septembre 25, 2020 | Posted by admin
Un nouvel article scientifique intitulé «Which imaging outcomes for axSpA are most sensitive to change? A 5-Year analysis of The DESIR Cohort» a été publié dans le journal Arthritis Care Res (Hoboken).
Alexandre Sepriano, Sofia Ramiro, Désirée van der Heijde, Maxime Dougados, Pascal Claudepierre, Antoine Feydy, Monique Reijnierse, Damien Loeuille, Robert Landewé.
Objective:
To compare the sensitivity to change of different imaging scoring methods in patients with early axial spondyloarthritis (axSpA).
Methods:
Patients from the DESIR cohort fulfilling the ASAS axSpA criteria were included. Radiographs and MRI of the sacroiliac joints (SIJ) and spine were obtained at baseline, 1, 2 and 5 years. Each image was scored by 2 or 3 readers in 3 separate ‘reading-waves’. The rate of change of outcomes measuring spinal and SIJ inflammation (e.g. SPARCC score) and structural damage on MRI (e.g. ≥3 fatty lesions) and radiographs (e.g. mNY grading) was assessed using multilevel generalized estimating equations (GEE) models (taking all readers and waves into account). To allow comparisons across outcomes, rates were standardized (difference between the individual’s value and the population mean divided by the standard deviation).
Results:
In total, 345 patients were included. Inflammation on MRI-SIJ (standardized rate range: -0.278; -0.441) was more sensitive to change compared to spinal inflammation (range: -0.030; -0.055). Structural damage in the SIJ showed a higher standardized rate of change on MRI-SIJ (range: 0.015-0.274) compared to X-SIJ (range: 0.043-0.126). MRI-SIJ damage defined by ≥3 fatty lesions showed the highest sensitivity to change (0.274). Spinal structural damage slowly progressed over time with no meaningful difference between radiographic (range: 0.037-0.043) and MRI structural outcomes (range: 0.008-0.027).
Conclusion:
Structural damage assessed in pelvic radiographs has low sensitivity to change, while fatty lesions detected on MRI-SIJ are a promising alternative. In contrast, MRI-spine is not better than X-spine in detecting structural changes in early axSpA patients.
Keywords: Axial spondyloarthritis; imaging; sensitivity to change.
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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.
Categories: Newsletter Patients | Tags: | No Comments »
