septembre 24, 2013 | Posted by admin
Un nouvel article scientifique intitulé « Factors associated with radiographic lesions in early axial spondyloarthritis. Results from the DESIR cohort » vient d’être publié dans le journal Oxford University Press.
Blachier M, Canouï-Poitrine F, Dougados M, Lethuaut A, Fautrel B, Ferkal S, Le Corvoisier P, Farrenq V, Poulain C, Ghaleh B, Bastuji-Garin S,Claudepierre P.
Rheumatology (Oxford). 2013 Sep;52(9):1686-93. doi: 10.1093/rheumatology/ket207.
Pour le consulter, merci de cliquer ici.
Abstract
OBJECTIVE:
To assess whether factors such as inflammation by laboratory tests and MRI differ between early axial SpA with and withoutradiographic lesions.
METHODS:
Cross-sectional analysis of baseline data from Devenir des Spondylarthropathies Indifferenciées Récentes (DESIR) cohort patients having recent-onset inflammatory back pain and meeting Assessment of SpondyloArthritis international Society criteria. The baseline evaluation included radiographs and MRI of the SI joints (SIJs) and spine. Patients were classified as having radiographic lesions if they had at least one obvious sacroiliitis, grade 2 for at least one vertebral corner or grade 1 for at least two vertebral corners (at the cervical or lumbar level, according to the modified Stoke Ankylosing Spondylitis Spine Score). Associations between baseline characteristics and the presence of radiographic lesionswere evaluated by estimating multi-adjusted odd ratios (aORs) and their 95% CIs using a logistic regression model.
RESULTS:
Of 475 patients, 180 (37.9%) had radiographic lesions. Factors positively associated with radiographic lesions were alcohol use (aOR 2.42; 95% CI 1.31, 4.44; P = 0.005), CRP level (aOR 1.44; 95% CI 1.13, 1.84; P = 0.003) and SIJ inflammation by MRI (aOR 2.25; 95% CI 1.40, 3.60; P = 0.001); negative associations occurred with good NSAID responsiveness (aOR 0.44; 95% CI 0.24, 0.81; P = 0.008); spinal MRI inflammation was associated with radiographic lesions only in smokers (aOR 1.99; 95% CI 1.01, 3.92; P = 0.048).
CONCLUSION:
Alcohol use, poor responsiveness to NSAIDs, CRP elevation, SIJ MRI inflammation and spinal MRI inflammation in smokers were independently associated with radiographic lesions in early axial SpA.
KEYWORDS: MRI; axial spondylorarthritis; epidemiology; inflammation; radiographic lesions; spondyloarthritis
Categories: Publication de travaux dans des journaux médicaux | 
Tags: axial spondyloarthritis, cohorte DESIR, Pascal Claudepierre | 
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septembre 9, 2013 | Posted by admin
Un nouvel article scientifique intitulé « Differences between women and men with recent-onset axial spondyloarthritis: results from a prospective multicenter French cohort» a été publié dans le journal Arthritis Care and Research en Mars 2013.
Tournadre A, Pereira B, Lhoste A, Dubost JJ, Ristori JM, Claudepierre P, Dougados M, Soubrier M.
Arthritis Care Res (Hoboken). 2013 Sep;65(9):1482-9. doi: 10.1002/acr.22001.
Abstract
OBJECTIVE:
To clarify sex differences in early axial spondyloarthritis (SpA).
METHODS:
In total, 475 patients included in the Devenir des Spondylarthropathies Indifférenciées Récentes (Outcome of Recent Undifferentiated Spondylarthropathies) cohort, a prospective multicenter French cohort of patients with early inflammatory back pain suggestive of SpA, and fulfilling the Assessment of SpondyloArthritis international Society (ASAS) classification criteria for axial SpA were studied. The clinical and imaging features were compared between sexes and according to the clinical or imaging arm of the ASAS criteria using univariate and multivariate analysis.
