Descriptor: "MESH: Antirheumatic Agents" - Searchworks@Jio Institute Digital Library Search Results

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97 results on '"MESH: Antirheumatic Agents"'

51. Drug-specific risk of non-tuberculosis opportunistic infections in patients receiving anti-TNF therapy reported to the 3-year prospective French RATIO registry

Author: D, Salmon-Ceron, F, Tubach, O, Lortholary, O, Chosidow, S, Bretagne, N, Nicolas, E, Cuillerier, B, Fautrel, C, Michelet, J, Morel, X, Puéchal, D, Wendling, M, Lemann, P, Ravaud, X, Mariette, Stéphane, Bretagne, Service de médecine interne et centre de référence des maladies rares [CHU Cochin], Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Modèles et méthodes de l'évaluation thérapeutique des maladies chroniques (U738 / UMR_S738), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Diderot - Paris 7 (UPD7), Centre d'infectiologie Necker-Pasteur [CHU Necker], Institut Pasteur [Paris]-CHU Necker - Enfants Malades [AP-HP], Service de Dermatologie, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor, Hôpital Henri Mondor, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Service de rhumatologie [CHU Pitié Salpêtrière] (GRC-08 EEMOIS), Université Pierre et Marie Curie - Paris 6 (UPMC)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Service des maladies infectieuses et réanimation médicale [Rennes] = Infectious Disease and Intensive Care [Rennes], CHU Pontchaillou [Rennes], Service de Rhumatologie [CH Le Mans], Centre Hospitalier Le Mans (CH Le Mans), Service de Rhumatologie, Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), Service de gastro-entérologie, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Régulation de la réponse immune, infection VIH-1 et autoimmunité, Université Paris-Sud - Paris 11 (UP11)-Institut National de la Santé et de la Recherche Médicale (INSERM), RATIO group, Assistance publique - Hôpitaux de Paris (AP-HP)-CHU Cochin [AP-HP], Modèles et méthodes de l'évaluation thérapeutique des maladies chroniques, Université Paris Diderot - Paris 7 ( UPD7 ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Assistance publique - Hôpitaux de Paris (AP-HP)-CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP)-Hôpital Henri-Mondor, Assistance publique - Hôpitaux de Paris (AP-HP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 ( UPEC UP12 ), Service de rhumatologie [CHU Pitié Salpêtrière] ( GRC-08 EEMOIS ), Université Pierre et Marie Curie - Paris 6 ( UPMC ) -Assistance publique - Hôpitaux de Paris (AP-HP), Service des maladies infectieuses et réanimation médicale, Université de Rennes 1 ( UR1 ), Université de Rennes ( UNIV-RENNES ) -Université de Rennes ( UNIV-RENNES ) -Hôpital Pontchaillou, Centre Hospitalier du Mans, Hôpital Jean Minjoz, Assistance publique - Hôpitaux de Paris (AP-HP)-Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Université Paris-Sud - Paris 11 ( UP11 ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Cochin [AP-HP], Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM), Université Pierre et Marie Curie - Paris 6 (UPMC)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Sorbonne Université (SU), Institut Pasteur [Paris] (IP)-CHU Necker - Enfants Malades [AP-HP], Épidémiologie et Évaluation des Maladies Ostéoarticulaires Inflammatoires et Systémiques (GRC-08 EEMOIS), Service des maladies infectieuses et réanimation médicale [Rennes], Université de Rennes 1 (UR1), and Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou
Subjects: Male, MESH: Antirheumatic Agents, Opportunistic infection, Anti-Inflammatory Agents, MESH : Aged, MESH: Epidemiologic Methods, Receptors, Tumor Necrosis Factor, Etanercept, MESH: Antibodies, Monoclonal, 0302 clinical medicine, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Pneumocystosis, Immunology and Allergy, MESH : Female, 030212 general & internal medicine, MESH : Tumor Necrosis Factor-alpha, MESH: Aged, MESH: Immunoglobulin G, MESH: Middle Aged, MESH: Immunologic Factors, Antibodies, Monoclonal, Middle Aged, MESH : Adult, MESH : Antirheumatic Agents, 3. Good health, [ SDV.MHEP.MI ] Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Antirheumatic Agents, Rheumatoid arthritis, MESH : Antibodies, Monoclonal, Female, France, medicine.drug, Adult, medicine.medical_specialty, MESH : Immunoglobulin G, MESH : Male, Immunology, Opportunistic Infections, MESH : Anti-Inflammatory Agents, Antibodies, Monoclonal, Humanized, MESH : Immunologic Factors, General Biochemistry, Genetics and Molecular Biology, MESH : Antibodies, Monoclonal, Humanized, MESH : Epidemiologic Methods, 03 medical and health sciences, Rheumatology, Psoriasis, Internal medicine, medicine, Adalimumab, Humans, Immunologic Factors, MESH : Middle Aged, Risk factor, MESH : France, Aged, 030203 arthritis & rheumatology, MESH: Humans, Tumor Necrosis Factor-alpha, business.industry, MESH : Humans, MESH : Opportunistic Infections, MESH: Adult, MESH: Opportunistic Infections, medicine.disease, MESH: Receptors, Tumor Necrosis Factor, Infliximab, MESH : Receptors, Tumor Necrosis Factor, MESH: Male, MESH: France, MESH: Antibodies, Monoclonal, Humanized, Immunoglobulin G, MESH: Tumor Necrosis Factor-alpha, MESH: Anti-Inflammatory Agents, Epidemiologic Methods, business, MESH: Female
Abstract: BackgroundAnti-tumour necrosis factor (TNF) therapy may be associated with opportunistic infections (OIs).ObjectiveTo describe the spectrum of non-tuberculosis OIs associated with anti-TNF therapy and identify their risk factors.MethodsA 3-year national French registry (RATIO) collected all cases of OI in patients receiving anti-TNF treatment for any indication in France. A case–control study was performed with three controls treated with anti-TNF agents per case, matched for gender and underlying inflammatory disease.Results45 cases were collected of non-TB OIs in 43 patients receiving infliximab (n=29), adalimumab (n=10) or etanercept (n=4) for rheumatoid arthritis (n=26), spondyloarthritides (n=3), inflammatory colitis (n=8), psoriasis (n=1) or other conditions (n=5). One-third (33%) of OIs were bacterial (4 listeriosis, 4 nocardiosis, 4 atypical mycobacteriosis, 3 non-typhoid salmonellosis), 40% were viral (8 severe herpes zoster, 3 varicella, 3 extensive herpes simplex, 4 disseminated cytomegalovirus infections), 22% were fungal (5 pneumocystosis, 3 invasive aspergillosis, 2 cryptococcosis) and 4% were parasitic (2 leishmaniasis). Ten patients (23%) required admission to the intensive care unit, and four patients (9%) died. Risk factors for OIs were treatment with infliximab (OR=17.6 (95% CI 4.3 - 72.9); p10 mg/day or intravenous boluses during the previous year (OR=6.3 (2.0 to 20.0); p=0.002).ConclusionVarious and severe OIs, especially those with intracellular micro-organisms, may develop in patients receiving anti-TNF treatment. Monoclonal anti-TNF antibody rather than soluble TNF receptor therapy and steroid use >10 mg/day are independently associated with OI.
Published: 2011
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52. Disease activity score-driven therapy versus routine care in patients with recent-onset active rheumatoid arthritis: data from the GUEPARD trial and ESPOIR cohort

Author: Soubrier, M., Lukas, C., Sibilia, J., Fautrel, B., Roux, F., Gossec, L., Patternotte, S., Dougados, M., Saraux, Alain, Département de Rhumatologie (CLERMONT - RHUMATO), CHU Clermont-Ferrand, Département de Rhumatologie[Montpellier], Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Hôpital Lapeyronie, Physiopathologie des arthrites, Université Louis Pasteur - Strasbourg I, Service de Rhumatologie [CHU Pitié-Salpêtrière], Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-CHU Pitié-Salpêtrière [APHP], Laboratoire Biostatistique-Santé (LBS), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Hospices Civils de Lyon (HCL)-Centre National de la Recherche Scientifique (CNRS), Université Paris Descartes - Faculté de Médecine (UPD5 Médecine), Université Paris Descartes - Paris 5 (UPD5), Service de rhumatologie [CHU Cochin], CHU Cochin [AP-HP]-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP), Immunologie et Pathologie (EA2216), Université de Brest (UBO)-IFR148, Centre d'Investigation Clinique (CIC - Brest), Université de Brest (UBO)-Institut National de la Santé et de la Recherche Médicale (INSERM), CHRU Brest - Service de Rhumatologie (CHU - BREST - Rhumato), Centre Hospitalier Régional Universitaire de Brest (CHRU Brest), Département de Rhumatologie ( CLERMONT - RHUMATO ), Centre Hospitalier Régional Universitaire [Montpellier] ( CHRU Montpellier ) -Hôpital Lapeyronie, Assistance publique - Hôpitaux de Paris (AP-HP)-CHU Pitié-Salpêtrière [APHP], Laboratoire Biostatistique-Santé ( LBS ), Université Claude Bernard Lyon 1 ( UCBL ), Université de Lyon-Université de Lyon-Hospices Civils de Lyon ( HCL ) -Centre National de la Recherche Scientifique ( CNRS ), Université Paris Descartes - Faculté de Médecine ( UPD5 Médecine ), Université Paris Descartes - Paris 5 ( UPD5 ), Assistance publique - Hôpitaux de Paris (AP-HP)-CHU Cochin [AP-HP], Immunologie et Pathologie ( EA2216 ), Université de Brest ( UBO ) -IFR148, Centre d'Investigation Clinique ( CIC - Brest ), Université de Brest ( UBO ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), CHRU Brest - Service de Rhumatologie ( CHU - BREST - Rhumato ), Centre Hospitalier Régional Universitaire de Brest ( CHRU Brest ), Service de Rhumatologie [CHU Clermont-Ferrand], CHU Gabriel Montpied [Clermont-Ferrand], CHU Clermont-Ferrand-CHU Clermont-Ferrand, Service de rhumatologie [CHU Pitié Salpêtrière] (GRC-08 EEMOIS), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Biostatistiques santé, Département biostatistiques et modélisation pour la santé et l'environnement [LBBE], Laboratoire de Biométrie et Biologie Evolutive - UMR 5558 (LBBE), Université de Lyon-Université de Lyon-Institut National de Recherche en Informatique et en Automatique (Inria)-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de Recherche en Informatique et en Automatique (Inria)-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS)-Laboratoire de Biométrie et Biologie Evolutive - UMR 5558 (LBBE), Université de Lyon-Université de Lyon-Institut National de Recherche en Informatique et en Automatique (Inria)-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS), Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Cochin [AP-HP], and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)
Subjects: Male, MESH: Remission Induction, MESH: Antirheumatic Agents, [SDV]Life Sciences [q-bio], Arthritis, Severity of Illness Index, MESH: Antibodies, Monoclonal, Arthritis, Rheumatoid, 0302 clinical medicine, MESH: Drug Monitoring, Immunology and Allergy, MESH : Female, 030212 general & internal medicine, MESH: Treatment Outcome, MESH : Tumor Necrosis Factor-alpha, MESH: Arthritis, Rheumatoid, MESH: Middle Aged, medicine.diagnostic_test, Remission Induction, Antibodies, Monoclonal, Middle Aged, MESH : Adult, MESH : Antirheumatic Agents, MESH : Drug Monitoring, 3. Good health, Treatment Outcome, MESH: Methotrexate, Rheumatoid arthritis, Erythrocyte sedimentation rate, Antirheumatic Agents, MESH : Antibodies, Monoclonal, Cohort, Disease Progression, Drug Therapy, Combination, Female, MESH : Severity of Illness Index, MESH: Disease Progression, Drug Monitoring, medicine.drug, Adult, musculoskeletal diseases, medicine.medical_specialty, MESH : Male, Immunology, MESH : Treatment Outcome, Antibodies, Monoclonal, Humanized, General Biochemistry, Genetics and Molecular Biology, MESH : Antibodies, Monoclonal, Humanized, 03 medical and health sciences, Rheumatology, Internal medicine, MESH: Severity of Illness Index, medicine, Adalimumab, Rheumatoid factor, Humans, MESH : Middle Aged, 030203 arthritis & rheumatology, MESH : Remission Induction, MESH: Humans, [ SDV ] Life Sciences [q-bio], business.industry, Tumor Necrosis Factor-alpha, MESH : Drug Therapy, Combination, MESH : Humans, MESH: Quality of Life, MESH: Adult, MESH : Quality of Life, MESH : Disease Progression, Clinical and Epidemiological Research, medicine.disease, MESH: Male, Radiography, MESH: Drug Therapy, Combination, Methotrexate, MESH: Antibodies, Monoclonal, Humanized, MESH : Methotrexate, MESH: Tumor Necrosis Factor-alpha, Propensity score matching, MESH : Arthritis, Rheumatoid, Physical therapy, Quality of Life, business, MESH: Female
Abstract: ObjectivesTo compare the efficacy of disease activity score in 28 joints (DAS28ESR)-driven therapy with anti-tumour necrosis factor (patients from the GUEPARD trial) and routine care in patients with recent-onset rheumatoid arthritis (patients of the ESPOIR cohort).ResultsAfter matching GUEPARD and ESPOIR patients on the basis of a propensity score and a 1:2 ratio, at baseline all patients had comparable demographic characteristics, rheumatoid factor, anticyclic citrullinated peptide antibody positivity and clinical disease activity parameters: erythrocyte sedimentation rate, C-reactive protein, mean DAS (6.26±0.87), Sharp/van der Heijde radiographic score (SHS), health assessment questionnaire (HAQ). Disease duration was longer in GUEPARD patients (5.6±4.6 vs 3.5±2.0 months, pConclusionsIn patients with recent onset active rheumatoid arthritis, a tight control of disease activity allows more patients to achieve remission without disability and radiographic progression.
Published: 2011
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53. Sarcoïdose pulmonaire apparue sous étanercept [Pulmonary sarcoidosis developing during treatment with etanercept]

Author: Kerjouan, Mallorie, Jouneau, Stéphane, Lena, Hervé, Luraine, R., Desrues, Benoit, Delaval, Philippe, Service de pneumologie [Rennes] = Pneumology [Rennes], and CHU Pontchaillou [Rennes]
Subjects: Pneumopathie médicamenteuse, MESH: Immunoglobulin G, Étanercept, MESH: Antirheumatic Agents, MESH: Humans, MESH: Middle Aged, MESH: Sarcoidosis, Pulmonary, Sarcoïdose, MESH: Receptors, Tumor Necrosis Factor, MESH: Spondylitis, Ankylosing, [SDV.MHEP.PSR]Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract, TNF⍺, MESH: Male, Granulomatose, MESH: Glucocorticoids, MESH: Treatment Outcome
Abstract: International audience; INTRODUCTION: TNF blockers are widely used to treat inflammatory rheumatic diseases and also in the treatment of extrapulmonary sarcoidosis. TNFα plays a major role in the development and persistence of sarcoid granulomata. However, recent studies have reported the involvement of anti-TNF therapies in the development of granulomatosis associated with the clinical and radiological features of sarcoidosis. CASE REPORT: A 54-years-old man with ankylosing spondylitis was treated with etanercept for two years. He was admitted with symptoms of bronchitis associated with radiological evidence of bilateral pulmonary nodules and a right upper lobe infiltrate. Anti-TNF therapy was stopped even though the patient had received 3 months of prophylactic treatment with rifampicin and isoniazid before starting etanercept. Bronchoalveolar lavage excluded infection, particularly tuberculosis. The chest CT-scan showed bilateral pulmonary nodules with peribronchovascular micronodules and enlarged mediastinal lymph nodes. Surgical lung biopsy was performed and revealed non-caseating granulomata. All the data were consistent with a diagnosis of pulmonary sarcoidosis. The patient remained symptomatic despite discontinuation of etanercept for ten months. Corticosteroids were then introduced, leading to a clinical, functional and radiological improvement. CONCLUSION: This case report underlines the importance of studying the pulmonary complications of TNF blockers. The first priority is to exclude tuberculosis but a diagnosis of sarcoid-like granulomatosis has to be considered. Twenty-three cases have been described in the literature to date.
Published: 2011
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54. Gene expression profiling in peripheral blood cells of patients with rheumatoid arthritis in response to anti-TNF-alpha treatments

Author: Hubert Vidal, Jacques Tebib, Fabienne Coury, Emmanuelle Meugnier, Jean Sibilia, Sophie Rome, Nicole Fabien, Jacques Bienvenu, Carole Ferraro-Peyret, Centre de Recherche en Cancérologie de Lyon (CRCL), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Centre Léon Bérard [Lyon]-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Institut de biologie et chimie des protéines [Lyon] (IBCP), Université de Lyon-Université de Lyon-Centre National de la Recherche Scientifique (CNRS), Régulations métaboliques, nutrition et diabètes - UM55 (RMND UM55), Université de Lyon-Université de Lyon-Institut National des Sciences Appliquées de Lyon (INSA Lyon), Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Hospices Civils de Lyon (HCL)-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de la Recherche Agronomique (INRA), Physiopathologie des arthrites, Université Louis Pasteur - Strasbourg I, Cardiovasculaire, métabolisme, diabétologie et nutrition (CarMeN), Institut National de la Recherche Agronomique (INRA)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Hospices Civils de Lyon (HCL), Hospices Civils de Lyon (HCL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National des Sciences Appliquées de Lyon (INSA Lyon), Université de Lyon-Institut National des Sciences Appliquées (INSA)-Université de Lyon-Institut National des Sciences Appliquées (INSA)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Institut National de la Recherche Agronomique (INRA), Centre de Recherche en Cancérologie de Lyon (UNICANCER/CRCL), Centre Léon Bérard [Lyon]-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM), Hospices Civils de Lyon, Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Hospices Civils de Lyon (HCL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Institut National des Sciences Appliquées (INSA)-Université de Lyon-Institut National des Sciences Appliquées (INSA)-Université de Lyon-Université Claude Bernard Lyon 1 (UCBL), Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Claude Bernard Lyon 1 (UCBL), and Université de Lyon-Université de Lyon-Centre Léon Bérard [Lyon]
Subjects: Male, MESH: Antirheumatic Agents, Physiology, [SDV]Life Sciences [q-bio], Arthritis, LYMPHOCYTES, Polymerase Chain Reaction, DISEASE, Receptors, Tumor Necrosis Factor, Etanercept, MESH: Antibodies, Monoclonal, Pathogenesis, ACTIVATION, Arthritis, Rheumatoid, 0302 clinical medicine, JUVENILE IDIOPATHIC ARTHRITIS, ComputingMilieux_MISCELLANEOUS, TUMOR-NECROSIS-FACTOR, Oligonucleotide Array Sequence Analysis, MESH: Immunoglobulin G, 0303 health sciences, MESH: Arthritis, Rheumatoid, MESH: Middle Aged, Antibodies, Monoclonal, Middle Aged, 3. Good health, Rheumatoid arthritis, Antirheumatic Agents, Female, Antibody, medicine.symptom, medicine.drug, Adult, [SDV.CAN]Life Sciences [q-bio]/Cancer, KAPPA-B, Biology, Antibodies, Monoclonal, Humanized, 03 medical and health sciences, MESH: Gene Expression Profiling, Genetics, medicine, Adalimumab, Humans, 030304 developmental biology, 030203 arthritis & rheumatology, MONONUCLEAR-CELLS, MESH: Humans, THERAPEUTIC TARGET, Tumor Necrosis Factor-alpha, P-SELECTIN, SYNOVIAL-FLUIDS, Gene Expression Profiling, MESH: Adult, MESH: Polymerase Chain Reaction, medicine.disease, MESH: Receptors, Tumor Necrosis Factor, MESH: Male, Gene expression profiling, anti-TNF-alpha therapies, Mechanism of action, MESH: Antibodies, Monoclonal, Humanized, MESH: Tumor Necrosis Factor-alpha, Immunoglobulin G, Immunology, MESH: Oligonucleotide Array Sequence Analysis, biology.protein, MESH: Female
Abstract: International audience; The efficacy of anti-TNF-α therapies highlights the role of TNF-α in the pathogenesis of rheumatoid arthritis (RA). However, the mechanism of action of these agents is poorly understood at the molecular level. The aim of this study was to characterize the effects of anti-TNF-α treatment on the global gene expression profile in peripheral blood mononuclear cells (PBMCs) of responder RA patients. Changes in gene expression were determined using oligonucleotide microarrays (25,341 genes) in PBMCs obtained before and after 12 wk of treatment with either etanercept or adalimumab from responder RA patients. Two hundred fifty-one genes displayed significant changes (false discovery rate < 0.1%) in expression level (178 upregulations with mean fold change = 1.5 and 73 downregulations with mean fold change = -1.50) after 12 wk of treatment. Importantly, the expression of several genes, including those coding for the calcium binding proteins S100A12 and A8, CD14 antigen, Selectin P, or ribosomal protein L39, reported to be upregulated in RA patients, were found to be decreased after anti-TNF-α treatment. Globally, inflammation, immune response, apoptosis, protein synthesis, and mitochondrial oxido-reduction were the most affected pathways in response to anti-TNF-α treatment. The obtained gene expression signature in PBMCs provides new information to better understand the mechanisms of action of anti-TNF-α treatment in RA patients.
Published: 2011
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55. Infliximab in ankylosing spondylitis: alone or in combination with methotrexate? A pharmacokinetic comparative study

