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1. The green-house gas (GHG) emission’s reduction mechanisms for biofuels in the European legislation☆

Author

Dusser Philippe

Subjects
ghg reductions, sustainability criteria, renewable energy directive, red ii, german ghg quota system, carbon footprint, fuel quality directive, effort sharing regulation (esr), clean planet for all, carbon neutrality, Oils, fats, and waxes, TP670-699
Abstract

GHG reductions are a major focus of the EU policy. Several regulations have been set in order to meet the EU commitments under the Paris Agreement with an overall reduction of 40% from 1990 level. For the transport sector which is responsible for around 20% of the total GHG emissions, the GHG reductions obligations have been translated by i) reinforced GHG reduction thresholds for biofuels into the recast Renewable Energy Directive RED II; ii) an ambitious target of 30% GHG emission reduction target from 2005 level in the Effort Sharing Regulation (ESR) common to “non-ETS sector” (not covered by the Emission Trading System – ETS) as agriculture, building, waste… and transport. Furthermore, other EU regulations directed to Cars, Vans as well as Heavy Duty Vehicles set GHG emission reduction targets for new vehicle up to 2030. Finally, in its communication “A Clean Planet for All” the EU Commission describes A Strategy for 2050 to achieve a carbon neutral economy. This article addresses also the case of the German “GHG quota” which is a national support system for biofuels and as such is parallel to the European obligations stemming from the RED II renewable energy mandates that are to be met by Germany.

Published
2019
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2. The European Energy Policy for 2020–2030 RED II: what future for vegetable oil as a source of bioenergy?☆

Author

Dusser Philippe

Subjects
renewable energy directive (red ii), biofuels, biodiesel, indirect land use change (iluc), delegated act, high iluc-risk, low iluc-risk, palm oil, deforestation, Oils, fats, and waxes, TP670-699
Abstract

The support for vegetable oils biodiesel is defined by the Renewable Energy Directive (RED). After three years of negotiations, RED II (recast of the 2010–2020 RED I) has been adopted and published in December 2018. RED II sets the framework for the EU renewable energy policy for 2021–2030. Although RED II gives a priority to advanced biofuels and electricity in transport with specific targets and multipliers. For crop-based biofuels as vegetable oil biodiesel, RED II offers the possibility to preserve the current investments by giving the Member States the possibility to cap their consumption at the national 2020 consumption level (plus 1%) with maximum of 7%. With the idea to cut the link of crop-based biofuels with deforestation, a change of approach on the ILUC issue is introduced by RED II with the definition of “high ILUC-risk feedstocks with a significant expansion on land with high carbon stocks”. The high ILUC-risk feedstocks will be capped in each Member State at the 2019 level until 2023, and then progressively eliminated by 2030. An exemption from these constraints is provided for to low ILUC-risk feedstocks not linked to deforestation – direct or indirect – and identified by a certification granted to additional feedstocks produced either through productivity improvements or from cultivation on abandoned or degraded land. An Implementing Act will further detail by 2021 the conditions of the low ILUC-risk certification. In a Delegated Act published in March 2019, the EU Commission classified the palm oil as the sole high ILUC-risk feedstock with more than 40% expansion on high carbon stock land (vs. 8% for soybean) on the base of the current available data. Nevertheless, there is a certain uncertainty on the final use of palm oil in bioenergy, as the details of the certification of low ILUC-risk feedstocks are unknown before the publication of the Implementing Act (2021), and as the Delegated Act himself will be reviewed in 2021 and 2023.

Published
2019
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4. La réorganisation des échanges internationaux de produits agricoles

Author

Dusser Philippe

Subjects
agricultural commodities markets, oilseeds, European agriculture outlook, grains, Oils, fats, and waxes, TP670-699
Abstract

Markets for agricultural commodities are changing patterns: the leadership is moving between commodities as well as between countries. Demands for meals for feed as well as demand for vegetable oil for human consumption have resulted in a strongly growing world market for oilseed which are seriously challenging the leadership to cereals in term of volume (170 million tons vs 200 million tons) while already coming first in value ($45 billion vs $25 billion). The growth in demand is mainly localized in emerging countries in Asia (China, India) due to rising consumption of white meats: poultry and pork. Countries tend to produce locally the meats and the grains for feed, while accepting to rely strongly on imports for additional needs of proteins for feed and as well as of vegetable oil for human consumption. This is sustaining the growth of oilseed world exchanges. Parallel to new import markets in emerging countries in Asia, new producers are taking the leadership in exports, outpacing the USA and EU, longtime leaders on ag. markets. South America, and Brazil in particular, thanks to land availability and cheap labor are progressively becoming leaders in soybean, pork, poultry, beef, orange juice, sugar… Russia, Ukraine, are resuming a significant presence on grains markets. For the European Union, the new world context leads to a serious review of future positioning, especially in light of the future WTO obligations – less protection on access, elimination of export subsidies and less internal support. EU Animal productions sector will suffer most from the new context. Grains and oilseed EU production will continue to increase. As prices for grains will be curbed to world market level, some additional land may be diverted to oilseed. Nevertheless the availabilities of cereals will maintain high EU export. Biofuels appear to be a strategic outlet for European agricultural sector, biofuels use grains and sugar beet for ethanol as well as oilseed for biodiesel. Extent of biofuels development will determine the final balance of EU arable crops and especially availability of grains to export.

Published
2005
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5. Biodiesel : la réglementation européenne et le débat sur son évolution

Author

Dusser Philippe

Subjects
Biodiesel, carburant, directive energie renouvelable, directive qualité des carburants, CASI, Oils, fats, and waxes, TP670-699
Abstract

La réglementation communautaire sur les biocarburants a été mise en place à partir de 2003 pour répondre à un triple objectif : réduction des émissions de gaz à effet de serre, réduction de la dépendance énergétique, et soutien à la production agricole dans un contexte où 10 % des terres étaient obligatoirement gelées. Cette réglementation a été renforcée en 2009 dans le cadre du « paquet énergie » par l’introduction par la directive energie renouvelable d’un objectif obligatoire d’incorporation de 10 % d’énergie renouvelable dans les carburants à l’horizon 2020. Cette législation est complétée par une directive qualité des carburants qui impose une réduction de 6 % d’ici 2020 de l’empreinte carbone des carburants. La forte diésélisation du parc de véhicule en Europe a conduit à une rapide progression de la consommation de biodiesel (11 millions de tonnes dont 9 produites dans l’UE). L’huile de colza est la principale matière première du biodiesel. L’augmentation de la production de colza a permis de répondre à cette demande, tout en fournissant un coproduit protéique permettant de réduire significativement le déficit en protéines européen. Le débat sur l’impact du CASI (changement indirect d’affectation des sols) des biocarburants, ainsi que celui sur l’équilibre alimentaire, a conduit la Commission européenne, 3 ans après avoir défini sa politique, à proposer de plafonner les carburants issus des cultures (1ere génération) à 5 % et à introduire des « facteurs CASI » dans l’évaluation des effets de réduction des gaz à effets de serre. Cette proposition qui pourrait fortement remettre en cause le développement du biodiesel...et de la culture de colza fait à la date de rédaction de cet article (juillet 2013) l’objet de difficiles négociations à Bruxelles, dont l’issue est difficile à prédire.

Published
2013
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6. OMC : l’échec de Cancun sera-t-il surmonté en 2004 ?

Author

Dusser Philippe

Subjects
OMC, Cancun, multilatéralisme, G20, agriculture, subventions, Oils, fats, and waxes, TP670-699
Abstract

Après Cancun, la relance du processus de négociation dans les réunions de Genève, a permis de surmonter l’échec. La coalition du G20 autour du Brésil, de l’Inde et de la Chine s’est confirmée. L’agriculture est toujours en première ligne, mais les divergences sur les subventions export et interne, sur les formules de réduction des droits de douanes sont toujours très fortes. Les discussions actuelles pourront-elles permettre de passer l’étape d’un accord sur les « modalités » avant le mois de juillet ? Au-delà de cette date, tout serait reporté à 2005 pour causes d’élections américaines.

Published
2004
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7. Ocular involvement in pediatric Behçet’s disease: is it different than in adults? (a short case series and mini review)

Author

Casem Azri, Perrine Dusser, Laura Eid, Emmanuel Barreau, Isabelle Kone-Paut, Charlotte Borocco, Caroline Galeotti, Sami Saad, Marc Labetoulle, and Antoine Rousseau

Subjects
Pediatric Behçet disease, Uveitis, Vasculitis, Biotherapies, Ophthalmology, RE1-994
Abstract

Abstract Background Pediatric Behçet’s disease (PBD) is rarer than BD and can be a challenging diagnosis as clinical picture may be incomplete. As in adult patients, sight-threatening ocular manifestations may lead to diagnosis. In this study, we aimed to report a series of cases of PBD with ocular manifestations and provide a review of the literature. Methods Retrospective case series of PBD patients with ocular manifestations. Demographic, ophthalmological and systemic data at presentation and during follow-up were collected and analyzed. Results Four patients, aged 13.0 ± 2.9 years (9–16) were included. Posterior uveitis with retinal vasculitis, papillitis and macular edema was present in all patients, with associated anterior uveitis in 2 cases. Other features included occlusive vasculitis (2/4) and necrotizing retinitis (2/4). All patients were improved by systemic treatments except one patient with severe bilateral optic neuropathy. Ocular manifestations were the presenting symptoms in 3/4 cases. Conclusion Ocular manifestations and systemic associations of PBD are comparable to those encountered in adult patients. The lack of complains in pediatric patients may lead to a longer diagnosis delay, especially in unilateral uveitis. Aggressive and long-term treatment is mandatory to prevent vision loss and recurrences.

Published
2023
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8. Subcutaneous anakinra in the management of refractory MIS-C in France

Author

Perrine Dusser, Alexandre Belot, Fanny Bajolle, Charlotte Kevorkian-Verguet, Ulrich Meinzer, Frédéric Huet, Soizic Tiriau, and Isabelle Kone-paut

Subjects
COVID-19, epidemiology, multisystem inflammatory syndrome in children, myocarditis, anakinra, interleukin-1, Pediatrics, RJ1-570
Abstract

IntroductionMultisystemic inflammatory syndrome in children (MIS-C) is a therapeutic emergency and can lead to myocardial dysfunction (17%–75%) and heart failure (52%–53%). Intravenous immunoglobulins (IVIG) and corticosteroids (CST) have been validated for the management of this condition. Recent reports suggest that an interleukin-1 (IL-1) receptor antagonist, namely anakinra, may be a valuable add-on to the 2019 novel coronavirus disease (COVID-19) treatment for refractory patients. The purpose of this study was to describe the clinico-biological characteristics of patients treated with anakinra as well as the efficacy and safety of subcutaneous anakinra therapy in this condition.MethodsThe prospective multicentre study of children hospitalized for MIS-C between March 2020 and September 2022, including 23 international paediatric centres, followed for a mean duration of 3.072 ± 3.508 months. The patient data were extracted from the Juvenile Inflammatory Rheumatism (JIR) cohort. The clinico-pathological characteristics, cardiac ultrasound data, and adverse events were reported in patients receiving anakinra.ResultsOf the 470 children admitted with MIS-C, 18 French patients (50% girls) with a mean age of 10.06 ± 3.9 years were treated with subcutaneous anakinra. Anakinra was used in two situations, macrophage activation syndrome (MAS) (4 patients) and heart failure (14 patients) with a median left ventricular ejection fraction (LVEF) of 39.5% (30%–45%). The average dose of anakinra received was 2.53 ± 1.3 mg/kg/day for a median duration of 3 days. Prior to introduction, 78% (n = 14/18) of the patients had received CST and 56% (n = 10/18) had received IVIG. Only two patients received IVIG alone and six received CST alone plus anakinra. In 10% of cases, IVIG was poorly tolerated from a cardiovascular point of view and was discontinued. Transient elevations in serum transaminases were noted in four patients on anakinra without the need for treatment or dose modification. In all patients, rapid (48 h) improvement in myocardial function was observed (LVEF > 55%) with a concomitant significant decrease in myocardial enzymes (p

Published
2024
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12. Criteria Associated with Treatment Decisions in Juvenile Idiopathic Arthritis with a Focus on Ultrasonography: Results from the JIRECHO Cohort

Author

Baydoun, Sara, Jousse-Joulin, Sandrine, Saraux, Alain, Dusser-Benesty, Perrine, Borocco, Charlotte, Galeotti, Caroline, Von Scheven, Annette, Hofer, Michael, Bader-Meunier, Brigitte, Aeschlimann, Florence, Breton, Sylvain, Sparsa, Laetitia, Carbasse, Aurélia, Mouterde, Gaël, Rossi-Semerano, Linda, and Devauchelle-Pensec, Valérie

Published
2023
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14. Well-being in chronic pediatric inflammatory rheumatic diseases: the experience of a French healthcare network

Author

Rita El Haddad, Khalil El Asmar, Chrystelle Hascoët, Linda Rossi-Semerano, and Perrine Dusser

Subjects
Quality of life, Chronic inflammatory rheumatic diseases, Children, Adolescents, Healthcare network, Medicine
Abstract

Abstract Objective Current management of patients with pediatric rheumatic diseases (PRD) should aim at achieving the best possible well-being. To identify sociodemographic/clinical characteristics, needed paramedical services and school accommodations associated with well-being in patients at inclusion in a French health network Réseau pour les Rhumatismes Inflammatoires Pédiatriques (RESRIP) that supports coordination of the patient’s health pathway. To evaluate the evolution of well-being over time in this patients benefiting from such support. Methods Patients > 3 years old enrolled in RESRIP (2013–2020) were included. At enrollment, data were collected on sociodemographic/clinical characteristics, ongoing medications, and paramedical and educational actions to be implemented by RESRIP. Well-being during the last 6 months was reported with a standardized questionnaire at enrollment and every 6 months. A well-being score was calculated with scores ranging from 0 to 18, 18 corresponding to absolute well-being. Patients were followed up from inclusion until June 2020. Results In total, 406 patients were included and followed up for 36 months on average: 205 juvenile idiopathic arthritis, 68 connective tissue diseases, 81 auto-inflammatory diseases and 52 other diseases. The well-being score did not differ between the groups and improved significantly, by 0.04 score units, every 6 months (95% confidence interval [0.03; 0.06]). At inclusion, use of homeopathy, need for implementation of hypnosis or psychological support, occupational therapy or for adjustment of school tests were associated with worse well-being score. Conclusion Well-being seems associated more with the impact of chronic illness than the type of PRD underlining the importance of a comprehensive patient care.

