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1. The Fami-life study: protocol of a prospective observational multicenter mixed study of psychological consequences of grieving relatives in French palliative care units on behalf of the family research in palliative care (F.R.I.P.C research network)

Author

Maité Garrouste-Orgeas, Cécile Flahault, Edith Poulain, Adrien Evin, Frédéric Guirimand, Virginie Fossez-Diaz, Ségolène Perruchio, Catherine Verlaine, Anne Vanbésien, Willeme Kaczmarek, Laurence Birkui de Francqueville, Emmanuel De Larivière, Guillaume Bouquet, Laure Copel, Virginie Verliac, Véronique Marché, Carmen Mathias, Dominique Gracia, Alaa Mhalla, Véronique Michonneau-Gandon, Cécile Poupardin, Licia Touzet, Gaelle Ranchou, Virginie Guastella, Bruno Richard, Florent Bienfait, Marie Sonrier, Dominique Michel, Stéphane Ruckly, Sébastien Bailly, and Jean-François Timsit

Subjects
Palliative care, Stress disorders, Post-traumatic, Relatives, Anxiety, Grief, Special situations and conditions, RC952-1245
Abstract

Abstract Background Grieving relatives can suffer from numerous consequences like anxiety, depression, post-traumatic stress disorder (PTSD) symptoms, and prolonged grief. This study aims to assess the psychological consequences of grieving relatives after patients’ death in French palliative care units and their needs for support. Methods This is a prospective observational multicenter mixed study. Relatives of adult patients with a neoplasia expected to be hospitalized more than 72 h in a palliative care unit for end-of-life issues will be included within 48 h after patient admission. End-of-life issues are defined by the physician at patient admission. Relatives who are not able to have a phone call at 6-months are excluded. The primary outcome is the incidence of prolonged grief reaction defined by an ICG (Inventory Complicate Grief) > 25 (0 best-76 worst) at 6 months after patient’ death. Prespecified secondary outcomes are the risk factors of prolonged grief, anxiety and depression symptoms between day 3 and day 5 and at 6 months after patients’ death based on an Hospital Anxiety and Depression score (range 0–42) > 8 for each subscale (minimal clinically important difference: 2.5), post-traumatic stress disorder symptoms 6 months after patient’ death based on the Impact of Events Scale questionnaire (0 best-88 worst) score > 22, experience of relatives during palliative care based on the Fami-Life questionnaire, specifically built for the study. Between 6 and 12 months after the patient’s death, a phone interview with relatives with prolonged grief reactions will be planned by a psychologist to understand the complex system of grief. It will be analyzed with the Interpretative Phenomenological Analysis. We planned to enroll 500 patients and their close relatives assuming a 25% prolonged grief rate and a 6-month follow-up available in 60% of relatives. Discussion This study will be the first to report the psychological consequences of French relatives after a loss of a loved one in palliative care units. Evaluating relatives’ experiences can provide instrumental insights for means of improving support for relatives and evaluation of bereavement programs. Trial registration NCT03748225 registered on 11/19/2018. Recruiting patients.

Published
2019
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2. Incidence and risk factors of prolonged grief in relatives of patients with terminal cancer in French palliative care units: The Fami-Life multicenter cohort study

Author

Maité Garrouste-Orgeas, Véronique Marché, Nicolas Pujol, Dominique Michel, Adrien Evin, Virginie Fossez-Diaz, Ségolène Perruchio, Anne Vanbésien, Catherine Verlaine, Laure Copel, Willeme Kaczmarek, Laurence Birkui de Francqueville, Véronique Michonneau-Gandon, Emmanuel de Larivière, Cécile Poupardin, Licia Touzet, Virginie Guastella, Carmen Mathias, Alaa Mhalla, Guillaume Bouquet, Bruno Richard, Dominique Gracia, Florent Bienfait, Virginie Verliac, Gaelle Ranchou, Sylvie Kirsch, Cécile Flahault, Ambre Loiodice, Sébastien Bailly, Stéphane Ruckly, and Jean-François Timsit

Subjects
Psychiatry and Mental health, Clinical Psychology, General Medicine, General Nursing
Abstract

Objectives Psychological consequences of grief among relatives are insufficiently known. We reported incidence of prolonged grief among relatives of deceased patients with cancer. Methods Prospective cohort study of 611 relatives of 531 patients with cancer hospitalized for more than 72 hours and who died in 26 palliative care units was conducted. The primary outcome was prolonged grief in relatives 6 months after patient death, measured with the Inventory Complicated Grief (ICG > 25, range 0–76, a higher score indicates more severe symptoms) score. Secondary outcomes in relatives 6 months after patient death were anxiety and depression symptoms based on Hospital Anxiety and Depression Scale (HADS) score (range 0 [best]–42 [worst]), higher scores indicate more severe symptoms, minimally important difference 2.5. Post-traumatic stress disorder symptoms were defined by an Impact Event Scale-Revised score >22 (range 0–88, a higher score indicates more severe symptoms). Results Among 611 included relatives, 608 (99.5%) completed the trial. At 6 months, significant ICG scores were reported by 32.7% relatives (199/608, 95% CI, 29.0–36.4). The median (interquartile range ICG score) was 20.0 (11.5–29.0). The incidence of HADS symptoms was 87.5% (95% CI, 84.8–90.2%) at Days 3–5 and 68.7% (95% CI, 65.0–72.4) 6 months after patient’s death, with a median (interquartile range) difference of −4 (–10 to 0) between these 2 time points. Improvement in HADS anxiety and depression scores were reported by 62.5% (362/579) relatives. Significance of results These findings support the importance of screening relatives having risk factors of developing prolonged grief in the palliative unit and 6 months after patient’s death.

Published
2023

3. The Fami-life study: protocol of a prospective observational multicenter mixed study of psychological consequences of grieving relatives in French palliative care units on behalf of the family research in palliative care (F.R.I.P.C research network)

Author

Véronique Michonneau-Gandon, Laure Copel, Virginie Verliac, Dominique Gracia, Gaelle Ranchou, Willeme Kaczmarek, Emmanuel De Larivière, Maité Garrouste-Orgeas, Adrien Evin, Virginie Guastella, Catherine Verlaine, Frédéric Guirimand, Jean-François Timsit, Alaa Mhalla, Florent Bienfait, Licia Touzet, Guillaume Bouquet, Marie Sonrier, Laurence Birkui de Francqueville, Ségolène Perruchio, Cécile Flahault, Anne Vanbésien, Sébastien Bailly, Carmen Mathias, Virginie Fossez-Diaz, Edith Poulain, Stéphane Ruckly, Véronique Marché, Cécile Poupardin, Dominique Michel, Bruno Richard, Salvy-Córdoba, Nathalie, Epidémiologie pronostique des cancers et affections graves, Université Joseph Fourier - Grenoble 1 (UJF)-Institut National de la Santé et de la Recherche Médicale (INSERM), Laboratoire de Psychopathologie et Processus de Santé (LPPS - EA 4057), Université Paris Descartes - Paris 5 (UPD5), Centre hospitalier universitaire de Nantes (CHU Nantes), Centre de recherche Versailles Saint-Quentin Institutions Publiques (VIP), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), CH de Troyes, Centre Hospitalier [Douai, Nord], Centre Hospitalier de la Dracénie [Draguignan], Centre Hospitalier Compiègne-Noyon, Centre Hospitalier Tourcoing, Groupe Hospitalier Diaconesses Croix Saint-Simon, Groupe hospitalier de la région de Mulhouse Sud-Alsace (GHRMSA), Hopital de Salon d eProvence, AP-HP Hôpital A. Chenevier [Créteil], Centre Hospitalier Intercommunal Castres-Mazamet, Service d'Hépato-Gastroentérologie, Hôpital Louis Mourier - AP-HP [Colombes], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Groupe Hospitalier Intercommunal Le Raincy-Montfermeil, Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Hopital de Périgueux (CH Périgueux), Hopital de Périgueux, Centre de Soins Palliatifs [CHU Clermont-Ferrand] (CSP), CHU Louise Michel [Clermont-Ferrand], CHU Clermont-Ferrand-CHU Clermont-Ferrand, Informatique et Distribution (ID-IMAG), Institut National de Recherche en Informatique et en Automatique (Inria)-Institut National Polytechnique de Grenoble (INPG)-Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Centre Hospitalier Universitaire d'Angers (CHU Angers), PRES Université Nantes Angers Le Mans (UNAM), Institut de psychiatrie et neurosciences de Paris (IPNP - U1266 Inserm), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité), Infection, Anti-microbiens, Modélisation, Evolution (IAME (UMR_S_1137 / U1137)), Université Paris 13 (UP13)-Université Paris Diderot - Paris 7 (UPD7)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut d'oncologie/développement Albert Bonniot de Grenoble (INSERM U823), Université Joseph Fourier - Grenoble 1 (UJF)-CHU Grenoble-EFS-Institut National de la Santé et de la Recherche Médicale (INSERM), INSERM U823, équipe 11 (Epidémiologie des cancers et des affections graves), Université Joseph Fourier - Grenoble 1 (UJF)-CHU Grenoble-EFS-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Joseph Fourier - Grenoble 1 (UJF)-CHU Grenoble-EFS-Institut National de la Santé et de la Recherche Médicale (INSERM)-Clinique de réanimation médicale, Université Joseph Fourier - Grenoble 1 (UJF)-CHU Grenoble-Hôpital Michallon-Hôpital Michallon, CIC - CHU Bichat, Institut National de la Santé et de la Recherche Médicale (INSERM), and Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Paris (UP)

Subjects
medicine.medical_specialty, Palliative care, media_common.quotation_subject, lcsh:Special situations and conditions, [SDV.NEU.PC] Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC]/Psychology and behavior, [SDV.CAN]Life Sciences [q-bio]/Cancer, Anxiety, Study Protocol, 03 medical and health sciences, 0302 clinical medicine, Clinical Protocols, [SDV.CAN] Life Sciences [q-bio]/Cancer, Surveys and Questionnaires, Humans, Medicine, Family, Prospective Studies, 030212 general & internal medicine, Psychiatry, Depression (differential diagnoses), media_common, Interpretative phenomenological analysis, [SDV.NEU.PC]Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC]/Psychology and behavior, business.industry, Minimal clinically important difference, Incidence (epidemiology), lcsh:RC952-1245, Post-traumatic, General Medicine, Stress disorders, Relatives, 3. Good health, 030220 oncology & carcinogenesis, Grief, Observational study, France, medicine.symptom, business
Abstract

