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1. Successful treatment of congenital erythropoietic porphyria using matched unrelated hematopoietic stem cell transplantation in an adult: A case report

Author

Pierre Peterlin, Julia Bonnelye, Alice Garnier, Amandine Le Bourgeois, Thierry Guillaume, Maxime Jullien, Hervé Dutartre, Marie Le Moigne, Caroline Schmitt, Laurent Gouya, Antoine Poli, Sebastien Barbarot, and Patrice Chevallier

Subjects
Dermatology, RL1-803
Abstract

Abstract Congenital erythropoietic porphyria (CEP), or Gunther disease, is a rare genetic disease responsible for severe dermatologic, hepatic and/or haematological damages related to the deficient activity of the uroporphyrinogen III synthase. Allogeneic stem cell transplantation (Allo‐SCT) represents the only curative treatment and few allotransplanted cases have been reported in children but not in adults. Here we report for the first time the successful cure of a 46‐year old man with CEP with a 5‐year follow‐up after Allo‐SCT.

Published
2024
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2. Efficacy of Spironolactone Compared with Doxycycline in Moderate Acne in Adult Females: Results of the Multicentre, Controlled, Randomized, Double-blind Prospective and Parallel Female Acne Spironolactone vs doxyCycline Efficacy (FASCE) Study

Author

Brigitte Dréno, Jean-Michel Nguyen, Ewa Hainaut, Laurent Machet, Marie-Thérèse Leccia, Nathalie Beneton, Jean-Paul Claudel, Philippe Célérier, Marie Le Moigne, Sarah Le Naour, Florence Vrignaud, Alexandra Poinas, Cécile Dert, Aurélie Boisrobert, Laurent Flet, Simon Korner, and Amir Khammari

Subjects
acne, spironolactone, adult female acne, AFAST, doxycycline, quality of life, Dermatology, RL1-803
Abstract

Acne in adult females is triggered mainly by hormones. Doxycycline is a reference treatment in acne. Spironolactone targets the androgen receptor of sebaceous glands and is prescribed off-label for female adult acne. This multicentre, controlled, randomized, double-blind prospective and parallel study assessed the efficacy of spironolactone compared with doxycycline in adult female acne. A total of 133 women with moderate acne were randomized to receive treatment with: (i) doxycycline and benzoyl peroxide for 3 months followed by a 3-month treatment with its placebo and benzoyl peroxide, or (ii) spironolactone and benzoyl peroxide for 6 months. Successfully treated patients continued with benzoyl peroxide or spironolactone alone for a further 6 months. Primary endpoints were treatment success at month 4 and month 6 with the AFAST score. At all visits, the ECLA score, lesion counts, local and systemic safety and quality of life were assessed. Spironolactone performed better at month 4 and showed a statistically significant better treatment success after 6 months than doxycycline (p = 0.007). Spironolactone was 1.37-times and 2.87-times more successful compared with doxycycline at respective time-points. AFAST and ECLA scores, as well as lesion counts always improved more with spironolactone. Patients’ quality of life was better with spironolactone at month 4 and month 6. Spironolactone was very well tolerated. This is the first study to show that, in female adults with moderate acne, treatment with spironolactone is significantly more successful than doxycycline and very well tolerated.

Published
2024
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4. Plasma cell-directed therapies in monoclonal gammopathy-associated scleromyxedema

