octobre 4, 2015 | Posted by admin
Un nouvel article scientifique intitulé « Clinical presentation of patients suffering from recent onset chronicinflammatory back pain suggestive of spondyloarthritis: The DESIR cohort » a été publié dans le journal Joint Bone Spine.
Dougados M, Etcheto A, Molto A, Alonso S, Bouvet S, Daurès JP, Landais P, d’Agostino MA, Berenbaum F, Breban M, Claudepierre P,Combe B,Fautrel B, Feydy A, Goupille P, Richette P, Pham T, Roux C, Treluyer JM, Saraux A, van der Heijde D, Wendling D;DESIR cohort.
Joint Bone Spine. 2015 Oct;82(5):345-51. doi: 10.1016/j.jbspin.2015.02.006
Pour le consulter, cliquez ici.
Abstract
OBJECTIVES:
DESIR is a prospective longitudinal multicentric French cohort of patients with inflammatory back pain suggestive ofspondyloarthritis, with a 10-year-follow-up. The purpose is to evaluate the performances of the different sets of classification criteria for axialspondyloarthritis, and to describe the frequency and characteristics of the clinical features of axial spondyloarthritis.
METHODS:
Demographic data and items allowing classification and indices calculation were collected, as well as biologic and imaging data. Baseline data are analyzed. The performance of the several classification criteria sets was evaluated (likelihood ratio) with the physician’s diagnosis as external gold standard. For the clinical presentation of axial spondyloarthritis, a descriptive analysis was conducted.
RESULTS:
Seven hundred and eight patients are included. Ninety-two percent of them satisfy at least one set of classification criteria: mNY 26%, Amor 79%, ESSG 78%, ASAS 70%; physician’s confidence level 6.8±2.7. 81 and 83% of patients fulfil modified (including MRI) Amor or ESSG criteria. Axial involvement is present in 100% of the cases. NSAIDs are taken by 90%, with an NSAID sore of 50±46. BASDAI over 40 is noted in 60% and elevated CRP in 30% of the cases. HLA-B27 is present in 58%. According to ASDAS CRP levels, 12.7% are in inactive disease, 63% in high disease activity; mean BASFI was 30. Peripheral involvement is present in 57%, with arthritis in 37% of these. Enthesitis is noted in 49% of thepatients, and first symptom in 22.5%; anterior chest wall involvement is noted in 44.6%, and dactylitis in 13%. For extra articular manifestations, psoriasis is recorded in 16%, uveitis in 8.5% and IBD in 5.1%. Smoking is present in 36.3% and hypertension in 5.1% of the cases.
CONCLUSION:
These data represent the base of evaluation of the follow-up of this cohort, allowing future specific studies.
Categories: Publication de travaux dans des journaux médicaux | 
Tags: DESIR, Maxime Dougados, SPA | 
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septembre 29, 2015 | Posted by admin
Un nouvel article scientifique intitulé «Cardiovascular and selected comorbidities in early arthritis and early spondyloarthritis, a comparative study: results from the ESPOIR and DESIR cohorts» a été publié dans le journal RMD Open.
Gherghe AM, Dougados M, Combe B, Landewé R, Mihai C, Berenbaum F, Mariette X, Wolterbeek R, van der Heijde D.
OBJECTIVES:
To investigate the prevalence of comorbidities in early rheumatoid arthritis (ERA) and early axial spondyloarthritis (ESpA) versus the general population.
METHODS:
Baseline data of 689 patients with ERA from the Etude et Suivi des Polyarthrites Indifférenciées Récentes (ESPOIR) cohort (age 48.2±12.1 years, symptoms duration 14.2±14.5 weeks) and 645 patients with ESpA from Devenir des Spondylarthropathies Indifférenciées Récentes (DESIR; age 32.8±8.4 years, axial symptoms duration 79.0±45.7 weeks) were analysed. Metabolic and cardiovascular diseases (CVD), infections and neoplasia were determined in each cohort. The prevalence (95% CI) of several comorbidities was compared with that in the French general population. For patients without CVD, the 10-year risk of developing CVD was calculated using the Framingham and SCORE equations. The heart age was calculated using the 2008 Framingham points system.
RESULTS:
42% of patients with ERA and 20.3% of patients with ESpA had at least 1 comorbidity; the most common were arterial hypertension (AHT) and dyslipidaemia. AHT prevalence (95% CI) in ERA (18.2% (15.5% to 21.3%)), but not in ESpA (5.08% (3.57% to 7.14%)), was significantly increased (p<0.05) compared with the general population (7.58%). Prevalence of tuberculosis history was higher in ERA (4.7% (3.3% to 6.6%)), and ESpA (0.99% (0.4% to 2.3%)) than in the general population (0.02%; both p<0.05). No differences were observed in malignancies, coronary heart disease or diabetes. In ERA, among patients without a history of CVD, an intermediate to high CVD risk was found. The heart age exceeded the real age by 4.1±9.6 years in ERA and by 2.1±7.0 years in ESpA (p<0.001).
