Jean-Claude CARON et Nathalie PONSARD (dir.), La France en guerre. Cinq « années terribles ». 1792-1793. 1814-1815. 1870-1871. 1914-1915. 1939-1940

Fruit d’un colloque tenu à Clermont-Ferrand en 2016, La France en guerre propose un retour collectif sur la notion d’« année terrible », popularisée par Victor Hugo pour désigner l’année 1870-1871. À cette acception hugolienne, Jean-Claude Caron et Nathalie Ponsard proposent d’ajouter quatre autres séquences de l’histoire de France marquées par l’invasion étrangère et le déferlement de la violence, et dans certains cas par le spectre de la défaite ou de la guerre civile. Le chrononyme s’en tr..

Natalizumab treatment shows low cumulative probabilities of confirmed disability worsening to EDSS milestones in the long-term setting.

Abstract Background Though the Expanded Disability Status Scale (EDSS) is commonly used to assess disability level in relapsing-remitting multiple sclerosis (RRMS), the criteria defining disability progression are used for patients with a wide range of baseline levels of disability in relatively short-term trials. As a result, not all EDSS changes carry the same weight in terms of future disability, and treatment benefits such as decreased risk of reaching particular disability milestones may not be reliably captured. The objectives of this analysis are to assess the probability of confirmed disability worsening to specific EDSS milestones (i.e., EDSS scores ≥3.0, ≥4.0, or ≥6.0) at 288 weeks in the Tysabri Observational Program (TOP) and to examine the impact of relapses occurring during natalizumab therapy in TOP patients who had received natalizumab for ≥24 months. Methods TOP is an ongoing, open-label, observational, prospective study of patients with RRMS in clinical practice. Enrolled patients were naive to natalizumab at treatment initiation or had received ≤3 doses at the time of enrollment. Intravenous natalizumab (300 mg) infusions were given every 4 weeks, and the EDSS was assessed at baseline and every 24 weeks during treatment. Results Of the 4161 patients enrolled in TOP with follow-up of at least 24 months, 3253 patients with available baseline EDSS scores had continued natalizumab treatment and 908 had discontinued (5.4% due to a reported lack of efficacy and 16.4% for other reasons) at the 24-month time point. Those who discontinued due to lack of efficacy had higher baseline EDSS scores (median 4.5 vs. 3.5), higher on-treatment relapse rates (0.82 vs. 0.23), and higher cumulative probabilities of EDSS worsening (16% vs. 9%) at 24 months than those completing therapy. Among 24-month completers, after approximately 5.5 years of natalizumab treatment, the cumulative probabilities of confirmed EDSS worsening by 1.0 and 2.0 points were 18.5% and 7.9%, respectively (24-week confirmation), and 13.5% and 5.3%, respectively (48-week confirmation). The risks of 24- and 48-week confirmed EDSS worsening were significantly higher in patients with on-treatment relapses than in those without relapses. An analysis of time to specific EDSS milestones showed that the probabilities of 48-week confirmed transition from EDSS scores of 0.0–2.0 to ≥3.0, 2.0–3.0 to ≥4.0, and 4.0–5.0 to ≥6.0 at week 288 in TOP were 11.1%, 11.8%, and 9.5%, respectively, with lower probabilities observed among patients without on-treatment relapses (8.1%, 8.4%, and 5.7%, respectively). Conclusions In TOP patients with a median (range) baseline EDSS score of 3.5 (0.0–9.5) who completed 24 months of natalizumab treatment, the rate of 48-week confirmed disability worsening events was below 15%; after approximately 5.5 years of natalizumab treatment, 86.5% and 94.7% of patients did not have EDSS score increases of ≥1.0 or ≥2.0 points, respectively. The presence of relapses was associated with higher rates of overall disability worsening. These results were confirmed by assessing transition to EDSS milestones. Lower rates of overall 48-week confirmed EDSS worsening and of transitioning from EDSS score 4.0–5.0 to ≥6.0 in the absence of relapses suggest that relapses remain a significant driver of disability worsening and that on-treatment relapses in natalizumab-treated patients are of prognostic importance

Sortir de l’ombre – Des combattants clandestins en quête de reconnaissance

Environ 6000 citoyens belges ont été impliqués durant la Grande Guerre dans des réseaux renseignement. L’Armistice est pour eux le moment de sortir de l'ombre et d'acquérir en tant que combattants de l'ombre une dignité comparable à celle des soldats du front. Or, tandis qu’un hommage unanime est rendu par la Nation à leurs morts, les rescapés peinent à obtenir satisfaction à leur besoin de reconnaissance, tant matérielle que symbolique. Malgré les démarches de plusieurs anciens du renseignement dans l’arène parlementaire, les agents n’obtiendront jamais leur « militarisation », c’est-à-dire leur assimilation légale au personnel militaire. La déception sera d'autant plus grande que la plupart ont travaillé pour les services secrets français ou britanniques plutôt que belges, et essuient par conséquent le reproche d'avoir espionné pour le compte de l'étranger. Indemnités et décorations nationales leur seront refusées par les autorités belges, qui laisseront les gouvernements alliés se charger de leur cas. Le travail des bureaux de liquidation établis à cette fin stimulera cependant la création d’une Commission des Archives patriotiques, qui rassemblera une importante documentation sur l’activité des réseaux clandestins et de leurs agents.During the Great War, almost 6,000 people were committed in “resistance” activities, like the publication of underground papers (the so-called “prohibés”), evasion help (the “passeurs d’hommes”) and, above all, intelligence. For these people, the Armistice is the moment of coming out of the shadows, of getting recognition for their action, of getting a comparable dignity as clandestine fighters as the one of the front soldiers. But, while an unanimous tribute is paid by the Nations to the executed agents (Gabrielle Petit, Edith Cavell, Philippe Baucq, etc.), the living ones struggle to obtain any kind of status, unless of course their incarceration makes them enter the category of political prisoners. Disappointment will be all the greater as some will even be blamed for having worked for the French or the British services, and therefore having spied for foreign countries. This “national un-recognition” will however be tempered, from the late nineteen-twenties to the second occupation, by the editorial success of a few agents’ memories and fictional tales relating their heroic experience