Published
2023
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15. Criteria Associated with Treatment Decisions in Juvenile Idiopathic Arthritis with a Focus on Ultrasonography: Results from the JIRECHO Cohort

Author

Sara Baydoun, Sandrine Jousse-Joulin, Alain Saraux, Perrine Dusser-Benesty, Charlotte Borocco, Caroline Galeotti, Annette Von Scheven, Michael Hofer, Brigitte Bader-Meunier, Florence Aeschlimann, Sylvain Breton, Laetitia Sparsa, Aurélia Carbasse, Gaël Mouterde, Linda Rossi-Semerano, and Valérie Devauchelle-Pensec

Subjects
Juvenile idiopathic arthritis, Ultrasonography, Synovitis, Therapeutic decision, Treatment, Diseases of the musculoskeletal system, RC925-935
Abstract

Abstract Background The treatment of children with juvenile idiopathic arthritis (JIA) to prevent disability is a major challenge in paediatric rheumatology. The presence of synovitis, which is difficult to detect in children, is associated with structural damage. Musculoskeletal ultrasonography (MSUS) can be used in patients with JIA to reveal subclinical synovitis. Objective The primary aim was to determine whether the use of MSUS was associated with therapeutic modification in patients with JIA. The secondary aim was to identify other factors associated with therapeutic decisions. Methods We conducted an observational study based on the JIRECHO multi-centre cohort, which was developed to provide a systematic MSUS follow-up for patients with JIA. Follow-up occurred every 6 months and included clinical and MSUS examinations. We included children who underwent MSUS of the elbows, wrists, second metacarpophalangeal joints, knees and ankles, which was performed by expert sonographers. Clinical and biological data, disease activity scores and information on therapeutics were collected. Results A total of 185 visits concerning 112 patients were recorded. Three groups were defined according to the therapeutic decision: escalation (22%, n = 40), de-escalation (14%, n = 26) or stable (64%, n = 119). In the “therapeutic escalation” group: the presence of ultrasonographic synovitis in B-mode and the presence of grade 2 or 3 synovitis in B-mode were not significantly more frequent than in the “stable therapeutic or de-escalation” group (80% versus 65%, p = 0.06; 33% versus 19%, p = 0.06), and the patient’s and physician’s visual analogue scale (VAS) scores, the clinical JADAS and the C-reactive protein level were significantly higher, but only physician’s VAS score remained in the model of logistic regression. In the “therapeutic de-escalation” group: there was no difference in the presence of US synovitis compared with the “stable therapeutic or escalation” group (62% versus 69%, p = 0.48). Conclusion Even though US synovitis tended to be more frequent in patients with therapeutic escalation, the study did not show that the presence of synovitis in MSUS was statistically associated with therapeutic modifications in patients with JIA. Treatment remained stable despite the presence of US synovitis.

Published
2022
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16. An Immunological Axis Involving Interleukin 1β and Leucine-Rich-α2-Glycoprotein Reflects Therapeutic Response of Children with Kawasaki Disease: Implications from the KAWAKINRA Trial

Author

Kessel, Christoph, Koné-Paut, Isabelle, Tellier, Stéphanie, Belot, Alexandre, Masjosthusmann, Katja, Wittkowski, Helmut, Fuehner, Sabrina, Rossi-Semerano, Linda, Dusser, Perrine, Marie, Isabelle, Boukhedouni, Nadja, Agostini, Helène, Piedvache, Céline, and Foell, Dirk

Published
2022
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17. Multisystem inflammatory syndrome in children during the COVID-19 waves: data from the Juvenile Inflammatory Rheumatism cohort

Author

Robin Kechiche, Charlotte Borocco, Fanny Bajolle, Alexandre Belot, Sylvaine Poignant, Noémie Lachaume, Lucas Percheron, Ulrich Meinzer, Clara Mertes, Véronique Despert, Luc Morin, Virginie Lambert, Perrine Dusser, Nassima Matsa, Véronique Hentgen, Isabelle Kone-Paut, and Caroline Galeotti

Subjects
multisystem inflammatory syndrome in children, COVID-19, waves of COVID-19, epidemiology, myocarditis, Pediatrics, RJ1-570
Abstract

IntroductionMultisystem inflammatory syndrome in children (MIS-C) is a new condition that first appeared in children and adolescents during the COVID-19 pandemic. We aimed to describe the diagnostic course, clinical and biological manifestations, and treatment of MIS-C during the first three COVID-19 waves.MethodsWe extracted patient data from the Juvenile Inflammatory Rheumatism (JIR) cohort. We analyzed data for patients meeting the World Health Organization diagnostic criteria for MIS-C from the start of the COVID-19 pandemic from March 2020 to June 30, 2021. We then compared data for patients in wave one to those in waves two and three.ResultsWe identified 136 patients with MIS-C. The median age decreased but not significantly during the waves, from 9.9 years to 7.3 years (p = 0.105). Boys represented 52.2% (n = 71) of patients, and 46% (n = 41) of patients originated from sub-Saharan Africa (p

Published
2023
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18. POS0221 CLUSTER ANALYSIS IDENTIFIES THREE CLINICAL PATTERNS OF PATIENTS WITH ANTI-KU ANTIBODIES: A MULTICENTRE STUDY OF 154 PATIENTS.

Author

Robert, M., primary, Nguyen, Y., additional, Allenbach, Y., additional, Sacre, K., additional, Terrier, B., additional, Borie, R., additional, Uzunhan, Y., additional, Amoura, Z., additional, Comparon, C., additional, Dieudé, P., additional, Le Guern, V., additional, Morélot-Panzini, C., additional, Humbert, M., additional, Sitbon, O., additional, Goujard, C., additional, Bader-Meunier, B., additional, Fautrel, B., additional, Chrétien, P., additional, Roland-Nicaise, P., additional, Goulvestre, C., additional, Charuel, J. L., additional, Benveniste, O., additional, Mouthon, L., additional, De Lastours, V., additional, Dusser, P., additional, Zaidan, M., additional, Aslangul, E., additional, Saillour, M., additional, Dingulu, G., additional, Chasset, F., additional, Nocturne, G., additional, Mariette, X., additional, Bitoun, S., additional, and Seror, R., additional

Published
2024
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20. Thrombotic manifestations in pediatric Behçet syndrome: a multicenter comparative study from the EUROFEVER registry

Author

Mastrolia, Mv, Matucci-Cerinic, C, Ozen, S, Kasapcopur, O, Gaggiano, C, Koné-Paut, I, Cantarini, L, Dusser, P, Kaya-Akça, Ü, Yildiz, M, Brunner, J, Filocamo, G, Gallizzi, R, Insalaco, A, Pastore, S, Rigante, Donato, Sanchez-Manubens, J, Tsitsami, E, Ruperto, N, Gattorno, M, Simonini, G, Rigante D (ORCID:0000-0001-7032-7779), Mastrolia, Mv, Matucci-Cerinic, C, Ozen, S, Kasapcopur, O, Gaggiano, C, Koné-Paut, I, Cantarini, L, Dusser, P, Kaya-Akça, Ü, Yildiz, M, Brunner, J, Filocamo, G, Gallizzi, R, Insalaco, A, Pastore, S, Rigante, Donato, Sanchez-Manubens, J, Tsitsami, E, Ruperto, N, Gattorno, M, Simonini, G, and Rigante D (ORCID:0000-0001-7032-7779)

Abstract

Introduction: Vascular events account for a considerable burden of morbidity and mortality in Behçet syndrome (BS). Thrombosis occurs in 1.8–21 % pediatric BS patients, even if the real prevalence is still largely unknown. Objectives: To report clinical features and outcomes of pediatric BS patients with thrombosis and to compare the demographic and clinical characteristics of BS patients with and without thrombosis. Methods: Retrospective data collection of BS patients with thrombosis (T+) included in the EUROFEVER registry. BS patients without thrombosis (T-), belonging to the same rheumatology units, were matched in a 2:1 ratio. Results: 37 T+ were compared to 74 T- patients. At onset, ICBD criteria fulfillment was higher in the T- group (p = 0.015). Caucasian patients were more often T-, Turkish patients were more frequent in T+ group (p = 0.002). At onset, pustulosis was most frequently observed in the T- (p < 0.001) as well as gastrointestinal symptoms (p < 0.001) and ocular involvement (p = 0.022). Neurological symptoms were more often described in T+ (p = 0.034). As for T+, thrombosis was reported at BS presentation in 8/37 (21.6 %). For the T + e patients who developed thrombosis later, oral aphthosis (p = 0.003), genital aphthosis (p = 0.014) were more frequently observed at BS onset, while pustulosis (p = 0.005) and fever (p = 0.043) coexisted with thrombosis. Thrombosis was mainly venous (26/37,70.3 %), involving the cerebral sinuses (21/37, 56.8 %). After thrombosis, 35/37 (94.6 %) T+ patients received an immunomodulatory treatment compared with 16/29 (55.2 %) pre-thrombosis. A recurrence was reported in 6/31(19.4 %). Conclusion: Thrombosis was reported at BS presentation in one fifth of cases. Pustolosis and fever were more frequently concomitant to thrombosis. Sinus veins were the most frequent site.

Published
2024

22. Phénotypes cliniques et pronostics associes aux anticorps anti-Ku déterminés par une analyse en clusters : une étude multicentrique de 154 patients

Author

Robert, M., primary, Nguyen, Y., additional, Allenbach, Y., additional, Sacre, K., additional, Terrier, B., additional, Borie, R., additional, Uzunhan, Y., additional, Amoura, Z., additional, Dieude, P., additional, Le Guern, V., additional, Morelot-Panzini, C., additional, Humbert, M., additional, Sitbon, O., additional, Goujard, C., additional, Bader-Meunier, B., additional, Fautrel, B., additional, Chrétien, P., additional, Roland Nicaise, P., additional, Goulvestre, C., additional, Charuel, J.L., additional, Benveniste, O., additional, Mouthon, L., additional, De Lastours, V., additional, Dusser, P., additional, Zaidan, M., additional, Aslangul, E., additional, Saillour, M., additional, Dingulu, G., additional, Chasset, F., additional, Nocturne, G., additional, Mariette, X., additional, Bitoun, S., additional, and Seror, R., additional

Published
2023
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23. Treatment of exacerbations as a predictor of subsequent outcomes in patients with COPD

Author

Calverley PMA, Anzueto AR, Dusser D, Mueller A, Metzdorf N, and Wise RA

Subjects
tiotropium, TIOSPIR®, severity, exacerbations of COPD, hospitalization, Diseases of the respiratory system, RC705-779
Abstract

Peter MA Calverley,1 Antonio R Anzueto,2 Daniel Dusser,3 Achim Mueller,4 Norbert Metzdorf,5 Robert A Wise6 1Clinical Science Centre, Institute of Ageing and Chronic Disease, University of Liverpool, Liverpool, UK; 2Pulmonary/Critical Care, University of Texas and South Texas Veterans Health Care System, San Antonio, TX, USA; 3Department of Pneumology, Hôpital Cochin, AP-HP, Université Paris Descartes, Sorbonne Paris Cité, Paris, France; 4Biostatistics and Data Sciences Europe, Boehringer Ingelheim Pharma GmbH & Co. KG, Biberach an der Riss, Germany; 5Respiratory Medicine, Boehringer Ingelheim Pharma GmbH & Co. KG, Ingelheim am Rhein, Germany; 6Division of Pulmonary and Critical Care Medicine, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA Rationale: Exacerbations of COPD are managed differently, but whether treatment of one exacerbation predicts the likelihood of subsequent events is unknown. Objective: We examined whether the treatment given for exacerbations predicted subsequent outcomes. Methods: This was a post-hoc analysis of 17,135 patients with COPD from TIOtropium Safety and Performance In Respimat® (TIOSPIR®). Patients treated with tiotropium with one or more moderate to severe exacerbations on study were analyzed using descriptive statistics, logistic and Cox regression analysis, and Kaplan–Meier plots. Results: Of 8,061 patients with moderate to severe exacerbation(s), demographics were similar across patients with exacerbations treated with antibiotics and/or steroids or hospitalization. Exacerbations treated with systemic corticosteroids alone or in combination with antibiotics had the highest risk of subsequent exacerbation (HR: 1.21, P=0.0004 and HR: 1.33, P