CONCLUSIONS:
We found an increased prevalence of AHT and tuberculosis history in ERA and ESpA, and an increased CVD risk. These results should prompt rheumatologists to check these comorbidities early in the disease.
KEYWORDS:
Cardiovascular Disease; Rheumatoid Factor; Spondyloarthritis; Tuberculosis
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septembre 4, 2015 | Posted by admin
Un nouvel article scientifique intitulé « Brief Report: Nonsteroidal Antiinflammatory Drug-Sparing Effect of Tumor Necrosis Factor Inhibitors in Early Axial Spondyloarthritis: Results From the DESIR Cohort» a été publié dans le journal Arthritis Rheumatology.
Moltó A, Granger B, Wendling D, Breban M, Dougados M, Gossec L.
Arthritis Rheumatol. 2015 Sep;67(9):2363-8. doi: 10.1002/art.39208.
OBJECTIVE:
To evaluate the effect of tumor necrosis factor (TNF) inhibitors on nonsteroidal antiinflammatory drug (NSAID) intake in a cohort of patients with early axial spondyloarthritis (SpA) over the first 2 years of followup.
METHODS:
The Devenir des Spondylarthropathies Indifférenciées Récentes (DESIR) cohort is a prospective, multicenter, observational study cohortof patients with early inflammatory back pain. The management and treatment of these patients were decided by their treating rheumatologists. Data regarding NSAID intake (yes/no) and the Assessment of SpondyloArthritis international Society NSAID score were collected at each visit over 2 years of followup. Patients receiving a TNF inhibitor were matched with those receiving usual care, based on a propensity score. The NSAID-sparingeffect of TNF inhibitors was estimated by comparing the percentage of patients reaching several end points (e.g., a decrease in the NSAID score to <10 over 2 years) and by modeling NSAID intake using mixed models.
RESULTS:
Among the 627 patients who were followed up, 181 (28.9%) received a TNF inhibitor, and these patients were matched to 181 patients who received usual care. The baseline characteristics of the patients in the 2 groups were comparable (∼40% of the patients were male, and the mean age was 34 years). Initially, 90.2% of patients receiving TNF inhibitors and 90.0% of those receiving usual care had been treated with NSAIDs during the previous 6 months. The number of patients who received an NSAID decreased over time in both groups, but the decrease was greater in the group receiving TNF inhibitors (P = 0.04). The decrease in the median NSAID score was significantly greater in the TNF inhibitor group (54.9 versus 41.9), and the percentage of patients in whom the NSAID score decreased by >50% or to <10 or in whom NSAID treatment was discontinued was greater in the TNF inhibitor group (67.6% versus 46.2%).
CONCLUSION:
Treatment with TNF inhibitors was associated with a decrease in the proportion of patients taking NSAIDs and with a rapid and sustained decrease in NSAID intake. This study is the first to confirm the NSAID-sparing effect of TNF inhibitors in patients with early axial SpA in a real-life clinical setting.
Categories: Publication de travaux dans des journaux médicaux | Tags: AINS, Anna Molto, cohorte DESIR, DESIR, non steroidal | No Comments »
août 4, 2015 | Posted by admin
Un nouvel article scientifique intitulé « Increase in Dickkopf-1 Serum Level in Recent Spondyloarthritis. Data from the DESIR Cohort» a été publié dans le journal PLoS One.
Nocturne G, Pavy S, Boudaoud S, Seror R, Goupille P, Chanson P, van der Heijde D, van Gaalen F, Berenbaum F, Mariette X, Briot K, Feydy A,Claudepierre P, Dieudé P, Nithitham J, Taylor KE, Criswell LA, Dougados M, Roux C, Miceli-Richard C.
PLoS One. 2015 Aug 27;10(8):e0134974. doi: 10.1371/journal.pone.0134974. eCollection 2015.
Abstract
OBJECTIVES:
To investigate DKK-1 and SOST serum levels among patients with recent inflammatory back pain (IBP) fulfilling ASAS criteria for SpA and associated factors.
METHODS:
The DESIR cohort is a prospective, multicenter French cohort of 708 patients with early IBP (duration >3 months and <3 years) suggestive of AxSpA. DKK-1 and SOST serum levels were assessed at baseline and were compared between the subgroup of patients fulfilling ASAS criteria for SpA (n = 486; 68.6%) and 80 healthy controls.
