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1. Altered epithelial barrier functions in the colon of patients with spina bifida

Author: Charlène Brochard, Guillaume Bouguen, Raphael Olivier, Tony Durand, Sébastien Henno, Benoît Peyronnet, Mael Pagenault, Chloé Lefèvre, Gaëlle Boudry, Mikael Croyal, Alain Fautrel, Maxime Esvan, Alain Ropert, Anne Dariel, Laurent Siproudhis, and Michel Neunlist
Subjects: Medicine, Science
Abstract: Abstract Our objectives were to better characterize the colorectal function of patients with Spina Bifida (SB). Patients with SB and healthy volunteers (HVs) completed prospectively a standardized questionnaire, clinical evaluation, rectal barostat, colonoscopy with biopsies and faecal collection. The data from 36 adults with SB (age: 38.8 [34.1–47.2]) were compared with those of 16 HVs (age: 39.0 [31.0–46.5]). Compared to HVs, rectal compliance was lower in patients with SB (p = 0.01), whereas rectal tone was higher (p = 0.0015). Ex vivo paracellular permeability was increased in patients with SB (p = 0.0008) and inversely correlated with rectal compliance (r = − 0.563, p = 0.002). The expression of key tight junction proteins and inflammatory markers was comparable between SB and HVs, except for an increase in Claudin-1 immunoreactivity (p = 0.04) in SB compared to HVs. TGFβ1 and GDNF mRNAs were expressed at higher levels in patients with SB (p = 0.02 and p = 0.008). The levels of acetate, propionate and butyrate in faecal samples were reduced (p = 0.04, p = 0.01, and p = 0.02, respectively). Our findings provide evidence that anorectal and epithelial functions are altered in patients with SB. The alterations in these key functions might represent new therapeutic targets, in particular using microbiota-derived approaches. Clinical Trials: NCT02440984 and NCT03054415.
Published: 2022
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2. Correction: Efficacy of ustekinumab, vedolizumab, or a second anti-TNF agent after the failure of a first anti-TNF agent in patients with Crohn’s disease: a multicentre retrospective study

Author: Cassandra Rayer, Maria Nachury, Arnaud Bourreille, Xavier Roblin, Laurent Peyrin-Biroulet, Stephanie Viennot, Mathurin Flamant, David Laharie, Bénédicte Caron, Marie Dewitte, Laurent Siproudhis, Mathurin Fumery, and Guillaume Bouguen
Subjects: Diseases of the digestive system. Gastroenterology, RC799-869
Published: 2023
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3. Determinants of high-grade anal intraepithelial lesions in HIV-positive men having sex with men

Author: Isabelle Etienney, Laurent Siproudhis, Lionel Piroth, Isabelle Poizot-Martin, Sylvie Radenne, Jacques Reynes, Anne-Carole Lesage, Isabelle Heard, Sébastien Henno, Jean-François Flejou, Ana Canestri, Olivier Patey, Annie Lion, Cédric Arvieux, Gilles Maincent, Emmanuelle Ressiot, Marine Landon, Tristan Ferry, Jean-Michel Didelot, Lucie Marchand, Jean-Damien Combes, and Gary M. Clifford, For the ANRS EP57 APACHES Study group.
Subjects: Infectious and parasitic diseases, RC109-216
Abstract: Background: Identifying determinants for histologically proven high-grade anal intraepithelial lesions (hHSIL) in HIV-positive MSM would allow better targeted screening. Methods: APACHES is a prospective study of anal HPV and related-lesions in 513 HIV-positive MSM aged ≥35 in six clinics across France. At baseline, participants underwent high resolution anoscopy (HRA) with biopsy of suspicious lesions, preceded by anal swabs for liquid-based cytology, p16/Ki67 immunostaining, and HPV DNA. hHSIL diagnosis was established by histopathological review panel consensus, and determinants assessed by logistic regression. Results: Baseline hHSIL prevalence was 10.4% and did not differ significantly by age, sexual behaviour or any HIV/immunodeficiency markers. hHSIL prevalence was significantly elevated in participants that smoked (ORadj=2.6, 95%CI 1.3–5.5) or who, in concurrent anal swabs, had ASCUS/LSIL (3.6, 95% CI 1.4–9.3) or ASC-H/HSIL (22.2, 95% CI 6.8–72.6) cytologic abnormalities, p16/Ki67 dual positivity (3.4, 95%CI 1.5–7.5), or non16-HR HPV (13.0, 95%CI 1.7–102), but most notably, HPV16 (46.3, 6.1–355) infection. Previous diagnosis of low- (2.3, 95%CI 1.0–5.4) or high- (3.8, 95%CI 1.5–9.9) grade anal lesion also conveyed higher hHSIL risk. After controlling for patient-specific determinants, there remained significant clinic-specific effects, especially in higher risk groups (HPV16-positive participants: 31.3% hHSIL in clinics A-D versus 5.1% in clinics E-F, p
Published: 2018
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4. Incidental colorectal focal 18F-FDG uptake: a novel indication for colonoscopy

Author: Eugénie Rigault, Laurence Lenoir, Guillaume Bouguen, Mael Pagenault, Astrid Lièvre, Etienne Garin, Laurent Siproudhis, and Jean-François Bretagne
Subjects: Diseases of the digestive system. Gastroenterology, RC799-869
Abstract: Background and study aims The relevance of incidental colorectal focal 18F-FDG PET/CT uptake is debatable. All patients who were referred for colonoscopy because of incidental colonic focal FDG uptake were included in this retrospective study. Patients and methods PET/CT imaging characteristics were reviewed by a nuclear physician who was blinded to endoscopic and histopathological findings to determine the location of FDG uptake sites and to measure the maximum standardized uptake values (SUVmax) and metabolic volume (MV). Endoscopic findings were categorized as malignant lesions (ML), high-risk polyps (HRP), low-risk polyps (LRP) or other non-neoplastic lesions (NNL). Results Seventy patients with 84 foci of FDG uptake were included. The proportions of true-positive (lesions found at colonoscopy at the same location) and false-positive (no lesion at colonoscopy) PET/CT findings were 65.5 % (n = 55) and 34.5 % (n = 29). Median SUVmax values did not differ between true-positive and false-positive findings (P = 0.27). Median MV30 values differed significantly between true-positive (5.5 cm3, [3.3 – 10.9 cm3]) and false-positive (9.7 cm3, [5.2 – 40.8 cm3]) findings (P = 0.015). Among the 55 true-positive FDG uptake sites, there were 14 (25.5 %) malignant lesions, 30 (54.5 %) HRP, 4 (7.3 %) LRP, and 7 (12.7 %) NNL. Median MV30 values differed significantly between advanced neoplasia (5.0 cm3, [2.9 – 9.7 cm3]) and other endoscopic findings (9.4 cm3, [5.2 – 39.8 cm3]) (P = 0.001); the AUROC was 0.71. By per-colonic segment analysis, the distribution of true-positive, false-negative, false-positive, and true-negative FDG PET/CT findings was as follows: 21.5 %, 14.2 %, 11.5 %, and 52.8 %, respectively. Conclusion Our study demonstrates that follow-up complete colonoscopy is mandatory in all patients with incidental colorectal focal 18F-FDG PET/CT uptake.
Published: 2017
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5. Efficacy of ustekinumab, vedolizumab, or a second anti-TNF agent after the failure of a first anti-TNF agent in patients with Crohn’s disease: a multicentre retrospective study

Author: Cassandra, Rayer, Nachury, Maria, Arnaud, Bourreille, Xavier, Roblin, Laurent, Peyrin-Biroulet, Stephanie, Viennot, Mathurin, Flamant, David, Laharie, Bénédicte, Caron, Marie, Dewitte, Laurent, Siproudhis, Mathurin, Fumery, and Guillaume, Bouguen
Published: 2022
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6. Incontinence fécale: sémantiques, scores et cotations

Author: Laurent Siproudhis
Subjects: General Medicine
Published: 2023
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7. Real-world evidence of quality of life improvement in patients with distal ulcerative colitis treated by mesalazine: the Quartz study

Author: Thierry, Paupard, Florent, Gonzalez, Bénédicte, Caron, Laurent, Siproudhis, and Laurent, Peyrin-Biroulet
Subjects: Hepatology, Anti-Inflammatory Agents, Non-Steroidal, Quality of Life, Gastroenterology, Humans, Colitis, Ulcerative, Quartz, Mesalamine, Proctocolitis, Inflammatory Bowel Diseases, Ulcer
Abstract: Distal ulcerative colitis (UC) is responsible for distressing symptoms and reduces quality of life (QoL). Oral and topical formulations of 5-amino-salicylic acid are the first line therapy for mild to moderate distal UC.Our aim was to evaluate the impact of mesalazine treatment for mild to moderate ulcerative proctitis and proctosigmoiditis on patient QoL.Ninety-three patients with mild to moderate ulcerative proctitis and proctosigmoiditis, initiating a treatment with Pentasa, were prospectively included. The primary endpoint was the change from baseline to W8 in patient health-related QoL (HRQoL) as measured by the Short Inflammatory Bowel Disease Questionnaire (SIBDQ) total score.More than 80% of patients were prescribed with a rectal formulation, either alone (47.9%) or with an oral formulation (35.1%), and 17.0% of patients were prescribed oral formulation alone. Mean SIBDQ score was improved at W8 in patients affected with mild and moderate disease ( P lt; 0.001 versus baseline in both groups, as well as in patients who achieved clinical remission ( P lt; 0.001). Patients who achieved clinical remission at W8 reached a mean change of +6.7 (±7.1), whereas those who did not achieve clinical remission had a mean change of +1.1 (±8.9). Seventy-five per cent of patients had an improvement of their disability index at W8. Fecal incontinence was also improved at W8.HRQoL measuring with the SIBDQ is proportionally related to disease activity in patients with distal UC treated with mesalazine.
Published: 2022
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8. Natural History of Anal Ulcerations in Pediatric-Onset Crohn's Disease: Long-Term Follow-Up of a Population-Based Study

Author: Perrine Mortreux, Ariane Leroyer, Claire Dupont, Delphine Ley, Valérie Bertrand, Claire Spyckerelle, Nathalie Guillon, Pauline Wils, Corinne Gower-Rousseau, Guillaume Savoye, Mathurin Fumery, Dominique Turck, Laurent Siproudhis, Hélène Sarter, CHU Lille, Institute for Translational Research in Inflammation - U 1286 (INFINITE (Ex-Liric)), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lille-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Nutrition, Inflammation et axe Microbiote-Intestin-Cerveau (ADEN), Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU)-Institute for Research and Innovation in Biomedicine (IRIB), Normandie Université (NU)-Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM), Institute for Research and Innovation in Biomedicine (IRIB), Normandie Université (NU)-Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Service de Pédiatrie Médicale [Caen], Université de Caen Normandie (UNICAEN), Normandie Université (NU)-Normandie Université (NU)-CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Tumorothèque de Caen Basse-Normandie (TCBN), CHU Le Havre, Groupement des Hôpitaux de l'Institut Catholique de Lille (GHICL), Université catholique de Lille (UCL), Centre Hospitalier Universitaire de Reims (CHU Reims), Normandie Université (NU), Service d'Hépato-Gastroentérologie [CHU Rouen], Hôpital Charles Nicolle [Rouen], CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Service d'Hépato Gastroenterologie [CHU Amiens-Picardie], CHU Amiens-Picardie, Service d'hépato-gastro-entérologie [Rennes] = Gastroenterology [Rennes], CHU Pontchaillou [Rennes], Hôpital St Vincent de Paul, Service d'Epidémiologie et de Santé Publique [Lille], Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Périnatalité et Risques Toxiques - UMR INERIS_I 1 (PERITOX), and Institut National de l'Environnement Industriel et des Risques (INERIS)-Université de Picardie Jules Verne (UPJV)-CHU Amiens-Picardie
Subjects: Hepatology, [SDV]Life Sciences [q-bio], Gastroenterology, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract: International audience; Background: Anal ulcerations are frequently observed in Crohn's disease (CD). However, their natural history remains poorly known, especially in pediatric-onset CD.Methods: All patients with a diagnosis of CD before the age of 17 years between 1988 and 2011 within the population-based registry EPIMAD were followed retrospectively until 2013. At diagnosis and during follow-up, the clinical and therapeutic features of perianal disease were recorded. An adjusted time-dependent Cox model was used to evaluate the risk of evolution of anal ulcerations towards suppurative lesions.Results: Among the 1,005 included patients (females, 450 (44.8%); median age at diagnosis 14.4 years (IQR, 12.0-16.1)), 257 (25.6%) had an anal ulceration at diagnosis. Cumulative incidence of anal ulceration at 5 and 10 years from diagnosis was 38.4% (CI95%, 35.2-41.4) and 44.0% (CI95%, 40.5-47.2), respectively. In multivariable analysis, the presence of extra-intestinal manifestations (Hazard Ratio (HR) 1.46, CI95% 1.19-1.80, p=0.0003) and upper digestive location (HR 1.51, CI95% 1.23-1.86, p
Published: 2023
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9. Obesity in adult patients with inflammatory bowel disease: Clinical features and impact on disability. A cross-sectional survey from the GETAID

Author: Rose Al Bacha, Yoram Bouhnik, Melanie Serrero, Jerome Filippi, Xavier Roblin, Anne Bourrier, Guillaume Bouguen, Denis Franchimont, Guillaume Savoye, Anthony Buisson, Edouard Louis, Stephane Nancey, Vered Abitbol, Jean-Marie Reimund, Olivier DeWit, Lucine Vuitton, Nicolas Mathieu, Laurent Peyrin-Biroulet, Cyrielle Gilletta, Matthieu Allez, Stephanie Viennot, Catherine Le Berre, David Laharie, Maria Nachury, Aurelien Amiot, Sara Tadbiri, Charlotte Gagniere, Jenny Tannoury, Benjamin Pariente, Pauline Wils, Carmen Stefanescu, Xavier Treton, Carole Martins, Mathieu Uzzan, Xavier Hébuterne, Nadia Arab, Virginie Cluzeau, Emilie Del Tedesco, Laurent Beaugerie, Philippe Seksik, Cecilia Landmann, Julien Kirchgesner, Harry Sokol, Laurent Siproudhis, Marie DeWitte, Catherine Reenaers, Gilles Boschetti, Claire Gay, Pauline Danion, Bernard Flourié, Georgia Malamut, Benedicte Caron, Olivier DeWitt, Sandie Pestour, Thomas Chateau, Camille Zallot, Jean-Marc Gornet, Clotilde Baudry, Arnaud Bourreille, Caroline Trang-Poisson, Nina Dib, Hedi Brixi, Guillaume Cadiot, Medina Boualit, Claire Painchart, Laurianne Plastaras, Romain Altwegg, Lucile Boivineau, Mathurin Fumery, Ludovic Caillo, Pauline Riviere, Florian Poullenot, Benoit Coffin, Henri Duboc, Stephane Nahon, Noemie Tavernier, Marion Simon, Baya Coulibaly, Morgane Amil, Duveau Nicolas, Sherine Khater, Mehdi Kaassis, Felix Goutorbe, Driffa Moussata, Laurence Picon, AP-HP Hôpital Bicêtre (Le Kremlin-Bicêtre), Hôpital Beaujon [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Hôpital Nord [CHU - APHM], Immunité muqueuse et vaccination, Université Nice Sophia Antipolis (1965 - 2019) (UNS), COMUE Université Côte d'Azur (2015-2019) (COMUE UCA)-COMUE Université Côte d'Azur (2015-2019) (COMUE UCA)-IFR50-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Côte d'Azur (UCA), Service de Gastro-entérologie et Hépatologie [CHU Saint-Etienne], Centre Hospitalier Universitaire de Saint-Etienne [CHU Saint-Etienne] (CHU ST-E), Centre de Recherche Saint-Antoine (CRSA), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), CHU Pontchaillou [Rennes], Nutrition, Métabolismes et Cancer (NuMeCan), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Hôpital Erasme [Bruxelles] (ULB), Faculté de Médecine [Bruxelles] (ULB), Université libre de Bruxelles (ULB)-Université libre de Bruxelles (ULB), CHU Rouen, Normandie Université (NU), CHU Clermont-Ferrand, Microbes, Intestin, Inflammation et Susceptibilité de l'Hôte (M2iSH), Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre de Recherche en Nutrition Humaine d'Auvergne (CRNH d'Auvergne)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)-Université Clermont Auvergne (UCA), Centre Hospitalier Universitaire de Liège (CHU-Liège), Hospices Civils de Lyon (HCL), Hôpital Cochin [AP-HP], Voies de Signalisation du Développement et du Stress Cellulaire dans les Cancers Digestifs et Urologiques, Université de Strasbourg (UNISTRA)-Institut National de la Santé et de la Recherche Médicale (INSERM), Catholic University of Leuven - Katholieke Universiteit Leuven (KU Leuven), Service de Gastro-Entérologie [CHRU Besançon], Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), CHU Grenoble, 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), Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Hopital Saint-Louis [AP-HP] (AP-HP), CHU Amiens-Picardie, Périnatalité et Risques Toxiques - UMR INERIS_I 1 (PERITOX), Institut National de l'Environnement Industriel et des Risques (INERIS)-Université de Picardie Jules Verne (UPJV)-CHU Amiens-Picardie, Groupe d’Étude Thérapeutique des Affections Inflammatoires du Tube Digestif (GETAID), and This study was supported by Abbvie.
Subjects: Crohn's disease, Disability, Ulcerative colitis, Hepatology, Gastroenterology, [SDV.MHEP.HEG]Life Sciences [q-bio]/Human health and pathology/Hépatology and Gastroenterology, Fatigue, Inflammatory bowel disease, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract: International audience; Background: In recent years, an increasing prevalence of obesity in inflammatory bowel disease (IBD) has been observed. However, only a few studies have focused on the impact of overweight and obesity on IBD-related disability.Aims: To identify the factors associated with obese and overweight patients with IBD, including IBD-related disability.Patients and methods: In this cross-sectional study, we included 1704 consecutive patients with IBD in 42 centres affiliated with the Groupe d'Etude Therapeutique des Affections Inflammatoires du tube Digestif (GETAID) using a 4-page questionnaire. Factors associated with obesity and overweight were assessed using univariate and multivariate analyses (odds ratios (ORs) are provided with 95% confidence intervals).Results: The prevalence rates of overweight and obesity were 24.1% and 12.2%, respectively. Multivariable analyses were stratified by age, sex, type of IBD, clinical remission and age at diagnosis of IBD. Overweight was significantly associated with male sex (OR = 0.52, 95% CI [0.39-0.68], p < 0.001), age (OR = 1.02, 95% CI [1.01-1.03], p < 0.001) and body image subscore (OR = 1.15, 95% CI [1.10-1.20], p < 0.001) (Table 2). Obesity was significantly associated with age (OR = 1.03, 95% CI [1.02-1.04], p < 0.001), joint pain subscore (OR = 1.08, 95% CI [1.02-1.14], p < 0.001) and body image subscore (OR = 1.25, 95% CI [1.19-1.32], p < 0.001) (Table 3).Conclusion: The increasing prevalence of overweight and obesity in patients with IBD is associated with age and poorer body image. A holistic approach to IBD patient care should be encouraged to improve IBD-related disability and to prevent rheumatological and cardiovascular complications.
Published: 2023
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10. Allogenic stem cells for anal Crohn’s fistula: treating early improves the deep response rate

