juillet 17, 2017 | Posted by admin
Un nouvel article scientifique intitulé «Remission is related to CRP and smoking in early axial spondyloarthritis. The DESIR cohort.» a été publié dans le journal Joint Bone Spine.
Wendling D, Guillot X, Gossec L, Prati C, Saraux A, Dougados M
Joint Bone Spine. 2016 Jul 20. doi: 10.1016/j.jbspin.2016.06.004
Abstract
INTRODUCTION:
No evaluation of factors associated with remission has been performed in early SpA. The aim of the study was to evaluate percentage of patients in remission using and comparing different definitions of remission, and to evaluate factors associated with remission at inclusion in the prospective DESIR cohort, and after 24 months.
METHODS:
Performance of three definitions (ASAS partial remission [PR], ASDAS-CRP less than 1.3 [ASDAS-R], BASDAI less than 3.6 [BASDAI-R]) were assessed using sensibility, specificity and Youden Index. Data at M0 and M24 were analyzed in uni- and multivariate analysis.
RESULTS:
Seven hundred and six patients were evaluated at M0 and 577 at M24. At M0, percentage of patients in remission was 4% (PR), 8% (ASDAS), 34% (BASDAI), and at M24: 15%, 24% and 54% respectively, in the whole population and similar in Amor, ESSG and ASAS classified patients. BASDAI less than 3.6 had the best sensitivity, and ASDAS-R the best Youden index when using each of the two other definitions of remission as a gold standard. At M24 in multivariate analysis, remission was associated with less smoking, less analgesics, ASAS clinical arm fulfilling, less NSAIDs (ASDAS-R), low CRP (ASDAS-R), low BMI (BASDAI-R). However, over the two years, this study did not allow to demonstrate a relation between remission and structural progression or morbidity.
CONCLUSION:
In this population suggestive of early SpA, smoking and CRP appear as major markers of disease activity in early SpA, and associated with absence of remission.
Copyright © 2016 Société française de rhumatologie. Published by Elsevier SAS. All rights reserved.
KEYWORDS:
Early disease; Remission; Spondyloarthritis
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juillet 1, 2017 | Posted by admin
Une nouvelle review scientifique intitulé «Biomarkers for outcomes of spondyloarthritis» a été publié dans le journal Joint Bone Spine.
Xavier Romand, Claire Douillard, Athan Baillet.
No abstract available Keywords: Adipokines; Anti-Saccharomyces cerevisiæ antibodies; Biomarkers; Calprotectin; Cytokines; Spondyloarthritis.
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juin 28, 2017 | Posted by admin
Des nouveaux travaux ont été présentés lors du congrès du collège américain (ACR) de rhumatologie qui s’est déroulé du 3 au 8 novembre 2017 à San Diego (Etats-Unis) :
▫ Inflammation on MRI of Spine and Sacroiliac Joints Is Highly Predictive of Structural Damage in Axial Spondyloarthrisis: The 5 Years Data of the DESIR Cohort. Alexandre Sepriano
▫ Which Imaging Outcomes for AxSpA Are Most Sensitive to Change? a 5-Year Analysis of the DESIR Cohort : Alexandre Sepriano
▫ Progression of Structural Damage on MRI in Patients with Axial Spondyloarthritis Is Limited: The 5 –Year Results in the DESIR Cohort : Alexandre Sepriano
▫ Evaluation of the Adherence to Recommendations for Tnfα Blockers Use and Its Impact over 5 Years of Follow-up in Early Axial Spondyloarthritis. Data from the DESIR Cohort : Clementina López-Medina
▫ Integrated Longitudinal Analysis Increases Precision and Reduces Bias: A Comparative 5-Year Analysis in the DESIR Cohort : Alexandre Sepriano
▫ Detection of Structural Lesions on T1 Weighted MRI Versus Radiography of the Sacroiliac Joints in Early Axial Spa: 2-Year Data Walter : P. Maksymowych
▫ Inflammatory Lesions of the Sacroiliac Joints, but Not of the Spine, Are of High Utility for Recent Onset Axial Spondyloarthritis Recognition : Anna Molto