RESULTS:
Mean SOST serum levels were lower in ASAS+ patients than healthy controls (49.21 ± 25.9 vs. 87.8 ± 26 pmol/L; p<0.0001). In multivariate analysis, age (p = 5.4 10-9), CRP level (p<0.0001) and serum DKK-1 level (p = 0.001) were associated with SOST level. Mean DKK-1serum levels were higher in axial SpA patients than controls (30.03 ± 15.5 vs. 11.6 ± 4.2 pmol/L; p<0.0001). In multivariate analysis, DKK-1 serumlevels were associated with male gender (p = 0.03), CRP level (p = 0.006), SOST serum level (p = 0.002) and presence of sacroiliitis on radiography (p = 0.05). Genetic association testing of 10 SNPs encompassing the DKK-1 locus failed to demonstrate a significant contribution of genetics to control of DKK-1 serum levels.
CONCLUSIONS:
DKK-1 serum levels were increased and SOST levels were decreased among a large cohort of patients with early axial SpA compared to healthy controls. DKK-1 serum levels were mostly associated with biological inflammation and SOST serum levels.
Categories: Publication de travaux dans des journaux médicaux | Tags: cochorte desir, Dickkopf-1, Nocturne G, Pavy Stephan | No Comments »
juin 28, 2015 | Posted by admin
De nouveaux travaux ont été présentés lors du congrès de la Société Française de Rhumatologie (SFR) qui s’est déroulé du 13 au 15 décembre 2015 à la Porte de Versailles à Paris :
▫ La discordance patient-médecin dans l’évaluation globale des spondyloarthrites axiales récentes et les changements au cours du temps : résultats de la cohorte DESIR. C. Desthieux(1), A. Molto(1), B. Granger(1), A. Saraux(2), B. Fautrel(1), L. Gossec(1), (1) Paris, (2) Brest
▫ Rémission dans la spondyloarthrite axiale récente : données de la cohorte DESIR. D. Wendling(1), X. Guillot(1), L. Gossec(2), C. Prati(1), A. Saraux(3), M. Dougados(2), (1) Besançon, (2) Paris, (3) Brest
▫ Évaluation échographique des enthèses chez des patients présentant une lombalgie inflammatoire récente : résultats de la cohorte DESIR. C. Poulain(1), MA. d’Agostino(2), S. Thibault(3), JP. Daures(3), S. Ferkal(1), P. Le Corvoisier(1), A. Rahmouni(1), D. Loeuille(4), P. Claudepierre(1), (1) Créteil, (2) Boulogne-Billancourt, (3) Montpellier, (4) Vandoeuvre-lès-Nancy
▫ La cohorte DESIR a déjà 5 ans et fournit plein d’informations. A. Molto (Paris)
▫ La cohorte DESIR va dépasser les 10 ans. L. Gossec (Paris)
▫ Fiabilité du modified Stoke Ankylosing Spondylitis Spine Score (mSASSS) dans la pratique quotidienne des centres de la cohorte DESIR : étude transversale de concordance avec une lecture centralisée. L. Stefko-Comte(1), M. De Hooge(2), A. Feydy(3), M. Reijnierse(2), A. Saraux(4), M. Dougados(3), D. Van Der Heijde(2), P. Claudepierre(1), (1) Créteil, (2) Leiden, Pays-Bas, (3) Paris, (4) Brest
▫ Évaluation échographique des enthèses chez des patients présentant une lombalgie inflammatoire récente : résultats de la cohorte DESIR. C. Poulain(1), MA. d’Agostino(2), S. Thibault(3), JP. Daures(3), S. Ferkal(1), P. Le Corvoisier(1), A. Rahmouni(1), D. Loeuille(4), P. Claudepierre(1), (1) Créteil, (2) Boulogne-Billancourt, (3) Montpellier, (4) Vandoeuvre-lès-Nancy
▫ Augmentation du taux sérique d’IL31 dans les spondyloarthrites récentes : données de la cohorte DESIR. N. Rosine(1), A. Etcheto(1), A. Molto(1), Y. Taoufik(2), H. Hendel-Chavez(2), F. Berenbaum(1), C. Roux(1), K. Briot(1), M. Dougados(1), C. Miceli-Richard(1), (1) Paris, (2) Le Kremlin-Bicêtre
▫ Association entre le polymorphisme 158 V/F du FCGR3A et la réponse aux anti-TNFα dans les spondyloarthrites axiales récentes : données issues de la cohorte DESIR. C. Luxembourger(1), A. Molto(2), A. Cantagrel(1), D. Nigon(1), P. Claudepierre(3), M. Dougados(2), C. Simon(2), A. Constantin(1), A. Ruyssen-Witrand(1), (1) Toulouse, (2) Paris, (3) Créteil