Author: Nadia Fathallah, Laurent Siproudhis, Mélissa Akaffou, Mohamed Amine Haouari, Amandine Landemaine, Elise Pommaret, Lucas Spindler, Charlène Brochard, Guillaume Bouguen, and Vincent Parades
Abstract: Purpose: The aim of this study was to evaluate the real-life clinical and radiological efficacy of darvadstrocel injection into complex perianal fistulas in Crohn’s disease. Secondary endpoints were to assess symptomatic efficacy, outcomes and factors associated with complete combined clinical-radiological response (deep response). Methods: After marketing the product in France, all patients treated consecutively were included. A complete clinical response was defined by a complete closure of all external openings with no discharge on pressure. A partial response was defined by closure of ≥ 50% of external openings with no discharge on pressure. A complete radiological response (MRI), evaluated at least after six months of follow-up, was defined by a completely fibrotic sequela without abscess. Results: Forty-three patients were included (M/F: 22/21, median age 37 [26-45] years). The fistulas of all patients were already drained with seton(s) and were on biologic treatment. After a median follow-up of 383 [359-505] days, 28 (65%) patients showed a clinical response (22 complete and 6 partial). Only 16 (37%) achieved a deep response. The PDAI decreased significantly after treatment: 39 (91%) patients reported symptomatic improvement in terms of discharge, pain, and induration, and 28 (65%) no longer had any perineal symptoms. Only a short history of Crohn’s disease < 3 years was significantly associated with deep response (OD 4.5 [1.0-19.1], p = 0.04). Conclusion: Darvadstrocel injection resulted in a clinical response for two thirds of patients and deep response for one third. A shorter duration of Crohn’s disease was associated with deep response.
Published: 2023
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11. Transanal irrigation is a better choice for bowel dysfunction in adults with spina bifida: a randomized controlled trial

Author: Charlène Brochard, Magali Jezequel, Anne Blanchard‐Dauphin, Jacques Kerdraon, Brigitte Perrouin‐Verbe, Anne‐Marie Leroi, Jean Michel Reymann, Benoît Peyronnet, Jeff Morçet, Laurent Siproudhis, CHU Pontchaillou [Rennes], The Enteric Nervous System in gut and brain disorders [U1235] (TENS), Institut National de la Santé et de la Recherche Médicale (INSERM)-Nantes Université - UFR de Médecine et des Techniques Médicales (Nantes Univ - UFR MEDECINE), Nantes Université - pôle Santé, Nantes Université (Nantes Univ)-Nantes Université (Nantes Univ)-Nantes Université - pôle Santé, Nantes Université (Nantes Univ)-Nantes Université (Nantes Univ), CHU Lille, Centre Mutualiste de Kerpape, Ploemeur, Centre hospitalier universitaire de Nantes (CHU Nantes), Nutrition, Inflammation et axe Microbiote-Intestin-Cerveau (ADEN), Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU)-Institute for Research and Innovation in Biomedicine (IRIB), Normandie Université (NU)-Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM), Institute for Research and Innovation in Biomedicine (IRIB), Normandie Université (NU)-Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Service de physiologie digestive, urinaire, respiratoire et de l'exercice [CHU Rouen], Hôpital Charles Nicolle [Rouen], CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU), Centre d'Investigation Clinique [Rennes] (CIC), Université de Rennes (UR)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), Service d'urologie [Rennes] = Urology [Rennes], Hôpital Pontchaillou-CHU Pontchaillou [Rennes], Service des Maladies de l'Appareil Digestif [CHU Rennes], Nutrition, Métabolismes et Cancer (NuMeCan), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), and French Ministry of Health. Grant Number: 2013-A01520-45
Subjects: transanal irrigation, faecal incontinence, [SDV]Life Sciences [q-bio], Gastroenterology, bowel dysfunction, conservative treatment, [SDV.MHEP.HEG]Life Sciences [q-bio]/Human health and pathology/Hépatology and Gastroenterology, Spina bifida, randomised controlled trial
Abstract: International audience; Aim: To compare transanal irrigation with conservative bowel management for the treatment of bowel dysfunction in Spina bifida (SB) patients.Methods: Patients with SB and bowel dysfunction were randomly assigned to receive either transanal irrigation or conservative bowel management. The effectiveness of the treatment was defined as a decrease of 4 points in the neurogenic bowel dysfunction (NBD) score at week 10. Data on incontinence (Cleveland scores; Jorge-Wexner [JW]) and constipation (Knowles-Eccersley-Scott Symptom Constipation Score [KESS]) were recorded at 10 and 24 weeks after inclusion. Data were analysed on an intention-to-treat basis.Results: A total of 34 patients were randomised: 16 patients to conservative bowel management and 18 patients to transanal irrigation. A total of 19/31 (61%) patients improved at week 10, 13 (76%) in the transanal irrigation group versus six (43%) in the conservative group (p = 0.056). In the irrigation group, the decrease in NBD score was -6.9 (-9.9 to -4.02) versus -1.9 (-6.5 to -2.8) in the conservative group (p = 0.049 in univariate and p = 0.004 in multivariate analysis). The NBD, Cleveland (JW and KESS) and Rosenberg scores were significantly lower in the transanal irrigation group than in the conservative bowel management group at week 10.Conclusions: This prospective, randomised, controlled, multicentre study in adult patients with SB suggests that transanal irrigation may be more effective than conservative bowel management.
Published: 2023
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12. Identification of the optimal medical and surgical management for patients with perianal fistulising Crohn’s disease

Author: Mathilde Laland, Marie François, Ferdinando D'Amico, Camille Zallot, Charlène Brochard, Marie Dewitte, Laurent Siproudhis, Laurent Peyrin‐Biroulet, Guillaume Bouguen, CHU Pontchaillou [Rennes], Nutrition-Génétique et Exposition aux Risques Environnementaux (NGERE), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL), Humanitas University [Milan] (Hunimed), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Centre d'Investigation Clinique [Rennes] (CIC), Université de Rennes (UR)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), Nutrition, Métabolismes et Cancer (NuMeCan), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), and Jonchère, Laurent
Subjects: [SDV] Life Sciences [q-bio], Crohn’s disease, medical and surgical management, [SDV]Life Sciences [q-bio], Gastroenterology, [SDV.MHEP.HEG]Life Sciences [q-bio]/Human health and pathology/Hépatology and Gastroenterology, perianal fistula, [SDV.MHEP.HEG] Life Sciences [q-bio]/Human health and pathology/Hépatology and Gastroenterology, combination therapy
Abstract: International audience; AIMS: The aims of our study were to assess the best medical and surgical approaches for Perianal Crohn’s Disease (PCD) in order to identify an optimal combined medical and surgical treatment. METHODS: Medical records of all patients with PCD treated with TNFα antagonists in two referral centers between 1998 and 2018 were reviewed. Predictors of long-term outcomes were identified using a Cox proportional hazard model. RESULTS: A total of 200 patients were included. Fifty-three patients (26.5%) were treated with adalimumab and 147 (73.5%) with infliximab. Combination of TNFα antagonist with an immunosuppressant and presence of proctitis were independently associated with fistula closure. Seton was placed in 127 patients (63.5%) before starting biological therapy. Eighty patients (40%) underwent additional perineal surgery. Prior PCD surgery, seton positioning, additional perineal surgery, and additional surgery within 52 weeks of anti-TNFα treatment were associated with an increased rate of fistula closure. Finally, medical combination therapy (anti-TNFα plus immunosuppressant) along with seton placement and additional surgery within one year was the best management for PCD patients (p=0,02). CONCLUSION: Combined medical and surgical management is required for the treatment of PCD patients. Medical combination therapy associated with seton placement and additional surgery within one year is the best management for PCD patients.
Published: 2023
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13. Prise en charge des lésions obstétricales du sphincter anal : enquête des pratiques françaises et des perceptions selon les disciplines

Author: Aurélien Venara, Valérie Bridoux, C. Brochard, Laurent Abramowitz, G. Legendre, Laurent Siproudhis, and X. Fritel
Subjects: Surgery
Abstract: Resume But de l’etude Faire une enquete de pratique sur la prise en charge des lesions obstetricales du sphincter anal (LOSA) et comparer les pratiques a court, moyen et long terme en fonction de la filiere de prise en charge. Patients et methodes Un questionnaire de 50 questions a ete adresse aux differents specialistes via les societes savantes nationales. Il etait demande uniquement aux praticiens prenant en charge des LOSA de repondre au questionnaire de pratiques. Resultats Sur les 135 professionnels de sante repondeurs, 57 etaient des specialistes de l’anus et du rectum (42,2 %) et 78 des specialistes de la naissance (57,8 %). En periode aigue, la prise en charge etait similaire selon les specialites et 50 % des praticiens ne suturaient pas les sphincters internes. Par ailleurs, peu de specialistes de la naissance recommandaient une consultation systematique avec un specialiste de l’anus et du rectum dans cette situation. A moyen terme, les specialistes de l’anus et du rectum exploraient plus, cliniquement ou par examens paracliniques, la symptomatologie digestive. Les examens n’aboutissaient toutefois pas systematiquement a une prise en charge en l’absence de consensus notamment sur la suture sphincterienne a moyen terme. Par ailleurs, 25 % des praticiens recommandaient la realisation d’une cesarienne de maniere systematique pour un nouvel accouchement apres LOSA. A long terme (> 12 mois), la prise en charge d’une LOSA etait significativement differente entre les specialites, mais aussi au sein d’une meme specialite. Conclusion Les differents specialistes devraient se coordonner pour proposer des recommandations multidisciplinaires sur la prise en charge des LOSA.
Published: 2021
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14. Long-term outcomes and predictors of disabling disease in a population-based cohort of patients with incident Crohn's disease diagnosed between 1994 and 1997

Author: Marie-Laure, Rabilloud, Emma, Bajeux, Laurent, Siproudhis, Stéphanie, Hamonic, Maël, Pagenault, Charlène, Brochard, Agathe, Gerfaud, Alain, Dabadie, Jean-François, Viel, Isabelle, Tron, Michel, Robaszkiewicz, Jean-François, Bretagne, Guillaume, Bouguen, CHU Pontchaillou [Rennes], Centre d'Investigation Clinique [Rennes] (CIC), Université de Rennes (UR)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), Nutrition, Métabolismes et Cancer (NuMeCan), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Institut de recherche en santé, environnement et travail (Irset), Université d'Angers (UA)-Université de Rennes (UR)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Observatoire régional de la santé Bretagne, This work received a grant from ABBVIE, Rungis, France, and Jonchère, Laurent
Subjects: Hepatology, [SDV]Life Sciences [q-bio], Gastroenterology, [SDV.MHEP.HEG]Life Sciences [q-bio]/Human health and pathology/Hépatology and Gastroenterology, Outcomes, Population-based, [SDV.MHEP.HEG] Life Sciences [q-bio]/Human health and pathology/Hépatology and Gastroenterology, Cohort Studies, Intestines, [SDV] Life Sciences [q-bio], Crohn's disease, Treatment Outcome, Crohn Disease, Disease Progression, Humans, Immunosuppressive Agents
Abstract: International audience; Background: The identification of early prognostic factors during Crohn's disease (CD) remains needed for physician decision-making to minimize structural bowel damage, which this study aimed to assess in a population-based setting. Methods: All incident cases of CD were prospectively registered from 1994 to 1997 in Brittany, a limited area of France. All charts of patients were reviewed from the diagnosis to the last clinic visit in 2015. Disabling CD course was defined according to the Saint-Antoine criteria. Results: Among the 331 incident cases of CD, 272 (82%) were followed-up for a median time of 12.8 years. The cumulative probability of developing stricturing or fistulizing CD was 66% at 15 years, and 107 (39%) patients underwent surgery. The cumulative probabilities of immunosuppressant and TNF antagonist use at 15 years were 37% and 22%, respectively. The cumulative risks for disabling disease and bowel damage were 74% and 71% at 15 years, respectively. Systemic symptoms and perianal lesions at diagnosis were independently associated with a disabling disease course. Perianal disease and short disease extension were associated with the onset of bowel damage. Deep ulcers was not predictive of any outcome. Conclusions: A disabling disease course and bowel damage occurred early in the course of CD, which suggests the need for early diagnosis and early treatment, particularly for patients with systematic symptoms and perianal disease.
Published: 2022
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15. Prospective and multicentre study of radiofrequency treatment in anal fistula

Author: Marie Sautereau, Dominique Bouchard, Charlène Brochard, François Pigot, Laurent Siproudhis, Jean Marie Fayette, Cécile Train, Anne Laurain, Charlotte Favreau, Laurent Abramowitz, CIC - CHU Bichat, Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Pontchaillou [Rennes], Nutrition, Métabolismes et Cancer (NuMeCan), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), and Ramsay Santé
Subjects: Crohn’s disease, radiofrequency, anal incontinence, [SDV]Life Sciences [q-bio], sphincter-sparing, Gastroenterology, fistula-in-ano
Abstract: International audience; BACKGROUND: The most effective treatment for anal fistula is fistulotomy, but it involves a risk of anal incontinence. To reduce this morbidity, sphincter-sparing treatments have been developed, but their success in real life is often less than 50%. The aim is to determine clinical healing rate 6 months after radiofrequency treatment. PATIENTS AND METHODS: We planned to evaluate 50 patients from 3 French proctology centres. Treatment efficacy was evaluated at 6 and 12 months by means of clinical and magnetic resonance imaging examination. We evaluated morbidity and healing prognostic factors. RESULTS: Fifty patients with a mean age of 51years [22-82] were included. Eleven patients had a low transsphincteric fistula(LTS), 21 high transsphincteric fistula(HTS), 8 complex fistula and 9 Crohn’s disease fistula. After 6 months, 17 patients (34.7%) had a clinically healed fistula, including 5 (45.5%) with LTS fistula, 7 (33.3%) with HTS fistula, 1 (12.5%) with complex fistula, 4 (44.4%) with Crohn’s disease, with no significant difference between these fistula types (p:0.142). At 12 months, the healing rate was identical. MRI in 15 out of 17 clinically healed patients showed a deep remission of 73.3% at 12 months. Energy power was associated with the success of the treatment. There was an 8.2% incidence of post-surgical complications with 4.1% being abscesses (one required surgical management). Postoperative pain was minor. No new cases or deterioration of continence have been shown. CONCLUSION: Radiofrequency is effective in less than 50% of the cases as an anal fistula treatment in this first prospective study, with low morbidity and no effect on continence. Clinical healing was deep (MRI) in ¾ at 1 year. The increase in energy power during the procedure seems to be a key point to be analysed to optimise results.
Published: 2022
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16. Effectiveness and Safety of Ustekinumab Intensification at 90 mg Every 4 Weeks in Crohn’s Disease: A Multicentre Study