Background Grieving relatives can suffer from numerous consequences like anxiety, depression, post-traumatic stress disorder (PTSD) symptoms, and prolonged grief. This study aims to assess the psychological consequences of grieving relatives after patients’ death in French palliative care units and their needs for support. Methods This is a prospective observational multicenter mixed study. Relatives of adult patients with a neoplasia expected to be hospitalized more than 72 h in a palliative care unit for end-of-life issues will be included within 48 h after patient admission. End-of-life issues are defined by the physician at patient admission. Relatives who are not able to have a phone call at 6-months are excluded. The primary outcome is the incidence of prolonged grief reaction defined by an ICG (Inventory Complicate Grief) > 25 (0 best-76 worst) at 6 months after patient’ death. Prespecified secondary outcomes are the risk factors of prolonged grief, anxiety and depression symptoms between day 3 and day 5 and at 6 months after patients’ death based on an Hospital Anxiety and Depression score (range 0–42) > 8 for each subscale (minimal clinically important difference: 2.5), post-traumatic stress disorder symptoms 6 months after patient’ death based on the Impact of Events Scale questionnaire (0 best-88 worst) score > 22, experience of relatives during palliative care based on the Fami-Life questionnaire, specifically built for the study. Between 6 and 12 months after the patient’s death, a phone interview with relatives with prolonged grief reactions will be planned by a psychologist to understand the complex system of grief. It will be analyzed with the Interpretative Phenomenological Analysis. We planned to enroll 500 patients and their close relatives assuming a 25% prolonged grief rate and a 6-month follow-up available in 60% of relatives. Discussion This study will be the first to report the psychological consequences of French relatives after a loss of a loved one in palliative care units. Evaluating relatives’ experiences can provide instrumental insights for means of improving support for relatives and evaluation of bereavement programs. Trial registration NCT03748225 registered on 11/19/2018. Recruiting patients.

Published
2019

4. Impact of complementary and alternative medicine on the quality of life in inflammatory bowel disease

Author

Alain Olympie, Bruno Lesgourgues, A Buisson, Vered Abitbol, Stanislas Chaussade, Stéphane Nahon, Cécile Poupardin, and Pierre Lahmek

Subjects
Adult, Complementary Therapies, Male, medicine.medical_specialty, animal structures, Adolescent, Psychometrics, Naturopathy, MEDLINE, Gastroenterology, Medication Adherence, Young Adult, Patient satisfaction, Gastrointestinal Agents, Quality of life, Internal medicine, medicine, Humans, Young adult, Child, Aged, Gastrointestinal agent, Hepatology, business.industry, Odds ratio, Middle Aged, Inflammatory Bowel Diseases, medicine.disease, Ulcerative colitis, Treatment Outcome, Socioeconomic Factors, Patient Satisfaction, Health Care Surveys, Quality of Life, Female, France, business
Abstract

Background Complementary and alternative medicines (CAM) are widely used by patients with inflammatory bowel disease (IBD). Few data have been published on the impact of CAM on the quality of life (QOL). Aims The aim of the study was to describe CAM use in French patients with IBD, identify characteristics associated with CAM use, and assess the impact of CAM on the QOL. Methods We conducted an internet survey on CAM through the French IBD patient’s association website. Patients had to answer a questionnaire (LimeSurvey application) about sociodemography, IBD treatment, CAM type, socioeconomic data, and QOL using the Short IBD Questionnaire (SIBDQ). Patients noted the impact of CAM on their symptoms and on their QOL on a scale of 0–100. CAM users and nonusers were compared by univariate and multivariate analyses. Results A total of 936 IBD patients responded and 767 (82.4%) filled up the whole questionnaire: 503 reported CAM use and 172 had never used. The types of CAM reported were diet-based (30.7%), body-based (25.1%), homeopathic or traditional medicine (19.6%), naturopathy (15.2%), and mind–body medicine (9.1%). The gastroenterologist was aware of CAM use in only 46% of patients. CAM users were more likely to have ulcerative colitis [odds ratio (OR)=1.78, P=0.018], clinical remission (OR=1.42, P=0.06), high level of education (OR=1.51, P=0.02), poor observance (OR=1.81, P=0.017), or to have terminated conventional treatment (OR=2.03, P=0.003). CAM users tend to have higher rates of SIBDQ scores, greater than 50 (OR=1.57, P=0.06). Improvement in symptoms and QOL was reported with all CAM types except mind medicine. Conclusion CAM use is widespread among IBD patients. CAM users report improvement in symptoms and QOL, but they tend to stop their conventional treatment. Better information about CAM might improve adherence to conventional treatment.