Author: Emilie Ducourau, David Ternant, Philippe Goupille, Gilles Paintaud, Daniel Wendling, F. Lauféron, D. Mulleman, Génétique, immunothérapie, chimie et cancer (GICC), UMR 6239 CNRS [2008-2011] (GICC UMR 6239 CNRS), Université de Tours (UT)-Centre National de la Recherche Scientifique (CNRS), Service de Rhumatologie, Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), The University Hospital of Tours, France, received funding from the French Ministry of Health and Sport for this clinical trial within the framework of the 'Programme Hospitalier de Recherche Clinique 2004'., and Université de Tours-Centre National de la Recherche Scientifique (CNRS)
Subjects: Male, MESH: Antirheumatic Agents, Gastroenterology, MESH: Antibodies, Monoclonal, 0302 clinical medicine, immune system diseases, Immunology and Allergy, Prospective Studies, skin and connective tissue diseases, BASDAI, MESH: Treatment Outcome, MESH: Middle Aged, Antibodies, Monoclonal, Middle Aged, MESH: Spondylitis, Ankylosing, 3. Good health, Treatment Outcome, MESH: Methotrexate, [SDV.MHEP.RSOA]Life Sciences [q-bio]/Human health and pathology/Rhumatology and musculoskeletal system, Rheumatoid arthritis, Antirheumatic Agents, Area Under Curve, Drug Therapy, Combination, Female, medicine.drug, Research Article, Adult, musculoskeletal diseases, medicine.medical_specialty, Immunology, Antibodies, 03 medical and health sciences, Pharmacokinetics, Rheumatology, Internal medicine, medicine, Humans, Spondylitis, Ankylosing, Spondylitis, 030203 arthritis & rheumatology, Ankylosing spondylitis, MESH: Humans, business.industry, MESH: Antibodies, MESH: Adult, medicine.disease, Infliximab, MESH: Male, MESH: Prospective Studies, Surgery, stomatognathic diseases, MESH: Drug Therapy, Combination, Methotrexate, MESH: Area Under Curve, business, MESH: Female, 030217 neurology & neurosurgery
Abstract: International audience; INTRODUCTION: Methotrexate (MTX) has been shown to modify infliximab pharmacokinetics in rheumatoid arthritis. However, its combination with infliximab in the treatment of ankylosing spondylitis (AS) is not recommended. The objective of this study was to examine the influence of MTX on infliximab exposure in patients with AS. METHODS: Patients with AS patients who had predominantly axial symptoms were randomised to receive infliximab alone (infusions of 5 mg/kg at weeks 0, 2, 6, 12 and 18) or infliximab combined with MTX (10 mg/week). Infliximab concentrations were measured before and 2 hours after each infusion and at 1, 3, 4, 5, 8, 10, 14 and 18 weeks. We estimated individual cumulative area under the concentration versus time curves (AUC) for infliximab concentration between baseline and week 18 (AUC(0-18)). Clinical and laboratory evaluations were performed at each visit. The Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) score was the primary end point for clinical response. RESULTS: Twenty-six patients were included (infliximab group: n = 12, infliximab + MTX group: n = 14), and 507 serum samples were available for measurement of infliximab concentration. The two groups did not differ with regard to AUC(0-18) or evolution of BASDAI scores and biomarkers of inflammation. CONCLUSIONS: The combination of MTX and infliximab does not increase the exposure to infliximab over infliximab alone in patients with AS. TRIAL REGISTRATION: ClinicalTrials.gov: NCT00507403.
Published: 2011
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56. Long-term efficacy of infliximab in autoimmune sensorineural hearing loss associated with rheumatoid arthritis

Author: Pierre Gazeau, Alain Saraux, Divi Cornec, Valérie Devauchelle-Pensec, CHRU Brest - Service de Rhumatologie (CHU - BREST - Rhumato), Centre Hospitalier Régional Universitaire de Brest (CHRU Brest), Immunologie et Pathologie (EA2216), Université de Brest (UBO)-IFR148, and Michel, Geneviève
Subjects: MESH: Antirheumatic Agents, Pediatrics, medicine.medical_specialty, [SDV.IMM] Life Sciences [q-bio]/Immunology, MESH: Antibodies, Monoclonal, 03 medical and health sciences, MESH: Audiometry, 0302 clinical medicine, Rheumatology, immune system diseases, MESH: Autoimmune Diseases, medicine, Pharmacology (medical), Autoimmune sensorineural hearing loss, skin and connective tissue diseases, 030223 otorhinolaryngology, 030203 arthritis & rheumatology, MESH: Arthritis, Rheumatoid, MESH: Humans, MESH: Middle Aged, business.industry, medicine.disease, Infliximab, 3. Good health, MESH: Hearing Loss, Sensorineural, Rheumatoid arthritis, [SDV.IMM]Life Sciences [q-bio]/Immunology, business, MESH: Female, medicine.drug
Abstract: International audience; Systemic lupus erythematosus (SLE) disease is an autoimmune disease of unknown aetiology that affects predominantly women of child bearing age. Since previous studies, including ours, have demonstrated that CD4+ T cells and B cells from SLE patients are defective in their ability to methylate their DNA upon antigen stimulation, the aim of this study was to investigate whether DNA demethylation affects the transcription of HRES-1 in B cells. HRES-1 is the prototype of Human Endogenous Retrovirus (HERV) overexpressed in SLE. We have observed that SLE B cells were characterized by their incapacity to methylate the HRES-1 promoter, both in unstimulated and in anti-IgM stimulated B cells. In turn, HRES-1/p28 expression was increased in SLE B cells after B cell receptor engagement, but not in controls. In SLE B cells the Erk/DNMT1 pathway was defective. In addition, blocking the autocrine-loop of IL-6 in SLE B cells with an anti-IL-6 receptor monoclonal antibody restores DNA methylation and control of HRES-1/p28 expression became effective. As a consequence, a better understanding of HERV dysregulation in SLE reinforces our comprehension of the disease and opens new therapeutic perspectives.
Published: 2014
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57. The Schnitzler syndrome

Author: Dan Lipsker, BMC, Ed., Biologie des Cellules Dendritiques Humaines, EFS-Cancéropôle du Grand Est-Université Louis Pasteur - Strasbourg I-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de dermatologie [Strasbourg], CHU Strasbourg, and D. Lipsker has received a grant from the Société Française de Dermatologie to study the inflammatory pathways involved in the Schnitzler syndrome.
Subjects: MESH: Antirheumatic Agents, MESH: Exanthema, lcsh:Medicine, Spontaneous remission, [SDV.GEN] Life Sciences [q-bio]/Genetics, Review, MESH: Lymphoproliferative Disorders, AA amyloidosis, Genetics(clinical), Pharmacology (medical), Schnitzler Syndrome, Genetics (clinical), Skin, Medicine(all), MESH: Middle Aged, MESH: Genetic Predisposition to Disease, MESH: Schnitzler Syndrome, General Medicine, Middle Aged, Rash, MESH: Interleukin 1 Receptor Antagonist Protein, Schnitzler syndrome, Antirheumatic Agents, Female, medicine.symptom, medicine.drug, Adult, medicine.medical_specialty, Adolescent, MESH: Carrier Proteins, MESH: Skin, NLR Family, Pyrin Domain-Containing 3 Protein, medicine, Humans, Genetic Predisposition to Disease, Urticarial vasculitis, Bone pain, POEMS syndrome, MESH: Adolescent, [SDV.GEN]Life Sciences [q-bio]/Genetics, Anakinra, MESH: Humans, business.industry, lcsh:R, MESH: Adult, Exanthema, medicine.disease, Dermatology, Lymphoproliferative Disorders, Interleukin 1 Receptor Antagonist Protein, Immunology, business, Carrier Proteins, MESH: Female
Abstract: The Schnitzler syndrome is a rare and underdiagnosed entity which is considered today as being a paradigm of an acquired/late onset auto-inflammatory disease. It associates a chronic urticarial skin rash, corresponding from the clinico-pathological viewpoint to a neutrophilic urticarial dermatosis, a monoclonal IgM component and at least 2 of the following signs: fever, joint and/or bone pain, enlarged lymph nodes, spleen and/or liver, increased ESR, increased neutrophil count, abnormal bone imaging findings. It is a chronic disease with only one known case of spontaneous remission. Except of the severe alteration of quality of life related mainly to the rash, fever and pain, complications include severe inflammatory anemia and AA amyloidosis. About 20% of patients will develop a lymphoproliferative disorder, mainly Waldenström disease and lymphoma, a percentage close to other patients with IgM MGUS. It was exceedingly difficult to treat patients with this syndrome until the IL-1 receptor antagonist anakinra became available. Anakinra allows a complete control of all signs within hours after the first injection, but patients need continuous treatment with daily injections. In many aspects, the Schnitzler syndrome resembles the genetically determined auto-inflammatory syndromes involving activating mutations of the NLRP3 inflammasome. This latter point and its consequences will be addressed.
Published: 2010
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58. Gene expression profile in the salivary glands of primary Sjögren's syndrome patients before and after treatment with rituximab

Author: Jacques-Olivier Pers, Gilles Chiocchia, Pierre Youinou, Alain Saraux, Nicolas Cagnard, Valérie Devauchelle-Pensec, Immunologie et Pathologie (EA2216), Université de Brest (UBO)-IFR148, plateforme de bioinformatique, Université Paris Descartes - Paris 5 (UPD5), Laboratoire d'Immunologie et Immunothérapie, Centre Hospitalier Régional Universitaire de Brest (CHRU Brest), Physiopathologie et Pharmacologie Clinique de la Douleur (LPPD), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Institut National de la Santé et de la Recherche Médicale (INSERM), Laboratoire d'Immunothérapies et Pathologies lymphocytaires B (EA2216), Université de Bretagne Occidentale (UBO) - Institut National de la Santé et de la Recherche Médicale (INSERM), CHRU Brest, Physiopathologie et pharmacologie clinique de la douleur, Université de Versailles Saint-Quentin-en-Yvelines (UVSQ) - Institut National de la Santé et de la Recherche Médicale (INSERM), and Michel, Geneviève
Subjects: MESH: Signal Transduction, Male, MESH: Antirheumatic Agents, Salivary Glands, MESH: Antibodies, Monoclonal, Antibodies, Monoclonal, Murine-Derived, 0302 clinical medicine, Immunopathology, MESH: Reverse Transcriptase Polymerase Chain Reaction, Gene expression, Immunology and Allergy, Cluster Analysis, Pharmacology (medical), MESH: Treatment Outcome, Oligonucleotide Array Sequence Analysis, 0303 health sciences, B-Lymphocytes, Reverse Transcriptase Polymerase Chain Reaction, Antibodies, Monoclonal, 3. Good health, medicine.anatomical_structure, Sjogren's Syndrome, Treatment Outcome, Antirheumatic Agents, Monoclonal, [SDV.IMM]Life Sciences [q-bio]/Immunology, Rituximab, Female, medicine.drug, Signal Transduction, MESH: Salivary Glands, [SDV.IMM] Life Sciences [q-bio]/Immunology, Immunology, 03 medical and health sciences, MESH: Gene Expression Profiling, Rheumatology, MESH: B-Lymphocytes, medicine, Humans, RNA, Messenger, Gene, B cell, 030304 developmental biology, MESH: RNA, Messenger, 030203 arthritis & rheumatology, MESH: Humans, business.industry, Microarray analysis techniques, Gene Expression Profiling, MESH: Cluster Analysis, MESH: Male, Gene expression profiling, MESH: Sjogren's Syndrome, MESH: Antibodies, Monoclonal, Murine-Derived, MESH: Oligonucleotide Array Sequence Analysis, business, MESH: Female
Abstract: Objective Primary Sjogren's syndrome (SS) is a complex disorder, in part due to B cell abnormalities. Although anti–B cell therapy is promising in primary SS, no treatment has yet been demonstrated to modify the disease course. This open-label study was undertaken to evaluate the efficacy of rituximab in primary SS and to investigate whether expression of specific genes is associated with efficacy of this treatment. Methods Fifteen patients with primary SS were treated in an open-label trial. Salivary gland biopsy specimens were obtained, and total RNA was extracted and amplified. Microarray analysis with the Affymetrix Human Genome U133 Plus 2.0 Array was used to analyze >54,000 transcripts, and potential pathways were identified. Results With gene expression data obtained before treatment, patients could be correctly classified in terms of whether they would be responders or nonresponders to rituximab. Gene pathway analysis demonstrated that the B cell signaling pathway was the most profoundly differentially expressed before treatment in the responders compared with nonresponders. Subclassification of patients based on the level of infiltration also demonstrated differential expression of genes belonging to the interferon (IFN) pathway between responders and nonresponders. Furthermore, unsupervised analysis based on gene expression modification before and after treatment allowed identification of 8 genes that were differentially expressed between responders and nonresponders, with the difference remaining significant after Bonferroni correction. Conclusion Our results demonstrate the ability to elaborate a set of genes predictive of rituximab efficacy and highlight the importance of studying the differential expression of B cell and IFN pathway signaling molecules in relation to the response to anti-CD20 treatment. A randomized controlled study is currently ongoing to confirm these results.
Published: 2010

59. Articular manifestations in primary Sjögren's syndrome: clinical significance and prognosis of 188 patients

Author: Daniel Petit, Marie-Odile Jauberteau, Véronique Loustaud-Ratti, Eric Hachulla, Marc Lambert, Anne-Laure Fauchais, Kim Heang Ly, Holly Bezanahari, Bali Ouattara, Guillaume Gondran, Pierre-Yves Hatron, Elisabeth Vidal, Fabrice Lalloué, Eric Liozon, David Launay, Homéostasie Cellulaire et Pathologies (HCP), Université de Limoges (UNILIM)-CHU Limoges-Génomique, Environnement, Immunité, Santé, Thérapeutique (GEIST FR CNRS 3503), Service de Médecine interne A et polyclinique médicale [CHU Limoges], CHU Limoges, Université de Limoges (UNILIM), Service de médecine interne, Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Biologie moléculaire et cellulaire des microorganismes (EA3175), and Université de Limoges (UNILIM)-Génomique, Environnement, Immunité, Santé, Thérapeutique (GEIST FR CNRS 3503)-Institut National de la Santé et de la Recherche Médicale (INSERM)
Subjects: Male, Pathology, MESH: Antirheumatic Agents, MESH: Hydroxychloroquine, Systemic scleroderma, Gastroenterology, Etanercept, Cohort Studies, 0302 clinical medicine, Pharmacology (medical), 030212 general & internal medicine, MESH: Cohort Studies, MESH: Aged, [SDV.MHEP.ME]Life Sciences [q-bio]/Human health and pathology/Emerging diseases, MESH: Middle Aged, [SDV.MHEP.EM]Life Sciences [q-bio]/Human health and pathology/Endocrinology and metabolism, Middle Aged, Prognosis, Cryoglobulinemia, 3. Good health, MESH: Joints, Sjogren's Syndrome, MESH: Joint Diseases, Antirheumatic Agents, Cohort, Corticosteroid, Female, France, Joint Diseases, medicine.drug, Hydroxychloroquine, musculoskeletal diseases, Adult, medicine.medical_specialty, medicine.drug_class, MESH: Multivariate Analysis, MESH: Prognosis, 03 medical and health sciences, Rheumatology, Internal medicine, Synovitis, medicine, Humans, Clinical significance, Aged, 030203 arthritis & rheumatology, MESH: Humans, business.industry, MESH: Adult, medicine.disease, eye diseases, MESH: Male, MESH: France, stomatognathic diseases, Peripheral neuropathy, MESH: Sjogren's Syndrome, Multivariate Analysis, Joints, business, MESH: Female
Abstract: International audience; OBJECTIVES: Articular manifestations (AMs) occurred in approximately 30-60% of patients with primary SS (pSS). We conducted the current study to describe clinical presentation, specific treatment and to report clinical outcome of pSS patients with AM in a large bicentric French cohort. METHODS: Clinical, biological and immunological features of 419 consecutive patients with pSS were recorded in order to describe the clinical and immunological course of pSS AM and to point out the impact of those rheumatological features on pSS evolution. RESULTS: A total of 188 patients with pSS (172 women, 16 men) exhibited AM. They preceded sicca symptoms in 32, were simultaneous to pSS diagnosis in 98 and followed diagnosis in 59 patients. Clinical presentation was polyarticular and concerned mostly peripheral joints (synovitis, n = 66). Symptoms responded readily to symptomatic treatment in 45 cases (24%). DMARDs or immunosuppressive treatments were introduced in 133 patients: HCQ (n = 111), corticosteroid (n = 53), MTX (n = 12), SSZ (n = 6), AZA (n = 3), LEF (n = 1), etanercept (n = 1) and allochrysine (n = 1). Only one case of RA was diagnosed during the evolution. Statistical analysis identified clinical and biological factors associated with AM (P < or = 0.05): RP, muscular manifestations, renal involvement, peripheral neuropathy, cutaneous vasculitis, and positivity of RF, anti-SSB antibodies and cryoglobulinaemia. Patients with AM at diagnosis were characterized by a multisystemic involvement at the end of the follow-up period (P < 0.001). CONCLUSION: Although AMs are frequent and usually mild in pSS, these manifestations are associated with a pluri-systemic involvement of pSS.
Published: 2010
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60. Effects of rituximab therapy on quality of life in patients with primary Sjögren's syndrome

Author: Devauchelle-Pensec V, Morvan J, Ac, Rat, Jousse-Joulin S, Pennec Y, Jo, Pers, Jamin C, Yves Renaudineau, Quintin-Roué I, Cochener B, Youinou P, Saraux A, CHRU Brest - Service de Rhumatologie (CHU - BREST - Rhumato), Centre Hospitalier Régional Universitaire de Brest (CHRU Brest), Maladies chroniques, santé perçue, et processus d'adaptation (APEMAC), Université Paris Descartes - Paris 5 (UPD5)-Université de Lorraine (UL), Centre d'Investigation Clinique - Epidemiologie Clinique/essais Cliniques Nancy, Cancéropôle du Grand Est-Institut National de la Santé et de la Recherche Médicale (INSERM), Service d'Epidémiologie et Evaluations Cliniques [CHRU Nancy] (Pôle S2R), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Service de Rhumatologie [CHRU Nancy], Institut d’Électronique, de Microélectronique et de Nanotechnologie - UMR 8520 (IEMN), Centrale Lille-Institut supérieur de l'électronique et du numérique (ISEN)-Université de Valenciennes et du Hainaut-Cambrésis (UVHC)-Université de Lille-Centre National de la Recherche Scientifique (CNRS)-Université Polytechnique Hauts-de-France (UPHF), Hôpital Morvan [Brest], CHRU Brest - Laboratoire d'Anatomo-Pathologie (CHU - AnaPath), Université de Brest (UBO), Service d'ophtalmologie [Brest], Université de Brest (UBO)-Centre Hospitalier Régional Universitaire de Brest (CHRU Brest), Immunologie et Pathologie (EA2216), Université de Brest (UBO)-IFR148, Centre d'Investigation Clinique (CIC - Brest), Université de Brest (UBO)-Institut National de la Santé et de la Recherche Médicale (INSERM), Université de Lorraine (UL), Lymphocyte B et Auto-immunité (LBAI), Université de Brest (UBO)-Institut Brestois Santé Agro Matière (IBSAM), Laboratoire de dynamique et structures des matériaux moléculaires (LDSMM), Université de Lille, Sciences et Technologies-Université du Littoral Côte d'Opale-Centre National de la Recherche Scientifique (CNRS), Laboratoire d'Immunologie et Immunothérapie, Laboratoire de Traitement de l'Information Medicale (LaTIM), Institut National de la Santé et de la Recherche Médicale (INSERM)-IMT Atlantique Bretagne-Pays de la Loire (IMT Atlantique), Institut Mines-Télécom [Paris] (IMT)-Institut Mines-Télécom [Paris] (IMT)-Centre Hospitalier Régional Universitaire de Brest (CHRU Brest)-Université de Brest (UBO)-Institut Brestois Santé Agro Matière (IBSAM), Institut d’Électronique, de Microélectronique et de Nanotechnologie (IEMN) - UMR 8520 (IEMN), Centre National de la Recherche Scientifique (CNRS)-Université de Lille-Université Polytechnique Hauts-de-France (UPHF)-Ecole Centrale de Lille-Université Polytechnique Hauts-de-France (UPHF)-Institut supérieur de l'électronique et du numérique (ISEN), Unite mixte de recherche en droit comparé (UMRDC), Université Panthéon-Sorbonne (UP1)-Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier Universitaire, CHRU Brest - Service de Rhumatologie ( CHU - BREST - Rhumato ), Centre Hospitalier Régional Universitaire de Brest ( CHRU Brest ), Maladies chroniques, santé perçue, et processus d'adaptation ( APEMAC ), Université Paris Descartes - Paris 5 ( UPD5 ) -Université de Lorraine ( UL ), Cancéropôle du Grand Est-Institut National de la Santé et de la Recherche Médicale ( INSERM ), Service d'Epidémiologie et Evaluations Cliniques [CHRU Nancy] ( Pôle S2R ), Centre Hospitalier Régional Universitaire de Nancy ( CHRU Nancy ), Institut d’Électronique, de Microélectronique et de Nanotechnologie (IEMN) - UMR 8520 ( IEMN ), Ecole Centrale de Lille-Institut supérieur de l'électronique et du nunérique (ISEN)-Université de Valenciennes et du Hainaut-Cambresis ( UVHC ) -Université de Lille-Centre National de la Recherche Scientifique ( CNRS ), Unite mixte de recherche en droit comparé ( UMRDC ), Université Panthéon-Sorbonne ( UP1 ) -Centre National de la Recherche Scientifique ( CNRS ), CHRU Brest - Laboratoire d'Anatomo-Pathologie ( CHU - AnaPath ), Université de Brest ( UBO ), Université de Brest ( UBO ) -Centre Hospitalier Régional Universitaire de Brest ( CHRU Brest ), Immunologie et Pathologie ( EA2216 ), Université de Brest ( UBO ) -IFR148, Centre d'Investigation Clinique ( CIC - Brest ), and Université de Brest ( UBO ) -Institut National de la Santé et de la Recherche Médicale ( INSERM )
Subjects: Male, MESH: Antirheumatic Agents, Health Status, Severity of Illness Index, Antibodies, Monoclonal, Murine-Derived, hemic and lymphatic diseases, Surveys and Questionnaires, MESH : Female, MESH: Health Status, MESH: Treatment Outcome, MESH: Middle Aged, MESH : Questionnaires, MESH : Adult, Middle Aged, MESH : Antirheumatic Agents, humanities, Sjogren's Syndrome, Treatment Outcome, [SDV.MHEP.RSOA]Life Sciences [q-bio]/Human health and pathology/Rhumatology and musculoskeletal system, MESH: Young Adult, Antirheumatic Agents, MESH : Severity of Illness Index, Female, MESH: Rituximab, MESH: Pain, Rituximab, MESH : Pain, Adult, Adolescent, MESH : Male, MESH : Young Adult, Pain, MESH : Treatment Outcome, Young Adult, MESH : Adolescent, [ SDV.MHEP ] Life Sciences [q-bio]/Human health and pathology, MESH: Severity of Illness Index, Humans, MESH : Middle Aged, MESH : Health Status, MESH: Surveys and Questionnaires, MESH: Adolescent, MESH: Humans, MESH: Questionnaires, MESH : Humans, MESH: Quality of Life, MESH: Adult, MESH : Quality of Life, MESH: Male, MESH : Antibodies, Monoclonal, Murine-Derived, stomatognathic diseases, MESH: Sjogren's Syndrome, MESH: Antibodies, Monoclonal, Murine-Derived, Quality of Life, MESH : Sjogren's Syndrome, MESH: Female, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract: International audience; OBJECTIVES: To assess the efficacy of the anti-CD20 antibody rituximab in improving physical function and health-related quality of life (HRQoL) in patients with active primary Sjögren's syndrome (pSS), as well as the duration and sources of HRQoL improvements. METHODS: Sixteen patients with pSS received rituximab infusions (375 mg/m2) at weeks 0 and 1 and were followed up for 36 weeks. All patients fulfilled 2002 American-European Consensus Group criteria for pSS and had active disease defined as scores >50 mm on two of four 100-mm visual analogue scales (VAS) evaluating global disease activity, fatigue, pain, and dryness. Standardised evaluations including the Short Form 36 Health Survey (SF-36) were conducted. SF-36 score changes from baseline to weeks 12, 24, and 36 were assessed. RESULTS: Baseline mean SF-36 scores were considerably decreased, compared to the general same-age population. Role-physical (14.1 ± 27.4), role-emotional (12.5 ± 29.9), vitality (26.2 ± 14.3), and general health (32.6 ± 11.2) were the dimensions with the worst scores. Twelve weeks after rituximab, the mental component summary score was improved in 15 patients (mean improvement, 31.2 ± 36.4, p=0.001) and the physical component summary score in 14 patients (mean improvement, 16.9 ± 26.2, p=0.049). Further improvements occurred from week 12 to week 24, and most of the gains were sustained at week 36. Improvements in the physical and mental component summary scores failed to correlate with improvements in the VAS scores. CONCLUSIONS: Substantial alterations in HRQoL were noted in patients with pSS. Rituximab infusions without corticosteroid therapy produced meaningful improvements in HRQoL. Controlled studies of rituximab are needed.
Published: 2010