Author: Lieven Pouillon, Guillaume Bouguen, Bernard Flourié, Mathurin Fumery, Stephanie Viennot, Laurent Siproudhis, Franck Brazier, Jérôme Filippi, Pauline Veyrard, Florian Poullenot, Anthony Buisson, Lucile Boivineau, Xavier Treton, Momar Diouf, David Laharie, Cyrielle Gilletta, Stéphane Nancey, Romain Altwegg, Xavier Roblin, Anne Bozon, and Laurent Peyrin-Biroulet
Subjects: medicine.medical_specialty, Crohn's disease, medicine.diagnostic_test, business.industry, Gastroenterology, Colonoscopy, General Medicine, medicine.disease, 3. Good health, 03 medical and health sciences, 0302 clinical medicine, Interquartile range, Internal medicine, Ustekinumab, medicine, 030211 gastroenterology & hepatology, 030212 general & internal medicine, Every Four Weeks, Calprotectin, Adverse effect, business, medicine.drug, Cohort study
Abstract: Background The approved maintenance regimens for ustekinumab in Crohn’s disease [CD] are 90 mg every 8 or 12 weeks. Some patients will respond partially to ustekinumab or will experience a secondary loss of response. It remains poorly known if these patients may benefit from shortening the interval between injections. Methods All patients with active CD, as defined by Harvey–Bradshaw score ≥ 4 and one objective sign of inflammation [C-reactive protein > 5 mg/L and/or faecal calprotectin > 250 µg/g and/or radiological and/or endoscopic evidence of disease activity] who required ustekinumab dose escalation to 90 mg every 4 weeks for loss of response or incomplete response to ustekinumab 90 mg every 8 weeks were included in this retrospective multicentre cohort study. Results One hundred patients, with a median age of 35 years [interquartile range, 28–49] and median disease duration of 12 [7–20] years were included. Dose intensification was performed after a median of 5.0 [2.8–9.0] months of ustekinumab treatment and was associated with corticosteroids and immunosuppressants in respectively 29% and 27% of cases. Short-term clinical response and clinical remission were observed in respectively 61% and 31% after a median of 2.4 [1.3–3.0] months. After a median follow-up of 8.2 [5.6–12.4] months, 61% of patients were still treated with ustekinumab, and 26% were in steroid-free clinical remission. Among the 39 patients with colonoscopy during follow-up, 14 achieved endoscopic remission [no ulcers]. At the end of follow-up, 27% of patients were hospitalized, and 19% underwent intestinal resection surgery. Adverse events were reported in 12% of patients, including five serious adverse events. Conclusion In this multicentre study, two-thirds of patients recaptured response following treatment intensification with ustekinumab 90 mg every 4 weeks.
Published: 2020
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17. Management of solitary rectal ulcer syndome: Results of a french national survey

Author: Marion Chambaz, Guillaume Meurette, Aurélien Venara, Laurent Siproudhis, Charlène Brochard, Alain Ropert, Guillaume Bouguen, and Claire Gouriou
Subjects: medicine.medical_specialty, Rehabilitation, Hepatology, Medical treatment, business.industry, medicine.medical_treatment, General surgery, Gastroenterology, Laxative, Biofeedback, Solitary rectal ulcer syndrome, 3. Good health, 03 medical and health sciences, Solitary rectal ulcer, 0302 clinical medicine, Quality of life, 030220 oncology & carcinogenesis, Intervention (counseling), medicine, 030211 gastroenterology & hepatology, business
Abstract: There is no consensus on the treatment for solitary rectal ulcer syndrome (SRUS). This study aimed to obtain information from physicians treating patients with SRUS in a French medical surgical society to facilitate management plans and to develop a support algorithm. Members of the French National Society of Coloproctology (SNFCP) were invited to complete a survey that included twenty items about therapeutic management and healing criteria. Overall, 91 practitioners (median age: 52 [42-59] years) responded to the questionnaire; 64/91 (70.3%) were proctologists, and 27/91 (29.7%) were colorectal surgeons. Only 15 members (16.5%) followed more than 5 patients with SRUS per year. The therapeutic objectives were to improve both patient symptoms (100%) and quality of life (98.9%). Laxative treatment and first-line rehabilitation were agreed upon by 83.5% and 73% of the respondents, respectively. Surgery, mainly rectopexy, was offered after failed medical treatment by 81.1% of the practitioners (79.1%). The first-line strategy preferred by the professionals included laxatives and biofeedback rehabilitation. Surgical treatment, preferably rectopexy, was proposed as a second intervention. No consensus was reached regarding other therapeutic alternatives, and additional studies are required to clarify their indications.
Published: 2020
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18. Ten-year Evaluation of a Large Retrospective Cohort Treated by Sacral Nerve Modulation for Fecal Incontinence

Author: Vincent Wyart, Laurent Siproudhis, Guillaume Meurette, Henri Damon, François Mion, Elsa Lambrescak, Charlotte Desprez, Paul-Antoine Lehur, Anne-Marie Leroi, Club Nemo, Isabelle Etienney, Igor Sielezneff, Thomas Duflot, Guillaume Gourcerol, Diane Mege, Jean-Luc Faucheron, Charlène Brochard, Nadine Ajamie, and Valérie Bridoux
Subjects: Male, medicine.medical_specialty, Lumbosacral Plexus, Electric Stimulation Therapy, Internal medicine, medicine, Humans, Fecal incontinence, Favorable outcome, Adverse effect, Aged, Retrospective Studies, business.industry, Background data, Retrospective cohort study, Middle Aged, 3. Good health, Treatment Outcome, Increased risk, Multicenter study, Sacral nerve, Female, Surgery, France, medicine.symptom, business, Fecal Incontinence
Abstract: OBJECTIVE The aim of this study was to assess the effectiveness of sacral nerve modulation (SNM) in a large cohort of patients implanted for at least 10 years, quantify adverse event rates, and identify predictive factors of long-term success. SUMMARY BACKGROUND DATA Few studies have evaluated the long-term success of SNM. METHODS Data collected prospectively from patients implanted for fecal incontinence (FI) in 7 French centers between January 1998 and December 2008 were retrospectively analyzed. Patient FI severity scores were assessed before and 10 years after implantation. The main evaluation criterion was the success of SNM defined by the continuation of the treatment without additional therapies. The secondary evaluation criteria were the rate of device revisions and explantations. Preoperative predictors of success at 10 years were sought. RESULTS Of the 360 patients (27 males, mean age: 59 ± 12 years) implanted for FI, 162 (45%) had a favorable outcome 10 years post-implantation, 115 (31.9%) failed, and 83 (23.1%) were lost to follow-up. The favorable outcome derived from the time-to-event Kaplan-Meier curve at 10 years was 0.64 (95% CI 0.58-0.69). FI severity scores were significantly better 10 years post-implantation compared to preimplantation (7.4 ± 4.3 vs 14.0 ± 3.2; P < 0.0001). During the 10-year follow-up, 233 patients (64.7%) had a surgical revision and 94 (26.1%) were explanted. A history of surgery for FI and sex (male) were associated with an increased risk of an unfavorable outcome. CONCLUSIONS Long-term efficacy was maintained in approximately half of the FI patients treated by SNM at least 10 years post-implantation.
Published: 2020
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19. Disruption of Circadian Rhythms and Gut Motility

Author: Laurent Siproudhis, Henri Duboc, and Benoit Coffin
Subjects: Gastrointestinal tract, Suprachiasmatic nucleus, business.industry, Gastrointestinal Physiology, Circadian clock, Gastroenterology, medicine.disease, CLOCK, Rhythm, medicine, Circadian rhythm, business, Neuroscience, Irritable bowel syndrome
Abstract: Circadian rhythms ensure that physiological processes occur at the most biologically meaningful time. The circadian timing in the gastrointestinal tract involves interlocking transcriptional and translational feedback loops that culminate in the rhythmic expression and activity of a set of clock genes and related hormones. The suprachiasmatic nucleus and peripheral core molecular clocks oscillate every 24 hours and are responsible for the periodic activity of various segments and transit along the gastrointestinal tract. Environmental cues may alter or reset these rhythms to align them with new circumstances. Colonic motility also follows a circadian rhythm with reduced nocturnal activity. Healthy humans have normal bowel motility during the day, frequently following awakening or following a meal, with minimal activity during the night. Maladjusted circadian rhythms in the bowel have been linked to digestive pathologies, including constipation and irritable bowel syndrome. Our advanced knowledge of the link between the circadian clock and gastrointestinal physiology provides potential therapeutic approaches for the treatment of gastrointestinal diseases. This review seeks to establish evidence for the correlation between circadian rhythm, bowel movements and digestive health, and examine the implications of disrupted circadian rhythms on gut physiology.
Published: 2020
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20. Natural History of Perianal Crohn's Disease: Long-term Follow-up of a Population-Based Cohort

Author: Charlène Brochard, Marie-Laure Rabilloud, Stéphanie Hamonic, Emma Bajeux, Maël Pagenault, Alain Dabadie, Agathe Gerfaud, Jean-François Viel, Isabelle Tron, Michel Robaszkiewicz, Jean-François Bretagne, Laurent Siproudhis, Guillaume Bouguen, Etienne Cruchant, Jean-Luc Alexandre, Jacques Arnaud Seyrig, Centre d'Investigation Clinique [Rennes] (CIC), Université de Rennes (UR)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), Nutrition, Métabolismes et Cancer (NuMeCan), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), CHU Pontchaillou [Rennes], Institut de recherche en santé, environnement et travail (Irset), Université d'Angers (UA)-Université de Rennes (UR)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Observatoire Régional de Santé (ORS Bretagne), ORS Bretagne, Centre Hospitalier Régional Universitaire de Brest (CHRU Brest), AbbVie, Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES), Université d'Angers (UA)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), and Jonchère, Laurent
Subjects: medicine.medical_specialty, [SDV]Life Sciences [q-bio], Disease, outcomes, population based, Cohort Studies, 03 medical and health sciences, 0302 clinical medicine, Crohn Disease, Internal medicine, medicine, Humans, Rectal Fistula, Proctitis, Retrospective Studies, Crohn's disease, Hepatology, business.industry, Incidence (epidemiology), Hazard ratio, Gastroenterology, Retrospective cohort study, [SDV.MHEP.HEG]Life Sciences [q-bio]/Human health and pathology/Hépatology and Gastroenterology, medicine.disease, [SDV.MHEP.HEG] Life Sciences [q-bio]/Human health and pathology/Hépatology and Gastroenterology, 3. Good health, Natural history, [SDV] Life Sciences [q-bio], natural history, 030220 oncology & carcinogenesis, 030211 gastroenterology & hepatology, business, Perianal Crohn’s disease, Anal stricture, Follow-Up Studies
Abstract: International audience; BACKGROUND AND AIMS: The natural history of perianal Crohn’s disease (PCD) remains poorly described and is mainly based on retrospective studies from referral centres. The aim of this study was to assess the incidence, outcomes and predictors of the onset of PCD. METHODS: All incident cases of patients diagnosed with possible CD were prospectively registered from 1994 to 1997 in Brittany, a limited area in France. At diagnosis, the clinical features of perianal disease were recorded. All patient charts were reviewed from the diagnosis to the last clinic visit in 2015. RESULTS: Among the 272 out of 331 incident CD patients followed up, 51 (18.7%) patients had PCD at diagnosis. After a mean follow-up of 12.8 years, 93 (34%) patients developed PCD. The cumulative probabilities of perianal CD occurrence were 22%, 29%, and 32% after 1 year, 5 years, and 10 years, respectively. The cumulative probabilities of anal ulceration were 14%, and 19% after 1 year and 10 years, respectively. Extraintestinal manifestations were associated with the occurrence of anal ulceration. The cumulative probabilities of fistulizing PCD were 11%, 16%, and 19% after 1 year, 5 years, and 10 years, respectively. Extraintestinal manifestations, rectal involvement and anal ulceration were predictors of fistulizing PCD. The cumulative probability of developing anal stricture was 4% after 10 years. CONCLUSIONS: PCD is frequently observed during CD, in approximately one-third of patients. These data underline the need for targeted therapeutic research on primary perianal lesions (proctitis, anal ulceration) to avoid the onset of fistulizing perianal disease.
Published: 2022
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21. Risk factors for upper urinary tract deterioration in adult patients with spina bifida

Author: Camille Haudebert, Juliette Hascoet, Emmanuelle Samson, Magali Jezequel, Caroline Voiry, Charlène Brochard, Claire Richard, Jacques Kerdraon, Laurent Siproudhis, Andréa Manunta, and Benoit Peyronnet
Subjects: Urology
Published: 2023
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22. Patients’ real-world experience with inflammatory bowel disease: A cross-sectional survey in tertiary care centres from the GETAID group