Published
2014

5. High Risk of Anal and Rectal Cancer in Patients With Anal and/or Perianal Crohn’s Disease

Author

Laurent Beaugerie, Fabrice Carrat, Stéphane Nahon, Jean-David Zeitoun, Jean-Marc Sabaté, Laurent Peyrin-Biroulet, Jean-Frédéric Colombel, Matthieu Allez, Jean-François Fléjou, Julien Kirchgesner, Magali Svrcek, Jacques Cosnes, Jean-Pierre Gendre, Marc Lémann, Xavier Hébuterne, Antoine Cortot, Yoram Bouhnik, David Laharie, Jean Louis Dupas, Bernard Flourié, Eric Lerebours, Bernard Messing, Guillaume Cadiot, Philippe Marteau, Jean-Claude Soulé, Jean-Marc Gornet, Michel Veyrac, Bernard Duclos, Philippe Beau, Arnaud Bourreille, Philippe Baumer, Franck Carbonnel, Denis Heresbach, Etienne-Henry Metman, Christian Florent, Antoine Blain, Jean-Luc Faucheron, Bruno Bonaz, Xavier Roblin, Pascal Potier, Christian Boehm, Thierry Kurtz, Hervé Lamouliatte, Isabelle Nion-Larmurier, Jean-Charles Delchier, Stanislas Chaussade, Anne Marie Weiss, Jean Pierre Cézard, Laurent Siproudhis, Daniel Sondag, Raymond Jian, Jean-Christophe Souquet, Pierre Bord, Benoit Coffin, Hélène D’almagne, Patrick Delasalle, Régis Fournier, Maryan Cavicchi, Marc-Henry Souffran, Luc Vandromme, Claire Guedon, Philippe Seksik, Christophe Michiels, Pascal Renard, Patrice Rogier, Sylvie Gouilloud, André Rotenberg, Guillaume Savoye, Alain Thevenin, Laurent Mallet, Franck Brazier, Francois Jean, Anne-Marie Justum, Jean-Paul Latrive, Jean-Luc Gerbal, Robert Pierrugues, Gérard Chardonnal, Laurence Picon, Nicole Reix, Nicolas Drouët D’aubigny, Hervé Uettwiller, Anne Courillon Mallet, Alain Palacci, Raoul-Jacques Bensaude, Pierre Bonniaud, Olivier Empinet, Andrée Nisard, Alain Rudelli, Bernard Tubiana, Philippe Capelle, Alain Dabadie, Daniel Evard, Pierre-Emile Julien, Magali Picon-Coste, Stéphane Schneider, Denis Goldfain, Jérôme Bellanger, Jean-Pierre Blondelot, Philippe Lamy, Sébastien Lemière, Jean Francois Mockly, Benoit Pellat, Gilles Gatineau-Sailliant, Bernard Nalet, Stéphane Nancey, Daniel Kusielewicz, Patrick Loison, Jean-Michel Popot, François Merite, Jean-Pol Roux, Pauline Afchain, Alain Blanquart, Laurent Heyries, Marc Reville, Dominique Viron, Frank Zerbib, Christophe Claviere, Didier Léostic, Philippe Pouderoux, Alain Moitry, Hervé Hagège, Jean-Pierre Hugot, Benoit Humeau, Jean-Marc Sabate, Emmanuel Lederman, Dominique Lescut, Fabrice Luneau, Bruno Mesnard, Lionel Smadja, Michel Steinberg, Marc Brun, Gilles Macaigne, Jean Luc Marchal, Stéphane Ollivier, Dominique Ouvry, Jean Paul Perche, Serge Rambaud, Robert Benamouzig, Jean Louis Cazenave, Jean-Charles Coffin, Martine Blazquez, Marion Lagneau, Bruno Person, Christian Wittersheim, Bertrand Napoleon, Israël Cemachovic, Franck Iglicki, Mehran Howaizi, Eric Leprince, Bruno Leurent, Thierry Morin, Riad Darsouni, Alain Attar, Philippe Baron, Anne Breton, Jean Marie Gillion, Jean-Marc Guemene, Claude Jouffre, Xavier Moreau, Pierre Claude, André Quinton, Vered Abitbol, Jean Michel Brichard, Benoit Desaint, Martin Bouygues, Philippe Chatrenet, Marcelo Salmeron, Jean Silvie, Bruno Waldner, Yves Emery, Armand Moraillon, Daniel Kunkel, Philippe Dubois, Patrick Faure, Christian L'Hirondel, Jean-Eric Labérenne, Pierre Moreau, Adelino Pereira, Genevieve Plihon, Thierry Wolff, Yann Ngo, Arnaud Boruchowicz, Béatrice Jost, Jean Pierre Gotlib, Odile Danne, Philippe Raoux, Marie-José Ramond-Bouhali, Andre Baetz, Bruno Veyres, Christian Chapoutot, Gérard Le Dréau, Jérôme Filippi, Jean Mudry, Philippe Kalt, Sophie Minault, Pierre-André Bounin, Tony Andréani, Jacky Charneau, Didier Reijasse, Jean-Louis Bolze, Jean Luc Thaunat, Christian Le Couteulx, Chantal Maurage, Robert Bader, Philippe Codjovi, Jean-Luc Migairou, Alain Morali, Philippe Rey, Bruno Richard Molard, Richard Petit, Stéphane Koch, Philippe Cassan, Jean-Paul Deschamps, Christine Meicler Caby, Jean-Jacques Meurisse, Philippe Prades, James Boulant, Michel Diacono, Jean-Marie Monsch, J-François Dupuy, Guy Bellaiche, Martine Guegan, Jean-Marc Comte, Jean-Michel Cayla, Francois Le Tallec, Franck Meurisse, Philippe Desurmont, Laurent Roget, Philippe Bouyssou, Bruno Le Gall, Francis Bloch, Loic Larvol, Monique Jullien, Jacques Moreau, Laurent Rebouissoux, Bruno Decroix, Nina Dib, Paul Dieterling, Frédéric Lenormand, Emmanuel Lagier, Philippe Fallourd, Serge Charpin, Hugues Bertrand, Gilles Bommelaer, Daniel Battistelli, Bernard Delon, Lionel Dentant, Etienne Dorval, Jérôme Dumortier, Eric Gaye-Bareyt, Yves Gerosa, Chantal Guez, Martine Mornet, Paul Benfredj, René Piperaud, Noel Stremsdoerfer, Eric Verdier, Alain Grinholtz, Georges Barjonet, Antoine See, Ramuntxo Arotçarena, Anne Baudet, Joel Broyer, Antoine Charachon, Hugues Blondon, Pascal Mouton, Hubert Claudez, Jacques Labat-Labourdette, Jacques Haëm, Patrick Estable, Patrick Levy, Alain Rosenbaum, Yvon Balavoine, Alain Blanchi, Pierre Coutarel, Nadege Delaperriere, Michel Dervichian, Francis Marois, Jacques Seroka, Laurent Michaud, Olivier Leroy, Emmanuel Meyran, Bernard Poilroux, Abdallah Tensaouti, Thierry Paupard, Dominique Agard, Sandrine Beaulieu, Kader Benfiguig, Patrice Capony, Jean Cottereau, Pierre Desreumaux, Jean-Michel Dramard, Mathieu Duché, Patrick Mamou, Isabelle Etienney, Gilles D'Abrigeon, Béatrice Godeberge, Gilbert Tucat, Jean Puech, Jean Roger, Marie-George Lapalus, Paul Bauret, Philippe Houcke, Béatrice Pornin, Bruno Champigneulle, Laurent Cuissard, Xavier-Richard David, Frédéric Lombard, Antoine Granveau, Jean-François Hamon, Olivier Ink, Fabienne Blondel, Alain Namias, Didier Pillon, Antoine Reignier, Gilles Tordjman, Christos Christidis, Simon Zirabe, Michel Audebert, Eric Bion, Claude Bourgeaux, Cécile Poupardin, Philippe Deplaix, Gérard Fratini, Thierry Garnier, Gerard Desseaux, Hervé Magois, Sylvain Lochum, Jean-Francois Vergier, Patrick Texereau, Christel Rat, Francoise Uzzan, Alain Vidal, Nadia Vinante, Bernard Watrin, Cécile Wurtz-Huckert, Bruno Barre, Dominique Chaslin Ferbus, Jean-François Contou, Dominique Coupier, Benoit David, Dany Gargot, Denis Huc, Remy Barraya, Roger Faroux, Jean-Luc Fourgeaud, Hubert Grimprel, Jean Auroux, Jean-François Rey, Jean Pierre Arnoux, Franck Lentini, Ludovic Tardy, Olivier Mouterde, Claire Spyckerelle, Bruno Vacherot, Alain Weissman, Michel Alpérine, Anne Le Sidaner, Pierre-Olivier Bonnet-Eymard, Jean Louis Colson, Daniel Pellet, Bernard Deltombe, André Edouard, Henri Maechel, Jean-Claude Jaillet, Julien Genes, Anne-Marie Leveque, Damien Lucidarme, Philippe Maignan, Nathalie Mallier Gehrke, Jérôme Sanchez, Frank Tusseau, Alban Casteur, Jacques Bottlaender, Denis Constantini, Thierry Coton, Philippe Even, Francois Druart, François Riot, Jean-Michel Gauchet, Geneviève Hecquet, Gerard Henry, Patrick Hochain, Jean Pierre Arpurt, Abdelkrim Medini, Michele Dartois-Hoguin, Henri Moindrot, Philippe Emery, Pierre Periac, Annie Prunier, Pascal Renkes, Christine Tawil-Longreen, Edmond Vincent, René-Louis Vitte, Christian Loeb, Alain Carwana, Didier Barbereau, Philippe Bohon, Céline Corrieri-Baizeau, Daniel Sahy, Philippe Derreveaux, Dominique David, François Desbazeille, Patrick Fontenelle, Jean Luc Slama, Yvon Le Mercier, Michel Certin, Jean Jacques Reig, Isabelle Rosa, Thierry Helbert, Patrick Tounian, Luc Turner, Valéry Perot, Luc Aillet, Arnaud Pauwels, Philippe Barré, Bernard Nury, Claude Cazalbou, Franck Devulder, Alain Durget, Jeanne Dubroca, Daniele Gaudy, Michel Greff, Christian Jacques, Jocelyne Lafarge, Gilles Kezachian, Ronan Le Gall, Alex Pariente, Tiphaine Pinault, Michaël Bismuth, Nathalie Boyer-Darrigrand, Philippe Bretagnolle, Stephane Carpentier, Franck Cholet, Christian Theodore, Rémi Combes, Francois Combet, Christophe Delanoe, Stéphanie De Montigny, Denis Soudan, Olivier Fourdan, Gilles Minier, Jeanne Languepin, Jean Roche, Jean-Louis Ginies, Olivier Nouel, Philippe Petitgars, Edith Robin, Romain Hamm, Jean François Roques, Sylvie Roussin-Bretagne, Agnès Sénéjoux, Sophie Muron, Nicolas Bardoux, Philippe Berthelemy, Patrick Madonia, Bertrand Carles, Catherine Reynier, Emmanuel Cuillerier, Innocenti Dadamessi, Jacques Danis, Bernard Debenes, Nathalie Dubuc-Rey, Gilles Lesur, Pauline Jouet, Catherine Lenaerts, Marc Garret, Alexandra Mineur, Bernard Chabry, Francois Pigot, Valérie Rossi, Ruth Tennenbaum, Julien Salloum, Maurice Hakim Slaoui, Stéphane Mathieu, Valérie Papapietro, Sheila Viola, Alexis Bezet, Claude Altman, Alain Audan, Jean Calabet, Claude Masliah, Laurent Fayemendy, Marc Duruy, Benoit Gauffeny, Ludovic Helie, Kamran Imani, Raoul Janin-Manificat, Jean-Paul Galmiche, Anne Kerlirzin, Laurent Bedenne, Christophe Locher, Gilles Michaudel, Gilles Missonnier, Michel Rinaldi-Dovio, Jean-Michel Rouillon, Stéphane Ecuer, Arnaud Patenotte, Jean Ariel Bronstein, Vincent Baty, Michel Bougnol, Pierre Bourbon, Philippe Cerbelaud, Annick Chavaillon, Franck Boiffin, Béatrice Dubern, Isabelle Duval De Laguierce, Fernand Greco, Florence Bouhot, Philippe Godeberge, Brigitte Grandmaison, Pascal Gros, Guy Targues, Jacques Corallo, Jean Boutin, Jacques Guillan, Jean Pierre Barbieux, Isabelle Loury Lariviere, Henri Le Genissel, Henri Leroi, Marc Bellaiche, Marie-Claire Elie-Legrand, Michel Dapoigny, Philippe Denoyel, Patrice Pienkowski, Philippe Pouche, Marc Michel Saurfelt, Jean Marie Thorel, Thierry Piche, Bruno Travers, Patrick Tuvignon, Marc Zalcberg, Guy Boulay, Christophe Zamora, Joelle Samama, Etienne Ricotie, Patrice De Fleury, Francois Maille, Jean Louis Mougenel, Olivier Gonot, Jean Philippe Menat, Mehdi Kaassis, Francoise Lang, Laurent Abramowitz, Nathalie Ganne, Olivier Pecriaux, Jacques-Arnaud Seyrig, Iradj Sobhani, Thierry Parmentier, Antoine Van Nieuwenhuyse, Francois-Xavier Weber, André Glibert, Catherine Bineau, Bernard Canet, Catherine Collin, Frederic Cordet, David David Parlier, Dominique Carre, Annie Peytier, Francine Fein, Jerome Barouk, Jacques Dewannieux, Johannes Hartwig, Jean-Louis Jouve, Bertrand Laplane, Gilles Lascar, Christophe Legrand, Pierre Le Marchand, Marie Pierre Liebaert, Michele Terdiman-Pire, Naceur Abdelli, Dominique Neveu, Philippe De La Lande, Patrick De Saint Louvent, Cécile Pelatan, Agnès Petit, Martial Richecoeur, Frederic Texier, Jean Brice Cazals, Bertrand Tissot, Christian Mourrut, Marie Doubremelle, Marc Foltz, Florence Gautier-Jubé, Jacques Martin, Elie Khouri, Thierry Lons, Martine Carlier-Bandu, Jean-Luc Monnin, Hervé Roche, Bernard Willemin, Xavier Houard, Abdelaziz Fatisse, Michèle Algard, Kamel Arab, Isabelle Borel, Cécile Lagarrigue, Ariane Chryssostalis, Dominique Boutroux, Jean-Pierre Dupuychaffray, Saïd Khaddari, François Mion, Thierry Puy-Montbrun, Jean-Philippe Girardet, Bruno Gury, Alain Landau, Monique Le Bihan, Sandrine Nieuviarts, Jean Ollivry, Philippe Le Bourgeois, Marie-Astrid Piquet, Michel -Pierre Escartin, Remi Systchenko, Franck Venezia, Michel Wantiez, Xavier Lesage, Elie Zrihen, Philippe Aygalenq, Barbara Dieumegard, Bernard Savarieau, Philippe Bulois, Stéphane Cattan, Jean-Lucien Diez, Olivier Fauchot, Eric Durous, Valérie Gazut, Christian Guilleminet, Jean-Marc Bories, Isabelle Joly Le Floch, Jean-Paul Vove, Stéphane Lelouch, Philippe Lévy, François Lhopital, Norma Marcato, Marianne Mozer-Bernardeau, Jean-Baptiste Nousbaum, Philippe Cattan, Alain Plane, Jean-Michel Raymond, Gilles Roseau, Gerald Rozental, Christian Boustière, Corinne Bonny, Mariepierre Cordier-Collet, Laurent Courat, Bernard Croguennec, Karine Delaunay- Tardy, Damien Labarriere, Edmond Geagea, Frédéric Gottrand, Eve Gelsi, Gerard Thiefin, Eric Wohlschies, Mathieu Miguet, Philippe Ponsot, Jean Suzanne, Yves Teste, Anne-Claire Dupont Gossart, Jean-Luc Baroni, Benabdallah Benchaa, Georges Blanc, Bernard Maroy, Philippe Bonjean, Catherine Brézault, Laure Bridoux-Henno, Claude Chayette, Dominique Auby, Robert Fiorucci, Georges Galindo, Gilles Hubert, Gilles Bonneau, Evelyne Marinier, Michele Pouteau, Afchine Alamdari, Bruno Delbende, Patrick Chamouard, Pascale D'Abravanel, Hélène Dall'Osto, Sophie Hervé, Jean Lefebvre, Damien Levoir, Philippe Lillo, Michel Rouch, Muriel Mathonnet, Mercédes De Lustrac, François-Jean Ramond, Bernard Roupret, and Alain Soupison

