Influenza‐like illness in individuals treated with immunosuppressants, biologics, and/or systemic corticosteroids for autoimmune or chronic inflammatory disease: A crowdsourced cohort study, France, 2017–2018

International audienceBackground:Influenza-like illness (ILI) incidence estimates in individuals treated withimmunosuppressants and/or biologics and/or corticosteroid for an autoimmune orchronic inflammatory disease are scarce. We compared the ILI incidence amongimmunocompromised population and the general population.Method:We conducted a prospective cohort study during the 2017–2018 seasonalinfluenza epidemic, on theGrippeNet.frelectronic platform, which allows the collec-tion of epidemiological crowdsourced data on ILI, directly from the French generalpopulation. The immunocompromised population were adults treated with systemiccorticosteroids, immunosuppressants, and/or biologics for an autoimmune or chronicinflammatory disease, recruited directly onGrippeNet.frand also among patients ofthe departments of a single university hospital that were asked to incorporateGrippeNet.fr. The general population consisted of adults reporting none of the abovetreatments or diseases participating inGrippeNet.fr. The incidence of ILI was esti-mated on a weekly basis and compared between the immunocompromised popula-tion and the general population, during the seasonal influenza epidemic. Results:Among the 318 immunocompromised patients assessed for eligibility,177 were included. During the 2017–2018 seasonal influenza epidemic period,immunocompromised population had 1.59 (95% CI: 1.13–2.20) higher odds to expe-rience an ILI episode, compared to the general population (N=5358). An influenzavaccination was reported by 58% of the immunocompromised population, comparedto 41% of the general population (p< 0.001).Conclusion:During a seasonal influenza epidemic period, the incidence of influenza-like illness was higher in patients treated with immunosuppressants, biologics, and/orcorticosteroids for an autoimmune or chronic inflammatory disease, compared to the general population

Management of severe renal disease in anti-neutrophil-cytoplasmic-antibody-associated vasculitis: the place of rituximab and plasma exchange?

Abstract Objective The optimal induction therapy for severe glomerulonephritis of ANCA-associated vasculitis (AAV) is debated. We compared the efficacy of glucocorticoid and rituximab (RTX) or CYC induction therapy for severe AAV-related glomerulonephritis and evaluated the potential benefit of plasma exchange (PE) as adjunct therapy to CYC. Methods This retrospective, multicentre study included AAV patients with severe renal active disease (serum creatinine level ≥350 µmol/l and/or estimated glomerular filtration ratio ≤15 ml/min/1.73 m2). Propensity-score analysis was used to adjust for potential confounders. Results Between 2005 and 2017, 153 patients with AAV-related glomerulonephritis were studied (96 [60%] men; mean [s.d.] age 63 [13.1] years): 19 (12%) were treated with RTX and 134 (88%) with CYC. Remission rates did not differ between RTX- and CYC-treated groups. Although more patients with RTX than CYC were dialysis-free at month (M) 12 (79% vs 68%), the difference was not significant after adjustment. Among 134 patients with CYC-treated glomerulonephritis, 76 (57%) also had PE. M3 and M6 remission rates were comparable for weighted CYC groups with or without PE. For weighted groups, the dialysis-free survival rate with CYC was higher with than without PE at M6 (72% vs 64%; odds ratio 2.58) and M12 (74% vs 60%; odds ratio 2.78) reaching statistical significance at M12. Conclusion We could not find any difference between RTX and CYC as induction therapy for patients with severe AAV-related glomerulonephritis. In patients receiving CYC induction regimen, the addition of PE conferred short-term benefits with higher dialysis-free rate at M12

Inflammatory disorders associated with trisomy 8‐myelodysplastic syndromes: French retrospective case‐control study

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Inflammatory Disorders Associated with Trisomy 8-myelodysplastic Syndromes: French Retrospective Case-control Study

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Tocilizumab for Severe Worsening COVID-19 Pneumonia: a Propensity Score Analysis

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Gastrointestinal Behcet's-like Disease with Myelodysplastic Neoplasms with Trisomy 8: A French Case Series and Literature Review

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Vasculitis associated with myelodysplastic syndrome and chronic myelomonocytic leukemia: French multicenter case-control study

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