septembre 12, 2014 | Posted by admin
Un nouvel article scientifique intitulé « Agreement between clinical practice and trained central reading in reading of sacroiliac joints on plain pelvic radiographs. Results from the DESIR cohort » a été publié dans le journal Arthritis Rhheumatology
van den Berg R, Lenczner G, Feydy A, van der Heijde D, Reijnierse M, Saraux A, Rahmouni A, Dougados M, Claudepierre P
Arthritis Rheumatol. 2014 Sep;66(9):2403-11. doi: 10.1002/art.38738.
Abstract
OBJECTIVE:
To investigate the degree of agreement between local rheumatologists/radiologists and central trained readers (external standard) on the presence/absence of sacroiliitis on radiographs of the sacroiliac (SI) joints.
METHODS:
Patients with inflammatory back pain (duration ≥3 months but <3 years) suggestive of axial spondyloarthritis (SpA) were included in the Devenir des Spondylarthropathies Indifferérenciées Récentes (DESIR) cohort. Baseline radiographs of the SI joints were interpreted by 2 centralreaders (modified New York criteria); cases of disagreement were adjudicated by a third reader, yielding a positive or a negative result (centralreading). The same radiographs were also interpreted by local radiologists/rheumatologists and were rated as « normal, » « doubtful sacroiliitis, » « obvious sacroiliitis, » or « SI joint fusion » (local reading); positive findings were defined as « at least unilateral obvious sacroiliitis, » « bilateral obvious sacroiliitis, » or « at least unilateral fusion. » Agreement and misclassifications between central readers and between central reading versus localreading were calculated (kappa values).
RESULTS:
Interreader agreement between the central readers was moderate (κ = 0.54); 108 of 688 radiographs (15.7%) were adjudicated. According to local reading ( »at least unilateral obvious sacroiliitis »), 183 of the 688 patients (26.6%) had sacroiliitis, whereas according to central reading, 145 of 688 patients (21.1%) had sacroiliitis. Agreement between local reading and central reading was also moderate (κ = 0.55); 76 of 183 patients (41.5%) with « at least unilateral obvious sacroiliitis » (positive by local reading) and 32 of 109 patients (29.4%) with « bilateral obvious sacroiliitis » or « at least unilateral fusion » (positive by local reading) were rated as « negative » by central reading, and 38 of 505 patients (7.5%) and 68 of 579 patients (11.7%), respectively, without sacroiliitis (negative by local reading) were interpreted as « positive » by central reading.
CONCLUSION:
In patients with recent-onset inflammatory back pain, both trained readers and local rheumatologists/radiologists agreed only moderately on the recognition of radiographic sacroiliitis. A significant proportion of locally recognized ankylosing spondylitis (AS) patients were not confirmed as having AS by central reading (false positive), while a small minority of patients were false negative, indicating the necessity of reevaluating the role of radiographic sacroiliitis as diagnostic criterion for axial SpA.
Categories: Publication de travaux dans des journaux médicaux | 
Tags: cohorte DESIR, DESIR, spondyloarthritis | 
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septembre 12, 2014 | Posted by admin
Un nouvel article scientifique intitulé «Early tumor necrosis factor α antagonist therapy in everyday practice for inflammatory back pain suggesting axial spondyloarthritis: results from a prospective multicenter french cohort.» a été publié dans le journal Arthritis Care Research
Canouï-Poitrine F1, Poulain C, Molto A, Le Thuaut A, Lafon C, Farrenq V, Ferkal S, Le Corvoisier P, Ghaleh B, Bastuji-Garin S, Fautrel B, Dougados M,Claudepierre P.
Arthritis Care Res (Hoboken). 2014 Sep;66(9):1395-402. doi: 10.1002/acr.22330
Abstract
OBJECTIVE:
To determine the frequency of and factors associated with early tumor necrosis factor α (TNFα) antagonist therapy in everyday clinical practice in patients with suspected axial spondyloarthropathy (SpA).
METHODS:
We used data from the prospective observational study in the French Devenir des Spondylarthropathies Indifférenciées Récentes (DESIR; Outcome of Recent Undifferentiated Spondylarthropathies) cohort of 708 patients with recent-onset (<3 years) inflammatory back pain (IBP) suggesting axial SpA. TNFα antagonist use was recorded at months 6 and 12 and factors independently associated with TNFα antagonist therapy were identified by multivariate logistic regression.
