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Given the high mortality rate observed in our data, tocilizumab is not recommended as a salvage therapy for patients affected by acute exacerbation of pulmonary fibrosis who did not show clinical improvement after three steroids bolus https://bit.ly/3ClggYb., Competing Interests: Conflict of interest: M. Le Brun reports grants or contracts from GSK and AstraZeneca; payment or honoraria for lectures, presentations, manuscript writing or educational events from GSK, La revue du praticien and AstraZeneca; and support for attending meetings and/or travel from Asten Santé, Novartis and Sanofi; all outside the submitted work. Q. Philippot reports grants or contracts from Fondation Bettencourt Schuller and royalties or licenses form Elsevier, all outside the submitted work. C. Dupin reports consulting fees from AstraZeneca, Sanofi and GSK; lecture honoraria from AstraZeneca, GSK, Sanofi, Novartis, Chiesi, OPA Pratique, Pneumoscoop and La Lettre du Pneumologue; and travel support from AstraZeneca, Sanofi, Novartis, Chiesi and GSK; all outside the submitted work. M-P. Debray reports consulting fees from Boehringer Ingelheim and Sanofi, and support for attending meetings and/or travel form Boehringer Ingelheim, all outside the submitted work. R. Borie reports consulting fees from Boehringer Ingelheim, Ferrer and Sanofi; payment or honoraria for lectures, presentations, manuscript writing or educational events from Boehringer Ingelheim; and support for attending meetings and/or travel form Boehringer Ingelheim, all outside the submitted work. B. Crestani reports grants or contracts from Boehringer Ingelheim; consulting fees from BMS, Boehringer Ingelheim, Chiesi, GSK and Sanofi; payment or honoraria for lectures, presentations, manuscript writing or educational events from AstraZeneca, BMS, Boehringer Ingelheim, GSK, Novartis, Roche and Sanofi; support for attending meetings and/or travel from AstraZeneca, BMS, Boehringer Ingelheim, Roche and Sanofi; participation on a data safety monitoring board or advisory board for BMS, Boehringer Ingelheim, Horizon and Sanofi; and he is president of the board of the Fondation du Souffle, a French charity, all outside the submitted work. G. Franco, P. Le Guen, C. Bancal and C. Taillé have no conflict of interest to declare., (Copyright ©The authors 2024.)

Identification of therapeutic targets other than asthma can guide the choice of biologics in cases of severe asthma. Some of the allergic diseases (atopic dermatitis, food allergies, allergic rhinoconjunctivitis) that may be associated with asthma can be treated with biologics. In this review, we aim to assess the effectiveness of these biologic therapies on the allergic comorbidities of asthma. In the treatment of atopic dermatitis, only Dupilumab, an anti-IL4Rα, has proven its effectiveness and has received reimbursement authorization for this indication. In patients presenting with allergic rhinoconjunctivitis, Omalizumab has shown effectiveness, but has not been approved for this indication. Data from post-hoc analyses of studies on severe asthma likewise suggest the effectiveness of Dupilumab regarding allergic rhinitis. While these two biologic therapies have shown positive signals, inducing oral food tolerance, the relevant data are not robust. Biologic therapies targeting IL-5 or its receptor (Mepolizumab, Benralizumab) have seldom been evaluated in allergic comorbidities, excepting atopic dermatitis, for which their effectiveness has not been proven. Lastly, there are interesting data on the combination of biologic therapy and allergen immunotherapy in cases of allergic rhinitis and food allergies, but they need to be confirmed by randomized studies., (Copyright © 2024 SPLF. Published by Elsevier Masson SAS. All rights reserved.)

The term "littératie" is derived from the English word "literacy", which refers to knowledge and skills in the fields of reading, writing, speech (or other means of communication) and calculation that allow people to be efficient and integrated into society. Health literacy is a recent concept that relies on the ability to find, understand, evaluate and communicate information in ways that promote, maintain and improve the health of the individual in various settings over the course of life. The objectives of this review are first of all to realize an overview on the health literacy of populations in Europe. Then, we propose to study the link between health literacy and health status (risk behaviors, chronic diseases, morbi-mortality, adherence to care and medical monitoring) and to study its medico-economic impact. We also analyzed the association between personalized therapeutic education and health literacy. Finally, we propose a review of the means put in place in the care system to improve the health literacy of the patients we manage., (Copyright © 2024 The Author(s). Published by Elsevier Masson SAS.. All rights reserved.)