Subjects
Adult, Male, medicine.medical_specialty, Adolescent, Colorectal cancer, Population, Risk Assessment, Gastroenterology, Inflammatory bowel disease, Young Adult, 03 medical and health sciences, 0302 clinical medicine, Crohn Disease, Risk Factors, Internal medicine, medicine, Humans, Anal cancer, education, Aged, education.field_of_study, Crohn's disease, Hepatology, Rectal Neoplasms, business.industry, Incidence, Cancer, Odds ratio, Middle Aged, Anus Neoplasms, medicine.disease, Ulcerative colitis, Case-Control Studies, 030220 oncology & carcinogenesis, Female, 030211 gastroenterology & hepatology, France, business, Follow-Up Studies
Abstract

Background & Aims Little is known about the magnitude of the risk of anal and rectal cancer in patients with anal and/or perineal Crohn's disease. We aimed to assess the risk of anal and rectal cancer in patients with Crohn's perianal disease followed up in the Cancers Et Surrisque Associe aux Maladies Inflammatoires Intestinales En France (CESAME) cohort. Methods We collected data from 19,486 patients with inflammatory bowel disease (IBD) enrolled in the observational CESAME study in France, from May 2004 through June 2005; 14.9% of participants had past or current anal and/or perianal Crohn's disease. Subjects were followed up for a median time of 35 months (interquartile range, 29–40 mo). To identify risk factors for anal cancer in the total CESAME population, we performed a case-control study in which participants were matched for age and sex. Results Among the total IBD population, 8 patients developed anal cancer and 14 patients developed rectal cancer. In the subgroup of 2911 patients with past or current anal and/or perianal Crohn's lesions at cohort entry, 2 developed anal squamous-cell carcinoma, 3 developed perianal fistula–related adenocarcinoma, and 6 developed rectal cancer. The corresponding incidence rates were 0.26 per 1000 patient-years for anal squamous-cell carcinoma, 0.38 per 1000 patient-years for perianal fistula–related adenocarcinoma, and 0.77 per 1000 patient-years for rectal cancer. Among the 16,575 patients with ulcerative colitis or Crohn's disease without anal or perianal lesions, the incidence rate of anal cancer was 0.08 per 1000 patient-years and of rectal cancer was 0.21 per 1000 patient-years. Among factors tested by univariate conditional regression (IBD subtype, disease duration, exposure to immune-suppressive therapy, presence of past or current anal and/or perianal lesions), the presence of past or current anal and/or perianal lesions at cohort entry was the only factor significantly associated with development of anal cancer (odds ratio, 11.2; 95% CI, 1.18-551.51; P = .03). Conclusions In an analysis of data from the CESAME cohort in France, patients with anal and/or perianal Crohn's disease have a high risk of anal cancer, including perianal fistula–related cancer, and a high risk of rectal cancer.

Published
2018

6. Socioeconomic deprivation does not influence the severity of Crohnʼs disease

Author

Antoine Fleury, Stéphane Nahon, Gilles Macaigne, Cécile Poupardin, Jean‐Pierre Faurel, Georges Barjonet, Mehran Howaizi, Catherine Sass, Jean-Jacques Moulin, Alice Baju, GillesGatineau Saillant, Christophe Locher, and Pierre Lahmek

Subjects
Adult, Male, Paris, Pediatrics, medicine.medical_specialty, Outpatient Clinics, Hospital, Disease, Logistic regression, Severity of Illness Index, Health Services Accessibility, Health examination, Crohn Disease, Surveys and Questionnaires, medicine, Humans, Immunology and Allergy, Clinical severity, Prospective Studies, Socioeconomic status, Digestive System Surgical Procedures, Crohn's disease, business.industry, Gastroenterology, Mean age, Health Status Disparities, Middle Aged, medicine.disease, Hospitalization, Logistic Models, Social Class, Multicenter study, Female, business
Abstract

Background: Socioeconomic deprivation is associated with poor health. The aims of this study were to evaluate the influence of deprivation in the characteristics and comparisons of deprived and nondeprived Crohn's disease (CD) patients. Methods: CD patients were prospectively recruited from September 2006 to June 2007 in 6 hospitals in the Paris area. To assess the level of deprivation we used the EPICES score (Evaluation of Precarity and Inequalities in Health Examination Centers; http://www.cetaf.asso.fr), a validated individual index of deprivation developed in France, a score >30 defining deprivation. We defined CD as severe when at least 1 of the conventionally predefined criteria of clinical severity was present. Results: In all, 207 patients (128 women and 79 men, mean age 40 years) were included and had a median score of deprivation of 20.7 (0–100). Seventy-three (35%) were deprived. There were no statistical differences between deprived and nondeprived patients for the following parameters: 1) mean age: 39 ± 14.6 versus 40.6 ± 13.5, P = 0.4; 2) sex ratio (female/male): 87/47 (65%) versus 41/32 (56%), P = 0.2; 3) duration of disease (years) 9 ± 8.8 versus 8.5 ± 7.2, P = 0.7; 4) delay from onset of symptoms to diagnosis >1 year: 22/115 (19%) versus 13/63 (21%), P = 0.8; and 5) severity of disease 71% versus 70% (P = 0.9). Nondeprived patients had a lower rate of hospitalization (40 versus 56%, P = 0,04) and a higher rate of surgery (44 versus 22%, P = 0,004); the rate of surgery was only identified by logistic regression. Conclusions: In this study deprivation does not seem to influence the severity of CD. This can be explained by easy access to healthcare in France. (Inflamm Bowel Dis 2008)

Published
2009

7. Long-term Follow-up and Predictive Factors of Recurrence of Anemia in a Cohort of 102 Very Elderly Patients Explored for Iron-deficiency Anemia

Author

Cécile Poupardin, Bruno Lesgourgues, Nicolas Delas, Francine Barclay, Stéphane Nahon, Pierre Lahmek, Gilles Macaigne, and Vincent Jounnaud

Subjects
Male, medicine.medical_specialty, Pediatrics, Long term follow up, Colorectal cancer, Anemia, Kaplan-Meier Estimate, Angiodysplasia, Recurrence, Risk Factors, Neoplasms, hemic and lymphatic diseases, Humans, Medicine, Prospective Studies, Aged, Aged, 80 and over, Anemia, Iron-Deficiency, business.industry, Palliative Care, Gastroenterology, nutritional and metabolic diseases, Cancer, Mean age, medicine.disease, Surgery, Survival Rate, Iron-deficiency anemia, Multivariate Analysis, Cohort, Female, Erythrocyte Transfusion, business, Rectal disease, Follow-Up Studies
Abstract

To evaluate long-term follow-up and predictors of relapse of anemia in a cohort of 102 very elderly patients previously explored for iron-deficiency anemia (IDA).One hundred and two patients [61 women and 41 men, mean age 82+/-5.8 y (75 to 98)] explored for IDA were prospectively followed up from inclusion (June 2003 to May 2005) until death or May 2006. Survival rate was estimated by the Kaplan-Meier method and compared by the log-rank test. Predictors of recurrence of anemia were identified by multivariate analysis in the 4 following subgroups: unexplained IDA (subgroup 1, n=27), benign lesion (subgroup 2, n=37), cancer treated curatively (subgroup 3, n=28), cancers treated palliatively (subgroup 4, n=10).Median follow-up was 20 months. At baseline, main clinical and laboratory data were not significantly different in the 4 subgroups, especially as regards severe comorbidities. Thirty-three patients died, 10 (30%) of them in the first month. Ten (100%) belonged to subgroup 4 versus, respectively, n=7 (26%), n=8 (22%), and n=8 (29%) of patients from subgroups 1, 2, and 3 (P0.001). No death was directly related to recurrence of anemia. Survival rate at 1 year was 10% in subgroup 4, significantly lower than the other 3 subgroups (subgroup 1: 84%; subgroup 2: 86%; subgroup 3: 78%; log-rank test, P0.0001). Anemia recurred in 18 cases, and required red cell transfusion in 13 cases. Predictive factors of recurrence of anemia [odds ratio (confidence interval 95%), P] were cancers treated palliatively [14.9 (3-72), P0.01] and angiodysplasias [4.5 (1.1-18.2), 0.035].In a cohort of very elderly patients explored for IDA, the mortality rate and the long-term survival were not different for patients with IDA related to a cancer treated curatively than those with unexplained IDA and those with IDA related to a benign lesion. Angiodysplasias and cancers treated palliatively were associated with recurrence of anemia. These results suggest interventionist strategies (including endoscopic investigation and appropriate surgery) for elderly patients with IDA.