RESULTS:
Comparisons between the 239 men and 236 women showed that women had higher disease activity when measured by the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) and Bath Ankylosing Spondylitis Patient Global Score and higher fatigue and functional scores despite having less radiographic sacroiliitis and magnetic resonance imaging (MRI) inflammation of sacroiliac joints and the spine than men. Disease activity measured by the C-reactive protein (CRP)-based Ankylosing Spondylitis Disease Activity Score was not different between men and women. In contrast to patients classified with the clinical arm, disease activity and functional scores did not differ between women and men with sacroiliitis on imaging scans, except for fatigue and the Ankylosing Spondylitis Quality of Life questionnaire. Women with sacroiliitis had more peripheral involvement and more family history, whereas HLA-B27 positivity, elevated CRP, and MRI inflammation of the spine were associated with male sex.
CONCLUSION:
Women with early axial SpA according to the ASAS criteria had greater disease activity when measured by the BASDAI and worse functioning despite fewer radiologic abnormalities than men. The differences in disease expression may be confounding factors to establish the diagnosis of SpA and to assess disease activity in women, suggesting that the imaging arm is a pivotal measure in the ASAS criteria.
Categories: Publication de travaux dans des journaux médicaux | Tags: Anne Tournadre, axial spondyloarthritis, DESIR, Travaux scientifiques | No Comments »
juillet 19, 2013 | Posted by admin
La newsletter N° 4 rédigée par le Pr Antoine Feydy et le Dr jean-Baptiste Pialat en juillet 2013 est maintenant disponible sur notre blog en cliquant ici.
Bonne lecture!
Categories: Newsletter Radiologues | Tags: Dr Jean-Baptiste Pialat, Newsletter, Newsletter Radiologues, Pr Antoine Feydy | No Comments »
juillet 19, 2013 | Posted by admin
Une nouvelle newsletter a été rédigée par le Pr Francis Berenbaum à l’attention de tous les rhumatologues impliqués et portant un intérêt à la cohorte DESIR.
Vous pouvez la consulter en cliquant ici.
Bonne lecture!
Categories: Newsletter Rhumatologues | Tags: Newsletter, Newsletter Rhumatologues, Pr Fancis Berenbaum | No Comments »
juillet 12, 2013 | Posted by admin
Un nouvel article scientifique intitulé « Anterior chest wall pain in recent inflammatory back pain suggestive of spondyloarthritis. data from the DESIR cohort. » a été publié dans le journal J. Rheumatol.
Wendling D, Prati C, Demattei C, Loeuille D, Richette P, Dougados M.
J Rheumatol. 2013 Jul;40(7):1148-52. doi: 10.3899/jrheum.121460.
Abstract
OBJECTIVE:
To determine the prevalence of anterior chest wall (ACW) pain in patients with recent inflammatory back pain (IBP) suggestiveofspondyloarthritis (SpA), and to investigate the influence of ACW pain on the overall features of these patients.
METHODS:
The DESIR cohort is a prospective, multicenter French cohort of patients with early IBP suggestive of SpA, including 708 patients (mean age 33.8 yrs, 53.8% females, 57.3% HLA-B27-positive). ACW pain was defined by at least 1 episode of chest wall painattributed to SpA by the rheumatologist, after ruling out other causes of chest pain. Data on the baseline demographic characteristics, functional status and quality of life, imaging features, bone mineral density, and blood tests were compared in patients with and those without ACW pain. Factors associated with ACWpain were identified by univariate and multivariate analysis (logistic regression).
RESULTS:
The prevalence of ACW pain in the DESIR cohort (n = 316/708 patients) was 44.6% (95% CI 40.9-48.3). ACW pain occurred after the first symptoms of IBP in 62%. Localization was diffuse in 41% of the positive cases. A stepwise multivariate analysis found an association between ACW pain and the enthesitis score, involvement of thoracic spine, diagnosis of ankylosing spondylitis (AS), and radiographic abnormalities of sacroiliac joints.
CONCLUSION:
In recent IBP suggestive of SpA, presence of ACW pain is associated with enthesitis, thoracic spine involvement, radiographic sacroiliitis, diagnosis of AS, and with a more severe disease. ACW pain could be interpreted as a diagnostic feature for AS.
