory to conventional immunosuppressive drugs, interferon α2a, and anti-TNFα agents. After a follow-up of 22 months, patients exhibited an improvement of both visual acuity and macular edema. A corticosteroid-sparing effect was achieved in both cases.
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Affiliation(s)
- Mathilde Leclercq
- Normandie Université UNI Rouen, Service de Médecine Interne, CHU Charles Nicolle, 76000, Rouen, France.
| | - M Le Besnerais
- Normandie Université UNI Rouen U1096, Service de Médecine Interne, CHU Charles Nicolle, 76000, Rouen, France
| | - V Langlois
- Service de Médecine Interne et Maladies Infectieuses, CH Le Havre, 76290, Montivilliers, France
| | - N Girszyn
- Normandie Université UNI Rouen, Service de Médecine Interne, CHU Charles Nicolle, 76000, Rouen, France
| | - Y Benhamou
- Normandie Université UNI Rouen U1096, Service de Médecine Interne, CHU Charles Nicolle, 76000, Rouen, France
| | - C Ngo
- Normandie Université UNI Rouen, Service d'Ophtalmologie, CHU Charles Nicolle, 76000, Rouen, France
| | - H Levesque
- Normandie Université UNI Rouen U1096, Service de Médecine Interne, CHU Charles Nicolle, 76000, Rouen, France
| | - M Muraine
- Normandie Université UNI Rouen, Service d'Ophtalmologie, CHU Charles Nicolle, 76000, Rouen, France
| | - J Gueudry
- Normandie Université UNI Rouen, Service d'Ophtalmologie, CHU Charles Nicolle, 76000, Rouen, France
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Prével R, Roubaud-Baudron C, Jamme M, Benhamou Y, Galicier L, Poullin P, Hamidou M, Deligny C, Hie M, Veyradier A, Coppo P. Particularités gériatriques du purpura thrombotique thrombocytopénique acquis. Rev Med Interne 2017. [DOI: 10.1016/j.revmed.2017.10.336] [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: 10/18/2022]
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Mirouse A, Comarmond C, Biard L, Lambert M, Mekinian A, Kahn J, Benhamou Y, Chiche L, Messas E, Resche-Rigon M, Cacoub P, Saadoun D. Survie globale et facteurs de risque de mortalité de la maladie de Takayasu : étude multicentrique de 318 patients. Rev Med Interne 2017. [DOI: 10.1016/j.revmed.2017.10.299] [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: 10/18/2022]
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Adham S, Miranda S, Doucet J, Lévesque H, Benhamou Y. [Statins in primary prevention of cardiovascular disease]. Rev Med Interne 2017; 39:42-49. [PMID: 28866432 DOI: 10.1016/j.revmed.2017.08.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [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: 05/17/2017] [Revised: 07/31/2017] [Accepted: 08/07/2017] [Indexed: 12/12/2022]
Abstract
Cardiovascular events are the second leading cause of death in France. The assessment of overall cardiovascular risk using a personalized assessment with weighting risk factors can predict the risk of cardiovascular events in ten years. The validated treatments to reduce cardiovascular mortality in primary prevention are few. The use of statins in primary prevention is discussed. We report in this review the updated conclusions from clinical trials regarding the treatment with statins in primary prevention.
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Affiliation(s)
- S Adham
- Centre de référence des maladies vasculaires rares, service de génétique, hôpital européen Georges-Pompidou, AP-HP, 20-40, rue Leblanc, 75015 Paris, France.