Author: Maria Nachury, Yoram Bouhnik, Melanie Serrero, Jerome Filippi, Xavier Roblin, Julien Kirchgesner, Guillaume Bouguen, Denis Franchimont, Guillaume Savoye, Anthony Buisson, Edouard Louis, Stephane Nancey, Vered Abitbol, Jean-Marie Reimund, Olivier DeWit, Lucine Vuitton, Nicolas Matthieu, Laurent Peyrin-Biroulet, Cyrielle Gilletta, Sara Tadbiri, Matthieu Allez, Stephanie Viennot, Arnaud Bourreille, David Laharie, Aurelien Amiot, Charlotte Gagniere, Jenny Tannoury, Benjamin Pariente, Pauline Wils, Carmen Stefanescu, Xavier Treton, Xavier Hébuterne, Nadia Arab, Virginie Cluzeau, Emilie Del Tedesco, Laurent Beaugerie, Philippe Seksik, Anne Bourrier, Cecilia Landmann, Harry Sokol, Laurent Siproudhis, Marie DeWitte, Catherine Reenaers, Gilles Boschetti, Claire Gay, Pauline Danion, Bernard Flourié, Georgia Malamut, Benedicte Caron, Olivier DeWitt, Nicolas Mathieu, Sandie Pestour, Camille Zallot, Jean-Marc Gornet, Clotilde Baudry, Caroline Trang-Poisson, Nina Dib, Hedi Brixi, Guillaume Cadiot, Medina Boualit, Claire Painchart, Laurianne Plastaras, Romain Altwegg, Lucile Boivineau, Mathurin Fumery, Ludovic Caillo, Pauline Riviere, Florian Poullenot, Benoit Coffin, Henri Duboc, Stephane Nahon, Noemie Tavernier, Marion Simon, Baya Coulibaly, Morgane Amil, Duveau Nicolas, Sherine Khater, Mehdi Kaassis, Felix Goutorbe, Driffa Moussata, Laurence Picon, Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Service de Gastroentérologie [Hôpital Beaujon], Hôpital Beaujon [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Hôpital Nord [CHU - APHM], CIC - Biotherapie - Marseille, Institut National de la Santé et de la Recherche Médicale (INSERM), Hôpital Pasteur [Nice] (CHU), Université Côte d'Azur (UCA), Centre Hospitalier Universitaire de Saint-Etienne [CHU Saint-Etienne] (CHU ST-E), CHU Saint-Antoine [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Laboratoire des biomolécules (LBM UMR 7203), Chimie Moléculaire de Paris Centre (FR 2769), École normale supérieure - Paris (ENS-PSL), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Ecole Nationale Supérieure de Chimie de Paris - Chimie ParisTech-PSL (ENSCP), Université Paris sciences et lettres (PSL)-Ecole Superieure de Physique et de Chimie Industrielles de la Ville de Paris (ESPCI Paris), Université Paris sciences et lettres (PSL)-Institut de Chimie du CNRS (INC)-Sorbonne Université (SU)-Centre National de la Recherche Scientifique (CNRS)-École normale supérieure - Paris (ENS-PSL), Université Paris sciences et lettres (PSL)-Institut de Chimie du CNRS (INC)-Sorbonne Université (SU)-Centre National de la Recherche Scientifique (CNRS)-Département de Chimie - ENS Paris, Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Centre d'Investigation Clinique [Rennes] (CIC), Université de Rennes (UR)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), Nutrition, Métabolismes et Cancer (NuMeCan), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), CHU Pontchaillou [Rennes], Hôpital Erasme [Bruxelles] (ULB), Faculté de Médecine [Bruxelles] (ULB), Université libre de Bruxelles (ULB)-Université libre de Bruxelles (ULB), CHU Rouen, Normandie Université (NU), CHU Estaing [Clermont-Ferrand], CHU Clermont-Ferrand, Université Clermont Auvergne (UCA), Centre Hospitalier Universitaire de Liège (CHU-Liège), Service d'Hépatologie et de Gastroentérologie [Lyon], Hospices Civils de Lyon (HCL), Centre International de Recherche en Infectiologie (CIRI), École normale supérieure de Lyon (ENS de Lyon)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Université Jean Monnet - Saint-Étienne (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Hôpital de Hautepierre [Strasbourg], Interface de Recherche Fondamentale et Appliquée en Cancérologie (IRFAC - Inserm U1113), Université de Strasbourg (UNISTRA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre Paul Strauss : Centre Régional de Lutte contre le Cancer (CRLCC)-Fédération de Médecine Translationelle de Strasbourg (FMTS), Cliniques Universitaires Saint-Luc [Bruxelles], Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), Centre Hospitalier Universitaire [Grenoble] (CHU), 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), Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Early detection of Colon Cancer using Molecular Markers and Microbiota (EA 7375) (EC2M3), Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Service d'hépato-gastro-entérologie [APHP Henri Mondor], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Hopital Saint-Louis [AP-HP] (AP-HP), CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN), Centre hospitalier universitaire de Nantes (CHU Nantes), CIC Bordeaux, Université Bordeaux Segalen - Bordeaux 2-Institut National de la Santé et de la Recherche Médicale (INSERM), Hôpital Haut-Lévêque - CHU de Bordeaux (Centre médico chirurgical Magellan), AbbVie, GETAID-patient experience study group: Aurelien Amiot , Sara Tadbiri , Charlotte Gagniere , Jenny Tannoury , Maria Nachury , Benjamin Pariente , Pauline Wils , Yoram Bouhnik , Carmen Stefanescu , Xavier Treton , Melanie Serrero , Jerome Filippi , Xavier Hébuterne , Nadia Arab , Virginie Cluzeau , Xavier Roblin , Emilie Del Tedesco , Laurent Beaugerie , Philippe Seksik , Anne Bourrier , Cecilia Landmann , Julien Kirchgesner , Harry Sokol , Guillaume Bouguen , Laurent Siproudhis , Marie DeWitte , Denis Franchimont , Guillaume Savoye , Anthony Buisson , Edouard Louis , Catherine Reenaers , Stephane Nancey , Gilles Boschetti , Claire Gay , Pauline Danion , Bernard Flourié , Vered Abitbol , Georgia Malamut , Jean-Marie Reimund , Benedicte Caron , Olivier DeWitt , Lucine Vuitton , Nicolas Mathieu , Sandie Pestour , Laurent Peyrin-Biroulet , Camille Zallot , Cyrielle Gilletta , Matthieu Allez , Jean-Marc Gornet , Clotilde Baudry , Stephanie Viennot , Arnaud Bourreille , Caroline Trang-Poisson , Nina Dib , Hedi Brixi , Guillaume Cadiot , Medina Boualit , Claire Painchart , Laurianne Plastaras , Romain Altwegg , Lucile Boivineau , Mathurin Fumery , Ludovic Caillo , David Laharie , Pauline Riviere , Florian Poullenot , Benoit Coffin , Henri Duboc , Stephane Nahon , Noemie Tavernier , Marion Simon , Baya Coulibaly , Morgane Amil , Duveau Nicolas , Sherine Khater , Mehdi Kaassis , Felix Goutorbe , Driffa Moussata , Laurence Picon, CHU Saint-Etienne, Centre National de la Recherche Scientifique (CNRS)-Sorbonne Université (SU)-Département de Chimie - ENS Paris, École normale supérieure - Paris (ENS Paris), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-École normale supérieure - Paris (ENS Paris), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Chimie Moléculaire de Paris Centre (FR 2769), Institut de Chimie du CNRS (INC)-École normale supérieure - Paris (ENS Paris), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Centre National de la Recherche Scientifique (CNRS)-Ecole Nationale Supérieure de Chimie de Paris - Chimie ParisTech-PSL (ENSCP), Université Paris sciences et lettres (PSL)-Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut de Chimie du CNRS (INC)-Centre National de la Recherche Scientifique (CNRS)-Ecole Nationale Supérieure de Chimie de Paris - Chimie ParisTech-PSL (ENSCP), Université Paris sciences et lettres (PSL)-Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Nutrition, inflammation et dysfonctionnement de l'axe intestin-cerveau (ADEN), Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Institute for Research and Innovation in Biomedicine (IRIB), Normandie Université (NU)-Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Service d'Hépato-Gastroentérologie [CHU Rouen], Hôpital Charles Nicolle [Rouen]-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU)-CHU Rouen, UNIROUEN - UFR Santé (UNIROUEN UFR Santé), Normandie Université (NU)-Normandie Université (NU), Autophagie infection et immunité - Autophagy Infection Immunity (APY), Centre International de Recherche en Infectiologie - UMR (CIRI), Institut National de la Santé et de la Recherche Médicale (INSERM)-École normale supérieure - Lyon (ENS Lyon)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-École normale supérieure - Lyon (ENS Lyon)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Centre National de la Recherche Scientifique (CNRS), Voies de Signalisation du Développement et du Stress Cellulaire dans les Cancers Digestifs et Urologiques, Université de Strasbourg (UNISTRA)-Institut National de la Santé et de la Recherche Médicale (INSERM), Université Catholique de Louvain = Catholic University of Louvain (UCL), CHU Toulouse [Toulouse], CIC - Biotherapie - CHU Henri Mondor, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), UCL - SSS/IREC/GAEN - Pôle d'Hépato-gastro-entérologie, UCL - (SLuc) Service de gastro-entérologie, Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Université Pierre et Marie Curie - Paris 6 (UPMC)-Ecole Nationale Supérieure de Chimie de Paris - Chimie ParisTech-PSL (ENSCP), Université Paris sciences et lettres (PSL)-Institut de Chimie du CNRS (INC)-Centre National de la Recherche Scientifique (CNRS)-École normale supérieure - Paris (ENS-PSL), Université Paris sciences et lettres (PSL)-Institut de Chimie du CNRS (INC)-Centre National de la Recherche Scientifique (CNRS)-Département de Chimie - ENS Paris, Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Centre National de la Recherche Scientifique (CNRS), Hôpital Charles Nicolle [Rouen]-CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), École normale supérieure - Lyon (ENS Lyon)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-École normale supérieure - Lyon (ENS Lyon)-Université Claude Bernard Lyon 1 (UCBL), and Université de Lyon-Université de Lyon-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)
Subjects: Adult, Male, Crohn’s disease, medicine.medical_specialty, Health Knowledge, Attitudes, Practice, Cross-sectional study, [SDV]Life Sciences [q-bio], Disease, Patients experience, Inflammatory bowel disease, Tertiary care, digestive system, Tertiary Care Centers, 03 medical and health sciences, 0302 clinical medicine, Belgium, Physicians, Outpatients, medicine, Quantitative assessment, Humans, Adverse effect, Crohn's disease, Physician-Patient Relations, Hepatology, business.industry, Gastroenterology, Middle Aged, Patient Acceptance of Health Care, medicine.disease, Inflammatory Bowel Diseases, Ulcerative colitis, digestive system diseases, 3. Good health, Cross-Sectional Studies, 030220 oncology & carcinogenesis, Family medicine, 030211 gastroenterology & hepatology, Female, France, Self Report, business
Abstract: International audience; BACKGROUND: Patients’ experience with healthcare professionals could influence their clinical outcomes. AIMS: To assess inflammatory bowel disease (IBD) patients’ experience with their disease, their treatment and their relationship with their physician. METHODS: A one-week cross-sectional study was conducted in 42 IBD centres. 2011 consecutive outpatients with IBD completed an anonymous self-report questionnaire assessing their experience with and knowledge of IBD. RESULTS: A quantitative assessment of the doctor-patient relationship revealed that patients’ knowledge of IBD and IBD treatment ranged from 7.4 to 8.3 out of 10. In addition to IBD physicians, other sources of information about IBD and current treatment mainly included the internet (80% and 63%, respectively) and general practitioners (61% and 54%). Knowledge about education programmes (28%) was poor, resulting in a lack of willingness to further use these resources (25%). Concerns about IBD treatment were raised in 76% of patients, mostly related to the fear of adverse events (47%) and a lack of efficacy (33%). The need of alternative healthcare professionals was reported by 89% of the sample. CONCLUSION: In a large cohort of patients, we highlighted gaps in the management of patients with IBD regarding the need for higher-quality information and the implementation of alternative healthcare professionals.
Published: 2021
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23. Surgical closure, mainly with glue injection and anti-tumour necrosis factor alpha, in fistulizing perianal Crohn's disease: A multicentre randomized controlled trial

Author: Dominique Bouchard, Béatrice Vinson Bonnet, Guillaume Meurette, Cécile Train, Charlène Brochard, Pauline Roumeguère, Laurent Siproudhis, Laurent Abramowitz, Jean Marie Fayette, François Pigot, Ghislain Staumont, Hélène Pillant, Guillaume Bonnaud, A. Senéjoux, Jean Luc Faucheron, AP-HP - Hôpital Bichat - Claude Bernard [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), CHU Pontchaillou [Rennes], Centre d'Investigation Clinique [Rennes] (CIC), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), Maison de Santé Protestante de Bordeaux-Bagatelle (MSPB), Clinique Tivoli Ducos [Bordeaux], Hôpital Léopold-Bellan, CHI Poissy-Saint-Germain, Centre Hospitalier Universitaire [Grenoble] (CHU), CHP Saint Grégoire, Hôpital Ambroise Paré [AP-HP], Centre hospitalier universitaire de Nantes (CHU Nantes), ClinSearch [Malakoff, France], Clinique Saint-Jean Languedoc [Toulouse] (CSJL), Abbvie Laboratory AbbVie, and Université de Rennes (UR)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM)
Subjects: medicine.medical_specialty, Fistula, [SDV]Life Sciences [q-bio], fistulizing perianal, law.invention, 03 medical and health sciences, 0302 clinical medicine, Crohn Disease, Randomized controlled trial, law, medicine, Adalimumab, Humans, Rectal Fistula, Abscess, GLUE, Perianal Crohn's disease, Crohn's disease, business.industry, Anti tumour necrosis factor, Gastroenterology, [SDV.MHEP.HEG]Life Sciences [q-bio]/Human health and pathology/Hépatology and Gastroenterology, medicine.disease, surgical closure, 3. Good health, Surgery, seton removal, Treatment Outcome, 030220 oncology & carcinogenesis, Drainage, 030211 gastroenterology & hepatology, business, medicine.drug
Abstract: Clinical trial registration: ClinicalTrials.gov Identifier NCT01388257; International audience; Aim In patients with fistulizing perianal Crohn's disease (CD), the need for a secondary surgical step is not defined. The aim was to assess the efficacy of surgical closure compared to a single seton removal in patients with drained fistulizing perianal CD treated with adalimumab. Methods This was a multicentre, randomized controlled trial, comparing seton removal + surgical closure (closure group) to seton removal alone (control group) with a stratification according to the American Gastroenterological Association classification. The primary end-point was fistula closure at month 12 defined by the association of the following criteria: no seton, absence of a visible external opening, absence of discharge from the tract after finger compression, absence of an internal opening, absence of perianal pain/abscess and absence of fistula-related abnormalities. Results Among the 64 included patients (262 expected) (48 complex fistula, 75%), 33 were randomized to the closure group and 31 to the control group. In the closure group, 26 patients (78.8%) had glue. At month 12, overall fistula closure was achieved in 35 of the evaluable 58 patients (60%): 18/32 (56%) in the surgery group and 17/26 (65%) in the control group (P = 0.479). In the closure group, fistula closure was observed in 13/25 (52%) and 5/7 (71%) patients with complex and simple fistula respectively (P = 0.426), compared with 12/18 (67%) and 5/8 (63%), respectively in the control group (P = 1.000). Conclusions Seton removal alone seems to be no more effective than a secondary surgical step (in particular glue injection) in patients having fistulizing perianal CD controlled by an initial drainage combined with adalimumab. The results should be interpreted with caution.
Published: 2021
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24. P295 VALIDation of the IBD-Disk instrument for assessing disability in inflammatory bowel diseases in a population-based cohort: The VALIDate study

Author: Nina Dib, Laurent Siproudhis, Mathurin Flamant, Arnaud Bourreille, Pierre-Antoine Gourraud, Elodie Cesbron-Métivier, Elise Kerdreux, Guillaume Bouguen, Alexandra Poinas, C Le Berre, Thomas Goronflot, Marie Dewitte, and Caroline Trang-Poisson
Subjects: medicine.medical_specialty, Population based cohort, business.industry, Internal medicine, Gastroenterology, medicine, Inflammatory Bowel Diseases, General Medicine, medicine.disease, business, digestive system, Inflammatory bowel disease, digestive system diseases
Abstract: Background Inflammatory bowel diseases (IBD) are disabling disorders. The IBD-Disability Index (IBD-DI) was developed for quantifying disability in IBD patients but is difficult to use. The IBD-Disk is a shortened and visual adaptation of the IBD-DI. It has not been validated yet. The main objectives were to validate the IBD-Disk in a large cohort of IBD patients and to assess its variability over time. Methods From March 2018 to July 2019, IBD patients from three university-affiliated hospitals responded twice to both IBD-Disk and IBD-DI at 3–12 months intervals (NCT03590639). Validation included concurrent validity, reproducibility, internal consistency, and evaluation of IBD-Disk correlation with IBD activity. Variability was assessed by comparing scores between baseline and follow-up visits. Results A total of 559 patients (73% Crohn’s disease, 27% ulcerative colitis) were included and 389 were followed up (Table 1). There was a good correlation between IBD-Disk and IBD-DI scores (r = 0.75, p < 0.001) (Figure 1). The IBD-Disk was significantly higher in patients with active disease according to Physician/Patient Global Assessment (Figure 2), clinical scores (Figure 3), and biomarkers levels, compared with patients with inactive disease. Reproducibility was excellent (intra-class correlation coefficient = 0.90), as well as internal consistency (Cronbach’s α = 0.89). The IBD-Disk score significantly decreased in patients becoming inactive over time. Conclusion This is the first study to validate the IBD-Disk in a large cohort of IBD patients, demonstrating that it is a valid and reliable tool for quantifying disability in clinical practice. Further studies are warranted to assess its correlation with endoscopic activity, to explore its responsiveness to change, and to evaluate the factors associated with disability.
Published: 2020
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25. Urinary biomarkers profiles in patients with neurogenic detrusor overactivity according to their neurological condition

Author: C. Voiry, C. Richard, Laurent Siproudhis, Benoit Peyronnet, Quentin Alimi, Zine-Eddine Khene, Charlène Brochard, Juliette Hascoet, Andrea Manunta, Claude Bendavid, Jacques Kerdraon, Xavier Gamé, and Guillaume Bouguen
Subjects: Adult, Male, Nephrology, medicine.medical_specialty, Multiple Sclerosis, Urology, Urinary system, 030232 urology & nephrology, 03 medical and health sciences, chemistry.chemical_compound, 0302 clinical medicine, Internal medicine, medicine, Humans, Prospective Studies, Urinary Bladder, Neurogenic, Spinal Dysraphism, Spinal cord injury, Spinal Cord Injuries, Aged, Creatinine, Urinary bladder, Urinary Bladder, Overactive, business.industry, Spina bifida, Multiple sclerosis, Middle Aged, medicine.disease, Pathophysiology, medicine.anatomical_structure, chemistry, 030220 oncology & carcinogenesis, Female, business, Biomarkers
Abstract: The aim of this study was to investigate the disease-specific urinary levels variations of neurotrophins (NGF, BDNF), mediators of inflammation (TGFβ-1, PGE-2) and markers of extracellular matrix alterations (TIMP-2) in patients with multiple sclerosis (MS) spinal cord injury (SCI), or spina bifida (SB), and neurogenic detrusor overactivity (NDO). A prospective single-center study was conducted between March 2015 and March 2017. Patients aged over 18 years old, with neurological disease, with a urodynamic diagnosis of NDO were included. The urinary levels of NGF, BDNF, TIMP-2, PGE 2, and TGF-β1 were measured using dedicated ELISA kits. Forty-one patients were included: 6 with MS, 20 with SCI, and 15 with spina bifida. The average urinary level of NGF/Cr was significantly higher in MS patients compared to other neurologic populations (8 vs. 0.56 vs. 1.25 pg/mg of creatinine; p = 0.001) as well for the average urinary level of BDNF (88.3 vs. 5 vs. 4.8 pg/mg of creatinine; p
Published: 2019
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26. Online training on how to diagnose anoperineal lesions of Crohn's disease: Do pictures matter? A nationwide randomized study

Author: Laurent Siproudhis, P. Roumeguère, Paul Benfredj, C. Bord, E. Pommaret, A Nouts, Laurent Abramowitz, Guillaume Bonnaud, Dominique Bouchard, C Geffrier, F Devulder, V. de Parades, J M Didelot, T. Higuero, Ghislain Staumont, Jean-David Zeitoun, Guillaume Bouguen, P Marteau, F. Pigot, X. Lesage, P Petit, Nadia Fathallah, Clinique Beau Soleil [Montpellier], Service de Chirurgie Hépatobiliaire et Digestive [Rennes] = Hepatobiliary and Digestive Surgery [Rennes], CHU Pontchaillou [Rennes], Clinique Saint Augustin, CHU Saint-Antoine [AP-HP], and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)
Subjects: medicine.medical_specialty, [SDV]Life Sciences [q-bio], Perineum, law.invention, Education, Distance, 03 medical and health sciences, 0302 clinical medicine, Crohn Disease, Randomized controlled trial, law, Medical Illustration, Skin Ulcer, Photography, Clinical endpoint, Humans, Rectal Fistula, Medicine, In patient, Anus Diseases, Crohn's disease, Electronic Mail, Hepatology, business.industry, Gastroenterology, medicine.disease, Abscess, 3. Good health, Erythema, 030220 oncology & carcinogenesis, Physical therapy, Online teaching, 030211 gastroenterology & hepatology, Educational Measurement, France, business
Abstract: Summary Any gastroenterologist must be trained to properly diagnose anoperineal lesions in patients with Crohn's disease (APLOC). The aim of this study was to establish whether adding pictures would improve teaching effectiveness of the diagnosis of APLOC to French gastroenterology trainees. Method Trainees were asked to answer a first web-based survey consisting of evaluating 12 pictures of APLOC with a closed answer questionnaire. They were then randomized in 2 groups. Group A received an online teaching with typical pictures and APLOC definitions and group B definitions only. Trainees were asked again seven days later to answer a second survey with 12 other pictures of APLOC and 14 experts also answered this survey. Diagnostic scores were expressed in %. The primary endpoint was the comparison of the score of survey 2 between the two groups of trainees. Secondary endpoints were to compare results of survey 2 between trainees of both groups and experts, and assess diagnosis of each lesion. Results Two hundred fourty eight trainees among 465 answered survey 1, and 195 survey 2. The diagnostic score was 71.9% for groups A and B and 74.6% for experts (differences NS). After training diagnosis of ulceration was 72% for group A and 72.9% for group B, fistulae 85.2% versus 85.8%, erythema 44.1% vs. 55.6%, anoperineal scars 67.5% vs. 65.6%, and abscess 100% (differences NS). Conclusion There was no difference between the two teaching methods. Further research should be performed aiming at improving teaching material and quotation baremes.
Published: 2019
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27. How to manage anal ulcerations and anorectal stenosis in Crohn’s disease: algorithm-based decision making

