Étude de l'action de l'interleukine 22 sur les lymphocytes T (contribution des puces à ADN)

POITIERS-BU Médecine pharmacie (861942103) / SudocSudocFranceF

Assessment of adherence to disease-modifying anti-rheumatic drugs in rheumatoid arthritis

International audienc

Relapse in rheumatoid arthritis patients undergoing dose reduction and withdrawal of biologics: are predictable factors more relevant than predictive parameters? An observational prospective real-life study

International audienc

Impact of ACR 2010 fibromyalgia criteria fulfillment on disease activity evaluation in patients with axial spondyloarthritis treated with infliximab

International audienc

Analyse descriptive des spondylodiscites sans documentation bactériologique issues d’une cohorte de 329 spondylodiscites suspectées d’être infectieuses à l’imagerie

Devant une image de spondylodiscite (SD) sur l’imagerie, la SD infectieuse est l’étiologie la plus redoutée. L’enquête bactériologique n’est pas concluante dans environ 30 % des cas. Au cours de ces dernières années, plusieurs étiologies de SD non infectieuses ont été décrites : inflammatoire, microcristalline, dégénérative. Notre travail consistait, à partir d’une population de SD suspectées à l’imagerie, à comparer les SD dont l’étiologie infectieuse était prouvée par une documentation bactériologique aux SD non documentées

Switching from an anti-TNF monoclonal antibody to soluble TNF-receptor yields better results than vice versa: An observational retrospective study of 72 rheumatoid arthritis switchers

International audienceObjectives : To evaluate the benefits for rheumatoid arthritis (RA) patients of switching from one tumor necrosis factor inhibitor (TNFi) to another based on reason for change (primary failure, escape or intolerance) and molecule-switching order.Methods : Between 2000 and 2008, 356 RA patients prescribed a TNFi (infliximab [IFX], etanercept [ETA] or adalimumab [ADA]) and undergoing standardized evaluation were included in this retrospective study. Detailed demographic, clinical and biological data were collected before first biologic use and ≤ 6 months later to evaluate response based on EULAR-criteria. Primary failure, escape or intolerance of first TNFi triggered switch to another TNFi, the response of which was evaluated 6 months later. Propensity score then measured any interaction with baseline variables.Results : Of the 356 RA patients, 38 switched from IFX/ADA to ETA, 26 from ETA to IFX/ADA, and eight from one monoclonal antibody (mAb; IFX/ADA) to another. Clinical parameters for switchers and non-switchers were comparable. Switchers changed therapies because of primary failure (36.1%), escape (33.3%), or intolerance (30.6%), with no difference found in these subgroups. More switchers responded to the second TNFi than the first (P < 0.01), respectively, regardless of switch (ETA to IFX/ADA: 50 vs. 23.1% [P < 0.05]; IFX/ADA to ETA: 57.9 vs. 15.8% [P < 0.001]) or reason for changing. In addition, DAS28 decreased more with the second antagonist (P < 0.001) and regardless of molecules switched (P < 0.01). Survival of the second TNFi was significantly longer with switch from mAb to the soluble receptor than vice versa (P < 0.05).Discussion : Overall, any switching from one TNFi to another, especially mAb to soluble receptor, was often beneficial for RA patients

Impact of assessment of bone status before corrective surgery of lumbar spine in patients over 50 years old

International audienc

Étude des facteurs associés à un risque d’atteinte neurologique sévère dans les spondylodiscites infectieuses dans une cohorte de 329 cas

Les spondylodiscites infectieuses (SPI) sont des infections du disque intervertébral et des vertèbres adjacentes potentiellement sévères, en particulier du fait d’un risque de complications neurologiques déficitaires survenant dans environ 9,2 % selon l’étude SPONDIMMO. Seules deux études françaises ont étudié les facteurs de risque d’atteinte déficitaire qui sont : la présence d’un abcès épidural, une atteinte cervicale ou thoracique, une CRP > 150 mg/L et une SPI à S. aureus. L’objectif de cette étude monocentrique, rétrospective, était de décrire les caractéristiques des patients présentant une SPI déficitaire et de déterminer les facteurs associés à la survenue d’un tel déficit

Screening for and management of comorbidities after a nurse-led program: results of a 3-year longitudinal study in 769 established rheumatoid arthritis patients

International audienceBackground/purpose Cardiovascular (CV) risk, cancer, infections and osteoporosis should be screened for in rheumatoid arthritis (RA). The objective was to assess 3-year effects of a nurse visit for comorbidity counselling. Methods This was an open long-term (3 years) extension of the Comorbidities and Education in Rheumatoid Arthritis 6-month randomised controlled trial in which patients with definite, stable RA were visiting a nurse for comorbidity counselling. Comorbidity status was assessed and nurses provided advice on screening and management, at baseline and 3 years later. A score was developed to quantify comorbidity screening and management: 0–100, where lower scores indicate better screening and management. The score was compared between baseline and 3-year assessment using a Wilcoxon test for paired data. Results Of the 970 recruited patients, 776 (80%) were followed-up at 2–4 years and 769 (79%) had available data for comorbidities at both time points: mean (±SD) age 58 (±11) years and mean disease duration 14 (±10) years; 614 (80%) were women, the mean Disease Activity Score 28 was 3.0±1.3, and 538 (70%) were receiving a biologic. At baseline, the mean comorbidity screening score was 36.6 (±19.9) and it improved at 3 years to 24.3 (±17.8) (p<0.0001), thus with a relative improvement of 33% (improvement of 12 points). CV risk screening, vaccination status and bone densitometry performance improved the most. Conclusions Comorbidity screening was suboptimal but improved notably over 3 years, after a nurse-led programme aiming at checking systematically for comorbidity screening and giving patient advice. This long-term efficacy pleads in favour of nurse-led interventions to better address comorbidities in RA. Trial registration number NCT0131565

Is self-assessment by patients of disease activity acceptable over the long term in rheumatoid arthritis? A 3-year follow-up of 771 patients

International audienceSelf-assessment of disease activity is feasible in rheumatoid arthritis, but its frequency decreases over time