mai 18, 2023 | Posted by admin
Un nouvel article scientifique intitulé «Bone marrow edema in the sacroiliac joints is associated with the development of structural lesions at the same anatomical location over time in patients with axial spondyloarthritis» a été publié dans le journal Semin Arthritis Rheum.
Rodrigues-Manica S, Sepriano A, Ramiro S, Landewé R, Claudepierre P, Moltó A, Dougados M, van Lunteren M, van der Heijde D.
Objective:
To assess whether the presence of bone marrow edema (BME) leads to the development of structural lesions at the same anatomical location of the sacroiliac joints (SIJ), and to investigate the association between BME patterns over time and structural lesions in patients with early axial spondyloarthritis (axSpA).
Methods:
Patients with axSpA from the DESIR cohort with ≥2 consecutive magnetic resonance imaging (MRI)-SIJ were assessed at baseline, 2 and 5 years. MRI-SIJ images were divided into 8 quadrants. The association between BME and subsequent structural lesions (sclerosis, erosions, fatty lesions, and ankylosis) on MRI in the same quadrant was tested longitudinally. Additionally, patients were grouped according to the pattern of BME evolution across quadrants over time (no BME, sporadic, fluctuating, and persistent). The association between these patterns and 5-year imaging outcomes (eg: ≥5 erosions and/or fatty lesions on MRI-SIJ) was tested.
Results:
In total, 196 patients were included. BME in each quadrant was associated with sclerosis (OR:1.9 (95%CI: 1.1;3.4)), erosions (1.9 (1.5;2.5)) and fatty lesions (1.9 (1.4;2.6)). Ankylosis was uncommon. There was a gradient between increased level of inflammation and subsequent damage: compared to the ‘no BME’ pattern, the sporadic (OR (95% CI): 2.1 (1.0;4.5)), fluctuating (OR:5.6(2.2;14.4)) and persistent (OR:7.5(2.8;19.6)) patterns were associated with higher structural damage on MRI-SIJ at 5-years.
Conclusions:
In early axSpA, inflammation on MRI-SIJ leads to damage at the quadrant level. The higher the exposure to inflammation across quadrants in the SIJs over time the higher the likelihood of subsequent structural damage, suggesting a cumulative effect.
Categories: Publication de travaux dans des journaux médicaux | 
Tags: | 
No Comments »
avril 2, 2023 | Posted by admin
Un nouvel article scientifique intitulé «A deep learning model for the diagnosis of sacroiliitis according to Assessment of SpondyloArthritis International Society classification criteria with magnetic resonance imaging» a été publié dans le journal Diagn Interv Imaging.
Bordner A, Aouad T, Medina CL, Yang S, Molto A, Talbot H, Dougados M, Feydy A.
Purpose:
The purpose of this study was to develop and evaluate a deep learning model to detect bone marrow edema (BME) in sacroiliac joints and predict the MRI Assessment of SpondyloArthritis International Society (ASAS) definition of active sacroiliitis in patients with chronic inflammatory back pain.
Materials and methods:
MRI examinations of patients from the French prospective multicenter DESIR cohort (DEvenir des Spondyloarthropathies Indifférenciées Récentes) were used for training, validation and testing. Patients with inflammatory back pain lasting three months to three years were recruited. Test datasets were from MRI follow-ups at five years and ten years. The model was evaluated using an external test dataset from the ASAS cohort. A neuronal network classifier (mask-RCNN) was trained and evaluated for sacroiliac joints detection and BME classification. Diagnostic capabilities of the model to predict ASAS MRI active sacroiliitis (BME in at least two half-slices) were assessed using Matthews correlation coefficient (MCC), sensitivity, specificity, accuracy and AUC. The gold standard was experts’ majority decision.
Results:
A total of 256 patients with 362 MRI examinations from the DESIR cohort were included, with 27% meeting the ASAS definition for experts. A total of 178 MRI examinations were used for the training set, 25 for the validation set and 159 for the evaluation set. MCCs for DESIR baseline, 5-years, and 10-years follow-up were 0.90 (n = 53), 0.64 (n = 70), and 0.61 (n = 36), respectively. AUCs for predicting ASAS MRI were 0.98 (95% CI: 0.93-1), 0.90 (95% CI: 0.79-1), and 0.80 (95% CI: 0.62-1), respectively. The ASAS external validation cohort included 47 patients (mean age 36 ± 10 [SD] years; women, 51%) with 19% meeting the ASAS definition. MCC was 0.62, sensitivity 56% (95% CI: 42-70), specificity 100% (95% CI: 100-100) and AUC 0.76 (95% CI: 0.57-0.95).
