juin 28, 2016 | Posted by admin
Des nouveaux travaux ont été présentés lors du congrès du collège américain (ACR) de rhumatologie qui s’est déroulé du 11 au 16 novembre 2016 à Washington :
▫ Polymorphisms of ERAP1, IL23R and TRAILR1 Are Associated with MRI-Sacroiliitis in Early Axial Spondyloarthritis: Data from the French DESIR Cohort : Cécile Luxembourger
▫ 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 27, 2016 | Posted by admin
Lors du congrès de l’EULAR 2016 qui s’est déroulé à Londres du 8 au 11 juin 2016, 6 abstracts ont été acceptés pour une présentation orale ou par poster :
▫ Inflammation On Mri Of The Spine Is Longitudinally Related To Disease Activity In Smokers But Not In Non-smokers In Axial Spondyloarthritis: 2-year Data From The Desir Cohort : V. Navarro-Compán et al.
▫ Asdas-based Remission Was Less Frequent Than Basdai-based Remission, And Both Were Related To Crp And Smoking In Early Axial Spondyloarthritis. The Desir Cohort : D. Wendling et al.
▫ Visceral Adipose Tissue And Cardiovascular Risk In Spondyloarthritis: Results From The Desir And Comospa Cohorts : H. Che et al.
▫ Increase In Il-31 Serum Level In Recent Spondyloarthritis: Data From The Desir Cohort : N. Rosine et al.
▫ Factors Associated With Elevated Acute Phase Reactants In Patients With Recent Inflammatory Back Pain: Impact Of C Reactive Protein On The Phenotype Of Patients. Data From The Prospective Multicenter French Cohort Desir : P. Manicki et al.
▫ Validity Of The Short Form 6d Utility Measure In Early Axial Spondyloarthritis: Results From The Desir Cohort : C. Gaujoux-Viala et al.
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mai 29, 2016 | Posted by admin
Un nouvel article scientifique intitulé «Vitamin D, disease activity and comorbidities in early spondyloarthritis» a été publié dans le journal Clin Exp Rheumatol.
Hmamouchi I, Paternotte S, Molto A, Etcheto A, Borderie D, Combe B, Dougados M.
OBJECTIVES:
To assess the vitamin D status in patients presenting inflammatory back pain suggestive of axial spondyloarthritis and to assess the relationship between vitamin D status and disease activity/severity; comorbidities at baseline and during the first two years of follow-up.
METHODS:
DESIR is a prospective, multicentre, observational study. Vitamin D deficiency was defined as <50 nmol/L and severe deficiency less than 25 nmol/L. Clinical variables were collected at each six month interval visits during the two-year follow-up.
RESULTS:
A total of 700 patients were analysed. The mean vitamin D was 54.2±28.7 nmol/L. Severe deficiency were observed in 11.7% versus 5% in the DESIR cohort versus the French population respectively. In the DESIR cohort, after adjusting for season and ethnicity, vitamin D deficiency remained significantly associated with presence of radiological sacroiliitis, higher ASDAS score and elevated BASDAI. Such association was also found between vitamin D deficiency and the mean value of disease activity/severity parameters during the two-year follow-up. Otherwise, vitamin D deficiency was significantly associated with the presence of baseline abdominal obesity (OR=1.65 [1.05-2.61], p=0.03), low HDL (OR=1.71 [1.14-2.55], p=0.01) and presence of metabolic syndrome (OR=2.20 [1.04-4.64], p=0.03) at baseline.
CONCLUSIONS:
We found a higher percentage of patients with severe vitamin D deficiency in early axial spondyloarthritis. Vitamin D deficiency was associated with higher disease activity and severity and presence of metabolic syndrome. Further longitudinal studies are required to evaluate the interest of vitamin D supplementation on the long-term outcome of the disease.
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mai 4, 2016 | Posted by admin
Un nouvel article scientifique intitulé « Disease Activity is Longitudinally Related to Sacroiliac Inflammation on MRI in Male Patients with Axial Spondyloarthritis: 2-year of the DESIR cohort» a été publié dans le journal Ann Rheum Dis.
Navarro-Compán V, Ramiro S, Landewé R, Dougados M, Miceli-Richard C, Richette P, van der Heijde D.
Ann Rheum Dis. 2015 Sep 24. pii: annrheumdis-2015-207786. doi: 10.1136/annrheumdis-2015-207786
ABSRACT
Objectives
To investigate the longitudinal relationship between inflammatory lesions in sacroiliac joints on MRI (MRI-SI) and clinical disease activity measures (DA) in patients with axial spondyloarthritis (axSpA).
Methods
Two-year follow-up data from 167 patients (50% males, mean (SD) age 33 (9) years) fulfilling the Assessment of SpondyloArthritis international Society axSpA criteria in the DEvenir des Spondylarthopathies Indifférenciées Récentes cohort with MRI-SI at baseline, 1 year and 2 years were analysed. The relationship between MRI-SI (as dependent variable) and DA (Ankylosing Spondylitis Disease Activity Score (ASDAS), Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), patient’s global DA, night pain, C reactive protein and erythrocyte sedimentation rate, as independent variables) was investigated using two types of generalised estimating equations (GEE) models: model of absolute scores and model of change scores.