▫ Erosions at the Sacroiliac Joints and Fatty Lesions at the Spine Are the Most Discriminant Lesions for Recent Onset Axial Spondyloarthritis Recognition : Anna Molto
▫ Sustained Remission of Inflammation Is Associated with Reduced Structural Damage on SI Joint MRI in Patients with Early Axial Spa: Evidence to Support the Concept of Treat-to-Target Walter : P. Maksymowych
▫ X-Ray Spine Lesions Are Rare and Not Discriminant for Axial Spondyloarthritis Recognition in Patients with Recent Onset Chronic Back Pain : Anna Molto
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juin 28, 2017 | Posted by admin
De nouveaux travaux ont été présentés lors du congrès de la Société Française de Rhumatologie (SFR) qui s’est déroulé du 10 au 12 décembre 2017 :
Présentations orales :
▫ La cohorte après les 10 premières années de suivi : A. Ruyssen-Witrand (Toulouse)
▫ Les données de l’imagerie après 5 ans de suivi : A. Molto (Paris)
Liste des abstracts de DESIR :
▫ Incidence des fractures vertébrales dans les spondyloarthrites récentes : 5 ans de données Prospectives de la cohorte DESIR (J. Sahuguet, J. Fechtenbaum, A. Molto, A. Etcheto, P. Richette, M. Dougados, C. Roux, K. Briot (Paris))
▫ L’évaluation globale du patient semble être l’instrument le plus discriminatif pour évaluer le Changement de qualité de vie dans la spondyloarthrite ankylosante axiale (axSpA) débutante sur 3 ans de suivi : 442 patients de la cohorte DESIR (D. Puyraimond-Zemmour(1), C. Desthieux(1), A. Ruyssen-Witrand(2), B. Fautrel(1), L. Gossec(1), (1) Paris) ;(2) Toulouse)
▫ Impact des maladies inflammatoires de l’intestin sur les spondyloarthrites récentes : résultats de la cohorte DESIR. (D. Wendling(1), X. Guillot(1), C. Prati(1), R. Lories(2), M. Dougados(3), (1) Besançon, (2) Louvain, BELGIQUE, (3) Paris)
▫ Impact de l’inflammation sur la perte osseuse chez des patients présentant une lombalgie inflammatoire récente : données à 5 ans de la cohorte DESIR(M. Fechtenbaum(1), A. Molto(1), C. Roux(1), P. Goupille(3), S. Chevret(1), K. Briot(1), (1) Paris, (3) Tours)
▫ Plus de 70 % des patients atteints de spondyloarthrite axiale récente ont présenté au moins un épisode d’enthésitique périphérique au cours de leur maladie : les données de l’étude DESIR.(A.Molto(1), V. Nadon(1), A. Etcheto(1), L. Michou(2), L. Bessette(2), P. Claudepierre(3), D. Wendling(4), P. Haraoui(2), M. Dougados(1), (1) Paris, (2) Québec, CANADA, (3) Créteil, (4) Besançon)
▫ Évaluation de l’adhérence aux recommandations pour l’utilisation des anti-TNFα dans la spondyloarthrite axiale et leur impact après 5 ans de suivi : les données de la cohorte DESIR (C. Lopez-Medina(1), M. Dougados(1), E. Collantes(2), A. Molto(1), (1) Paris, (2) Cordoue, Espagne)
Présentations par posters :
▫ La qualité de vie est légèrement améliorée alors que l’activité de la maladie diminue au cours des 5 premières années dans la spondyloarthrite ankylosante axiale (axSpA) débutante : 646 patients de la cohorte DESIR (D. Puyraimond-Zemmour(1), C. Desthieux(1), B. Granger(1), A. Molto(1), A. Ruyssen-Witrand(2), B. Fautrel(1), L. Gossec(1), (1) Paris, (2) Toulouse )
▫ La discordance patient-médecin dans l’évaluation globale chez 401 patients avec une Spondyloarthrite axiale récente (axSpA) de la cohorte DESIR : quel est l’effet sur l’évolution à 3 ans ? (C. Desthieux(1), A. Molto(1), A. Saraux(2), B. Fautrel(1), L. Gossec(1), (1) Paris, (2) Brest)
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juin 28, 2017 | Posted by admin
Lors du congrès de l’EULAR 2017 qui s’est déroulé à Madrid du 14 au 17 juin 2017, des abstracts ont été acceptés pour une présentation orale ou par poster :
Présentation orale
▫ Incidence of vertebral fractures in early spondyloarthritis : 5-year prospective data of the desir cohort : J. Sahuguet et al.