KEYWORDS:
ANTERIOR CHEST WALL; INFLAMMATORY BACK PAIN; MANUBRIOSTERNAL; SPONDYLOARTHRITIS; STERNOCLAVICULAR JOINT; STERNOCOSTAL JOINT
Categories: Publication de travaux dans des journaux médicaux | Tags: cohorte DESIR, DESIR, spondyloarthritis | No Comments »
juin 27, 2013 | Posted by admin
Un nouvel article scientifique intitulé « Does the site of magnetic resonance imaging abnormalities match the site of recent-onset inflammatory back pain? The DESIR cohort« vient d’être publié dans le journal Annals of the Rheumatic Diseases.
Blachier M, Coutanceau B, Dougados M, Saraux A, Bastuji-Garin S, Ferkal S, Le Corvoisier P, Farrenq V, Poulain C, Ghaleh B, Canouï-Poitrine F,Claudepierre P.
Ann Rheum Dis. 2013 Jun;72(6):979-85. doi: 10.1136/annrheumdis-2012-201427.
Pour le consulter, merci de cliquer ici.
Abstract
OBJECTIVES:
To assess whether the site of axial pain (thoracic spine, lumbar spine or buttock(s)) was associated with the site of MRI lesions in patients with recent inflammatory back pain (IBP) suggesting spondyloarthritis.
METHODS:
We conducted a cross-sectional study of baseline data in 708 patients with recent IBP from the DESIR cohort. Radiographs of the sacroiliac joints (SIJs) and MRI scans of the SIJs and thoracic and lumbar spine were obtained routinely. Associations between painsites and sites of inflammatory and structural MRI changes were evaluated using separate multivariate logistic regressions.
RESULTS:
Of the 648 patients with complete data, 61% had thoracic pain, 91.6% lumbar pain and 79.2% buttock pain. MRI inflammation was seen in 19%, 21% and 46% of patients at the thoracic, lumbar and SIJ sites, respectively. By multivariate analysis, pain was significantly associated with MRI inflammation only at the same site (adjusted OR (aOR)thoracic pain 1.71; 95% CI 1.09 to 2.67; p=0.02; aORlumbar pain 2.53; 95% CI 1.03 to 6.20; p=0.04; aORbuttock pain 2.86; 95% CI 1.84 to 4.46; p<0.0001). Pain site was not significantly associated with the site of structural MRI changes, except for buttock pain and SIJ structural MRI changes (aORbuttock pain 1.89; 95% CI 1.22 to 2.90; p=0.004). The association betweenpain site and site of MRI inflammation persisted in the subgroups with normal or doubtful SIJ radiographs or with Assessment of SpondyloArthritis international Society criteria for axial spondyloarthritis.
CONCLUSIONS:
The site of pain (thoracic spine, lumbar spine or buttock(s)) is associated with MRI inflammation at the same site in patients with recent IBP.
KEYWORDS: Ankylosing Spondylitis; Low Back Pain; Magnetic Resonance Imaging; Spondyloarthritis
Categories: Publication de travaux dans des journaux médicaux | Tags: annal of rheumatic diseases, DESIR, Inflammatory back pain, MRI, Pascal Claudepierre, Travaux scientifiques | No Comments »
mai 31, 2013 | Posted by admin
Un nouvel article scientifique intitulé « Value of high-sensitivity C-reactive protein for classification of early axial spondyloarthritis : results from the DESIR cohort» a été publié dans le journal Annals of the Rheumatic Diseases en janvier 2013.
Navarro-Compán V, van der Heijde D, Combe B, Cosson C, van Gaalen FA.
Ann Rheum Dis. 2013 May;72(5):785-6. doi: 10.1136/annrheumdis-2012-202504.
ABSTRACT
The average delay in axial spondyloarthritis (axSpA) diagnosis after symptom onset is one of the longest among inflammatory rheumatic diseases.1 New tools, such as magnetic resonance imaging,2 have been developed to reduce this delay. Elevated C-reactive protein (CRP) has been incorporated as one of the features for Assessment of SpondyloArthritis international Society (ASAS) SpA criteria,3 and in the Berlin diagnostic algorithm.4 However, CRP levels are elevated in only a minority of early SpA patients.5 More sensitive tests, so-called high-sensitivity CRP (hsCRP), have been developed and can detect lower concentrations of CRP compared with traditional methods.6 HsCRP levels are increased in other rheumatic chronic inflammatory diseases,7 and show a better correlation with disease activity parameters compared with routine CRP in patients with axSpA.8 Therefore, hsCRP could be more sensitive than traditional CRP in diagnosing axial SpA. The aim of this study was to assess the contribution of hsCRP versus CRP to classification of early axSpA using the ASAS criteria.