61. Rituximab in the spondyloarthropathies: data of eight patients followed up in the French Autoimmunity and Rituximab (AIR) registry

Author: G, Nocturne, M, Dougados, A, Constantin, C, Richez, J, Sellam, A, Simon, D, Wendling, X, Mariette, J-E, Gottenberg, Service de rhumatologie [CHU Cochin], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Institut de Chimie des Substances Naturelles (ICSN), Centre National de la Recherche Scientifique (CNRS)-Institut de Chimie du CNRS (INC), Service de Rhumatologie, Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), Agents pathogènes et inflammation - UFC (EA 4266) (API), Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), CHU Cochin [AP-HP] - Assistance publique - Hôpitaux de Paris (AP-HP), Centre National de la Recherche Scientifique (CNRS), and Centre Hospitalier Régional Universitaire [Besançon] (CHRU Besançon) - Hôpital Jean Minjoz
Subjects: MESH: Antirheumatic Agents, MESH : Treatment Outcome, MESH: Antibodies, Monoclonal, Antibodies, Monoclonal, Murine-Derived, Humans, MESH: Off-Label Use, MESH : Middle Aged, MESH : Immunosuppressive Agents, MESH : Off-Label Use, ComputingMilieux_MISCELLANEOUS, MESH: Treatment Outcome, [SDV.MHEP.RSOA] Life Sciences [q-bio]/Human health and pathology/Rhumatology and musculoskeletal system, [SDV.MHEP] Life Sciences [q-bio]/Human health and pathology, MESH: Humans, MESH: Middle Aged, MESH : Humans, Antibodies, Monoclonal, MESH : Follow-Up Studies, Off-Label Use, MESH: Follow-Up Studies, Middle Aged, MESH : Antirheumatic Agents, Treatment Outcome, MESH : Spondylarthropathies, [SDV.MHEP.RSOA]Life Sciences [q-bio]/Human health and pathology/Rhumatology and musculoskeletal system, Antirheumatic Agents, MESH : Antibodies, Monoclonal, Spondylarthropathies, MESH: Immunosuppressive Agents, Rituximab, Immunosuppressive Agents, MESH: Spondylarthropathies, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology, Follow-Up Studies
Abstract: International audience
Published: 2010
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62. Lymphoma in patients treated with anti-TNF: results of the 3-year prospective French RATIO registry.: Lymphoma complicating anti-TNF therapy

Author: Mariette , Xavier, Tubach , Florence, Bagheri , Haleh, Bardet , Michel, Berthelot , Jean-Marie, Gaudin , Philippe, Heresbach , Denis, Martin , Antoine, Schaeverbeke , Thierry, Salmon , Dominique, Lemann , Marc, Hermine , Olivier, Raphael , Martine, Ravaud , Philippe, Service de rhumatologie, Université Paris-Sud - Paris 11 (UP11)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Bicêtre, Modèles et méthodes de l'évaluation thérapeutique des maladies chroniques (U738 / UMR_S738), Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM), Unité de Pharmacoépidémiologie : Evaluation de l'exposition et du risque médicamenteux, Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-CHU Toulouse [Toulouse], Service de médecine interne et rhumatologie, Centre Hospitalier Régional d'Orléans (CHRO)-Hôpital de la source, Service de Rhumatologie, Hôtel-Dieu, Université Joseph Fourier - Grenoble 1 (UJF)-CHU Grenoble-Hôpital Michallon, Service d'hépato-gastro-entérologie [Rennes] = Gastroenterology [Rennes], CHU Pontchaillou [Rennes], Hôpital de St Brieuc, CHU Bordeaux [Bordeaux], Service de médecine interne et centre de référence des maladies rares [CHU Cochin], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Service de gastro-entérologie, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Service d'immuno-hématologie pédiatrique [CHU Necker], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Necker - Enfants Malades [AP-HP], Laboratoire d'Hématologie, Centre Hospitalier Régional d'Orléans (CHR)-Hôpital de la source, Service d'hépato-gastro-entérologie [Rennes], Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-CHU Pontchaillou [Rennes], Université Paris-Sud - Paris 11 ( UP11 ) -Assistance publique - Hôpitaux de Paris (AP-HP)-Hôpital Bicêtre, Modèles et méthodes de l'évaluation thérapeutique des maladies chroniques, Université Paris Diderot - Paris 7 ( UPD7 ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Université Toulouse III - Paul Sabatier ( UPS ), Centre Hospitalier Régional d'Orléans ( CHR ) -Hôpital de la source, Université Joseph Fourier - Grenoble 1 ( UJF ) -CHU Grenoble-Hôpital Michallon, Service de Gastroentérologie, Hôpital Pontchaillou, Assistance publique - Hôpitaux de Paris (AP-HP)-CHU Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP)-Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], and Assistance publique - Hôpitaux de Paris (AP-HP)-CHU Necker - Enfants Malades [AP-HP]
Subjects: MESH: Antirheumatic Agents, Lymphoma, MESH: Registries, MESH : Male, MESH : Aged, MESH: Arthritis, MESH: Epidemiologic Methods, MESH : Lymphoma, MESH : Epidemiologic Methods, Anti-TNF, immune system diseases, hemic and lymphatic diseases, MESH: Immunocompromised Host, MESH : Middle Aged, MESH : Female, Rheumatoid arthritis, MESH : France, MESH : Immunosuppressive Agents, MESH : Tumor Necrosis Factor-alpha, MESH: Aged, MESH: Middle Aged, MESH: Humans, MESH : Humans, [ SDV.SPEE ] Life Sciences [q-bio]/Santé publique et épidémiologie, MESH : Arthritis, MESH : Immunocompromised Host, MESH : Antirheumatic Agents, MESH: Male, MESH: France, MESH: Tumor Necrosis Factor-alpha, Spondylarthropathies, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, MESH: Immunosuppressive Agents, Safety, MESH: Lymphoma, MESH: Female, MESH : Registries
Abstract: International audience; OBJECTIVE: To describe cases of lymphoma associated with anti-TNF therapy, identify risk factors, estimate the incidence and compare the risks for different anti-TNF agents. METHODS: A national prospective registry was designed (Research Axed on Tolerance of bIOtherapies; RATIO) to collect all cases of lymphoma in French patients receiving anti-TNF therapy from 2004 to 2006, whatever the indication. A case-control analysis was conducted including two controls treated with anti-TNF per case and an incidence study of lymphoma with the French population was used as the reference. RESULTS: 38 cases of lymphoma, 31 non-Hodgkin's lymphoma (NHL) (26 B cell and five T cell), five Hodgkin's lymphoma (HL) and two Hodgkin's-like lymphoma were collected. Epstein-Barr virus was detected in both of two Hodgkin's-like lymphoma, three of five HL and one NHL. Patients receiving adalimumab or infliximab had a higher risk than those treated with etanercept: standardised incidence ratio (SIR) 4.1 (2.3-7.1) and 3.6 (2.3-5.6) versus 0.9 (0.4-1.8). The exposure to adalimumab or infliximab versus etanercept was an independent risk factor for lymphoma in the case-control study: odds ratio 4.7 (1.3-17.7) and 4.1 (1.4-12.5), respectively. The sex and age-adjusted incidence rate of lymphoma was 42.1 per 100 000 patient-years. The SIR was 2.4 (95% CI 1.7 to 3.2). CONCLUSION: The two to threefold increased risk of lymphoma in patients receiving anti-TNF therapy is similar to that expected for such patients with severe inflammatory diseases. Some lymphomas associated with immunosuppression may occur, and the risk of lymphoma is higher with monoclonal-antibody therapy than with soluble-receptor therapy.
Published: 2010
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63. Measure of function in rheumatoid arthritis: individualised or classical scales?

Author: Philippe Ravaud, Raphaèle Seror, Francis Guillemin, Florence Tubach, Gabriel Baron, Modèles et méthodes de l'évaluation thérapeutique des maladies chroniques (U738 / UMR_S738), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Diderot - Paris 7 (UPD7), Département d'épidémiologie, biostatistique et recherche clinique, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-AP-HP - Hôpital Bichat - Claude Bernard [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Modèles et méthodes de l'évaluation thérapeutique des maladies chroniques, Institut National de la Santé et de la Recherche Médicale (INSERM), Centre d'investigation clinique - Epidémiologie clinique [Nancy] (CIC-EC), Centre d'investigation clinique [Nancy] (CIC), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL)-Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL), Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM), and Gillet, Catherine
Subjects: Male, MESH: Antirheumatic Agents, Activities of daily living, Psychometrics, Severity of Illness Index, Arthritis, Rheumatoid, Disability Evaluation, 0302 clinical medicine, Activities of Daily Living, Immunology and Allergy, 030212 general & internal medicine, Prospective Studies, Prospective cohort study, skin and connective tissue diseases, MESH: Treatment Outcome, MESH: Aged, MESH: Arthritis, Rheumatoid, MESH: Middle Aged, MESH: Disability Evaluation, Patient's perspective, Middle Aged, MESH: Reproducibility of Results, Treatment Outcome, Rheumatoid arthritis, Antirheumatic Agents, Patient-reported outcome, Female, Leflunomide, musculoskeletal diseases, medicine.medical_specialty, Immunology, Patient-specific index, General Biochemistry, Genetics and Molecular Biology, Article, 03 medical and health sciences, Rheumatology, Cronbach's alpha, MESH: Psychometrics, Internal medicine, MESH: Severity of Illness Index, Severity of illness, medicine, Individualization, Humans, Aged, 030203 arthritis & rheumatology, MESH: Humans, business.industry, MESH: Activities of Daily Living, Reproducibility of Results, Health assessment questionnaire, Isoxazoles, medicine.disease, Patient reported outcome, MESH: Prospective Studies, MESH: Male, MESH: Isoxazoles, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Physical therapy, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, business, MESH: Female
Abstract: Background:The Health Assessment Questionnaire Disability Index (HAQ-DI) is the most widely used measure of function in rheumatoid arthritis (RA).Objective:To evaluate individualised forms of the HAQ-DI and thus enhance the incorporation of patients’ views in outcome assessment.Patients and methods:HAQ-DI data were prospectively obtained from 370 outpatients with RA treated with leflunomide over a 6-month period. At baseline and final visits, patients had to rate the importance they attached to each activity addressed by the 20 HAQ-DI items, and to select the five activities they considered the most important. Different individualised scales were evaluated: scales preserving all domains, in which the score for each item is multiplied by or added to its importance; and scales involving, for each patient, only the five most important items. The psychometric properties of these scales were compared with those of the HAQ-DI.Results:For each HAQ-DI item, severity and importance scores were weakly correlated. Scores for all individualised scales were highly correlated with the HAQ-DI score (rs>0.75). All scales had a good internal consistency (Cronbach’s α 0.87–0.88). Compared with the HAQ-DI, individualised scales did not have better sensitivity to change (standardised response mean 0.64–0.69 vs 0.74).Conclusion:Individualised scales have similar properties to the HAQ-DI. However, individualised questionnaires measuring importance gave complementary information to the measure of disability. Individualisation is probably not needed for group assessment in all randomised controlled trials but, the use of individualised questionnaires may be clinically relevant for individual patients with RA.
Published: 2010
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64. Lymphoma in patients treated with anti-TNF: results of the 3-year prospective French RATIO registry.: Lymphoma complicating anti-TNF therapy

Author: Mariette, Xavier, Tubach, Florence, Bagheri, Haleh, Bardet, Michel, Berthelot, Jean-Marie, Gaudin, Philippe, Heresbach, Denis, Martin, Antoine, Schaeverbeke, Thierry, Salmon, Dominique, Lemann, Marc, Hermine, Olivier, Raphael, Martine, Ravaud, Philippe, Gillet, Catherine, Service de rhumatologie, Université Paris-Sud - Paris 11 (UP11)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Bicêtre, Modèles et méthodes de l'évaluation thérapeutique des maladies chroniques (U738 / UMR_S738), Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM), Unité de Pharmacoépidémiologie [CHU Toulouse], Service Pharmacologie Clinique [CHU Toulouse], Pôle Santé publique et médecine publique [CHU Toulouse], Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Pôle Santé publique et médecine publique [CHU Toulouse], Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Service de médecine interne et rhumatologie, Centre Hospitalier Régional d'Orléans (CHRO)-Hôpital de la source, Service de Rhumatologie, Hôtel-Dieu, Université Joseph Fourier - Grenoble 1 (UJF)-CHU Grenoble-Hôpital Michallon, Service d'hépato-gastro-entérologie [Rennes] = Gastroenterology [Rennes], CHU Pontchaillou [Rennes], Hôpital de St Brieuc, CHU Bordeaux [Bordeaux], Service de médecine interne et centre de référence des maladies rares [CHU Cochin], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Service de gastro-entérologie, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Service d'immuno-hématologie pédiatrique [CHU Necker], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Necker - Enfants Malades [AP-HP], and Laboratoire d'Hématologie
Subjects: MESH: Aged, MESH: Antirheumatic Agents, MESH: Middle Aged, MESH: Humans, Lymphoma, MESH: Registries, MESH: Arthritis, MESH: Epidemiologic Methods, MESH: Male, Anti-TNF, MESH: France, immune system diseases, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, hemic and lymphatic diseases, MESH: Tumor Necrosis Factor-alpha, MESH: Immunocompromised Host, Spondylarthropathies, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, MESH: Immunosuppressive Agents, Safety, Rheumatoid arthritis, MESH: Lymphoma, MESH: Female
Abstract: International audience; OBJECTIVE: To describe cases of lymphoma associated with anti-TNF therapy, identify risk factors, estimate the incidence and compare the risks for different anti-TNF agents. METHODS: A national prospective registry was designed (Research Axed on Tolerance of bIOtherapies; RATIO) to collect all cases of lymphoma in French patients receiving anti-TNF therapy from 2004 to 2006, whatever the indication. A case-control analysis was conducted including two controls treated with anti-TNF per case and an incidence study of lymphoma with the French population was used as the reference. RESULTS: 38 cases of lymphoma, 31 non-Hodgkin's lymphoma (NHL) (26 B cell and five T cell), five Hodgkin's lymphoma (HL) and two Hodgkin's-like lymphoma were collected. Epstein-Barr virus was detected in both of two Hodgkin's-like lymphoma, three of five HL and one NHL. Patients receiving adalimumab or infliximab had a higher risk than those treated with etanercept: standardised incidence ratio (SIR) 4.1 (2.3-7.1) and 3.6 (2.3-5.6) versus 0.9 (0.4-1.8). The exposure to adalimumab or infliximab versus etanercept was an independent risk factor for lymphoma in the case-control study: odds ratio 4.7 (1.3-17.7) and 4.1 (1.4-12.5), respectively. The sex and age-adjusted incidence rate of lymphoma was 42.1 per 100 000 patient-years. The SIR was 2.4 (95% CI 1.7 to 3.2). CONCLUSION: The two to threefold increased risk of lymphoma in patients receiving anti-TNF therapy is similar to that expected for such patients with severe inflammatory diseases. Some lymphomas associated with immunosuppression may occur, and the risk of lymphoma is higher with monoclonal-antibody therapy than with soluble-receptor therapy.
Published: 2010
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65. Survey of the therapeutic management of rheumatoid arthritis in France: the OPALE study

Author: Saraux, Alain, Combe, Bernard, Blin, Philippe, Bregman, Bruno, Chartier, Melanie, Durieux-Mehlman, Stephanie, Guillemin, Francis, Michel, Geneviève, Immunologie et Pathologie (EA2216), Université de Brest (UBO)-IFR148, CHRU Brest - Service de Rhumatologie (CHU - BREST - Rhumato), Centre Hospitalier Régional Universitaire de Brest (CHRU Brest), Département de Rhumatologie[Montpellier], Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Hôpital Lapeyronie, Département Hospitalo-Universitaire de Pharmacologie de Bordeaux, and CHU de Bordeaux Pellegrin [Bordeaux]-Université Victor Segalen - Bordeaux 2
Subjects: MESH: Decision Making, Male, musculoskeletal diseases, MESH: Antirheumatic Agents, MESH: Registries, [SDV.IMM] Life Sciences [q-bio]/Immunology, Decision Making, MESH: Medical Staff, Hospital, MESH: Health Care Surveys, Arthritis, Rheumatoid, MESH: Cross-Sectional Studies, Rheumatology, immune system diseases, MESH: Rheumatology, Surveys and Questionnaires, Medical Staff, Hospital, Humans, Registries, skin and connective tissue diseases, MESH: Family Practice, Aged, MESH: Aged, MESH: Arthritis, Rheumatoid, MESH: Humans, MESH: Middle Aged, MESH: Questionnaires, Middle Aged, MESH: Male, MESH: France, Cross-Sectional Studies, Antirheumatic Agents, Health Care Surveys, [SDV.IMM]Life Sciences [q-bio]/Immunology, Female, France, Family Practice, MESH: Female
Abstract: International audience; To describe the therapeutic practice used in 2006 by French rheumatologists and hospital staff in RA patients, and to estimate the proportion of patients currently treated with DMARDs including biologics, and to estimate the ratio of patients treated according to the SFR national recommendations. This multicentre cross-sectional study was performed in a random sample of rheumatologists selected from a comprehensive national database and stratified by setting and region. Each rheumatologist established a registry of subsequent RA patients (first step), and filled in a detailed questionnaire for the 10 first patients from the registry (second step). At the day of inclusion, RA characteristics and DMARD treatments over the past 12 months were recorded. The majority of the RA patients were women (mean age: 58 yrs). The mean DAS 28 score was 3.6, and RA was considered as clinically and radiologically severe in almost 27.0% of the cases. In the registry part, 89.9% of RA patients were currently treated with DMARDs, and 29.3% of them received a biologic DMARD alone or in combination. In 1610 patients with detailed questionnaire record, the efficacy of the current DMARD treatment was good in almost 60% of the patients. Finally, the physician's decision was to continue the ongoing treatment in 4/5 cases. In this study, RA characteristics were similar to the typical RA observed in previous studies. Biologics were major drugs in DMARD treatments with 30.1% RA patients currently treated. Modification of treatments was essentially linked to a lack of therapeutic response.
Published: 2010

