septembre 16, 2020 | Posted by admin
Un nouvel article scientifique intitulé «Inflammation of the sacroiliac joints and spine on MRI predicts structural changes on MRI in axial spondyloarthritis: 5-year data from DESIR » a été publié dans le journal Arthritis Care Res (Hoboken).
Alexandre Sepriano, Sofia Ramiro, Robert Landewé, Anna Moltó, Pascal Claudepierre, Daniel Wendling, Maxime Dougados, Désirée van der Heijde.
Objective:
To test the impact of inflammation on MRI-structural changes occurring in the sacroiliac joints (SIJ) and the spine.
Methods:
Patients with early axSpA from the DESIR cohort were included. MRIs of the SIJ (MRI-SIJ) and spine (MRI-spine), obtained at baseline, 2 and 5 years, were scored by 3 central readers. Inflammation and structural damage on MRI-SIJ/MRI-spine were defined by the agreement of ≥2 of 3 readers (binary outcomes), and by the average of 3 readers (continuous outcomes). The effect of inflammation (MRI-SIJ/MRI-spine) on damage (MRI-SIJ/MRI-spine, respectively) was evaluated in two models: i. Baseline prediction model: effect of baseline inflammation on damage assessed at 5-year; and ii. Longitudinal model: effect of inflammation on structural damage assessed during 5 years.
Results:
202 patients were included. Both the presence of bone marrow edema (BME) on MRI-SIJ and on MRI-spine at baseline were predictive of 5-year damage (≥3 fatty lesions) on MRI-SIJ [OR=4.2 (95% CI: 2.4; 7.3)] and MRI-spine [OR=10.7 (95% CI: 2.4; 49.0)], respectively, when adjusted for CRP. The association was also confirmed in longitudinal models (when adjusted for ASDAS) both in the SIJ [OR=5.1 (95% CI: 2.7; 9.6)] and spine [OR=15.6 (95% CI: 4.8; 50.3)]. Analysis of other structural outcomes (i.e. erosions) on MRI-SIJ yielded similar results. In the spine, a significant association was found for fatty lesions but not for erosions and bone spurs, which occurred infrequently over time.
Conclusion:
We found a predictive and longitudinal association between MRI-inflammation and several types of MRI-structural damage in patients with early axSpA which adds to the proof for a causal relationship.
Keywords:
Axial spondyloarthritis; Inflammation; magnetic resonance imaging; structural damage.
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septembre 15, 2020 | Posted by admin
Un nouvel article scientifique intitulé «Pregnancy rates and outcomes in early axial spondyloarthritis: an analysis of the DESIR cohort» a été publié dans le journal Joint Bone Spine.
Marion Pons, Maxime Dougados, Nathalie Costedoat-Chalumeau, Karine Briot, Philippe Goupille, Christian Roux, Anna Molto.
Objectives:
Only scarce data is available regarding pregnancy outcomes in early axSpA, particularly little is known about the impact of disease activity. The objective is to identify a) the factors associated with the occurrence of a clinical pregnancy during follow-up and b) the risk factors for an unfavorable pregnancy outcome (e.g. miscarriage, medical termination or pre-term delivery) in an early axSpA population.
Methods:
Observational prospective French cohort (DESIR) with 6 years of follow-up including 381 TNFi-naïve women with early axSpA. Factors associated with a clinical pregnancy occurring over follow-up and risk factors for an unfavorable pregnancy outcome were estimated by multivariable multilevel models (i.e. Frailty Shared Models and Mixed Models).
Results:
During follow-up, 124 pregnancies occurred. Patients who got pregnant during follow-up were more likely to have discontinued their TNFi treatment in the 6 months preceding the pregnancy (HR=2.0 [95%IC 1.1-3.3], p=0.01) and to have an increased CRP at the previous visit (HR=1.7 [95%IC 1.2-2.5], p= 0.01). Full-term delivery was by far the most frequent pregnancy outcome (75% of all pregnancies), and only NSAID use in the 6 months prior to the outcome was associated with an unfavorable outcome (OR=2.5 [95%IC 1.1-5.0], p=0.02). No association was found between TNFi use and an unfavorable pregnancy outcome.
Conclusion:
Full-term delivery was the most frequent pregnancy outcome. NSAID use within 6 months of outcome, but not TNFi use, was associated with an unfavorable pregnancy outcome in this early axSpA cohort.
Keywords: Epidemiology; Pregnancy; Spondyloarthritis.
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septembre 4, 2020 | Posted by admin
Un nouvel article scientifique intitulé «Serum calprotectin is increased in early axial spondyloarthritis with sacroiliitis and objective signs of inflammation: results from the DESIR cohort » a été publié dans le journal Joint Bone Spine
Xavier Romand, Marie-Hélène Paclet, Anaïs Courtier, Minh Vu Chuong Nguyen, Daniel Wendling , Francis Berenbaum, Philippe Gaudin, Athan Baillet.