Articular manifestations should be screened before and during anti-IL-5/5R biologic treatment in severe asthma. Rigorous multidisciplinary team discussion should be carried out to assess the risk-benefit balance of withholding effective treatment. https://bit.ly/3vfPn4k., Competing Interests: Conflict of interest: C. Dupin reports consulting fees from AstraZeneca, Sanofi and GSK; lecture honoraria from AstraZeneca, GSK, Sanofi, Novartis, Chiesi, OPA Pratique, Pneumoscoop and La Lettre du Pneumologue; and travel support from AstraZeneca, Sanofi, Novartis, Chiesi and GSK; all outside the submitted work. Conflict of interest: L. Guilleminault reports grants from AstraZeneca; consulting fees from Bayer, MSD, AstraZeneca, GSK, Novartis, Sanofi and Chiesi; lecture honoraria from MSD, AstraZeneca, GSK, Novartis, Sanofi and Chiesi; payment for expert testimony from Bayer, MSD and Sanofi; and travel support from MSD, AstraZeneca, GSK, Novartis and Sanofi; all outside the submitted work. Conflict of interest: G. Devouassoux reports lecture or consulting fees from GSK, Menarini, ALK, AstraZeneca, Novartis, Chiesi and Sanofi; payment for expert testimony from GSK, AstraZeneca, Sanofi and Chiesi; and travel support from AstraZeneca, GSK, Sanofi, Novartis, Chiesi; all outside the submitted work. Conflict of interest: M. Le Brun reports grants from GSK, AstenSante and Novartis; lecture honoraria from GSK and La Revue du Praticien; and travel support from Asten Santé and Novartis; all outside the submitted work. Conflict of interest: G. Mourin reports lecture honoraria from AstraZeneca and GSK; and travel support from AstraZeneca, Sanofi, Menarini and GSK; all outside the submitted work. Conflict of interest: P. Bonniaud reports grants from AstraZeneca; lecture honoraria from Sanofi and AstraZeneca; travel support from AstraZeneca, Novartis and Sanofi; advisory board participation from AstraZeneca, Novartis, Sanofi and GSK; all outside the submitted work. Conflict of interest: E. Ebstein reports consulting fees from Abbvie, Novartis and BMS; lecture honoraria from UCB and Galapagos; and travel support from UCB and Novartis; all outside the submitted work. Conflict of interest: C. Taillé reports grants from GSK; consulting fees from AstraZeneca, GSK and Sanofi; lecture honoraria from AstraZeneca, GSK, Sanofi, Novartis, Stallergenes and Chiesi; and travel support from AstraZeneca and GSK; all outside the submitted work. Conflict of interest: S. Valéry, M. Merveilleau, M. Russier, J. Pradelli, P-A. Juge all have nothing to disclose., (Copyright ©The authors 2024.)

Introduction: In France, opioids are responsible for the majority of overdose deaths in France. The antidote naloxone is available in France in take home formulations since 2016. Addiction specialized centres are in front-line for naloxone diffusion. The objective was to provide an overview of professional practices, difficulties and needs regarding overdose prevention and naloxone diffusion in these centres of the Provence-Alpes-Côte d'Azur (PACA) region., Methods: The POP programme "Prevention and harm reduction of opioid overdoses in PACA region" aims to improve the care of patients at risk of overdose and facilitate naloxone diffusion. The 75 addiction specialized centres of the PACA region were invited to respond to a semi-structured interview or a telephone questionnaire. Data collected included 2020 centres' activity and professionals' perceptions of overdose risk in their active file, their practices, difficulties and needs., Results: Overall, 33 centres answered. Among them, 22 were dispensing naloxone with a mean of 20 kits dispensed in 2020 (min-max: 1-100). Two strategies were pointed out: systematically offering of naloxone to all opioids users or targeting people considered at risk. Several difficulties limiting naloxone diffusion were expressed: a lack of knowledge from opioids users, refusal from people not feeling concerned or refusing the injectable formulation, a lack of training of some professionals to be comfortable with the tool or reglementary or time constraints., Conclusion: Naloxone diffusion is incrementally getting into common practices. However barriers are persisting. On the basis of expressed difficulties and needs, information and training materials were co-designed and diffused., (Copyright © 2023 Société française de pharmacologie et de thérapeutique. Published by Elsevier Masson SAS. All rights reserved.)

Patients with autosomal dominant (AD) hyper-IgE syndrome (HIES) suffer from a constellation of manifestations including recurrent bacterial and fungal infections, severe atopy, and skeletal abnormalities. This condition is typically caused by monoallelic dominant-negative (DN) STAT3 variants. In 2020, we described 12 patients from eight kindreds with DN IL6ST variants resulting in a new form of AD HIES. These variants encoded truncated GP130 receptors, with intact extracellular and transmembrane domains, but lacking the intracellular recycling motif and the four STAT3-binding residues, resulting in an inability to recycle and activate STAT3. We report here two new DN variants of IL6ST in three unrelated families with HIES-AD. The biochemical and clinical impacts of these variants are different from those of the previously reported variants. The p.(Ser731Valfs*8) variant, identified in seven patients from two families, lacks the recycling motif and all the STAT3-binding residues, but its levels on the cell surface are only slightly increased and it underlies mild biological phenotypes with variable clinical expressivity. The p.(Arg768*) variant, identified in a single patient, lacks the recycling motif and the three most distal STAT3-binding residues. This variant accumulates at the cell surface and underlies severe biological and clinical phenotypes. The p.(Ser731Valfs*8) variant shows that a DN GP130 expressed at near normal levels on the cell surface can underlie heterogeneous clinical presentations, ranging from mild to severe. The p.(Arg768*) variant demonstrates that a truncated GP130 protein retaining one STAT3-binding residue can underlie severe HIES., (© 2023. The Author(s).)