66. Pulmonary nodulosis and aseptic granulomatous lung disease occurring in patients with rheumatoid arthritis receiving tumor necrosis factor-alpha-blocking agent: a case series

Author: Béatrice Bouvard, J M Berthelot, Le Cri, Daniel Wendling, Edouard Pertuiset, Eric Toussirot, Emmanuelle Lecuyer, José le Noach, Anne Lohse, Philippe Gaudin, Agents pathogènes et inflammation - UFC (EA 4266) (API), Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), Service de Rhumatologie, and Université Joseph Fourier - Grenoble 1 (UJF)-CHU Grenoble-Hôpital Michallon
Subjects: Lung Diseases, Male, Pathology, MESH: Antirheumatic Agents, MESH: Granuloma, Rheumatoid nodule, Arthritis, Receptors, Tumor Necrosis Factor, Etanercept, MESH: Antibodies, Monoclonal, Arthritis, Rheumatoid, MESH: Lung Diseases, 0302 clinical medicine, Immunology and Allergy, 030212 general & internal medicine, MESH: Treatment Outcome, MESH: Aged, MESH: Immunoglobulin G, MESH: Arthritis, Rheumatoid, MESH: Middle Aged, Granuloma, Antibodies, Monoclonal, Middle Aged, 3. Good health, Treatment Outcome, [SDV.MHEP.RSOA]Life Sciences [q-bio]/Human health and pathology/Rhumatology and musculoskeletal system, Rheumatoid arthritis, Antirheumatic Agents, Female, medicine.symptom, medicine.drug, Adult, medicine.medical_specialty, Immunology, Antibodies, Monoclonal, Humanized, 03 medical and health sciences, Rheumatology, Internal medicine, Adalimumab, medicine, Rheumatoid factor, Humans, Aged, 030203 arthritis & rheumatology, MESH: Humans, business.industry, Tumor Necrosis Factor-alpha, MESH: Adult, medicine.disease, MESH: Receptors, Tumor Necrosis Factor, Dermatology, Infliximab, MESH: Male, MESH: Tumor Necrosis Factor-alpha, Immunoglobulin G, business, MESH: Female
Abstract: Objective.To describe cases of development of pulmonary nodulosis or aseptic granulomatous lung disease in patients with rheumatoid arthritis (RA) receiving anti-tumor necrosis factor-α (TNF-α) therapy.Methods.A call for observation of such cases was sent to members of the French “Club Rhumatismes et Inflammation.” The cases had to occur after introduction of TNF-α-blocking therapy.Results.Eleven cases were examined: 6 patients were treated with etanercept, 2 with infliximab, and 3 with adalimumab. Pulmonary nodular lesions were observed after a mean treatment period of 23.3 ± 15.3 months. Clinical symptoms were observed in 5 cases. Radiographs or computed tomography of the chest showed single or multiple nodular lesions in 10 cases and hilar adenopathies in 1 case. Biopsy of the nodular chest lesions or mediastinal lymphadenopathies were performed in 8 patients, and revealed typical rheumatoid nodules in 4 cases and noncaseating granulomatous lesions in 4 cases. Mycobacterial or opportunistic infections were excluded for all cases. Outcome was favorable for all the patients, with either discontinuation or maintenance of anti-TNF-α treatment.Conclusion.Aseptic pulmonary nodular inflammation corresponding to rheumatoid nodules or noncaseating granulomatous inflammation can occur during anti-TNF-α therapy for RA, mainly etanercept. The mechanism explaining such a reaction is not clear but certainly includes different processes. These cases of pulmonary nodular inflammation generally have a benign course and do not systematically require withdrawal of treatment.
Published: 2009
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67. Pharmacological treatment (biotherapy excluded) of peripheral psoriatic arthritis: Development of recommendations for clinical practice based on data from the literature and experts opinion

Author: Jacques Tebib, Xavier Le Loët, Thierry Schaeverbeke, Philippe Gaudin, Alain Saraux, Philippe Goupille, Carine Salliot, René Marc Flipo, Bernard Combe, Pascal Claudepierre, Daniel Wendling, Emmanuelle Dernis, Alain Cantagrel, Carle Paul, F. Lavie, Jean-Francis Maillefert, Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Hôpital Lariboisière, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Lariboisière-Fernand-Widal [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Diderot - Paris 7 (UPD7), CHU Dijon, Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Génétique, immunothérapie, chimie et cancer (GICC), UMR 6239 CNRS [2008-2011] (GICC UMR 6239 CNRS), Université de Tours-Centre National de la Recherche Scientifique (CNRS), Hôpital Henri Mondor, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), CHU Grenoble, Université Joseph Fourier - Grenoble 1 (UJF)-CHU Grenoble, Hôpital Pellegrin, CHU Bordeaux [Bordeaux]-Groupe hospitalier Pellegrin, Hôpital Lapeyronie [Montpellier] (CHU), Cambefort, Jeanne, Université de Tours (UT)-Centre National de la Recherche Scientifique (CNRS), Service de rhumatologie, Hôpital Bicêtre-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris-Sud - Paris 11 (UP11), Service de Rhumatologie, Hôpital Claude Huriez [Lille], CHU Lille-CHU Lille-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Service de rhumatologie [CHU Henri Mondor], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor, Université Joseph Fourier - Grenoble 1 (UJF)-CHU Grenoble-Hôpital Michallon, Service d'immunologie et rhumatologie, Hospices Civils de Lyon (HCL)-Hôpital Edouard Herriot [CHU - HCL], Hospices Civils de Lyon (HCL), Agents pathogènes et inflammation - UFC (EA 4266) (API), Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), CHU Bordeaux [Bordeaux], Service de rhumatologie [CHU Rouen], CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU), Département de Rhumatologie[Montpellier], Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Hôpital Lapeyronie, CHU Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpital Lariboisière-Université Paris Diderot - Paris 7 (UPD7), Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), CHU Cochin [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) - Hôpital Lariboisière - Université Paris Diderot - Paris 7 (UP7), Centre Hospitalier Universitaire de Dijon (CHU Dijon), Génétique, Immunothérapie, Chimie et Cancer (GICC), Université François Rabelais - Tours - Centre National de la Recherche Scientifique (CNRS), Assistance publique - Hôpitaux de Paris (AP-HP) - Hôpital Henri Mondor - Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Université Joseph Fourier - Grenoble 1 (UJF) - CHU Grenoble, CHU Bordeaux [Bordeaux] - Groupe hospitalier Pellegrin, Hôpital Lapeyronie, and Université Montpellier 1 (UM1) - Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier) - Hôpital Lapeyronie
Subjects: MESH: Antirheumatic Agents, [SDV]Life Sciences [q-bio], Alternative medicine, Recommendations, Placebos, 0302 clinical medicine, MESH: Practice Guidelines as Topic, Azathioprine, MESH: Arthritis, Psoriatic, 030212 general & internal medicine, MESH: Advisory Committees, computer.programming_language, Randomized Controlled Trials as Topic, Evidence-Based Medicine, Anti-Inflammatory Agents, Non-Steroidal, MESH: Follow-Up Studies, MESH: Anti-Inflammatory Agents, Non-Steroidal, 3. Good health, Clinical Practice, [SDV] Life Sciences [q-bio], MESH: Joints, [SDV.MHEP.RSOA]Life Sciences [q-bio]/Human health and pathology/Rhumatology and musculoskeletal system, Antirheumatic Agents, Psoriatic arthritis, Practice Guidelines as Topic, Leflunomide, MESH: Expert Testimony, medicine.medical_specialty, Advisory Committees, MEDLINE, MESH: Placebos, Pharmacological treatment, 03 medical and health sciences, Rheumatology, medicine, Humans, Hospitals, Teaching, Expert Testimony, Glucocorticoids, MESH: Azathioprine, 030203 arthritis & rheumatology, MESH: Humans, Spondylarthropathy, Task force, business.industry, Arthritis, Psoriatic, Everyday clinical practice, Isoxazoles, MESH: Hospitals, Teaching, medicine.disease, Sulfasalazine, Treatment, MESH: Randomized Controlled Trials as Topic, Methotrexate, MESH: Isoxazoles, Family medicine, Physical therapy, Joints, business, MESH: Glucocorticoids, computer, Delphi, Rheumatism, MESH: Evidence-Based Medicine, Follow-Up Studies
Abstract: International audience; Objectives: To develop recommendations about treatment (except anti-TNF agents) of psoriatic arthritis with peripheral joint involvement (PsA) seen in everyday practice, using evidence from the literature, supplemented with expert opinion when needed. Methods: The recommendations were based on evidence from the literature. First, a scientific committee used a Delphi procedure to select five focal points of interest. Then, a literature task force looked for relevant publications in the following: Cochrane, Pubmed, and Ovid databases and abstracts from the French Society for Rheumatology, European League against Rheumatism and American College of Rheumatology. Based on the data from these publications, recommendations were drafted and then validated by a group of 68 experts. The strength of each recommendation was determined, as well as the extent of agreement among the experts. Results: The evidence extracted from 73 selected papers was presented to experts during interactive workshops. At the end of the workshops, the experts drafted six recommendations, which were then validated by a final vote including all participants. These six recommendations displayed various strength from B to D. Conclusion: These recommendations should help to improve practice uniformity and, ultimately, to improve the management of PsA in France. (C) 2009 Societe francaise de rhumatologie. Published by Elsevier Masson SAS. All rights reserved.
Published: 2009
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68. Sarcoid-like granulomatosis in patients treated with tumor necrosis factor blockers: 10 cases

Author: Daïen, Claire Immediato, Monnier, Agnes, Claudepierre, Pascal, Constantin, Arnaud, Eschard, Jean-Paul, Houvenagel, Eric, Samimi, Mahtab, Pavy, Stephan, Pertuiset, Edouard, Toussirot, Eric, Combe, Bernard, Morel, Jacques, Renseigné, Non, Service de rhumatologie [CHU Henri Mondor], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor, Agents pathogènes et inflammation - UFC (EA 4266) (API), Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), Département de Rhumatologie[Montpellier], and Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Hôpital Lapeyronie
Subjects: Male, Systemic disease, MESH: Antirheumatic Agents, MESH: Granuloma, MESH: Sarcoidosis, Pulmonary, Gastroenterology, Receptors, Tumor Necrosis Factor, Etanercept, MESH: Rheumatic Diseases, MESH: Antibodies, Monoclonal, 0302 clinical medicine, Pharmacology (medical), MESH: Aged, MESH: Immunoglobulin G, Granuloma, MESH: Middle Aged, Antibodies, Monoclonal, Middle Aged, 3. Good health, [SDV.MHEP.RSOA]Life Sciences [q-bio]/Human health and pathology/Rhumatology and musculoskeletal system, 030220 oncology & carcinogenesis, Antirheumatic Agents, Female, Sarcoidosis, MESH: Immunosuppressive Agents, Immunosuppressive Agents, medicine.drug, Adult, MESH: Sarcoidosis, medicine.medical_specialty, MESH: Skin Diseases, Antibodies, Monoclonal, Humanized, Skin Diseases, 03 medical and health sciences, Rheumatology, Sarcoidosis, Pulmonary, Internal medicine, Rheumatic Diseases, medicine, Adalimumab, Humans, Aged, 030203 arthritis & rheumatology, MESH: Humans, business.industry, MESH: Adult, medicine.disease, MESH: Receptors, Tumor Necrosis Factor, Infliximab, MESH: Male, Discontinuation, Surgery, Anti-Tumor Necrosis Factor Therapy, Immunoglobulin G, business, MESH: Female
Abstract: International audience; OBJECTIVE: TNF blockers have been recently evaluated for treating refractory sarcoidosis and could be efficient. However, several cases of sarcoidosis have been diagnosed during anti-TNF therapy. Here, we report the largest series of sarcoid-like granulomatosis following TNF blocker treatment. METHODS: A call for observations of sarcoid-like granulomatosis following TNF blocker treatment was sent to the members of the French 'Club Rhumatismes et Inflammation'. Histological evidence of granulomatosis was required. RESULTS: Observations of 10 patients [seven females; median age 50.5 (range 27-72) years] with sarcoid-like granulomatosis while on anti-TNF treatment were collected: five were treated with etanercept and five with monoclonal antibodies; four patients received TNF blockers for RA and six for SpA. The median delay between anti-TNF agent introduction and granulomatosis diagnosis was 18 (range 1-51) months. Clinical symptoms were mainly pulmonary and cutaneous. Angiotensin-converting enzyme activity was increased in six cases. Lymph-node and/or lung involvement were observed by CT scan of the chest for eight patients. The median delay between drug discontinuation and remission was 6 (range 1-11) months for clinical signs and 6 (range 2-12) months for biological and radiographic findings. Improvement was observed in all patients after drug discontinuation with or without steroids. CONCLUSIONS: Sarcoid-like granulomatosis is rare but not exceptional in patients treated with TNF blockers (approximately 1/2800) and does not seem to be related to gender, rheumatic disease or in our series the type of anti-TNF drug used (monoclonal antibodies or soluble receptor). Discontinuation of anti-TNF usually leads to recovery.
Published: 2009
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69. Apolipoprotein A-I and platelet factor 4 are biomarkers for infliximab response in rheumatoid arthritis

Author: Candice Trocme, Athan Baillet, Jérôme Garin, Pierre Miossec, Laurent Grange, Jacques Tebib, François Berger, Hubert Marotte, Béatrice Pallot-Prades, Michael John Nissen, Françoise Morel, Philippe Gaudin, Robert Juvin, GREPI, Techniques de l'Ingénierie Médicale et de la Complexité - Informatique, Mathématiques et Applications, Grenoble - UMR 5525 (TIMC-IMAG), VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-Centre National de la Recherche Scientifique (CNRS)-Université Joseph Fourier - Grenoble 1 (UJF)-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-Centre National de la Recherche Scientifique (CNRS)-Université Joseph Fourier - Grenoble 1 (UJF)-Laboratoire d'enzymologie/DBPC, CHU Grenoble-Hôpital Michallon-CHU Grenoble-Hôpital Michallon, Service d'immunologie et rhumatologie, Hospices Civils de Lyon (HCL)-Hôpital Edouard Herriot [CHU - HCL], Hospices Civils de Lyon (HCL), VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-Centre National de la Recherche Scientifique (CNRS)-Université Joseph Fourier - Grenoble 1 (UJF)-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-Centre National de la Recherche Scientifique (CNRS)-Université Joseph Fourier - Grenoble 1 (UJF)-Service de Rhumatologie, Université Joseph Fourier - Grenoble 1 (UJF)-CHU Grenoble-Hôpital Michallon-CHU Grenoble-Hôpital Michallon, Clinique de Rhumatologie, CHU Saint-Etienne-Hôpital Bellevue, Laboratoire de chimie des protéines, Université Joseph Fourier - Grenoble 1 (UJF)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Institut National de la Santé et de la Recherche Médicale (INSERM), Neurosciences précliniques, Université Joseph Fourier - Grenoble 1 (UJF)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de Rhumatologie, Université Joseph Fourier - Grenoble 1 (UJF)-CHU Grenoble-Hôpital Michallon, Ministère de l'Enseignement Supérieur et de la Recherche, Région Rhône-Alpes, Joseph Fourier University, GEFLUC de Grenoble, Fondation pour la Recherche Médicale, Direction Régionale de la Recherche Clinique du CHU Grenoble, Ligue Nationale contre le Cancer, Groupe de Recherche et d’Étude du Processus Inflammatoire (TIMC-IMAG-GREPI), Université Joseph Fourier - Grenoble 1 (UJF)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS)-Université Joseph Fourier - Grenoble 1 (UJF)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier Universitaire de Saint-Etienne [CHU Saint-Etienne] (CHU ST-E), and Issartel, Jean-Paul
Subjects: Male, Proteomics, rheumatoid arthritis, MESH: Antirheumatic Agents, Apolipoprotein B, MESH: Apolipoprotein A-I, Arthritis, Pharmacology, Platelet Factor 4, MESH: Antibodies, Monoclonal, Arthritis, Rheumatoid, 0302 clinical medicine, MESH: Drug Monitoring, MESH: Platelet Factor 4, SELDI-TOF-MS, Immunology and Allergy, MESH: Treatment Outcome, MESH: Aged, 0303 health sciences, education.field_of_study, MESH: Arthritis, Rheumatoid, MESH: Middle Aged, biology, MESH: Proteomics, Antibodies, Monoclonal, Middle Aged, Prognosis, 3. Good health, Treatment Outcome, Rheumatoid arthritis, Antirheumatic Agents, Biomarker (medicine), [SDV.BBM.GTP] Life Sciences [q-bio]/Biochemistry, Molecular Biology/Genomics [q-bio.GN], Female, Drug Monitoring, medicine.drug, Adult, medicine.medical_specialty, Immunology, Population, Sensitivity and Specificity, General Biochemistry, Genetics and Molecular Biology, Article, MESH: Prognosis, 03 medical and health sciences, Rheumatology, Internal medicine, [SDV.BBM.GTP]Life Sciences [q-bio]/Biochemistry, Molecular Biology/Genomics [q-bio.GN], medicine, [SDV.BBM] Life Sciences [q-bio]/Biochemistry, Molecular Biology, Humans, [SDV.BBM]Life Sciences [q-bio]/Biochemistry, Molecular Biology, education, 030304 developmental biology, Aged, 030203 arthritis & rheumatology, MESH: Humans, Apolipoprotein A-I, business.industry, MESH: Biological Markers, biomarkers, treatment response, MESH: Adult, medicine.disease, Infliximab, MESH: Male, MESH: Sensitivity and Specificity, MESH: Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization, Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization, biology.protein, business, infliximab, MESH: Female, Platelet factor 4
Abstract: International audience; OBJECTIVES: The use of biologicals such as infliximab has dramatically improved the treatment of rheumatoid arthritis (RA). However, factors predictive of therapeutic response need to be identified. A proteomic study was performed prior to infliximab therapy to identify a panel of candidate protein biomarkers of RA predictive of treatment response. METHODS: Plasma profiles of 60 patients with RA (28 non-responders (as defined by the American College of Rheumatology 20% improvement criteria (ACR20)) negative and 32 responders (ACR70 positive) to infliximab) were studied by surface enhanced laser desorption/ionisation time-of-flight mass spectrometry (SELDI-TOF MS) technology on two types of arrays, an anion exchange array (SAX2) and a nickel affinity array (IMAC3-Ni). Biomarker characterisation was carried out using classical biochemical methods (purification by ammonium sulfate precipitation or metal affinity chromatography) and identification by matrix assisted laser desorption/ionisation time-of-flight (MALDI-TOF) MS analysis. RESULTS: Two distinct protein profiles were observed on both arrays and several proteins were differentially expressed in both patient populations. Five proteins at 3.86, 7.77, 7.97, 8.14 and 74.07 kDa were overexpressed in the non-responder group, whereas one at 28 kDa was increased in the responder population (sensitivity>56%, specificity>77.5%). Moreover, combination of several biomarkers improved the sensitivity and specificity of the detection of patient response to over 97%. The 28 kDa protein was characterised as apolipoprotein A-I and the 7.77 kDa biomarker was identified as platelet factor 4. CONCLUSIONS: Six plasma biomarkers are characterised, enabling the detection of patient response to infliximab with high sensitivity and specificity. Apolipoprotein A-1 was predictive of a good response to infliximab, whereas platelet factor 4 was associated with non-responders.
Published: 2009
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70. Biologic agents in the treatment of rheumatic diseases with chronic viral infection. Where are we?