| | - S Miranda
- Département de médecine interne, CHU de Rouen, 1, rue de Germont, 76031 Rouen cedex, France
| | - J Doucet
- Service de médecine interne, gériatrie et thérapeutique, hôpital de Saint-Julien, CHU de Rouen, rue Guillaume-Lecointe, 76140 Le Petit-Quevilly, France
| | - H Lévesque
- Département de médecine interne, CHU de Rouen, 1, rue de Germont, 76031 Rouen cedex, France; Unité inserm U1096, UFR de médecine et de pharmacie de Rouen, 22, boulevard Gambetta, 76000 Rouen, France
| | - Y Benhamou
- Département de médecine interne, CHU de Rouen, 1, rue de Germont, 76031 Rouen cedex, France; Unité inserm U1096, UFR de médecine et de pharmacie de Rouen, 22, boulevard Gambetta, 76000 Rouen, France
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Delaval L, De Boysson H, Liozon E, Daumas A, Lazaro E, Blockmans D, Puyade M, Benhamou Y, Sacré K, Berezne A, Samson M, Terrier B. Caractéristiques des vascularites des vaisseaux de gros calibre diagnostiquées entre 50 et 60 ans : étude rétrospective portant sur 181 cas. Rev Med Interne 2017. [DOI: 10.1016/j.revmed.2017.03.094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Miranda S, Dhamy A, Le Cam Duchez V, Barbay V, Cailleux N, Armengol G, Levesque H, Benhamou Y. Évaluation du risque de récidive de la maladie thromboembolique veineuse par les dosages de D-dimères et du fragment F1 + 2 de la prothrombine : analyse d’une cohorte de 125 patients. Rev Med Interne 2017. [DOI: 10.1016/j.revmed.2017.03.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Langlois V, Bedat Millet AL, Lebesnerais M, Miranda S, Marguet F, Benhamou Y, Marcorelles P, Lévesque H. [Small fiber neuropathy]. Rev Med Interne 2017; 39:99-106. [PMID: 28410768 DOI: 10.1016/j.revmed.2017.03.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [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: 01/29/2017] [Accepted: 03/11/2017] [Indexed: 12/15/2022]
Abstract
Small fiber neuropathy (SFN) is still unknown. Characterised by neuropathic pain, it typically begins by burning feet, but could take many other expression. SFN affects the thinly myelinated Aδ and unmyelinated C-fibers, by an inherited or acquired mechanism, which could lead to paresthesia, thermoalgic disorder or autonomic dysfunction. Recent studies suggest the preponderant role of ion channels such as Nav1.7. Furthermore, erythromelalgia or burning mouth syndrome are now recognized as real SFN. Various aetiologies of SFN are described. It could be isolated or associated with diabetes, impaired glucose metabolism, vitamin deficiency, alcohol, auto-immune disease, sarcoidosis etc. Several mutations have recently been identified, like Nav1.7 channel leading to channelopathies. Diagnostic management is based primarily on clinical examination and demonstration of small fiber dysfunction. Laser evoked potentials, Sudoscan®, cutaneous biopsy are the main test, but had a difficult access. Treatment is based on multidisciplinary management, combining symptomatic treatment, psychological management and treatment of an associated etiology.
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Affiliation(s)
- V Langlois
- Service de médecine interne et maladies infectieuses, CH Le Havre, 29, avenue Pierre-Mendès, 76290 Montivilliers, France; U1096, service de médecine interne, Normandie univ, UNIROUEN, 76000 Rouen, France.