Background: At the time of the SARS-CoV-2 emergence, asthma patients were initially considered vulnerable because respiratory viruses, especially influenza, are associated with asthma exacerbations, increased risk of hospitalization and more severe disease course. We aimed to compare the asthma prevalence in patients hospitalized for COVID-19 or influenza and risk factors associated with poor prognosis with the diseases., Methods: This retrospective cohort study used the Paris university hospitals clinical data warehouse to identify adults hospitalized for COVID-19 (January to June 2020) or influenza (November 2017 to March 2018 for the 2017-2018 influenza period and November 2018 to March 2019 for the 2018-2019 period). Asthma patients were identified with J45 and J46 ICD-10 codes. Poor outcomes were defined as admission in intensive care or death., Results: Asthma prevalence was significantly higher among influenza than COVID-19 patients (n = 283/3 119, 9.1%, 95% CI [8.1-10.1] in 2017-2018 and n = 309/3 266, 9.5%, 95% CI [8.5-10.5] in 2018-2019 versus n = 402/9 009, 4.5%, 95% CI [4.0-4.9]). For asthma patients, 31% with COVID-19 were admitted to an intensive care unit versus 23% and 21% with influenza. Obesity was a risk factor for the 2017-2018 influenza period, smoking and heart failure for the 2018-2019 period. Among COVID-19 patients with asthma, smoking and obesity were risk factors for the severe form., Conclusions: In this study, patients with an asthma ICD-10 code were less represented among COVID-19 patients than among influenza-infected ones. However, outcomes were poorer for COVID-19 than influenza patients, both with asthma. These data highlight the importance of protective shields and vaccination against influenza and COVID-19 in this population., (© 2022. The Author(s).)

NEW DEVELOPMENTS IN THE DIAGNOSIS AND MANAGEMENT OF ADULT ASTHMA Asthma management must be comprehensive, focusing on control¬ling symptoms with inhaled corticosteroids adapted to the stage of severity, but also on limiting the occurrence of exacerbations by correcting poor control factors and educating the patient. The diagnosis of asthma is not only clinical, but it must also include a measurement of respiratory function. Research is active in the field of asthma, with the development of new strategies for prescribing inhaled corticosteroids, which are simpler for patients, but which prescribers must take on board in order to control them. Biotherapies have revolutionized the management of severe asthma. It is important to identify severe patients so that they can benefit from these treat¬ments. It can be considered that any patient who has had two exa¬cerbations in the year should be referred to pulmonology., Competing Interests: M. Le Brun déclare n’avoir aucun lien d’intérêts. - C. Taillé déclare des interventions ponctuelles pour les laboratoires AstraZeneca, GSK, Novartis, Sanofi, Chiesi, ALK.

Background: Lockdown measures during the first wave of the COVID-19 pandemic in France led to serious public health concerns over people who use illicit drugs, especially in terms of mental health. We assessed changes in cannabis use during the first lockdown in France among daily cannabis users and associated correlates., Methods: CANNAVID is a French, national, cross-sectional web-based survey, conducted from 17 April to 11 May 2020. Daily cannabis users aged ≥ 18 years and living in France were invited to participate through advertisements. Respondents completed an ad hoc questionnaire on a dedicated online platform. We analyzed changes in cannabis use during the first lockdown (i.e., stopped, decreased, unchanged, or increased) and performed a multinomial logistic regression analysis to evaluate correlates of these changes., Results: Of the 4019 participants, 74.0% were men. Median age was 27 years (interquartile range: 22-37). With regard to cannabis use, 293 (7.3%) persons stopped, 1153 (28.7%) decreased, 1146 (28.5%) did not change, and 1427 (35.5%) increased their use during the lockdown. A multinomial logistic regression model revealed several sociodemographic, behavioral and health-related factors associated with changes in cannabis use. Compared with participants with an unchanged level of cannabis use during the lockdown, those who increased and those who stopped cannabis use were more likely to have increased tobacco and alcohol use and to have experienced depression and sleep disorders intensification. Those who stopped cannabis use were also more likely to have increased benzodiazepine use and to have experienced pain increase during lockdown., Conclusions: France's first COVID-19-related lockdown had a differential impact on daily cannabis users' consumption patterns. Most study respondents reported changes to their cannabis consumption pattern. Those who reported a stable cannabis use were more likely to report fewer negative changes. Specific interventions are needed for this population, as well as research to assess the long-term impacts of these changes., (© 2022. The Author(s).)