Published
2018

24. Determinants of exacerbation risk in patients with COPD in the TIOSPIR study

Author

Calverley PMA, Tetzlaff K, Dusser D, Wise RA, Mueller A, Metzdorf N, and Anzueto A

Subjects
COPD, exacerbation, frequent exacerbators, Diseases of the respiratory system, RC705-779
Abstract

Peter MA Calverley,1 Kay Tetzlaff,2 Daniel Dusser,3 Robert A Wise,4 Achim Mueller,5 Norbert Metzdorf,2 Antonio Anzueto6 1Clinical Science Centre, Institute of Ageing and Chronic Disease, University of Liverpool, Liverpool, UK; 2Respiratory Medicine, Boehringer Ingelheim Pharma GmbH, Ingelheim am Rhein, Germany; 3Department of Pneumology, Hôpital Cochin, Université Paris Descartes, Sorbonne Paris Cité, Paris, France; 4Division of Pulmonary and Critical Care Medicine, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA; 5Biostatistics and Data Sciences Europe, Boehringer Ingelheim Pharma GmbH, Biberach an der Riss, Germany; 6Pulmonary Medicine and Critical Care, University of Texas Health Sciences Center and South Texas Veterans’ Health Care System, San Antonio, TX, USA Background: Exacerbation history is used to grade the risk of COPD exacerbation, but its reliability and relationship to other risk factors and prior therapy is unclear. To examine these interrelationships, we conducted a post hoc analysis of patients in the TIOSPIR trial with ≥2 years’ follow-up or who died on treatment.Patients and methods: Patients were grouped by their annual exacerbation rate on treatment into nonexacerbators, infrequent, and frequent exacerbators (annual exacerbation rates 0, ≤1, and >1, respectively), and baseline characteristics discriminating among the groups were determined. We used univariate and multivariate analyses to explore the effect of baseline characteristics on risk of exacerbation, hospitalization (severe exacerbation), and death (all causes).Results: Of 13,591 patients, 6,559 (48.3%) were nonexacerbators, 4,568 (33.6%) were infrequent exacerbators, and 2,464 (18.1%) were frequent exacerbators; 45% of patients without exacerbations in the previous year exacerbated on treatment. Multivariate analysis identified baseline pulmonary maintenance medication as a predictive factor of increased exacerbation risk, with inhaled corticosteroid treatment associated with increased exacerbation risk irrespective of exacerbation history.Conclusion: Our data confirm established risk factors for exacerbation, but highlight the limitations of exacerbation history when categorizing patients and the importance of prior treatment when identifying exacerbation risk. Keywords: COPD, exacerbation, frequent exacerbators