Author

Sébastien Barbarot, O. Carpentier, François Lifermann, Bernard Cribier, Jean-Luc Schmutz, Amélie Osio, Marie Jachiet, Cristina Bulai Livideanu, Marie Beylot-Barry, Martine Bagot, Fabien Le Bras, Jean-David Bouaziz, Marie Le Moigne, Amandine Servy, Emilie Sbidian, Alexis Talbot, Laurence Michel, Pierre Aucouturier, Nicolas Limal, Camille Francès, Marie Tauber, Philippe Humbert, Vincent Descamps, Sébastien Debarbieux, Alain Dupuy, Ruba Y. Taha, Emilie Baubion, Arsène Mekinian, Michel Rybojad, Adèle de Masson, Maxime Battistella, Charles Zarnitsky, T. Mahévas, Philippe Modiano, Michel D'Incan, Olivier Fain, Bruno Sassolas, Claire de Moreuil, Fanny Brault, Bertrand Arnulf, Sandy Peltier, D. Thomas-Beaulieu, Romain Prud'homme, Thierry Passeron, Olivier Hermine, Dan Lipsker, Sorbonne Université (SU), Hôpital Saint-Louis, Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées, CHU Henri Mondor, Centre Hospitalier Universitaire de Strasbourg (CHU de Strasbourg ), Centre Hospitalier Régional Universitaire de Brest (CHRU Brest), Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Tenon [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), AP-HP - Hôpital Bichat - Claude Bernard [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), CHU Clermont-Ferrand, Imagerie Moléculaire et Stratégies Théranostiques (IMoST), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Clermont Auvergne [2017-2020] (UCA [2017-2020]), Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), CHU Bordeaux [Bordeaux], Centre Hospitalier Universitaire de Nice (CHU Nice), National Center for Cancer Care and Research (NCCCR - DOHA - QATAR), Centre Hospitalier Universitaire [Rennes], Physiopathologie des Adaptations Nutritionnelles (PhAN), Université de Nantes - UFR de Médecine et des Techniques Médicales (UFR MEDECINE), Université de Nantes (UN)-Université de Nantes (UN)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Centre Hospitalier Universitaire de Lyon, Centre Hospitalier de Roubaix, Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), CHI Poissy-Saint-Germain, Hôpital Saint-Vincent de Paul, Centre Hospitalier, Centre Hospitalier de Dax, Centre Hospitalier Universitaire (CHU), Centre hospitalier universitaire de Nantes (CHU Nantes), CHU Toulouse [Toulouse], CHU Limoges, Université de Toulouse (UT), CHU Henri Mondor [Créteil], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), and Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)

Subjects
Adult, Male, 0301 basic medicine, medicine.medical_specialty, medicine.medical_treatment, Plasma Cells, Immunology, Paraproteinemias, Antineoplastic Agents, Plasma cell, Biochemistry, Gastroenterology, Dexamethasone, Bortezomib, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, Scleromyxedema, medicine, Humans, Immunologic Factors, Glucocorticoids, Lenalidomide, Aged, Retrospective Studies, Skin, business.industry, Immunoglobulins, Intravenous, Plasmapheresis, Cell Biology, Hematology, Middle Aged, medicine.disease, 3. Good health, 030104 developmental biology, medicine.anatomical_structure, Leonine facies, Female, Transcriptome, business, Refractory cytopenia with multilineage dysplasia, [SDV.MHEP.DERM]Life Sciences [q-bio]/Human health and pathology/Dermatology, 030215 immunology, medicine.drug
Abstract

International audience; Scleromyxedema is a rare skin and systemic mucinosis that is usually associated with monoclonal gammopathy (MG). In this French, multicenter, retrospective study of 33 patients, we investigated the clinical and therapeutic features of MG-associated scleromyxedema. Skin molecular signatures were analyzed using a transcriptomic approach. Skin symptoms included papular eruptions (100%), sclerodermoid features (91%), and leonine facies (39%). MG involved an IgG isotype in all patients, with a predominant λ light chain (73%). Associated hematologic malignancies were diagnosed in 4/33 patients (12%) (smoldering myeloma, n=2; chronic lymphoid leukemia, n=1; and refractory cytopenia with multilineage dysplasia n=1). Carpal tunnel syndrome (33%), arthralgia (25%) and dermato-neuro syndrome (DNS) (18%) were the most common systemic complications. One patient with mucinous cardiopathy died of acute heart failure. Intravenous immunoglobulin (HDIVig) treatment alone or in combination with steroids appeared to be quite effective in nonsevere cases (clinical complete response achieved in 13/31 patients). Plasma cell-directed therapies using lenalidomide and/or bortezomib with dexamethasone and HDIVig led to a significant improvement in severe cases (HDIVig-refractory or cases with central nervous system or cardiac involvement). The emergency treatment of DNS with combined plasmapheresis, HDIVig, and high-dose corticosteroids induced the complete remission of neurological symptoms in 4/5 patients. Quantitative reverse transcriptase-PCR (RT-PCR) analysis of 6 scleromyxedema skin samples showed significantly higher profibrotic pathway levels (transforming growth factor β (TGFβ) and collagen-1) than in healthy skin. Prospective studies targeting plasma cell clones and/or fibrotic pathways are warranted for long-term scleromyxedema management.

