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 »
novembre 12, 2015 | Posted by admin
Un nouvel article scientifique intitulé « Classification of axial SpA based on positive imaging (radiographs and/or MRI of the sacroiliac joints) by local rheumatologists or radiologists versus central trained readers in the DESIR-cohort» a été publié dans le journal Ann Rheum Dis.
van den Berg R, Lenczner G, Thévenin F, Claudepierre P, Feydy A, Reijnierse M, Saraux A, Rahmouni A, Dougados M, van der Heijde D
Ann Rheum Dis. 2015 Nov;74(11):2016-21. doi: 10.1136/annrheumdis-2014-205432
Abstract
OBJECTIVE:
Investigating changes in patient classification (ASAS (Assessment of SpondyloArthritis international Society) axSpA criteria) based on evaluation of images of the sacro-iliac joints (MRI-SI and X-SI) by local and central readers.
METHODS:
The DESIR cohort included patients with inflammatory back pain (IBP; ≥3 months, but <3 years), suggestive of axSpA. Localradiologists/rheumatologists (local-reading) and two central readers (central-reading) evaluated baseline images. Agreement regarding positive MRI(pos-MRI) between central readers and between local-reading and central-reading was calculated (κs). Number of patients classified differently (ASAS criteria) by using local-reading instead of central-reading was calculated.
RESULTS:
Inter-reader agreement between the two central readers and between local-reading and central-reading was substantial (κ=0.73 and κ=0.70, respectively). In 89/663 MRI-SIs (13.4%) local-reading and central-reading disagreed; 38/223 patients (17.0%) with pos-MRI(local-reading) were negative by central-reading; 51/440 patients (11.6%) with neg-MRI (local-reading) were positive by central-reading.In 163/582 patients eligible for applying ASAS criteria (28.0%), local-reading and central-reading disagreed on positive imaging (MRI-SI and/or X-SI; κ=0.68). In 46/582 patients (7.9%) a different evaluation resulted in a different classification; 18/582 patients (3.1%) classified no-SpA(central-reading) were axSpA by local-reading; 28/582 patients (4.8%) classified axSpA (central-reading) were no-SpA by local-reading. Among axSpA patients (central-reading), 16/419 patients (3.8%) fulfilling imaging-arm by central-reading fulfilled clinical-arm by local-reading; 29/419 patients (6.9%) fulfilling clinical-arm by central-reading fulfilled also imaging-arm by local-reading.
CONCLUSIONS:
In patients with recent onset IBP, trained readers and local rheumatologists/radiologists agree well on recognising a pos-MRI. While disagreeing in 28% of the patients on positive imaging (MRI-SI and/or X-SI), classification of only 7.9% of the patients changed based on a different evaluation of images, showing the ASAS axSpA criteria’s robustness.
Categories: Publication de travaux dans des journaux médicaux | Tags: cohorte DESIR, DESIR, spondyloarthritis | No Comments »
octobre 28, 2015 | Posted by admin
Bonjour,
Nous mettons en ligne aujourd’hui la nouvelle Newsletter patients.
Pour y avoir accès, merci de cliquer ici.
Categories: Newsletter Patients | Tags: | No Comments »
octobre 12, 2015 | Posted by admin
Bonjour,
Nous mettons en ligne aujourd’hui la nouvelle Newsletter patients rédigée par le Pr Alain SARAUX.
Pour y avoir accès, merci de cliquer ici.
Categories: Newsletter Rhumatologues | Tags: cohorte DESIR, Newsletter Rhumatologues, Pr Alain Saraux | No Comments »
octobre 12, 2015 | Posted by admin
Bonjour,
Nous mettons en ligne aujourd’hui la nouvelle Newsletter patients rédigée par le Pr Antoine FEYDY.
Pour y avoir accès, merci de cliquer ici.
Categories: Newsletter Radiologues | Tags: | No Comments »
octobre 12, 2015 | Posted by admin
Bonjour,
Nous mettons en ligne aujourd’hui la nouvelle Newsletter patients rédigée par le Pr Philippe Goupille.
Pour y avoir accès, merci de cliquer ici.
Categories: Newsletter Patients | Tags: cohorte DESIR, Newsletter Patient, Pr Philippe Goupille | No Comments »
octobre 12, 2015 | Posted by admin
Bonjour,
Nous mettons en ligne aujourd’hui la nouvelle Newsletter patients rédigée par le Pr Daniel Wendling.
Pour y avoir accès, merci de cliquer ici.
Categories: Newsletter Patients | Tags: cohorte DESIR, Pr Daniel Wendling | No Comments »