Published
2017

25. Proceedings of the 23rd Paediatric Rheumatology European Society Congress: part one

Author

F. De Benedetti, J. Anton, M. Gattorno, H. Lachmann, I. Kone-Paut, S. Ozen, J. Frenkel, A. Simon, A. Zeft, E. Ben-Chetrit, H. M. Hoffman, Y. Joubert, K. Lheritier, A. Speziale, J. Guido, Roberta Caorsi, Federica Penco, Alice Grossi, Antonella Insalaco, Maria Alessio, Giovanni Conti, Federico Marchetti, Alberto Tommasini, Silvana Martino, Romina Gallizzi, Annalisa Salis, Francesca Schena, Francesco Caroli, Alberto Martini, Gianluca Damonte, Isabella Ceccherini, Marco Gattorno, Marie-Louise Frémond, Carolina Uggenti, Lien Van Eyck, Isabelle Melki, Darragh Duffy, Vincent Bondet, Yoann Rose, Bénédicte Neven, Yanick Crow, Mathieu P. Rodero, Yvonne Kusche, Johannes Roth, Katarzyna Barczyk-Kahlert, Giovanna Ferrara, Annalisa Chiocchetti, Silvio Polizzi, Josef Vuch, Diego Vozzi, Anna Mondino, Erica Valencic, Serena Pastore, Andrea Taddio, Flavio Faletra, Umberto Dianzani, Ugo Ramenghi, Qing Zhou, Xiaomin Yu, Erkan Demirkaya, Natalie Deuitch, Deborah Stone, Wanxia Tsai, Amanda Ombrello, Tina Romeo, Elaine F. Remmers, JaeJin Chae, Massimo Gadina, Steven Welch, Seza Ozen, Rezan Topaloglu, Mario Abinun, Daniel L. Kastner, Ivona Aksentijevich, Donatella Vairo, Rosalba Monica Ferraro, Giulia Zani, Jessica Galli, Micaela De Simone, Marco Cattalini, Elisa Fazzi, Silvia Giliani, Ebun Omoyinmi, Ariane Standing, Dorota Rowczenio, Annette Keylock, Sonia Melo Gomes, Fiona Price-Kuehne, Sira Nanthapisal, Claire Murphy, Thomas Cullup, Lucy Jenkins, Kimberly Gilmour, Despina Eleftheriou, Helen Lachmann, Philip Hawkins, Nigel Klein, Paul Brogan, Anita Dhanrajani, Mercedes Chan, Stephanie Pau, Janet Ellsworth, Jaime Guzman, Florence A. Aeschlimann, Marinka Twilt, Simon W. Eng, Shehla Sheikh, Ronald M. Laxer, Diane Hebert, Damien Noone, Christian Pagnoux, Susanne M. Benseler, Rae S. Yeung, Christoph Kessel, Katrin Lippitz, Toni Weinhage, Claas Hinze, Helmut Wittkowski, Dirk Holzinger, Niklas Grün, Dirk Föll, Pieter Van Dijkhuizen, Federica Del Chierico, Clara Malattia, Alessandra Russo, Denise Pires Marafon, Nienke M. ter Haar, Silvia Magni-Manzoni, Sebastiaan J. Vastert, Bruno Dallapiccola, Berent Prakken, Fabrizio De Benedetti, Lorenza Putignani, Berna Eren Fidanci, Kenan Barut, Serap Arıcı, Dogan Simsek, Mustafa Cakan, Ezgi D. Batu, Sezgin Şahin, Ayşenur Kısaarslan, Ebru Yilmaz, Özge Basaran, Ferhat Demir, Kubra Ozturk, Zübeyde Gunduz, Betül Sozeri, Balahan Makay, Nuray Ayaz, Onder Yavascan, Ozlem Aydog, Yelda Bilginer, Zelal Ekinci, Dilek Yıldız, Faysal Gök, Muferret Erguven, Erbil Unsal, Ozgur Kasapcopur, For the FMF Arthritis Vasculitis and Orphan Disease Research in Paediatric Rheumatology (FAVOR), Hafize E. Sönmez, Betül Sözeri, Yonatan Butbul, Seza Özen, Claudia Bracaglia, Giusi Prencipe, Manuela Pardeo, Geneviève Lapeyre, Emiliano Marasco, Walter Ferlin, Robert Nelson, Cristina de Min, N. Ruperto, H. I. Brunner, P. Quartier, T. Constantin, E. Alexeeva, K. Marzan, N. Wulffraat, R. Schneider, S. Padeh, V. Chasnyk, C. Wouters, J. B. Kuemmerle-Deschner, T. Kallinich, B. Lauwerys, E. Haddad, E. Nasonov, M. Trachana, O. Vougiouka, K. Leon, E. Vritzali, A. Martini, D. Lovell, PRINTO/PRCSG, Stefano Volpi, Claudia Pastorino, Francesca Kalli, Alessia Omenetti, Sabrina Chiesa, Arinna Bertoni, Paolo Picco, Gilberto Filaci, Elisabetta Traggiai, Marie-Louise Fremond, Naoki Kitabayashi, Olivero Sacco, Isabelle Meyts, Marie-Anne Morren, Carine Wouters, Eric Legius, Isabelle Callebaut, Christine Bodemer, Frederic Rieux-Laucat, Mathieu Rodero, Nadia Jeremiah, Alexandre Belot, Eric Jeziorski, Didier Bessis, Guilhem Cros, Gillian I. Rice, Bruno Charbit, Anne Hulin, Nihel Khoudour, Consuelo Modesto Caballero, Monique Fabre, Laureline Berteloot, Muriel Le Bourgeois, Philippe Reix, Thierry Walzer, Despina Moshous, Stéphane Blanche, Alain Fischer, Brigitte Bader-Meunier, Frédéric Rieux-Laucat, K. Annink, N. ter Haar, S. Al-Mayouf, G. Amaryan, K. Barron, S. Benseler, P. Brogan, L. Cantarini, M. Cattalini, A. Cochino, F. Dedeoglu, A. De Jesus, O. Dellacasa, E. Demirkaya, P. Dolezalova, K. Durrant, G. Fabio, R. Gallizzi, R. Goldbach-Mansky, E. Hachulla, V. Hentgen, T. Herlin, M. Hofer, H. Hoffman, A. Insalaco, A. Jansson, I. Koné-Paut, A. Kozlova, J. Kuemmerle-Deschner, R. Laxer, S. Nielsen, I. Nikishina, A. Ombrello, E. Papadopoulou-Alataki, A. Ravelli, D. Rigante, R. Russo, Y. Uziel, Nienke ter Haar, Jerold Jeyaratnam, Anna Simon, Matteo Doglio, Jordi Anton, Consuelo Modesto, Pierre Quartier, Esther Hoppenreijs, Luca Cantarini, Loredana Lepore, Inmaculada Calvo Penades, Christina Boros, Rita Consolini, Donato Rigante, Ricardo Russo, Jana Pachlopnik Schmid, Thirusha Lane, Nicolino Ruperto, Joost Frenkel, Chiara Passarelli, Elisa Pisaneschi, Virginia Messia, Antonio Novelli, Fabrizio Debenedetti, P. A. Brogan, X. Wei, Martina Finetti, Francesca Orlando, Elisabetta Cortis, Angela Miniaci, Nicola Ruperto, Charlotte Eijkelboom, Pavla Dolezalova, Isabelle Koné-Paut, Marija Jelusic-Drazic, Liliana Bezrodnik, Mari Carmen Pinedo, Valda Stanevicha, Marielle van Gijn, Silvia Federici, Hermann Girschick, Gerd Ganser, Susan Nielsen, Troels Herlin, Sulaiman Mohammed Al-Mayouf, Michael Hofer, Jasmin Kuemmerle-Deschner, Susanne Schalm, Annette Jansson, on behalf of PRINTO and Eurofever registry, Marta Marchi, Chiara Marini, Angelo Ravelli, Alberto Garaventa, Sonia Carta, Enrica Balza, Patrizia Castellani, Caterina Pellecchia, Silvia Borghini, Maria Libera Trotta, Anna Rubartelli, Andrew Henrey, Thomas Loughin, Roberta Berard, Natalie Shiff, Roman Jurencak, Susanne Benseler, Lori Tucker, on behalf of ReACCh-Out Investigators, Charalampia Papadopoulou, Ying Hong, Petra Krol, Yiannis Ioannou, Clarissa Pilkington, Hema Chaplin, Stephania Simou, Marietta Charakida, Lucy Wedderburn, Lynn R. Spiegel, Sara Ahola Kohut, Jennifer Stinson, Paula Forgeron, Miriam Kaufman, Nadia Luca, Khush Amaria, Mary Bell, J Swart, F. Boris, E. Castagnola, A. Groll, G. Giancane, G. Horneff, H. I. Huppertz, T. Wolfs, E. Alekseeva, V. Panaviene, F. Uettwiller, V. Stanevicha, L. M. Ailioaie, E. Tsitami, S. Kamphuis, G. Susic, F. Sztajnbok, B. Flato, A. Pistorio, Stephanie J. W. Shoop, Suzanne M. M. Verstappen, Janet E. McDonagh, Wendy Thomson, Kimme L. Hyrich, CAPS, Maarit Tarkiainen, Pirjo Tynjala, Pekka Lahdenne, Janne Martikainen, Acute-JIA Study Group, Meredyth Wilkinson, Christopher Piper, Georg Otto, Claire T. Deakin, Stefanie Dowle, Stefania Simou, Daniel Kelberman, Claudia Mauri, Elizabeth Jury, David Isenberg, Lucy R. Wedderburn, Kiran Nistala, I. Foeldvari, D. J. Lovell, G. Simonini, M. Bereswill, J. Kalabic, Kiem Oen, Brian M. Feldman, Brenden Dufault, Jennifer Lee, Karen Watanabe Duffy, Ciaran Duffy, ReACCh-Out Investigators, N. Tzaribachev, G. Vega-Cornejo, I. Louw, A. Berman, I. Calvo, R. Cuttica, F. Avila-Zapata, R. Cimaz, E. Solau-Gervais, R. Joos, G. Espada, X. Li, M. Nys, R. Wong, S. Banerjee, For Pediatric Rheumatology International Trials Organization (PRINTO)/Pediatric Rheumatology Collaborative Study Group (PRCSG), Rebecca Nicolai, Margherita Verardo, Adele D’Amico, Luisa Bracci-Laudiero, Gian Marco Moneta, Gillian Rice, Anne-Laure Mathieu, Sulliman O. Omarjee, Tracy A. Briggs, James O’Sullivan, Simon Williams, Rolando Cimaz, Eve Smith, Michael W. Beresford, Yanick J. Crow, GENIAL Investigators, UK JSLE Study Group, Madeleine Rooney, Nick Bishop, joyce davidson, Clarissa pilkington, Michael Beresford, Jacqui Clinch, Rangaraj Satyapal, Helen Foster, Janet Gardner Medwin, Janet McDonagh, Sue Wyatt, On Behalf of the British Society for Paediatric and Adolescent Rheumatology, Valentina Litta Modignani, Francesco Baldo, Stefano Lanni, Alessandro Consolaro, Giovanni Filocamo, Helen J. Lachmann, on behalf of Eurofever Registry, Gianmarco Moneta, Camilla Celani, Bilade Cherqaoui, Linda Rossi-Semerano, Perrine Dusser, Véronique Hentgen, Claire Grimwood, Linda Rossi, Isabelle Kone Paut, Veronique Hentgen, Denise Lasigliè, Denise Ferrera, Giulia Amico, Marco Di Duca, Laura Obici, Roberto Ravazzolo, Ryuta Nishikomori, Juan Arostegui, Andrea Petretto, Chiara Lavarello, Elvira Inglese, Federica Vanoni, Michaël Hofer, on behalf of EUROFEVER PROJECT, P. N. Hawkins, T. van der Poll, U. A. Walker, H. H. Tilson, Pascal N. Tyrrell, Raphaela Goldbach-Mansky, Norbert Blank, Hal M. Hoffman, Elisabeth Weissbarth-Riedel, Boris Huegle, Tilmann Kallinich, Ahmet Gul, Marlen Oswald, Fatma Dedeoglu, Aki Hanaya, Takako Miyamae, Manabu Kawamoto, Yumi Tani, Takuma Hara, Yasushi Kawaguchi, Satoru Nagata, Hisashi Yamanaka, Almira Ćosićkić, Fahrija Skokić, Belkisa Čolić, Sanimir Suljendić, Anna Kozlova, Irina Mersiyanova, Mariya Panina, Lily Hachtryan, Vasiliy Burlakov, Elena Raikina, Alexey Maschan, Anna Shcherbina, Banu Acar, Meryem Albayrak, Betul Sozeri, Sezgin Sahin, Amra Adrovic, Nese Inan, Serhan Sevgi, Caroline M. Andreasen, Anne Grethe Jurik, Mia B. Glerup, Christian Høst, Birgitte T. Mahler, Ellen-Margrethe Hauge, Cecilia Lazea, Laura Damian, Calin Lazar, Rodica Manasia, Chloe M. Stephenson, Vimal Prajapati, Paivi M. Miettunen, Dilek Yılmaz, Yavuz Tokgöz, Yasin Bulut, Harun Çakmak, Ferah Sönmez, Elif Comak, Gülşah Kaya Aksoy, Mustafa Koyun, Sema Akman, Yunus Arıkan, Ender Terzioğlu, Osman Nidai Özdeş, İbrahim Keser, Hüseyin Koçak, Ayşen Bingöl, Aygen Yılmaz, Reha Artan, X. Xu, Fatemeh F. Mehregan, Vahid Ziaee, Mohammad H. Moradinejad, Francesco La Torre, Clotilde Alizzi, Pio D’Adamo, G. Junge, J. Gregson, Hasmik Sargsyan, Hulya Zengin, Berna E. Fidanci, Cagla Kaymakamgil, Dilek Konukbay, Dilek Yildiz, Faysal Gok, Iris Stoler, Judith Freytag, Banu Orak, Christine Seib, Lars Esmann, Eva Seipelt, Faekah Gohar, Dirk Foell, Ismail Dursun, Sebahat Tulpar, Sibel Yel, Demet Kartal, Murat Borlu, Funda Bastug, Hakan Poyrazoglu, Zubeyde Gunduz, Kader Kose, Mehmet E. Yuksel, Abdullah Calıskan, Ahmet B. Cekgeloglu, Ruhan Dusunsel, Katerina Bouchalova, Jana Franova, Marcel Schuller, Marie Macku, Katerina Theodoropoulou, Raffaella Carlomagno, Annette von Scheven-Gête, Claudia Poloni, Laura O. Damian, Dan Cosma, Amanda Radulescu, Dan Vasilescu, Liliana Rogojan, Simona Rednic, Mihaela Lupse, Lien De Somer, Pierre Moens, Rocio Galindo Zavala, Laura Martín Pedraz, Esmeralda Núñez Cuadros, Gisela Díaz-Cordovés Rego, Antonio L. Urda Cardona, Ilaria Dal Forno, Sara Pieropan, Ombretta Viapiana, Davide Gatti, Gloria Dallagiacoma, Paola Caramaschi, Domenico Biasi, Daniel Windschall, Ralf Trauzeddel, Hartwig Lehmann, Rainer Berendes, Maria Haller, Manuela Krumrey-Langkammerer, Antje Nimtz-Talaska, Philipp Schoof, Ralf Felix Trauzeddel, Christine Nirschl, Estefania Quesada-Masachs, Carla Aguilar Blancafort, Sara Marsal Barril, Francisca Aguiar, Rita Fonseca, Duarte Alves, Ana Vieira, Alberto Vieira, Jorge A. Dias, Iva Brito, Gordana Susic, Vera Milic, Goran Radunovic, Ivan Boricic, Pauline Marteau, Catherine Adamsbaum, Michel De Bandt, Irène Lemelle, Chantal Deslandre, Tu Anh Tran, Anne Lohse, Elisabeth Solau-Gervais, Pascal Pillet, Julien Wipff, Cécile Gaujoux-Viala, Sylvain Breton, Valérie Devauchelle-Pensec, Sandra Gran, Olesja Fehler, Stefanie Zenker, Michael Schäfers, Thomas Vogl, Severine Guillaume Czitrom, EH Pieter Van Dijkhuizen, Silvia Magni Manzoni, Francesca Magnaguagno, Laura Tanturri de Horatio, Nienke M. Ter Haar, Annemieke S. Littooij, Vitor A. Teixeira, Raquel Campanilho-Marques, Ana F. Mourão, Filipa O. Ramos, Manuela Costa, Wafa A. Madan, Orla G. Killeen, Adriana Rodriguez Vidal, Diana Sueiro Delgado, Maria Isabel Gonzalez Fernandez, Berta Lopez Montesinos, Aleksey Kozhevnikov, Nina Pozdeeva, Mikhail Konev, Evgeniy