▫ Evaluation of the changes in structural damage in axial spondyloarthritis on plain pelvic radiographs: the 5 years data of the desir cohort : M. Dougados et al.
▫ Switch from non-radiographic to radiographic axial spondyloarthritis is highly dependent of baseline objective signs of inflammation: 5 year data of the desir cohort : M. Dougados et al.
▫ Evaluation of the predictive validity of the asas axial spondyloarthritis criteria in the desir cohort : B. Meghnath et al.
▫ Erap1 is a susceptibility factor for early axial spondyloarthritis meeting the asas classification criteria: results from the desir and space cohorts: A. De Koning et al.
▫ Health-related quality of life improved only slightly although disease activity decreased over 3 years in early axial spondyloarthritis: 442 patients from the desir cohort : D. Puyraimond-Zemmour
▫ Family matters: value of family history of spondyloarthritis in the diagnostic work-up of patients with chronic back pain: results from the space and desir cohorts: Z. Ez-Zaitouni et al.
Poster tour
▫ Patient-physician discordance in global assessment in 401 early axial spondyloarthritis (axspa) patients from the desir cohort: what is the effect on outcomes at 3 years: C. Desthieux et al.
Présentation par poster
▫ Angles of sacrum inclination effect on radiologic imaging reading in spondyloarthritis (the antelope-desir study) : M. Herbette et al.
▫ Impact of lumbar spine morphology (scoliosis) on early spondyloarthritis pattern (the impala-desir study) : M. Voirin-Hertz et al.
▫ Patient global assessment is more sensitive to change than health-related quality of life instruments in early axial spondyloarthritis over 3 years: data from the desir cohort : D. Puyraimond-Zemmour et al.
Publication
▫ Clinical characteristics of spondylarthritis (spa) with and without peripheral enthesitis – data from the desir cohort : V. Nadon et al.
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juin 19, 2017 | Posted by admin
Bonjour,
Nous mettons en ligne aujourd’hui la nouvelle Newsletter rhumatologues rédigée par le Pr Wendling , rhumatologue au CHU Jean Minjoz à Besançon .
Pour y avoir accès, merci de consulter le lien suivant: cliquer ici.
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juin 13, 2017 | Posted by admin
Un nouvel article scientifique intitulé «Remission is related to CRP and smoking in early axial spondyloarthritis. The DESIR cohort.» a été publié dans le journal Ann Rheum Dis.
Molto A, Tezenas du Montcel S, Wendling D, Dougados M, Vanier A, Gossec L
Ann Rheum Dis. 2016 Nov 25. pii: annrheumdis-2016-209785.
Abstract
BACKGROUND:
Disease activity may change over time in axial spondyloarthritis (axSpA). The objectives were to identify patterns of disease activity evolution in patients with early axSpA.
METHODS:
Patients from the prospective early axSpA cohort (DEvenir des Spondyloarthrites Indifférenciées Récentes (DESIR)) who fulfilled the Assessment in SpondyloArthritis Society (ASAS) criteria for axSpA at baseline and with at least three Ankylosing Spondylitis Disease Activity Score (ASDAS) values available over the 3 years of follow-up were analysed.
STATISTICAL ANALYSES:
trajectories were estimated by group-based trajectory modelling; predisposing baseline factors for such trajectories were identified by univariate and multivariable multinomial (logit) regression; work disability over time was compared between the trajectories by Cox hazard model.
RESULTS:
In all, 370 patients were analysed: mean disease duration was 1.6 (±0.9) years. The five distinct trajectories of disease activity over the 3 years were (t1) ‘persistent moderate disease activity’ (n=134 (36.2%)); (t2) ‘persistent inactive disease’ (n=66 (17.8%); (t3) ‘changing from very high disease activity to inactive disease’ ((n=29 (7.8%)); (t4) ‘persistent high disease activity’ (n=126 (34.1%)) and (t5) ‘persistent very high disease activity’ (n=15 (4.1%)). After adjustment for other characteristics, t2 was associated with a white-collar job (OR=2.6 (95% CI 1.0 to 6.7)) and t3 with male gender (OR=7.1 (1.6 to 32.2)), higher education level (OR=9.4 (1.4 to 63.4)) and peripheral joint involvement (OR=6.2 (1.23 to 31.32)). Patients from (t4) and (t5) were more often declared work disabled over follow-up (HR=5.2 (1.5 to 18.0) and HR=8.0 (1.3 to 47.9), respectively).