| | - A-L Bedat Millet
- Département de neurophysiologie, CHU de Rouen, 1, rue de Germont, 76031 Rouen, France
| | - M Lebesnerais
- U1096, service de médecine interne, Normandie univ, UNIROUEN, 76000 Rouen, France
| | - S Miranda
- U1096, service de médecine interne, Normandie univ, UNIROUEN, 76000 Rouen, France
| | - F Marguet
- Département d'anatomie et cytologie pathologiques, CHU de Rouen, 1, rue de Germont, 76031 Rouen, France
| | - Y Benhamou
- U1096, service de médecine interne, Normandie univ, UNIROUEN, 76000 Rouen, France
| | - P Marcorelles
- Département d'anatomie et cytologie pathologiques, hôpital Morvan, centre hospitalier régional et universitaire de Brest, 2, avenue Foch, 29609 Brest cedex, France
| | - H Lévesque
- U1096, service de médecine interne, Normandie univ, UNIROUEN, 76000 Rouen, France
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Nahon P, Lescat M, Layese R, Bourcier V, Talmat N, Allam S, Marcellin P, Guyader D, Pol S, Larrey D, De Lédinghen V, Ouzan D, Zoulim F, Roulot D, Tran A, Bronowicki JP, Zarski JP, Goria O, Calès P, Péron JM, Alric L, Bourlière M, Mathurin P, Blanc JF, Abergel A, Serfaty L, Mallat A, Grangé JD, Attali P, Bacq Y, Wartelle C, Dao T, Benhamou Y, Pilette C, Silvain C, Christidis C, Capron D, Bernard-Chabert B, Hillaire S, Di Martino V, Trinchet JC, Moreau R, Roudot-Thoraval F. Bacterial infection in compensated viral cirrhosis impairs 5-year survival (ANRS CO12 CirVir prospective cohort). Gut 2017; 66:330-341. [PMID: 26511797 DOI: 10.1136/gutjnl-2015-310275] [Citation(s) in RCA: 50] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2015] [Revised: 09/27/2015] [Accepted: 09/29/2015] [Indexed: 02/06/2023]
Abstract
OBJECTIVE To assess incidence and prognostic significance of bacterial infections (BIs) occurring in compensated viral cirrhosis. DESIGN This prospective study involved 35 French centres. Inclusion criteria were biopsy-proven HCV or HBV cirrhosis, Child-Pugh A and no previous hepatic complications. Cumulative incidence (CumI) of events was estimated in a competing risks framework. RESULTS 1672 patients were enrolled (HCV 1323, HBV 318, HCV-HBV 31). During a median follow-up of 43 months, 234 BIs occurred in 171 patients (5 year CumI: 12.9%), among whom 14.6% had septic shock. Main localisations included the urinary tract (27.4%), lung (25.2%) and peritoneum (10.7%) (other, 86 (36.7%)). Most BIs occurred as a first event prior to liver decompensation (n=140, 81.8%) and were community-acquired (CA, 84.2%). The risk of BI was higher in patients with HCV than in patients with HBV (5 year CumI: 15.2% vs 5.5%, p=0.0008). Digestive localisation, concomitant interferon-based treatment, isolation of resistant bacteria and non-CA BIs were associated with lowest probability of resolution. The occurrence of a first BI impaired survival in patients infected with HCV (5 year survival: 60.2% vs 90.4%, p<0.001) and patients infected with HBV (5 year survival: 69.2% vs 97.6%, p<0.001). BIs represented the third cause of death (14.1%) after liver failure and liver cancer. BI risk factors comprised older age, lower albumin, proton pump inhibitor intake and absence of virological eradication/control. CONCLUSION BI mostly occurs as a first complication and represents a turning point in the course of compensated viral cirrhosis. Its occurrence impacts long-term prognosis and may define a subgroup of patients in whom adaptation of management is warranted.
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Affiliation(s)
- Pierre Nahon
- AP-HP, Hôpital Jean Verdier, Service d'Hépatologie, Bondy, Université Paris 13, Bobigny et INSERM U1162, Université Paris 5, Paris, France
| | - Mathilde Lescat