Published
2020
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5. 5-fluorouracil chemowraps for the treatment of multiple actinic keratoses

Author

Gaëlle Quéreux, Lucie Peuvrel, Brigitte Dréno, Mélanie Saint-Jean, Amir Khammari, Cécile Frenard, Anabelle Brocard, and Marie Le Moigne

Subjects
Male, medicine.medical_specialty, Dermatology, Administration, Cutaneous, Drug Administration Schedule, 030207 dermatology & venereal diseases, 03 medical and health sciences, 0302 clinical medicine, medicine, Humans, Aged, Retrospective Studies, Aged, 80 and over, Response rate (survey), Multiple actinic keratoses, Bowen's disease, business.industry, Actinic keratosis, Off-Label Use, Middle Aged, medicine.disease, Keratosis, Actinic, Treatment Outcome, Tolerability, Fluorouracil, 030220 oncology & carcinogenesis, Toxicity, Female, Dermatologic Agents, business, Contact dermatitis, medicine.drug
Abstract

Few satisfactory treatment options are available for widespread areas affected by multiple actinic keratoses (AKs). Our primary objective was to assess the response rate to weekly 5-fluorouracil (5-FU) chemowraps on widespread AK lesions, and secondarily to assess tolerability, the percentage of patients with recurrence and time to recurrence, the response rate for patients with associated Bowen's disease (BD), and the percentage of squamous cell carcinomas (SCCs) identified after treatment. We conducted an open study which included all the patients who had been treated with weekly 5-FU chemowraps in our department over the course of five years for areas of widespread AKs. The response rate for AKs was 60%, with 20% complete responses among 25 patients after an average of 9.6 sessions (1 to 64). The treatment had to be discontinued because of toxicity in four patients; one case of contact dermatitis, one case of erosive pustular dermatosis, and two cases of Grade 2 irritations. Invasive SCCs were identified in five patients after treatment cessation. The median recurrence-free survival was five months. A 64% response rate was achieved for associated BD. The weekly application of 5-FU under occlusion seems to be an interesting, well-tolerated therapeutic option for the treatment of widespread AKs.

Published
2017
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6. Adult female acne treated with spironolactone: a retrospective data review of 70 cases

Author

Mélanie Saint-Jean, Elodie Boisrobert, Brigitte Dréno, Amir Khammari, Jean-Michel Nguyen, Anne Isvy-Joubert, Aurélie Gaultier, Marie Le Moigne, Département de Dermatologie [CHU Nantes], Centre hospitalier universitaire de Nantes (CHU Nantes), Clinical and Translational Research in Skin Cancer (CRCINA-ÉQUIPE 2), Centre de Recherche en Cancérologie et Immunologie Nantes-Angers (CRCINA), 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)-Centre hospitalier universitaire de Nantes (CHU Nantes)-Centre National de la Recherche Scientifique (CNRS)-Université d'Angers (UA)-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)-Centre hospitalier universitaire de Nantes (CHU Nantes)-Centre National de la Recherche Scientifique (CNRS)-Université d'Angers (UA), Unité méthodologique [CHU Nantes] (Département de recherche clinique), Bernardo, Elizabeth, and Université d'Angers (UA)-Université de Nantes (UN)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Centre hospitalier universitaire de Nantes (CHU Nantes)-Université d'Angers (UA)-Université de Nantes (UN)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Centre hospitalier universitaire de Nantes (CHU Nantes)

Subjects
medicine.medical_specialty, medicine.drug_class, [SDV.CAN]Life Sciences [q-bio]/Cancer, Dermatology, Severity of Illness Index, Retrospective data, Young Adult, 030207 dermatology & venereal diseases, 03 medical and health sciences, chemistry.chemical_compound, 0302 clinical medicine, [SDV.CAN] Life Sciences [q-bio]/Cancer, Risk Factors, Internal medicine, Acne Vulgaris, Androgen Receptor Antagonists, medicine, Humans, 030212 general & internal medicine, acne, Isotretinoin, Acne, Retrospective Studies, Back, Adult female, Proportional hazards model, business.industry, adult, isotretinoin, Middle Aged, medicine.disease, Dermatitis, Seborrheic, progestin, 3. Good health, Surgery, Androgen receptor, Treatment Outcome, spironolactone, female, contraception, chemistry, Spironolactone, Dermatologic Agents, Progestins, business, Progestin, Facial Dermatoses, Contraceptives, Oral, medicine.drug
Abstract