▫ Quelle est la fiabilité de lecteurs non entraînés à reconnaître des lésions structurales sur l’IRM des sacro-iliaques chez des patients ayant des rachialgies inflammatoires récentes ? Résultats de la cohorte DESIR. C. Jacquemin(1), R. Rubio Vargas(2), R. Van Den Berg(2), F. Thévenin(3), G. Lenczner(4), M. Reijnierse(2), S. Ferkal(1), P. Le Corvoisier(1), A. Rahmouni(1), D. Loeuille(5), A. Feydy(3), M. Dougados(3), D. Van Der Heijde(2), P. Claudepierre(1), (1) Créteil, (2) Leiden, Pays-Bas, (3) Paris, (4) Neuilly-sur-Seine, (5) Vandoeuvre-lès-Nancy
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juin 28, 2015 | Posted by admin
Lors du congrès de l’EULAR 2015 qui s’est déroulé à Rome (Italy) du 10 au 13 juin 2015, un abstract a été accepté pour une présentation :
▫ SACROILIAC INFLAMMATION ON MRI IS RELATED TO DISEASE ACTIVITY ONLY IN MALE PATIENTS WITH AXIAL SPONDYLOARTHRITIS: A LONGITUDINAL ANALYSIS IN THE DESIR COHORT : Navarro-Compán Victoria
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juin 28, 2015 | Posted by admin
Des nouveaux travaux ont été présentés lors du congrès du collège américain (ACR) de rhumatologie qui s’est déroulé du 6 au 11 novembre 2015 à San Francisco :
▫ Increase in IL-31 Serum Level in Recent Onset Spondyloarthritis – Data from the DESIR Cohort : Nicolas Rosine Jr. and al.
▫ Inflammation on MRI in Sacroiliac-Joints and Spine Is Longitudinally Related to Disease Activity in Male but Not in Female Patients with Axial Spondyloarthritis: 2-Year Data from the DESIR Cohort : Victoria Navarro-Compán and al.
▫ Spinal Radiographic Progression in Early Axial Spondyloarthritis: Data from the DESIR Cohort : Sofia Ramiro and al.
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avril 14, 2015 | Posted by admin
Un nouvel article scientifique intitulé « Evaluation of the validity of the different arms of the ASAS set of criteria for axial spondyloarthritis and description of the different imaging abnormalities suggestive of spondyloarthritis: data from the DESIR cohort» a été publié dans le journal Annals of the Rheumatic Diseases en janvier 2014.
Moltó A, Paternotte S, van der Heijde D, Claudepierre P, Rudwaleit M, Dougados M.
Ann Rheum Dis. 2015 Apr;74(4):746-51. doi: 10.1136/annrheumdis-2013-204262. Epub 2014 Jan 3.
Abstract
BACKGROUND:
The Assessment of Spondyloarthritis International Society (ASAS) criteria for axial spondyloarthritis (SpA) allows classification of patients with (’imaging‘ arm) and without (’clinical’ arm) imaging abnormalities of the sacroiliac joints.
OBJECTIVE:
To compare the phenotype of early axial SpA with regard to the two arms of the ASAS axial SpA criteria.
METHODS:
Demographics, clinical and biological features of SpA, disease activity, severity parameters, and imaging abnormalities at the sacroiliac and spine levels were compared, in the two arms of the ASAS axial SpA criteria, in the patients of the French cohort of early SpA.
RESULTS:
Of the 615 patients analysed, 435 (70.7%) met the ASAS criteria (262 (60.2%) and 173 (39.8%) in the imaging and clinical arms, respectively). There were no major differences in the characteristics of the two groups except that those in the imaging arm were more likely to be younger, male and have higher concentrations of C-reactive protein. Imaging abnormalities other than those meeting the ASAS criteria for theimaging arm (ie, x-ray-determined structural damage or MRI-revealed inflammatory changes in the sacroiliac joint (SIJ)) were observed (MRI-SIJ structural damage (55.0% vs 3.5%), MRI-spine inflammatory changes (35.1% vs 12.9%), MRI-spine structural damage (10.3% vs 5.3%) and x-ray-syndesmophytes (11.8% vs 5.3%)) in the imaging versus clinical arm, respectively.
CONCLUSIONS:
Our study confirms the external validity of the clinical arm of the ASAS criteria. It is notable that many patients in the clinical arm showed other imaging changes in SIJs and spine.