Author: F. Pigot, Yves Panis, B. Vinson-Bonnet, Charlène Brochard, Nadia Fathallah, Paul Benfredj, Laurent Siproudhis, Laurent Abramowitz, Dominique Bouchard, T. Higuero, Jean-Luc Faucheron, David Laharie, Ghislain Staumont, and V. de Parades
Subjects: medicine.medical_specialty, Consensus, Clinical Decision-Making, education, Disease, Proctocolitis, 03 medical and health sciences, 0302 clinical medicine, Crohn Disease, Humans, Medicine, Crohn's disease, business.industry, Gastroenterology, Disease Management, medicine.disease, Anorectal Malformations, Colorectal surgery, Anorectal stenosis, 030220 oncology & carcinogenesis, Treatment strategy, 030211 gastroenterology & hepatology, Surgery, France, business, Colorectal Surgery, Algorithm, Algorithms
Abstract: The French National Society of Coloproctology established national recommendations for the treatment of anoperineal lesions associated with Crohn's disease. Treatment strategies for anal ulcerations and anorectal stenosis are suggested. Recommendations have been graded following international recommendations, and when absent professional agreement was established. For each situation, practical algorithms have been drawn.
Published: 2019
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28. What is the optimal treatment for T1N0 anal squamous cell carcinoma? Analysis of current practices in the prospective French FFCD ANABASE cohort

Author: Emilie Barbier, Philippe Ronchin, Astrid Lièvre, Manon Bacci, Nabil Baba-Hamed, Laurène Parrot, Laurent Quero, P. Pommier, Lucas Spindler, Côme Lepage, Laurent Siproudhis, Véronique Vendrely, L. Bazire, Claire Lemanski, Eric Francois, Eleonor Rivin del Campo, Laurent Abramowitz, Frédéric Juguet, Isabelle Etienney, CHU Pessac, Hopital Saint-Louis [AP-HP] (AP-HP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Laboratoire de Neurosciences Cognitives & Computationnelles (LNC2), Département d'Etudes Cognitives - ENS Paris (DEC), École normale supérieure - Paris (ENS Paris), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-École normale supérieure - Paris (ENS Paris), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Institut National de la Santé et de la Recherche Médicale (INSERM), AP-HP - Hôpital Bichat - Claude Bernard [Paris], Clinique Tivoli Ducos [Bordeaux], Centre Léon Bérard [Lyon], Institut Curie [Paris], Groupe Hospitalier Diaconesses Croix Saint-Simon, Centre de Lutte contre le Cancer Antoine Lacassagne [Nice] (UNICANCER/CAL), UNICANCER-Université Côte d'Azur (UCA), Institut du Cancer de Montpellier (ICM), CHU Pontchaillou [Rennes], Institut de Génétique et Développement de Rennes (IGDR), Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique )-Centre National de la Recherche Scientifique (CNRS)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES), Centre d'Investigation Clinique [Rennes] (CIC), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), Nutrition, Métabolismes et Cancer (NuMeCan), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Biothérapies des maladies génétiques et cancers, Université Bordeaux Segalen - Bordeaux 2-Institut National de la Santé et de la Recherche Médicale (INSERM), Federation Francophone de Cancerologie Digestive (FFCD) , France, Hôpital Haut-Lévêque [CHU Bordeaux], CHU Bordeaux [Bordeaux], Equipe EPICAD (LNC - U1231), Lipides - Nutrition - Cancer [Dijon - U1231] (LNC), Université de Bourgogne (UB)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut Agro Dijon, Institut national d'enseignement supérieur pour l'agriculture, l'alimentation et l'environnement (Institut Agro)-Institut national d'enseignement supérieur pour l'agriculture, l'alimentation et l'environnement (Institut Agro)-Université de Bourgogne (UB)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut Agro Dijon, Institut national d'enseignement supérieur pour l'agriculture, l'alimentation et l'environnement (Institut Agro)-Institut national d'enseignement supérieur pour l'agriculture, l'alimentation et l'environnement (Institut Agro), Centre hospitalier Saint-Joseph [Paris], Centre Azuréen de Cancérologie [Mougins, France], CHU Tenon [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Sorbonne Université (SU), and Clinique Blomet
Subjects: Male, medicine.medical_specialty, Local excision, medicine.medical_treatment, Anal Canal, [SDV.CAN]Life Sciences [q-bio]/Cancer, Gastroenterology, Disease-Free Survival, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, medicine, Humans, 030212 general & internal medicine, Aged, Retrospective Studies, Aged, 80 and over, Univariate analysis, Hepatology, Radiotherapy, business.industry, Optimal treatment, Anal Squamous Cell Carcinoma, Chemoradiotherapy, Middle Aged, Anus, Anus Neoplasms, 3. Good health, Radiation therapy, medicine.anatomical_structure, Anal canal carcinoma, 030220 oncology & carcinogenesis, Cohort, Carcinoma, Squamous Cell, Female, France, business
Abstract: International audience; Introduction: for localized T1N0 squamous cell carcinoma of the anus (SCCA) standard radiotherapy (RT) may result in overtreatment and alternative strategies are debated. Methods: T1N0M0 SCCA treated between 2015 and 2020 by local excision (LE) or RT were analyzed from the French prospective FFCD ANABASE cohort. Treatment strategies, recurrence-free and colostomy-free survivals (RFS, CFS) and prognostic factors were reported. Results: among 1135 SCCA patients, 99 T1N0M0 were treated by LE(n = 17,17.2%), or RT ( n = 82,82.8%) including RT alone ( n = 65,79.2%) or chemo-RT ( n = 17, 20.7%). Median follow-up was 27.2 months [0.03 and ndash;54.44]. Median tumor size were 11.4 mm [0.9 and ndash;20] and 15.3 mm [2 and ndash;20] in the LE and RT groups respectively. Mean RT tumor dose was 59.4 Gy [18 and ndash;69.4 Gy]. One patient in LE group and 9 in RT group had a pelvic recurrence, either local (60%), nodal (10%) or both (30%). RFS and CFS at 24 months were 92.2%[95%CI,83.4 and ndash;96.4] and 94.6%[95%CI,86.1 and ndash;98.0], at 36 months 88.1%[95%CI,77.1 and ndash; 94.2] and 88.5%[95%CI,77.0 and ndash;94.5], in LE and RT group respectively, without any significative difference (HR = 0.57;[95%CI,0.07 and ndash;4.45];p= 0.60). By univariate analysis, male gender was the only prognostic fac-tor(HR = 5.57;95%CI, 1.76 and ndash;17.63; p = 0.004). Conclusion: this cohort confirms the heterogeneity of T1N0M0 SCCA management, questioning the place of RT alone, reduced dose or RT volume, and the safety of LE. (c) 2021 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.
Published: 2021
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29. Bacterial gut dysbiosis is associated with Crohn’s disease symptoms but not with elevated fecal calprotectin

Author: Laurent Siproudhis, Vincent Cattoir, Sylvie Buffet-Bataillon, Guillaume Bouguen, Clémence Landreau, Nutrition, Métabolismes et Cancer (NuMeCan), Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES), CHU Pontchaillou [Rennes], Centre d'Investigation Clinique [Rennes] (CIC), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), ARN régulateurs bactériens et médecine (BRM), Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique )-Université de Rennes 1 (UR1), No funding, Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Université de Rennes (UR)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), and Jonchère, Laurent
Subjects: Crohn’s disease, medicine.medical_specialty, Mucosal inflammation, [SDV]Life Sciences [q-bio], Probiotic, Gastroenterology, law.invention, Feces, 03 medical and health sciences, 0302 clinical medicine, Fecal calprotectin, Crohn Disease, law, Internal medicine, medicine, Humans, ComputingMilieux_MISCELLANEOUS, 030304 developmental biology, 0303 health sciences, Crohn's disease, Hepatology, business.industry, Microbiota, [SDV.MHEP.HEG]Life Sciences [q-bio]/Human health and pathology/Hépatology and Gastroenterology, medicine.disease, [SDV.MHEP.HEG] Life Sciences [q-bio]/Human health and pathology/Hépatology and Gastroenterology, Gastrointestinal Microbiome, 3. Good health, [SDV] Life Sciences [q-bio], Symptoms, Dysbiosis, 030211 gastroenterology & hepatology, Gut dysbiosis, Calprotectin, business, Leukocyte L1 Antigen Complex, Biomarkers
Abstract: International audience
Published: 2021
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30. Cumulative Exposure to Infliximab, But Not Trough Concentrations, Correlate With Rate of Infection

Author: Laurent Siproudhis, Eric Bellissant, Thomas Grainville, Guillaume Bouguen, Amandine Landemaine, Antoine Petitcollin, Eric Le Balch, Céline Miard, Marie Dewitte, Charlène Brochard, CHU Pontchaillou [Rennes], Centre d'Investigation Clinique [Rennes] (CIC), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), Nutrition, Métabolismes et Cancer (NuMeCan), Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES), Université de Rennes (UR)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), and Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)
Subjects: Adult, Male, medicine.medical_specialty, tumor necrosis factor, [SDV]Life Sciences [q-bio], Gastroenterology, 03 medical and health sciences, 0302 clinical medicine, Crohn Disease, Gastrointestinal Agents, Internal medicine, medicine, Humans, Trough Concentration, Crohn's disease, Hepatology, treatment, business.industry, Area under the curve, [SDV.MHEP.HEG]Life Sciences [q-bio]/Human health and pathology/Hépatology and Gastroenterology, Odds ratio, anti-TNF, Inflammatory Bowel Diseases, medicine.disease, Ulcerative colitis, Infliximab, 3. Good health, CD, Regimen, Area Under Curve, 030220 oncology & carcinogenesis, Trough level, 030211 gastroenterology & hepatology, France, business, medicine.drug
Abstract: Background & Aims Infliximab increases the risk of infection in patients with inflammatory bowel diseases (IBD), but there is controversy over the relationship between drug concentration and infections. We aimed to assess factors associated with infection in infliximab-treated patients, including pharmacokinetic features. Methods We collected data from 209 patients with IBD (102 men; mean age, 39 y; 159 with Crohn’s disease; 54 received combination therapy) who received an infliximab maintenance regimen from November 2016 through April 2017 in France. Data were collected from each infusion visit (total of 640 infusions). Infliximab exposure was estimated based on the area under the curve (AUC) of drug concentration in pharmacokinetic models; individual exposures over the 6-month period were estimated based on the sum of the AUC (ΣAUC). Results The mean infliximab trough level was 5.46 mg/L, and the mean ΣAUC was 3938 ± 1427 mg.d/L. A total of 215 infections were collected from the 640 infusion visits; 123 patients (59%) had at least 1 infection. Factors independently associated with infection after multivariate analysis were smoking (odds ratio [OR], 2.05; P = .046), IBD flare (OR, 2.71; P = .006), and a high ΣAUC of infliximab (above 3234 mg x d/L) (OR, 2.02; P = .02). The ΣAUC was higher in patients with an occurrence of infection (P = .04) and correlated with the number of infections (P = .04). Trough concentration of infliximab alone was not associated with infection. Conclusions Almost two-thirds of patients treated with infliximab developed an infection; risk was individually correlated with cumulative increase in drug exposure, but not infliximab trough level.
Published: 2021
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31. Solitary rectal ulcer syndrome in 102 patients: Do different phenotypes make sense?

Author: Charlène Brochard, Laurent Siproudhis, Alain Ropert, Aurore Carlo, Timothée Wallenhorst, Alexandre Merlini-l’Heritier, Marion Chambaz, Claire Gouriou, Guillaume Bouguen, CHU Pontchaillou [Rennes], Centre d'Investigation Clinique [Rennes] (CIC), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), Nutrition, Métabolismes et Cancer (NuMeCan), Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES), Université de Rennes (UR)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), and Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)
Subjects: Adult, Male, medicine.medical_specialty, [SDV]Life Sciences [q-bio], Anal Canal, Solitary rectal ulcer syndrome, Gastroenterology, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, medicine, Humans, Defecography, Ulcer, Aged, Retrospective Studies, Hepatology, medicine.diagnostic_test, Obstructed defecation, business.industry, Rectal Ulcer, Anorectal manometry, Faecal incontinence, Rectal Prolapse, Syndrome, Middle Aged, Hypotonia, 3. Good health, Endoscopy, Phenotype, Rectal Diseases, 030220 oncology & carcinogenesis, Female, 030211 gastroenterology & hepatology, medicine.symptom, business, Constipation, Fecal Incontinence, Procidentia
Abstract: International audience; Background - Little is known about the pathophysiological mechanisms of solitary rectal ulcer syndrome (SRUS). Aims - We aim to identify the different phenotypes, taking into account complaints, anatomy and anorectal physiology. Methods - Complaints, endoscopy results, and physiology data of patients with histologically proven SRUS were collected and analysed. The associated anorectal diseases were faecal incontinence and obstructed defecation. The clinical aspects of SRUS were compared, and factors associated with anorectal diseases were identified. Results - Overall, 102 consecutive patients were included. The predominant lesion was a rectal ulcer (66%), and inflammation of the rectal wall was present in 42% of patients. Abnormal rectal capacities and/or rectal perception was observed in more than half. Nearly half (52%) of the patients met the criteria for obstructed defecation and they tended to more frequently have psychiatric disease (66.7% vs 33.3%; p=0.07). Patients with faecal incontinence (17%) reported more self-perception of anal procidentia (p=0.01) and were more likely to have inflammation of the rectal wall (p=0.02), high-grade internal rectal procidentia (p=0.06) and anal hypotonia (p=0.004); their maximum tolerable volume was lower (p=0.004). Conclusion - The characteristics of patients with SRUS suggest different phenotypes. This may be a way to develop a comprehensive treatment strategy.
Published: 2021
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32. Management of obstetrical injuries to the anal sphincter: A survey of French current practice and perceptions according to the specialties

Author: C. Brochard, X. Fritel, Laurent Siproudhis, Laurent Abramowitz, Valérie Bridoux, G. Legendre, Aurélien Venara, Centre Hospitalier Universitaire d'Angers (CHU Angers), PRES Université Nantes Angers Le Mans (UNAM), CHU Pontchaillou [Rennes], Centre hospitalier universitaire de Poitiers (CHU Poitiers), Nutrition, inflammation et dysfonctionnement de l'axe intestin-cerveau (ADEN), Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Institute for Research and Innovation in Biomedicine (IRIB), Normandie Université (NU)-Normandie Université (NU)-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM), UNIROUEN - UFR Santé (UNIROUEN UFR Santé), Normandie Université (NU)-Normandie Université (NU), Service de chirurgie digestive [CHU Rouen], CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU), SFNCP, GREP, and IHFIH UPRES EA 3859
Subjects: medicine.medical_specialty, medicine.medical_treatment, Specialty, Anal Canal, Interventional management, Medium term, 03 medical and health sciences, 0302 clinical medicine, Pregnancy, Surveys and Questionnaires, [SDV.MHEP.PHY]Life Sciences [q-bio]/Human health and pathology/Tissues and Organs [q-bio.TO], Humans, Medicine, Caesarean section, ComputingMilieux_MISCELLANEOUS, Health professionals, Cesarean Section, business.industry, Urethral sphincter, General Medicine, Delivery, Obstetric, 3. Good health, Current practice, 030220 oncology & carcinogenesis, Family medicine, Female, 030211 gastroenterology & hepatology, business, Anal sphincter, Fecal Incontinence
Abstract: Summary Aim of the study To conduct a survey of current practice in the management of obstetrical anal sphincter injuries (OASI) and to compare short, medium and long-term practices according to the specialty of the surgeon. Patients and methods A 50-item questionnaire was addressed by mail to various specialists via the national learned societies. The questionnaire was addressed only to practitioners who currently managed OASI in their practice. Results Of the 135 healthcare professionals who responded, 57 were sub-specialists in ano-rectal surgery (42.2%) and 78 were obstetrical or gynecological specialists (OB-GYN) (57.8%). Management in the acute period after OASI was similar among the specialties and 50% of the practitioners did not perform suture repair of the internal sphincter. Furthermore, few gynecological specialists recommended systematic consultation with an ano-rectal specialist during acute management. In the medium term, ano-rectal specialists were more likely to explore gastro-intestinal symptoms, either clinically or through para-clinical studies. However, these studies did not systematically lead to interventional management in the absence of consensus, particularly for medium-term sphincter repair. In addition, 25% of practitioners recommended that patients undergo systematic delivery by caesarean section for further pregnancies after OASI. In the long term (> 12 months), there were substantial differences in management of OASI not only between specialties but also within the same specialty. Conclusion The various specialists should coordinate to propose multidisciplinary recommendations on the management of OASI.
Published: 2021
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33. Effectiveness and safety of ustekinumab intensification at 90 Mg every four weeks In Crohn's disease: a multicenter study