Melchenko, Vladimir Kenis, Gennadiy Novik, Aysenur Pac Kısaarslan, Butsabong Lerkvaleekul, Suphaneewan Jaovisidha, Witaya Sungkarat, Niyata Chitrapazt, Praman Fuangfa, Thumanoon Ruangchaijatuporn, Soamarat Vilaiyuk, Dan Ø. Pradsgaard, Arne Hørlyck, Anne H. Spannow, Carsten W. Heuck, Talia Diaz, Fernando Garcia, Lorenia De La Cruz, Nadina Rubio, Joanna Świdrowska-Jaros, Elzbieta Smolewska, Mirta Lamot, Lovro Lamot, Mandica Vidovic, Edi Paleka Bosak, Ivana Rados, Miroslav Harjacek, Nikolay Tzaribachev, Polymnia Louka, Romiesa Hagoug, Chiara Trentin, Olga Kubassova, Mark Hinton, Mikael Boesen, Olena A. Oshlianska, Illya A. Chaikovsky, G. Mjasnikov, A. Kazmirchyk, Umberto Garagiola, Irene Borzani, Paolo Cressoni, Fabrizia Corona, Eszter Dzsida, Giampietro Farronato, Antonella Petaccia, Alenka Gagro, Agneza Marija Pasini, Goran Roic, Ozren Vrdoljak, Lucija Lujic, Matija Zutelija-Fattorini, Monika M. Esser, Deepthi R. Abraham, Craig Kinnear, Glenda Durrheim, Mike Urban, Eileen Hoal, Victoria B. Nikolayenko, Kubilay Şahin, Yasar Karaaslan, Adele Civino, Giovanni Alighieri, Sergio Davì, Roberto Rondelli, Andrea Magnolato, Francesca Ricci, Alma Olivieri, Valeria Gerloni, Bianca Lattanzi, Francesca Soscia, Alessandro De Fanti, Stefania Citiso, Lorenzo Quartulli, Maria Cristina Maggio, Manuela Marsili, Maria Antonietta Pelagatti, Valentino Conter, Franca Fagioli, Andrea Pession, Marco Garrone, Mariangela Rinaldi, Jaime De Inocencio, Stella Garay, Daniel J. Lovell, Berit Flato, EPOCA Study Group, Angela Aquilani, Simona Cascioli, Ivan Caiello, Denise Pires-Marafón, Rita Carsetti, Emily Robinson, Salvatore Albani, Wilco de Jager, Sytze de Roock, Trang Duong, Justine Ellis, Kimme Hyrich, Laetitia Jervis, Daniel Lovell, Lucy Marshall, Elizabeth D. Mellins, Kirsten Minden, Jane Munro, Peter A. Nigrovic, Jason Palman, Sunil Sampath, Laura E. Schanberg, Susan D. Thompson, Richard Vesely, Chris Wallace, Chris Williams, Qiong Wu, Nico Wulffraat, Rae S. M. Yeung, M. B. Seyger, D. Arikan, J. K. Anderson, A. Lazar, D. A. Williams, C. Wang, R. Tarzynski-Potempa, J. S. Hymans, Gabriele Simonini, Erika Scoccimarro, Irene Pontikaki, Teresa Giani, Alessandro Ventura, Pier Luigi Meroni, Gaetana Minnone, Marzia Soligo, Luigi Manni, Luisa Bracci Laudiero, Noortje Groot, I. Grein, N. M. Wulffraat, R. Schepp, G. Berbers, C. C. Barbosa Sandoval de Souza, V. Paes Leme Ferriani, G. Pileggi, S. de Roock, Ingrid H. R. Grein, Silvia Scala, Elisa Patrone, Casper Schoemaker, on behalf of Dutch JIA patient organization, Wendy Costello, on behalf of ENCA, Suzanne Parsons, Jean-David Cohen, Damien Bentayou, Marc-Antoine Bernard Brunel, Sonia Trope, Jens Klotsche, Miriam Listing, Martina Niewerth, Gerd Horneff, Angelika Thon, Hans-Iko Huppertz, Kirsten Mönkemöller, Ivan Foeldvari, ICON study group, Achille Marino, Stefano Stagi, Niccolò Carli, Federico Bertini, Adriana S. Díaz-Maldonado, Sally Pino, Pilar Guarnizo, Alfonso Ragnar Torres-Jimenez, Berenice Sanchez-Jara, Eunice Solis-Vallejo, Adriana Ivonne Cespedes-Cruz, Maritza Zeferino-Cruz, Julia Veronica Ramirez-Miramontes, Ankur Kumar, Anju Gupta, Deepti Suri, Amit Rawat, Nandita Kakkar, Surjit Singh, Özge A. Gücenmez, Erbil Ünsal, Bo Magnusson, Karina Mördrup, Anna Vermé, Christina Peterson, Board of the Swedish Pediatric Rheumatology Registry, Caroline Freychet, Jean Louis Stephan, Cathryn E. Harkness, Leanne Foster, Emma Henry, Pauline Taggart, Coskun F. Ozkececi, Esra Kurt, Gokalp Basbozkurt, Daiva Gorczyca, Jacek Postępski, Aleksandra Czajkowska, Bogumiła Szponar, Mariola Paściak, Anna Gruenpeter, Iwona Lachór-Motyka, Daria Augustyniak, Edyta Olesińska, Emediong S. Asuka, Tatyana Golovko, Samuel U. Aliejim, Emilio Inarejos Clemente, Estibaliz Iglesias Jimenez, Joan Calzada Hernandez, Sergi Borlan Fernandez, Clara Gimenez Roca, David Moreno Romo, Natalia Rodriguez Nieva, Juan Manuel Mosquera Angarita, Jordi Anton Lopez, Esmeralda Nuñez-Cuadros, Gisela Diaz-Cordovés, Rocío Galindo-Zavala, Antonio Urda-Cardona, Antonio Fernández-Nebro, Daniel Álvarez de la Sierra, Marina Garcia Prat, Mónica Martínez Gallo, Ricardo Pujol Borrell, Ana M. Marín Sánchez, Etienne Merlin, Sylvie Fraitag, Jean-Louis Stephan, Federico Annoni, Giancarla Di Landro, Sofia Torreggiani, Marta Torcoletti, Georgina Tiller, Jo Buckle, Angela Cox, Peter Gowdie, Roger C. Allen, Jonathan D. Akikusa, Hayde G. Hernández-Huirache, Edel R. Rodea-Montero, William Fahy, Christelle Sordet, Karin B. Berggren, Johanna T. Kembe, Joyce Bos, Wineke Armbrust, Marco van Brussel, Jeanette Cappon, Pieter Dijkstra, Jan Geertzen, Elizabeth Legger, Marion van Rossum, Pieter Sauer, Otto Lelieveld, Levent Buluc, Gur Akansel, Bahar Muezzinoglu, Ljubov Rychkova, Tatyana Knyazeva, Anna Pogodina, Tatyana Belova, Tamara Mandzyak, Ekaterina Kulesh, Alessandro Cafarotti, Cosimo Giannini, Roberta Salvatore, Giuseppe Lapergola, Caterina Di Battista, Maria Loredana Marcovecchio, Raffaella Basilico, Piernicola Pelliccia, Francesco Chiarelli, Luciana Breda, Beverley Almeida, Sarah Tansley, Harsha Gunawardena, Neil McHugh, Juvenile Dermatomyositis Research Group (JDRG), Jessie Aouizerate, Marie De Antonio, Christine Barnerias, Guillaume Bassez, Isabelle Desguerre, Romain Gherardi, Jean-Luc Charuel, François-Jérôme Authier, Cyril Gitiaux, C. H. Spencer, Rabheh Abdul Aziz, Chack-Yung Yu, Brent Adler, Sharon Bout-Tabaku, Katherine Lintner, Melissa Moore-Clingenpeel, Liza McCann, Nicola Ambrose, Mario Cortina-Borja, Juvenile Dermatomyositis Cohort and Biomarker Study (JCDBS), Prasad T. Oommen, Fabian Speth, Johannes-Peter Haas, Working Group “Juvenile Dermatomyositis” of the German Society for Paediatric and Adolescent Rheumatology (GKJR), Claudio Lavarello, Gabriella Giancane, Angela Pistorio, Lisa Rider, Rohit Aggarwal, Sheila K. Oliveira, Ruben Cuttica, Michel Fischbach, Gary Sterba, Karine Brochard, Frank Dressler, Patrizia Barone, Ruben Burgos-Vargas, Elizabeth Candell Chalom, Marine Desjonqueres, Graciela Espada, Anders Fasth, Stella Maris Garay, Rose-Marie Herbigneaux, Claire Hoyoux, Chantal Job Deslandre, Frederick W. Miller, Jiri Vencovsky, Erdal Sag, Gulsev Kale, Haluk Topaloglu, Beril Talim, Francesco Zulian, Tadej Avcin, Roberto Marini, Anne Pagnier, Michel Rodiere, Christine Soler, Rebecca Ten Cate, Yosef Uziel, Jelena Vojinovic, Ana V. Villarreal, Nydia Acevedo, Yuridiana Ramirez, Enrique Faugier, Rocio Maldonado, Bita Arabshahi, John H. Lee, Ian Leibowitz, Lawrence O. Okong’o, Jo Wilmshurst, Monika Esser, Christiaan Scott, Ezgi Deniz Batu, Nagehan Emiroglu, Hafize Emine Sonmez, Gokcen Dilsa Tugcu, Zehra Serap Arici, Ebru Yalcin, Deniz Dogru, Ugur Ozcelik, Mithat Haliloglu, Nural Kiper, Masato Yashiro, Mutsuko Yamada, Toshihiko Yabuuchi, Tomonobu Kikkawa, Nobuyuki Nosaka, Yosuke Fujii, Yukie Saito, Hirokazu Tsukahara, Sulaiman M. Al-Mayouf, Nora AlMutiari, Mohammed Muzaffer, Rawiah shehata, Adel Al-Wahadneh, Reem Abdwani, Safia Al-Abrawi, Mohammed Abu-shukair, Zeyad El-Habahbeh, Abdullah Alsonbul, Aleksandra Szabat, Monika Chęć, Violetta Opoka-Winiarska, Biman Saikia, Ranjana W. Minz, Christine Arango, Clara Malagon, Maria D. P. Gomez, Angela C. Mosquera, Ricardo Yepez, Tatiana Gonzalez, Camilo Vargas, GRIP study group, Marta Balzarin, Biagio Castaldi, Elena Reffo, Francesca Sperotto, Giorgia Martini, Alessandra Meneghel, Ornella Milanesi, Ozgur Kasapçopur, Maria Teresa Terreri, Ekaterina Alexeeva, Maria Katsicas, Mikhail Kostik, Thomas Lehman, W.-Alberto Sifuentes-Giraldo, Vanessa Smith, Flavio Sztajnbok, Tadey Avcin, Maria Jose Santos, Dana Nemcova, Cristina Battagliotti, Liora Harel, Mahesh Janarthanan, Kathryn Torok, Nicola Helmus, Eileen Baildem, Michael Blakley, Kim Fligelstone, Antonia Kienast, Clare Pain, Amanda Saracino, Gabriele Simoni, Lisa Weibel, Maria K. Osminina, Nathalia A. Geppe, Olga V. Niconorova, Olesya V. Karashtina, Oksana V. Abbyasova, Olga V. Shpitonkova, Sinem Durmus, Hafize Uzun, Angela Mauro, Eleonora Fanti, Fabio Voller, Franca Rusconi, Fernando Garcia-Rodriguez, Ana V. Villarreal-Treviño, Angel J. Flores-Pineda, Paola B. Lara-Herrea, Diego R. Salinas-Encinas, Talia Diaz-Prieto, Maria R. Maldonado-Velazquez, Sarbelio Moreno-Espinosa, Enrique Faugier-Fuentes, Mirella Crapanzano, Ilaria Parissenti, Man S. Parihar, Pandiarajan Vignesh, ManojKumar Rohit, Kavitha Gopalan, Savita V. Attri, Alan Salama, David Jayne, Mark Little, Yulia Kostina, Galina Lyskina, Olga Shpitonkova, Alena Torbyak, Olga Shirinsky, Maria Francesca Gicchino, Maria Cristina Smaldone, Mario Diplomatico, Alma Nunzia Olivieri, C H. Spencer, Richard McClead, Hiren Patel, Chung-Yung Yu, Dita Cebecauerová, Tomáš Dallos, Edita Kabíčková, Martin Kynčl, Daniela Chroustová, Jozef Hoza, Dana Němcová, Vladimír Tesař, Pavla Doležalová, Tuncay Hazirolan, Fatih Ozaltin, Fabiola Almeida, Isabela H. Faria de Paula, Maíra M. Sampaio, Fernando N. Arita, Andressa G. Alves, Maria Carolina Santos, Eunice M. Okuda, Silvana B. Sacchetti, Fernanda Falcini, Marini Francesca, Gemma Lepri, Marco Matucci-Cerinic, Maria Luisa Brandi, Hakan Kisaoglu, Sema Misir, Selim Demir, Yuksel Aliyazicioglu, Mukaddes Kalyoncu, Carlos Eduardo Ramalho, Fabiola D. Almeida, Joan Calzada-Hernández, Rosa Bou, Estíbaliz Iglesias, Judith Sánchez-Manubens, Fredy Hermógenes Prada Martínez, Clara Giménez Roca, Sergi Borlan Fernández, Marek Bohm, Kamran Mahmood, Valentina Leone, Mark Wood, Ken-Ichi Yamaguchi, Satoshi Fujikawa, Working Group of Behçet’s Disease, Pediatric Rheumatology Association of Japan (PRAJ), Kyu Yeun Kim, Do Young Kim, Dong Soo Kim, Maka Ioseliani, Ivane Chkhaidze, Maia Lekishvili, Nana Tskhakaia, Shorena Tvalabeishvili, Aleksandre Kajrishvili, Maiko Takakura, Masaki Shimizu, Natsumi Inoue, Mao Mizuta, Akihiro Yachie, Giovanni Corsello, Maryam Piram, Carla Maldini, Sandra Biscardi, Nathalie Desuremain, Catherine Orzechowski, Emilie Georget, Delphine Regnard, Isabelle Kone-Paut, Alfred Mahr, Mihaela Sparchez, Zeno Sparchez, Nydia Acevedo Silva, Ana V. Villarreal Treviño, Yuridiana Ramirez Loyola, Talia Diaz Prieto, Enrique Faugier Fuentes, Maria D. R. Maldonado Velazquez, Pilar Perez, Sagar Bhattad, Ranjana Minz, Jitendra Shandilya, Pediatric Allergy and Immunology Unit, PGIMER, Chandigarh, Ana Villarreal, Yuridiana Ramírez, Zeynep Birsin Özçakar, Suat Fitoz, Fatos Yalcinkaya, Annacarin Horne, Francesca Minoia, Francesca Bovis, Sergio Davi, Priyankar Pal, Kimo Stein, Sandra Enciso, Michael Jeng, Despoina Maritsi, Randy C. Cron, Anne Thorwarth, Sae Lim von Stuckrad, Angela Rösen-Wolff, Hella Luksch, Patrick Hundsdoerfer, Peter Krawitz, Nuray Aktay Ayaz, Doğan Simsek, Şebnem Sara Kılıc, Emine Sonmez, Aysenur Pac Kisaarslan, Ozge Altug Gucenmez, Z. Serap Arıcı, Fatih Kelesoglu, Zelal Ekinci Ekinci, Maria Miranda-Garcia, Carolin Pretzer, Michael Frosch, F. Gohar, Angela McArdle, Niamh Callan, Belinda Hernandez, Miha Lavric, Oliver FitzGerald, Stephen R. Pennington, Joachim Peitz, Joern Kekow, Ariane Klein, Anna C. Schulz, Frank Weller-Heinemann, Anton Hospach, J-Peter Haas, BIKER collaborative group, Karen Put, Jessica Vandenhaute, Anneleen Avau, Annemarie van Nieuwenhuijze, Ellen Brisse, Tim Dierckx, Omer Rutgeerts, Josselyn E. Garcia-Perez, Jaan Toelen, Mark Waer, Georges Leclercq, An Goris, Johan Van Weyenbergh, Adrian Liston, Patrick Matthys, Carine H. Wouters, Yasuo Nakagishi, Michael J. Ombrello, Victoria Arthur, Anne Hinks, Patricia Woo, International Childhood Arthritis Genetics (INCHARGE) Consortium, Barbara Stanimirovic, Biljana Djurdjevic-Banjac, Olivera Ljuboja, Boris Hugle, MArgarita Onoufriou, Olga Vougiouka, Kenza Bouayed, Sanae El Hani, Imane Hafid, Nabiha Mikou, Nunu Shelia, Mari Laan, Jaanika Ilisson, and Chris Pruunsild