Published
2008

9. Prévention des récidives de la maladie de Crohn : pourquoi et comment?

Author

Cécile Poupardin and Stéphane Nahon

Subjects
Gynecology, medicine.medical_specialty, Prostaglandin-Endoperoxide Synthase, Anticorps monoclonal, business.industry, Crohn disease, Mesalazina, Medicine, Radiology, Nuclear Medicine and imaging, Anti tnf alpha, business, Tumor necrosis factor α
Abstract

L’etiologie de la maladie de Crohn est, jusqu’a present, inconnue et aucun traitement ne permet de guerir definitivement la maladie. L’histoire naturelle de la maladie de Crohn se caracterise par la recidive des symptomes y compris apres chirurgie. Certains scores cliniques et endoscopiques (score endoscopique de Rutgeerts apres chirurgie) pourraient permettre d’identifier des groupes a risque de rechute precoce. La strategie therapeutique differe selon qu’il s’agit d’une remission induite par traitement medical ou chirurgical. Apres remission induite par traitement medical, l’azathioprine a la dose de 2–2,5 mg/kg/jour est le traitement le plus efficace et presente des effets secondaires peu frequents et bien connus. En revanche, la mesalazine semble inefficace dans cette indication, tout au plus pourraitelle etre proposee chez les patients ayant une localisation ileale dont la remission a ete induite par un 5-ASA. En cas d’intolerance aux analogues des purines, le methotrexate a montre son efficacite pour maintenir une remission clinique au long cours. Plus recemment, les anticorps anti-TNF a (infliximab) se sont reveles efficaces a la fois pour induire mais aussi pour maintenir une remission clinique et endoscopique. Cependant, en raison de certains effets secondaires potentiellement graves, la prescription de ce traitement doit toujours etre vigilante. Apres remission induite par la chirurgie, la mesalazine permet une diminution moderee (de 13 %) du taux de rechute, comparee au placebo. Les antibiotiques (imidazoles) sont efficaces pour prolonger la remission induite par la chirurgie ; cependant, la frequence des effets secondaires ne permet pas leur prescription au long cours. Leur place ainsi que celle des probiotiques dans la strategie therapeutique necessite d’etre precisee. L’azathioprine semblerait efficace dans cette situation ; cependant, peu d’etudes sont actuellement disponibles. Quelle que soit la situation, l’arret du tabac est fondamental notamment apres chirurgie.

Published
2006

10. Efficacy of infliximab in Crohn's disease. Results of a retrospective multicenter study with a 15-month follow-up

Author

Jean-Charles Delchier, Raoul Poupon, Jean-Marc Sabate, Yves Benhamou, Yoram Bouhnik, Philippe Marteau, Marc Lémann, Benoit Coffin, Jean-Claude Chaput, Cécile Poupardin, Soulé Jc, Stanislas Chaussade, Jean-Pierre Gendre, and Jean-Didier Grangé

Subjects
Adult, Male, medicine.medical_specialty, Anticorps monoclonal, Treatment outcome, Crohn Disease, Gastrointestinal Agents, medicine, Humans, Retrospective Studies, Gynecology, Crohn's disease, business.industry, Crohn disease, Gastroenterology, Follow up studies, Antibodies, Monoclonal, General Medicine, medicine.disease, Infliximab, Treatment Outcome, Multicenter study, Female, business, Follow-Up Studies, Month follow up, medicine.drug
Abstract

Resume Objectifs Le but de cette etude etait d’etudier les modalites d’utilisation du traitement et le devenir des malades traites par infliximab pour maladie de Crohn MC en 2000 a l’Assistance Publique-Hopitaux de Paris (AP-HP). Malades et methodes Les dossiers des malades atteints de MC traites dans un des services d’Hepato Gastro-enterologie adulte de l’AP-HP par au moins une injection d’infliximab durant l’annee 2000 ont ete analyses de maniere retrospective. Resultats Cent trente-sept malades (36,0 ≥ 12,7 ans, 92 femmes) traites dans 12 centres ont ete inclus. L’indication du traitement etait une maladie fistulisee ou des lesions ano-perineales dans 39% des cas, une maladie active dans 45 % et une forme mixte dans 16 %. Le nombre moyen d’injection administre a ete de 3,6 p 2,4 injections par malade. Le suivi moyen etait de 15,2 ≥ 7,2 mois. Au total, 85 % des malades ont eu une reponse initiale. Aucun facteur predictif de duree d’efficacite n’a ete retrouve. Le delai moyen de rechute etait de 3,9 ≥ 3,1 mois. Trente-huit malades etaient en traitement d’entretien a la fin du suivi, avec echappement progressif au traitement chez 37 %. Un traitement immunosuppresseur a ete associe au traitement par infliximab dans 78 % des cas. L’efficacite de l’infliximab n’etait pas modifiee par l’adjonction d’un immunosuppresseurs (P = 0,36). Un effet indesirable, le plus souvent peu severe, a ete note chez 23 % des malades. Conclusion Cette etude retrospective confirme l’efficacite du traitement par infliximab dans la MC, son role d’epargne en corticoides et sa securite d’emploi.

Published
2006

11. Diagnostic delay in a French cohort of Crohn's disease patients

Author

Stanislas Chaussade, Pierre Lahmek, Bruno Lesgourgues, Cécile Poupardin, Vered Abitbol, Laurent Peyrin-Biroulet, Stéphane Nahon, Service d’hépato-gastro-entérologie [CH Le Raincy-Montfermeil], Groupe Hospitalier Intercommunal Le Raincy-Montfermeil, Centre Hospitalier Emile Roux [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Service d'hépato-gastro-entérologie, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Cochin [AP-HP], Nutrition-Génétique et Exposition aux Risques Environnementaux (NGERE), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL), Service d'Hépato-gastro-entérologie [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Département de gastroentérologie, Hôpital Cochin [AP-HP], and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)

Subjects
Adult, Male, Pediatrics, medicine.medical_specialty, Multivariate analysis, Delayed Diagnosis, Time Factors, Referral, Adolescent, [SDV]Life Sciences [q-bio], Disease, 03 medical and health sciences, Young Adult, 0302 clinical medicine, Crohn Disease, Risk Factors, Medicine, Humans, Prospective Studies, Young adult, Prospective cohort study, business.industry, Incidence (epidemiology), Incidence, Gastroenterology, General Medicine, 3. Good health, Diagnostic delay, Socioeconomic deprivation, Crohn's disease, Quartile, Socioeconomic Factors, 030220 oncology & carcinogenesis, Cohort, Disease Progression, 030211 gastroenterology & hepatology, Female, France, business, Follow-Up Studies
Abstract

Diagnostic delay is frequent in Crohn's disease (CD) and may partly depend on socioeconomic status. The aim of this study was to determine the diagnostic delay and to identify associated risk factors, including socioeconomic deprivation in a French cohort of CD patients. Methods Medical and socioeconomic characteristics of all consecutive CD patients followed in 2 referral centers between September 2002 and July 2012 were prospectively recorded using an electronic database. Diagnostic delay was defined as the time period (months) from the first symptom onset to CD diagnosis. A long diagnostic delay was defined by the upper quartile of this time period. Univariate and multivariate analyses were performed to identify the baseline characteristics of patients associated with a long diagnostic delay. Results Three hundred and sixty-four patients with CD (mean age = 29.2 ± 12.6 years, 40.8% men) were analyzed. Median diagnostic delay was 5 months, and a long diagnostic delay was more than 12 months. Fifty-six patients (15.3%) had perianal lesions, and 28 patients (8.6%) had complicated disease at diagnosis. None of the following factors were associated with a long diagnostic delay: age, gender, CD location and behavior, marital and educational, language understanding, geographic origin and socioeconomic deprivation score measured by the EPICES score. Conclusion In this French referral center-based cohort of CD patients, the median diagnostic delay was 5 months. None of the baseline characteristics of the CD, including socioeconomic deprivation, influenced diagnostic delay in this cohort.

Published
2014

14. Management and predictors of early mortality in elderly patients with iron deficiency anemia: a prospective study of 111 patients

Author

Stéphane Nahon, Bruno Lesgourgues, Pierre Lahmek, Nicolas Delas, Cécile Poupardin, Nazmye Aras, and Gilles Macaigne

Subjects
Gynecology, Aged, 80 and over, Male, medicine.medical_specialty, Anemia, Iron-Deficiency, business.industry, Gastrointestinal Diseases, Gastroenterology, General Medicine, Comorbidity, medicine.disease, Surgery, Iron-deficiency anemia, medicine, Feasibility Studies, Humans, Female, Endoscopy, Digestive System, France, Prospective Studies, business, Colonic disease
Abstract

Resume Objectifs L’anemie ferriprive (AF) chez la personne âgee resulte essentiellement d’un saignement digestif necessitant une exploration endoscopique. Le but de cette etude prospective a ete d’evaluer dans cette population: 1) la faisabilite de l’endoscopie, 2) l’impact therapeutique (recours a un traitement), et 3) d’identifier des facteurs predictifs de mortalite a court terme. Malades et Methodes De juin 2003 a mai 2005, tous les malades âges de plus de 75 ans hospitalises et ayant une AF ont ete inclus. Les donnees cliniques (notamment les comorbidites), biologiques, endoscopiques et therapeutiques ont ete collectees. Un suivi un mois apres l’endoscopie ou apres traitement a ete realise afin d’en apprecier la morbidite et la mortalite. Resultats Cent onze malades (69 femmes, 82,3 ≥ 6,4 ans) avaient une AF, 102 (92 %) ont eu une endoscopie haute et 91 (82 %) une coloscopie. Neuf (8 %) n’ont eu aucune exploration en raison d’un mauvais etat general (N = 4) ou d’une demence (N = 5). Soixante-quatre malades avaient au moins deux comorbidites significatives. Une cause de saignement a ete identifiee chez 75 (68 %) malades dont 12 (11 %) avaient une lesion synchrone, 43 (39 %) une cause colique dont 31 (72 %) cancers colorectaux, et 44 (40 %) une cause digestive haute. Soixante-neuf (92 %) des 75 malades ont recu au moins un des traitements suivants: medical (N = 27), endoscopique (N = 20), et chirurgical (N = 31). La chirurgie etait curative dans 28/31 (90 %) cas. A un mois, la mortalite globale etait de 11/111 (10 %) et de 4/31 (13 %) apres chirurgie. Les facteurs predictifs de mortalite etaient ( Odd ratio , Intervalle de Confiance a 95 %): une cause maligne (42; 3-588), l’absence de traitement (34; 3-423), et la presence d’au moins 2 comorbidites significatives (20; 1-400). Conclusion Dans une population non selectionnee de personnes âgees hospitalisees et ayant une AF, une exploration endoscopique est generalement realisable, permettant d’identifier frequemment une cause, notamment un cancer du colon. Un traitement curateur notamment chirurgical est possible sans augmentation de la mortalite a court terme.