- AP-HP, Hôpital Jean Verdier, Service de Microbiologie, Bondy, Université Paris 13, Bobigny, et INSERM UMR 1139, Paris, France
| | - Richard Layese
- AP-HP, Hôpital Henri Mondor, Département de Santé Publique, Créteil, France
| | - Valérie Bourcier
- AP-HP, Hôpital Jean Verdier, Service d'Hépatologie, Bondy, Université Paris 13, Bobigny et INSERM U1162, Université Paris 5, Paris, France
| | - Nabila Talmat
- AP-HP, Hôpital Jean Verdier, Service d'Hépatologie, Bondy, Université Paris 13, Bobigny et INSERM U1162, Université Paris 5, Paris, France
| | - Setty Allam
- Unit for Basic and Clinical research on Viral Hepatitis, ANRS (France REcherche Nord & sud Sida-HIV Hépatites-FRENSH), Paris, France
| | | | | | - Stanislas Pol
- AP-HP, Hôpital Cochin, Département d'Hépatologie et INSERM UMS20, Institut Pasteur, Université Paris Descartes, Paris, France
| | | | | | - Denis Ouzan
- Institut Arnaud Tzanck, Service d'Hépatologie, St Laurent du Var, France
| | - Fabien Zoulim
- Hôpital Hôtel Dieu, Service d'Hépatologie, Lyon, France
| | | | - Albert Tran
- CHU de Nice, Service d'Hépatologie, et INSERM U1065, Université de Nice-Sophia-Antipolis, Nice, France
| | | | | | - Odile Goria
- Hôpital Charles-Nicolle, Service d'Hépatologie, Rouen, France
| | - Paul Calès
- CHU d'Angers, Service d'Hépatologie, Angers, France
| | | | - Laurent Alric
- CHU Toulouse, Service de Médecine Interne-Pôle Digestif UMR 152, Toulouse, France
| | - Marc Bourlière
- Hôpital Saint Joseph, Service d'Hépatologie, Marseille, France
| | | | | | - Armand Abergel
- Hôpital Hôtel Dieu, Service d'Hépatologie, Clermont-Ferrand, France
| | - Lawrence Serfaty
- AP-HP, Hôpital Saint-Antoine, Service d'Hépatologie, Paris, France
| | - Ariane Mallat
- AP-HP, Hôpital Henri Mondor, Service d'Hépatologie, Créteil, France
| | | | - Pierre Attali
- AP-HP, Hôpital Paul Brousse, Service d'Hépatologie, Villejuif, France
| | - Yannick Bacq
- Hôpital Trousseau, Unité d'Hépatologie, CHRU de Tours, Tours, France
| | - Claire Wartelle
- Hôpital d'Aix-En-Provence, Service d'Hépatologie, Aix-En-Provence, France
| | - Thông Dao
- Hôpital de la Côte de Nacre, Service d'Hépatologie, Caen, France
| | - Yves Benhamou
- AP-HP, Groupe Hospitalier de La Pitié-Salpêtrière, Service d'Hépatologie, Paris, France
| | | | | | | | | | | | | | | | - Jean-Claude Trinchet
- AP-HP, Hôpital Jean Verdier, Service d'Hépatologie, Bondy, Université Paris 13, Bobigny et INSERM U1162, Université Paris 5, Paris, France
| | - Richard Moreau
- AP-HP, Hôpital Beaujon, Service d'Hépatologie, Clichy, France
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50
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Nahon P, Bourcier V, Layese R, Audureau E, Cagnot C, Marcellin P, Guyader D, Fontaine H, Larrey D, De Lédinghen V, Ouzan D, Zoulim F, Roulot D, Tran A, Bronowicki JP, Zarski JP, Leroy V, Riachi G, Calès P, Péron JM, Alric L, Bourlière M, Mathurin P, Dharancy S, Blanc JF, Abergel A, Serfaty L, Mallat A, Grangé JD, Attali P, Bacq Y, Wartelle C, Dao T, Benhamou Y, Pilette C, Silvain C, Christidis C, Capron D, Bernard-Chabert B, Zucman D, Di Martino V, Thibaut V, Salmon D, Ziol M, Sutton A, Pol S, Roudot-Thoraval F, Marcellin P, Guyader D, Pol S, Fontaine H, Larrey D, De Lédinghen V, Ouzan D, Zoulim F, Roulot D, Tran A, Bronowicki JP, Zarski JP, Leroy V, Riachi G, Calès P, Péron JM, Alric L, Bourlière M, Mathurin P, Blanc JF, Abergel A, Serfaty L, Mallat A, Grangé JD, Attali P, Bacq Y, Wartelle C, Dao T, Benhamou Y, Pilette C, Silvain C, Christidis C, Capron D, Thiefin G, Hillaire S, Di Martino V. Eradication of Hepatitis C Virus Infection in Patients With Cirrhosis Reduces Risk of Liver and Non-Liver Complications. Gastroenterology 2017; 152:142-156.e2. [PMID: 27641509 DOI: 10.1053/j.gastro.2016.09.009] [Citation(s) in RCA: 365] [Impact Index Per Article: 52.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2016] [Revised: 09/06/2016] [Accepted: 09/07/2016] [Indexed: 02/07/2023]