Author: Daniel Wendling, Vincent Di Martino, Georges Herbein, Service de Rhumatologie, Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), Service d'Hépato-Gastro-Entérologie [CHU Pitié-Salpêtrière], CHU Pitié-Salpêtrière [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Agents pathogènes et inflammation - UFC (EA 4266) (API), Université de Franche-Comté (UFC), and Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC)
Subjects: MESH: Antirheumatic Agents, MESH: Biological Products, Immunology, Etanercept, MESH: Rheumatic Diseases, 03 medical and health sciences, 0302 clinical medicine, Rheumatology, medicine, Adalimumab, MESH: Immunocompromised Host, Immunology and Allergy, ComputingMilieux_MISCELLANEOUS, 030203 arthritis & rheumatology, Hepatitis, MESH: Humans, business.industry, MESH: Chronic Disease, Lamivudine, medicine.disease, Infliximab, 3. Good health, Discontinuation, MESH: Virus Diseases, [SDV.MHEP.RSOA]Life Sciences [q-bio]/Human health and pathology/Rhumatology and musculoskeletal system, 030220 oncology & carcinogenesis, Rheumatoid arthritis, MESH: Tumor Necrosis Factor-alpha, MESH: Immunosuppressive Agents, business, Viral load, medicine.drug
Abstract: Biologic agents have increased the therapeutic armamentarium against immune-mediated disorders, and particularly rheumatic diseases such as rheumatoid arthritis (RA) and ankylosing spondylitis (AS). Nevertheless, infectious side effects are a major concern in the use of these biologics, especially anti-tumor necrosis factor (TNF) agents1. In this context, the use of TNF blockers in patients with chronic viral infection seems hazardous, and represents an unresolved issue2. In this issue of The Journal , Zingarelli, et al 3 report 3 cases of patients with RA positive for HBsAg, in which anti-TNF therapies (etanercept, infliximab then etanercept, adalimumab) under prophylactic use of lamivudine were not associated with hepatitis reactivation, even after anti-TNF discontinuation with prolonged lamivudine therapy. In one of their cases, an increase in HBV viral load occurred after discontinuation of methotrexate. Methotrexate was reported to induce subfulminant hepatitis B virus reactivation after its withdrawal4,5. This illustrates the interactions of the underlying condition and the associated immunosuppressive therapy that may confuse our interpretation of the responsibility of … Address reprint requests to Dr. Wendling. E-mail: dwendling{at}chu-besancon.fr
Published: 2009
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71. Abatacept therapy and safety management

Author: Thao Pham, Pascal Claudepierre, Arnaud Constantin, Bruno Fautrel, Laure Gossec, Jacques-Éric Gottenberg, Philippe Goupille, Éric Hachulla, Charles Masson, Jacques Morel, Alain Saraux, Thierry Schaeverbeke, Daniel Wendling, Xavier Mariette, Jean Sibilia, Service de Rhumatologie [Hôpital de la Conception - APHM], Assistance Publique - Hôpitaux de Marseille (APHM)-Hôpital de la Conception [CHU - APHM] (LA CONCEPTION), Service de rhumatologie [CHU Henri Mondor], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor, Service de rhumatologie [CHU Pitié Salpêtrière] (GRC-08 EEMOIS), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Modèles et méthodes de l'évaluation thérapeutique des maladies chroniques (U738 / UMR_S738), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Diderot - Paris 7 (UPD7), Service de rhumatologie [CHU Cochin], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Service de rhumatologie [Strasbourg], CHU Strasbourg-Hôpital de Hautepierre [Strasbourg], Service de rhumatologie, Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Médecine Interne, Hôpital Claude Huriez [Lille], CHU Lille-CHU Lille, CHU Bordeaux [Bordeaux], Agents pathogènes et inflammation - UFC (EA 4266) (API), Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), Hôpital Bicêtre-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris-Sud - Paris 11 (UP11), Hôpital Henri Mondor, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), CHU Pitié-Salpêtrière [AP-HP], Hôpital Cochin [AP-HP], Génétique, immunothérapie, chimie et cancer (GICC), UMR 6239 CNRS [2008-2011] (GICC UMR 6239 CNRS), Université de Tours (UT)-Centre National de la Recherche Scientifique (CNRS), Hôpital Lapeyronie [Montpellier] (CHU), Hôpital Pellegrin, CHU Bordeaux [Bordeaux]-Groupe hospitalier Pellegrin, Hôpital Bicêtre, Université Paris-Sud - Paris 11 (UP11)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Bicêtre, Cambefort, Jeanne, Service de Rhumatologie [CHU Pitié Salpêtrière], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM), Assistance publique - Hôpitaux de Paris (AP-HP) - Hôpital Henri Mondor - Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), CHU Pitié-Salpêtrière [APHP], CHU Cochin [APHP], Génétique, Immunothérapie, Chimie et Cancer (GICC), Université François Rabelais - Tours - Centre National de la Recherche Scientifique (CNRS), Hôpital Lapeyronie, Université Montpellier 1 (UM1) - Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier) - Hôpital Lapeyronie, CHU Bordeaux [Bordeaux] - Groupe hospitalier Pellegrin, Université Paris-Sud - Paris 11 (UP11) - Assistance publique - Hôpitaux de Paris (AP-HP) - Hôpital Bicêtre, Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Université de Tours-Centre National de la Recherche Scientifique (CNRS), Assistance Publique - Hôpitaux de Marseille ( APHM ) -Hôpital de la Conception [CHU - APHM] ( LA CONCEPTION ), Assistance publique - Hôpitaux de Paris (AP-HP)-Hôpital Henri Mondor, Service de Rhumatologie [CHU Pitié-Salpêtrière], Assistance publique - Hôpitaux de Paris (AP-HP)-CHU Pitié-Salpêtrière [APHP], Modèles et méthodes de l'évaluation thérapeutique des maladies chroniques, Université Paris Diderot - Paris 7 ( UPD7 ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Assistance publique - Hôpitaux de Paris (AP-HP)-CHU Cochin [AP-HP], CHRU Tours, Hôpital Claude Huriez, Agents pathogènes et inflammation - UFC (EA 4266) ( API ), Université de Franche-Comté ( UFC ), and Université Paris-Sud - Paris 11 ( UP11 ) -Assistance publique - Hôpitaux de Paris (AP-HP)-Hôpital Bicêtre
Subjects: musculoskeletal diseases, Safety Management, MESH: Antirheumatic Agents, Immunoconjugates, Monitoring, MESH : Safety Management, [SDV]Life Sciences [q-bio], MESH : Treatment Outcome, Arthritis, Rheumatoid, [ SDV.MHEP.RSOA ] Life Sciences [q-bio]/Human health and pathology/Rhumatology and musculoskeletal system, Abatacept, MESH : Immunoconjugates, 03 medical and health sciences, 0302 clinical medicine, Rheumatology, MESH: Immunoconjugates, Humans, 030304 developmental biology, MESH: Treatment Outcome, 030203 arthritis & rheumatology, 0303 health sciences, MESH: Arthritis, Rheumatoid, MESH: Humans, MESH : Humans, MESH : Antirheumatic Agents, Health services, 3. Good health, [SDV] Life Sciences [q-bio], Treatment Outcome, MESH: Safety Management, [SDV.MHEP.RSOA]Life Sciences [q-bio]/Human health and pathology/Rhumatology and musculoskeletal system, Antirheumatic Agents, MESH : Arthritis, Rheumatoid, Safety
Abstract: International audience; Objectives: To elaborate a how-to-use abatacept material intended to help physicians in the management of patients with inflammatory diseases treated with this drug in routine practice. Methods: 1) Selection of the relevant domains by a rheumatologists' panel; 2) Search for published evidence in each domain; 3) Elaboration of the clinical tool guide with a 3-level gradation of evidence (evidence-based medicine EBM, official recommendations and expert's opinion). The experts were 11 academic rheumatologists with a large experience in prescribing abatacept and in managing rheumatoid arthritis. They were all members of the CRI (Club Rhumatismes et Inflammation), a section of the French Rheumatology Society dedicated to the inflammatory rheumatic diseases. Each fact sheet was reviewed by two other experts; 4) Regular updating based on medical literature and post-marketing surveillance data. Results: Four domains were considered relevant: abatacept contraindication s, management of side effects or associated diseases appearing during abatacept treatment, management of "practical situations" such as surgery or pregnancy, physician and patient information. After the literature analysis and discussion during an experts' meeting, a consensus was reached on: - a pre-treatment checklist aimed at searching abatacept contra indications; - a what-to-do document when facing side effects or associated diseases (autoimmune pathology, bacterial or viral infections, cardiovascular diseases, intolerance to abatacept, solid or haematological malignancy) or "practical situations" (surgery, pregnancy, vaccination, travel, drug-drug interactions); - an example of standard information letter to be addressed to the attending physician (rheumatologist and general practitioner); - an example of standard information letter to be addressed to the patient. Conclusion: Based on both an EBM approach and an expert's opinion approach, this abatacept clinical tool guide should provide assistance to all physicians attending patients treated with abatacept. For a better implementation in clinical practice, this tool guide will be available online at www.cri-net.com and regularly updated.
Published: 2009
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72. Spondyloarthropathy and chronic B hepatitis. Effect of anti-TNF therapy

Author: Georges Herbein, Clément Prati, Eric Toussirot, Vincent Di Martino, Daniel Wendling, Service de Rhumatologie, Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), Service d'Hépato-Gastro-Entérologie [CHU Pitié-Salpêtrière], CHU Pitié-Salpêtrière [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Agents pathogènes et inflammation - UFC (EA 4266) (API), Université de Franche-Comté (UFC), and Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC)
Subjects: Male, MESH: Antirheumatic Agents, medicine.disease_cause, Receptors, Tumor Necrosis Factor, Etanercept, MESH: Antibodies, Monoclonal, MESH: Virus Activation, 0302 clinical medicine, MESH: Immunocompromised Host, MESH: Treatment Outcome, MESH: Immunoglobulin G, Antibodies, Monoclonal, Lamivudine, Viral Load, Hepatitis B, 3. Good health, MESH: Hepatitis B virus, Treatment Outcome, MESH: Methotrexate, [SDV.MHEP.RSOA]Life Sciences [q-bio]/Human health and pathology/Rhumatology and musculoskeletal system, Antirheumatic Agents, Drug Therapy, Combination, Female, 030211 gastroenterology & hepatology, Tumor necrosis factor alpha, MESH: Viral Load, Viral load, MESH: Spondylarthropathies, medicine.drug, MESH: Lamivudine, Adult, MESH: Antiviral Agents, Hepatitis B virus, MESH: Adenine, MESH: Hepatitis B, Chronic, Organophosphonates, MESH: Phosphonic Acids, Antiviral Agents, Immunocompromised Host, 03 medical and health sciences, Hepatitis B, Chronic, Rheumatology, medicine, Humans, 030203 arthritis & rheumatology, Hepatitis, MESH: Humans, Tumor Necrosis Factor-alpha, business.industry, Adenine, Antagonist, MESH: Adult, medicine.disease, MESH: Receptors, Tumor Necrosis Factor, Infliximab, MESH: Male, MESH: Drug Therapy, Combination, Methotrexate, Immunoglobulin G, MESH: Tumor Necrosis Factor-alpha, Immunology, Spondylarthropathies, Virus Activation, business, MESH: Female
Abstract: International audience; Several cases of TNF antagonist-related reactivation of hepatitis B have been reported. Here, we describe 4 cases in patients with spondyloarthropathies. Long-term monitoring of the hepatitis B virus (HBV) load is in order in HBV-positive patients treated with TNF antagonists. CASE REPORTS: There were 3 men and 1 woman, aged 30-40 years. Follow-up ranged from 1 to 5 years. In 2 patients, the HBV infection was not discovered until the pre-TNF antagonist therapy workup. A viral load increase was noted after a TNF antagonist was added to methotrexate in 2 patients, whose viral load values returned to baseline after the introduction of the antiviral agent lamivudine. Lamivudine was started at the same time as the TNF antagonist in the other 2 patients, whose viral loads remained undetectable. Escape phenomenon requiring a switch to another antiviral agent was required in 1 patient after more than 4 years of treatment with 3 TNF antagonists. CONCLUSION: These 4 case reports illustrate the challenges raised by latent HBV infection in patients who require TNF antagonist therapy. They support routine HBV testing before treatment initiation, followed in HBV-positive patients by viral load monitoring. Antiviral therapy can be used preventively and should be given if the viral load increases under TNF antagonist therapy. In patients on antiviral therapy, viral load monitoring should be continued, given the risk of escape phenomenon after several years.
Published: 2009
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73. [Spondylarthropathy with Behçet's disease: response to infliximab]

Author: Toussirot , Eric, Schwartz , Claire, Hafsaoui , Chafika, Bossert , Marie, Bertolini , Ewa, Wendling , Daniel, Agents pathogènes et inflammation - UFC (EA 4266) ( API ), Université de Franche-Comté ( UFC ), Agents pathogènes et inflammation - UFC (EA 4266) (API), Université de Franche-Comté (UFC), and Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC)
Subjects: Adult, Male, MESH: Antirheumatic Agents, MESH : Male, MESH : Treatment Outcome, MESH: Antibodies, Monoclonal, [ SDV.MHEP.RSOA ] Life Sciences [q-bio]/Human health and pathology/Rhumatology and musculoskeletal system, MESH : Tomography, X-Ray Computed, Humans, MESH : Behcet Syndrome, ComputingMilieux_MISCELLANEOUS, MESH: Treatment Outcome, MESH: Humans, Behcet Syndrome, MESH : Humans, Antibodies, Monoclonal, MESH: Adult, MESH : Adult, MESH : Antirheumatic Agents, Infliximab, MESH: Male, Treatment Outcome, MESH : Spondylarthropathies, [SDV.MHEP.RSOA]Life Sciences [q-bio]/Human health and pathology/Rhumatology and musculoskeletal system, Antirheumatic Agents, MESH : Antibodies, Monoclonal, Spondylarthropathies, MESH: Behcet Syndrome, Tomography, X-Ray Computed, MESH: Tomography, X-Ray Computed, MESH: Spondylarthropathies
Abstract: National audience
Published: 2009
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74. The gap between practice and guidelines in the choice of first-line disease modifying antirheumatic drug in early rheumatoid arthritis: results from the ESPOIR cohort

Author: Thierry Schaeverbeke, Violaine Foltz, Philippe Ravaud, Carine Roy, Nathalie Rincheval, Jean Sibilia, Pierre Bourgeois, Sylvie Rozenberg, Mathilde Benhamou, Bruno Fautrel, Gillet, Catherine, Service de Rhumatologie [CHU Pitié Salpêtrière], CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Centre de coordination, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Hôpital Lapeyronie, Département d'épidémiologie, biostatistique et recherche clinique, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-AP-HP - Hôpital Bichat - Claude Bernard [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Physiopathologie des arthrites, Université Louis Pasteur - Strasbourg I, Service de rhumatologie, CHU Bordeaux [Bordeaux], An unrestricted grant from Merck Sharp and Dohme (MSD) was allocated for the first 5 years of ESPOIR cohort. Two additional grants from INSERM were obtained to support part of the biological database. The French Society of Rheumatology, Abbott, Amgen and Wyeth also supported the ESPOIR cohort study., Service de rhumatologie [CHU Pitié Salpêtrière] (GRC-08 EEMOIS), and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)
Subjects: Male, rheumatoid arthritis, MESH: Antirheumatic Agents, Time Factors, medicine.medical_treatment, Arthritis, Arthritis, Rheumatoid, 0302 clinical medicine, MESH: Practice Guidelines as Topic, MESH: Early Diagnosis, Immunology and Allergy, 030212 general & internal medicine, Prospective Studies, Disease management (health), Practice Patterns, Physicians', skin and connective tissue diseases, guideline adherence, MESH: Aged, MESH: Arthritis, Rheumatoid, MESH: Middle Aged, Uncertainty, Middle Aged, 3. Good health, earlyarthritis, MESH: Young Adult, Rheumatoid arthritis, Antirheumatic Agents, Cohort, Practice Guidelines as Topic, Female, France, clinical practice guideline, MESH: Uncertainty, Cohort study, Adult, musculoskeletal diseases, medicine.medical_specialty, first-line DMARD, Adolescent, Immunology, Article, 03 medical and health sciences, Young Adult, Rheumatology, Internal medicine, MESH: Rheumatology, medicine, Humans, Disease-modifying antirheumatic drug, Medical prescription, MESH: Physician's Practice Patterns, Aged, 030203 arthritis & rheumatology, MESH: Adolescent, MESH: Humans, business.industry, MESH: Time Factors, MESH: Adult, medicine.disease, MESH: Prospective Studies, MESH: Male, MESH: France, Early Diagnosis, disease management, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Physical therapy, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, business, MESH: Female
Abstract: Objective.To compare rheumatologists’ prescription for first disease modifying antirheumatic drug (DMARD) in early rheumatoid arthritis (RA) in real-life settings with 2 clinical practice guidelines (CPG), the French Society of Rheumatology/STPR 2004 and EULAR/ESCISIT 2007, and thus assess the gap between practices and guidelines.Method.ESPOIR was a French multicenter cohort study of 813 patients with early arthritis between 2002 and 2005. “Definite” and “probable” RA were defined according to ACR criteria and the level of diagnostic certainty. The objectives were to assess conformity between the observed first-line DMARD prescribed for those patients and the DMARD recommended in the guidelines; and to conduct a mail survey of patients’ usual rheumatologists to investigate the reasons for their nonconformity with guidelines.Results.In total 627 patients with definite or probable RA were identified. Conformity rates were 58% for STPR guidelines and 54% for EULAR guidelines. At 6 months, 83 (34%) patients with early RA did not receive any DMARD. Main determinants associated with conformity to guidelines were disease activity and presence of severity-predictive factors. The main reason leading to a discrepancy between guidelines and daily practice appeared to be diagnostic uncertainty, i.e., the difficulty to reliably assess RA diagnosis as early as the first visits to the rheumatologist.Conclusion.There is a substantial gap between CPG and rheumatologists’ daily practice concerning the first DMARD to prescribe in early RA. This is explained mainly by diagnostic uncertainty. More attention should be paid in future guidelines to the diagnostic difficulties of early RA.
Published: 2009
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75. Factors determining a DMARD initiation in early inflammatory arthritis patients. The ESPOIR cohort study

Author: C, Lukas, F, Guillemin, R, Landewé, D, van der Heijde, I, Logeart, B, Fautrel, J P, Daures, B, Combe, Nathalie, Rincheval, Immunologie et Pathologie (EA2216), Université de Brest (UBO)-IFR148, Centre d'Investigation Clinique (CIC - Brest), Université de Brest (UBO)-Institut National de la Santé et de la Recherche Médicale (INSERM), CHRU Brest - Service de Rhumatologie (CHU - BREST - Rhumato), Centre Hospitalier Régional Universitaire de Brest (CHRU Brest), and Calvez, Ghislaine
Subjects: Adult, Male, musculoskeletal diseases, MESH: Antirheumatic Agents, [SDV]Life Sciences [q-bio], MESH: Drug Administration Schedule, Severity of Illness Index, Drug Administration Schedule, Arthritis, Rheumatoid, MESH: Proportional Hazards Models, MESH: Severity of Illness Index, Humans, Prospective Studies, Practice Patterns, Physicians', MESH: Physician's Practice Patterns, Proportional Hazards Models, MESH: Arthritis, Rheumatoid, MESH: Humans, MESH: Middle Aged, MESH: Adult, Middle Aged, MESH: Prospective Studies, MESH: Male, [SDV] Life Sciences [q-bio], MESH: France, Antirheumatic Agents, Female, France, MESH: Female
Abstract: International audience; BACKGROUND: To describe the rate and timing of DMARD start in patients with early inflammatory arthritis in France, and to determine the factors leading to this treatment start. METHODS: The ESPOIR cohort study collects data on patients presenting with early arthritis. Baseline characteristics were assessed, and Cox regression analysis was performed to estimate the likelihood of starting DMARD treatment over time, adjusting for patient-, disease- and physician characteristics. RESULTS: Of the 775 analysed patients, 598 (77.2%) received at least 1 DMARD during the follow-up period, after a median time of 4.0 months. In general, a higher tender joint count, involvement of the hands, involvement of more than 3 joint groups, presence of abnormal CRP-levels or CCP-antibodies significantly increased the likelihood of being treated (p
Published: 2009

76. Infliximab concentration monitoring improves the control of disease activity in rheumatoid arthritis

Author: Charlotte Magdelaine-Beuzelin, Jean-Camille Méric, Gilles Paintaud, Jean-Pierre Valat, Denis Mulleman, Emilie Ducourau, Philippe Goupille, Cambefort, Jeanne, Génétique, immunothérapie, chimie et cancer (GICC), UMR 6239 CNRS [2008-2011] (GICC UMR 6239 CNRS), Université de Tours-Centre National de la Recherche Scientifique (CNRS), and Université de Tours (UT)-Centre National de la Recherche Scientifique (CNRS)
Subjects: Male, MESH: Antirheumatic Agents, Arthritis, 030226 pharmacology & pharmacy, Gastroenterology, MESH: Antibodies, Monoclonal, Arthritis, Rheumatoid, 0302 clinical medicine, immune system diseases, MESH: Drug Monitoring, Immunology and Allergy, skin and connective tissue diseases, ComputingMilieux_MISCELLANEOUS, MESH: Aged, MESH: Arthritis, Rheumatoid, MESH: Middle Aged, medicine.diagnostic_test, Antibodies, Monoclonal, Middle Aged, 3. Good health, [SDV.MHEP.RSOA]Life Sciences [q-bio]/Human health and pathology/Rhumatology and musculoskeletal system, Antirheumatic Agents, Rheumatoid arthritis, [SDV.SP.PHARMA] Life Sciences [q-bio]/Pharmaceutical sciences/Pharmacology, Female, Drug Monitoring, medicine.drug, Adult, musculoskeletal diseases, medicine.medical_specialty, Immunology, MESH: Drug Administration Schedule, Drug Administration Schedule, 03 medical and health sciences, Rheumatology, Internal medicine, medicine, Humans, Trough Concentration, Aged, 030203 arthritis & rheumatology, MESH: Humans, business.industry, MESH: Adult, medicine.disease, Infliximab, MESH: Male, Clinical trial, stomatognathic diseases, Therapeutic drug monitoring, [SDV.SP.PHARMA]Life Sciences [q-bio]/Pharmaceutical sciences/Pharmacology, Observational study, business, MESH: Female, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract: International audience; INTRODUCTION: Adjustment of infliximab dosage for individuals may be useful in improving therapeutic response in rheumatoid arthritis (RA). Herein, we aimed to determine whether measurement of infliximab serum concentration modifies the therapeutic decision and improves the control of disease activity. METHODS: RA patients routinely treated with infliximab were included in an observational open-label study. On visit 1 (V1), according to the disease activity, a preliminary therapeutic decision was selected among four therapeutic options and a blood sample was collected to measure trough serum infliximab concentration. The final therapeutic decision, based on both disease activity and serum infliximab concentration assessed at V1, was applied at the following infusion (V2). Clinical and biological evaluations were performed at V3 and V4 and compared with those at V1. RESULTS: We included 24 patients. The final therapeutic decision differed from the preliminary decision for 12 patients (50%). For patients with increased infliximab dosage at V2, mean disease activity score for 28 joints (DAS28) decreased by about 20% at V3 or V4 as compared with V1 (P < 0.05). Decreased DAS28 was correlated with increased serum infliximab concentration (P < 0.02). CONCLUSIONS: The measurement of infliximab trough concentration modifies the therapeutic decision for RA patients and helps improve control of disease activity. Therapeutic drug monitoring of infliximab in RA may be useful for individual dosage adjustment.
Published: 2009
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77. [Should we be afraid of the anti-TNFalpha drugs in 2008?]