Subjects
Pediatrics, RJ1-570, Diseases of the musculoskeletal system, RC925-935
Published
2017
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26. Proceedings of the 23rd Paediatric Rheumatology European Society Congress: part three

Author

Riccardo Papa, Alessandro Consolaro, Francesca Minoia, Roberta Caorsi, Gianmichele Magnano, Marco Gattorno, Angelo Ravelli, Paolo Picco, Roberto Pillon, Denise Pires Marafon, Lidia Meli, Claudia Bracaglia, Andrea Taddio, Fabrizio De Benedetti, Enes Turan, Sara Sebnem Kilic, Yasuhiko Itoh, Tomoko Shigemori, Shingo Yamanishi, Hidehiko Nagasaki, Ela Tarakci, Nilay Arman, Devrim Tarakci, Yusuf S. Akgul, Ozgur Kasapcopur, Emily Wilson, Hanna Lythgoe, Eve Smith, Jenny Preston, Michael W. Beresford, Lynn R. Spiegel, Jennifer Stinson, Mark Connelly, Adam Huber, Nadia Luca, Argerie Tsimicalis, Stephanie Luca, Naweed Tajuddin, Roberta Berard, Julie Barsalou, Sarah Campillo, Brian Feldman, Shirley Tse, Paul Dancey, Ciaran Duffy, Nicole Johnson, Patrick McGrath, Natalie Shiff, Lori Tucker, Charles Victor, Chitra Lalloo, Lauren Harris, Joseph Cafazzo, Kristin Houghton, Ronald Laxer, Madeleine Rooney, Roisin Campbell, Catherine Wright, Wineke Armbrust, Otto Lelieveld, Jolanda Tuinstra, Nico Wulffraat, Joyce Bos, Jeanette Cappon, Marion van Rossum, Mariët Hagedoorn, Anna Vermé, Ylva Lampela, Ayse Huri Ozdogan, S. Ugurlu, K. Barut, A. Androvic, O. Kasapçopu, Jody Etheridge, Katie Dobson, Sue Kemp, AnnaCarin Horne, Karin Palmblad, Malin Höglund, Natalia Stepanenko, Svetlana Salugina, Evgeny Fedorov, Irina Nikishina, Maria Kaleda, Kenan Barut, Amra Adrovic, Sezgin Sahin, Laurence Toumoulin, Johnny Frossard, Stephanie Archimbaut, Anne Paitier, Rolande Guastalli, Severine Guillaume Czitrom, Sirirat Charuvanij, Chollada Chaiyadech, Takako Miyamae, Hisashi Yamanaka, Cecile Picard, Guillaume Thouvenin, Caroline Kannengiesser, Jean-Christophe Dubus, Nadia Jeremiah, Frédéric Rieux-Laucat, Bruno Crestani, Véronique Secq, Christelle Ménard, Martine Reynaud-Gaubert, Françoise Thivolet-Bejui, Philippe Reix, Alexandre Belot, Ezgi Deniz Batu, Hafize Emine Sonmez, Abdulsamet Erden, Ekim Z. Taskiran, Omer Karadag, Umut Kalyoncu, İbrahim Oncel, Berkan Kaplan, Zehra Serap Arici, Cagri Mesut Temucin, Haluk Topaloglu, Yelda Bilginer, Mehmet Alikasifoglu, Seza Ozen, Lien Van Eyck, Ellen De Langhe, Isabelle Jéru, Erika Van Nieuwenhove, Vasiliki Lagou, Paul J. Baker, Jocelyn Garcia-Perez, James Dooley, Lien De Somer, Raf Sciot, Pierre-Yves Jeandel, Julia Ruuth-Praz, Bruno Copin, Myrna Medley-Hashim, Andre Megarbane, Sinisa Savic, An Goris, Serge Amselem, Adrian Liston, Seth Masters, Carine Wouters, Nami Okamoto, Yuko Sugita, Kousuke Shabana, Takuji Murata, Hiroshi Tamai, Juliana Ferenczová, Erika Banóova, Pavol Mrážik, Veronika Vargova, Dubravko Bajramovic, Ksenija Stekic Novacki, Kristina Potocki, Marijan Frkovic, Marija Jelusic, Olga Kostareva, Svetlana Arsenyeva, Anna Shapovalenko, Lennart Jans, Nele Herregods, Jacob Jaremko, Rik Joos, Joke Dehoorne, Xenofon Baraliakos, Sofia Ramiro, Julio C. Casasola-Vargas, Désirée van der Heijde, Robert Landewé, Ruben Burgos-Vargas, Shirley M. Tse, Gerd Horneff, Kristina Unnebrink, Jaclyn K. Anderson, Aysenur Paç Kisaarslan, Betül Sözeri, Zübeyde Gündüz, Gökmen Zararsız, Hakan Poyrazoğlu, Ruhan Düşünsel, Kazutaka Ouchi, Shinji Akioka, Hiroshi Kubo, Norio Nakagawa, Hajime Hosoi, Lovro Lamot, Fran Borovecki, Sanja Kapitanovic, Kristina Gotovac, Mandica Vidovic, Mirta Lamot, Edi Paleka Bosak, Miroslav Harjacek, Ricardo A. Russo, María M. Katsicas, Ruben Burgos Vargas, Ana L. Ortiz-Peyegahud, Zhang Pingping, Mou Yikun, Qi Jun, Jiang Yutong, Gu Jieruo, Mikhail M. Kostik, Shilova Ekaterina, Ilia Avrusin, Yuriy Korin, Olga Kopchak, Eugenia Isupova, Irina Chikova, Panova Tatyana, Margarita Dubko, Vera Masalova, Ludmila Snegireva, Tatyana Kornishina, Olga Kalashnikova, Vyacheslav Chasnyk, Tatyana Likhacheva, N. Ruperto, H. I. Brunner, P. Quartier, T. Constantin, E. Alexeeva, R. Schneider, I. Kone-Paut, K. Schikler, K. Marzan, N. Wulffraat, S. Padeh, V. Chasnyk, C. Wouters, J. B. Kuemmerle-Deschner, T. Kallinich, B. Lauwerys, E. Haddad, E. Nasonov, M. Trachana, O. Vougiouka, K. Leon, A. Speziale, K. Lheritier, E. Vritzali, A. Martini, D. Lovell, PRINTO/PRCSG, Nienke Ter Haar, Rianne Scholman, Wilco de Jager, Tamar Tak, Pieter Leliefeld, Bas Vastert, Sytze de Roock, Ariane de Ganck, Nadia Ryter, Miha Lavric, Dirk Foell, Renee F. Modica, Kathleen G. Lomax, Pamela Batzel, Armelle Cassanas, Melissa E. Elder, Rina Denisova, Ekaterina Alexeeva, Saniya Valieva, Tatyana Bzarova, Kseniya Isayeva, Tatyana Sleptsova, Olga Lomakina, Alexandra Chomahidze, Margarita Soloshenko, Meyry Shingarova, Elena Kachshenko, Wilco De Jager, Sebastiaan J. Vastert, Gerdien Mijnheer, Berent J. Prakken, Nico M. Wulffraat, Hafize E. Sönmez, Asuman N. Karhan, Ezgi D. Batu, Zehra S. Arıcı, Ersin Gümüş, Hülya Demir, Aysel Yüce, Seza Özen, Jasmina Ahluwalia, Bhavneet Bharti, Sweta Rajpal, Varun Uppal, Alaknanda Walia, Surjit S. Samlok, Narender Kumar, Clarissa C. Valões, Beatriz C. Molinari, Ana Claudia G. Pitta, Natali W. Gormezano, Sylvia C. Farhat, Kátia Kozu, Adriana M. Sallum, Simone Appenzeller, Ana Paula Sakamoto, Maria T. Terreri, Rosa M. Pereira, Claudia S. Magalhães, Cássia Maria Barbosa, Francisco Hugo Gomes, Eloisa Bonfá, Clovis A. Silva, Kubra Ozturk, Zelal Ekinci, Maie Helal, Natalia Cabrera, Jean Christophe Lega, Jocelyne Drai, Rene Ecochard, O. V. Shpitonkova, N. S. Podchernyaeva, Y. O. Kostina, N. G. Dashkova, M. K. Osminina, Gozde Yucel, Ahmet Arvas, Nandini Moorthy, Paraskevi Dimou, Angela Midgley, Matthew Peak, Simon C. Satchell, Rachael D. Wright, Rachel Corkhill, Eve M. Smith, Sagar Bhattad, Amit Rawat, Surjit Singh, Anju Gupta, Deepti Suri, Martin de Boer, Taco Kuijpers, Vignesh Pandiarajan, Sapna Sandal, Sebastian Giraldo, Roy Sanguino, Adriana S. Diaz, Selcuk Uzuner, Gizem Durcan, Ali Guven Kilicoglu, Ayhan Bilgic, Kayhan Bahali, Sinem Durmus, Hafize Uzun, Nur Canpolat, Salim Caliskan, Lale Sever, Tomomi Sato, Fuminori Kimura, Wafaa Suwairi, Reem Abdwani, Abdulaziz Al Rowais, Jubran Al qanatish, Abdulrahman Al Asiri, Ekaterina Gaidar, Mikhail Kostik, Elena Serogodskaya, Tatyana Nikitina, Evgenia Isupova, Elham Sardar, Perrine Dusser, Antoine Rousseau, Marc Labetoulle, Emanuel Barreau, Bahram Bodaghi, Isabelle Kone-Paut, Ivan Foeldvari, Jordi Anton, Rosa Bou, Sheila Angeles-Han, Regitze Bangsgaard, Gabriele Brumm, Tamas Constantin, Clive Edelsten, Jens Klotsche, Kirsten Minden, Elisabetta Miserocchi, Susan Nielsen, Gabriele Simonini, Arnd Heiligenhaus, Juan Manuel Mosquera Angarita, Carmen Garcia de Vicuña, Maria Victoria Hernandez, Alfredo Adan, Victor Llorens, Rosa Alcobendas, Susana Noval, Juan Carlos Lopez Robledillo, Isabel Valls, Mari Carmen Pinedo, Alejandro Fonollosa, Jaime de Inocencio, Pilar Tejada, Beatriz Bravo, Manuel Torribio, María Jesús García de Yebenes, Jordi Antón, Uveitis Working Group of the Spanish Pediatric Rheumatology Society, Lorenza Maria Argolini, Irene Pontikaki, Maria Orietta Borghi, Laura Cesana, Barbara Castiglioni, Maurizio Gattinara, Pierluigi Meroni, Pierre Quartier, Veronique Despert, Sylvaine Poignant, Amandine Baptiste, Caroline Elie, Laurent Kodjikian, Dominique Monnet, Michel Weber, Laura Moal, LuuLy Pham, Emmanuel Barreau, Cherif Titah, Pascal Dureau, Vanessa Cecchin, Maria Elisabetta Zannin, Daniele Ferrari, Francesco Comacchio, Rolando Cimaz, Fernanda Falcini, Antonella Petaccia, Stefania Viola, Luciana Breda, Francesco La Torre, Fabio Vittadello, Giorgia Martini, Francesco Zulian, Caroline Galeotti, Guillaume Sarrabay, Olivier Fogel, Isabelle Touitou, Corinne Miceli-Richard, Isabelle Koné-Paut, Hala Etayari, Hashad Soad, Ihab El Kadry, Habibullah Eatamadi, Kais AlAlgawi, Mustafa Al Maini, Khulood Khawaja, Sophie Van den Berghe, Ilse de Schryver, Ann Raes, Lídia L. C. Teixeira, Ana Duarte, Sandra Sousa, Filipe Vinagre, Maria J. Santos, Nataly S. Shevchenko, Ludmila F. Bogmat, Marina V. Demyanenko, Navdha R. Ramchurn, Mark Friswell, Rebecca A. James, Lucy R. Wedderburn, Reshma Pattani, Clarissa A. Pilkington, Sandrine Compeyrot-Lacassagne, Ana V. Villarreal, Nydia Acevedo, Enrique Faugier, Rocio Maldonado, Dilek Yılmaz, Hilal Bektaş Uysal, Elena Kamenets, Ekaterina Zaharova, Stefka Radenska-Lopovok, Joao Nascimento, Helena Sofia, Carla Zilhão, Rui Almeida, Margarida Guedes, Murat Deveci, Svetlana Rodionovskaya, Vera Vinnikova, Irina Tsymbal, Edyta Olesińska, Jacek Postępski, Agnieszka Mroczkowska-Juchkiewicz, Agnieszka Pawłowska-Kamieniak, Beata Chrapko, Damjana Ključevšek, Nina Emeršič, Nataša Toplak, Tadej Avčin, Faina Rokhlina, Galina Glazyrina, Natalia Kolyadina, Kwangnam Kim, Sinae Eom, Daeyoung Kim, Jungwoo Rhim, Francesca Ricci, Paola Montesano, Barbara Bonafini, Veronica Medeghini, Ilaria Parissenti, Antonella Meini, Marco Cattalini, Paolo Airò, Nataliya Panko, Nataliya Shevchenko, Iryna Lebec, Yevgeniya Zajceva, Sara Rostlund, Marie André, Takuma Hara, Takayuki Kishi, Yumi Tani, Aki Hanaya, Satoru Nagata, Velma Selmanovic, Aida Omercahic-Dizdarevic, Adisa Cengic, Almira Cosickic, Aida Omerčahić Dizdarević, Gemma Lepri, Clara Malattia, Eleonora Bellucci, Marco Matucci-Cerinic, Anton Solovyev, Elena Fedotova, Ana Victoria Villarreal, Talia Diaz, Yuridiana Ramirez, Teresa Giani, Achille Marino, Daniel Hunt, Muthana Al Obaidi, Veli Veli, Charalampia Papadopoulou, Jochen Kammermeier, Anna Poluha, Gangadhara C. Bharmappanavara, Alison Kelly, Lindsay Shaw, Giovanna Ferrara, Michele Luzzati, Mattia Giovannini, Liliana Jurado, Juliana Chamorro, Lorena Sarmiento, Ester Conversano, Maria Francesca Gicchino, Giulia Macchini, Carmela Granato, Assunta Tirelli, Alma N. Olivieri, Marija Perica, Lana Tambić Bukovac, Reza Sinaei, Vadood Javadi Parvaneh, Reza Shiari, Khosro Rahmani, Fatemeh F. Mehregan, Mehrnoush Hassas Yeganeh, Inmaculada Calvo Penadés, Berta López Montesinos, Ma Isabel González Fernández, Adriana Rodríguez Vidal, Anand Prahalad Rao, Ayesha Romana, Jyothi Raghuram, Ankur Kumar, Vishali Gupta, Elif Comak, Gülşah Kaya Aksoy, Aygen Yılmaz, Atike Atalay, Mustafa Koyun, Reha Artan, Sema Akman, Maria I. Kaleda, Irina P. Nikishina, Sergei K. Soloviev, Victor A. Malievsky, Ekaterina V. Nikolaeva, Agnieszka Gazda, Beata Kołodziejczyk, Lidia Rutkowska-Sak, Angela Mauro, Pierluigi Marzuillo, Stefano Guarino, and Angela La Manna

