janvier 3, 2017 | Posted by admin Un nouveau bilan du nombre de projets soumis et acceptés par le comité scientifique depuis le début de l’étude est accessible cliquer ici .
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décembre 19, 2016 | Posted by admin Un nouvel article scientifique intitulé Reliability of mSASSS scoring in everyday practice in DESIR-cohort study centres: cross-sectional study of agreement with trained readers..» a été publié dans le journal Ann Rheum Dis.
Claudepierre P, de Hooge M, Feydy A, Reijnierse M, Saraux A, Dougados M, van der Heijde D
Ann Rheum Dis. 2016 Dec;75(12):2213-2214. doi: 10.1136/annrheumdis-2016-209906. Epub 2016 Sep 20.
KEYWORDS:
Ankylosing Spondylitis; Outcomes research; Spondyloarthritis
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novembre 19, 2016 | Posted by admin Un nouvel article scientifique intitulé «What is the reliability of non-trained investigators in recognising structural MRI lesions of sacroiliac joints in patients with recent inflammatory back pain? Results of the DESIR cohort.» a été publié dans le journal RMD Open.
Jacquemin C, Rubio Vargas R, van den Berg R, Thévenin F, Lenczner G, Reijnierse M, Ferkal S, Le Corvoisier P, Rahmouni A, Loeuille D, Feydy A, Dougados M, van der Heijde D, Claudepierre P.
RMD Open. 2016 Nov 11;2(2):e000303. eCollection 2016.
Epidemiology; Magnetic Resonance Imaging; Spondyloarthritis
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septembre 4, 2016 | Posted by admin Un nouvel article scientifique intitulé « Patient-physician discordance in global assessment in early spondyloarthritis and its change over time: the DESIR cohort» a été publié dans le journal Ann Rheum Dis.
Desthieux C, Molto A, Granger B, Saraux A, Fautrel B, Gossec L.
Ann Rheum Dis. 2015 Oct 22. pii: annrheumdis-2015-208251. doi: 10.1136/annrheumdis-2015-208251.
To assess patient-physician discordance in global assessment of disease activity in early axial spondyloarthritis (axSpA) over timeand determinants of discordance.
DESIR (Devenir des Spondyloarthropathies Indifférenciées Récentes) is a French, multicentre, longitudinal cohort of patients with earlyinflammatory back pain suggestive of axSpA. Patient global assessment (PGA) and physician global assessment (PhGA) were rated with a 0-10 numerical rating scale, every 6 months during 2 years then at 3 years. Discordance was defined by the absolute difference |PGA-PhGA|≥3 (range 0-10) and was analysed at each visit. Determinants of (PGA-PhGA) were assessed at the visit level by a generalised linear mixed model.
A total of 702 patients were analysed at baseline (401 with complete data over 3 years): mean age 33.8±8.6 years, 379 (54.0%) female, mean symptom duration 18.1±10.5 months. Mean PGA values were always higher than mean PhGA values with a mean absolute difference of 1.8 points. At baseline, 202 (28.8%) patients had discordance mainly by PGA>PhGA; over 3 years the frequency of discordance was stable (range 25.5-28.8%). Discordance was not stable at the patient level, 118 (29.4%) patients were discordant once and 88 (22.0%) twice, and only 92 (22.9%) more than twice. Determinants of (PGA-PhGA) were spine pain (β=0.24, p<0.001) and fatigue (β=0.13, p<0.001).
Discordance concerned a quarter of patients with early axSpA. Over 3 years of follow-up, discordance did not decrease (no ‘reference shift’). Discordance was not a stable trait, indicating discordance is not a patient characteristic.
Categories: Publication de travaux dans des journaux médicaux | Tags: Carole Desthieux, Coorte desir, DESIR, SPA | No Comments »
août 30, 2016 | Posted by admin Un nouvel article scientifique intitulé « Rate and predisposing factors of sacroiliac radiographic progression after a 2 years follow-up period in recent onset spondyloarthritis.» a été publié dans le journal Arthritis Rheumatol.
Dougados M, Demattei C, van den Berg R, Hoang VV, Thevenin F, Reijnierse M, Loeuille D, Feydy A, Claudepierre P, van der Heijde D.
Arthritis Rheumatol. 2016 Mar 18. doi: 10.1002/art.39666.