Categories: Publication de travaux dans des journaux médicaux | Tags: annal of rheumatic diseases, DESIR, Dr Navarro-Compan, spondyloarthritis | No Comments »
avril 14, 2013 | Posted by admin
Un nouvel article intitulé «Psoriasis and phenotype of patients with early inflammatory back pain» – P. Richette, et al. a été publié dans le journal Annals of Rheumatic Diseases en juin 2012.
Pour le consulter, merci de cliquer ici.
Psoriasis and phenotype of patients with early inflammatory back pain.
Richette P, Tubach F, Breban M, Viguier M, Bachelez H, Bardin T, Dougados M.
Ann Rheum Dis. 2013 Apr;72(4):566-71. doi: 10.1136/annrheumdis-2012-201610. Epub 2012 Jun 7.
Abstract
BACKGROUND:
Psoriasis is an important clinical feature in spondyloarthritis. However, the influence of psoriasis on the clinical, functional and imaging features of patients with inflammatory back pain (IBP) related to spondyloarthritis is not known.
OBJECTIVES:
To determine the prevalence of psoriasis and its impact in patients with recent IBP suggestive of spondyloarthritis.
METHODS:
The prevalence of psoriasis was determined in 692 patients (mean age 33.3±8.5 years, 53.8% female, 58.3% human leucocyte antigen B27 positive) included in the DESIR cohort. Demographic characteristics, imaging features and blood tests of patients with and without psoriasiswere compared.
RESULTS:
The prevalence of psoriasis was 16.6%. Patients with rather than without psoriasis more often presented with enthesitis (59.1% vs 47.5%; p=0.02) and had more active disease (BASDAI 4.8±1.8 vs 4.4±2.0; p=0.05) and poorer functional status (BASFI 3.6±2.2 vs 3.0±2.3; p=0.006; SF-36 (physical function) 61.9±24.4 vs 66.9±24.9; p=0.04). Patients with psoriasis showed higher levels of C-reactive protein (p=0.02), total cholesterol (p=0.01) and triglycerides (p=0.02). The two groups did not differ in structural changes as assessed by standard x-rays or MRI at the spinal and sacroiliac levels. However, ultrasonography of the Achilles tendon revealed psoriasis associated with bone erosions (p=0.0003) and abnormal vascularisation (p=0.04). Multivariate regression analysis revealed BASFI score (p=0.03), cholesterol level (p=0.02), dactylitis (p=0.0006) and family history of psoriasis (p<0.0001) as independent predictors of psoriasis.
CONCLUSIONS:
In patients with recent IBP suggestive of spondyloarthritis, psoriasis is associated with active axial disease and frequent concomitant enthesopathy and dactylitis.
Categories: Publication de travaux dans des journaux médicaux | Tags: annal of rheumatic diseases, axial spondylarthritis, DESIR, Florence Tubach, Maxime Breban, Maxime Dougados, Pascal Richette, présentation de travaux, psoriasis, Travaux scientifiques | No Comments »
mars 13, 2013 | Posted by admin
La newsletter N° 18 rédigée par le Professeur Alain Saraux le 26 Février 2013 est maintenant disponible sur notre blog en cliquant ici.
Bonne lecture!
Categories: Newsletter Rhumatologues | Tags: DESIR, Newsletter Rhumatologues, Pr Alain Saraux | No Comments »
mars 11, 2013 | Posted by admin
La newsletter N°17 rédigée par le Professeur Daniel Wendling le 30 novembre 2012 est maintenant disponible sur notre blog en cliquant ici.
Bonne lecture!
Categories: Newsletter Rhumatologues | Tags: Daniel Wendling, DESIR, Newsletter, rhumatologue | No Comments »