Conclusion:
The deep learning model achieves performance close to those of experts for BME detection in sacroiliac joints and determination of active sacroiliitis according to the ASAS definition.
Categories: Publication de travaux dans des journaux médicaux | Tags: | No Comments »
février 14, 2023 | Posted by admin
Un nouvel article scientifique intitulé «Influence of Sex on Early Axial Spondyloarthritis: A Six-Year Longitudinal Analysis From a Large National Cohort» a été publié dans le journal Arthritis Care Res (Hoboken).
Aouad K, Tournadre A, Lucasson F, Wendling D, Molto A, Fautrel B, Gossec.
Objective:
The objective was to determine sex differences in disease outcomes in recent axial spondyloarthritis (SpA) over time.
Methods:
We analyzed the first 6 years of follow-up of the prospective French multicenter DESIR cohort. Patients analyzed had <3 years of disease, were naive to disease-modifying antirheumatic drugs, and fulfilled the Assessment of SpondyloArthritis international Society classification criteria for axial SpA. Disease activity (Ankylosing Spondylitis Disease Activity Score [ASDAS] using the C-reactive protein [CRP] level), patient global assessment (PtGA), CRP level, and radiographic sacroiliitis were compared between men and women (self-reported sex) by linear and logistic mixed-effects models. Models were created for trajectories of disease activity over 6 years in men and women, using k-means.
Results:
Of 494 patients analyzed (mean ± SD age 31.9 ± 7.5 years, symptoms duration 20.7 ± 11.7 months), 50.4% were men. Over 6 years of follow-up, both men and women showed clear improvements in ASDAS-CRP, PtGA, and CRP level. Women had higher ASDAS-CRP and PtGA over time compared to men (both P < 0.0001) with overall similar CRP levels (P = 0.089), whereas structural damage increased more in men (P < 0.0001). One-third of both men (33%) and women (34%) belonged to persistent high/very high disease activity trajectories, but ASDAS-CRP was globally higher in women in these trajectories.
Conclusion:
In early axial SpA, clinical outcomes (disease activity and symptoms) were worse in women than men over 6 years of follow-up, whereas CRP was similar and structural damage was more frequent in men. Although similarly distributed, disease activity scores were higher in women in high/very high disease activity trajectories. Sex appears to be an important contextual factor in axial SpA.
Categories: Publication de travaux dans des journaux médicaux | Tags: | No Comments »
janvier 31, 2023 | 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 .
Categories: Nombre de projets scientifiques acceptés | Tags: | No Comments »
décembre 28, 2022 | 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.
Categories: Newsletter Patients | Tags: | No Comments »
décembre 13, 2022 | Posted by admin
De nouveaux travaux ont été présentés lors du congrès de la Société Française de Rhumatologie (SFR) qui s’est déroulé du 11 au 13 décembre 2022 à Versailles :
• Facteurs associés aux différentes stratégies thérapeutiques dans la spondyloarthrite axiale débutante : une analyse multi-états sur 10 ans de la cohorte DESIR. E. Portier, S. Chevret, A. Ruyssen-Witrand, A. Molto.
Categories: Présentation de travaux lors des congrès | Tags: | No Comments »
novembre 14, 2022 | Posted by admin
Lors du congrès de l’ACR 2022 qui s’est déroulé du 10 au 14 novembre 2022 à Philadelphie, 1 abstract a été accepté :
▫ Determinants of Clinically Important Worsening in Early Axial Spondyloarthritis: Analysis of the DESIR Cohort over 5 Years. Faten Hamitouche , Sushmitha Kumaradev, Désirée van der Heijde, Sofia Ramiro, Alexandre Sepriano and Anna Molto.