Abstract
BACKGROUND & AIMS We performed a prospective study to investigate the effects of a sustained viral response (SVR) on outcomes of patients with hepatitis C virus (HCV) infection and compensated cirrhosis. METHODS We collected data from 1323 patients included in the prospective Agence Nationale pour la Recherche sur le SIDA et les hépatites virales (ANRS) viral cirrhosis (CirVir) cohort, recruited from 35 clinical centers in France from 2006 through 2012. All patients had HCV infection and biopsy-proven cirrhosis, were Child-Pugh class A, and had no prior liver complications. All patients received anti-HCV treatment before or after inclusion (with interferon then with direct antiviral agents) and underwent an ultrasound examination every 6 months, as well as endoscopic evaluations. SVR was considered as a time-dependent covariate; its effect on outcome was assessed by the Cox proportional hazard regression method. We used a propensity score to minimize confounding by indication of treatment and capacity to achieve SVR. RESULTS After a median follow-up period of 58.2 months, 668 patients (50.5%) achieved SVR. SVR was associated with a decreased incidence of hepatocellular carcinoma (hazard ratio [HR] compared with patients without an SVR, 0.29; 95% confidence interval [CI], 0.19-0.43; P < .001) and hepatic decompensation (HR, 0.26; 95% CI, 0.17-0.39; P < .001). Patients with SVRs also had a lower risk of cardiovascular events (HR, 0.42; 95% CI, 0.25-0.69; P = .001) and bacterial infections (HR, 0.44; 95% CI, 0.29-0.68; P < .001). Metabolic features were associated with a higher risk of hepatocellular carcinoma in patients with SVRs, but not in patients with viremia. SVR affected overall mortality (HR, 0.27 compared with patients without SVR; 95% CI, 0.18-0.42; P < .001) and death from liver-related and non-liver-related causes. Similar results were obtained in a propensity score-matched population. CONCLUSIONS We confirmed a reduction in critical events, liver-related or not, in a prospective study of patients with HCV infection and compensated cirrhosis included in the CirVir cohort who achieved an SVR. We found an SVR to reduce overall mortality and risk of death from liver-related and non-liver-related causes. A longer follow-up evaluation is required to accurately describe and assess specific risk factors for complications in this population.
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Affiliation(s)
- Pierre Nahon
- AP-HP, Hôpital Jean Verdier, Service d'Hépatologie, Bondy, France; Université Paris 13, Sorbonne Paris Cité, "Equipe Labellisée Ligue Contre le Cancer," Saint-Denis, France; Inserm, UMR-1162, "Génomique Fonctionnelle des Tumeur Solides," Paris, France.
| | - Valérie Bourcier
- AP-HP, Hôpital Jean Verdier, Service d'Hépatologie, Bondy, France
| | - Richard Layese
- AP-HP, Hôpital Henri Mondor, Département de Santé Publique, and Université Paris-Est, Ageing-Thorax-Vessels-Blood Département Hospitalo-Universitaire, Clinical Epidemiology and Aging Unit, Université Paris-Est Créteil, Créteil, France
| | - Etienne Audureau
- AP-HP, Hôpital Henri Mondor, Département de Santé Publique, and Université Paris-Est, Ageing-Thorax-Vessels-Blood Département Hospitalo-Universitaire, Clinical Epidemiology and Aging Unit, Université Paris-Est Créteil, Créteil, France
| | - Carole Cagnot