Abstract disponible uniquement sur Joint Bone Spine journal.
lien : https://www.sciencedirect.com/science/article/pii/S1297319X20301536?via%3Dihub
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août 7, 2020 | Posted by admin
Un nouvel article scientifique intitulé «Determinants of the patient global assessment of well-being in early axial spondyloarthritis: 5-year longitudinal data from the DESIR cohort » a été publié dans le journal Rheumatology (Oxford).
Fumio Hirano, Désirée van der Heijde, Floris A van Gaalen, Robert B M Landewé, Cécile Gaujoux-Viala , Sofia Ramiro.
Abstract
Objectives :
To investigate the determinants of patient well-being over time, and the influence of age, gender and education in patients with early axial spondyloarthritis (axSpA).
Methods :
Five-year data from DESIR, a cohort of early axSpA, were analysed. The outcome was the BAS-G over 5 years. Generalized estimating equations (GEE) were used to test the relationship between potential explanatory variables from five outcome domains (disease activity, physical function, spinal mobility, structural damage and axial inflammation) and BAS-G over time. Longitudinal relationships were analysed using an autoregressive GEE model. Age, gender and educational level were tested as effect modifiers or confounders.
Results :
A total of 708 patients were included. Higher BASDAI questions on fatigue [β (95% CI): 0.17 (0.13, 0.22)], back pain [0.51 (0.46, 0.56)], peripheral joint pain [0.08 (0.04, 0.12)] and severity of morning stiffness [0.08 (0.03-0.13)], and higher BASFI [0.14 (0.08, 0.19)] were associated with a higher BAS-G. In the autoregressive model, the same variables except for morning stiffness were associated with a worsening in BAS-G. Age, gender and educational level were neither effect modifiers nor confounders.
Conclusion :
A higher level of back pain is associated with a worsening of patient well-being, as are, though to a lesser extent, higher levels of fatigue, peripheral joint pain and physical disability. Age, gender and educational level do not have an impact on these relationships.
Keywords :
disability evaluation; outcome measures; patient attitude to health; quality of life; spondyloarthritis.
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juin 30, 2020 | 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 cliquer ici .
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juin 20, 2020 | Posted by admin
Un nouvel article scientifique intitulé «Do Smoking and Socioeconomic Factors Influence Imaging Outcomes in Axial Spondyloarthritis? Five-year Data From the DESIR Cohort » a été publié dans le journal Arthritis Rheumatol.
Elena Nikiphorou, Sofia Ramiro, Alexandre Sepriano, Adeline Ruyssen Witrand, Robert B M Landewé, Désirée van der Heijde.
Abstract
Objectives: To investigate the relationship between smoking and imaging outcomes over 5 years in axSpA and assess if socioeconomic (SE) factors influence these relationships.
Methods: Patients with axSpA from the DESIR cohort were included. Four imaging outcomes (spine radiographs [modified Stoke Ankylosing Spondylitis Spine Score, mSASSS]; SIJ radiographs [modified New York grading, mNY]); MRI-Spine [Spondyloarthritis Research Consortium of Canada scoring, SPARCC] and MRI-SIJ [SPARCC]) were assessed by three central readers at baseline, 2 and 5-years. Explanatory variable of interest was smoking status at baseline. Interactions between smoking and SE factors (job type [blue- vs white-collar] and education [low vs high]) were first tested and if significant, analyses were run in separate strata. Generalized estimating equations models were used, adjusted for confounders.
Results: In total, 406 axSpA patients were included: 52% male, 40% smokers and 18% blue-collar. Smoking was independently associated with more MRI-SIJ inflammation at each visit over the 5-years, an effect that was seen only in blue-collar patients (β[95% CI]:5.41 [1.35,9.48]) and in patients with low education (β[95% CI]:2.65 [0.42, 4.88] (separate model). Smoking was also significantly associated with spinal inflammation (β[95% CI]:1.69 [0.45, 2.93] and SIJ damage (β[95% CI]:0.57 [0.18, 0.96] across all patients, irrespective of SE factors and other potential confounders.
Conclusion: Strong associations were found in particular between smoking at baseline and MRI-SIJ inflammation at each visit over 5-years in axSpA patients with blue-collar job or low education. These findings suggest a possible role for mechanical stress amplifying the effect of smoking on axial inflammation in axSpA.
Keywords: axial spondyloarthritis; imaging; inflammation; smoking; socioeconomic.