Author: Gaudin, P., GREPI, Techniques de l'Ingénierie Médicale et de la Complexité - Informatique, Mathématiques et Applications, Grenoble - UMR 5525 (TIMC-IMAG), and VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-Centre National de la Recherche Scientifique (CNRS)-Université Joseph Fourier - Grenoble 1 (UJF)-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-Centre National de la Recherche Scientifique (CNRS)-Université Joseph Fourier - Grenoble 1 (UJF)
Subjects: MESH: Immunoglobulin G, MESH: Antirheumatic Agents, MESH: Arthritis, Rheumatoid, MESH: Humans, MESH: Time Factors, MESH: Cardiovascular Diseases, MESH: Receptors, Tumor Necrosis Factor, MESH: Male, MESH: Antibodies, Monoclonal, MESH: Randomized Controlled Trials as Topic, MESH: Pregnancy, [SDV.MHEP.RSOA]Life Sciences [q-bio]/Human health and pathology/Rhumatology and musculoskeletal system, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, MESH: Risk Factors, MESH: Tumor Necrosis Factor-alpha, MESH: Bone Density, MESH: Female, ComputingMilieux_MISCELLANEOUS
Abstract: International audience
Published: 2008
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78. Are inflammation and ossification on separate tracks in ankylosing spondylitis?

Author: Pascal Claudepierre, Daniel Wendling, Service de rhumatologie [CHU Henri Mondor], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor, Agents pathogènes et inflammation - UFC (EA 4266) (API), Université de Franche-Comté (UFC), and Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC)
Subjects: MESH: Inflammation, Pathology, medicine.medical_specialty, MESH: Antirheumatic Agents, Tnf alpha antagonists, Guinea Pigs, Inflammation, Receptors, Tumor Necrosis Factor, Etanercept, MESH: Guinea Pigs, Mice, 03 medical and health sciences, MESH: Ossification, Heterotopic, 0302 clinical medicine, Rheumatology, Animals, Humans, Medicine, Spondylitis, Ankylosing, MESH: Animals, 030212 general & internal medicine, MESH: Mice, ComputingMilieux_MISCELLANEOUS, 030203 arthritis & rheumatology, MESH: Immunoglobulin G, Ankylosing spondylitis, MESH: Humans, Tumor Necrosis Factor-alpha, business.industry, Ossification, Ossification, Heterotopic, Disease progression, medicine.disease, MESH: Spondylitis, Ankylosing, MESH: Receptors, Tumor Necrosis Factor, Pathophysiology, Disease Models, Animal, [SDV.MHEP.RSOA]Life Sciences [q-bio]/Human health and pathology/Rhumatology and musculoskeletal system, Antirheumatic Agents, Immunoglobulin G, MESH: Tumor Necrosis Factor-alpha, medicine.symptom, MESH: Disease Models, Animal, business
Abstract: International audience
Published: 2008
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79. Efficacy of anakinra in a patient with refractory relapsing polychondritis

Author: Sophie Govindaraju, Daniel Wendling, Clément Prati, Eric Toussirot, Ewa Bertolini, Agents pathogènes et inflammation - UFC (EA 4266) (API), Université de Franche-Comté (UFC), and Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC)
Subjects: MESH: Polychondritis, Relapsing, medicine.medical_specialty, MESH: Antirheumatic Agents, MESH: Remission Induction, Drug resistance, Gastroenterology, 030207 dermatology & venereal diseases, 03 medical and health sciences, Remission induction, 0302 clinical medicine, Rheumatology, Refractory, Internal medicine, MESH: C-Reactive Protein, medicine, MESH: Blood Sedimentation, Relapsing polychondritis, ComputingMilieux_MISCELLANEOUS, 030203 arthritis & rheumatology, Anakinra, MESH: Humans, biology, business.industry, C-reactive protein, MESH: Adult, medicine.disease, Antirheumatic Agents, MESH: Interleukin 1 Receptor Antagonist Protein, [SDV.MHEP.RSOA]Life Sciences [q-bio]/Human health and pathology/Rhumatology and musculoskeletal system, biology.protein, MESH: Drug Resistance, Interleukin 1 Receptor Antagonist Protein, business, MESH: Female, medicine.drug
Abstract: International audience
Published: 2008
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80. Lack of short-term efficacy of rituximab upon symptoms of ankylosing spondylitis treated for an associated vasculitis

Author: Gérald Streit, Sandra Mathieu, Daniel Wendling, Eric Toussirot, B. Auge, Agents pathogènes et inflammation - UFC (EA 4266) (API), Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), Centre de biologie du développement (CBD), Centre National de la Recherche Scientifique (CNRS)-Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Centre de Biologie Intégrative (CBI), Université Toulouse III - Paul Sabatier (UT3), and Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Centre National de la Recherche Scientifique (CNRS)-Centre National de la Recherche Scientifique (CNRS)
Subjects: medicine.medical_specialty, MESH: Antirheumatic Agents, 030204 cardiovascular system & hematology, MESH: Antibodies, Monoclonal, 03 medical and health sciences, 0302 clinical medicine, Rheumatology, medicine, ComputingMilieux_MISCELLANEOUS, MESH: Treatment Outcome, 030203 arthritis & rheumatology, Ankylosing spondylitis, MESH: Humans, business.industry, MESH: Vasculitis, MESH: Time Factors, MESH: Adult, medicine.disease, MESH: Spondylitis, Ankylosing, Dermatology, 3. Good health, Term (time), [SDV.MHEP.RSOA]Life Sciences [q-bio]/Human health and pathology/Rhumatology and musculoskeletal system, Rituximab, Vasculitis, business, MESH: Female, medicine.drug
Abstract: International audience
Published: 2008
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81. Rituximab (MabThera) therapy and safety management. Clinical tool guide

Author: Pham, Thao, Fautrel, Bruno, Gottenberg, Jacques-Eric, Goupille, Philippe, Hachulla, Eric, Masson, Charles, Morel, Jacques, Mouthon, Luc, Saraux, Alain, Schaeverbeke, Thierry, Wendling, Daniel, Mariette, Xavier, Sibilia, Renseigné, Non, Service de Rhumatologie [Hôpital de la Conception - APHM], Assistance Publique - Hôpitaux de Marseille (APHM)-Hôpital de la Conception [CHU - APHM] (LA CONCEPTION), Service de rhumatologie [CHU Pitié Salpêtrière] (GRC-08 EEMOIS), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Service de rhumatologie [Strasbourg], CHU Strasbourg-Hôpital de Hautepierre [Strasbourg], Service de rhumatologie, Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Médecine Interne, Hôpital Claude Huriez [Lille], CHU Lille-CHU Lille, Service de médecine interne et centre de référence des maladies rares [CHU Cochin], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), CHU Bordeaux [Bordeaux], Agents pathogènes et inflammation - UFC (EA 4266) (API), Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), Université Paris-Sud - Paris 11 (UP11)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Bicêtre, Hôpital Bicêtre-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris-Sud - Paris 11 (UP11), Assistance Publique - Hôpitaux de Marseille ( APHM ) -Hôpital de la Conception [CHU - APHM] ( LA CONCEPTION ), Service de Rhumatologie [CHU Pitié-Salpêtrière], Assistance publique - Hôpitaux de Paris (AP-HP)-CHU Pitié-Salpêtrière [APHP], CHRU Tours, Hôpital Claude Huriez, Assistance publique - Hôpitaux de Paris (AP-HP)-CHU Cochin [AP-HP], Agents pathogènes et inflammation - UFC (EA 4266) ( API ), Université de Franche-Comté ( UFC ), Université Paris-Sud - Paris 11 ( UP11 ) -Assistance publique - Hôpitaux de Paris (AP-HP)-Hôpital Bicêtre, Service de Rhumatologie [CHU Pitié Salpêtrière], CHU Pitié-Salpêtrière [AP-HP], and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)
Subjects: Vasculitis, Safety Management, MESH: Antirheumatic Agents, Drug-Related Side Effects and Adverse Reactions, MESH : Safety Management, MESH: Professional Practice, MESH : Dose-Response Relationship, Drug, MESH: Drug Toxicity, MESH: Antibodies, Monoclonal, MESH: Dose-Response Relationship, Drug, [ SDV.MHEP.RSOA ] Life Sciences [q-bio]/Human health and pathology/Rhumatology and musculoskeletal system, Arthritis, Rheumatoid, Antibodies, Monoclonal, Murine-Derived, MESH: Pregnancy, Rheumatology, Pregnancy, MESH: Rheumatology, MESH : Lupus Erythematosus, Systemic, Humans, Lupus Erythematosus, Systemic, MESH : Female, MESH: Lupus Erythematosus, Systemic, MESH : Rheumatology, ComputingMilieux_MISCELLANEOUS, MESH: Arthritis, Rheumatoid, MESH: Humans, Dose-Response Relationship, Drug, MESH: Vasculitis, MESH : Humans, MESH : Drug Toxicity, Antibodies, Monoclonal, Professional Practice, MESH : Antirheumatic Agents, MESH : Vasculitis, MESH : Pregnancy, MESH : Professional Practice, MESH: Safety Management, [SDV.MHEP.RSOA]Life Sciences [q-bio]/Human health and pathology/Rhumatology and musculoskeletal system, MESH : Antibodies, Monoclonal, Antirheumatic Agents, MESH : Arthritis, Rheumatoid, Female, Rituximab, MESH: Female
Abstract: International audience
Published: 2008
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82. [Severe tularaemia mimicking glandular tuberculosis during adalimumab therapy]

Author: Konstantinou, M.-P., Abecassis-Cotta, S., Valeyrie-Allanore, L., Ortonne, N., Maurin, M., Roujeau, J.-C., Revuz, J., Bagot, M., Laboratoire Adaptation et pathogénie des micro-organismes [Grenoble] (LAPM), and Centre National de la Recherche Scientifique (CNRS)-Université Joseph Fourier - Grenoble 1 (UJF)
Subjects: Male, MESH: Antirheumatic Agents, MESH: Tularemia, MESH: Humans, MESH: Middle Aged, [SDV.BID.EVO]Life Sciences [q-bio]/Biodiversity/Populations and Evolution [q-bio.PE], Adalimumab, Antibodies, Monoclonal, Middle Aged, Tuberculosis, Lymph Node, Antibodies, Monoclonal, Humanized, MESH: Tuberculosis, Lymph Node, Severity of Illness Index, MESH: Male, MESH: Antibodies, Monoclonal, Diagnosis, Differential, MESH: Antibodies, Monoclonal, Humanized, MESH: Diagnosis, Differential, MESH: Severity of Illness Index, Antirheumatic Agents, Humans, Tularemia
Abstract: International audience; BACKGROUND: Tularaemia is an anthropozoonosis, transmitted by small mammals (hares) and arthropods (ticks, horseflies). The causative agent is Francisella tularensis, a facultatively intracellular Gram-negative bacillus. We report a case of tularaemia in its ulceroglandular form occurring during methotrexate and adalimumab treatment (Humira) for rheumatoid arthritis. PATIENTS AND METHODS: A 58-year-old man with a history of primary tuberculosis receiving adalimumab in combination with methotrexate for rheumatoid arthritis for almost 1 year consulted for a febrile inflammatory plaque on the left leg with a small central necrotic area. An enlarged left inguinal lymph node was present. Doxycycline has previously been prescribed for a tick bite. The lymphadenopathy gradually became enlarged resulting in skin fistulisation. After surgical excision, histopathology revealed epithelioid granulomas accompanied by giant cells and central necrosis. Mycobacterial cultures were negative. Positive tularaemia serology at significant titres suggested a diagnosis of tularaemia, with probable transmission via a tick bite. The diagnosis was confirmed by F. tularensis DNA amplification using PCR on a lymph node biopsy. Doxycycline was continued for a further 6 weeks. One year later, no relapse had occurred. DISCUSSION: A febrile adenopathy presenting the histological features of necrotic granulomas in a patient receiving anti-TNF alpha treatment initially suggested reactivation of tuberculosis. However, the history of tick bite and failure to isolate mycobacteria from different tissue specimens prompted screening for a tick-borne disease, finally leading to a diagnosis of tularaemia. We discuss the possible relationship between immunosuppression and the clinical course of this rare infection.
Published: 2008
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83. Systemic nocardiosis in a case of rheumatoid arthritis treated with tumor necrosis factor blockers

Author: Wendling, Daniel, Murad, Muhsen, Mathieu, Sandra, Berger, Eric, Rumbach, Lucien, Agents pathogènes et inflammation - UFC (EA 4266) (API), Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), Laboratoire de Neuroimagerie in Vivo (LNV), CHU Strasbourg-Centre National de la Recherche Scientifique (CNRS), Agents pathogènes et inflammation - UFC (EA 4266) ( API ), Université de Franche-Comté ( UFC ), Centre de recherche d'histoire quantitative ( CRHQ ), Centre National de la Recherche Scientifique ( CNRS ) -Université de Caen Normandie ( UNICAEN ), Normandie Université ( NU ) -Normandie Université ( NU ), Laboratoire de Neuroimagerie in Vivo ( LNV ), CHU Strasbourg-Centre National de la Recherche Scientifique ( CNRS ), and Humbert, Murielle
Subjects: MESH: Antirheumatic Agents, MESH : Male, MESH: Central Nervous System Infections, MESH : Central Nervous System Infections, MESH: Antibodies, Monoclonal, MESH: Magnetic Resonance Imaging, [ SDV.MHEP.RSOA ] Life Sciences [q-bio]/Human health and pathology/Rhumatology and musculoskeletal system, MESH : Magnetic Resonance Imaging, MESH: Immunocompromised Host, MESH : Middle Aged, ComputingMilieux_MISCELLANEOUS, MESH : Tumor Necrosis Factor-alpha, [SDV.MHEP.RSOA] Life Sciences [q-bio]/Human health and pathology/Rhumatology and musculoskeletal system, MESH: Arthritis, Rheumatoid, MESH: Middle Aged, MESH: Humans, MESH : Drug Therapy, Combination, MESH : Humans, MESH : Immunocompromised Host, MESH : Antirheumatic Agents, MESH: Male, MESH: Drug Therapy, Combination, MESH: Methotrexate, [SDV.MHEP.RSOA]Life Sciences [q-bio]/Human health and pathology/Rhumatology and musculoskeletal system, MESH : Antibodies, Monoclonal, MESH : Methotrexate, MESH: Nocardia Infections, MESH: Tumor Necrosis Factor-alpha, MESH : Arthritis, Rheumatoid, MESH : Nocardia Infections
Abstract: International audience
Published: 2008

84. Long-term effects of infliximab on bone and cartilage turnover markers in patients with rheumatoid arthritis

Author: Patrick Garnero, Charles Zarnitsky, F Debiais, D. Wendling, A Daragon, C. Roux, Philippe Ravaud, Florence Chopin, J Sany, A. Le Henanff, Thierry Thomas, Institut Pierre-Simon-Laplace (IPSL), École normale supérieure - Paris (ENS Paris), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Université Pierre et Marie Curie - Paris 6 (UPMC)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Institut national des sciences de l'Univers (INSU - CNRS)-École polytechnique (X)-Centre National d'Études Spatiales [Toulouse] (CNES)-Centre National de la Recherche Scientifique (CNRS), Institut de biologie et chimie des protéines [Lyon] (IBCP), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Centre National de la Recherche Scientifique (CNRS), Service de rhumatologie [CHU Rouen], CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU), Laboratoire de Chimie de la Matière Condensée de Paris (site Paris VI) (LCMCP (site Paris VI)), Université Pierre et Marie Curie - Paris 6 (UPMC)-Collège de France (CdF (institution))-Ecole Nationale Supérieure de Chimie de Paris - Chimie ParisTech-PSL (ENSCP), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Institut de Chimie du CNRS (INC)-Centre National de la Recherche Scientifique (CNRS), Service de Rhumatologie, Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), Agents pathogènes et inflammation - UFC (EA 4266) (API), Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), and École normale supérieure - Paris (ENS-PSL)
Subjects: Cartilage, Articular, Pathology, MESH: Antirheumatic Agents, MESH: Bone Resorption, Arthritis, Gastroenterology, Severity of Illness Index, Bone remodeling, MESH: Antibodies, Monoclonal, Arthritis, Rheumatoid, MESH: Lumbar Vertebrae, 0302 clinical medicine, Absorptiometry, Photon, Bone Density, Immunology and Allergy, Medicine, Prospective Studies, MESH: Bone Density, Bone mineral, MESH: Aged, 0303 health sciences, MESH: Arthritis, Rheumatoid, Lumbar Vertebrae, MESH: Middle Aged, Antibodies, Monoclonal, Middle Aged, 3. Good health, [SDV.MHEP.RSOA]Life Sciences [q-bio]/Human health and pathology/Rhumatology and musculoskeletal system, Rheumatoid arthritis, Antirheumatic Agents, Female, Hip Joint, Bone Remodeling, Type I collagen, medicine.drug, Adult, MESH: Hip Joint, medicine.medical_specialty, Immunology, MESH: Absorptiometry, Photon, General Biochemistry, Genetics and Molecular Biology, Bone resorption, 03 medical and health sciences, Rheumatology, N-terminal telopeptide, Internal medicine, MESH: Severity of Illness Index, MESH: Bone Remodeling, Humans, Bone Resorption, 030304 developmental biology, Aged, 030203 arthritis & rheumatology, MESH: Humans, business.industry, Tumor Necrosis Factor-alpha, MESH: Biological Markers, MESH: Adult, medicine.disease, Infliximab, MESH: Prospective Studies, MESH: Tumor Necrosis Factor-alpha, MESH: Cartilage, Articular, business, MESH: Female, Biomarkers
Abstract: International audience; BACKGROUND: Rheumatoid arthritis (RA) is associated with systemic bone loss, subchondral bone erosion and cartilage degradation under the control of pro-inflammatory cytokines, including tumour necrosis factor alpha (TNFalpha). Therefore, we tested the hypothesis that administration of infliximab, an anti-TNFalpha drug in the treatment of RA, would modulate systemic and local bone resorption and reduce cartilage degradation. METHODS: We performed a prospective study of a multicentric cohort of 48 women, mean (SD) age 54.2 (12.1) years old, with severe RA for 11.4 (7.8) years, who started infliximab after failure of other disease-modifying antirheumatic drugs. At baseline and 6, 22 and 54 weeks after initiating Infliximab therapy we measured the following biochemical markers: pro-collagen serum type I N-terminal propeptide (PINP), a marker of bone formation; serum C-terminal cross-linked telopeptide of type I collagen (CTX-I), a marker of cathepsin K-mediated bone collagen degradation believed to reflect systemic bone resorption; serum C-terminal cross-linked telopeptide of type I collagen (ICTP), an index of matrix metalloprotease (MMP) mediated type I collagen degradation reflecting preferential joint metabolism; and urinary CTX-II a biochemical markers of cartilage degradation. Total hip and lumbar spine bone mineral density (BMD) was assessed at baseline, and after 6 and 12 months by dual-energy x-ray absorptiometry (DXA). No patient received bisphosphonates while 77% were under oral glucocorticoids. RESULTS: BMD remained stable over 1 year. Serum CTX-I levels rapidly decreased by 19% and 28% at week 6 and week 22, respectively (analysis of variance (ANOVA) p = 0.032) values returning to pre-treatment level at week 54. By contrast, ICTP levels progressively declined with a maximal 25% decrease at week 54 (ANOVA p = 0.028). By contrast, PINP levels remained stable over time, which led to a 30 to 40% improvement in bone remodelling balance, as assessed by the ratios PINP/CTX and PINP/ICTP (p
Published: 2008
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85. Sarcoidosis occuring during anti-TNF-alpha treatment for inflammatory rheumatic diseases: report of two cases