Subjects
Pediatrics, RJ1-570, Diseases of the musculoskeletal system, RC925-935
Published
2017
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28. Safety of tiotropium in patients with asthma

Author

Daniel Dusser and Francine M. Ducharme

Subjects
Diseases of the respiratory system, RC705-779
Abstract

Given the high proportion of patients with asthma who remain uncontrolled despite controller treatment, there remains a need for the development of more effective treatment options with a proven safety and tolerability profile. Recently, asthma guidelines have evolved to incorporate new therapies, including long-acting muscarinic antagonists (LAMAs) and biologics. Here we focus on the safety profile of tiotropium, a LAMA, using data from the large-scale UniTinA-asthma ® clinical trial program, which investigated the use of tiotropium in over 6000 patients with asthma who remained symptomatic despite receiving inhaled corticosteroids maintenance therapy, with or without other adjunct therapies. The large number of patients included allows robust analysis of safety and tolerability. Overall, a similar incidence of patients reporting any adverse event (AE) was observed in the tiotropium (5 µg and 2.5 µg) and placebo groups. Asthma worsening, decreased peak expiratory flow, and upper respiratory tract infections were the most frequently reported AEs. Serious AEs (SAEs) and investigator-defined drug-related AEs were infrequently reported across all treatment groups, including the placebo group, and there were no deaths in any study. Reports of side effects typically associated with anticholinergic drugs, such as dry mouth and urinary retention, were either infrequent or not reported in children, adolescents or adults. The similar proportions of tiotropium- versus placebo-treated patients reporting AEs and SAEs in African-American and Japanese populations, as well as in elderly patients, contribute to the accumulating evidence of the safety and tolerability of tiotropium across broad ethnic and age populations.

Published
2019
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31. Differences in outcomes between GOLD groups in patients with COPD in the TIOSPIR® trial

Author

Dusser D, Wise RA, Dahl R, Anzueto A, Carter K, Fowler A, and Calverley PM

Subjects
TIOSPIR, GOLD, cardiovascular comorbidity, Diseases of the respiratory system, RC705-779
Abstract

Daniel Dusser,1 Robert A Wise,2 Ronald Dahl,3 Antonio Anzueto,4,5 Kerstine Carter,6 Andy Fowler,7 Peter M Calverley8 1Service de Pneumologie, Hôpital Cochin, AP-HP, Université Paris Descartes, Sorbonne Paris Cité, Paris, France; 2Asthma and Allergy Center, Johns Hopkins University School of Medicine, Baltimore, MD, USA; 3Allergy Centre, Odense University Hospital, Odense C, Denmark; 4Pulmonary/Critical Care, University of Texas, 5South Texas Veterans Health Care System, San Antonio, TX, USA; 6Boehringer Ingelheim Pharmaceuticals Inc, Ridgefield, CT, USA; 7Boehringer Ingelheim Pharma Ltd, Bracknell, UK; 8Institute of Ageing and Chronic Disease, University of Liverpool, Liverpool, UK Background: The aim of this study was to evaluate whether Global Initiative for Chronic Obstructive Lung Disease (GOLD) classification could predict mortality risk factors and whether baseline treatment intensity would relate to mortality within each group, using data from TIOSPIR®, the largest randomized clinical trial in COPD performed to date.Methods: A total of 17,135 patients from TIOSPIR® were pooled and grouped by GOLD grading (A–D) according to baseline Medical Research Council breathlessness score, exacerbation history, and spirometry. All-cause mortality and adjudicated cardiovascular (CV) and respiratory mortality were assessed.Results: Of the 16,326 patients classified, 1,248 died on treatment. Group B patients received proportionally more CV treatment at baseline. CV mortality risk, but not all-cause mortality risk, was significantly higher in Group B than Group C patients (CV mortality – hazard ratio [HR] =1.74, P=0.004; all-cause mortality – HR =1.18, P=0.11). Group D patients had a higher incidence of all-cause mortality than Group B patients (10.9% vs 6.6%). Similar trends were observed regardless of respiratory or CV medication at baseline. In contrast, respiratory deaths increased consistently from Groups A–D (0.3%, 0.8%, 1.6%, and 4.2% of patients, respectively).Conclusion: The data obtained from the TIOSPIR® trial, supporting earlier studies, suggest that proportionally more CV medication and CV deaths occur in GOLD Group B COPD patients, although deaths attributed to respiratory causes are more prevalent in Groups C and D. Keywords: TIOSPIR®, GOLD, cardiovascular comorbidity, mortality, respiratory death, cardiovascular death

Published
2016

32. Facteurs prédictifs de rechutes après l'arrêt des traitements chez les enfants présentant une AJI inactive sous b/ts-DMARDs : étude de cohorte rétrospective.

Author

Jallot, V., Dusser, P., Hentgen, V., Cavelot, S., and Koné-Paut, I.

Abstract

Les modalités d'arrêt des traitements biologiques chez les patients atteints d'AJI en rémission sous traitement sont encore non consensuelles. À ce jour, il n'existe que quelques articles sur la meilleure façon d'arrêter les b/ts-DMARDs. L'objectif de l'étude est d'identifier des facteurs prédictifs de rechute après l'arrêt du b/ts-DMARD chez des patients atteints d'AJI en rémission sous traitement. Il s'agit d'une étude rétrospective de patients atteints d'AJI qui répondaient aux critères de l'ILAR et qui ont arrêté leur b/ts-DMARD entre 2000 et 2023 dans des hôpitaux français. Les données utilisées sont issues de la cohorte JIR, un registre international multicentrique créé en 2013. La définition de la rémission était basée sur les critères de Wallace. Le critère d'évaluation principal a été défini comme l'absence ou la présence d'une rechute dans l'année suivant l'arrêt du traitement par b/ts-DMARD pour rémission. Une rechute a été définie comme le fait de ne plus remplir les critères de rémission dans l'année suivant l'arrêt du traitement par b-DMARD. Dans deux centres principaux, 697 patients ont été traités pour une AJI pendant la période de l'étude. Cent quinze d'entre eux (16,5 %) répondaient aux critères d'inclusion (23,8 % oligo-JIA, 23,1 % poly-JIA, 14,6 % pso-JIA, 22,3 % ERA, et 16,2 % so-JIA). Cent trente arrêts de traitement ont été analysés : 70,8 % étaient des filles, avec un âge médian de 5,3 ans au moment du diagnostic. Les patients ont reçu de l'anakinra, du canakinumab, du tocilizumab, de l'étanercept, de l'adalimumab, de l'infliximab ou du baricitinib. Tous ont interrompu leur traitement après une durée médiane de 2,6 ans sous b/ts-DMARD. Au total, 56,2 % d'entre eux ont présenté une rechute dans l'année qui a suivi l'arrêt du traitement (le taux de rechute le plus élevé a été enregistré dans le groupe psoriasis avec un taux de 89,5 %, le plus faible dans le groupe AJI systémique avec un taux de 33,3 %). Des anticorps antinucléaires positifs au moment du diagnostic semblaient fortement associés à une plus grande probabilité de rechute (p < 0,05) ; au contraire, une longue rémission prolongée sous traitement avant l'arrêt du b/ts-DMARD était un facteur prédictif indépendant d'une diminution du risque de rechute. De nombreux travaux sont en cours afin de créer une nouvelle classification de l'AJI. La dernière révision (PRINTO) ne faisant actuellement pas l'objet d'un consensus. Les études sur les facteurs prédictifs pourraient contribuer aux nouvelles classifications et à l'élaboration de protocoles de suivi corrélés à la probabilité de rechute. Les données de cette cohorte ont montré 56 % de rechutes dans l'année suivant l'arrêt des b/ts-DMARD. Les patients atteints d'AJI systémique semblent présenter un plus faible risque de rechute après l'arrêt du traitement. Des AAN positifs au moment du diagnostic semblent fortement associés au risque de rechute après l'arrêt du b/ts-DMARD. [ABSTRACT FROM AUTHOR]

Published
2024
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33. Empreintes de naissance : les expositions au cours de la période périnatale modifient-elles le risque le risque de polyarthrite rhumatoïde.

Author

Dusser, P., Nguyen, Y., Perin, C., Frenoy, P., Mariette, X., Boutron-Ruault, M.C., Gianluca, S., Salliot, C., and Seror, R.

Abstract

La polyarthrite rhumatoïde (PR) est une maladie auto-immune pour laquelle divers facteurs environnementaux précoces, tels que le tabagisme dans l'enfance, jouent un rôle crucial dans son développement. L'impact de l'environnement, en particulier lors de la période périnatale, est de plus en plus étudié. Certaines études ont suggéré que les paramètres de naissance, le tabagisme in utero pourraient influencer le risque de PR. L'objectif de cette étude est d'explorer l'association entre les facteurs périnataux avec le risque de PR dans la cohorte E3N. La cohorte E3N (« étude épidémiologique auprès de femmes de la mutuelle générale de l'éducation nationale ») comprend 98 995 femmes suivies depuis 1990. Parmi elles, 698 ont développé une PR validée. Les données périnatales (poids, taille, terme), le tabagisme in utero, l'allaitement et la privation alimentaire durant l'enfance ont été collectées à partir du questionnaire Q7 en 2002. Les Hazard Ratios (HR) et les intervalles de confiance (IC 95 %) pour le risque de PR ont été estimés via des modèles de Cox ajustés pour l'âge et d'autres facteurs de confusion identifiés par une analyse de graphique acyclique dirigé (DAG). Sur les 78 473 femmes étudiées, 698 cas incidents de polyarthrite rhumatoïde ont été identifiés. Sur l'ensemble de la population, aucune association significative n'a été identifiée entre les paramètres de périnatalité et le risque de PR. Cependant, une tendance non significative à un risque accru de PR a été observée chez les individus de grande taille à la naissance (HR = 1,24 [0,91–1,70]), et chez ceux nés prématurément (HR = 1,34 [0,92–1,95]). Chez les femmes ayant été allaitées on trouvait une tendance non significative vers un risque accru de PR (HR = 1,21 [0,99–1,47]), de même en cas d'exposition au tabac in utero (HR = 1,60 [0,88–2,93]. Enfin, la privation alimentaire durant l'enfance (pendant la seconde guerre mondiale) n'était pas associée au risque de PR (HR = 0,95 [0,78–1,15]). L'analyse stratifiée selon le statut tabagique montre que chez les fumeuses, la prématurité est associée à un risque accru de PR (HR = 1,63 [1,02–2,64]) et une tendance non significative pour le tabagisme in utero (HR = 1,83 [0,91–3,69]). Chez les non-fumeuses, un risque accru significatif a été observé pour les femmes de grande taille à la naissance (HR = 1,55 [1,02–2,35]). Nos résultats suggèrent que la prématurité et l'exposition au tabac in utero pourraient influencer le risque de PR, particulièrement chez les fumeuses, tandis que la taille à la naissance aurait une influence chez les non-fumeuses. Concernant l'allaitement, la littérature présente des résultats contradictoires, certains suggérant que la prolactine, sécrétée durant l'allaitement, pourrait augmenter le risque de PR. Des études complémentaires sont nécessaires pour clarifier cet impact potentiel. [ABSTRACT FROM AUTHOR]

Published
2024
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34. An official American Thoracic Society/European Respiratory Society statement: research questions in COPD

Author

Bartolome R. Celli, Marc Decramer, Jadwiga A. Wedzicha, Kevin C. Wilson, Alvar A. Agustí, Gerard J. Criner, William MacNee, Barry J. Make, Stephen I. Rennard, Robert A. Stockley, Claus Vogelmeier, Antonio Anzueto, David H. Au, Peter J. Barnes, Pierre-Regis Burgel, Peter M. Calverley, Ciro Casanova, Enrico M. Clini, Christopher B. Cooper, Harvey O. Coxson, Daniel J. Dusser, Leonardo M. Fabbri, Bonnie Fahy, Gary T. Ferguson, Andrew Fisher, Monica J. Fletcher, Maurice Hayot, John R. Hurst, Paul W. Jones, Donald A. Mahler, François Maltais, David M. Mannino, Fernando J. Martinez, Marc Miravitlles, Paula M. Meek, Alberto Papi, Klaus F. Rabe, Nicolas Roche, Frank C. Sciurba, Sanjay Sethi, Nikos Siafakas, Don D. Sin, Joan B. Soriano, James K. Stoller, Donald P. Tashkin, Thierry Troosters, Geert M. Verleden, Johny Verschakelen, Jorgen Vestbo, John W. Walsh, George R. Washko, Robert A. Wise, Emiel F.M. Wouters, and Richard L. ZuWallack

Subjects
Diseases of the respiratory system, RC705-779
Abstract

Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity, mortality and resource use worldwide. The goal of this official American Thoracic Society (ATS)/European Respiratory Society (ERS) Research Statement is to describe evidence related to diagnosis, assessment, and management; identify gaps in knowledge; and make recommendations for future research. It is not intended to provide clinical practice recommendations on COPD diagnosis and management. Clinicians, researchers and patient advocates with expertise in COPD were invited to participate. A literature search of Medline was performed, and studies deemed relevant were selected. The search was not a systematic review of the evidence. Existing evidence was appraised and summarised, and then salient knowledge gaps were identified. Recommendations for research that addresses important gaps in the evidence in all areas of COPD were formulated via discussion and consensus. Great strides have been made in the diagnosis, assessment and management of COPD, as well as understanding its pathogenesis. Despite this, many important questions remain unanswered. This ATS/ERS research statement highlights the types of research that leading clinicians, researchers and patient advocates believe will have the greatest impact on patient-centred outcomes.