- Unit for Basic and Clinical Research on Viral Hepatitis, Association Nationale pour la Recherche sur le SIDA et les hépatites virales (ANRS), France REcherche Nord and sud Sida-HIV Hépatites, Paris, France
| | | | - Dominique Guyader
- Centre Hospitalo-Universitaire Pontchaillou, Service d'Hépatologie, Rennes, France
| | | | | | | | - Denis Ouzan
- Institut Arnaud Tzanck, Service d'Hépatologie, St Laurent du Var, France
| | - Fabien Zoulim
- Hospices Civils de Lyon, Service d'Hépatologie et Université de Lyon, Lyon, France
| | | | - Albert Tran
- Centre Hospitalo-Universitaire de Nice, Service d'Hépatologie, Nice, France; Inserm U1065, C3M, Team 8, "Hepatic Complications in Obesity," Nice, France
| | - Jean-Pierre Bronowicki
- Inserm 954, Centre Hospitalo-Universitaire de Nancy, Université de Lorraine, Vandoeuvre-les-Nancy, France
| | | | - Vincent Leroy
- Hôpital Michallon, Service d'Hépatologie, Grenoble, France
| | - Ghassan Riachi
- Hôpital Charles-Nicolle, Service d'Hépatologie, Rouen, France
| | - Paul Calès
- Centre Hospitalo-Universitaire d'Angers, Service d'Hépato-Gastroentérologie, Angers, France
| | | | - Laurent Alric
- Centre Hospitalo-Universitaire Toulouse, Service de Médecine Interne-Pôle Digestif UMR 152, Toulouse, France
| | - Marc Bourlière
- Hôpital Saint Joseph, Service d'Hépatologie, Marseille, France
| | | | | | | | - Armand Abergel
- Hôpital Hôtel Dieu, Service d'Hépatologie, Clermont-Ferrand, France
| | - Lawrence Serfaty
- AP-HP, Hôpital Saint-Antoine, Service d'Hépatologie, Paris, France
| | - Ariane Mallat
- AP-HP, Hôpital Henri Mondor, Service d'Hépatologie, Créteil, France
| | | | - Pierre Attali
- AP-HP, Hôpital Paul Brousse, Service d'Hépatologie, Villejuif, France
| | - Yannick Bacq
- Hôpital Trousseau, Unité d'Hépatologie, Centre Hospitalier Régional Universitaire de Tours, France
| | - Claire Wartelle
- Hôpital d'Aix-en-Provence, Service d'Hépatologie, Aix-En-Provence, France
| | - Thông Dao
- Hôpital de la Côte de Nacre, Service d'Hépatologie, Caen, France
| | - Yves Benhamou
- AP-HP, Groupe Hospitalier de La Pitié-Salpêtrière, Service d'Hépatologie, Paris, France
| | - Christophe Pilette
- Centre Hospitalo-Universitaire Le Mans, Service d'Hépatologie, Le Mans, France
| | - Christine Silvain
- Centre Hospitalo-Universitaire de Poitiers, Service d'Hépatologie, Poitiers, France
| | | | | | | | - David Zucman
- Hôpital Foch, Service de Médecine Interne, Suresnes, France
| | | | - Vincent Thibaut
- Centre Hospitalo-Universitaire Pontchaillou, Service de Virologie, Rennes, France
| | - Dominique Salmon
- AP-HP, Hôpital Cochin, Service de Maladies Infectieuses, Université Paris Descartes, Paris, France
| | - Marianne Ziol
- Université Paris 13, Sorbonne Paris Cité, "Equipe Labellisée Ligue Contre le Cancer," Saint-Denis, France; Inserm, UMR-1162, "Génomique Fonctionnelle des Tumeur Solides," Paris, France; AP-HP, Hôpital Jean Verdier, Service d'Anatomopathologie, Bondy, France; Centre de Ressources Biologiques (Liver Disease Biobank) Groupe Hospitalier Paris, Seine-Saint-Denis, France
| | - Angela Sutton
- Centre de Ressources Biologiques (Liver Disease Biobank) Groupe Hospitalier Paris, Seine-Saint-Denis, France; AP-HP, Hôpital Jean Verdier, Service de Biochimie, Bondy, France; Inserm U1148, Université Paris 13, Bobigny, France
| | - Stanislas Pol
- AP-HP, Hôpital Cochin, Département d'Hépatologie, France; Inserm UMS20 et U1223, Institut Pasteur, Université Paris Descartes, Paris, France
| | - Françoise Roudot-Thoraval
- AP-HP, Hôpital Henri Mondor, Département de Santé Publique, and Université Paris-Est, Ageing-Thorax-Vessels-Blood Département Hospitalo-Universitaire, Clinical Epidemiology and Aging Unit, Université Paris-Est Créteil, Créteil, France
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