Author: Toussirot , E., Pertuiset , E., Kantelip , B., Wendling , D., Institut de biologie et chimie des protéines [Lyon] (IBCP), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Centre National de la Recherche Scientifique (CNRS), Agents pathogènes et inflammation - UFC (EA 4266) (API), Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), Carcinogénèse épithéliale : facteurs prédictifs et pronostiques - UFC (EA 3181) (CEF2P / CARCINO), Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon)-Université de Franche-Comté (UFC), Service de Rhumatologie, Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), Humbert, Murielle, Institut de biologie et chimie des protéines [Lyon] ( IBCP ), Université Claude Bernard Lyon 1 ( UCBL ), Université de Lyon-Université de Lyon-Centre National de la Recherche Scientifique ( CNRS ), Agents pathogènes et inflammation - UFC (EA 4266) ( API ), Université de Franche-Comté ( UFC ), Carcinogénèse épithéliale : facteurs prédictifs et pronostiques - UFC ( CEF2P / CARCINO ), Université Bourgogne Franche-Comté ( UBFC ) -Université de Franche-Comté ( UFC ) -Centre Hospitalier Régional Universitaire [Besançon] ( CHRU Besançon ), and Centre Hospitalier Régional Universitaire [Besançon] ( CHRU Besançon ) -Hôpital Jean Minjoz
Subjects: MESH: Sarcoidosis, MESH: Antirheumatic Agents, MESH : Immunoglobulin G, MESH: Granuloma, MESH : Male, MESH : Rheumatic Diseases, MESH : Sarcoidosis, MESH: Antibodies, Monoclonal, MESH: Rheumatic Diseases, [ SDV.MHEP.RSOA ] Life Sciences [q-bio]/Human health and pathology/Rhumatology and musculoskeletal system, MESH: Lung Diseases, MESH: Lymphatic Diseases, MESH : Middle Aged, MESH : Female, MESH : Tumor Necrosis Factor-alpha, MESH : Granuloma, MESH: Immunoglobulin G, [SDV.MHEP.RSOA] Life Sciences [q-bio]/Human health and pathology/Rhumatology and musculoskeletal system, MESH: Middle Aged, MESH: Humans, MESH : Lung Diseases, MESH : Lymphatic Diseases, MESH : Humans, MESH: Adult, MESH : Adult, MESH: Receptors, Tumor Necrosis Factor, MESH : Antirheumatic Agents, MESH : Receptors, Tumor Necrosis Factor, MESH: Male, [SDV.MHEP.RSOA]Life Sciences [q-bio]/Human health and pathology/Rhumatology and musculoskeletal system, MESH : Antibodies, Monoclonal, MESH: Tumor Necrosis Factor-alpha, MESH: Female
Abstract: International audience; Anti-TNF-alpha agents have been tried in cases of refractory sarcoidosis, giving favourable results. Thus, the occurrence of a granulomatous disease in a patient receiving such drug seems paradoxical. We describe 2 patients with inflammatory rheumatic disease, the first with ankylosing spondylitis, the second with rheumatoid arthritis, under anti-TNF-alpha treatment (infliximab and etanercept respectively) who developed non-caseating granulomas of the lungs and lymph nodes consistent with the diagnosis of sarcoidosis. Limited and various similar cases have been reported. It is generally considered that these granulomatous diseases are related to the anti-TNF-alpha agent.
Published: 2008

86. Bone and matrix remodeling markers: a new tool for assessment of treatment efficacy in ankylosing spondylitis?

Author: Wendling, Daniel, Toussirot, Eric, Agents pathogènes et inflammation - UFC (EA 4266) (API), Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), and Humbert, Murielle
Subjects: MESH: Immunoglobulin G, [SDV.MHEP.RSOA] Life Sciences [q-bio]/Human health and pathology/Rhumatology and musculoskeletal system, MESH: Antirheumatic Agents, MESH: Bone Morphogenetic Protein 7, MESH: Humans, MESH: Macrophage Colony-Stimulating Factor, MESH: Bone Morphogenetic Proteins, MESH: Biological Markers, MESH: Osteoprotegerin, MESH: Bone Matrix, MESH: Receptors, Tumor Necrosis Factor, MESH: Spondylitis, Ankylosing, MESH: Matrix Metalloproteinase 3, [SDV.MHEP.RSOA]Life Sciences [q-bio]/Human health and pathology/Rhumatology and musculoskeletal system, MESH: Bone Remodeling, ComputingMilieux_MISCELLANEOUS, MESH: Transforming Growth Factor beta, MESH: Treatment Outcome
Abstract: International audience
Published: 2007

87. Continuation of treatment with infliximab in ankylosing spondylitis: 2-yr open follow-up

Author: P. Claudepierre, C. Alexandre, Maxime Breban, A. Le Henanff, Eric Lespessailles, Eric Vignon, Aleth Perdriger, Maxime Dougados, Daniel Wendling, Valérie Devauchelle, J. Sibilia, Liana Euller-Ziegler, Laure Gossec, inconnu, Inconnu, Service de Rhumatologie, Centre Hospitalier Régional Universitaire [Besançon] (CHRU Besançon) - Hôpital Jean Minjoz, Agents pathogènes et inflammation - UFC (EA 4266) (API), Université de Franche-Comté (UFC), Service de rhumatologie, CHU Nice - Hôpital l'Archet, Physiopathologie des arthrites, Université Louis Pasteur - Strasbourg I, Contraintes mécaniques et tissu osseux, Université Jean Monnet [Saint-Étienne] (UJM) - Institut National de la Santé et de la Recherche Médicale (INSERM), Service de rhumatologie [CHU Cochin], CHU Cochin [AP-HP] - Assistance publique - Hôpitaux de Paris (AP-HP), Centre Hospitalier Régional Universitaire [Besançon] (CHRU Besançon)-Hôpital Jean Minjoz, Centre Hospitalier Universitaire de Nice (CHU Nice)-Hôpital l'Archet, Université Jean Monnet [Saint-Étienne] (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Cochin [AP-HP]-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP), Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Cochin [AP-HP], and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)
Subjects: Male, MESH: Antirheumatic Agents, MESH : Spondylitis, Ankylosing, MESH : Patient Dropouts, MESH: Antibodies, Monoclonal, 0302 clinical medicine, Infusion Procedure, Pharmacology (medical), MESH : Female, 030212 general & internal medicine, Infusions, Intravenous, MESH: Treatment Outcome, [SDV.MHEP.RSOA] Life Sciences [q-bio]/Human health and pathology/Rhumatology and musculoskeletal system, MESH: Middle Aged, Antibodies, Monoclonal, MESH : Infusions, Intravenous, MESH: Follow-Up Studies, Middle Aged, MESH : Adult, MESH: Spondylitis, Ankylosing, MESH : Antirheumatic Agents, 3. Good health, Treatment Outcome, [SDV.MHEP.RSOA]Life Sciences [q-bio]/Human health and pathology/Rhumatology and musculoskeletal system, Antirheumatic Agents, MESH : Antibodies, Monoclonal, Drug Therapy, Combination, Female, medicine.drug, Adult, medicine.medical_specialty, Tuberculosis, Patient Dropouts, MESH : Male, MESH : Drug Administration Schedule, MESH : Treatment Outcome, MESH: Drug Administration Schedule, Drug Administration Schedule, 03 medical and health sciences, MESH: Patient Dropouts, Rheumatology, Refractory, Internal medicine, medicine, Humans, Spondylitis, Ankylosing, MESH : Middle Aged, Adverse effect, MESH: Infusions, Intravenous, 030203 arthritis & rheumatology, Ankylosing spondylitis, MESH: Humans, business.industry, MESH : Drug Therapy, Combination, MESH : Humans, MESH: Adult, MESH : Follow-Up Studies, medicine.disease, Infliximab, MESH: Male, Surgery, MESH: Drug Therapy, Combination, Observational study, business, MESH: Female, Follow-Up Studies
Abstract: International audience; OBJECTIVE: To evaluate the continuation and safety of treatment with infliximab in ankylosing spondylitis (AS) over a 2-yr period. METHODS: This study was an open, observational, 2-yr extension study of an open-label study of three induction infusions of infliximab in refractory AS. The fourth infusion was performed only in case of relapse. Thereafter, infliximab was to be administered as needed according to the rheumatologist's opinion; however, for some patients, infusions were performed systematically. RESULTS: None of the 50 recruited patients was lost to follow-up. Thirteen patients (26%) interrupted their treatment by infliximab: four for inefficacy, seven for adverse events, of which four were for allergic reactions to the infusion, and two for other reasons. For all of the 46 patients who had had three infusions judged efficacious and well tolerated, a fourth infusion was performed because of a flare of the disease, after a mean interval of 20.3+/-9.9 weeks (range 7.3-57.9). Over the 24 months, the mean interval between infusions was 11.6+/-9.0 weeks. This interval was longer when patients were treated only as needed (mean 14.3+/-12.1 weeks) than systematically (mean 9.8+/-5.7 weeks). Side-effects were similar to those noted in shorter-term studies; seven patients suffered serious adverse events. There were no deaths, no malignancies and no tuberculosis. CONCLUSION: This study confirms the long-term treatment continuation of infliximab in AS, and shows an acceptable safety profile. It appears that for some patients the disease can be controlled with long intervals between infusions; these findings warrant further studies.
Published: 2006
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88. Clinical practice format for choosing a second-line disease modifying anti-rheumatic drug in early rheumatoid arthritis after failure of 6 months' first-line DMARD therapy

Author: Meyer, Olivier, De Bandt, Michel, Berthelot, Jean-Marie, Cantagrel, Alain, Combe, Bernard, Fautrel, Bruno, Flipo, René-Marc, Lioté, Frédéric, Maillefert, Jean-Francis, Saraux, Alain, Wendling, Daniel, Guillemin, Francis, Le Loët, Xavier, Renseigné, Non, Hôpital Bichat - Claude Bernard, Service de Rhumatologie, Hôtel-Dieu, Département de Rhumatologie[Montpellier], Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Hôpital Lapeyronie, Service de rhumatologie [CHU Pitié Salpêtrière] (GRC-08 EEMOIS), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Hôpital Claude Huriez [Lille], CHU Lille-CHU Lille-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Os et articulations, Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM), Agents pathogènes et inflammation - UFC (EA 4266) (API), Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), Centre d'investigation clinique - Epidémiologie clinique [Nancy] (CIC-EC), Centre d'investigation clinique [Nancy] (CIC), Université de Lorraine (UL)-Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL)-Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de rhumatologie [CHU Rouen], CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), and Normandie Université (NU)
Subjects: MESH: Antirheumatic Agents, MESH: Treatment Failure, Disease, Receptors, Tumor Necrosis Factor, Etanercept, Arthritis, Rheumatoid, 0302 clinical medicine, MESH: Practice Guidelines as Topic, 030212 general & internal medicine, Treatment Failure, skin and connective tissue diseases, MESH: Immunoglobulin G, MESH: Arthritis, Rheumatoid, Anti rheumatic drugs, 3. Good health, Clinical Practice, MESH: Methotrexate, [SDV.MHEP.RSOA]Life Sciences [q-bio]/Human health and pathology/Rhumatology and musculoskeletal system, Rheumatoid arthritis, Antirheumatic Agents, Practice Guidelines as Topic, Drug Therapy, Combination, Leflunomide, musculoskeletal diseases, medicine.medical_specialty, MESH: Rheumatoid Factor, First line, MESH: Drug Administration Schedule, Drug Administration Schedule, Decision Support Techniques, 03 medical and health sciences, Rheumatology, Rheumatoid Factor, Dmard therapy, medicine, Rheumatoid factor, Humans, Intensive care medicine, 030203 arthritis & rheumatology, MESH: Humans, MESH: Sulfasalazine, business.industry, MESH: Biological Markers, MESH: Decision Support Techniques, Early rheumatoid arthritis, Isoxazoles, medicine.disease, MESH: Receptors, Tumor Necrosis Factor, Radiography, Sulfasalazine, MESH: Drug Therapy, Combination, Methotrexate, MESH: Isoxazoles, Immunoglobulin G, Physical therapy, business, Biomarkers
Abstract: International audience; BACKGROUND: The objective was to develop a clinical practice format for choosing a second-line disease-modifying anti-rheumatic drug (DMARD) after a 6-month course of a first-line DMARD in patients with early RA. METHODS: A panel of 34 experts selected treatment option from various scenarios using the Thurstone pairwise method. The experts had to choose between two proposed DMARDs without proposing other options. The scenarios were obtained using the three items: DAS28, rheumatoid factor status and radiographic structural damage. A sample of 240 among 480 scenarios for each expert was taken at random. Responses given by at least 20% of the experts were considered pertinent. RESULTS: Recommendations for choosing a second DMARD for early RA after failure of a 6-month course of a first-line DMARD were established according to 4 parameters: type of first-line DMARD, activity, RF status and radiographic joint damage. The results of this study suggest that in patients with early RA who fail a 6-month course of first-line DMARD therapy, the best options may be addition of corticosteroid when disease activity is moderate to high and switching to a biologic agent when further radiographic joint damage occurs, particularly in patients with positive tests for RF. CONCLUSION: Although our scenarios did not include step-up (add instead of substitute) strategies, except for corticosteroids, we feel that the format presented here can optimise the management of patients with early RA seen in clinical practice.
Published: 2006
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89. [Anti-TNF alpha in the treatment of psoriatic arthritis]

Author: Claudepierre , Pascal, Wendling , Daniel, Cohen , Jean-David, Service de rhumatologie [CHU Henri Mondor], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor, Agents pathogènes et inflammation - UFC (EA 4266) (API), Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), Humbert, Murielle, Assistance publique - Hôpitaux de Paris (AP-HP)-Hôpital Henri Mondor, Agents pathogènes et inflammation - UFC (EA 4266) ( API ), and Université de Franche-Comté ( UFC )
Subjects: MESH: Antirheumatic Agents, Time Factors, MESH : Randomized Controlled Trials as Topic, MESH: Risk Assessment, MESH : Multicenter Studies as Topic, Severity of Illness Index, Receptors, Tumor Necrosis Factor, MESH: Antibodies, Monoclonal, Etanercept, MESH: Arthritis, Psoriatic, Multicenter Studies as Topic, MESH : Risk Assessment, MESH : Algorithms, MESH: Treatment Outcome, Randomized Controlled Trials as Topic, MESH : Tumor Necrosis Factor-alpha, MESH: Immunoglobulin G, [SDV.MHEP.RSOA] Life Sciences [q-bio]/Human health and pathology/Rhumatology and musculoskeletal system, Antibodies, Monoclonal, MESH : Antirheumatic Agents, MESH : Dermatologic Agents, Treatment Outcome, [SDV.MHEP.RSOA]Life Sciences [q-bio]/Human health and pathology/Rhumatology and musculoskeletal system, MESH : Antibodies, Monoclonal, Antirheumatic Agents, MESH : Severity of Illness Index, Algorithms, MESH : Time Factors, MESH: Forecasting, MESH : Immunoglobulin G, MESH: Algorithms, MESH : Treatment Outcome, Antibodies, Monoclonal, Humanized, Risk Assessment, [ SDV.MHEP.RSOA ] Life Sciences [q-bio]/Human health and pathology/Rhumatology and musculoskeletal system, MESH: Severity of Illness Index, Humans, MESH : Forecasting, MESH : Arthritis, Psoriatic, MESH: Humans, Tumor Necrosis Factor-alpha, MESH : Humans, MESH: Time Factors, Arthritis, Psoriatic, Adalimumab, MESH: Receptors, Tumor Necrosis Factor, MESH : Receptors, Tumor Necrosis Factor, Infliximab, MESH: Dermatologic Agents, MESH: Randomized Controlled Trials as Topic, MESH: Tumor Necrosis Factor-alpha, Immunoglobulin G, MESH: Multicenter Studies as Topic, Dermatologic Agents, Forecasting
Abstract: National audience; Psoriatic arthritis is an inflammatory and possibly destructive form of arthritis. As in rheumatoid arthritis and ankylosing spondylitis, the use of biological therapy in psoriatic arthritis is a therapeutic revolution: both articular and cutaneous efficacy have been shown, and some improvement is visible on radiography. The benefit-risk ratio will improve when we learn to identify more accurately the patients likely to benefit from these treatments.
Published: 2006

90. ASAS/EULAR recommendations for the management of ankylosing spondylitis

Author: Zochling, J., Van Der Heijde, D., Burgos-Vargas, R., Collantes, E., Davis, J. C., Dijkmans, B., Dougados, M., Géher, P., Inman, R. D., Khan, M. A., Kvien, T. K., Leirisalo-Repo, M., Olivieri, I., Pavelka, K., Sieper, J., Stucki, G., Sturrock, R. D., Van Der Linden, S., Wendling, D., Böhm, H., Van Royen, B. J., Braun, J., Renseigné, Non, Service de rhumatologie [CHU Cochin], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Institut des Sciences de l'Evolution de Montpellier (UMR ISEM), Centre de Coopération Internationale en Recherche Agronomique pour le Développement (Cirad)-École pratique des hautes études (EPHE), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Université de Montpellier (UM)-Institut de recherche pour le développement [IRD] : UR226-Centre National de la Recherche Scientifique (CNRS), Service de Rhumatologie, Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), Agents pathogènes et inflammation - UFC (EA 4266) (API), Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), Institut für Wasserbau, Universität Stuttgart [Stuttgart], CHU Cochin [AP-HP] - Assistance publique - Hôpitaux de Paris (AP-HP), Institut des Sciences de l'Evolution de Montpellier (ISEM), Université de Montpellier (UM) - Institut de recherche pour le développement [IRD] : UR226 - Centre National de la Recherche Scientifique (CNRS), and Centre Hospitalier Régional Universitaire [Besançon] (CHRU Besançon) - Hôpital Jean Minjoz
Subjects: MESH: Antirheumatic Agents, Cost effectiveness, MESH : International Cooperation, Arthroplasty, Replacement, Hip, Cost-Benefit Analysis, International Cooperation, Delphi method, MESH : Spondylitis, Ankylosing, MESH : Arthroplasty, Replacement, Hip, Scientific evidence, 0302 clinical medicine, MESH : Exercise, MESH : Anti-Inflammatory Agents, Non-Steroidal, Immunology and Allergy, Medicine, MESH: Arthroplasty, Replacement, Hip, 030212 general & internal medicine, MESH: Treatment Outcome, MESH: Physical Therapy Modalities, MESH : Tumor Necrosis Factor-alpha, MESH : Evidence-Based Medicine, [SDV.MHEP.RSOA] Life Sciences [q-bio]/Human health and pathology/Rhumatology and musculoskeletal system, Evidence-Based Medicine, Anti-Inflammatory Agents, Non-Steroidal, MESH: Spondylitis, Ankylosing, MESH : Antirheumatic Agents, MESH: Anti-Inflammatory Agents, Non-Steroidal, 3. Good health, Extended Report, Treatment Outcome, [SDV.MHEP.RSOA]Life Sciences [q-bio]/Human health and pathology/Rhumatology and musculoskeletal system, Antirheumatic Agents, Number needed to treat, MESH : Cost-Benefit Analysis, Incremental cost-effectiveness ratio, medicine.medical_specialty, Evidence-based practice, Immunology, MEDLINE, MESH : Treatment Outcome, General Biochemistry, Genetics and Molecular Biology, 03 medical and health sciences, Rheumatology, Humans, Spondylitis, Ankylosing, Exercise, Physical Therapy Modalities, 030203 arthritis & rheumatology, MESH: Humans, Tumor Necrosis Factor-alpha, business.industry, MESH : Humans, Evidence-based medicine, MESH: International Cooperation, MESH : Physical Therapy Modalities, MESH: Exercise, MESH: Tumor Necrosis Factor-alpha, Physical therapy, business, MESH: Evidence-Based Medicine, MESH: Cost-Benefit Analysis
Abstract: International audience; OBJECTIVE: To develop evidence based recommendations for the management of ankylosing spondylitis (AS) as a combined effort of the 'ASsessment in AS' international working group and the European League Against Rheumatism. METHODS: Each of the 22 participants was asked to contribute up to 15 propositions describing key clinical aspects of AS management. A Delphi process was used to select 10 final propositions. A systematic literature search was then performed to obtain scientific evidence for each proposition. Outcome data for efficacy, adverse effects, and cost effectiveness were abstracted. The effect size, relative risk, number needed to treat, and incremental cost effectiveness ratio were calculated. On the basis of the search results, 10 major recommendations for the management of AS were constructed. The strength of recommendation was assessed based on the strength of the literature evidence, risk-benefit trade-off, and clinical expertise. RESULTS: The final recommendations considered the use of non-steroidal anti-inflammatory drugs (NSAIDs) (conventional NSAIDs, coxibs, and co-prescription of gastroprotective agents), disease modifying antirheumatic drugs, treatments with biological agents, simple analgesics, local and systemic steroids, non-pharmacological treatment (including education, exercise, and physiotherapy), and surgical interventions. Three general recommendations were also included. Research evidence (categories I-IV) supported 11 interventions in the treatment of AS. Strength of recommendation varied, depending on the category of evidence and expert opinion. CONCLUSION: Ten key recommendations for the treatment of AS were developed and assessed using a combination of research based evidence and expert consensus. Regular updating will be carried out to keep abreast of new developments in the management of AS.
Published: 2006
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91. The shared epitope is a marker of severity associated with selection for, but not with response to, infliximab in a large rheumatoid arthritis population