Results
In the model of absolute scores, the relationship between DA and MRI-SI was different for males and females: in males, but not in females, a statistically significant relationship with MRI-SI was found for all DA except BASDAI. In the model of changes, only ASDAS (beta (95% CI): 2.79 (0.85 to 4.73) and pain at night (0.97 (0.04 to 1.90)) were significantly associated in males while again in females no significant relationship was found. ASDAS fitted the data best.
Conclusions
In male patients, but not in female patients, with axSpA, clinical DA, especially if measured by ASDAS, is longitudinally associated with MRI-SI inflammatory lesions.
Categories: Publication de travaux dans des journaux médicaux | Tags: axial SPA, cohorte DESIR, Victoria Navarro-Compan | No Comments »
avril 29, 2016 | Posted by admin
Un nouvel article scientifique intitulé «Costs of early spondyloarthritis: estimates from the first 3 years of the DESIR cohort» a été publié dans le journal RMD Open.
Harvard S, Guh D, Bansback N, Richette P, Dougados M, Anis A, Fautrel B.
OBJECTIVES:
To value health resource utilisation and productivity losses in DESIR, a longitudinal French cohort of 708 patients with early spondyloarthritis (SpA) enrolled between 2007 and 2010, and identify factors associated with costs in the first 3 years of follow-up.
METHODS:
Self-reported clinical data from DESIR and French public data were used to value health resource utilisation and productivity losses in 2013 Euros. Factors associated with costs, including and excluding biological drugs, were identified in generalised linear models using the generalised estimating equations algorithm to account for repeated observations over participants.
RESULTS:
The mean (±SD) annual cost per patient was €5004±6870 in year 1, decreasing to €4961±7457 in year 3. Patients who never received a biologic had mean 3-year total costs of €4789±6022 compared to €38 206±19 829 among those who received a biologic. Factors associated with increased total costs were peripheral arthritis (rate ratio (RR) 1.19; 95% CI 1.04 to 1.37; p<0.0001), time on biologics (RR 1.23 per month; 1.21, 1.24; p<0.0001), and average BASFI score (RR 1.18/10 point increase; 1.15, 1.25; p<0.0001). Factors associated with increased costs excluding biologics were baseline age (RR 1.10 per 5 year increase; 1.05, 1.16; p<0.0001), peripheral arthritis (RR 1.20; 1.02, 1.40; p<0.0133), time on biologics (RR 1.04 per month; 1.02, 1.05; p<0.0001), and average BASDAI score (RR 1.21 per 10 point increase; 1.16, 1.25; p<0.0001).
CONCLUSIONS:
In addition to biologics, factors like age, peripheral arthritis and disease activity independently increase SpA-related costs. This study may serve as a benchmark for cost of illness among patients with early SpA in the biologic era.
KEYWORDS:
Ankylosing Spondylitis; Anti-TNF; Spondyloarthritis
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mars 6, 2016 | Posted by admin
Un nouvel article scientifique intitulé « Evaluation of physiotherapy in a prospective cohort of early axial spondyloarthritis. Data from the DESIR cohort» a été publié dans le journal Joint Bone Spine.
Escalas C, Dalichampt M, Dougados M, Poiraudeau S.
Joint Bone Spine. 2015 Dec 8. pii: S1297-319X(15)00244-4. doi: 10.1016/j.jbspin.2015.05.008.
Abstract
OBJECTIVE:
To evaluate the effect of physiotherapy on functional limitation in an observational cohort of early axial spondyloarthritis.
METHODS:
Design: prospective population-based cohort study.
PATIENTS:
708 patients with early axial spondyloarthritis between 2007 and 2010 naive of TNF blockers.
INTERVENTION:
early physiotherapy defined by at least eight supervised sessions of physical therapy during the first six months.
MEASUREMENTS:
the primary outcome was functional improvement defined by a relative improvement of at least 20% in BASFI at six months. Secondary outcomes were improvement in BASFI at one and two years and ASAS20 response criteria at six months.
STATISTICAL ANALYSIS:
a propensity score of having physiotherapy was developed and multivariate analysis using propensity score weighting were used to assess the effect of physiotherapy on outcome.
RESULTS:
Overall, 166 (24%) patients had physiotherapy during the first six months. After using propensity score weighting, there was no functional improvement on the primary outcome in patients treated with early physical therapy (relative risk [IC95%]: 1.15 [0.91-1.45]). No differences were observed on secondary outcomes (relative risk [IC95%]: 0.94 [0.80-1.11]).
CONCLUSIONS:
It seems there is no functional benefit for patients with early spondyloarthritis to be treated early by physiotherapy in daily practice, even though the efficacy of physiotherapy has been shown in several randomized controlled studies.