Categories: Présentation de travaux lors des congrès | Tags: | No Comments »
octobre 4, 2022 | Posted by admin
Un nouvel article scientifique intitulé «Machine-learning derived algorithms for prediction of radiographic progression in early axial spondyloarthritis» a été publié dans le journal Clin Exp Rheumatol.
Romain Garofoli, Matthieu Resche-Rigon, Christian Roux, Désirée van der Heijde, Maxime Dougados, Anna Moltó.
Objectives:
To compare machine learning (ML) to traditional models to predict radiographic progression in patients with early axial spondyloarthritis (axSpA).
Methods:
We carried out a prospective French multicentric DESIR cohort study with 5 years of follow-up that included patients with chronic back pain for <3 years, suggestive of axSpA. Radiographic progression was defined as progression at the spine (increase of at least 1 point of mSASSS scores/2 years) or at the sacroiliac joint (worsening of at least one grade of the mNY score between 2 visits). Statistical analyses were based on patients without any missing data regarding the outcome and variables of interest (295 patients).Traditional modelling: we performed a multivariate logistic regression model (M1); then variable selection with stepwise selection based on Akaike Information Criterion (stepAIC) method (M2), and Least Absolute Shrinkage and Selection Operator (LASSO) method (M3).ML modelling: using « SuperLearner » package on R, we modelled radiographic progression with stepAIC, LASSO, random forest, Discrete Bayesian Additive Regression Trees Samplers (DBARTS), Generalized Additive Models (GAM), multivariate adaptive polynomial spline regression (polymars), Recursive Partitioning And Regression Trees (RPART) and Super Learner. Accuracy of these models was compared based on their 10-fold cross-validated AUC (cv-AUC).
Results:
10-fold cv-AUC for traditional models were 0.79 and 0.78 for M2 and M3, respectively. The three best models in the ML algorithms were the GAM, the DBARTS and the Super Learner models, with 10-fold cv-AUC of: 0.77, 0.76 and 0.74, respectively.
Conclusions:
Two traditional models predicted radiographic progression as good as the eight ML models tested in this population.
Categories: Publication de travaux dans des journaux médicaux | Tags: | No Comments »
juillet 5, 2022 | Posted by admin
Un nouvel article scientifique intitulé «Hip Pain Associated with Acetabular Dysplasia in Patients with Suspected Axial Spondyloarthritis: DESIR Cohort Data» a été publié dans le journal BMC Musculosketel Disord.
Dewi Guellec, Guillaume Prado, Corinne Miceli-Richard, Guillermo Carvajal-Alegria, Alain Saraux.
Objectives:
To determine whether acetabular dysplasia is associated with hip pain at physical examination among adults with recent-onset inflammatory back pain (IBP) suggesting axial spondyloarthritis (axSpA).
Methods:
This cross-sectional ancillary study was conducted on the prospective DESIR cohort, which enrolled patients aged 18-50 years who had recent-onset IBP. Two readers used antero-posterior pelvic radiographs to assess the Tönnis angle, acetabular angle (AA), lateral centre-edge angle (LCEA), and femoral head extrusion index (FHEI). Abnormality of one or more of these four variables defined acetabular dysplasia. Hip pain upon physical examination was assessed based on Ritchie’s articular index.
Results:
The overall prevalence of acetabular dysplasia was 22% (139/636). The proportion of females was higher in the group with acetabular dysplasia. Hip pain was found in 21% (29/139) of patients with versus 12% (59/497) without acetabular dysplasia (OR, 1.96; 95% CI, 1.20 to 3.20); the association was significant in males (OR, 3.14; 95% CI, 1.44 to 6.86) but not females (OR, 1.39; 95% CI, 0.74 to 2.62). Results were similar when acetabular dysplasia was defined on the basis of LCEA alone (OR, 2.15; 95% CI, 1.18 to 2.62).
Conclusion:
Among patients with recent-onset IBP suggesting axSpA, acetabular dysplasia was significantly associated with hip pain in males. Hip pain related to acetabular dysplasia might result in overdiagnosis of hip involvement by axSpA.
Keywords: Acetabular dysplasia; Axial Spondyloarthritis; Hip.
Categories: Publication de travaux dans des journaux médicaux | Tags: | No Comments »
juin 21, 2022 | 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 .
Categories: Nombre de projets scientifiques acceptés | Tags: | No Comments »