Published
2007

15. P488 Impact of complementary and alternative medicine on quality of life in IBD patients

Author

Bruno Lesgourgues, Vered Abitbol, A. Olympie, A Buisson, Cécile Poupardin, Stéphane Nahon, Pierre Lahmek, and Stanislas Chaussade

Subjects
medicine.medical_specialty, business.industry, Gastroenterology, Alternative medicine, General Medicine, medicine.disease, Inflammatory bowel disease, Quality of life (healthcare), Internal medicine, medicine, Intensive care medicine, business, Irritable bowel syndrome
Published
2013

16. DIAGNOSTIC YIELD OF WATER ENEMA COMPUTED TOMOGRAPHY IN FIRST-LINE INVESTIGATION OF LOWER GASTROINTESTINAL BLEEDING IN ELDERLY PATIENTS

Author

Michel Cymbalista, Marie Lequoy, Cécile Poupardin, V Jouannaud, Bruno Lesgourgues, Huguette Caugant, and Stéphane Nahon

Subjects
medicine.medical_specialty, Gastrointestinal bleeding, Lower gastrointestinal bleeding, medicine.diagnostic_test, business.industry, medicine.medical_treatment, First line, Computed tomography, Enema, medicine.disease, Surgery, medicine, Radiology, Geriatrics and Gerontology, business
Published
2010

17. Su1202 Factors Associated With Diagnostic Delay in Crohn's Disease

Author

Bruno Lesgourgues, Vered Abitbol, Laurent Peyrin-Biroulet, Cécile Poupardin, Stanislas Chaussade, Stéphane Nahon, and Pierre Lahmek

Subjects
medicine.medical_specialty, Crohn's disease, Hepatology, business.industry, Internal medicine, Gastroenterology, Medicine, business, medicine.disease
Published
2013

18. Ulcérations coliques au cours de la colite collagène

Author

Jean-Marc Sabate, Benoit Coffin, Cécile Poupardin-Moulin, and Marc Atlani

Subjects
Gynecology, medicine.medical_specialty, business.industry, Gastroenterology, medicine, General Medicine, business
Abstract

Le diagnostic de colite collagene est habituellement porte lors de biopsies systematiques realisees chez un malade ayant une coloscopie sans lesions macroscopiques, dans le cadre de la recherche etiologique d'une diarrhee chronique. Rarement, des anomalies macroscopiques ont ete decrites [1]. Nous en rapportons un cas.

Published
2004

22. Diagnostic Yield of Water Enema Computed Tomography (WECT) in First Line Investigation for Lower GI Bleeding in Elderly Patients

Author

Huguette Houssard-Caugant, Bruno Lesgourgues, V Jouannaud, Cécile Poupardin, Marie Lequoy, Michel Cymbalista, Stéphane Nahon, and Pierre Lahmek

Subjects
medicine.medical_specialty, Yield (engineering), medicine.diagnostic_test, business.industry, medicine.medical_treatment, First line, Gastroenterology, Computed tomography, Enema, Lower GI bleeding, medicine, Radiology, Nuclear Medicine and imaging, Radiology, business
Published
2009

23. P.261 Rentabilité diagnostique du coloscanner à l’eau en première intention dans le bilan d’une hémorragie digestive basse extériorisée ou non chez la personne âgée

Author

Bruno Lesgourgues, Cécile Poupardin, Huguette Caugant, Stéphane Nahon, V Jouannaud, Pierre Lahmek, M. Cymbalista, and M. Lequoy

Subjects
Gynecology, medicine.medical_specialty, business.industry, Gastroenterology, medicine, General Medicine, business
Abstract

Introduction La realisation d’une coloscopie n’est pas toujours aisee chez la personne âgee presentant une cardiopathie et traitee par antiagregant et/ou anticoagulant. En effet, l’anesthesie, la preparation pour la coloscopie et l’arret du traitement anticoagulant/antiagregant peuvent compromettre le pronostic cardiaque. Le but de ce travail est d’evaluer la rentabilite diagnostique du coloscanner a l’eau [1] en premiere ligne dans le bilan d’un saignement digestif exteriorise ou non chez la personne âgee. Patients et Methodes De juin 2007 a juin 2008, nous avons realise un coloscanner a l’eau pour une anemie ferriprive (n = 47), une rectorragie (n = 29), un hemoccult positif (n = 2) chez 83 patients [47F/36H, âges en moyenne de 81,2 ans (65-94)]. Ils avaient au moins l’un des 3 criteres suivants : 1) une cardiopathie ou une fibrillation auriculaire, 2) un traitement par antiagregant plaquettaire et 3) un traitement anticoagulant. Une endoscopie œsogastroduodenale etait effectuee avant le scanner pour eliminer une lesion du tractus digestif superieur en cas d’anemie ferriprive. Le coloscanner etait juge rentable s’il mettait en evidence une lesion confirmee par la coloscopie ou s’il etait normal avec un suivi minimum de 6 mois sans recidive symptomatique. Resultats Le coloscanner etait exploitable au moins partiellement dans 91 % des cas. Aucune complication n’etait observee. On notait une cardiopathie ischemique dans 59 % des cas, hypertensive 14 % des cas, une AC/FA dans 36 % des cas, un AVC dans 14 % des cas. 52 % des patients prenaient de l’aspirine, 14 % du clopidrogel et 37 % un AVK. L’examen etait incomplet dans 7 cas, normal dans 48 cas et pathologique dans 28 cas (tableau 1). Le tableau 1 montre la concordance entre le coloscanner et la coloscopie. Le coloscanner etait juge rentable dans 63 % des cas (21 diagnostics confirmes par la coloscopie et 31 examens normaux sans recidive pathologique). Dans un cas, un cancer a ete diagnostique par la coloscopie alors que le coloscanner etait normal. Discussion Conclusion Le coloscanner a l’eau est techniquement realisable et sans complication chez la personne âgee. L’examen est anormal dans 33 % des cas (cancer dans 50 % des cas). L’examen est juge rentable dans 63 % des cas. Cependant, il est necessaire, lorsque l’examen est normal, de realiser une surveillance clinico-biologique et morphologique reguliere.

Published
2009

25. Sensory signalling effects of tegaserod in patients with irritable bowel syndrome with constipation

Author

Benoit Coffin, Jean-Marc Sabate, Amy Wagner, Yolande Loria, Didier Bouhassira, Cécile Poupardin, Service d'Hépato-Gastroentérologie, Hôpital Louis Mourier - AP-HP [Colombes], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), 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), Novartis Pharma AG, Novartis Pharma SA, and Novartis

Subjects
Abdominal pain, Indoles, Constipation, Physiology, Distension, constipation-predominant irritable bowel syndrome, Irritable Bowel Syndrome, Placebos, 0302 clinical medicine, MESH: Rectum, tegaserod, MESH: Double-Blind Method, RIII reflex, Irritable bowel syndrome, MESH: Indoles, MESH: Middle Aged, MESH: Compliance, MESH: Manometry, Gastroenterology, Middle Aged, Serotonin Receptor Agonists, Nociception, IBS-C, Anesthesia, Female, 030211 gastroenterology & hepatology, MESH: Constipation, medicine.symptom, Compliance, medicine.drug, Adult, Tegaserod, Manometry, MESH: Reflex, MESH: Placebos, Placebo, Article, 03 medical and health sciences, Double-Blind Method, MESH: Irritable Bowel Syndrome, Reflex, [SDV.MHEP.PHY]Life Sciences [q-bio]/Human health and pathology/Tissues and Organs [q-bio.TO], medicine, Humans, MESH: Serotonin Agonists, MESH: Humans, Endocrine and Autonomic Systems, business.industry, Rectum, abdominal pain, MESH: Adult, medicine.disease, business, MESH: Female, 030217 neurology & neurosurgery
Abstract

International audience; Tegaserod relieves overall and multiple individual constipation-predominant irritable bowel syndrome (IBS-C) symptoms. However, mechanisms for the relief of abdominal pain/discomfort are not well understood. The effects of tegaserod on rectal sensitivity to distension were measured by the nociceptive flexion RIII reflex, as evidenced by spinal hyperexcitability (i.e. increase or facilitation of the RIII reflex), in IBS-C patients. A randomized, double-blind, placebo-controlled, parallel study was performed in 30 women with IBS-C. The effects of slow ramp rectal distension on the RIII reflex, recorded from the lower limb, were measured before [first experimental day (D1)] and after 7 days [day 8 (D8)] of placebo (n=15) or 6 mg tegaserod bid (n=15). Pressure-volume and sensation-volume relationships were measured during distension, and patients reported their IBS symptoms daily. On D1, rectal distension facilitated the RIII reflex in both treatment groups. On D8 vs D1 these facilitatory effects were significantly lower (P

Published
2007

26. Treatment of Crohn's disease by infliximab: Long term efficiency in 137 patients treated during the year 2000

Author

Jean Charles Delcheir, Marc Lémann, Yoram Bouhnik, Jean Claude Chaput, Jean Claude Soulé, Yves Benhamou, Jean-Didier Grangé, Philippe Marteau, Raoul Poupon, Cécile Poupardin, Jean-Pierre Gendre, Stanislas Chaussade, and Benoit Coffin

Subjects
medicine.medical_specialty, Crohn's disease, Hepatology, business.industry, Internal medicine, Gastroenterology, medicine, business, medicine.disease, Infliximab, medicine.drug, Term (time)
Published
2003