Published
2015
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35. Host–microbe interactions in distal airways: relevance to chronic airway diseases

Author

Clémence Martin, Pierre-Régis Burgel, Patricia Lepage, Claire Andréjak, Jacques de Blic, Arnaud Bourdin, Jacques Brouard, Pascal Chanez, Jean-Charles Dalphin, Gaetan Deslée, Antoine Deschildre, Philippe Gosset, Lhousseine Touqui, and Daniel Dusser

Subjects
Diseases of the respiratory system, RC705-779
Abstract

This article is the summary of a workshop, which took place in November 2013, on the roles of microorganisms in chronic respiratory diseases. Until recently, it was assumed that lower airways were sterile in healthy individuals. However, it has long been acknowledged that microorganisms could be identified in distal airway secretions from patients with various respiratory diseases, including cystic fibrosis (CF) and non-CF bronchiectasis, chronic obstructive pulmonary disease, asthma and other chronic airway diseases (e.g. post-transplantation bronchiolitis obliterans). These microorganisms were sometimes considered as infectious agents that triggered host immune responses and contributed to disease onset and/or progression; alternatively, microorganisms were often considered as colonisers, which were considered unlikely to play roles in disease pathophysiology. These concepts were developed at a time when the identification of microorganisms relied on culture-based methods. Importantly, the majority of microorganisms cannot be cultured using conventional methods, and the use of novel culture-independent methods that rely on the identification of microorganism genomes has revealed that healthy distal airways display a complex flora called the airway microbiota. The present article reviews some aspects of current literature on host–microbe (mostly bacteria and viruses) interactions in healthy and diseased airways, with a special focus on distal airways.

Published
2015
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38. Cutaneous manifestations of monogenic auto-inflammatory diseases: An international cohort study from the Juvenile Inflammatory Rheumatism cohort

Author

Monfort, J.B., primary, Deshayes, S., additional, Dusser, P., additional, Bourguiba, R., additional, Savey, L., additional, Vinit, C., additional, Koné-Paut, I., additional, Amaryan, G., additional, Theodoropoulou, K., additional, Guedri, R., additional, Pachlopnik, J., additional, Belot, A., additional, Melki, I., additional, Perveen Maldar, N., additional, Hentgen, V., additional, Georgin-Lavialle, S., additional, Wouters, C., additional, Woerner, A., additional, Kaiser, D., additional, Berthet, G., additional, Merlin, E., additional, Pillet, P., additional, Richer, O., additional, Barbier, C., additional, Ballot, C., additional, Bolt, I., additional, Wittkowski, H., additional, Rotornaz, K., additional, Jurquet, A.L., additional, Poignant, S., additional, Meinzer, U., additional, Vanoni, F., additional, Dan, D., additional, Lega, J.C., additional, Brunner, J., additional, Aouba, A., additional, Uettwiller, F., additional, Kaplanski, G., additional, Ardois, S., additional, Schleinitz, N., additional, and Dehoorne, J., additional

Published
2022
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39. Manifestations cutanées des maladies auto-inflammatoires monogéniques : étude de cohorte internationale

Author

Monfort, J.B., primary, Deshayes, S., additional, Dusser, P., additional, Bourguiba, R., additional, Savey, L., additional, Vinit, C., additional, Kone-Paut, I., additional, Amaryan, G., additional, Theodoropoulou, K., additional, Guedri, R., additional, Pachlopnik, J., additional, Belot, A., additional, Melki, I., additional, Perveen-Maldar, N., additional, Hentgen, V., additional, and Georgin-Lavialle, S., additional

Published
2022
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40. Cutaneous manifestations of monogenic auto-inflammatory diseases: An international cohort study from the Juvenile Inflammatory Rheumatism cohort

Author

Wouters, C., Woerner, A., Kaiser, D., Berthet, G., Merlin, E., Pillet, P., Richer, O., Barbier, C., Ballot, C., Bolt, I., Wittkowski, H., Rotornaz, K., Jurquet, A.L., Poignant, S., Meinzer, U., Vanoni, F., Dan, D., Lega, J.C., Brunner, J., Aouba, A., Uettwiller, F., Kaplanski, G., Ardois, S., Schleinitz, N., Dehoorne, J., Monfort, J.B., Deshayes, S., Dusser, P., Bourguiba, R., Savey, L., Vinit, C., Koné-Paut, I., Amaryan, G., Theodoropoulou, K., Guedri, R., Pachlopnik, J., Belot, A., Melki, I., Perveen Maldar, N., Hentgen, V., and Georgin-Lavialle, S.

Published
2022
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41. Small airways diseases, excluding asthma and COPD: an overview

Author

Pierre-Régis Burgel, Anne Bergeron, Jacques de Blic, Philippe Bonniaud, Arnaud Bourdin, Pascal Chanez, Thierry Chinet, Jean-Charles Dalphin, Philippe Devillier, Antoine Deschildre, Alain Didier, Marianne Kambouchner, Christiane Knoop, François Laurent, Hilario Nunes, Thierry Perez, Nicolas Roche, Isabelle Tillie-Leblond, and Daniel Dusser

Subjects
Airway pathology, connective tissue disease, constrictive bronchiolitis, drug-induced lung disease, follicular bronchiolitis, immune deficiency, Diseases of the respiratory system, RC705-779
Abstract

This review is the summary of a workshop on small airways disease, which took place in Porquerolles, France in November 2011. The purpose of this workshop was to review the evidence on small airways (bronchiolar) involvement under various pathophysiological circumstances, excluding asthma and chronic obstructive pulmonary disease. Histopathological patterns associated with small airways disease were reviewed, including cellular and obliterative bronchiolitis. Many pathophysiological conditions have been associated with small airways disease including airway infections, connective tissue diseases and inflammatory bowel diseases, bone marrow and lung transplantation, common variable immunodeficiency disorders, diffuse panbronchiolitis, and diseases related to environmental exposures to pollutants, allergens and drugs. Pathogenesis, clinical presentation, a computed tomography scan and pulmonary function test findings are reviewed, and therapeutic options are described with the objective of providing an integrative approach to these disorders.

Published
2013
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42. POS1326 PIMS THROUGH THE WAVES OF COVID 19: DATA FROM THE JIR COHORT

Author

Kechiche, R., primary, Schvartz, A., additional, Bajolle, F., additional, Poignant, S., additional, Basmaci, R., additional, Pajot, C., additional, Meinzer, U., additional, Morin, L., additional, Lambert, V., additional, Dusser, P., additional, Matsa, N., additional, Hofer, M., additional, Koné-Paut, I., additional, and Caroline, G., additional

Published
2022
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44. OP0220 CRITERIA ASSOCIATED WITH TREATMENT DECISIONS IN JUVENILE IDIOPATHIC ARTHRITIS WITH A FOCUS ON ULTRASONOGRAPHY: RESULTS FROM THE JIRECHO COHORT.

Author

Mahmoud, S., primary, Jousse-Joulin, S., additional, Saraux, A., additional, Dusser, P., additional, Borocco, C., additional, Galeotti, C., additional, Von Scheven, A., additional, Hofer, M., additional, Bader-Meunier, B., additional, Aeschlimann, F., additional, Breton, S., additional, Sparsa, L., additional, Aurélia, C., additional, Mouterde, G., additional, Rossi-Semerano, L., additional, and Devauchelle-Pensec, V., additional

Published
2022
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45. Cutaneous manifestations of monogenic auto-inflammatory diseases: An international cohort study from the Juvenile Inflammatory Rheumatism cohort

Author

Monfort, J B, Deshayes, S, Dusser, P, Bourguiba, R, Savey, L, Vinit, C, Koné-Paut, I, Amaryan, G, Theodoropoulou, K, Guedri, R, Pachlopnik, Jana, Belot, A, Melki, I, Perveen Maldar, N, Hentgen, V, Georgin-Lavialle, S, University of Zurich, and Monfort, J B

Subjects
2708 Dermatology, 10036 Medical Clinic, 610 Medicine & health
Published
2022
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46. Update on the roles of distal airways in COPD

Author

N. Roche, C. Pilette, T. Perez, H. Morel, F. Laurent, G. Jebrak, G. Garcia, A. Didier, A. Deschildre, P. Devillier, J. de Blic, T. Chinet, A. Chaouat, F. Chabot, P. Chanez, A. Bourdin, P-R. Burgel, I. Tillie-Leblond, S. Verbanck, and D. Dusser

Subjects
Airway inflammation, airway remodelling, alveoli, bronchioles, chronic obstructive pulmonary disease, distal airways, Diseases of the respiratory system, RC705-779
Abstract

This review is the summary of a workshop on the role of distal airways in chronic obstructive pulmonary disease (COPD), which took place in 2009 in Vence, France. The evidence showing inflammation and remodelling in distal airways and the possible involvement of these in the pathobiology, physiology, clinical manifestations and natural history of COPD were examined. The usefulness and limitations of physiological tests and imaging techniques for assessing distal airways abnormalities were evaluated. Ex vivo studies in isolated lungs and invasive measurements of airway resistance in living individuals have revealed that distal airways represent the main site of airflow limitation in COPD. Structural changes in small conducting airways, including increased wall thickness and obstruction by muco-inflammatory exudates, and emphysema (resulting in premature airway closure), were important determinants of airflow limitation. Infiltration of small conducting airways by phagocytes (macrophages and neutrophils), dendritic cells and T and B lymphocytes increased with airflow limitation. Distal airways abnormalities were associated with patient-related outcomes (e.g. dyspnoea and reduced health-related quality of life) and with the natural history of the disease, as reflected by lung function decline and mortality. These data provide a clear rationale for targeting distal airways in COPD.

Published
2011

47. Update on the roles of distal airways in asthma

Author

P-R. Burgel, J. de Blic, P. Chanez, C. Delacourt, P. Devillier, A. Didier, J-C. Dubus, I. Frachon, G. Garcia, M. Humbert, F. Laurent, R. Louis, A. Magnan, B. Mahut, T. Perez, N. Roche, I. Tillie-Leblond, M. Tunon de Lara, and D. Dusser

Subjects
Airway inflammation, airway remodelling, alveoli, asthma, bronchioles, distal airway, Diseases of the respiratory system, RC705-779
Abstract

The present review is the summary of an expert workshop that took place in Vence (France) in 2007 on the role of distal airways in asthma. The evidence showing inflammation and remodelling in distal airways, and their possible involvement in asthma control and natural history, was reviewed. The usefulness and limitations of various techniques used for assessing distal airways were also evaluated, including pulmonary function tests and imaging. Finally, the available data studying the benefit of treatment better targeting distal airways in asthma was examined. It was concluded that both proximal and distal airways were involved in asthma and that distal airways were the major determinant of airflow obstruction. Inflammation in distal airways appeared more intense in severe and uncontrolled asthma. Distal airways were poorly attained by conventional aerosol of asthma medications owing to their granulometry, being composed of 3–5 µm particles. Both proximal and distal airways might be targeted either by delivering medications systemically or by aerosol of extra-fine particles. Extra-fine aerosols of long-acting β-agonists, inhaled corticosteroids or inhaled corticosteroid/long-acting β-agonist combinations have been shown in short-term studies to be not inferior to non-extra-fine aerosols of comparators. However, available studies have not yet demonstrated that extra-fine inhaled medications offer increased benefit compared with usual aerosols in asthmatic patients.

Published
2009

50. Caractéristiques cliniques de la Covid-19 chez les enfants et adolescents atteints de maladies rhumatismales et inflammatoires : données de la cohorte française RMD COVID-19 de 95 patients

Author

Mammou Mraghni, S., primary, Drumez, E., additional, Aeschlimann, F., additional, Pajot-Audouin, C., additional, Bader-Meunier, B., additional, Carbasse, A., additional, Clet, J., additional, Deslandre, C., additional, Duquesne, A., additional, Dusser, P., additional, Guillaume-Czitrom, S., additional, Hentgen, V., additional, Koné-Paut, I., additional, Melki, I., additional, Quartier, P., additional, Hachulla, E., additional, and Belot, A., additional

Published
2021
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