International audience; The prevalence of acne in the adult population is increasing, particularly in women. Spironolactone regulates sebaceous gland activity by blocking androgen receptor. To evaluate retrospectively the efficacy of spironolactone in women with acne. Data from 70 women of at least 20 years, treated for their acne between 2010 and 2015 with low-dose spironolactone (≤150 mg/day), were analysed. Remission was defined by the number of retentional lesions inferior or equal to five and inflammatory lesions inferior or equal to two on the face. Variables influencing the response were studied using the Cox model. The mean age was 31.3 years; 39 (56%) women had prior courses of isotretinoin and 53 (76%) had an oral contraception prior to treatment. Remission data from a median treatment period of six months (95% CI: 4-9) were obtained from 47 (71%) women. Markers for a positive response to spironolactone were a high number of inflammatory lesions at inclusion (OR: 1.08; 95% CI: 1.03-1.13; p = 0.001) and relapse with previous isotretinoin (OR: 2.46; 95% CI: 1.09-5.54; p = 0.03). The marker for a negative response was an association with oral contraceptives containing first or second-generation progestin (OR: 2.77; 95% CI: 1.35-5.71; p = 0.005). This retrospective data analysis confirms that the use of low doses of spironolactone is a valuable alternative in women with acne in whom oral isotretinoin has failed. Moreover, the analysis shows that first and second-generation oral contraceptives decrease the efficacy of spironolactone, confirming the interest of using two third or fourth-generation oral contraceptives.

Published
2017
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7. Adult acne in women is not associated with a specific type of Cutibacterium acnes

Author

M. Saint-Jean, Jean-Michel Nguyen, Stéphane Corvec, Amir Khammari, Brigitte Dréno, Marie Le Moigne, Aurélie Boisrobert, 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), Centre de Recherche en Cancérologie et Immunologie Nantes-Angers (CRCINA), Université d'Angers (UA)-Université de Nantes (UN)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Centre hospitalier universitaire de Nantes (CHU Nantes), Centre hospitalier universitaire de Nantes (CHU Nantes), Hôpital Saint-Jacques [Nantes], and CCSD, Accord Elsevier

Subjects
0303 health sciences, medicine.medical_specialty, Cutibacterium acnes, 030306 microbiology, business.industry, [SDV]Life Sciences [q-bio], MEDLINE, Dermatology, Drug resistance, medicine.disease, 3. Good health, [SDV] Life Sciences [q-bio], 030207 dermatology & venereal diseases, 03 medical and health sciences, Matrix-assisted laser desorption/ionization, 0302 clinical medicine, medicine, Young adult, business, Acne
Abstract

International audience; No abstract available

Published
2019
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8. Drug reaction with eosinophilia and systemic symptoms syndrome induced by combination of vemurafenib and cobimetinib in melanoma: A series of 11 cases

Author

Barbara Brégeon, Lucie Peuvrel, Claire Bernier, Mélanie Saint-Jean, Nicolas Josselin, Gaëlle Quéreux, and Marie Le Moigne

Subjects
Adult, Male, medicine.medical_specialty, Skin Neoplasms, Dermatology, Risk Assessment, Severity of Illness Index, Drug reaction with eosinophilia and systemic symptoms, Sampling Studies, chemistry.chemical_compound, Piperidines, medicine, Humans, Vemurafenib, Melanoma, Aged, Cobimetinib, Aged, 80 and over, business.industry, Middle Aged, medicine.disease, Prognosis, chemistry, Drug Hypersensitivity Syndrome, Azetidines, Drug Therapy, Combination, Female, business, medicine.drug
Published
2018