RESULTS:
Among the 708 patients (mean age 33.8 years, 46.2% men), 166 (23.4%) patients received TNFα antagonist therapy by month 12, including 120 (73.6%) patients who fulfilled Assessment of SpondyloArthritis international Society (ASAS) axial criteria and 157 (94.6%) who fulfilled at least 1 SpA criteria set; 109 (65.6%) had no sacroiliitis. Factors independently associated with early TNFα antagonist therapy were high Ankylosing Spondylitis Disease Activity Score using the C-reactive protein level (odds ratio [OR]1-point increase 1.60, 95% confidence interval [95% CI] 1.25-2.03, P < 0.001), high physician’s global disease activity score (OR 1.37, 95% CI 1.21-1.54, P < 0.001), ASAS nonsteroidal antiinflammatory drug score >50 (OR 1.88, 95% CI 1.24-2.87, P = 0.003), current or past disease-modifying antirheumatic drug use (OR 2.09, 95% CI 1.22-3.59, P = 0.008), systemic corticosteroid use (OR 2.48, 95% CI 1.43-4.34, P = 0.002), and mild to severe radiographic hip abnormalities (OR 9.43, 95% CI 2.11-42.09, P = 0.003). After adjustment on these factors, Achilles enthesis hypervascularization by power Doppler and number of work days missed were associated with TNFα antagonist therapy.
CONCLUSION:
In the DESIR cohort, approximately one-fourth of patients with recent IBP suggestive of axial SpA were under anti-TNFα therapy after 1 year of followup. All factors associated with this early initiation reflected higher disease activity, refractoriness, or severity, which suggests compliance of French rheumatologists with current treatment guidelines.
Categories: Publication de travaux dans des journaux médicaux | Tags: cohorte DESIR, DESIR, spondyloarthristis | No Comments »
juillet 12, 2014 | Posted by admin
Un nouvel article scientifique intitulé « Effectiveness of TNF-alpha blockers in early axial spondyloarthritis. Data from the desir cohort» a été publié dans le journal Arthritis Rhheumatology
Moltó A, Paternotte S, Claudepierre P, Breban M, Dougados M.
Arthritis Rheumatol. 2014 Jul;66(7):1734-44. doi: 10.1002/art.38613.
Abstract
OBJECTIVE:
To estimate the frequency of use and effectiveness in daily practice of tumor necrosis factor α (TNFα) blockers in a population with inflammatory back pain suggestive of early axial spondyloarthritis (SpA).
METHODS:
The Devenir des Spondylarthropathies Indifférenciées Récentes (DESIR) cohort is a prospective, multicenter, observational cohort of 708 patients with early (<3 years’ duration) inflammatory back pain suggestive of axial SpA. The percentage of patients receiving TNFα blockersover the first 2 years of followup was estimated by survival analysis. To evaluate effectiveness, the primary outcome (40% improvement in disease activity according to the Assessment of SpondyloArthritis international Society criteria [ASAS40]) was compared in patients who received TNFαblockers versus control patients who received any other treatment (usual care). Controls were matched to the patients based on a propensity score method.
RESULTS:
A total of 30.2% (95% confidence interval [95% CI] 26.7-33.7) patients received at least 1 TNFα blocker during the 24 months of followup. The percentage of ASAS40 responders was 31.5% (62 of 197 patients) in the group receiving TNFα blockers versus 13.2% (26 of 197) in the control group (OR 2.99 [95% CI 1.80-4.99], P = 0.0002). This effectiveness was more pronounced in the subgroup of patients with sacroiliitis identified on magnetic resonance imaging, with 46% of ASAS40 responders receiving TNFα blockers versus 15% of ASAS40 responders receiving usual care (OR 4.99 [95% CI 2.17-11.51]).
CONCLUSION:
Our study shows that TNFα blockers are frequently used in daily practice to treat patients with early axial SpA. Our findings confirm the effectiveness of TNFα blockers as compared to any other treatment, especially in the subgroup of patients with sacroiliitis on MRI.
Categories: Publication de travaux dans des journaux médicaux | Tags: cohorte DESIR, DESIR, spondyloarthritis | No Comments »
mai 14, 2014 | Posted by admin
Bonjour,
Une nouvelle newsletter rhumatologues est maintenant disponible. Elle a été rédigée par le Pr Bernard Combe.
Vous pouvez la consulter en cliquant ici.
Bonne lecture
Categories: Newsletter Rhumatologues | Tags: cohorte, DESIR, Newsletter, Rhumatologues, spondylarthropathie, spondyloarthrite | No Comments »
mai 14, 2014 | Posted by admin
Bonjour,
La newsletter rhumatologues N°21 rédigée par le Pr Philippe Goupille est maintenant disponible.
Vous pouvez la consulter en cliquant ici.
Bonne lecture
Categories: Newsletter Rhumatologues | Tags: cohorte, DESIR, Newsletter, Pr Philippe Goupille, rhumatologue, spondyloarthrites | No Comments »
décembre 4, 2013 | Posted by admin
Un nouvel article scientifique intitulé « Bone Oedema on MRI is highly associated with low bone mineral density in patients with early inflammatory back pain : results from the DESIR cohort» a été publié dans le journal Annals of the Rheumatic Deseases.
