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 | 
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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
Categories: Publication de travaux dans des journaux médicaux | Tags: | No Comments »
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 »
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 »