Abstract
OBJECTIVES:
to evaluate in radiographic (r) and non-radiographic (nr) axial (ax) spondyloarthritis (SpA) 1) the rate of radiographic sacroiliac joints (SIJ) structural progression 2) to evaluate the predisposing factors of such progression over 2 years.
METHODS:
Patients:Recent onset axial SpA(DESIR cohort).
OUTCOME MEASURES:
Radiographic SIJ score according to the mNew-York criteria (mNY). Potential predisposing factors: Demographics, smoking status, HLAB27 positivity, inflammation at MRI of the SIJ, disease activity and treatment intake .
ANALYSIS:
The main analysis consisted in the evaluation of the switch from nr-to r-axSpA but also other definitions of radiographic progression.
RESULTS:
of the 708 enrolled patients, 449 had baseline and 2-year pelvic radiographs(males: 47%, age: 34±9 years old, B27 positive: 61%, MRI-SIJ positive: 29%) . The % of switch from nr-to-r-axSpA (16/326: 4.9%) and from r-to-nr-axSpA: 7/123 (5.7%) was low. The mean changes in the total SIJ score (o-8) was small 0.1± 0.8 but highly statistically significant (p<0.001). The potential baseline predisposing factors for developing mNY criteria in the multivariate analysis were current smokers, HLAB27 positivity and MRI-SIJ positivity with the following respective odds-ratio: 3.3 [1.0 - 11.5], 12.6 [2.3 - 274] and 498 [9.3 - 904].
CONCLUSION:
Our study suggest that in early SpA: a)The structural progression does exist but is quite small and observed in a small number of patients b) Both environmental (smoking status), genetic (HLAB27 positivity) and inflammatory (MRI-SIJ) markers might be independent predisposing factors of progression. This article is protected by copyright. All rights reserved.
KEYWORDS: Imaging; Spondyloarthritis; X-Rays
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août 12, 2016 | Posted by admin Bonjour,
Nous mettons en ligne aujourd’hui la nouvelle Newsletter patients rédigée par le Pr Saraux, rhumatologue au CHU de Brest.
Pour y avoir accès, merci de cliquer ici.
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juillet 29, 2016 | Posted by admin Un nouvel article scientifique intitulé «Responsiveness of a simple RAPID-3-like index compared to disease-specific BASDAI and ASDAS indices in patients with axial spondyloarthritis» a été publié dans le journal RDM Open.
Castrejón I, Pincus T, Wendling D, Dougados M.
OBJECTIVE:
To evaluate the responsiveness of a simple routine assessment of patient index data (RAPID3)-like index that includes only 3 patient self-report measures (physical function, pain and patient global estimate) compared to that of traditional composite indices to assess change in patients with axial spondyloarthritis (Ax-SpA).
METHODS:
Devenir des Spondylarthropathies Indifférenciées Récentes (DESIR) is a prospective cohort of patients with inflammatory back pain suggestive of Ax-SpA. The study included 461 patients, who met the Assessment of SpondyloArthritis International Society (ASAS) classification criteria for Ax-SpA. A simple RAPID3-like index was compared with the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) and the AS Disease Activity Score (ASDAS) scores for responsiveness over 6 months. Construct validity was also evaluated through Pearson correlations and discrimination of disease activity through standardised mean differences for the 3 indices.
RESULTS:
The RAPID3-like index was correlated significantly with BASDAI (r=0.84, p<0.005) and ASDAS-C-reactive protein (CRP) (r=0.74, p<0.005), similar to correlations of BASDAI with ASDAS-CRP (r=0.76, p<0.005). The percentage of patients with inactive disease ranged from 9% to 25% and with high activity from 10% to 45%, according to various measures. The capacity to discriminate between high and low disease activity was similar for the 3 indices. The strength of agreement of RAPID3 with ASDAS-CRP was moderate (0.44) and lower with BASDAI (0.37). Responsiveness over 6 months was slightly higher for ASDAS-CRP and the RAPID3-like index than that for BASDAI.
CONCLUSIONS:
The RAPID3-like index provides similar information to BASDAI and ASDAS-CRP concerning responsiveness over 6 months. RAPID3 appears feasible to assess patients with Ax-SpA quantitatively over time in busy clinical settings.
KEYWORDS:
Disease Activity; Outcomes research; Patient perspective; Spondyloarthritis
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juillet 7, 2016 | Posted by admin Un nouvel article scientifique intitulé «Two Phenotypes are Identified by Cluster Analysis in Early Inflammatory Back Pain Suggestive of Spondyloarthritis. Results from the Desir Cohort.» a été publié dans le journal Arthritis Rheumatol.