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février 7, 2016 | Posted by admin
Un nouvel article scientifique intitulé «Factors associated with a bad functional prognosis in early inflammatory back pain: results from the DESIR cohort.» a été publié dans le journal RMD Open.
Lukas C, Dougados M, Combe B.
RMD Open. 2016 Feb 8;2(1):e000204. doi: 10.1136/rmdopen-2015-000204. eCollection 2016.
Abstract
BACKGROUND:
Spondyloarthritis (SpA) is a heterogeneous disease with hardly predictable potential courses. We aimed at determining prognostic factors of bad functional outcome at 2 years in patients with early inflammatory back pain (IBP).
METHODS:
Data from patients included in the French multicentre devenir des spondylarthropathies indifférenciées récentes (DESIR) cohort, that is, suffering from IBP starting before 50 years of age and lasting for 3-36 months, were used. A bad functional outcome at 24 months was defined as an increase in bath ankylosing spondylitis functional index (BASFI), or BASFI at 2 years higher than the 75th centile in the cohort. Demographic, clinical, biological and radiological data collected at inclusion were compared in patients with bad functional outcome versus others, by χ(2) test, then by a multivariate logistic regression model with stepwise selection of relevant factors.
RESULTS:
513 patients (54.4% females, 72.2% fulfilling ASAS criteria) were assessed. Of those, 130 (25.3%) fulfilled the aforementioned criteria of a bad functional outcome (BASFI increase ≥4 units or ≥36 at 2 years). Multivariate analysis revealed that not fulfilling ASAS criteria, female sex, age >33 years, lower educational level, active smoking status and high disease activity according to bath ankylosing spondylitis disease activity index (BASDAI) at baseline were independently associated with a bad functional outcome at 24 months. Sensitivity analyses restricted to patients fulfilling ASAS criteria for SpA resulted in similar results.
CONCLUSION:
We observed, in a large prospective cohort of patients with early IBP, formerly described bad prognostic factors, especially a low educational level, an older age and a high disease activity at onset, and revealed that active smoking status and female sex were also independently associated with a poor outcome. Fulfilment of ASAS criteria, on the other hand, was predictive of a better outcome, most likely due to the more consensual management of a defined disease.
KEYWORDS:
Epidemiology; Patient perspective; Spondyloarthritis
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février 4, 2016 | Posted by admin
Un nouvel article scientifique intitulé « Bone loss in patients with early inflammatory back pain suggestive of spondyloarthritis: results from the prospective DESIR cohort » a été publié dans le journal Rheumatology (Oxford)
Briot K, Etcheto A, Miceli-Richard C, Dougados M, Roux C.
Rheumatology (Oxford). 2016 Feb;55(2):335-42. doi: 10.1093/rheumatology/kev332.
Abstract
OBJECTIVES:
The objectives of the study were to assess the 2 year BMD changes and their determinants in patients with earlyinflammatory back pain suggestive of axial spondyloarthritis (SpA) (DESIR cohort).
METHODS:
A total of 265 patients (54% male, mean age 34.4 years) had BMD measurements at baseline and at 2 years. Low BMD was defined as a Z score ≤-2 (at at least one site) and significant bone loss was defined by a decrease in BMD ≥0.03 g/cm(2). Clinical, biological and imaging parameters were assessed over 2 years.
RESULTS:
Thirty-nine patients (14.7%) had low BMD at baseline; 112 patients (42.3%) had a 2 year significant bone loss. One hundred and eighty-seven (70.6%) used NSAIDs at baseline and 89 (33.6%) received anti-TNF therapy over 2 years. In anti-TNF users, BMD significantly increased at the lumbar spine and did not change at the hip site from baseline. In multivariate analysis, baseline use of NSAIDs [odds ratio (OR) 0.38, P = 0.006] had a protective effect on hip bone loss. In patients without anti-TNF treatments, baseline use of NSAIDs (OR 0.09, P = 0.006) and a 2 year increase in BMI (OR 0.55, P = 0.003) had protective effects on hip bone loss, whereas a 2 year increase in fat mass was associated with hip boneloss (OR 1.18, P = 0.046).
CONCLUSION:
Among patients with symptoms suggestive of early axial SpA, 42.3% of patients have significant bone loss over 2 years. Anti-TNF therapy is protective against bone loss and baseline use of NSAIDs has a protective effect on hip bone loss.
Categories: Publication de travaux dans des journaux médicaux | Tags: bone loss, briot, cohorte, DESIR, karine briot | No Comments »
janvier 4, 2016 | 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 ici
Categories: Nombre de projets scientifiques acceptés | Tags: bilan, projets scientifiques | No Comments »
janvier 4, 2016 | Posted by admin
Bonjour,
Une nouvelle newsletter rhumatologues est maintenant disponible. Elle a été rédigée par le Pr Pascal CLaudepierre.
Vous pouvez la consulter en cliquant sur ici .
Bonne lecture !
Categories: Newsletter Rhumatologues | Tags: DESIR, Newsletter Rhumatologues | No Comments »