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juin 3, 2020 | Posted by admin
Lors du congrès de l’EULAR 2020 qui s’est déroulé du 3 au 6 juin 2020 à Francfort, 6 abstracts ont été acceptés pour une présentation orale ou par poster :
Présentation orale
▫ CLINICAL DISEASE ACTIVITY, MRI SPINAL INFLAMMATION AND ENTHESITIS ARE KEY DETERMINANTS OF IMPAIRMENT OF SPINAL MOBILITY IN EARLY AXIAL SPONDYLOARTHRITIS – DATA FROM THE DESIR COHORT, P. Carvalho, A. Marreiros, J. E. Fonseca, A. Ruyssen-Witrand, P. M. Machado
▫ DETERMINANTS OF THE PHYSICIAN’S GLOBAL ASSESSMENT AND INFLUENCE OF CONTEXTUAL FACTORS IN EARLY AXIAL SPONDYLOARTHRITIS. F. Hirano, R. B. M. Landewé, F. A. Van Gaalen, D. Van der Heijde, C. Gaujoux-Viala, S. Ramiro
▫ FACTORS ASSOCIATED WITH 5-YEAR DRUG-FREE REMISSION IN EARLY ONSET AXIAL SPONDYLOARTHRITIS PATIENTS: DATA FROM DESIR COHORT, A. Ruyssen-Witrand, V. Rousseau, A. Sommet, P. Goupille, Y. Degboe, A. Constantin
Présentations par affiches.
▫ DETERMINANTS OF PATIENT’S GLOBAL ASSESSMENT OF WELL-BEING IN EARLY AXIAL SPONDYLOARTHRITIS; 5-YEAR LONGITUDINAL DATA FROM THE DESIR COHORT. F. Hirano, D. Van der Heijde, F. A. Van Gaalen, R. B. M. Landewé, C. Gaujoux-Viala, S. Ramiro
▫ MACHINE-LEARNING DERIVED ALGORITHMS FOR OUTCOMES PREDICTION IN RHEUMATIC DISEASES: APPLICATION TO RADIOGRAPHIC PROGRESSION IN EARLY AXIAL SPONDYLOARTHRITIS, R. Garofoli, M. Resche-Rigon, M. Dougados, D. Van der Heijde, C. Roux, A. Moltó
▫ UVEITIS OCCURRENCE IN EARLY INFLAMMATORY BACK PAIN. FIVE YEARS DATA FROM A PROSPECTIVE FRENCH NATIONWIDE COHORT, D. Wendling, C. Prati, T. Lequerre, C. Miceli Richard, M. Dougados, A. Moltó, X. Guillot
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mars 20, 2020 | Posted by admin
Bonjour,
Nous mettons en ligne aujourd’hui la nouvelle Newsletter patients rédigée par le Pr Laure GOSSEC, rhumatologue à l’hôpital La pitié-Salpêtrière.
Pour y avoir accès, merci de cliquer ici.
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mars 19, 2020 | Posted by admin
Bonjour,
Nous mettons en ligne aujourd’hui la nouvelle Newsletter patients rédigée par le Pr Laure GOSSEC, rhumatologue à l’hôpital La pitié-Salpêtrière.
Pour y avoir accès, merci de cliquer ici.
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mars 3, 2020 | Posted by admin
Un nouvel article scientifique intitulé «Effect of Gut Involvement in Patients With High Probability of Early Spondyloarthritis: Data From the DESIR Cohort» a été publié dans le journal J Rheumatol.
Daniel Wendling, Xavier Guillot, Clément Prati, Corinne Miceli-Richard, Anna Molto, Rik Lories, Maxime Dougados.
Abstract
Objective: Inflammatory bowel disease (IBD) is a well-known extraarticular feature of spondyloarthritis (SpA). The aims of this study were to evaluate factors associated with IBD and incidence over 5 years of followup in the DESIR cohort.
Methods: DESIR is a prospective observational cohort of patients with recent-onset inflammatory back pain suggestive of axial SpA. All available variables in the database were compared between patients with and without IBD at baseline and 5 years, and occurrence over 5 years of followup, with uni- and then multivariable analysis.
Results: At baseline, of 708 patients, 35 had IBD (prevalence 4.94%, CI 95% 3.3-6.5). IBD was associated (multivariable) with history of uveitis, levels of Dickkopf-1, and tumor necrosis factor, but not with phenotypic presentation (peripheral arthritis, enthesitis, dactylitis, uveitis) or baseline serum levels of other cytokines. At 5 years, 480 patients were analyzed, 58 with IBD. IBD was associated (multivariable) with fulfillment of modified New York criteria, sick leave, Bath Ankylosing Spondylitis Disease Activity Index, and smoking. There was no association with magnetic resonance imaging scores, enthesitis, psoriasis, and bone mineral density. Twenty-three incident cases of IBD were recorded: estimated occurrence rate of 0.95/100 (95% CI 0.57-1.35) patient-years (PY). Incidence of IBD is associated (multivariable) with HLA-B27 (OR 0.36, 95% CI 0.22-0.59), fulfillment of modified New York criteria (OR 3.35, 95% CI 1.85-6.08), and familial history of IBD (OR 3.31, 95% CI 1.62-6.77).
Conclusion: In early SpA, IBD occurs with an incidence of 1/100 PY, and is associated with poor outcome, familial history of IBD, absence of HLA-B27, and fulfillment of modified New York criteria.
Keywords: EPIDEMIOLOGY; GASTROINTESTINAL DISEASES; INFLAMMATORY BOWEL DISEASE; SPONDYLOARTHRITIS.
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