27. The effects of aminosalicylates or thiopurines on the risk of colorectal cancer in inflammatory bowel disease

Author

STEPHANE NANCEY, Francois MION, Nathalie Ganne-Carrié, ANTOINE CORTOT, Laurent Siproudhis, Bernard FLOURIE, ROBERT BENAMOUZIG, Isabelle Rosa, Jean-Ariel BRONSTEIN, Matthieu Allez, Frederic Gottrand, Guillaume Savoye, Gerard Thiefin, Xavier Roblin, Fabrice Carrat, Jean-Pierre Hugot, Bertrand Napoleon, Pierre DESREUMAUX, Laurent Peyrin-biroulet, Laurent Michaud, Christos CHRISTIDIS, Stéphane Nahon, CHU Saint-Antoine [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP), Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), Université Pierre et Marie Curie - Paris 6 (UPMC), Icahn School of Medicine at Mount Sinai [New York] (MSSM), Service d'Hépato-gastro-entérologie [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Nutrition-Génétique et Exposition aux Risques Environnementaux (NGERE), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL), CESAME Study Group: Jean-Frédéric Colombel, Jacques Cosnes, Jean-Pierre Gendre, Marc Lémann, Xavier Hébuterne, Antoine Cortot, Yoram Bouhnik, David Laharie, Jean Louis Dupas, Bernard Flourié, Eric Lerebours, Laurent Beaugerie, Laurent Peyrin-Biroulet, Matthieu Allez, Bernard Messing, Guillaume Cadiot, Philippe Marteau, Jean-Claude Soulé, Jean-Marc Gornet, Michel Veyrac, Bernard Duclos, Philippe Beau, Arnaud Bourreille, Philippe Baumer, Franck Carbonnel, Denis Heresbach, Etienne-Henry Metman, Christian Florent, Antoine Blain, Jean-Luc Faucheron, Bruno Bonaz, Xavier Roblin, Pascal Potier, Christian Boehm, Thierry Kurtz, Hervé Lamouliatte, Isabelle Nion-Larmurier, Jean-Charles Delchier, Stanislas Chaussade, Anne Marie Weiss, Jean Pierre Cézard, Laurent Siproudhis, Stéphane Nahon, Daniel Sondag, Raymond Jian, Jean-Christophe Souquet, Pierre Bord, Benoit Coffin, Hélène D'almagne, Patrick Delasalle, Régis Fournier, Maryan Cavicchi, Marc-Henry Souffran, Luc Vandromme, Claire Guedon, Philippe Seksik, Christophe Michiels, Pascal Renard, Patrice Rogier, Sylvie Gouilloud, André Rotenberg, Guillaume Savoye, Alain Thevenin, Laurent Mallet, Franck Brazier, Francois Jean, Anne-Marie Justum, Jean-Paul Latrive, Jean-Luc Gerbal, Robert Pierrugues, Gérard Chardonnal, Laurence Picon, Nicole Reix, Nicolas Drouët D'aubigny, Hervé Uettwiller, Anne Courillon Mallet, Alain Palacci, Raoul-Jacques Bensaude, Pierre Bonniaud, Olivier Empinet, Andrée Nisard, Alain Rudelli, Bernard Tubiana, Philippe Capelle, Alain Dabadie, Daniel Evard, Pierre-Emile Julien, Magali Picon-Coste, Stéphane Schneider, Denis Goldfain, Jérôme Bellanger, Jean-Pierre Blondelot, Philippe Lamy, Sébastien Lemière, Jean Francois Mockly, Benoit Pellat, Gilles Gatineau-Sailliant, Bernard Nalet, Stéphane Nancey, Daniel Kusielewicz, Patrick Loison, Jean-Michel Popot, François Merite, Jean-Pol Roux, Pauline Afchain, Alain Blanquart, Laurent Heyries, Marc Reville, Dominique Viron, Frank Zerbib, Christophe Claviere, Didier Léostic, Philippe Pouderoux, Alain Moitry, Hervé Hagège, Jean-Pierre Hugot, Benoit Humeau, Jean-Marc Sabate, Emmanuel Lederman, Dominique Lescut, Fabrice Luneau, Bruno Mesnard, Lionel Smadja, Michel Steinberg, Marc Brun, Gilles Macaigne, Jean Luc Marchal, Stéphane Ollivier, Dominique Ouvry, Jean Paul Perche, Serge Rambaud, Robert Benamouzig, Jean Louis Cazenave, Jean-Charles Coffin, Martine Blazquez, Marion Lagneau, Bruno Person, Christian Wittersheim, Bertrand Napoleon, Israël Cemachovic, Franck Iglicki, Mehran Howaizi, Eric Leprince, Bruno Leurent, Thierry Morin, Riad Darsouni, Alain Attar, Philippe Baron, Anne Breton, Jean Marie Gillion, Jean-Marc Guemene, Claude Jouffre, Xavier Moreau, Pierre Claude, André Quinton, Vered Abitbol, Jean Michel Brichard, Benoit Desaint, Martin Bouygues, Philippe Chatrenet, Marcelo Salmeron, Jean Silvie, Bruno Waldner, Yves Emery, Armand Moraillon, Daniel Kunkel, Philippe Dubois, Patrick Faure, Christian L'Hirondel, Jean-Eric Labérenne, Pierre Moreau, Adelino Pereira, Genevieve Plihon, Thierry Wolff, Yann Ngo, Arnaud Boruchowicz, Béatrice Jost, Jean Pierre Gotlib, Odile Danne, Philippe Raoux, Marie-José Ramond-Bouhali, Andre Baetz, Bruno Veyres, Christian Chapoutot, Gérard Le Dréau, Jérôme Filippi, Jean Mudry, Philippe Kalt, Sophie Minault, Pierre-André Bounin, Tony Andréani, Jacky Charneau, Didier Reijasse, Jean-Louis Bolze, Jean Luc Thaunat, Christian Le Couteulx, Chantal Maurage, Robert Bader, Philippe Codjovi, Jean-Luc Migairou, Alain Morali, Philippe Rey, Bruno Richard Molard, Richard Petit, Stéphane Koch, Philippe Cassan, Jean-Paul Deschamps, Christine Meicler Caby, Jean-Jacques Meurisse, Philippe Prades, James Boulant, Michel Diacono, Jean-Marie Monsch, J-François Dupuy, Guy Bellaiche, Martine Guegan, Jean-Marc Comte, Jean-Michel Cayla, Francois Le Tallec, Franck Meurisse, Philippe Desurmont, Laurent Roget, Philippe Bouyssou, Bruno Le Gall, Francis Bloch, Loic Larvol, Monique Jullien, Jacques Moreau, Laurent Rebouissoux, Bruno Decroix, Nina Dib, Paul Dieterling, Frédéric Lenormand, Emmanuel Lagier, Philippe Fallourd, Serge Charpin, Hugues Bertrand, Gilles Bommelaer, Daniel Battistelli, Bernard Delon, Lionel Dentant, Etienne Dorval, Jérôme Dumortier, Eric Gaye-Bareyt, Yves Gerosa, Chantal Guez, Martine Mornet, Paul Benfredj, René Piperaud, Noel Stremsdoerfer, Eric Verdier, Alain Grinholtz, Georges Barjonet, Antoine See, Ramuntxo Arotçarena, Anne Baudet, Joel Broyer, Antoine Charachon, Hugues Blondon, Pascal Mouton, Hubert Claudez, Jacques Labat-Labourdette, Jacques Haëm, Patrick Estable, Patrick Levy, Alain Rosenbaum, Yvon Balavoine, Alain Blanchi, Pierre Coutarel, Nadege Delaperriere, Michel Dervichian, Francis Marois, Jacques Seroka, Laurent Michaud, Olivier Leroy, Emmanuel Meyran, Bernard Poilroux, Abdallah Tensaouti, Thierry Paupard, Dominique Agard, Sandrine Beaulieu, Kader Benfiguig, Patrice Capony, Jean Cottereau, Pierre Desreumaux, Jean-Michel Dramard, Mathieu Duché, Patrick Mamou, Isabelle Etienney, Gilles D'Abrigeon, Béatrice Godeberge, Gilbert Tucat, Jean Puech, Jean Roger, Marie-George Lapalus, Paul Bauret, Philippe Houcke, Béatrice Pornin, Bruno Champigneulle, Laurent Cuissard, Xavier-Richard David, Frédéric Lombard, Antoine Granveau, Jean-François Hamon, Olivier Ink, Fabienne Blondel, Alain Namias, Didier Pillon, Antoine Reignier, Gilles Tordjman, Christos Christidis, Simon Zirabe, Michel Audebert, Eric Bion, Claude Bourgeaux, Cécile Poupardin, Philippe Deplaix, Gérard Fratini, Thierry Garnier, Gerard Desseaux, Hervé Magois, Sylvain Lochum, Jean-Francois Vergier, Patrick Texereau, Christel Rat, Francoise Uzzan, Alain Vidal, Nadia Vinante, Bernard Watrin, Cécile Wurtz-Huckert, Bruno Barre, Dominique Chaslin Ferbus, Jean-François Contou, Dominique Coupier, Benoit David, Dany Gargot, Denis Huc, Remy Barraya, Roger Faroux, Jean-Luc Fourgeaud, Hubert Grimprel, Jean Auroux, Jean-François Rey, Jean Pierre Arnoux, Franck Lentini, Ludovic Tardy, Olivier Mouterde, Claire Spyckerelle, Bruno Vacherot, Alain Weissman, Michel Alpérine, Anne Le Sidaner, Pierre-Olivier Bonnet-Eymard, Jean Louis Colson, Daniel Pellet, Bernard Deltombe, André Edouard, Henri Maechel, Jean-Claude Jaillet, Julien Genes, Anne-Marie Leveque, Damien Lucidarme, Philippe Maignan, Nathalie Mallier Gehrke, Jérôme Sanchez, Frank Tusseau, Alban Casteur, Jacques Bottlaender, Denis Constantini, Thierry Coton, Philippe Even, Francois Druart, François Riot, Jean-Michel Gauchet, Geneviève Hecquet, Gerard Henry, Patrick Hochain, Jean Pierre Arpurt, Abdelkrim Medini, Michele Dartois-Hoguin, Henri Moindrot, Philippe Emery, Pierre Periac, Annie Prunier, Pascal Renkes, Christine Tawil-Longreen, Edmond Vincent, René-Louis Vitte, Christian Loeb, Alain Carwana, Didier Barbereau, Philippe Bohon, Céline Corrieri-Baizeau, Daniel Sahy, Philippe Derreveaux, Dominique David, François Desbazeille, Patrick Fontenelle, Jean Luc Slama, Yvon Le Mercier, Michel Certin, Jean Jacques Reig, Isabelle Rosa, Thierry Helbert, Patrick Tounian, Luc Turner, Valéry Perot, Luc Aillet, Arnaud Pauwels, Philippe Barré, Bernard Nury, Claude Cazalbou, Franck Devulder, Alain Durget, Jeanne Dubroca, Daniele Gaudy, Michel Greff, Christian Jacques, Jocelyne Lafarge, Gilles Kezachian, Ronan Le Gall, Alex Pariente, Tiphaine Pinault, Michaël Bismuth, Nathalie Boyer-Darrigrand, Philippe Bretagnolle, Stephane Carpentier, Franck Cholet, Christian Theodore, Rémi Combes, Francois Combet, Christophe Delanoe, Stéphanie De Montigny, Denis Soudan, Olivier Fourdan, Gilles Minier, Jeanne Languepin, Jean Roche, Jean-Louis Ginies, Olivier Nouel, Philippe Petitgars, Edith Robin, Romain Hamm, Jean François Roques, Sylvie Roussin-Bretagne, Agnès Sénéjoux, Sophie Muron, Nicolas Bardoux, Philippe Berthelemy, Patrick Madonia, Bertrand Carles, Catherine Reynier, Emmanuel Cuillerier, Innocenti Dadamessi, Jacques Danis, Bernard Debenes, Nathalie Dubuc-Rey, Gilles Lesur, Pauline Jouet, Catherine Lenaerts, Marc Garret, Alexandra Mineur, Bernard Chabry, Francois Pigot, Valérie Rossi, Ruth Tennenbaum, Julien Salloum, Maurice Hakim Slaoui, Stéphane Mathieu, Valérie Papapietro, Sheila Viola, Alexis Bezet, Claude Altman, Alain Audan, Jean Calabet, Claude Masliah, Laurent Fayemendy, Marc Duruy, Benoit Gauffeny, Ludovic Helie, Kamran Imani, Raoul Janin-Manificat, Jean-Paul Galmiche, Anne Kerlirzin, Laurent Bedenne, Christophe Locher, Gilles Michaudel, Gilles Missonnier, Michel Rinaldi-Dovio, Jean-Michel Rouillon, Stéphane Ecuer, Arnaud Patenotte, Jean Ariel Bronstein, Vincent Baty, Michel Bougnol, Pierre Bourbon, Philippe Cerbelaud, Annick Chavaillon, Franck Boiffin, Béatrice Dubern, Isabelle Duval De Laguierce, Fernand Greco, Florence Bouhot, Philippe Godeberge, Brigitte Grandmaison, Pascal Gros, Guy Targues, Jacques Corallo, Jean Boutin, Jacques Guillan, Jean Pierre Barbieux, Isabelle Loury Lariviere, Henri Le Genissel, Henri Leroi, Marc Bellaiche, Marie-Claire Elie-Legrand, Michel Dapoigny, Philippe Denoyel, Patrice Pienkowski, Philippe Pouche, Marc Michel Saurfelt, Jean Marie Thorel, Thierry Piche, Bruno Travers, Patrick Tuvignon, Marc Zalcberg, Guy Boulay, Christophe Zamora, Joelle Samama, Etienne Ricotie, Patrice De Fleury, Francois Maille, Jean Louis Mougenel, Olivier Gonot, Jean Philippe Menat, Mehdi Kaassis, Francoise Lang, Laurent Abramowitz, Nathalie Ganne, Olivier Pecriaux, Jacques-Arnaud Seyrig, Iradj Sobhani, Thierry Parmentier, Antoine Van Nieuwenhuyse, Francois-Xavier Weber, André Glibert, Catherine Bineau, Bernard Canet, Catherine Collin, Frederic Cordet, David David Parlier, Dominique Carre, Annie Peytier, Francine Fein, Jerome Barouk, Jacques Dewannieux, Johannes Hartwig, Jean-Louis Jouve, Bertrand Laplane, Gilles Lascar, Christophe Legrand, Pierre Le Marchand, Marie Pierre Liebaert, Michele Terdiman-Pire, Naceur Abdelli, Dominique Neveu, Philippe De La Lande, Patrick De Saint Louvent, Cécile Pelatan, Agnès Petit, Martial Richecoeur, Frederic Texier, Jean Brice Cazals, Bertrand Tissot, Christian Mourrut, Marie Doubremelle, Marc Foltz, Florence Gautier-Jubé, Jacques Martin, Elie Khouri, Thierry Lons, Martine Carlier-Bandu, Jean-Luc Monnin, Hervé Roche, Bernard Willemin, Xavier Houard, Abdelaziz Fatisse, Michèle Algard, Kamel Arab, Isabelle Borel, Cécile Lagarrigue, Ariane Chryssostalis, Dominique Boutroux, Jean-Pierre Dupuychaffray, Saïd Khaddari, François Mion, Thierry Puy-Montbrun, Jean-Philippe Girardet, Bruno Gury, Alain Landau, Monique Le Bihan, Sandrine Nieuviarts, Jean Ollivry, Philippe Le Bourgeois, Marie-Astrid Piquet, Michel-Pierre Escartin, Remi Systchenko, Franck Venezia, Michel Wantiez, Xavier Lesage, Elie Zrihen, Philippe Aygalenq, Barbara Dieumegard, Bernard Savarieau, Philippe Bulois, Stéphane Cattan, Jean-Lucien Diez, Olivier Fauchot, Eric Durous, Valérie Gazut, Christian Guilleminet, Jean-Marc Bories, Isabelle Joly Le Floch, Jean-Paul Vove, Stéphane Lelouch, Philippe Lévy, François Lhopital, Norma Marcato, Marianne Mozer-Bernardeau, Jean-Baptiste Nousbaum, Philippe Cattan, Alain Plane, Jean-Michel Raymond, Gilles Roseau, Gerald Rozental, Christian Boustière, Corinne Bonny, Mariepierre Cordier-Collet, Laurent Courat, Bernard Croguennec, Karine Delaunay-Tardy, Damien Labarriere, Edmond Geagea, Frédéric Gottrand, Eve Gelsi, Gerard Thiefin, Eric Wohlschies, Mathieu Miguet, Philippe Ponsot, Jean Suzanne, Yves Teste, Anne-Claire Dupont Gossart, Jean-Luc Baroni, Benabdallah Benchaa, Georges Blanc, Bernard Maroy, Philippe Bonjean, Catherine Brézault, Laure Bridoux-Henno, Claude Chayette, Dominique Auby, Robert Fiorucci, Georges Galindo, Gilles Hubert, Gilles Bonneau, Evelyne Marinier, Michele Pouteau, Afchine Alamdari, Bruno Delbende, Patrick Chamouard, Pascale D'Abravanel, Hélène Dall'Osto, Sophie Hervé, Jean Lefebvre, Damien Levoir, Philippe Lillo, Michel Rouch, Muriel Mathonnet, Mercédes De Lustrac, François-Jean Ramond, Bernard Roupret, Alain Soupison, Djamila Ait-Ouadda, Yves Barbaza, Brice Bayart, Thomas Bottini, Franck Cochet, Isabelle Goderel, Orélien Maury, Léa Mbonyingo, Vanessa Pourtau, Elise Rasoanarivo, Laure Romain-Huttin, Anne-Violaine Sallé, Jonathan Trang, Hakeem Admane, Elodie Drouet, Service de santé publique [CHU Saint-Antoine], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Saint-Antoine [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Sorbonne Université (SU), Sorbonne Université (SU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de Gastroentérologie et nutrition [CHU Saint-Antoine], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), and Herrada, Anthony