Categories: Publication de travaux dans des journaux médicaux | Tags: Anna Molto, annal of rheumatic diseases, ASAS criteria, axial spondyloarthritis, cohorte, DESIR, Maxime Dougados | No Comments »
février 12, 2015 | Posted by admin
Un nouvel article scientifique intitulé « Calculating the ankylosing spondylitis disease activity score if the conventional c-reactive protein level is below the limit of detection or if high-sensitivity c-reactive protein is used: an analysis in the DESIR cohort » a été publié dans le journal Arthritis Rhheumatology
Machado P, Navarro-Compán V, Landewé R, van Gaalen FA, Roux C, van der Heijde D.
Arthritis Rheumatol. 2015 Feb;67(2):408-13.
Abstract
OBJECTIVE:
The Ankylosing Spondylitis Disease Activity Score (ASDAS) is a composite measure of disease activity in axial spondyloarthritis. The aims of this study were to determine the most appropriate method for calculating the ASDAS using the C-reactive protein (CRP) level when theconventional CRP level was below the limit of detection, to determine how low CRP values obtained by high-sensitivity CRP (hsCRP) measurement influence ASDAS-CRP results, and to test agreement between different ASDAS formulae.
METHODS:
Patients with axial spondyloarthritis who had a conventional CRP level below the limit of detection (5 mg/liter) were selected (n = 257). The ASDAS–conventional CRP with 11 different imputations for the conventional CRP value (range 0–5 mg/liter, at 0.5-mg/liter intervals) was calculated. The ASDAS-hsCRP and ASDAS using the erythrocyte sedimentation rate (ESR) were also calculated. Agreement between the ASDAS formulae was tested.
RESULTS:
The ASDAS-hsCRP showed better agreement with the ASDAS-CRP calculated using the conventional CRP imputation values of 1.5 and 2.0 mg/liter and with the ASDAS-ESR than with other imputed formulae. Disagreement occurred mainly in lower disease activitystates (inactive/moderate disease activity). When the CRP value was <2 mg/liter, the resulting ASDAS-CRP scores may have been inappropriately low.
CONCLUSION:
When the conventional CRP level is below the limit of detection or when the hsCRP level is <2 mg/liter, the constant value of 2 mg/liter should be used to calculate the ASDAS-CRP score. There is good agreement between the ASDAS-hsCRP and ASDAS-ESR; however, formulae are not interchangeable.
Categories: Publication de travaux dans des journaux médicaux | Tags: cohorte DESIR, DESIR, Maxime Dougados, spondyloarthrites, spondyloarthritis | No Comments »
novembre 27, 2014 | Posted by admin
De nouveaux travaux ont été présentés lors du congrès du collège américain (ACR) de rhumatologie qui s’est déroulé du 14 au 19 novembre 2014 à Boston :
▫ Two Years Sacroiliac Radiographic Progression Rate and Influence of Baseline Markers of Inflammation in Recent Onset Spondyloarthritis.
▫ Factors Associated with a Poor Functional Prognosis in Early Inflammatory Back Pain: Results from the DESIR Cohort.
▫ Prevalence of MRI Spinal Lesions Typical for Axial Spondyloarthritis in Patients with Inflammatory Back Pain.
▫ Scoring of Spinal Lesions Compatible with Axial Spondyloarthritis on MRI in Clinical Practice By Local Radiologist or Rheumatologist in Desir; Comparison with Central Reading.
▫ Is It Worth to Include MRI of the Spine in the ASAS Classification Criteria for Axial Spondyloarthritis?
▫ Do TNF Alpha Inhibitors Have an NSAID Sparing Effect in Real Life in Early Axial Spa? Results from the DESIR Cohort.
▫ Is the Degree of NSAID Treatment in Early Axial Spondyloarthritis a Reflection of the physician’s Diagnosic Confidence? Results from the DESIR Cohort.
▫ Are We over-Treating with Nsaids Our Early Axial Spa Patients? Results from the DESIR Cohort.
▫ Routine Assessment of Patient Index Data (RAPID3) Provides Similar Information Compared to Ankylosing Spondylitis Specific Indices: Analyses of the DESIR French Cohort.
▫ How Should We Calculate the ASDAS If the Conventional C-Reactive Protein Is below the Limit of Detection? – an Analysis in the DESIR Cohort.
▫ How to Classify Spondyloarthritis after a Two Year Follow up? Results from the French Recent onset spondyloarthritis Cohort.
▫ Degenerative Changes of the Spine on MRI in Patients with Inflammatory Back Pain from the DESIR Cohort.
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