9. Confocal microscopy in adult women with acne

Author

Mélanie Saint-Jean, Marie Le Moigne, A. Boisrobert, Morgane Vourc'h Jourdain, S. Corvec, Aurélie Gaultier, Amir Khammari, Brigitte Dréno, Charlotte Paugam, Louise Muguet Guenot, Clinical and Translational Research in Skin Cancer (CRCINA-ÉQUIPE 2), Centre de Recherche en Cancérologie et Immunologie Nantes-Angers (CRCINA), Université d'Angers (UA)-Université de Nantes (UN)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Centre hospitalier universitaire de Nantes (CHU Nantes)-Université d'Angers (UA)-Université de Nantes (UN)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-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), Service de dermatologie [Nantes], Université de Nantes (UN)-Centre hospitalier universitaire de Nantes (CHU Nantes), Département de bactériologie-hygiénique [CHU Nantes], Centre hospitalier universitaire de Nantes (CHU Nantes), SEB-PIMESP [CHU Nantes], Centre hospitalier universitaire de Nantes (CHU Nantes)-Hôpital Saint-Jacques [CHU Nantes], Bernardo, Elizabeth, Clinical and translational research in skin cancer ( CRCINA - Département INCIT - Equipe 2 ), Centre de recherche de Cancérologie et d'Immunologie / Nantes - Angers ( CRCINA ), Université d'Angers ( UA ) -Université de Nantes ( UN ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Centre National de la Recherche Scientifique ( CNRS ) -Institut de Recherche en Santé de l'Université de Nantes ( IRS-UN ) -Centre hospitalier universitaire de Nantes ( CHU Nantes ) -Université d'Angers ( UA ) -Université de Nantes ( UN ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Centre National de la Recherche Scientifique ( CNRS ) -Institut de Recherche en Santé de l'Université de Nantes ( IRS-UN ) -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 ), Université de Nantes ( UN ) -Centre hospitalier universitaire de Nantes ( CHU Nantes ), Centre hospitalier universitaire de Nantes ( CHU Nantes ), Centre hospitalier universitaire de Nantes ( CHU Nantes ) -Hôpital Saint-Jacques [CHU Nantes], 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)-Centre hospitalier universitaire de Nantes (CHU Nantes)-Centre National de la Recherche Scientifique (CNRS)-Université d'Angers (UA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Nantes - UFR de Médecine et des Techniques Médicales (UFR MEDECINE), and Université de Nantes (UN)-Université de Nantes (UN)-Centre hospitalier universitaire de Nantes (CHU Nantes)-Centre National de la Recherche Scientifique (CNRS)-Université d'Angers (UA)

Subjects
Adult, medicine.medical_specialty, Chin, [SDV.CAN]Life Sciences [q-bio]/Cancer, Dermatology, [ SDV.CAN ] Life Sciences [q-bio]/Cancer, Infundibulum, 030207 dermatology & venereal diseases, 03 medical and health sciences, Follicle, 0302 clinical medicine, [SDV.CAN] Life Sciences [q-bio]/Cancer, Keratin, Acne Vulgaris, medicine, Humans, Forehead, Acne, chemistry.chemical_classification, Microscopy, Confocal, integumentary system, business.industry, Mandible, Cheek, Middle Aged, medicine.disease, 3. Good health, medicine.anatomical_structure, chemistry, 030220 oncology & carcinogenesis, Case-Control Studies, Female, business, Hair Follicle, Facial Dermatoses
Abstract

International audience; Background Acne is an inflammatory disease of the pilosebaceous follicle, affecting 41–54% of adult women, with a particular form that involves the mandible.Methods We characterized infundibulum morphology in two groups of adult women using reflectance confocal microscopy. First, we investigated acne visually “healthy zones” on the forehead in 15 adult women with diffuse acne and compared with acne-free controls. We then compared healthy forehead and affected mandibular zone in 15 acne patients with mandibular involvement. Exposed results had a P < 0.05.Results Seven hundred and ninety-one follicles were observed on apparently healthy skin of 15 adult women with acne, with a larger diameter, thicker (68%), and hyper keratinized (65%) follicle border, and more keratin plugs (44%) than in controls. In the second group of 15 adult women with mandibular acne, we compared 569 follicles in the mandibular zone and 475 on forehead. In the mandibular area, follicles were significantly larger, thicker (76%), more hyper keratinized (72%), with more keratin plugs (47%) and increased inflammation (23%) compared with the forehead area. In the mandibular area, 0.2% of follicles showed isolated inflammation without hyper keratinization, and 15.3% had both thickened borders with an onion-like appearance and keratin plugs associated with inflammation.Conclusions Hyper keratinization was higher in healthy skin of adult women with acne compared with controls, confirming that microcomedo is crucial in the development of acne lesions. We also demonstrate that the repartition of comedones and microcomedones is inhomogeneous with a great number in the mandibular area where acne lesions are located.

Published
2018
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10. Hair‐pulling disorder complicated by skin‐picking disorder: An unknown side‐effect of dopamine replacement therapy?