CONCLUSIONS:
Trajectory modelling of disease activity was feasible in early axSpA: more than 30% patients (141/370) were in a trajectory with a persistent high disease activity. Persistent high disease activity trajectories were significantly associated with consequences on work.
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mai 19, 2017 | Posted by admin
Un nouvel article scientifique intitulé «Is the current ASAS expert definition of a positive family history useful in identifying axial spondyloarthritis? Results from the SPACE and DESIR cohorts.» a été publié dans le journal Arthritis Res Ther.
Ez-Zaitouni Z, Hilkens A, Gossec L, Berg IJ, Landewé R, Ramonda R, Dougados M, van der Heijde D, van Gaalen F.
Arthritis Res Ther. 2017 May 31;19(1):118. doi: 10.1186/s13075-017-1335-8.
Abstract
BACKGROUND:
The Assessment of SpondyloArthritis international Society (ASAS) definition of a positive family history (PFH) of spondyloarthritis (SpA) includes the following diseases in first- or second-degree relatives: ankylosing spondylitis (AS), acute anterior uveitis (AAU), reactive arthritis (ReA), inflammatory bowel disease (IBD), and psoriasis. However, it is not known if a PFH for each of these diseases contributes to making a diagnosis of axSpA, sacroiliitis on imaging, or fulfilling the ASAS criteria in patients presenting with chronic back pain (CBP). Therefore, the aim of this study was to assess which SpA diseases in family members are associated with human leukocyte antigen B27 (HLA-B27) and axial spondyloarthritis (axSpA) in CBP patients.
METHODS:
CBP patients suspected of axSpA from the SPACE (n = 438) and the DESIR (n = 647) cohort were asked about the presence of SpA diseases in first- or second-degree relatives (AS, AAU, ReA, IBD, and psoriasis). The associations between a PFH and HLA-B27, sacroiliitis on imaging (magnetic resonance imaging (MRI) or radiographs), axSpA diagnosis, and ASAS classification in CBP patients were assessed.
RESULTS:
In the SPACE and the DESIR cohort, a PFH of AS (odds ratio (OR) 5.9 (95% confidence interval (CI) 3.5-9.9), and OR 3.3 (95% CI 2.1-5.2)) and a PFH of AAU (OR 9.8 (95% CI 3.3-28.9) and OR 21.6 (95% CI 2.9-160.1)) were significantly associated with presence of HLA-B27. Furthermore, in both cohorts a PFH of AS and a PFH of AAU were positively associated with fulfilment of the ASAS criteria, but not with sacroiliitis on imaging. In SPACE but not in DESIR a PFH of AAU was positively associated with axSpA diagnosis. In both cohorts a PFH of ReA, IBD, or psoriasis was not positively associated with HLA-B27 positivity, sacroiliitis on imaging, axSpA diagnosis, or meeting the ASAS criteria for axSpA.
CONCLUSIONS:
In our cohorts, a PFH of AS or AAU is useful for case-finding of axSpA as this is correlated with HLA-B27 carriership. However, as a PFH of ReA, IBD, or psoriasis does not contribute to identifying axSpA in CBP patients, these data suggest that the widely used ASAS definition of a PFH of SpA should be updated.
TRIAL REGISTRATION:
Trial registration number, NCT01648907 . Registered on 20 July 2012.
KEYWORDS:
Acute anterior uveitis; Ankylosing spondylitis; Axial spondyloarthritis; Chronic back pain; Diagnostic work-up; Family history; IBD; Psoriasis; Reactive arthritis
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février 17, 2017 | Posted by admin
Un nouvel article scientifique intitulé «Can we use structural lesions seen on MRI of the sacroiliac joints reliably for the classification of patients according to the ASAS axial spondyloarthritis criteria? Data from the DESIR cohort » a été publié dans le journal Ann Rheum Dis.
Bakker PA1, van den Berg R1, Lenczner G2, Thévenin F3, Reijnierse M4, Claudepierre P5, Wendling D6, Dougados M7, van der Heijde D1
Ann Rheum Dis. 2016 Aug 4. doi: 10.1136/annrheumdis-2016-209405
Abstract
OBJECTIVES:
Investigating the utility of adding structural lesions seen on MRI of the sacroiliac joints to the imaging criterion of the Assessment of SpondyloArthritis (ASAS) axial SpondyloArthritis (axSpA) criteria and the utility of replacement of radiographic sacroiliitis by structural lesions on MRI.