Author: Marie-Angélique Cazalis, J.-L. Blond, Pierre Miossec, Jacques Tebib, Hubert Marotte, Bruno Mougin, Laurent Grange, Béatrice Pallot-Prades, Christian Alexandre, Philippe Gaudin, Service d'immunologie et rhumatologie, Hospices Civils de Lyon (HCL)-Hôpital Edouard Herriot [CHU - HCL], Hospices Civils de Lyon (HCL), Contraintes mécaniques et tissu osseux, Université Jean Monnet [Saint-Étienne] (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de Rhumatologie, Université Joseph Fourier - Grenoble 1 (UJF)-CHU Grenoble-Hôpital Michallon, Groupe de Recherche et d'Etude du Processus Inflammatoire (GREPI), VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes (UGA), Système macromoléculaires et mmunovirologie humaine, and IFR128-bioMérieux SA-Centre National de la Recherche Scientifique (CNRS)
Subjects: Male, MESH: Antirheumatic Agents, medicine.medical_treatment, MESH: Genetic Markers, Severity of Illness Index, MESH: Antibodies, Monoclonal, Arthritis, Rheumatoid, Epitopes, 0302 clinical medicine, Immunology and Allergy, Age of Onset, skin and connective tissue diseases, MESH: Treatment Outcome, MESH: Aged, education.field_of_study, MESH: Arthritis, Rheumatoid, MESH: Cytokines, MESH: Middle Aged, MESH: Genetic Predisposition to Disease, Antibodies, Monoclonal, Middle Aged, Prognosis, Connective tissue disease, 3. Good health, Extended Report, Treatment Outcome, Cytokine, [SDV.MHEP.RSOA]Life Sciences [q-bio]/Human health and pathology/Rhumatology and musculoskeletal system, Antirheumatic Agents, Rheumatoid arthritis, Cytokines, Female, medicine.drug, Adult, Genetic Markers, musculoskeletal diseases, medicine.medical_specialty, MESH: Epitopes, MESH: Age of Onset, Immunology, Population, General Biochemistry, Genetics and Molecular Biology, MESH: Prognosis, 03 medical and health sciences, Rheumatology, Internal medicine, MESH: Severity of Illness Index, MESH: Polymorphism, Genetic, Product Surveillance, Postmarketing, medicine, Humans, Genetic Predisposition to Disease, MESH: Patient Selection, MESH: Product Surveillance, Postmarketing, education, Aged, 030203 arthritis & rheumatology, Autoimmune disease, Polymorphism, Genetic, MESH: Humans, business.industry, Patient Selection, MESH: Adult, Odds ratio, medicine.disease, Infliximab, MESH: Male, business, MESH: Female, 030217 neurology & neurosurgery
Abstract: International audience; OBJECTIVE: To determine whether joint destruction, indication for, and response to infliximab in rheumatoid arthritis are associated with the shared epitope (SE) or selected cytokine gene polymorphisms (interleukin (IL) 1B, IL1-RN, and tumour necrosis alpha). METHODS: In a large rheumatoid arthritis population of 930 patients from the same area (Rhône-Alpes, France), patients with (n = 198) or without infliximab treatment (n = 732) were compared according to their genetic status. Clinical, biological, and radiological data were collected. Typing for SE status and cytokine polymorphisms was carried out using enzyme linked oligosorbent assay. Statistical analysis was by chi(2) testing and calculation of odds ratios (OR). RESULTS: A dose relation was observed between the number of SE copies and joint damage in the whole rheumatoid population (OR, 1 v 0 SE copy = 2.38 (95% confidence interval, 1.77 to 3.19), p
Published: 2006
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92. Cutaneous lymphocytic vasculitis during TNFalpha antagonist therapy for polyarthritis

Author: Alain Petitjean, Gérald Streit, Daniel Wendling, Eric Toussirot, Gaelle Lehuede, Agnès Aubin, Agents pathogènes et inflammation - UFC (EA 4266) (API), Université de Franche-Comté (UFC), and Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC)
Subjects: MESH: Antirheumatic Agents, Tnfα antagonist, MESH: Arthritis, Lymphocytic vasculitis, MESH: Antibodies, Monoclonal, 030207 dermatology & venereal diseases, 03 medical and health sciences, 0302 clinical medicine, Rheumatology, MESH: Vasculitis, Leukocytoclastic, Cutaneous, medicine, ComputingMilieux_MISCELLANEOUS, 030203 arthritis & rheumatology, MESH: Humans, business.industry, MESH: Adult, medicine.disease, 3. Good health, Tnf antagonists, MESH: Drug Therapy, Combination, MESH: Methotrexate, [SDV.MHEP.RSOA]Life Sciences [q-bio]/Human health and pathology/Rhumatology and musculoskeletal system, MESH: Tumor Necrosis Factor-alpha, Immunology, Polyarthritis, business, Vasculitis, MESH: Female, MESH: Prednisone
Abstract: International audience
Published: 2006
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93. Transient efficacy of pulse pamidronate treatment in active spondylarthropathies: an open study of 35 cases

Author: Toussirot, E., Le Huédé, G., Lohse, A., Cédoz, J.-P., Wendling, D., Institut de biologie et chimie des protéines [Lyon] (IBCP), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Centre National de la Recherche Scientifique (CNRS), Agents pathogènes et inflammation - UFC (EA 4266) (API), Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), Service de Rhumatologie, Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), and Humbert, Murielle
Subjects: [SDV.MHEP.RSOA] Life Sciences [q-bio]/Human health and pathology/Rhumatology and musculoskeletal system, MESH: Antirheumatic Agents, MESH: Humans, MESH: Diphosphonates, MESH: Adult, MESH: Spondylitis, Ankylosing, MESH: Male, MESH: Drug Therapy, Combination, [SDV.MHEP.RSOA]Life Sciences [q-bio]/Human health and pathology/Rhumatology and musculoskeletal system, MESH: Anti-Inflammatory Agents, MESH: Severity of Illness Index, MESH: Pulse Therapy, Drug, MESH: Female, ComputingMilieux_MISCELLANEOUS, MESH: Health Status, MESH: Treatment Outcome
Abstract: International audience
Published: 2006

94. Increase in methotrexate dose in patients with rheumatoid arthritis who have an inadequate response to infliximab

Author: Elisabeth Solau, Philippe Gaudin, J.-F. Maillefert, J.-M. Berthelot, Xavier Puéchal, Christian Tavernier, Paul Ornetti, Jean Sibilia, Service de Rhumatologie, Université Joseph Fourier - Grenoble 1 (UJF)-CHU Grenoble-Hôpital Michallon, Groupe de Recherche et d’Étude du Processus Inflammatoire (GREPI), Université Joseph Fourier - Grenoble 1 (UJF), Physiopathologie des arthrites, Université Louis Pasteur - Strasbourg I, Institut Supérieur des Mécaniques et Matériaux Avancés (ISMANS CESI), Service de Rhumatologie [CH Le Mans], Centre Hospitalier Le Mans (CH Le Mans), Thales Communications [Colombes], THALES, Groupe de Recherche et d'Etudes du Processus Inflammatoire (GREPI), Institut Supérieur des Matériaux du Mans (ISMANS), Le Mans Université (UM)-Institut Supérieur des Matériaux du Mans, and Service de Rhumatologie - CH Le Mans
Subjects: Male, MESH: Antirheumatic Agents, Letter, MESH: Treatment Failure, Gastroenterology, MESH: Antibodies, Monoclonal, Arthritis, Rheumatoid, chemistry.chemical_compound, 0302 clinical medicine, immune system diseases, Immunology and Allergy, Treatment Failure, 030212 general & internal medicine, skin and connective tissue diseases, ComputingMilieux_MISCELLANEOUS, MESH: Arthritis, Rheumatoid, MESH: Middle Aged, Antibodies, Monoclonal, Middle Aged, 3. Good health, Antirheumatic Agents, MESH: Methotrexate, [SDV.MHEP.RSOA]Life Sciences [q-bio]/Human health and pathology/Rhumatology and musculoskeletal system, Rheumatoid arthritis, Antifolate, Drug Therapy, Combination, Female, medicine.drug, Adult, musculoskeletal diseases, medicine.medical_specialty, medicine.drug_class, Immunology, MESH: Drug Administration Schedule, Antimetabolite, Drug Administration Schedule, General Biochemistry, Genetics and Molecular Biology, 03 medical and health sciences, Rheumatology, Internal medicine, medicine, Humans, 030203 arthritis & rheumatology, Autoimmune disease, MESH: Humans, Tumor Necrosis Factor-alpha, business.industry, MESH: Adult, medicine.disease, Infliximab, MESH: Male, Surgery, MESH: Drug Therapy, Combination, Methotrexate, chemistry, MESH: Tumor Necrosis Factor-alpha, business, MESH: Female
Abstract: The strategy needed for patients with inadequate response to treatment with infliximab and methotrexate (MTX) is not well defined. It has been suggested that an increase in the infliximab dosage, a shortening of the intervals between infusions, or a switch to another anti-tumour necrosis factor α agent might provide clinical benefit.1–4 Another, less expensive, strategy might be to increase the MTX weekly dose in patients not co-treated with MTX at the maximal dose. This study aimed at evaluating the efficacy of increasing the MTX dose in patients with rheumatoid arthritis (RA) with active disease despite treatment with infliximab and MTX. Data were obtained from six rheumatology departments that measure the 28 joint count Disease Activity Score (DAS28) before each infliximab infusion. All patients with RA with active disease (DAS28 ⩾3.2), despite treatment with a stable …
Published: 2005
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95. Antibodies toward infliximab are associated with low infliximab concentration at treatment initiation and poor infliximab maintenance in rheumatic diseases

Author: Philippe Goupille, Hervé Watier, F. Lauféron, David Ternant, Emilie Ducourau, D. Mulleman, Gilles Paintaud, Delphine Chu Miow Lin, Génétique, immunothérapie, chimie et cancer (GICC), UMR 6239 CNRS [2008-2011] (GICC UMR 6239 CNRS), Université de Tours (UT)-Centre National de la Recherche Scientifique (CNRS), and Université de Tours-Centre National de la Recherche Scientifique (CNRS)
Subjects: MESH: Antirheumatic Agents, Arthritis, 030226 pharmacology & pharmacy, Gastroenterology, MESH: Antibodies, Monoclonal, MESH: Dose-Response Relationship, Drug, Arthritis, Rheumatoid, 0302 clinical medicine, MESH: Drug Monitoring, immune system diseases, Immunology and Allergy, Young adult, Infusion reaction, skin and connective tissue diseases, MESH: Aged, MESH: Arthritis, Rheumatoid, MESH: Middle Aged, biology, Antibodies, Monoclonal, MESH: Follow-Up Studies, 3. Good health, [SDV.MHEP.RSOA]Life Sciences [q-bio]/Human health and pathology/Rhumatology and musculoskeletal system, MESH: Young Adult, Rheumatoid arthritis, Antibody, Research Article, medicine.drug, musculoskeletal diseases, medicine.medical_specialty, MESH: Spondylarthritis, Immunology, Antibodies, 03 medical and health sciences, Rheumatology, Internal medicine, Spondylarthritis, medicine, Humans, MESH: Kaplan-Meier Estimate, MESH: Adolescent, 030203 arthritis & rheumatology, MESH: Humans, business.industry, MESH: Antibodies, MESH: Adult, MESH: Retrospective Studies, Retrospective cohort study, medicine.disease, Infliximab, stomatognathic diseases, biology.protein, business
Abstract: International audience; INTRODUCTION: A proportion of patients receiving infliximab have antibodies toward infliximab (ATI), which are associated with increased risk of infusion reaction and reduced response to treatment. We studied the association of infliximab concentration at treatment initiation and development of ATI as well as the association of the presence of ATI and maintenance of infliximab. METHODS: All patients with rheumatoid arthritis (RA) or spondyloarthritis (SpA) receiving infliximab beginning in December 2005 were retrospectively followed until January 2009 or until infliximab discontinuation. Trough serum infliximab and ATI concentrations were measured at each visit. The patients were separated into two groups: ATI(pos) if ATI were detected at least once during the follow-up period and ATI(neg) otherwise. Repeated measures analysis of variance was used to study the association of infliximab concentration at treatment initiation and the development of ATI. Maintenance of infliximab in the two groups was studied by using Kaplan-Meier curves. RESULTS: We included 108 patients: 17 with RA and 91 with SpA. ATI were detected in 21 patients (19%). The median time to ATI detection after initiation of infliximab was 3.7 months (1.7 to 26.0 months). For both RA and SpA patients, trough infliximab concentration during the initiation period was significantly lower for ATI(pos) than ATI(neg) patients. RA patients showed maintenance of infliximab at a median of 19.5 months (5.0 to 31.0 months) and 12.0 months (2.0 to 24.0 months) for ATI(neg) and ATI(pos) groups, respectively (P = 0.08). SpA patients showed infliximab maintenance at a median of 16.0 months (3.0 to 34.0 months) and 9.5 months (3.0 to 39.0 months) for ATI(neg) and ATI(pos) groups, respectively (P = 0.20). Among SpA patients, those who were being treated concomitantly with methotrexate had a lower risk of developing ATI than patients not taking methotrexate (0 of 14 patients (0%) vs. 25 of 77 patients (32%); P = 0.03). CONCLUSIONS: High concentrations of infliximab during treatment initiation reduce the development of ATI, and the absence of ATI may be associated with prolonged maintenance of infliximab. Thus, trough serum infliximab concentration should be monitored early in patients with rheumatic diseases.
Published: 2011
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96. What Influences Patients' Opinion of Remission and Low Disease Activity in Psoriatic Arthritis? Principal Component Analysis of an International Study

Author: Laura C. Coates, Danielle E Robinson, Rossana Scrivo, Sandra Meisalu, Andra Balanescu, Laure Gossec, Adeline Ruyssen-Witrand, Ana Maria Orbai, Josef S Smolen, Ennio Lubrano, Lihi Eder, Maarten de Wit, Juan D. Cañete, Emmanuelle Dernis, Ying Ying Leung, Penelope Esther Palominos, Uta Kiltz, HAL-SU, Gestionnaire, University of Oxford, Johns Hopkins University (JHU), Herne und Ruhr-Universität Bochum, Singapore General Hospital, Universidade Federal do Rio Grande do Sul [Porto Alegre] (UFRGS), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona (UB), Università degli Studi di Roma 'La Sapienza' = Sapienza University [Rome] (UNIROMA), University of Medicine and Pharmacy 'Carol Davila' Bucharest (UMPCD), Centre Hospitalier Le Mans (CH Le Mans), Tallinn University, Epidémiologie et analyses en santé publique : risques, maladies chroniques et handicaps (LEASP), Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Santé et de la Recherche Médicale (INSERM), University of Toronto, Medizinische Universität Wien = Medical University of Vienna, Università degli Studi del Molise = University of Molise (UNIMOL), Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP), Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), Service de Rhumatologie [CHU Pitié Salpêtrière], CHU Pitié-Salpêtrière [AP-HP], and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)
Subjects: Male, treat-to-target, MESH: Remission Induction, MESH: Antirheumatic Agents, assessment, Disease, Logistic regression, 0302 clinical medicine, MESH: Arthritis, Psoriatic, Pharmacology (medical), 030212 general & internal medicine, psoriatic arthritis, MESH: Aged, Principal Component Analysis, [SDV.MHEP] Life Sciences [q-bio]/Human health and pathology, MESH: Middle Aged, Remission Induction, spondyloarthritis, Middle Aged, Explained variation, low disease activity, Antirheumatic Agents, Principal component analysis, Female, medicine.symptom, Adult, medicine.medical_specialty, Disease activity, 03 medical and health sciences, Psoriatic arthritis, outcome measures, remission, MESH: Cross-Sectional Studies, Rheumatology, Internal medicine, Psoriasis, medicine, Humans, Aged, 030203 arthritis & rheumatology, MESH: Principal Component Analysis, MESH: Humans, business.industry, Arthritis, Psoriatic, Enthesitis, MESH: Adult, medicine.disease, MESH: Male, Cross-Sectional Studies, business, disease activity, MESH: Female, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract: Objective In PsA, the treatment objective is remission or low disease activity (LDA), but patients’ perception of remission is poorly studied. This analysis aimed to identify factors associated with patient-defined remission. Methods This analysis uses ReFlaP data, an international PsA study, with remission defined as ‘At this time, is your psoriatic arthritis in remission, if this means: you feel your disease is as good as gone?’. Variables associated with, first, patient-defined remission and, second, LDA were identified using multivariable logistic regression and principal component analysis (PCA) to explore correlated variables. Results Of 424 patients (50.2% male, mean age 52 years) with established disease, 94 (22.2%) reported themselves as being in remission and 191 (45.0%) as LDA alone. In multivariable analysis pain, psoriasis, impact of disease, physician opinion of symptoms from joint damage and Groll comorbidity index were independent predictors of remission. For LDA, results were similar. Using PCA, variance explained was 74% by five components for men and 80% by six components for women. The key component from PCA for remission was, for both sex, disease impact (Psoriatic Arthritis Impact of Disease, pain and HAQ) explaining 22.2–27.5% of variance. Other factors included musculoskeletal disease activity, chronicity/joint damage, psoriasis, enthesitis and CRP. For LDA, similar factors were identified but the variance explained was lower (64–68%). Conclusion Many factors impact on patients’ opinion of remission, dominated by disease impact. Disease activity in multiple domains, chronicity/age, comorbidities and symptoms due to other conditions contribute to a robust model highlighting that patient-defined remission is multifaceted. Trials registration Clinicaltrials.gov, http://clinicaltrials.gov, NCT 03119805.
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97. Determining a low disease activity threshold for decision to maintain disease-modifying antirheumatic drug treatment unchanged in rheumatoid arthritis patients

Author: Frédéric Lioté, Daniel Wendling, Jean Marie Berthelot, Jean Francis Maillefert, Francis Guillemin, Michel De Bandt, Olivier Meyer, Xavier Le Loët, Alain Saraux, Bernard Combe, Bruno Fautrel, René-Marc Flipo, Service de Rhumatologie, Centre hospitalier d'Aulnay sous Bois, CHU Pitié-Salpêtrière [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Service de rhumatologie (hôpital général, CHU Dijon), Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Physiopathologie de la résorption osseuse et thérapie des tumeurs osseuses primitives, Université de Nantes (UN)-IFR26-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Hôpital Lapeyronie, Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Hôpital Lariboisière-Fernand-Widal [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Centre Viggo-Petersen, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-AP-HP - Hôpital Bichat - Claude Bernard [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Diderot - Paris 7 (UPD7), Centre Hospitalier Régional Universitaire de Brest (CHRU Brest)-Hôpital de la Cavale Blanche - CHRU Brest (CHU - BREST ), Agents pathogènes et inflammation - UFC (EA 4266) (API), Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), Service de rhumatologie [CHU Rouen], CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU), Physiopathologie et biothérapies des maladies inflammatoires et autoimmunes, Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre d'investigation clinique - Epidémiologie clinique [Nancy] (CIC-EC), Centre d'investigation clinique [Nancy] (CIC), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL)-Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL), Ecole de Santé Publique [Nancy], Faculté de Médecine [Nancy], Université de Lorraine (UL)-Université de Lorraine (UL), The research project was funded by an unrestricted grant from Sanofi-Aventis France., STPR group of the French Society of Rheumatology, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), and BMC, Ed.
Subjects: Male, MESH: Antirheumatic Agents, medicine.medical_treatment, Arthritis, Arthritis, Rheumatoid, 0302 clinical medicine, MESH: Practice Guidelines as Topic, immune system diseases, Immunology and Allergy, 030212 general & internal medicine, Practice Patterns, Physicians', skin and connective tissue diseases, media_common, [SDV.MHEP.RSOA] Life Sciences [q-bio]/Human health and pathology/Rhumatology and musculoskeletal system, MESH: Arthritis, Rheumatoid, 3. Good health, MESH: Reproducibility of Results, Antirheumatic Agents, [SDV.MHEP.RSOA]Life Sciences [q-bio]/Human health and pathology/Rhumatology and musculoskeletal system, Rheumatoid arthritis, Practice Guidelines as Topic, Female, Adult, Drug, musculoskeletal diseases, medicine.medical_specialty, media_common.quotation_subject, Immunology, Disease activity, 03 medical and health sciences, Rheumatology, MESH: Rheumatology, Internal medicine, Research article, medicine, Humans, Disease-modifying antirheumatic drug, MESH: Physician's Practice Patterns, 030203 arthritis & rheumatology, MESH: Humans, business.industry, Reproducibility of Results, MESH: Adult, medicine.disease, MESH: Male, Expert opinion, Physical therapy, business, MESH: Female
Abstract: International audience; INTRODUCTION: The aim of this study was to determine a low disease activity threshold--a 28-joint disease activity score (DAS28) value--for the decision to maintain unchanged disease-modifying antirheumatic drug (DMARD) treatment in rheumatoid arthritis patients, based on expert opinion. METHODS: Nine hundred and sixty-seven case scenarios with various levels for each component of the DAS28 (resulting in a disease activity score between 2 and 3.2) were presented to 44 panelists. For each scenario, panelists had to decide whether or not DMARD treatment (excluding steroids) could be maintained unchanged. In each scenario, for decision, the participants were given the DAS28 parameters, without knowledge of the resultant DAS28. The relationship between panelists' decision, DAS28 value, and components of the score were analysed by multiple logistic regression analysis. Each panelist analysed 160 randomised scenarios. Intra-rater and inter-rater reproducibility were assessed. RESULTS: Forty-four panelists participated in the study. Inter-panelist agreement was good (kappa = 0.63; 95% confidence interval = 0.61 to 0.65). Intra-panelist agreement was excellent (kappa = 0.87; 95% confidence interval = 0.82 to 0.92). Quasi-perfect agreement was observed for DAS28 < or = 2.4, less pronounced between 2.5 and 2.9, and almost no agreement for DAS28 > 3.0. For values below 2.5, panelists agreed to maintain unchanged DMARDs; for values above 2.5, discrepancies occurred more frequently as the DAS28 value increased. Multivariate analysis confirmed the relationship between panelist's decision, DAS28 value and components of the DAS28. Between DAS28 of 2.4 and 3.2, a major determinant for panelists' decision was swollen joint count. Female and public practice physicians decided more often to maintain treatment unchanged. CONCLUSIONS: As a conclusion, panelists suggested that in clinical practice there is no need to change DMARD treatment in rheumatoid arthritis patients with DAS28 < or = 2.4.
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