Author: Mathurin, Fumery, Laurent, Peyrin-Biroulet, Stephane, Nancey, Romain, Altwegg, Cyrielle, Gilletta, Pauline, Veyrard, Guillaume, Bouguen, Stephanie, Viennot, Florian, Poullenot, Jerome, Filippi, Anthony, Buisson, Anne, Bozon, Franck, Brazier, Lieven, Pouillon, Bernard, Flourie, Lucile, Boivineau, Laurent, Siproudhis, David, Laharie, Xavier, Roblin, Momar, Diouf, Xavier, Treton, Jonchère, Laurent, Périnatalité et Risques Toxiques - UMR INERIS_I 1 (PERITOX), Institut National de l'Environnement Industriel et des Risques (INERIS)-Université de Picardie Jules Verne (UPJV)-CHU Amiens-Picardie, Service d'Hépato Gastroenterologie [CHU Amiens-Picardie], CHU Amiens-Picardie, 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), Autophagie infection et immunité - Autophagy Infection Immunity (APY), Centre International de Recherche en Infectiologie - UMR (CIRI), École normale supérieure - Lyon (ENS Lyon)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-École normale supérieure - Lyon (ENS Lyon)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Service d'Hépatogastroentérologie [CHU Lyon-Sud], Hospices Civils de Lyon (HCL), Département d'Hépato-Gastroentérologie et de Transplantation Hépatique [CHU Saint-Eloi], Hôpital Saint Eloi (CHRU Montpellier), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Université de Montpellier (UM), Service de Gastroentérologie et pancréatologie [CHU Toulouse], Pôle Maladies de l'appareil digestif [CHU Toulouse], Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Service de gastroentérologie [CHU Saint-Etienne], Centre Hospitalier Universitaire de Saint-Etienne (CHU de Saint-Etienne), Centre d'Investigation Clinique [Rennes] (CIC), Université de Rennes (UR)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), Nutrition, Métabolismes et Cancer (NuMeCan), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Centre Hospitalier Universitaire [Rennes], Service d'Hépato-Gastro-Enterologie et Nutrition [CHU Caen], Université de Caen Normandie (UNICAEN), Normandie Université (NU)-Normandie Université (NU)-CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Tumorothèque de Caen Basse-Normandie (TCBN), Service d'Hépato-gastro-entérologie et oncologie digestive (CHU de Bordeaux), CHU Bordeaux [Bordeaux]-Hôpital Haut-Lévêque [CHU Bordeaux], CHU Bordeaux [Bordeaux], Hôpital Archet 2 [Nice] (CHU), Microbes, Intestin, Inflammation et Susceptibilité de l'Hôte (M2iSH), Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre de Recherche en Nutrition Humaine d'Auvergne (CRNH d'Auvergne)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)-Université Clermont Auvergne (UCA), Service d'Hépatologie Gastro-entérologie [CHU Clermont-Ferrand], CHU Estaing [Clermont-Ferrand], CHU Clermont-Ferrand-CHU Clermont-Ferrand, Service de Gastroentérologie [Hôpital Beaujon], Hôpital Beaujon [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Service Gastroentérologie [CHU Bordeaux], Centre Hospitalier Universitaire de Bordeaux (CHU Bordeaux), Direction de la recherche clinique et de l'innovation [CHU Amiens], Université de Picardie Jules Verne (UPJV)-CHU Amiens-Picardie-Institut National de l'Environnement Industriel et des Risques, Institut National de la Santé et de la Recherche Médicale (INSERM)-École normale supérieure - Lyon (ENS Lyon)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-École normale supérieure - Lyon (ENS Lyon)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Centre National de la Recherche Scientifique (CNRS), Université de Montpellier (UM)-CHU Saint-Eloi, Centre Hospitalier Universitaire Toulouse (CHU Toulouse), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Hôpital Haut-Lévêque [CHU Bordeaux], CHU Bordeaux [Bordeaux]-CHU Bordeaux [Bordeaux], Centre International de Recherche en Infectiologie (CIRI), École normale supérieure de Lyon (ENS de Lyon)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Université Jean Monnet - Saint-Étienne (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-École normale supérieure de Lyon (ENS de Lyon)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Université Jean Monnet - Saint-Étienne (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Service de Gastro-entérologie et Hépatologie [CHU Saint-Etienne], and Centre Hospitalier Universitaire de Saint-Etienne [CHU Saint-Etienne] (CHU ST-E)
Subjects: Crohn’s disease, [SDV] Life Sciences [q-bio], [SDV]Life Sciences [q-bio], [SDV.MHEP.HEG]Life Sciences [q-bio]/Human health and pathology/Hépatology and Gastroenterology, intensification, ustekinumab, [SDV.MHEP.HEG] Life Sciences [q-bio]/Human health and pathology/Hépatology and Gastroenterology
Abstract: International audience; Introduction: The approved maintenance regimens for ustekinumab in Crohn's disease (CD) are 90 mg every 8 or 12 weeks. Some patients will partially respond to ustekinumab or will experience a secondary loss of response. It remains poorly known if these patients may benefit from shortening the interval between injections.Methods: All patients with active CD, as defined by Harvey-Bradshaw score ≥ 4 and one objective sign of inflammation (CRP > 5 mg/L and/or fecal calprotectin > 250 µg/g and/or radiologic and/or endoscopic evidence of disease activity) who required ustekinumab dose escalation to 90mg every 4 weeks for loss of response or incomplete response to ustekinumab 90mg every 8 weeks were included in this retrospective multicenter cohort study.Results: One hundred patients, with a median age of 35 years (Interquartile Range (IQR), 28 - 49) and median disease duration of 12 (7 - 20) years were included. Dose intensification was performed after a median of 5.0 (2.8 - 9.0) months of ustekinumab treatment and was associated with corticosteroids and immunosuppressants in respectively 29% and 27% of cases. Short-term clinical response and clinical remission were observed in respectively 61% and 31% after a median of 2.4 (1.3 - 3.0) months. After a median follow-up of 8.2 (5.6-12.4) months, 61% of patients were still treated with ustekinumab, and 26% in steroid-free clinical remission. Among the 39 patients with colonoscopy during follow-up, 14 achieved endoscopic remission (no ulcers). At the end of follow-up, 27% of patients were hospitalized, and 19% underwent intestinal resection surgery. Adverse events were reported in 12% of patients, including five serious adverse events.Conclusion: In this multicenter study, two-thirds of patients recaptured response following treatment intensification with ustekinumab 90 mg every 4 weeks.
Published: 2021
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34. Clinical guidelines for the management of inflammatory bowel disease: Update of a French national consensus

Author: Aurélien Amiot, Guillaume Bouguen, Guillaume Bonnaud, Yoram Bouhnik, Hervé Hagege, Laurent Peyrin-Biroulet, Vered Abitbol, Georgia Malamut, Aurelien Amiot, Arnaud Boruchowicz, Laurent Siproudhis, Marie DeWitte, Carmen Stefanescu, Anthony Buisson, Ludovic Caillo, Maryan Cavicchi, Nina Dib, Isabelle Etienney, Jerome Filippi, Mathurin Fumery, Felix Goutorbe, Laurent Costes, Mathias Vidon, Frédéric Heluwaert, Christophe Locher, Mehdi Kaassis, Patrick Mamou, Chloe MARTINEAU, Nicolas Mathieu, Benjamin Pariente, Pauline WILS, Stephane Nancey, Magalie Picon-Coste, Camille Zallot, Marie-Pierre Pingannaud, Xavier Roblin, Julia Roux, Melanie Serrero, Marion Simon, Florence Skinazi, Lucas Spindler, Stephanie Viennot, Service d'hépato-gastro-entérologie [APHP Henri Mondor], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Early detection of Colon Cancer using Molecular Markers and Microbiota (EA 7375) (EC2M3), Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Centre d'Investigation Clinique [Rennes] (CIC), Université de Rennes (UR)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), Nutrition, Métabolismes et Cancer (NuMeCan), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Hôpital Ambroise Paré [AP-HP], Service de Gastroentérologie [Hôpital Beaujon], Hôpital Beaujon [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), CHI Créteil, Nutrition-Génétique et Exposition aux Risques Environnementaux (NGERE), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Jonchère, Laurent, Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12)-Hôpital Henri Mondor-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES), and Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)
Subjects: Clinical guidelines, Crohn’s disease, medicine.medical_specialty, Consensus, [SDV]Life Sciences [q-bio], Antibodies, Monoclonal, Humanized, Inflammatory bowel disease, Severity of Illness Index, Vedolizumab, 03 medical and health sciences, 0302 clinical medicine, Maintenance therapy, Crohn Disease, Gastrointestinal Agents, Ustekinumab, medicine, Humans, Intensive care medicine, Reimbursement, Crohn's disease, Tofacitinib, Hepatology, business.industry, Gastroenterology, medicine.disease, Ulcerative colitis, 3. Good health, Algorithm, [SDV] Life Sciences [q-bio], 030220 oncology & carcinogenesis, 030211 gastroenterology & hepatology, Colitis, Ulcerative, Tumor Necrosis Factor Inhibitors, France, business, Immunosuppressive Agents, medicine.drug
Abstract: International audience; BACKGROUND: New treatments and therapeutic approaches repeatedly emerged in the field of inflammatory bowel disease. AIM: to update the French treatment algorithms for Crohn’s disease (CD) and ulcerative colitis (UC). METHODS: A formal consensus method was used to determine changes to the treatment algorithms for various situations of CD and UC. Thirty-seven experts voted on questions that had been drafted by the steering committee ahead of time. Consensus was defined as at least 66% of experts agreeing on a response. RESULTS: Anti-TNF were reinforced as a first-line therapy rather than the use of immunosuppressant alone. Vedolizumab for UC, ustekinumab for CD took place as second-line maintenance therapy and potentially as a first-line therapy in the setting of unrestricted reimbursement for vedolizumab. Tofacitinib was recommended by the experts in case of vedolizumab failure for UC. Algorithms for complicated CD with abscess, intestinal and complex anal fistula were updated according to recent prospective cohort studies. CONCLUSION: The changes incorporated to the algorithms provide up-to-date and easy-to-use guidelines to treat patients with IBD.
Published: 2021
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35. Successful closure of a rectovesical fistula after radical prostatectomy using endoscopic submucosal dissection combined with an over-the-scope clip

Author: Mathieu Pioche, Guillaume Bouguen, Thomas Lambin, Charlène Brochard, Mael Pagenault, Timothée Wallenhorst, and Laurent Siproudhis
Subjects: Male, Prostatectomy, medicine.medical_specialty, Rectovesical fistula, Endoscopic Mucosal Resection, business.industry, medicine.medical_treatment, Treatment outcome, Gastroenterology, Closure (topology), Over the scope clip, Endoscopic submucosal dissection, Surgical Instruments, Surgery, Treatment Outcome, medicine, Humans, Rectal Fistula, business
Published: 2020

36. Protocol of a multicentric prospective cohort study for the VALIDation of the IBD-disk instrument for assessing disability in inflammatory bowel diseases: the VALIDate study

Author: Alexandra Poinas, Elise Kerdreux, Mathurin Flamant, Laurent Siproudhis, Caroline Trang-Poisson, Elodie Cesbron-Métivier, Nina Dib, C. Le Berre, M. Hanf, Marie Dewitte, Pierre-Antoine Gourraud, Arnaud Bourreille, Thomas Goronflot, Guillaume Bouguen, Institut des Maladies de l'Appareil Digestif, Université de Nantes (UN), CHU Pontchaillou [Rennes], Centre Hospitalier Universitaire d'Angers (CHU Angers), PRES Université Nantes Angers Le Mans (UNAM), Centre hospitalier universitaire de Nantes (CHU Nantes), Centre d’Investigation Clinique de Nantes (CIC Nantes), Université de Nantes (UN)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre hospitalier universitaire de Nantes (CHU Nantes), and BOURGEAIS, Véronique
Subjects: Quality of life, medicine.medical_specialty, IBD-disability index, Inclusion (disability rights), Psychometrics, [SDV]Life Sciences [q-bio], Validation Studies as Topic, Inflammatory bowel diseases, Severity of Illness Index, digestive system, 03 medical and health sciences, Disability Evaluation, Study Protocol, 0302 clinical medicine, Quality of life (healthcare), medicine, Humans, Multicenter Studies as Topic, Medical physics, 030212 general & internal medicine, Patient Reported Outcome Measures, Prospective Studies, lcsh:RC799-869, Prospective cohort study, Visual tool, Protocol (science), Disability, Patient-reported outcomes, business.industry, IBD disk, Gastroenterology, Inflammatory Bowel Diseases, Reproducibility of Results, General Medicine, University hospital, digestive system diseases, 3. Good health, [SDV] Life Sciences [q-bio], Research Design, Cohort, lcsh:Diseases of the digestive system. Gastroenterology, 030211 gastroenterology & hepatology, business
Abstract: Background Inflammatory Bowel Diseases (IBD) affect psychological, family, social and professional dimensions of patients’ life, leading to disability which is essential to quantify as part of Patient-Reported Outcomes (PROs) newly included in the targets to reach in IBD patients. Up to now, the IBD-Disability Index (IBD-DI) was the only validated tool to assess disability, but it is not appropriate for use in clinical practice. The IBD Disk was developed, a shortened and self-administered tool, adapted from the IBD-DI, in order to give immediate representation of patient-reported disability. However, the IBD Disk has not been validated yet in clinical practice. The aims of the VALIDate study are to validate this tool in a large population of IBD patients and to compare it to the already validated IBD-DI. Methods The VALIDate study is an ongoing multicentric prospective cohort study launched in April 2018 in 3 French University Hospitals (Nantes, Rennes, Angers), with an objective to reach a sample of 400 patients over a period inclusion of 6 months. Each patient will fill in the two questionnaires IBD Disk and IBD-DI at baseline, then between 3 and 12 months later, during a follow-up visit. Clinical and socio-demographic data will also be collected. During these two consultations, gastroenterologists and patients will evaluate disease activity thanks to a semi-quantitative 4-grade scale, named respectively PGA (Physician Global Assessment) and PtGA (Patient Global Assessment). This cohort will allow to evaluate the validity of the IBD Disk with respect to the IBD-DI in order to generalize its use for clinical practice. Other psychometric criteria of the IBD Disk will also be analysed as its reliability or its discriminant capacity. Close attention will nonetheless be needed to minimize the number of lost to follow-up patients between baseline and follow-up. Discussion The VALIDate study is the study designed to validate the IBD Disk, a visual tool easily useable in daily practice to assess disability in IBD patients. The results of this trial should enable the diffusion of this tool. Trial registration The trial is registered in ClinicalTrials.Gov with registration number NCT03590639. First posted: July 18, 2018.
Published: 2020
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37. VALIDation of the IBD-Disk Instrument for Assessing Disability in Inflammatory Bowel Diseases in a French Cohort: The VALIDate Study

Author: Laurent Siproudhis, Guillaume Bouguen, Pierre-Antoine Gourraud, Mathurin Flamant, Arnaud Bourreille, Caroline Trang-Poisson, Thomas Goronflot, Matthieu Hanf, Elodie Cesbron-Métivier, Alexandra Poinas, Elise Kerdreux, Catherine Le Berre, Marie Dewitte, Nina Dib, Institut des Maladies de l’Appareil Digestif et Oncologie Digestive [CHU Nantes] (Hôtel Dieu), Hôtel-Dieu de Nantes-Centre hospitalier universitaire de Nantes (CHU Nantes), Centre hospitalier universitaire de Nantes (CHU Nantes), Centre d'Investigation Clinique [Rennes] (CIC), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Pontchaillou [Rennes], Centre Hospitalier Universitaire d'Angers (CHU Angers), PRES Université Nantes Angers Le Mans (UNAM), Hémodynamique, Interaction Fibrose et Invasivité tumorales Hépatiques (HIFIH), Université d'Angers (UA), Centre de Recherche en Transplantation et Immunologie (U1064 Inserm - CRTI), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Nantes - UFR de Médecine et des Techniques Médicales (UFR MEDECINE), Université de Nantes (UN)-Université de Nantes (UN), and Université de Rennes (UR)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM)
Subjects: Adult, Male, Crohn’s disease, medicine.medical_specialty, [SDV]Life Sciences [q-bio], Concurrent validity, Disease, Severity of Illness Index, Inflammatory bowel disease, digestive system, Disability Evaluation, 03 medical and health sciences, 0302 clinical medicine, Cost of Illness, Crohn Disease, Cronbach's alpha, Internal medicine, Activities of Daily Living, medicine, Humans, Patient Reported Outcome Measures, ulcerative colitis, Crohn's disease, Patient-reported outcomes, business.industry, Gastroenterology, Reproducibility of Results, General Medicine, medicine.disease, Faecal calprotectin, Ulcerative colitis, digestive system diseases, 3. Good health, Research Design, 030220 oncology & carcinogenesis, Cohort, Quality of Life, Colitis, Ulcerative, Female, 030211 gastroenterology & hepatology, France, business
Abstract: Background and Aims Inflammatory bowel diseases [IBD] are disabling disorders. The IBD-Disability Index [IBD-DI] was developed for quantifying disability in IBD patients but is difficult to use. The IBD-Disk is a visual adaptation of the IBD-DI. It has not been validated yet. The main objectives were to validate the IBD-Disk and to assess the clinical factors associated with a change in the score and its variability over time. Methods From May 2018 to July 2019, IBD patients from three university-affiliated hospitals responded twice to both IBD-Disk and IBD-DI at 3–12 month intervals. Validation included concurrent validity, reproducibility, and internal consistency. Mean IBD-Disk scores were compared according to clinical factors. Variability was assessed by comparing scores between baseline and follow-up visits. Results A total of 447 patients [71% Crohn’s disease, 28% ulcerative colitis] were included in the analysis at baseline and 265 at follow-up. There was a good correlation between IBD-Disk and IBD-DI [r = 0.75, p Conclusions This study validated the IBD-Disk in a large cohort of IBD patients, demonstrating that it is a valid and reliable tool for quantifying disability for both CD and UC.
Published: 2020
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38. Improving the screening of precancerous anal lesions in high-risk subjects with normal cytology: A longitudinal cohort study using simple tests