Subjects
Adult, Male, medicine.medical_specialty, Colorectal cancer, Inflammatory bowel disease, Gastroenterology, Primary sclerosing cholangitis, 03 medical and health sciences, 0302 clinical medicine, Risk Factors, Internal medicine, medicine, Humans, Pharmacology (medical), Prospective Studies, Prospective cohort study, Mesalamine, Aged, Retrospective Studies, Hepatology, business.industry, Anti-Inflammatory Agents, Non-Steroidal, Case-control study, Cancer, Retrospective cohort study, [SDV.MHEP.HEG]Life Sciences [q-bio]/Human health and pathology/Hépatology and Gastroenterology, Middle Aged, medicine.disease, Colitis, Inflammatory Bowel Diseases, [SDV.MHEP.HEG] Life Sciences [q-bio]/Human health and pathology/Hépatology and Gastroenterology, digestive system diseases, 3. Good health, Aminosalicylic Acids, Treatment Outcome, [SDV.SP.PHARMA] Life Sciences [q-bio]/Pharmaceutical sciences/Pharmacology, 030220 oncology & carcinogenesis, Case-Control Studies, Cohort, Multivariate Analysis, [SDV.SP.PHARMA]Life Sciences [q-bio]/Pharmaceutical sciences/Pharmacology, 030211 gastroenterology & hepatology, Female, business, Colorectal Neoplasms
Abstract

SummaryBackground Whether aminosalicylates or thiopurines reduce the risk of colorectal cancer (CRC) in inflammatory bowel (IBD) disease is controversial. Aim To assess simultaneously the chemopreventive effect of aminosalicylates or thiopurines in a case–control study nested in the CESAME observational cohort that enrolled consecutive patients with IBD between May 2004 and June 2005. Patients were followed up to December 2007. Methods Study population comprised 144 case patients who developed CRC from the diagnosis of IBD (65 and 79 cases diagnosed, respectively, before and from 2004, starting year of the prospective observational period of CESAME) and 286 controls matched for gender, age, IBD subtype and year of diagnosis, and cumulative extent of colitis. Exposure to aminosalicylates or thiopurines was defined by an exposure to the treatment during the year of the diagnosis of cancer. The propensity of receiving 5-ASA and thiopurines was quantified by a composite score taking into account patient and IBD characteristics. The role of aminosalicylates or thiopurines was assessed by multivariate analysis. Propensity scores and the history of primary sclerosing cholangitis were entered into the multivariate model for adjustment. Results By multivariate analysis adjusted for propensity, a significant protective effect of exposure to drugs during the year of cancer was found for aminosalicylates (OR = 0.587, 95% CI: 0.367–0.937, P = 0.0257), but not for thiopurines (OR = 0.762, 95% CI: 0.432–1.343, P = 0.3468). Conclusion In a case–control study nested in the CESAME cohort, a significant decrease in the risk of colorectal cancer in IBD was associated with exposure to aminosalicylates, not to thiopurines.

Published
2017

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