Author

Marie Grall-Bronnec, Juliette Leboucher, Caroline Victorri-Vigneau, Marie Le Moigne, Jean-Marc Fève, Gaëlle Challet-Bouju, Pascal Derkinderen, MethodS in Patients-centered outcomes and HEalth ResEarch (SPHERE), Université de Tours (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Nantes - UFR des Sciences Pharmaceutiques et Biologiques, Université de Nantes (UN)-Université de Nantes (UN), and Université de Tours-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Nantes - UFR des Sciences Pharmaceutiques et Biologiques

Subjects
medicine.medical_specialty, Monoamine Oxidase Inhibitors, Indoles, Side effect, [SDV]Life Sciences [q-bio], 030226 pharmacology & pharmacy, Dopamine Agonists/*adverse effects, Trichotillomania, 03 medical and health sciences, Pramipexole, Indans/*adverse effects, 0302 clinical medicine, Hair-pulling, Drug Therapy, Dopamine, medicine, Humans, Skin-picking, Benzothiazoles, 030212 general & internal medicine, ComputingMilieux_MISCELLANEOUS, Self-Injurious Behavior/*chemically induced/*complications, Combination/adverse effects, Benzothiazoles/*adverse effects, business.industry, General Neuroscience, Trichotillomania/*chemically induced/*complications, General Medicine, Middle Aged, Dermatology, 3. Good health, Psychiatry and Mental health, Monoamine Oxidase Inhibitors/adverse effects, Neurology, Indans, Combination, Dopamine Agonists, Female, Neurology (clinical), business, Self-Injurious Behavior, Indoles/*adverse effects, medicine.drug
Abstract

International audience

Published
2018
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11. Dysgeusia and weight loss under treatment with vismodegib: benefit of nutritional management

Author

Adam Jirka, Marie Le Moigne, Lucie Peuvrel, Brigitte Dréno, Amir Khammari, Anabelle Brocard, Mélanie Saint-Jean, Aurélie Gaultier, Gaëlle Quéreux, Dominique Darmaun, Hôpital Hôtel-Dieu [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Institut National de la Santé et de la Recherche Médicale (INSERM), Immunobiologie fondamentale et clinique, Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-IFR128-Institut National de la Santé et de la Recherche Médicale (INSERM), Physiologie des Adaptations Nutritionnelles (PhAN), Institut National de la Recherche Agronomique (INRA)-Université de Nantes (UN), and SEB

Subjects
Male, medicine.medical_specialty, Weight loss, Skin Neoplasms, Pyridines, Vismodegib, Antineoplastic Agents, Pilot Projects, [SDV.CAN]Life Sciences [q-bio]/Cancer, Dysgeusia, Nutritional management, Cohort Studies, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, Medicine, Humans, Cumulative incidence, Anilides, 030212 general & internal medicine, Prospective Studies, Prospective cohort study, Aged, 2. Zero hunger, Aged, 80 and over, business.industry, Incidence (epidemiology), Malnutrition, Middle Aged, 3. Good health, Surgery, Oncology, Carcinoma, Basal Cell, 030220 oncology & carcinogenesis, Cohort, Female, medicine.symptom, business, [SDV.AEN]Life Sciences [q-bio]/Food and Nutrition, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology, medicine.drug, Cohort study
Abstract

International audience; Purpose Whereas vismodegib is effective in the treatment of locally advanced/metastatic basal cell carcinoma, dysgeusia and weight loss are common side effects of such treatment. The main objective of this study was to monitor the nutritional status of vismodegib-treated patients. Secondary objective was to assess the incidence of dysgeusia and the benefit of early nutritional management. Methods This prospective study included all patients who started vismodegib between October 2011 and May 2013 at Nantes University Hospital. Prior to July 2012, patients treated with vismodegib had not received any specific nutritional management (Historical cohort). Body weight and presence of dysgeusia were recorded monthly. Patients treated after July 2012 (Nutrition cohort) were evaluated by a physician of the Nutrition Support Unit and received dietary counseling at vismodegib initiation. A standardized nutritional management protocol was initiated in case of significant weight loss. Results Forty-five patients (21 and 24 in the Nutrition and Historical cohort, respectively) were enrolled. In the Nutrition cohort, five patients (24 %) were undernourished at vismodegib initiation, and the 6-month cumulative incidence of dysgeusia was 71 %. Eight patients (38 %) and 13 patients (54 %) had a weight loss greater than 5 % in the Nutrition and Historical cohort, respectively (p = 0.3727). Conclusion The results of this pilot study suggest the benefit of early nutritional screening. The potential benefit of nutritional support in this setting warrants further investigation.

Published
2016
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