Author: Charlène Brochard, Laurent Siproudhis, Aurore Carlo, Claire Gouriou, Emeric Boisteau, Sébastien Henno, Johanna Moreau, Astrid Lièvre, Vincent Thibault, Annie Lion, Guillaume Bouguen, CHU Pontchaillou [Rennes], Nutrition, Métabolismes et Cancer (NuMeCan), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Centre d'Investigation Clinique [Rennes] (CIC), Université de Rennes (UR)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut de recherche en santé, environnement et travail (Irset), Université d'Angers (UA)-Université de Rennes (UR)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Chemistry, Oncogenesis, Stress and Signaling (COSS), Université de Rennes (UR)-CRLCC Eugène Marquis (CRLCC)-Institut National de la Santé et de la Recherche Médicale (INSERM), CCSD, Accord Elsevier, Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique )-Institut National de la Santé et de la Recherche Médicale (INSERM)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Université d'Angers (UA), and Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-CRLCC Eugène Marquis (CRLCC)-Institut National de la Santé et de la Recherche Médicale (INSERM)
Subjects: Adult, Male, HPV16, medicine.medical_specialty, Anal Carcinoma, Biopsy, Cytodiagnosis, [SDV]Life Sciences [q-bio], Human immunodeficiency virus (HIV), Anal Canal, HIV Infections, medicine.disease_cause, Proctoscopy, 03 medical and health sciences, 0302 clinical medicine, Anal carcinoma, Internal medicine, medicine, Humans, Mass Screening, Anal cancer, Longitudinal Studies, Pap test, Longitudinal cohort, Normal cytology, Anal intraepithelial neoplasm, Retrospective Studies, Hepatology, medicine.diagnostic_test, business.industry, Papillomavirus Infections, Gastroenterology, Anoscopy, HIV, Middle Aged, Anus Neoplasms, medicine.disease, Annual Screening, 3. Good health, [SDV] Life Sciences [q-bio], 030220 oncology & carcinogenesis, Screening, Female, 030211 gastroenterology & hepatology, France, business, Precancerous Conditions, Carcinoma in Situ
Abstract: International audience; Unlabelled - For patients at high risk of anal cancer, annual screening strategies using invasive evaluation methods are stressful. According to a normal examination at baseline using simple and non invasive tests, the aim of the work was to quantify neoplastic events. Patients and method - Data from patients with a normal evaluation at the first visit were retrospectively extracted from a prospective database. The individual follow-up period was at least two years and three evaluations. Patients with abnormal cytology were assessed using high-resolution anoscopy and targeted biopsies. Results - A total of 182 subjects (F/M: 10/90, aged 48.1(10.6) years, HIV: 81%) were followed for 41(11) months. Anal cytology remained normal in 94 patients (52%), but high-grade anal neoplasms occurred in 28 patients (15%). Patients with a negative HPV16 status at baseline had cumulative probabilities of high-grade AIN of 0.4%(0.1%-1.9%), 2.6%(1.2%-5.9%) and 7.5%(4.5%-12.2%) after 1 year, 2 years and 3 years of follow-up, respectively. These probabilities were lower than those of patients with a positive HPV16 at baseline and those with a previous history of AIN. Conclusion - In patients with normal cytology and negative HPV16 at baseline, a three-year interval screening may be a less cumbersome alternative to traditional annual screening.
Published: 2020
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39. Management of solitary rectal ulcer syndome Results of a french national survey Société Nationale Française de Coloproctologie SNFCP, France

Author: Claire, Gouriou, Marion, Chambaz, Alain, Ropert, Guillaume, Bouguen, Aurélien, Venara, Guillaume, Meurette, Laurent, Siproudhis, Charlène, Brochard, CHU Pontchaillou [Rennes], Centre d'Investigation Clinique [Rennes] (CIC), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), Nutrition, Métabolismes et Cancer (NuMeCan), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Centre Hospitalier Universitaire d'Angers (CHU Angers), PRES Université Nantes Angers Le Mans (UNAM), Centre hospitalier universitaire de Nantes (CHU Nantes), Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES), Université de Rennes (UR)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), and Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)
Subjects: Adult, Male, Consensus, Therapeutic management, [SDV]Life Sciences [q-bio], Syndrome, Middle Aged, Solitary rectal ulcer syndrome, Rectal Diseases, Laxatives, Surveys and Questionnaires, Quality of Life, Humans, Female, France, Practice Patterns, Physicians', Colorectal Surgery, Ulcer
Abstract: International audience; There is no consensus on the treatment for solitary rectal ulcer syndrome (SRUS). This study aimed to obtain information from physicians treating patients with SRUS in a French medical surgical society to facilitate management plans and to develop a support algorithm. Members of the French National Society of Coloproctology (SNFCP) were invited to complete a survey that included twenty items about therapeutic management and healing criteria. Overall, 91 practitioners (median age 52 [42-59] years) responded to the questionnaire; 64/91 (70.3%) were proctologists, and 27/91 (29.7%) were colorectal surgeons. Only 15 members (16.5%) followed more than 5 patients with SRUS per year. The therapeutic objectives were to improve both patient symptoms (100%) and quality of life (98.9%). Laxative treatment and first-line rehabilitation were agreed upon by 83.5% and 73% of the respondents, respectively. Surgery, mainly rectopexy, was offered after failed medical treatment by 81.1% of the practitioners (79.1%). The first-line strategy preferred by the professionals included laxatives and biofeedback rehabilitation. Surgical treatment, preferably rectopexy, was proposed as a second intervention. No consensus was reached regarding other therapeutic alternatives, and additional studies are required to clarify their indications.
Published: 2020
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40. Efficacy and safety of sacral nerve modulation for faecal incontinence after pelvic radiotherapy

Author: Paul-Antoine Lehur, Laurent Siproudhis, François Mion, Guillaume Meurette, Elsa Lambrescak, Vincent Wyart, Jean-Luc Faucheron, Charlène Brochard, Valérie Bridoux, Igor Sielezneff, Bertrand Trilling, Diane Mege, Henri Damon, Anne-Marie Leroi, Isabelle Etienney, Hôpital de la Timone [CHU - APHM] (TIMONE), Centre recherche en CardioVasculaire et Nutrition = Center for CardioVascular and Nutrition research (C2VN), Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Neuropathies du système nerveux entérique et pathologies digestives, implication des cellules gliales entériques, Université de Nantes (UN)-Institut National de la Santé et de la Recherche Médicale (INSERM), Gestes Medico-chirurgicaux Assistés par Ordinateur (TIMC-GMCAO), Translational Innovation in Medicine and Complexity / Recherche Translationnelle et Innovation en Médecine et Complexité - UMR 5525 (TIMC ), VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes (UGA)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP ), Université Grenoble Alpes (UGA)-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes (UGA)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP ), Université Grenoble Alpes (UGA), Centre Hospitalier Universitaire [Grenoble] (CHU), Centre hospitalier universitaire de Nantes (CHU Nantes), Service de chirurgie digestive [CHU Rouen], CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU), Hôpital Edouard Herriot [CHU - HCL], Hospices Civils de Lyon (HCL), Groupe Hospitalier Diaconesses Croix Saint-Simon, Application des ultrasons à la thérapie (LabTAU), Centre Léon Bérard [Lyon]-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de physiologie digestive, urinaire, respiratoire et de l'exercice [CHU Rouen], Hôpital Charles Nicolle [Rouen], Normandie Université (NU)-Normandie Université (NU)-CHU Rouen, Nutrition, inflammation et dysfonctionnement de l'axe intestin-cerveau (ADEN), Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Institute for Research and Innovation in Biomedicine (IRIB), Normandie Université (NU)-Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), UNIROUEN - UFR Santé (UNIROUEN UFR Santé), Normandie Université (NU)-Normandie Université (NU), Centre d'Investigation Clinique [Rennes] (CIC), Université de Rennes (UR)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Pontchaillou [Rennes], Nutrition, Métabolismes et Cancer (NuMeCan), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Hôpital Charles Nicolle [Rouen]-CHU Rouen, Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), and Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)
Subjects: medicine.medical_specialty, Sacral nerve modulation, Success rate, medicine.medical_treatment, Electric Stimulation Therapy, Age and sex, 030218 nuclear medicine & medical imaging, 03 medical and health sciences, 0302 clinical medicine, [SDV.MHEP.PHY]Life Sciences [q-bio]/Human health and pathology/Tissues and Organs [q-bio.TO], Humans, Medicine, Radiology, Nuclear Medicine and imaging, In patient, Retrospective Studies, Outcome, Radiotherapy, business.industry, Faecal incontinence, Hematology, Electrodes, Implanted, 3. Good health, Surgery, Radiation therapy, Treatment Outcome, Increased risk, Oncology, 030220 oncology & carcinogenesis, Sacral nerve, Implant, business, Complication, Pelvic radiotherapy, Fecal Incontinence
Abstract: International audience; Objective: To assess the efficacy and safety of sacral nerve modulation (SNM) in patients with faecal incontinence (FI) after pelvic radiotherapy in comparison with results of SNM for FI related to other conditions.Methods: Prospectively collected data from patients who underwent SNM therapy between January 2010 and December 2015 at 7 tertiary colorectal units were reviewed retrospectively. Patients with FI following pelvic radiotherapy were identified and matched (1:2) for age and sex with 38 patients implanted over the same period for FI without previous radiotherapy. The treatment was considered favourable if the patient reported any therapeutic benefit from SNM, had no further complaints or interventions and did not consider stopping the treatment. Long-term results, surgical revision and definitive explantation rates were compared.Results: Among 352 patients who received a permanent SNM implant, 19 (5.4%) had FI following pelvic radiotherapy. After a mean follow-up of 3.5 ± 1.9 years, the cumulative successful treatment rates were similar between the groups (p = 0.60). For patients with FI following pelvic radiotherapy, the cumulative success rates were 99.4% [85.4-99.8], 96.7% [78.1-99.6], 91.7% [70.4-98.1] and 74.6% [48.4-94.8] at 1, 2, 3 and 5 years respectively. The revision and definitive explantation rates for infection did not differ significantly.Conclusion: The long-term success rate of SNM for FI after pelvic radiotherapy is similar to that of SNM for FI related to other more frequent conditions. Our study suggests that FI after pelvic radiotherapy could be improved with SNM without an increased risk of complication.
Published: 2020
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41. Incidence and Clearance of Anal Human Papillomavirus (HPV)-16 and HPV-18 Infection, and Their Determinants, Among Human Immunodeficiency Virus-Infected Men Who Have Sex With Men in France

Author: Catharina J, Alberts, Isabelle, Heard, Ana, Canestri, Lucie, Marchand, Jean-François, Fléjou, Lionel, Piroth, Tristan, Ferry, Jean-Michel, Didelot, Laurent, Siproudhis, Sébastien, Henno, Isabelle, Poizot-Martin, Teresa M, Darragh, Gary M, Clifford, Jean-Damien, Combes, Isabelle, Etienney, P, Tattevin, Centre International de Recherche contre le Cancer - International Agency for Research on Cancer (CIRC - IARC), Organisation Mondiale de la Santé / World Health Organization Office (OMS / WHO), CHU Tenon [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Centre National de Référence pour les Papillomavirus Humains - Génétique, Papillomavirus et Cancer Humain (CNR-HPV), Institut Pasteur [Paris] (IP), Service de Maladies infectieuses et tropicales [CHU Tenon], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), ANRS France Recherche Nord & sud Sida-hiv hépatites, Service d'anatomie et cytologie pathologiques [CHU Saint-Antoine], Université Pierre et Marie Curie - Paris 6 (UPMC)-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 - Faculté de Médecine (SU FM), Sorbonne Université (SU), CHU Dijon, Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Centre d'Investigation Clinique 1432 (Dijon) - Module Plurithématique : Périnatalité Cancérologie Handicap et Ophtalmologie (CIC-P803), Université de Bourgogne (UB)-Direction Générale de l'Organisation des Soins (DGOS)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Albert Trillat [Hôpital de la Croix-Rousse - HCL], Hôpital de la Croix-Rousse [CHU - HCL], Hospices Civils de Lyon (HCL)-Hospices Civils de Lyon (HCL), Service d'Hépatogastroentérologie, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Hôpital Saint Eloi (CHRU Montpellier), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Université de Montpellier (UM), CHU Pontchaillou [Rennes], Nutrition, Métabolismes et Cancer (NuMeCan), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Centre d'Investigation Clinique [Rennes] (CIC), Université de Rennes (UR)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), Sciences Economiques et Sociales de la Santé & Traitement de l'Information Médicale (SESSTIM - U1252 INSERM - Aix Marseille Univ - UMR 259 IRD), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), University of California [San Francisco] (UC San Francisco), University of California (UC), Groupe Hospitalier Diaconesses Croix Saint-Simon, Agence Nationale de Recherches sur le Sida et les Hépatites Virales, 14730, 'France Recherche Nord et Sud Sida-HIV et Hépatites', ANRS EP57 APACHES Study group: C Arvieux, A Canestri, G M Clifford, J D Combes, V Costes-Martineau, J Del Grande, J M Didelot, I Etienney, M Falguières, T Ferry, H Fischer, J F Flejou, I Heard, S Henno, N Hoyau, M Landon, H Laude, F Le Breton, A C Lesage, A Lion, G Maincent, L Marchand, H Njatonirina, O Patey, V Petrov Sanchez, V Pialoux, L Piroth, I Poizot-Martin, O Zaegel-Faucher, E Ressiot, S Radenne, J Reynes, L Siproudhis, C Tamalet, P Tattevin, Jonchère, Laurent, Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Institut Pasteur [Paris], Service des maladies infectieuses et tropicales [CHU Tenon], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Institut National de la Santé et de la Recherche Médicale (INSERM)-Direction Générale de l'Organisation des Soins (DGOS)-Université de Bourgogne (UB), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-CHU Saint-Eloi, Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), University of California [San Francisco] (UCSF), University of California, and CHU Saint-Antoine [AP-HP]
Subjects: Male, medicine.medical_specialty, Sexual Behavior, [SDV]Life Sciences [q-bio], Human immunodeficiency virus (HIV), men who have sex with men, HIV Infections, clearance, medicine.disease_cause, Rate ratio, Men who have sex with men, Sexual and Gender Minorities, 03 medical and health sciences, 0302 clinical medicine, Risk Factors, medicine, Humans, Immunology and Allergy, Prospective Studies, 030212 general & internal medicine, Homosexuality, Male, 030304 developmental biology, Gynecology, Anus Diseases, Human papillomavirus 16, 0303 health sciences, Human papillomavirus 18, human immunodeficiency virus, business.industry, Incidence (epidemiology), Papillomavirus Infections, virus diseases, Middle Aged, Anus, Confidence interval, 3. Good health, Natural history, [SDV] Life Sciences [q-bio], Infectious Diseases, medicine.anatomical_structure, Cohort, incidence, France, business, anal HPV infection
Abstract: Author(s): Alberts, Catharina J; Heard, Isabelle; Canestri, Ana; Marchand, Lucie; Flejou, Jean-Francois; Piroth, Lionel; Ferry, Tristan; Didelot, Jean-Michel; Siproudhis, Laurent; Henno, Sebastien; Poizot-Martin, Isabelle; Darragh, Teresa M; Clifford, Gary M; Combes, Jean-Damien; Etienney, Isabelle; ANRS EP57 APACHES Study group | Abstract: BackgroundProspective data on the natural history of anal human papillomavirus (HPV) infection are scarce in human immunodeficiency virus (HIV)-infected men who have sex with men (MSM).MethodsWe analyzed incidence and clearance of HPV-16 and HPV-18 in a French cohort of HIV-infected MSM, aged ≥35 years, followed-up annually (n = 438, 2014-2018).ResultsHuman papillomavirus-16 and HPV-18 incidence were similar (~10% incident infections at 24 months). Human papillomavirus-16 incidence was higher among high-grade versus no lesion at baseline (adjusted incidence rate ratio = 3.0; 95% confidence interval, 1.07-8.18). Human papillomavirus-16 cleared significantly slower than HPV-18 (32% versus 54% by 24 months).ConclusionsIn conclusion, anal HPV-16 is more persistent than HPV-18, and its incidence correlates with a prior detection of high-grade lesions.
Published: 2020
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42. MP30-07 MIDURETHRAL SLINGS ARE ASSOCIATED WITH POOR FUNCTIONAL OUTCOMES IN FEMALE PATIENTS WITH SPINA BIFIDA

Author: Benoit Peyronnet, Charlène Brochard, Isabelle Bonan, M. Jezequel, C. Voiry, Laurent Siproudhis, Quentin Alimi, Andrea Manunta, Jacques Kerdraon, and Juliette Hascoet
Subjects: Midurethral Slings, congenital, hereditary, and neonatal diseases and abnormalities, medicine.medical_specialty, Spina bifida, business.industry, Urology, Urinary incontinence, medicine.disease, nervous system diseases, Surgery, Female patient, medicine, medicine.symptom, business, Surgical treatment
Abstract: INTRODUCTION AND OBJECTIVE:Stress urinary incontinence (SUI) is relatively common in women with spina bifida. However, there is very little data available on the outcomes of surgical treatment of S...
Published: 2020
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43. Efficacy and Safety of Tumor Necrosis Factor Antagonists in Treatment of Internal Fistulizing Crohn's Disease