METHODS:
Two well-calibrated readers scored MRI STIR (inflammation, MRI-SI), MRI T1-w images (structural lesions, MRI-SI-s) and radiographs of the sacroiliac joints (X-SI) of patients in the DEvenir des Spondyloarthrites Indifférenciées Récentes cohort (inflammatory back pain: ≥3 months, <3 years, age <50). A third reader adjudicated MRI-SI and X-SI discrepancies. Previously proposed cut-offs for a positive MRI-SI-s were used (based on <5% prevalence among no-SpA patients): erosions (E) ≥3, fatty lesions (FL) ≥3, E/FL ≥5. Patients were classified according to the ASAS axSpA criteria using the various definitions of MRI-SI-s.
RESULTS:
Of the 582 patients included in this analysis, 418 fulfilled the ASAS axSpA criteria, of which 127 patients were modified New York (mNY) positive and 134 and 75 were MRI-SI-s positive (E/FL≥5) for readers 1 and 2, respectively. Agreement between mNY and MRI-SI-s (E/FL≥5) was moderate (reader 1: κ: 0.39; reader 2: κ: 0.44). Using the E/FL≥5 cut-off instead of mNY classification did not change in 478 (82.1%) and 469 (80.6%) patients for readers 1 and 2, respectively. Twelve (reader 1) or ten (reader 2) patients would not be classified as axSpA if only MRI-SI-s was performed (in the scenario of replacement of mNY), while three (reader 1) or six (reader 2) patients would be additionally classified as axSpA in both scenarios (replacement of mNY and addition of MRI-SI-s). Similar results were seen for the other cut-offs (E≥3, FL≥3).
CONCLUSIONS:
Structural lesions on MRI can be used reliably either as an addition to or as a substitute for radiographs in the ASAS axSpA classification of patients in our cohort of patients with short symptom duration.
Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/
KEYWORDS:
Ankylosing Spondylitis; Low Back Pain; Magnetic Resonance Imaging; Spondyloarthritis
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janvier 29, 2017 | Posted by admin
Un nouvel article scientifique intitulé «Use of nonsteroidal anti-inflammatory drugs in early axial spondyloarthritis in daily practice: Data from the DESIR cohort» a été publié dans le journal Joint Bone Spine.
Molto A, Granger B, Wendling D, Dougados M, Gossec L.
OBJECTIVES:
Nonsteroidal anti-inflammatory drugs (NSAID) are the cornerstone of treatment in axial spondyloarthritis (axSpA). We aimed to describe the real life NSAID use in early axSpA according to the disease characteristics.
METHODS:
The DESIR cohort is an observational study of patients presenting with inflammatory back pain suggestive of axSpA for less than 3 years. Patients who attended all 6 visits (every 6 months during the first 2 years and yearly at 3 years) were analysed. Data collected at every visit over 3 years was NSAID intake and the ASAS-NSAID score for the 6 months preceding the visit, where 100 reflects the full daily intake of an NSAID.
RESULTS:
In all, 627 patients were assessed: 46.1% males, mean age: 33.7 (standard deviation: 8.7) years, mean symptom duration: 1.5 (0.9) year and mean BASDAI: 44.3 (25.3). Over the 6 months preceding inclusion, 92.8% had received NSAIDs; this proportion significantly decreased over time, to 73% patients after 3 years (P<0.001). This decrease was not different with regard to the fulfillment (or not) of the ASAS criteria at baseline, nor with regard to the « arm » of the ASAS criteria fulfilled (i.e. imaging vs. clinical). The median ASAS-NSAID score was 36 [interquartile range: 13-72] at inclusion, and substantially decreased to reach 7 [0-44] after 3 years (P<0.001), although BASDAI at 3 years was 33.8 (21.7).
CONCLUSION:
NSAID prescription was very frequent in this early axSpA cohort, but the intake was low, and decreased significantly over time, even though symptoms remained present. Early axSpA patients may not be sufficiently treated with NSAIDs.
KEYWORDS:
Nonsteroidal anti-inflammatory drugs; Spondyloarthritis
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