Costantino F, Aegerter P, Dougados M, Breban M, D’Agostino MA
Arthritis Rheumatol. 2016 Feb 11. doi: 10.1002/art.39628.
Abstract
To examine whether in patients with early inflammatory back pain (IBP) suggestive of spondyloarthritis (SpA), disease manifestations at baseline would combine according to distinguishable ordered phenotypes.
Baseline clinical and demographic characteristics, as well as imaging and biological data of patients included in the French multicenter DESIR cohort were analyzed by multiple correspondence analysis and cluster analysis to identify subgroups of patients, based on shared characteristics.
Cluster analysis allowed us to classify the 679 patients of the cohort with no missing data into 2 major groups: one with a predominance of isolated axial manifestations and the other with associated peripheral symptoms. The application of the same analysis to selected subsets of the cohort such as HLA-B27 positive and negative patients, and patients fulfilling the Assessment of SpondyloArthritis international Society classification criteria for axial SpA, resulted again in an optimal division of the samples into 2 recurrent clusters of patients, similar to those observed in the whole cohort.
Cluster analysis of SpA manifestations among patients with early IBP highly suggestive of SpA, allowed us to clearly identify at baseline 2 different clinical phenotypes, one with predominant axial, and the other with predominant peripheral manifestations. Ongoing follow up will allow determining whether these clusters may correspond to different severity patterns. This article is protected by copyright. All rights reserved.
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juillet 4, 2016 | Posted by admin Un nouvel article scientifique intitulé « Fatigue in early axial spondyloarthritis. Results from the French DESIR cohort» a été publié dans le journal Joint Bone Spine.
Gossec L, Dougados M, D’Agostino MA, Fautrel B.
Joint Bone Spine. 2015 Dec 18. pii: S1297-319X(15)00289-4. doi: 10.1016/j.jbspin.2015.07.012
Fatigue is frequent in long-standing axial spondyloarthritis (axSpA); its frequency in early axSpA and its causes are unclear. The objective was to evaluate the magnitude of fatigue in early axSpA and to assess if fatigue appeared more strongly associated with patient- or with disease-related characteristics.
Patients were assessed in DESIR, a national observational cohort of patients with recent (<3 years duration) inflammatory back pain suggestive of axSpA. Magnitude of fatigue was assessed by a numeric rating scale (0-10) over one year. Factors associated with high fatigue(≥5/10) at 12 months were assessed by univariate and multivariate logistic regression, for patients fulfilling the ASAS axSpA criteria.
Of the 708 patients, 486 fulfilled the ASAS criteria for axSpA: mean age 33±9 years; 244 (50%) males. Magnitude of fatigue was high at baseline (mean fatigue: 5.7±2.3) and decreased only slightly over the first year, and was overlapping in patients fulfilling the ASAS criteria or not. High fatigue at 12 months was well explained (variance explained: 0.84) by a higher ASDAS-CRP (odds ratio [OR]: 3.05 [95% confidence interval (CI) 2.27-4.12], P<0.0001), higher Bath Anylosing Spondylitis Patient Global (BAS-G) (OR: 3.51 [95% CI, 2.08-6.02], P<0.0001) and with borderline significance, female gender (OR: 1.65 [95% CI, 1.00-2.71], P=0.049).
Fatigue levels were high in this population, both for patients fulfilling or not, the ASAS criteria for axSpA. High fatigue was closely related to disease-related variables, indicating fatigue may be an integral part of the disease process in axSpA.
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juin 28, 2016 | Posted by admin De nouveaux travaux ont été présentés lors du congrès de la Société Française de Rhumatologie (SFR) qui s’est déroulé du 11 au 13 décembre 2016 au Parc des Expositions à Paris :
▫ Association entre les polymorphismes des gènes ERAP1, IL23R et TRAILR1 et la présence d’une sacroiliite magnétique chez les patients atteints de spondyloarthrite axiale récente : données issues de la cohorte française DESIR. C. Luxembourger
▫ Intérêt de l’échographie des enthèses dans l’évaluation des activités et association avec la sévérité de la spondyloarthrite : donnée de la cohorte française DESIR. A. Ruyssen-Witrand
▫ Validité de la mesure d’utilité SF-SD dans la spondyloarthrite axiale débutante: résultats de la cohorte cohorte DESIR. C. Gaujoux-Viala
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