Newsletter Radiologue N°5

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.

Newsletter Patient N°13

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.

Newsletter Patients N°12

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.

Clinical presentation of patients suffering from recent onset chronicinflammatory back pain suggestive of spondyloarthritis: The DESIR cohort

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.

Cardiovascular and selected comorbidities in early arthritis and early spondyloarthritis, a comparative study: results from the ESPOIR and DESIR cohorts

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

Brief Report: Nonsteroidal Antiinflammatory Drug-Sparing Effect of Tumor Necrosis Factor Inhibitors in Early Axial Spondyloarthritis: Results From the DESIR Cohort.

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 AGranger BWendling DBreban MDougados MGossec 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.

Increase in Dickkopf-1 Serum Level in Recent Spondyloarthritis. Data from the DESIR Cohort.

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 SBoudaoud SSeror RGoupille PChanson Pvan der Heijde Dvan Gaalen F, Berenbaum FMariette XBriot KFeydy A,Claudepierre PDieudé PNithitham JTaylor KECriswell LADougados MRoux CMiceli-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.

SFR 2015

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

EULAR 2015

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

ACR 2015

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.