Briot K, Durnez A, Paternotte S, Miceli-Richard C, Dougados M, Roux C.
Ann Rheum Dis. 2013 Dec;72(12):1914-9. doi: 10.1136/annrheumdis-2012-201845.
Abstract
OBJECTIVES:
To assess bone mineral density (BMD) at lumbar spine and hip in a large cohort of patients with early inflammatory back pain(IBP) suggestive of axial spondyloarthritis (SpA), and to assess systemic and bone inflammation (according to MRI) as risk factors of lowBMD.
PATIENTS AND METHODS:
332 (52.4% male) patients with IBP suggestive of axial SpA defined by Calin or Berlin criteria were recruited; they had lumbar spine and hip BMD and body composition measurements. Low BMD was defined by Z≤-2 (at least one site). Clinical, biological (erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP)) and imaging (x-rays, spine and sacroiliac joint MRI) parameters were compared in patientswith and without low BMD (Z≤-2). Significant parameters in univariate analysis were tested in multivariate models.
RESULTS:
Patients (mean age 33.8 years) had a short duration of axial symptoms (mean 1.6 years); 71.4% fulfilled the Assessment of Spondyloarthritis International Society criteria for axial SpA and HLA-B27 was present in 62.1%. 43 (13.0%) had low BMD (88% male). Multivariate logistic regression showed that parameters significantly associated with low BMD (any site) were the presence of bonemarrow oedema(inflammatory lesions) on MRI (OR 4.63, p=0.001), either ESR or CRP (OR 2.60, p=0.037) and male gender (OR 9.60, p=0.0004).
CONCLUSIONS:
This study conducted in a large cohort of young adults with early IBP suggestive of SpA shows that 13.0% of patients have a lowBMD and that the main risk factor associated with low BMD was inflammation on MRI.
KEYWORDS: Bone Mineral Density; Osteoporosis; Spondyloarthritis
Categories: Publication de travaux dans des journaux médicaux | Tags: DESIR, Dr Karine Briot, Travaux scientifiques | No Comments »
octobre 14, 2013 | 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: cohorte DESIR, projet scientifique, Travaux scientifiques | No Comments »
octobre 14, 2013 | Posted by admin
« Madame, Monsieur,
Vous avez accepté de participer à la cohorte nationale DESIR il y a environ 5 ans. Vous êtes toujours suivi(e) régulièrement dans cette cohorte de patients atteints de lombalgies inflammatoires et nous vous en remercions très sincèrement.
Les patients, qui comme vous font partie de cette grande cohorte multicentrique nationale, permettent de constituer une source d’informations, que l’on appelle base de données. Cette base de données, extrêmement précieuse, concerne la démographie, les aspects cliniques et thérapeutiques, la biologie, la radiographie, l’IRM, l’échographie d’un groupe de rhumatismes inflammatoires chroniques désigné sous le terme de » spondyloarthrites ».
Ceci a permis de développer de nombreux projets scientifiques (près d’une cinquantaine actuellement) permettant d’améliorer les connaissances sur ces maladies et la prise en charge des patients qui en souffrent.
Il est prévu de vous suivre ainsi que les autres patients de cette cohorte sur une durée d’environ 10 ans et nous vous remercions, même si vous allez bien, de bien vouloir revenir régulièrement en consultation, voir les médecins et infirmières qui vous ont suivi depuis le début dans votre centre hospitalier régional. Si vous manquez un rendez-vous, ce n’est pas grave mais revenez dès que possible et veuillez répondre positivement aux contacts téléphoniques que ne manquera pas de vous adresser votre centre régional.
Vous pouvez avoir des informations sur la Cohorte DESIR sur le site : www.lacohortedesir.fr
Nous vous remercions très vivement pour votre participation et votre suivi.
Professeur Bernard Combe
Au nom du comité de coordination de la Cohorte DESIR «
Pour télécharger le pdf de cette newsletter, merci de cliquer ici.
Categories: Newsletter Patients | Tags: cohorte DESIR, DESIR, lombalgies inflammatoires, Newsletter, Newsletter Patient, Pr Bernar Combes, spondyloarthrites | No Comments »
septembre 27, 2013 | 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 ici.
Bonne lecture
Categories: Newsletter Rhumatologues | Tags: cohorte DESIR, DESIR, Newsletter, Newsletter Rhumatologues, Pascal Claudepierre, spondylarthropathie | No Comments »
septembre 27, 2013 | Posted by admin
Bonjour,
Nous mettons en ligne aujourd’hui la nouvelle Newsletter du Pr Pascal Claudepierre.
Pour y avoir accès, merci de cliquer ici.
Bonne lecture!
Categories: Newsletter Patients | Tags: axial spondyloarthritis, cohorte DESIR, DESIR, Newsletter, Pascal Claudepierre, spondyloarthropathies | No Comments »