Author: Laurent Siproudhis, Véronique Desfourneaux, Maria Nachury, Audrey Huguet, Jean-Marie Reimund, Mathurin Flamant, Franck Cholet, Stephanie Viennot, A. Boureille, Getaid, Guillaume Bouguen, Aurelien Amiot, Nutrition, Métabolismes et Cancer (NuMeCan), Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES), Centre d'Investigation Clinique [Rennes] (CIC), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Pontchaillou [Rennes], Service d'hépato-gastro-entérologie [APHP Henri Mondor], Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12)-Hôpital Henri Mondor-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Hôpital Côte de Nacre [CHU Caen], CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN), CHRU Brest - Service d'Hématologie (CHU-Brest-Hemato), Centre Hospitalier Régional Universitaire de Brest (CHRU Brest), Centre hospitalier universitaire de Nantes (CHU Nantes), Voies de Signalisation du Développement et du Stress Cellulaire dans les Cancers Digestifs et Urologiques, Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Strasbourg (UNISTRA), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Université de Rennes (UR)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Université de Strasbourg (UNISTRA)-Institut National de la Santé et de la Recherche Médicale (INSERM), and Jonchère, Laurent
Subjects: Male, medicine.medical_specialty, Fistula, Gastroenterology, Inflammatory bowel disease, 03 medical and health sciences, 0302 clinical medicine, Crohn Disease, Gastrointestinal Agents, Interquartile range, inflammatory bowel disease, Internal medicine, medicine, Humans, prognostic factor, GETAID, Retrospective Studies, Crohn's disease, Hepatology, Tumor Necrosis Factor-alpha, business.industry, Adalimumab, Retrospective cohort study, [SDV.MHEP.HEG]Life Sciences [q-bio]/Human health and pathology/Hépatology and Gastroenterology, [SDV.IMM.IMM]Life Sciences [q-bio]/Immunology/Immunotherapy, medicine.disease, Infliximab, [SDV.MHEP.HEG] Life Sciences [q-bio]/Human health and pathology/Hépatology and Gastroenterology, 3. Good health, Clinical trial, Treatment Outcome, 030220 oncology & carcinogenesis, Tumor Necrosis Factor Inhibitors, 030211 gastroenterology & hepatology, [SDV.IMM.IMM] Life Sciences [q-bio]/Immunology/Immunotherapy, business, infliximab, Abdominal surgery, medicine.drug
Abstract: International audience; Background & aims - Few data are available on the effects of tumor necrosis factor (TNF) antagonist therapy for patients with internal fistulizing Crohn's disease (CD) and there is debate regarding the risk of abscess. We aimed to assess the long-term efficacy and safety of anti-TNF therapy for patients with internal fistulas. Methods - We performed a retrospective study of data collected from the Groupe d'Etude Thérapeutique des Affections Inflammatoires Digestives trial, from January 1, 2000, through December 31, 2017. Our final analysis included 156 patients who began treatment with an anti-TNF agent for CD with internal fistula (83 men; median disease duration, 4.9 y). The primary end point was the onset of a major abdominal surgery. Secondary analysis included disappearance of the fistula tract during follow-up evaluation and safety. The Kaplan-Meier method was used for statistical analysis. Results - After a median follow-up period of 3.5 years, 68 patients (43.6%) underwent a major abdominal surgery. The cumulative probabilities for being surgery-free were 83%, 64%, and 51% at 1, 3, and 5 years, respectively. A concentration of C-reactive protein >18 mg/L, an albumin concentration
Published: 2020
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44. Incidental anal 18fluorodeoxyglucose uptake: Should we further examine the patient?

Author: Thomas Grainville, Laurent Siproudhis, Eric Le Balch, Etienne Garin, Alexandre Merlini l’Héritier, Anne-Sophie Moussaddaq, Timothée Wallenhorst, Astrid Lièvre, Charlène Brochard, Xavier Palard-Novello, Centre Hospitalier Universitaire [Rennes], Centre d'Investigation Clinique [Rennes] (CIC), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), CRLCC Eugène Marquis (CRLCC), Laboratoire Traitement du Signal et de l'Image (LTSI), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM), Jonchère, Laurent, Université de Rennes (UR)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), and Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)
Subjects: [SDV.IB] Life Sciences [q-bio]/Bioengineering, medicine.medical_specialty, Anorectal disease, medicine.diagnostic_test, business.industry, Computed tomography, Standardized uptake value, General Medicine, 3. Good health, 03 medical and health sciences, 0302 clinical medicine, Rare, Retrospective Study, 030220 oncology & carcinogenesis, medicine, 030211 gastroenterology & hepatology, [SDV.IB]Life Sciences [q-bio]/Bioengineering, Radiology, 18fdg pet, business, Incidental anal 18fluorodeoxyglucose uptake
Abstract: International audience; Background - There are no studies on incidental anal F-fluorodeoxyglucose (FDG) uptake. Aim - To assess the rate and aetiologies of incidental anal FDG uptake and to evaluate the correlation between FDG positron-emission tomography/computed tomography (PET/CT) parameters and the diagnosis of an anorectal disease. Methods - The data from patients with incidental anal FDG uptake were retrospectively analysed. Patients who underwent anorectal examinations were identified and compared to those who did not undergo examinations. Patients who were offered treatment were then identified and compared to those who did not receive treatment. Results - Among the 43020 FDG PET/CT scans performed, 197 FDG PET/CT scans of 146 patients (0.45%) reported incidental anal uptake. Among the 134 patients included, 48 (35.8%) patients underwent anorectal examinations, and anorectal diseases were diagnosed in 33 (69.0%) of these patients and treated in 18/48 (37.5%) patients. Among the examined patients, those with a pathology requiring treatment had significantly smaller metabolic volumes (MV) 30 and MV41 values and higher maximal and mean standardized uptake value measurements than those who did not require treatment. Conclusion - Incidental anal FDG uptake is rare, but a reliable anorectal diagnosis is commonly obtained when an anorectal examination is performed. The diagnosis of an anorectal disease induces treatment in more than one-third of the patients. These data should encourage practitioners to explore incidental anal FDG uptake systematically.
Published: 2020
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45. Vedolizumab for perianal Crohn's disease: a multicentre cohort study in 151 patients

Author: Constance, Chapuis-Biron, Anne, Bourrier, Maria, Nachury, Stéphane, Nancey, Yoram, Bouhnik, Mélanie, Serrero, Laura, Armengol-Debeir, Anthony, Buisson, My-Linh, Tran-Minh, Camille, Zallot, Mathurin, Fumery, Guillaume, Bouguen, Vered, Abitbol, Stéphanie, Viennot, Elise, Chanteloup, Sylvie, Rajca, Nina, Dib, Anne-Laure, Parmentier, Laurent, Peyrin-Biroulet, Lucine, Vuitton, Laurent, Siproudhis, Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), CHU Lille, Hôpital Nord [CHU - APHM], CHU Rouen, Normandie Université (NU), Centre Hospitalier Universitaire de Nancy (CHU Nancy), CHU Amiens-Picardie, CHU Pontchaillou [Rennes], CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN), Centre Hospitalier Universitaire d'Angers (CHU Angers), PRES Université Nantes Angers Le Mans (UNAM), and Association Francois Aupetit (AFA), France
Subjects: Adult, Male, medicine.medical_specialty, Fistula, [SDV]Life Sciences [q-bio], Physical examination, Antibodies, Monoclonal, Humanized, Vedolizumab, Cohort Studies, Young Adult, 03 medical and health sciences, 0302 clinical medicine, Crohn Disease, Recurrence, Internal medicine, medicine, Animals, Humans, Rectal Fistula, Pharmacology (medical), 030212 general & internal medicine, Young adult, Prospective cohort study, Anus Diseases, Hepatology, medicine.diagnostic_test, business.industry, Gastroenterology, Odds ratio, Middle Aged, medicine.disease, 3. Good health, Treatment Outcome, Cohort, Female, 030211 gastroenterology & hepatology, France, business, Perianal Glands, Cohort study, medicine.drug
Abstract: Background The management of Crohn's disease patients with perianal lesions and anti-TNF failure is challenging. Aims To assess the effectiveness of vedolizumab in perianal Crohn's disease and the predictors of success in a real-life cohort. Methods We conducted a nationwide multicentre cohort study in patients with perianal Crohn's disease who received vedolizumab. In patients with active perianal Crohn's disease, the success of vedolizumab was defined by clinical success (no draining fistula at clinical examination and no anal ulcers for primary lesions) at 6 months without medical or surgical treatment for perianal Crohn's disease. Logistic regression analyses were performed to identify predictors of success. In patients with inactive perianal Crohn's disease, recurrence was defined by the occurrence of lesions and/or the need for medical or surgical treatments. Results One hundred and fifty-one patients were included. Among them 102 patients had active perianal disease, 33 (32.4%) males, mean age 39.8 years, mean Crohn's disease duration 14.6 years; 101 (99%) had received at least one anti-TNF. The median follow-up time was 52 weeks. Sixty-eight per cent of patients discontinued therapy after a median time of 33 weeks. Vedolizumab success was reached in 23/102 (22.5%). Among patients with setons at initiation, 9/61(15%) had a successful removal. In multivariable analysis, factors associated with success were the number of prior biologic agents (≥3, odds ratio, OR: 0.20, 95% CI 0.04-0.98) and no antibiotics at initiation (OR: 4.76, 95% CI 1.25-18.19). In 49 patients with inactive perianal Crohn's disease, perianal disease recurred in 15/49 (30.6%), 11/49 (22.4%) needed dedicated treatments. Median time to recurrence was 22 weeks. Conclusions We identified a low rate of success of vedolizumab in patients with active perianal Crohn's disease, and nearly one third of patients with inactive perianal Crohn's disease had perianal recurrence. Further evaluation is warranted in prospective studies.
Published: 2020
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46. Risk of prolapse and urinary complications in adult spina bifida patients with neurogenic acontractile detrusor using clean intermittent catheterization versus Valsalva voiding

Author: C. Richard, Charlène Brochard, Jacques Kerdraon, Laurent Siproudhis, Xavier Gamé, Zine-Eddine Khene, Isabelle Bonan, Quentin Alimi, M. Jezequel, Andrea Manunta, Juliette Hascoet, Mehdi El Akri, B. Peyronnet, CHU Pontchaillou [Rennes], Foie, métabolismes et cancer, Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Centre d'Investigation Clinique [Rennes] (CIC), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Mutualiste de Rééducation et de Réadaptation Fonctionnelles de Kerpape, CHU Toulouse [Toulouse], Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Université de Rennes (UR)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), and Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)
Subjects: Adult, Male, congenital, hereditary, and neonatal diseases and abnormalities, medicine.medical_specialty, [SDV]Life Sciences [q-bio], Urology, Urinary system, 030232 urology & nephrology, acontractile, urologic and male genital diseases, 03 medical and health sciences, 0302 clinical medicine, Risk Factors, Uterine Prolapse, Intussusception (medical disorder), Urinary Bladder, Underactive, Clinical endpoint, Humans, Medicine, Intermittent Urethral Catheterization, Urinary Complication, Urinary Bladder, Neurogenic, Spinal Dysraphism, Retrospective Studies, valsalva pelvic organ prolapse, 030219 obstetrics & reproductive medicine, Urinary bladder, business.industry, Spina bifida, clean-intermittent catheterization, medicine.disease, spina bifida, body regions, Rectal prolapse, medicine.anatomical_structure, 030220 oncology & carcinogenesis, Relative risk, Urinary Tract Infections, Female, Neurology (clinical), urinary tract infection, business, urinary bladder, rectal prolapse
Abstract: International audience; Aims - To assess the relative risks of pelvic organ prolapse (POP) and urinary complications in adult spina bifida patients with neurogenic acontractile detrusor voiding with Valsalva versus those using clean-intermittent catheterization (CIC). Methods - We conducted a retrospective analysis including all spina bifida patients with neurogenic acontractile detrusor with a minimum follow-up of 12 months. Patients were then divided in two groups according to their bladder management: voiding with Valsalva versus CIC. The primary endpoint was any de novo or worsened rectal and/or pelvic organ prolapse (POP) diagnosed during follow-up. The secondary outcome was urinary complications defined as febrile urinary tract infections (UTI) and/or urolithiasis and/or renal failure. Results - Fifty-five patients (50.9% were males) met the inclusion/exclusion criteria: 28 voiding with Valsalva and 27 performing CIC. At baseline, the rates of vaginal prolapse (44.4% vs 50%; P = 0.99), and rectal prolapse/intussusception (25.9% vs 21.4%; P = 0.76) were similar in both groups. After a median follow-up of 80.6 and 65.6 months, respectively (P = 0.29), the rate of de novo or worsened rectal prolapse/intussusception was higher in the Valsalva voiding group than in the CIC group (32.1% vs 3.7%; P = 0.01). De novo or worsened vaginal prolapses were also more common in the Valsalva voiding group, but it did not reach statistical significance (33.3% vs 11.1%; P = 0.29). Conclusions - Valsalva voiding might be harmful in adult spina bifida patients with neurogenic acontractile detrusor as it may increase the risk of rectal prolapse/intussusception. Overall, the prevalence of POP and rectal prolapse was high in both groups.
Published: 2018
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47. Le pas de valse à trois temps de l’enseignement de la proctologie : entre opportunisme, manque de considération et déception…*

Author: F. Pigot, Laurent Siproudhis, Charlène Brochard, Guillaume Bouguen, V. de Parades, and Laurent Abramowitz
Subjects: Gastroenterology, Internal Medicine
Published: 2019
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48. Liste des collaborateurs

Author: Gérard, Amarenco, primary, Christophe, Courtieu, additional, Phillipe, Debodinance, additional, Xavier, Deffieux, additional, Pierre, Denys, additional, Renaud, De Tayrac, additional, Brigitte, Fatton, additional, Arnaud, Fauconnier, additional, Hervé, Fernandez, additional, Xavier, Fritel, additional, Jacques, Kerdraon, additional, Jacques, Labat Jean, additional, Vincent, Letouzey, additional, Nathalie, Michel-Laaengh, additional, Anne, Pizzoferrato, additional, Gilberte, Robain, additional, and Laurent, Siproudhis, additional
Published: 2011
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49. Mo1873 WHICH SECOND-LINE BIOLOGIC AFTER ANTI-TNF FAILURE DURING CROHN'S DISEASE: USTEKINUMAB OR VEDOLIZUMAB, A MULTICENTRE RETROSPECTIVE STUDY

Author: Rayer, Cassandra, primary, Roblin, Xavier, additional, Laharie, David, additional, Flamant, Mathurin, additional, Dewitte, Marie, additional, Fumery, Mathurin, additional, Caron, Benedicte, additional, Viennot, Stephanie, additional, Pariente, Benjamin, additional, Laurent, Siproudhis, additional, Peyrin-Biroulet, Laurent, additional, and Bouguen, Guillaume, additional
Published: 2020
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50. Bowel Dysfunction Related to Spina Bifida: Keep It Simple

Author: Guillaume Bouguen, Charlène Brochard, H. Menard, Laurent Siproudhis, Michel Neunlist, Andrea Manunta, Alain Ropert, Anne Dariel, Benoit Peyronnet, CHU Pontchaillou [Rennes], Institut des Maladies de l'Appareil Digestif, Université de Nantes (UN), Centre d'Investigation Clinique [Rennes] (CIC), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), Foie, métabolismes et cancer, Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Université de Rennes (UR)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), The Enteric Nervous System in gut and brain disorders [U1235] (TENS), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Nantes - UFR de Médecine et des Techniques Médicales (UFR MEDECINE), Université de Nantes (UN)-Université de Nantes (UN), and Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique )
Subjects: Adult, Male, congenital, hereditary, and neonatal diseases and abnormalities, Pediatrics, medicine.medical_specialty, Constipation, [SDV]Life Sciences [q-bio], Population, 030232 urology & nephrology, complication, Urinary incontinence, Severity of Illness Index, 03 medical and health sciences, 0302 clinical medicine, Neurogenic Bowel, Risk Factors, Severity of illness, Prevalence, medicine, Humans, Fecal incontinence, human, Prospective Studies, education, Prospective cohort study, Spinal Dysraphism, education.field_of_study, Spina bifida, business.industry, Gastroenterology, General Medicine, medicine.disease, 3. Good health, Intestinal Diseases, risk factor, Female, 030211 gastroenterology & hepatology, France, medicine.symptom, business, Fecal Incontinence, prospective study
Abstract: International audience; BACKGROUND: Although care of urological disorders in spina bifida is well established, there is yet no agreement on a standardized approach to bowel dysfunction in this population.OBJECTIVE: The purpose of this study was to assess bowel dysfunction using validated instruments and the risk factors in adults with spina bifida.DESIGN: A multidisciplinary team prospectively collected patient data, focusing on anorectal and urological symptoms.SETTINGS: The study was conducted with data from a French referral center for spina bifida.PATIENTS: A total of 228 adults with spina bifida (sex ratio men:women, 92 (40%):136 (60%)) with a median age of 34.7 years (range, 26.8-44.7 y) were assessed.MAIN OUTCOMES MEASURES: Factors associated with severe fecal incontinence (Cleveland Clinic Incontinence Score ≥9) and severe bowel dysfunction (Neurogenic Bowel Dysfunction score ≥14) were assessed in a multivariate analysis model.RESULTS: The prevalence rates of severe fecal incontinence and severe bowel dysfunction were 60% (130/217) and 42% (71/168). Bowel dysfunction was the second most common major concern of patients after lower urinary tract dysfunction. Male sex, obesity, urinary incontinence, and a Knowles-Eccersley-Scott symptom constipation score ≥10 were independently associated with severe fecal incontinence. Patients with soft stools had significantly less severe bowel dysfunction. Neither neurologic level nor other neurologic features of spina bifida were associated with severe fecal incontinence or severe bowel dysfunction.LIMITATIONS: The recruitment of patients with spina bifida through a national referral center might have resulted in selection bias, and some data were missing especially regarding BMI and Neurogenic Bowel Dysfunction score (21% and 26% of missing data).CONCLUSIONS: The prevalence rates of severe fecal incontinence and severe bowel dysfunction in adults with spina bifida were high and were adequately perceived by the patients. The present study emphasized the association of bowel dysfunction and fecal incontinence with obesity, urologic disorders, and stool consistency rather than neurologic features. See Video Abstract at http://links.lww.com/DCR/A394.
Published: 2017
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